
This article was exclusively written for The European Sting by Mr. Ryan Orr, a medical student currently entering his second year at the Chinese University of Hong Kong. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
Hong Kong, like many parts of the world, is experiencing steady population growth due to factors such as increased birth rates and immigration. Although the two local medical schools have increased places in their medical programs to train more doctors, there is still an acute shortage of doctors working in the public sector in Hong Kong. Hence, to address the issue of a shortage of medical staff, the government has recently implemented legislation allowing overseas-trained doctors to immigrate to Hong Kong and work in the city’s clinics and hospitals. These doctors are seen as vital to help stem the shortage of doctors in the city’s medical field. Nevertheless, the legislation is controversial as the local doctor’s association raised concerns about the quality control of foreign-trained doctors, as well as the difficulty of integrating foreign-trained doctors due to language barriers and them coming from a different healthcare system.
Although Hong Kong was the example used above, the lessons, problems and solutions mentioned are applicable worldwide. Places with an ever-increasing population, especially countries with a rapidly ageing population, will require increasing numbers of doctors and other healthcare professionals to cater to their populations’ healthcare needs. Oftentimes, local medical schools may not be able to make up for the shortage of doctors and hence immigration of doctors and healthcare professionals from overseas will be required.
However, there are challenges and ethical considerations too. Firstly, as mentioned above, overseas doctors may find it hard to adapt and fit in because of language barriers and structural differences in healthcare systems worldwide. Furthermore, there may be inherent bias and intolerance towards overseas doctors present in societies and these ingrained biases must be overcome slowly via education and the changing of societal sentiments, an objective that is often difficult and time-consuming. Next, there may be pushback from local doctor associations as they regard overseas doctors as competition in the job market, which is a barrier to the implementation of legislation allowing overseas doctors to practice. Another concern from local doctor associations concerns the quality control of foreign-trained doctors. Overseas medical exams are often different to local ones and some fear that overseas doctors may not reach the same standard of practice as local doctors. Lastly, most overseas doctors who immigrate to another country to practice go from less economically developed countries (LEDCs) to more economically developed countries (MEDCs). Hence, this raises the ethical consideration of depriving LEDCs of trained medical professionals that their population desperately needs.
However, there are possible solutions such as requiring foreign doctors to undergo a period of supervised practice in public hospitals to ensure they are well-adapted to the local healthcare system. Quality control can also be done via licensing examinations of foreign-trained doctors to ensure they have the same level of medical knowledge and skills as locally-trained ones.
Foreign-trained doctors are an eventual reality that we will all need to learn to accept as increasing populations and ageing populations continue to balloon the need for more healthcare professionals.
About the author
Ryan Orr is a medical student currently entering his second year at the Chinese University of Hong Kong. He is affiliated with AMSAHK, an associate member of IFMSA, and hopes to continue to deepen his engagement with both societies. His interests include public health, health policy, and bioethics, and welcomes opportunities to contribute to the discourse surrounding these topics.
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