SICOT e-Newsletter

Issue No. 4 - January 2009

Orthopaedic Training in Hong Kong

Dr Wai Pan Yau, Clinical Assistant Professor - Department of Orthopaedics and Traumatology
The University of Hong Kong

The training and accreditation of specialist orthopaedic surgeons in Hong Kong is organized by the Hong Kong College of Orthopaedic Surgeons. The training program is composed of two parts: basic surgical training and higher orthopaedic training. The whole training program lasts at least six years.

The basic surgical training in Hong Kong lasts for at least two years. The program is administered by the Intercollegiate Board of Surgical Colleges (HKICBSC) which consists of the Hong Kong College of Orthopaedic Surgeons, the College of Surgeons of Hong Kong, The Hong Kong College of Otorhinolaryngologists and the Hong Kong College of Emergency Medicine.

In order for a trainee to be registered as a basic surgical trainee in the HKICBSC, he/she must be a medical graduate registered with the Hong Kong Medical Council in good standing and is in a recognized training post in Hong Kong.

The basic surgical training program in Hong Kong consists of a minimum of 24 months of clinical rotations in approved training posts, including 12 months of uninterrupted training to be made of approved training posts (including either two of the followings: General surgery with emergency work, Orthopaedics with musculoskeletal trauma, Accident and Emergency Medicine with surgical and musculoskeletal trauma), in each of which a significant proportion of work will be spent with surgical emergencies requiring the emergency / critical care of patients. Another 12 months should be spent in approved training posts in other acute surgical specialties of the trainees' choice.

The basic surgical trainee is expected to complete a Basic Surgical Skills Course approved by the HKICBSC during the training period and pass an acceptable intermediate examination in order for them to be considered for subsequent Higher Orthopaedic Training. The recognized Intermediate Examination included any one of the following as an acceptable qualification:

1. Fellowship or Associate Fellowship of one of the British Royal Colleges in surgery, or of the College of Surgeons of Hong Kong.
2. The intermediate examination of the College of Surgeons of Hong Kong.
3. Membership of the Royal College of Surgeons of Edinburgh (MRCSEdin).
4. The Joint Membership of the Colleges of Surgeons of Great Britain and Ireland, starting from January 2004.

The Higher Orthopaedic Training in Hong Kong lasts for a minimum of 4 years. It is organized by the Hong Kong College of Orthopaedic Surgeons. At the present moment, the training program is also accredited by the Royal College of Surgeons of Edinburgh. The Fellowship examination is a conjoint examination. The successful trainee in completion of the training program and passing of the Fellowship examination will be granted the Fellowship of Hong Kong College of Orthopaedic Surgeons and may also be granted the Fellowship of the RCS Edin in orthopaedics.

In order to be admitted as a higher orthopaedic trainee in Hong Kong, the potential applicant has to be a Hong Kong citizen with a current full registration with the Medical Council in Hong Kong and in good standing, complete an accredited Basic Surgical Training and hold a recognized intermediate qualification.

There is a selection procedure for the qualified basic surgical trainees to be admitted as Higher Orthopaedic Trainees. Trainees who have received basic surgical training in overseas centers may also apply to the Hong Kong College of Orthopaedic Surgeons for consideration for higher orthopaedic training. The basic training should be of an equivalent quality and content to the requirements of Basic Surgical Training in Hong Kong.

Potential Higher Orthopaedic trainees selected by the College are required to obtain their own hospital positions in one of the accredited training centers.

The higher orthopaedic trainee in Hong Kong needs to be rotated through a minimum of 48 months in approved training posts. This includes 39 months of compulsory subspecialty training in Trauma (18 months), General Orthopaedics (12 months), Hand Surgery (3 months), Paediatric Orthopaedics (3 months) and Musculoskeletal Rehabilitation (3 months). The remaining 9 months may be spent in one or more orthopaedic subspecialties of the trainee's choice.

During this 48-month training period, the higher orthopaedic trainees need to acquire a total of 360 training points (45 points for every 6 months of training) by attending accredited local and overseas educational activity. These include scientific meeting, didactic lectures and tutorials.

The trainees are also required to complete four surgical skills training courses, including the Basic Orthopaedic Bioskill Course, Basic Microsurgery Course, Fracture fixation course (e.g. AO course) and ATLS course.

The trainee should also complete one research project under supervision, to make at least one oral presentation at an orthopaedic related local or overseas conference and to publish at least one orthopaedic scientific paper in a peer-reviewed journal as the first author.

Upon completion of the training program, the higher orthopaedic trainees are required to sit and pass the Fellowship examination before they can be admitted as Fellows of the College. The current Fellowship Examination consists of four parts, including assessment of the trainee's operation log book, written examination, clinical examination that consists of long cases and short cases and viva examination.