The Hong Kong College of Medicine was established in 1887 for the purpose of training local Chinese in Western Medicine. Its founders' pioneering effort was amongst the earliest in Southeast Asia. The College of Medicine was subsequently incorporated as the Faculty of Medicine of the University of Hong Kong (HKU), which was founded in 1912, and continued as the only institution for the training of undergraduate medical students for the next seven decades. In this regard, it was joined in 1980 by the Faculty of Medicine of the Chinese University of Hong Kong (CUHK).

Postgraduate training in Internal Medicine in Hong Kong used to follow the traditional practice in the United Kingdom (UK). An apprentice system of practical learning in academic units or medical units in public hospitals, with appropriate supervision for a period of two or three years, would qualify a candidate to sit the MRCP examination in the UK and gain recognition as a specialist in Medicine. Since the 1970s, the MRCP examination, which can be taken after two years of clinical experience, has become an entry requirement of the Royal Colleges for further training in the subspecialties. As a further development in the mid-1990s, UK has commenced the award of a Certificate of Completion of Specialist Training (CCST) on exit from an approved training programme lasting not less than four years after MRCP (i.e. two years pre- and fours years post-MRCP).

Since 1985, the entire (Parts I & II) MRCP (UK) examination can be taken in Hong Kong once a year in October. The completion rate of basic physician training in regional public hospitals in Hong Kong thus became very high, but problems with higher specialist training still existed. For this purpose, trainees had to enrol in pans the overseas training programmes in the UK, USA and Australia. This period of overseas training is followed by further in-service and/or self-learning experience in Hong Kong. This has produced a large pool of internationally recognised physician specialists arid enhanced the standard of local medical practice.

In October 1985, the Hong Kong College of Physicians was established as another Pioneering endeavor by the majority of trained specialists in Internal Medicine.

Key objectives of the Hong Kong College of Physicians are --

• To promote for the public benefit the advancement of knowledge of the science and all of medicine.
• To act as a body for the purpose of consultation in matters of educational or public interest concerning Medicine.
• To develop and maintain the good practice of Medicine by ensuring the highest professional standards of competence and ethical integrity.
• To promote, monitor and assess the training in Medicine.
• To promote research in Medicine for the public benefit.
• To provide a focus for academic medicine throughout Hong Kong.
• To liaise with other medical faculties or bodies about matters of mutual interest.
• To promote international communication in the field of Medicine.
  

Since the formation of the Hong Kong Academy of Medicine in August 1992, the College of Physicians has taken on the additional functions of structured training and examination.




Structured Postgraduate Medical Training in Internal Medicine

Basic Physician Training, which lasts for three years, aims at a broad-based training in general Internal Medicine. Experience in other disciplines which interact with internal Medicine and which enriches the trainees is also encouraged and accredited.

Trainees are continuously assessed throughout the training through the use of Trainee Logbook and supervisors' assessment reports. The Intermediate Examination tests the trainees' competence in basic clinical skills, attributes of a physician and level of basic knowledge in general medicine. This can be taken after two years of training. The College has agreed to conduct Joint Examinations twice yearly with MRCP (UK) starting from February 1994, in February and October, in Hong Kong. A pass in the joint MRCP (UK) - HKCP examination and three years of accredited basic physician training are the requirements for admission as Member of the College, which is the recognised higher qualification for entry to Higher Physician Training in the medical specialties.

Higher Physician Training in a medical specialty consists of three years of structured supervised training. To ensure a broad knowledge base, to prevent fragmentation in patient care delivery and to avoid the problems of "superspecialization", concurrent advanced training in Internal Medicine (AIM) and one other specialty is encouraged. These programmes would require a minimum of four years of supervised training, comprising 24 months (cumulative) of core training in Internal Medicine and 24 months (cumulative) of core training in one other specialty. Such training programmes must be approved by the AIM Board as well as the Board in the other specialty.

Concurrent training in two related specialties may also be undertaken in the same manner, provided approval is obtained from the relevant Specialty Boards. After award of certification in any specialty, a Fellow may also apply to individual Specialty Boards to undertake sequential training in AIM or another specialty.

Each trainee's progress will be judged on the basis of continuous assessment through the use of Trainee Logbook and supervisors' assessment reports. There are formal Annual Assessments at the end of each year, and a formal Exit Assessment at the end of training.

The final Exit Assessment normally takes place in June and/or December each year. The trainee is to submit a 5,000-word dissertation and attend in interview conducted by an Assessment Board. The Assessment Board comprises the Chairman of the Specialty Board or his/ her nominee, Specialty Programme Director, a member of the Specialty Board or Education & Accreditation Committee or Examination Committee, and an External Assessor who is usually a Specialty Programme Director from another region, or ail overseas expert of renown in that specialty. Trainees who are successful at the Exit Assessment will be invited to apply for College Fellowship.
Training Guidelines

The first edition of the Hong Kong College of Physicians (HKCP) Guidelines on Postgraduate Medical Training was published in July 1993 by the Joint Committee on Internal Medicine Training (JCIMT), just in time for the inauguration of the Hong Kong Academy of Medicine in December 1993

In May 1996, the Education & Accreditation Committee (E&AC) took over the function of the JCIMT, and established 12 Specialty Boards which were charged with reviewing individual Training Guidelines, appointment of trainers, overseeing trainees and their programmes, as well as accrediting Fellows in the respective specialties.

With experience gained in the first years of structured training, the E&AC and Specialty Boards deliberated on and modified the 1993 JCIMT Guidelines, and the second edition of Training Guidelines was published in 1998. In general, the objectives, structure and contents of training in each specialty in the new Guidelines were similar to the previous edition. Programme structures were however more clearly defined and new specialties were added. In some specialties where certain aspects of training requiring knowledge and skills in highly technical and complex procedures, special training programmes followed by Competency Certification were introduced. Examples include: Interventional Cardiology, Blood and Marrow Stein Cell Transplantation, Therapeutic Endoscopy, etc.