Under the amendment, doctors will be barred from practising if they do not complete a number of courses in a specified time.

The government plans to table an amendment to the Medical Registration Ordinance during the next legislative year, which starts in September, forcing doctors to obtain a Continuing Medical Education certificate, and obtain a license valid for only three years.

The Medical Council, which licenses all 10,100 practising doctors in Hong Kong, decided three years ago to extend the mandatory continuing medical education (CME) program from covering only specialists to all doctors.

Under the program, all doctors have to obtain 90 credit points, equal to about 90 hours of courses, within three years to be ``CME-certified.'' Currently, only specialists are required to take the knowledge-enhancement courses.

Doctors who fail to receive 90 points within three years will be warned and issued with a one-year practising certificate. They will have to obtain 120 points in the fourth year or lose their licenses. The courses are free of examinations.

The council's education and accreditation committee chairwoman Grace Tang told legislators at a health services panel meeting Monday that the voluntary CME program is running well.

``But the council is responsible in insuring that doctors are up to date with advances in the profession,'' Tang said.

She said linking the program with license renewal is an ``effective and feasible'' way to protect public health. She also said that many other countries are moving in this direction.

Countries that already link CME with the renewal of practising licenses include New Zealand, Singapore and South Africa as well as some states in the United States.

Doctors in Singapore must stop practising immediately they fail to meet the CME requirement.

Deputy Secretary for Health, Welfare and Food Susie Ho said Hong Kong's medical services were already at a high level, but that it was important to keep upgrading.

``Possible sanctions being considered include a fine, conditions on practise, the requirement of an examination and non-renewal of practising licenses,'' Ho said. ``We do not agree with fines as this would seem as though one was buying a license.''

She said stringent measures are needed to deal with a small minority of doctors who may not measure up.

Of all registered doctors, about 7,000 are specialists or specialist trainees and 3,000 are non-specialists. ``Discussions will be held over the next few months and the amendment bill on the Medical Registration Ordinance will likely be tabled during the next legislative year,'' Ho said.

Legislators are divided on the proposal.

Medical sector legislator Kwok Ka-ki said most doctors wanted to improve their knowledge and it did not matter whether this was voluntary or mandatory.

``But to link this with license renewal does not sound practicable,'' he said. ``In fact, the CME courses provided now are seen as a minimum requirement. A lot of enhancement programs doctors take on their own are more advanced. Making doctors sit for 90 hours of training is more a formality than a quality assurance.''

Kwok said doctors are not children and getting a license to practise medicine is not easy. Consequently, it should not be easy to lose one.

He refused to guess whether there were other reasons why the council and the government wanted to push forward the proposal, but he called for more discussions especially on the variety of enhancement programs.

Liberal Party vice-chairwoman Selina Chow said a practising license should be a life-long qualification and that further training programs should mean a higher level of recognition.

Labor sector legislator Li Fung-ying and unionist Chan Yuen-han both agreed that the level of doctors in Hong Kong was superb and that there was no need for a mandatory program.

Supporters of the change said that doctors were often involved in life and death situations and should be constantly monitored.

``As a lawyer, I have seen many cases of medical negligence,'' democrat Albert Ho said. ``I don't see this as an insult to the profession. I can't see why there is such strong opposition.''

Independent legislator Albert Cheng said the rights of patients should override those of doctors.

``Doctors are not the only people that matter as any malpractice can cost someone his or her life,'' Cheng said. ``The [CME program] doesn't require an examination yet the doctors still oppose it.''

The number of medical malpractice cases against the Hospital Authority dropped from 33 in 2000 to nine in 2003. The 2004 figure is not available.

matthew.lee@singtaonewscorp.com