Family medicine training in Hong Kong's public health care system: A focus group study

Abstract

Objective: General Outpatient Clinics (GOPCs) now provide the main bulk of basic community training for Family Medicine (FM) trainees. Although it is obvious that there is a rising number of FM trained doctors, there still remains a significant proportion of the GOPC workforce who have not been through any formal vocational training. With the increasing role of FM in Hong Kong's healthcare, the Chinese University of Hong Kong (CUHK) and the Hospital Authority conducted a joint project to review and define the role of GOPCs and FM training that can facilitate primary care development for the whole of Hong Kong and provide a robust community based medical service affordable to all. Thus, focus groups were formed to study and form part of the whole project which looked at FM training provision within the GOPC setting. Design: Focus group discussions. Subjects: Basic and higher FM trainees, doctors with no formal vocational FM training, and FM specialists working in the GOPCs. Main outcome measures: The discussions were based on several main themes, including current training modalities, current strengths and weaknesses of GOPC as a location for FM training, FM competency achievement and future training opportunities for FM trainees working in GOPCs. Results: Discussions from four focus groups consisting of a total of 34 doctors were reviewed. Themes emerging from the focus groups: large variation in training modalities, discrepancy between College requirements and GOPC practice, changing patient variety within the GOPC setting, manpower and resource limitations, time constraint and protected time for training. Conclusion: Findings from this study highlighted a gap between the Hong Kong College of Family Physicians (HKCFP) and GOPC in terms of training provision. Furthermore, trainees do not have a consistent view of FM qualities and competencies. Collaborations between the HKCFP and HA would be essential so that training provision and requirements are in line with each other. Changes will also need to take place at the GOPC level in order to improve the quality of training. Opportunities for non-GOPC training should be explored, including collaboration with hospital specialists and private doctors. It may be necessary to form a working group that incorporates these different parties so that the different ideas can be intertwined.