Revolution

It all began in Tunisia. Soon the Year of Revolution swept through Middle East. At a smaller scale, our local young doctors also voiced out their need and aspirations. I am no fan of the butterfly effect, but the mood is indeed infectious.

Last week, our department administrators held a brainstorm meeting with the medical officers. I was secretly sorry for them as they had little to offer unless radical changes occurred at the head office level. Nevertheless, it is good to listen. At least it is better than saying “When I was a medical officer, I worked 90 hours a week and had ward rounds every weekend”.

There are a few problems that cannot be solved overnight. The lack of promotional prospect is not a unique phenomenon in hospitals but also occur in other areas as middle-grade posts are occupied by people of the generation X. The monopolization of professional training by the public institution also encourages it to disregard the benefits and morale of its staff until recently. That said, these problems are still easy to solve when the institution realizes the need to improve the pay and recognition to frontline doctors. The real difficulty stems from the insufficient supply of new doctors and the huge salary gap between the public and private sectors.

In the past, most politicians representing the medical field were from the private sector. Understandably, they did their best to stop the number of medical graduates from growing. With changing political paradigm, we are finally expecting 320 new graduates per year in Hong Kong several years later. Time will tell if the pendulum will over swing again this time.

Having visited many cities in mainland China, I could not help noticing that many medical schools produced huge numbers of doctors. A medical school serving a population similar to that of Hong Kong may have 5000 graduates per year. This makes our own number look ridiculous. True, the doctor-to-patient ratio in China remains low. However, at the present level of development, urban hospitals cannot absorb these graduates. As a result, most graduates have to find other kinds of jobs (e.g. sales representatives of pharmaceutical companies) or work in rural clinics with little prospect.

Of course, the increase in medical student quota in Hong Kong is trivial compared to what happens in China. Nonetheless, with increasing supply the salary will likely drop gradually. This is certainly good news to patients and the community. It is however intriguing to speculate what will happen when the medical profession becomes less profitable. Will we still be able to recruit the best students? When the dollar sign shrinks, will we actually get more passionate candidates?