Towards better primary healthcare in Hong Kong
W W Lam 林永和

It is good to see that Family Medicine, as a specialty, is developing rapidly in Hong Kong. There are more and more new medical graduates who have taken up training in Family Medicine. As these formally trained Family Physicians start to practice in the community, the overall standard of Primary Care in Hong Kong will hopefully be improved. Nonetheless, without a parallel improvement in those practicing Primary Care Physicians (PCPs), the development of Family Medicine will be jeopardised in many ways and the already much criticised variability in the standard of Primary Care will actually be perpetuated.

In the pursuit of the ideal of lifelong learning, many of our colleagues regularly attend lectures, workshops, courses and sign up for clinical attachments. However, without assessment, it is difficult to know our standards and how much we have really learned. Of all the available assessment methods, formal examinations are still the most objective way to validate one's self-perceived achievements. As a candidate who sat for the last Conjoint Fellowship Examination, I think that this examination is not only challenging but also interesting and fair. The content tested is highly relevant to our daily practice within the local setting.

There has been much criticism about the examination as being unimaginably difficult. If there is a will, there is a way. I would say that, after proper training and guidance, it should not be too impossible to pass this examination.

I would encourage those who are interested in taking the examination, to take the first step, and not be held back for fear of failure.

At present, there are many opportunities for PCPs to help prepare them for the Conjoint Fellowship Examination. The Diploma Course in Family Medicine offered by The Chinese University of Hong Kong and the Certificate Course on Essentials of Primary Care organised by the College are excellent courses in providing the theoretical goundwork of the discipline of Family Medicine. The Pre-examination Course is a must as it provides a unique opportunity for candidates to familiarise themselves with the examination process.

The Assessment Enhancement Course (formerly named as the Distance Learning Course) for Fellowship Examinations in Family Medicine provides hands-on assistance to candidates in preparing for the examination. Different workshops and practices in simulated examination situations are invaluable opportunities for candidates, particularly those lacking formal Family Medicine training. More importantly, the idea of self-learning through study groups is emphasised in the course. Candidates of different training, backgrounds, strengths and weaknesses are grouped into study groups. While the trainees have more training and supervision, the PCPs have more experience with patients. With tutors' facilitation, the bombardment and exchange of ideas and knowledge help us greatly to grasp the essentials of Family Medicine. Preparing for it is an even more enjoyable part than sitting the examination. In fact, members in my study group are planning to continue this form of learning even after the examination. Special thanks are due to all tutors, who sacrifice their private time to help the study groups.

It was not until I applied what I had learned to my practice that I realised a better doctor-patient relationship, better patient satisfaction and hopefully better outcomes. Every PCP should be encouraged to undertake this examination exercise. It is never too late to start something new. Make good use of learning opportunities. Cry for more. Do not just let your 'cheese' move!

Though the problems we face in improving Primary Care in Hong Kong cannot be solved in the near future, it is crucial that we move in the right direction. Every small footstep we take, will, hopefully, add up to a great step forward before long.

The effort will not be wasted!

W W Lam, MBBS(HK), DFM(CUHK), FRACGP, FHKCFP
Family Physician in Private Practice.

Correspondence to :
Dr W W Lam,
G/F, 125 Belcher's Street, Kennedy Town, Hong Kong

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