Cutting Medical Student Intake
a prescription for doctors oversupply

(Keywords:- manpower needs, oversupply, interns, unemployed, student intake)

          When considering the manpower needs, doctors are no different from other professions -- there is no scientific way to determine the number. The manpower to population ratio, if it is a yardstick to go by, is dependent on the affluence of the society, the needs for not only quantitative but also qualitative care, and the expectation of the people at large. It is not surprising that such benchmark varies widely from country to country and even within the rural and urban sectors of the same country.

          Any policy makers will have a difficult balancing act to do in deciding the realistic manpower need. For whilst the public would like to see more doctors, any oversupply may lead to inadequate work for the profession. The nearly $3 million spent in training each medical student would not be cost effective. The weak ones may actually abuse professional ethics in an attempt to secure an expected income and thus lower health care standards!

          Further in the medical profession, not only do we have to balance the needs of the total number of doctors but also the proper manpower distribution amongst different specialties.

          The recent hue and cry again from "fresh from the oven" doctors who could not find a permanent job within the public institutes raise the manpower problem again.

          It therefore begs the following questions: Is there a major number of doctors to population ratio that Hong Kong can adopt? Is there an oversupply problem? Why does this happen? What is the solution?

          We have about 7,950 registered doctors (on the local list) for a population of 6.4 million, giving a current ratio of one doctor to about 805 population. A single figure alone may be insignificant. Yet when compared with the one to 1,000 ratio of the late 1980s and about 590 by the year 2010 as projected by the Health and Medical Development Advisory Committee (HMDAC), the manpower surplus picture is clear.

          Some would argue that the ever increasing waiting lists for public medical services must indicate a lack of manpower and that Government should plough more revenue to employ more doctors to cut down the waiting time. Regrettably, decrease in workload could not be achieved by just increasing doctor alone. Furthermore, unless and until taxpayers are willing to infinitely increase the public health care budget, there will always be waiting lists.

          Regrettably, whilst all concerned parties are awaiting the wisdom of the HMDAC (the highest power advisory body of the Government), it fails to give any solution, though acknowledges the oversupply crisis. It is rumoured that Government has, for the first time, suggested a cut in our local medical student intake. Ironically the HMDAC, for whatever reason unbeknown to the public, refuses to make a decision.

          Some has suggested to blockade medical practitioners return or come from overseas. But is this an honourable act when Hong Kong has boast its open and fair system that any bona fide medical graduates can practise in Hong Kong if they succeed in the universal licensing examination?

          Needless to say, cutting medical student intake will raise severe opposition from our two universities. After all, their budget is related to the number of students intake. Yet decrease in student number should not necessarily mean a cut in budget. With Hong Kong moving into the sharp edge of medical sciences, our highest education institutes can engage in more research and quality post graduate training.

          With the first sign of oversupply in 1992, why was it delayed till five years now to surface? The Hospital Authority (HA) and Government could not be absolved from blame. By squeezing money from within other HA services to employ more doctors then, and by the same token now under the disguise of "contract terms for training", wool is being pulled over the public's eyes whilst the time bomb is delayed until it is too late.

          Let us have the political will and honesty to face our problem head on at the beginning of an new era. Let the different sectors forgo their differences and their vested interest and work for a genuinely better future of Hong Kong!

(Hongkong Standard)