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iii. As of now, doctors who wish to obtain full registration to practice in Hong Kong must opt for the ‘exam pathway’ to registration. While a ‘non-exam pathway’ exists for
foreign-trained doctors who wish to obtain limited registration to practice at limited venues for a limited duration, this pathway does not lead to full registration. Both ‘exam’
limited
and ‘non-exam’ pathways have room for introducing greater flexibility to attract foreign-trained talent and reference could be made to international examples.

a. “Exam pathway”: foreign-trained individuals who wish to be considered for full registration (currently making up 7.5% of our fully registered doctor workforce) to practice in
Hong Kong must pass the 3-part MCHK Licensing Examination.

(i) This evidently is no easy way out where in 2017, the pass rate for part 1 (written exam) was an average of just 26.5% across two sittings and 42% for part 3 practical clinical exam.
More encouraging pass rates were observed in other jurisdictions such as the US (where approximately 25% of practicing doctors are foreign-trained) for both written (>70%
in 2017) and practical (>80% in 2017) exams. The comparatively less detailed and accessible examination syllabus, resources and reference material for examination preparation
in Hong Kong, compared with other international examples, potentially deter applicants from succeeding in their application. Therefore, we recommend the availability of a
comprehensive examination syllabus and revision material for the MCHK Licensing Examination to be reviewed in order to ensure fairness and facilitate examination
preparation.

(ii) Internship experience is a listed MCHK Licensing Examination prerequisite - a prerequisite not observed for ‘exam pathways’ in other jurisdictions including the UK and US, and
serves as a potential barrier for individuals who graduate from medical courses that do not o er relevant experience. To maximise the number of individuals eligible to sit the
local examination and stand a chance at obtaining full registration to practice in Hong Kong, consideration should be given to removing internship experience as a MCHK
Licensing Examination prerequisite.

(iii) English proficiency is examined in a standalone test in Hong Kong. While the pass rate is relatively promising (94.5% in 2017), applicants could not, like in the UK (where
approximately 29% of practicing doctors are foreign-trained), opt to demonstrate their English proficiency via other means such as satisfactory International English Language
Testing System (IELTS) results. There is a need to consider allowing the use of similar non-examination means to demonstrate English proficiency in Hong Kong.

(iv) In addition to passing the MCHK Licensing Examination, individuals looking to obtain full registration in Hong Kong must also complete a period of assessment (internship) at
approved local hospitals that cannot be substituted with equivalent overseas experience, like in other jurisdictions such as the UK. To attract more foreign-trained doctors to
serve at the public sector, those who pass the MCHK Licensing Examination should be given the option to substitute the post-exam internship with equivalent overseas
experience subject to set conditions (for example, requiring the individual to provide service in the public sector for a set number of years). Reference should be made
to requirements for obtaining full registration in the UK.