July 2005 - The Hong Kong College of Anaesthesiologists

Bull HK Coll Anaesthesiol Volume 14, Number 2 July, 2005scan and MRI. It is interesting that one can oftenfind advertisements and banners posted all overthe place including along the highways by thehospital administration to advertise the highstandard achieved by the hospital in order toattract patients to the hospital. Often servicedevelopment of the hospital also goes along thatline. Visits by overseas medical experts to thehospital are most welcome as that reflects theservice provided by the hospital is of a higherand well known level.The specialty classification is perhaps theeasiest to understand. Some hospitals provideonly one of the specialty services such asgynecology and obstetrics, maxillofacial, cardiac,and pediatrics. The type of specialty servicewould be reflected by the names of the hospitals.Although one rarely hears of a hospital for thehepatic specialty, one can find hospitals for liverdiseases. Hospitals for the combined specialty ofeye, ENT and maxillofacial can also be found.The training systemIt is not enough to just know about the hospitalone is going to work in. In order to provide asafe and efficient service, it is mandatory toknow how one’s co‐workers are trained andtheir clinical competence. There are so manyways a doctor can be trained to become aspecialist that one needs to carefully work outtheir qualifications and experience. There arehighly qualified and immensely experiencedcolleagues around doing very impressive works.However, there are some who are trained as“technicians” and unable to cope with difficultor unusual cases. The differentiation may behard initially as some of them may be experts intheir field but remain so humble that theywould not reveal how much they know.However some of them, although not so wellqualified, would tackle every case their ownway. If one’s intention is to provide the best carefor the patients and learn from each other, it isnot too difficult to learn how much they knowand one would try to fit in. Sooner or later onecan break down the barrier.Students in China can be qualified as“medical practitioners” through variouschannels. The quickest way is to go throughmedical technical schools which provide a fouryear course for the students who havegraduated from junior or senior high schools.Most of these practitioners go to the village towork in the health care clinics. It is unlikely thatthey would be accepted to train in the specialtyfield. Most medical practitioners are trained inthe medical schools of universities or medicalschools affiliated to hospitals. They then getsend to a hospital and stay in the specialty theyare assigned. While working as residents, theyreceive training and with time they becomespecialists. Some lucky ones may spent a year orso in a larger teaching hospital in a big city andreturn to their own hospital to stay workinguntil they are allowed to retire at about age of 50years or so. The really bright or lucky oneswould be encouraged and arranged to gooverseas for specialty training for a period oftime. United States of America is obviously theplace of choice. Some do come to Hong Kong tolearn. It is getting increasing popular for some ofthe smarter younger doctors to go through aDoctor of Medicine (MD) program in order toqualify in a specialty. Apart from intensiveclinical training, research activities are part ofthe requirements in getting a MD. Only untilabout three years ago, there was no uniformclinical examination for practicing doctors inChina. Recently a post graduate writtenexamination has become compulsory for theyounger doctors to pass before they are allowedto continue to practice. This in some ways servesas some form of continuing medical educationrather than specialist qualification assessment.The examination consists of multiple choicequestions of all specialties. The across thecountry compulsory specialist assessment for allspecialties are in the preparatory stage. It washope that a more uniform approach would bringa higher standard of training and specialistqualifications that are recognized all over China.At present some of the specialist qualificationscan only be recognized within the same city oreven the training institute. It is possible as onecan fast tract and turn oneself into a “specialist”about eight years after junior high school.Whereas some medical graduates may take69