Build a United Profession in face of
Overhaul of Medical Registration Ordinance

          The medical profession has been looking forward to a total revamp of our registration ordinance for some 10 years. The main areas we would like to achieve have been : 

          All these principles could be made possible through two amendment bills -- the Medical Registration (Amendment) Bill 1995 (passed on 28 July 1995) and the Medical Registration (Amendment) (No.2) Bill 1995 (to come up for resumption of second reading debate and third reading on 24 April 1996).

          I thought it would therefore be opportune to lead colleagues through the gist of the amendments and how our perceived values could be attained.

Changes as a result of amending 

the Medical Registration Ordinance in July 1995 

          A universal examination will be introduced for bona fide medical graduates who have satisfied all the criteria to practise medicine in the country where they received their medical education. This examination will consist of three parts (multiple choices, language proficiency test and clinical examination) and will be introduced in September this year to be completed by December. Those who passed will have to go through one year of clinical training in the same way as our own interns. Graduates from our two medical schools are exempted from taking the examination.

Changes consequential to enactment of the Medical Registration (Amendment) (No.2) Bill 1995 
(I) The Medical Council will be enlarged from 14 members to 28 members, amongst which will be four lay members.

Fourteen members will be elected from amongst the medical profession:-

          During the deliberation, many colleagues have raised queries on why the HKMA should have a direct representation; others felt that other medical associations ought to have assigned representatives too.

          The reason is straight forward. In the proposed Medical Council, there will be assigned representatives from the two universities, the Hospital Authority, the Department of Health etc. Understandably these members of the Medical Council will be in the Council representing the interest of the organisation from which he/she originates. It is only right to have members in the Medical Council to represent the medical profession at large. It follows therefore that the HKMA being the recognised representative body of the profession should have their own representatives elected from amongst its members to sit in the Medical Council. It should be remembered that the membership of the HKMA is opened to all registered medical practitioners.

(II) A specialist register will be established. Inclusion in such register will be on the basis of recommendation of the Academy of Medicine, either because one has achieved a recognised standard through being the Fellow of the Academy or that one’s standard is being vetted by the Academy to its satisfaction. Those rejected by the Academy could appeal directly to the Medical Council.

(III) An Ethics Committee will be introduced to advise the profession in relation to medical ethics and professional conduct.

(VI) A Health Committee will be set up to assess and advise on fitness to practise of colleagues should there be any doubt of his or her ability to practise because of health (physical or mental) reasons.

(V) The Preliminary Investigation Committee

The proposed composition of the PIC consists of a chairman and a deputy chairman elected by the Medical Council from its members; one of the four lay members of the Council; and four registered medical practitioners not being members of the Council, but being nominated by the Hong Kong Medical Association, the Hospital Authority, the Director of Health and any member of the Council respectively. At each of the PIC meeting, at least one of the attending members should be a lay member subject to the majority being registered medical practitioners.

Other Amendments

(I) Limited Registration

          A category of “Limited Registration” was introduced in 1992 basing on the “proven special needs”. This was initially introduced, despite opposition from myself and the medical profession, for the Vietnamese boat people camps where repeated attempts have failed to attract registered medical practitioners to work there.

          The “Limited Registration” category was therefore granted to proven special service needs to ensure that non-registrable medical practitioners could be employed on such basis for a limited period, working in a limited environment and limited in the type of practice they can perform.

          For the last few years, there were intense lobbying by the “Exempted Clinic practitioners” in relation to their status. Government gave in to pressure and considered they should be registrable in one form or the other. On balancing, it was felt that they could come under the category of Limited Registration. This is to take into consideration the services they have contributed to the society for so many years. It was also felt that putting them in this category in essence keeps them under the monitoring and control by the profession’s Code of Practice, rather than to have them placed by administrative means in a special category to be controlled by the Government of the day and not by the medical profession at large.

          Other than being recognised as medical practitioners since the amended provisions took effect from last November (in the past they were just clinic operators), these former exempted clinic practitioners are still under the same constraints as far as their practice mode is concerned.

(II) Temporary Registration

          This is another new category for non-registrable doctors engaged exclusively in performing clinical teaching or research in the two universities, the Department of Health and the Hospital Authority. In cases where such engagement is by a private hospital, the application must be supported by the Academy of Medicine and requested by the Academy.

          I am fully aware that these amendments may not be able to meet with all the aspiration of some colleagues and that some may even have reservation on certain aspects.

          Let me appeal to colleagues that the whole move is to achieve the highest possible degree of professional autonomy and a fair and non-discriminatory registration system that can stand the test of time and function beyond the change of sovereign. This we can only attain with a united profession!