Page 51 - CASA Bulletin 2019 Vol 6 No 4

Vol.6, No.4, 2019

a subspecialty of anaesthesia. Acute pain management was established at some public hospital
in the 1980’s. By 1996, almost all large public hospital had a formal pain team to manage acute
and chronic pain.

Fellow in Pain Medicine is a post fellowship qualification. That means the doctors need to
do a couple of additional years of chronic pain training, pass the pain examination and complete
a pain related project before the Fellowship in Hong Kong College of Anaesthesiologists (Pain

Medicine) is granted.

Working opportunities in Hong Kong

Specialist Anaesthesiologists in Hong Kong can either work within the HA system or in
private practice. Only a few are employed by the Universities. As of today, there are 504

Specialist Anaesthesiologists actively practicing in Hong Kong, 272 of whom are serving at
various HA hospitals. Together with 169 anaesthesia trainees and a few career medical officers,
they provide over 80% of all the anaesthesia service required in Hong Kong. The anaesthesia
services at the HA system are of diverse varieties. As the HA system would cater for over 80%
of all hospital services in Hong Kong, a number of bread and butter operations and anaesthesia
are done daily. In addition, the most challenging anaesthesia encounters such as cardiac, robotic,
transplant, and neonatal anaesthesia are mainly the responsibilities of HA employed Specialist
Anaesthesiologis. Tubeless anaesthesia was performed in Hong Kong in the 90’s and a modified
technique was used in 2003. Since then the modified technique was practiced regularly for
various laryngeal surgeries. An innovative technique, the EXIT procedure was done at a large
HA hospital in 2005 for airway management for a new born with cystic hygroma. Later that

year, the same procedure was used in a hospital nearby.

Around 232 Specialist Anaesthesiologists are providing services at the 12 private hospitals,
and numerous endoscopy and minor surgical suites in Hong Kong. As all HA hospitals are short
of Specialist Anaesthesiologists, sedation for endoscopies and minor surgeries in HA are mainly
managed by the surgeons themselves. Whereas in the private practice, more anaesthesia related
services such as monitored anaesthetic care (MAC) are provided.

Although Specialist Anaesthesiologists once qualified can practice in the private hospitals

and endoscopy suites, most of them would gain at least a few more year of experience before
embarking onto the private world. Whereas the Specialist Anaesthesiologists working at the HA
system, after reaching retirement age of 60 years, can either choose to stay in the HA system
by joining the retired-rehire scheme on a full or part time basis. However half of them would
venture out to restart a new journey in the private world.

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