THE HONG KONG COLLEGE OF FAMILY PHYSICIANS Family Physicians Links · 2015-10-02 · 1 Message from the President THE HONG KONG COLLEGE OF FAMILY PHYSICIANS Family Physicians Links

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Message from the President

THE HONG KONG COLLEGE OF FAMILY PHYSICIANS

Family Physicians LinksIssue 76June 2010

01 MessagefromthePresident02 PhotoGallery07 CollegeNews 07 Biography:Dr.theHonLeongCheHung 08 BoardofConjointExamination 09 CMOD,MembershipCommitteeNews 10 StudyGroups,ClassifiedAdvertisements 16 DiplomainFamilyMedicine(HKCFP) 18 CertificateCourseinFamilyMedicine(HKCFP)

11 Advertisements13 ExecutiveCorner14 TraineeColumn:TB’sSpecialMedical

Instruments:PartII20 NewsCorner: PregnancyandDiagnostic

Imaging21 LearningPointsfromBoardofEducation22 BoardofEducationNews28 CollegeCalendar

INSIDE THIS ISSUE

TheAnnualScientificMeetingwassuccessfullyandsmoothlyheldon29-30May. Imust thankChairladyDr.CheungManKuenandalltheASMCommitteemembersfortheirgoodplanningandorganization.Arichprogrammewithdepthandqualityhadbeenput togetherandwashighlyappreciatedbytheaudience.

Iwasmost impressedby the last twoplenaryspeakers Dr. Yiu Yuk Kwan and Prof. SamuelWong.Dr.Yiu talkedabout“CombatingNCDin Hong Kong- Plans and Initiatives from thePublicHealthSector”whileProf.Wongtalkedabout“TheroleofFamilyPhysicians inmeetingthechallengesofNCD”.Bothspeakersagreedthatthemodelofchronicdiseasemanagementat theprimarycare levelshouldbebasedonateamapproachforthedeliveryofcomprehensiveand holistic care to patients, especially inthe prevention of disease progression. Dr.Yiu described the role of various health careproviders in the PHC team which includedpatientsandpatientorganizations,nurses,healthcareorganizations,NGOsetc.However, Icouldnotseeclearly thefaceofaFamilyPhysician inthe team.Prof.Wonghaspresentedplentyofevidence toconfirm the importanceofpersonfocusedcareorpatient-centredmodelforqualityservicestothecommunity.Iwashappytoseethestrongadvocateandamuchclearerpicture forourfutureFamilyPhysicians.

It is expected that the Government is goingto roll out the guidelines for chronic diseasemanagement in hypertension and diabeteslater thisyear.Theconcernabout thediseasemanagementprogrammes is thepotential forfragmenting of care especially if the primarycarephysician isnotcentral in theprogramme.Asshownbythedata inthetalkbyProfWong,the reality in primary care is at least 50% ofpatients having co-morbidity of one or morechronicproblems.FamilyPhysiciansshouldnot

bedisease-focused.Moreover, riskfactorsandchronic illnesscannotbeconsidered in isolation.Wesupportthedevelopmentofmanagementguidelinestopromotequalityhealthcaredeliverytothepublic,buttheco-ordination,beingcentraloftheFamilyPhysiciansmustbe firmlyestablishedbyus,orelsenursesorcasemanagerswillsoonerorlatertakeover thecentral role in themanagementofourpatients. Iamworriedespecially forourcolleaguesandtraineeswhowork inthepublicsector with heavy workload and inadequateconsultationtime.TheconsultationmaybecomeasessionformakingvariousreferralstodifferentPrimaryHealthCareteammembersaccordingtoguidelines.

The last cartoon (http://www.glasbergen.com/?s=Dr.+Google)inProfWong’spresentationmay look funny and I quote the wordings ofthe doctor talking, “More and more patientsaregoingtothe internet formedicaladvice.Tokeepmypracticegoing, IchangedmynametoDr.Google.” Iamsurepatientscansearch fordifferentguidelinesfromtheinternetwithoutanydifficulty. If thepracticeofMedicineisbasedonsetsofguidelineandprotocol, Ithinkeventuallydoctors can be replaced by robots and Dr.GooglewillchangehisnameagaintoDr.Robot.

- The stethoscope is a USB slot

- The mouth is a DVD driver

- The eyes are webcam

- The one on his head is a loudspeaker / microphone

Dr.GeneWWTsoiPresident

The Role of Family Physicians in Non-Communicable Diseases — From Dr. Google to Dr. Robot

Plenary Speaker Prof. Samuel YS Wong on 30 May

From left to right: Dr. Gene Tsoi, Prof. Samuel Wong, Dr. Yiu Yuk Kwan, Dr. Cheung Man Kuen, Dr. Chris Mitchell, Prof. Cindy Lam, Dr. Stephen Foo, Prof. Jan Radford, Prof. Martin Wong

Plenary Speaker Dr. Chan Tat on

29 May

Invited Guests

From left to right: Prof. Samuel Wong, Dr. Chan Hung Chiu, Dr. Chan

Tat, Dr. Leung Ting Hung, JP, Prof. Goh Lee Gan, Dr. Cheung Man

Kuen, Dr. Gene Tsoi, Prof. Sian Griffiths, Dr. Chris Mitchell, Prof. Jan

Radford, Prof. Cindy Lam, Dr. Mary Kwong

ASM Organising Committee with guests

From left to right: Dr. Choi Wing Kin, Dr. Chan Yin Hang, Dr. Cheung

Sze Man, Dr. Judy Cheng, Dr. Gene Tsoi, Dr. Cheung Man Kuen, Dr.

Eddie Chan, Dr. Mary Kwong, Prof. Cindy Lam, Dr. Leung Ting Hung,

JP, Dr. Li Heung Wing, Dr. Lai Siu Wai, Dr. Hung Chi Bun

Prof. Martin Wong (left) receiving the Best

Research Paper Award from Prof. Goh Lee Gan

and Dr. Natalis Yuen

Annual Scientific Meeting

TwooftheimportantannualeventsofourCollegehavejusttakenplaceonthe29thand30thofMay,2010.WehaveinvitedtheChairpersonsofInternalAffairsCommitteeandASMOrganizingCommitteetosharetheirexperienceinorganizingtheeventsinthecomingissue.

Now,let’sfirstenjoythememorablemomentsinourPhotoGallery!

Plenary Speaker Dr. Yiu Yuk Kwan on 30 May

Opening CeremonyFront row (from left to right): Prof. Samuel Wong, Dr. Leung Ting Hung, JP, Prof. Goh Lee Gan, Prof. Sian Griffiths, Dr. Cheung Man Kuen, Dr Gene Tsoi, Dr. Gloria Tam, JP, Dr. Natalis Yuen, Dr. Eddie ChanBack row (from left to right): Dr. Lau Ho Lim, Dr. Chan Hung Chiu, Dr. Mary Kwong, Prof. Cindy Lam, Dr. Daniel Chu

Plenary Speaker Dr. Leung Ting Hung, JP

on 29 May

Ribbon-cutting - (from left to right): Prof. Goh Lee Gan, Prof. Sian

Griffiths, Dr. Cheung Man Kuen, Dr. Gene Tsoi, Dr. Gloria Tam, JP

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Registration

A group of enthusiastic trainees attending the ASM

Dinner Symposium speakers - Prof. Tang Siu Wa and Prof. Huang Yueqin

Dinner Symposium

Dr. Stephen Foo presenting souvenir

to Prof. Ng Chi Fai, the speaker of

Lunch Symposium on 30 May

Paper Presentation

Workshop 3: Dr. Cheung Man Kuen presenting

souvenir to Prof. Goh Lee Gan

Workshop 1: Dr. Cheung Man Kuen presenting souvenir to doctors from HKIMM (from left to right): Dr. Allen Ngai, Dr. Stanley Lam, Dr. Chan Kwok Wai, Dr. Cheung Man Kuen, Dr. Andrew Ip, Dr. Chan Yin Hang and Dr. Mark Lai

Workshop 2: Dr. Chan Yin Hang presenting souvenir to

Dr. Joyce Yau

Workshop 2: Dr. Cheung Man Kuen, Chair lady of the ASM Organiz ing Committee presenting souvenir to Dr. Fredriech Chan

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The 21s t Dr. Sun Yat Sen Orat ion, “To Expec t the Unexpected - What I Learned from My Journey in Research” by Prof. Lap-Chee Tsui

Prof. Lap-Chee Tsui receiving the Dr Sun

Yat Sen Gold Medallion

Speech by Dr. Chris Mitchell

Conferment Ceremony

Council members and invited guests on-stage at the Conferment Ceremony Opening Speech by Dr. Gene Tsoi

Speech by Dr. the Hon York Chow

Dr. the Hon Leong Che Hung receiving his

Honorary Fellowship of our College

Exchange souvenirs with RACGP

Dr. Yu Sze Kai, Frances receiving award of

the best candidate in Conjoint HKCFP &

RACGP Fellowship Examination 2009 and

Research Fellowship Award 2010

Recipients of Best Research Award 2009, Dr. Kong Yim Fai, Dr. Wong

Nai Ming and Dr. Mark Chan

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Platform guests entering the hall

From left to right: Dr. Mark Chan, Dr. Kong Yim Fai, Prof. Gabriel Leung, Prof. Lam Tai Pong, Dr. Lam Tsan and Dr. Wong Nai Ming

From left to right: Mr. Wu Ting Yuk Anthony, Ms. Sandra Lee, Dr. the Hon Leong Che Hung, Prof. Doris Young, Prof. Cindy Lam and Dr. Donald Li

From left to right: Dr. Natalis Yuen, Associate

Prof. Jan Ranford and Dr. Chris Mitchell

From left to right: Dr. Mary Kwong, Dr. Andrew Ip, Dr. the Hon Leong Che Hung and Dr. Hung Chi Tim

Dr. Stephen Foo and Dr. Gloria Tam

Dr. Wendy Lo (Public Orator) and Dr. the Hon

Leong Che Hung

From left to right: Prof. Rosie Young, Dr. Mary Kwong,

Prof. Lap-Chee Tsui and Dr. the Hon York Chow

From left to right: Dr. Gene Tsoi, Dr. Stephen Foo, Prof. Lap-Chee Tsui, Prof. Rosie Young, Dr. the Hon Leong Che Hung and Dr. Chan Hung Chiu

From left to right: Prof. Gabriel Leung, Mr. Wu Ting Yuk, Anthony, Dr. Gene Tsoi,

Dr. the Hon Leong Che Hung, Ms. Sandra Lee and Dr. Donald Li

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From left to right: Dr. the Hon York Chow, Mr. Anthony Wu, Prof. Lap-chee Tsui

From left to right: Dr. Lilian Leong, Dr. the Hon Che-hung Leong, Dr. Gene

Tsoi, Dr. the Hon York Chow, Prof. Cindy Lam, Prof. Lap-chee Tsui

From left to right: Dr. Gene Tsoi, Dr. Stephen Foo, Dr. Hung Chi Tim, Dr. Andrew Ip

Council Dinner30 May 2010Hong Kong Country Club

From left to right: Dr. Angus Chan, Dr. Mary Kwong, Dr. Simon

Au, Prof. Cindy Lam, Prof. Lap-chee Tsui

From left to right: Dr. Lilian Leong, Dr. the Hon Che-hung Leong,

Dr. Gene Tsoi, Dr. the Hon York Chow

From left to right: Prof. Fok Tai Fai, Dr. Lillian Leong, Prof. Lee Sum Ping

From lef t to right: Dr. Gene Tsoi, Dr. the Hon York Chow,

Prof. Gabriel Leung, Ms. Sandra Lee, Dr. Daniel Chu

From left to right: Dr. Donald Li, Prof. Gabriel Leung, Dr. Gene Tsoi, Dr. Chris Mitchell, Dr. Jun Liang

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SBiography: Dr. the Hon LEONG Che Hung, GBS, OBE, JP

Dr. the Honorab leLeong Che Hung iswell-knowntomostofthe people in HongKongasaprominentfigureboth in fieldofthemedicalprofessionand in the realm ofpubl ic ser v ices . Inre c og n i t ion o f h i scontributions to themedical professionandthecommunityof

HongKong,thisyearheisawardedtheHonoraryFellowshipof theHongKongCollegeofFamilyPhysicians.

Dr. Leong graduated in Medicine from theUniversityofHongKong in1962.Heservedasa surgeonanda teacher in theDepartmentofSurgery for fourteen years, from1964 to1978,beforehe joinedprivatepracticeasa surgeonspecialisinginurology.

In1975,withhiscontributionstothespecialistfieldofurologyandnephrologybeingwellrecognizedby his peers, Dr. Leong was made HunterianProfessorby theRoyalCollegeofSurgeonsofEngland,thetopaccoladeinthefieldofSurgery.

Dr.LeonghasalsobeenHonoraryProfessorofSurgeryoftheUniversityofHongKongsince2001.

In1990,Dr.LeongwaselectedastheFoundingPresidentoftheHKCollegeofSurgeons.In2000,hebecamethePresidentof theHKAcademyofMedicinewhichheserveduntil2004.

Dr.LeongholdsanumberofHonoraryFellowships,includingHonoraryFellowshipoftheHongKongAcademyofMedicine,andHonoraryFellowshipsof several Academy Colleges including thecolleges of Surgeons, Physicians, EmergencyMedicine,CommunityMedicine,DentalSurgeonsand Radiologists. He also holds an HonoraryFellowshipof theRoyalCollegeofSurgeonsofEngland.

Besides his many professional and academicachievements,Dr.Leong’scontributiontopublicservicesinHongKonghasbeenmostremarkableandimpressive.

In1988,Dr.LeongwaselectedtotheLegislativeCouncil as a representative of the medical

functionalconstituency,andservedasamemberfortwelveyearstilltheyear2000.

Heisclosely involvedwiththeHospitalAuthority,thebiggesthealthcareteaminHongKong,andservedasitsChairmanfrom2002to2004.

ForhisoutstandingcontributionstowardsHongKong’s successandprosperity,Dr. LeongwasawardedanOBEin1991andaGoldBauhiniaStar(GBS)in2001.

Currently, he is a Non-official Member of theExecutive Council of the Government of theHongKongSpecialAdministrativeRegion. HeisalsotheChairmanof theElderlyCommissionofHKSARGovernment,HKAIDSFoundation,andICAC Complaints Committee, Council of theUniversityofHongKong,andCouncilonHumanReproductiveTechnology.

AstheChairmanoftheElderlyCommissionsince2005,Dr.Leonghasbeendedicatedtoimprovingandpromoting thequalityof lifeofouragingpopulation, with par ticular emphasis on theformulationofcomprehensivepoliciesincaringforelders,withtheaimtoprovidethemwithasenseofsecurityandindependence,aswellasafeelingofhealthandworthiness.

Dr. Leong isalsoanEx-officioMemberof theFamilyCouncil,withtheroleofpromotingafamily-basedsupportnetworkfordevelopingcloserandharmoniousrelationshipamongstfamilymembers,andadvisingtheGovernmentontheformulationof policies and strategies for supporting andstrengtheningfamilies.

He isalsothememberofmanyother importantcommittees,includingtheHonoursCommitteeoftheHKSAR.

Dr.Leonghasanoutstandingprofessionalcareer.He is a true leader of the medical profession,and a great and dedicated ser vant to thecommunityofHongKong.Hehasdemonstratedtremendous energy, showing v is ion in thehealthcaredevelopment forHongKong,whichechoes with the core values of our discipline:comprehensiveness,continuityandholism.

Prepared by Dr. Chan Hung Chiu

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S Board of Conjoint ExaminationReport on Trainee Examiners' Workshop on 24 April 2010

WehadtheWorkshopandGatheringon24.4.2010withtheattendanceof6membersfromtheBoard,9TraineeExaminersand theBoardSecretariat.OurBoardmembersgaveawarmwelcometothetraineeexaminersbeforestartingthepresentation.

OurChairman,Dr.ChanHungChiugaveusanoverview of the Examination, its history andbenefitsandexplainedtousthesecurityprotocol,aswellas remindingus tokeepallExaminationmaterials confidential. He pointed out thatthe Exam is a fair, valid and reliable one andrepresentsan internationalcollaborativeeffort,not only to maintain the standards of FM butalso tobenchmark thesestandards. Inaddition,the longhistoryof theConjointExamwithhighstandards isoneof the important reasons forfamilymedicine tobe recognizedasauniquediscipline inHongKongandweareobligedtoupkeepitsstandard.

Dr. Lau Ho Lim, our KFP coordinator gave abrief introductionoftheKFPpaper,thetypesofquestionspreferred, followedbyadiscussiononthelogicalstepsofsettingaquestion,“Bottom-up”thinkingaswellas“Fidelity”anddiscriminatingpowerofaquestion.HealsoenlightenedusontheEbelMethodforstandardizationof theKFPPaper.

Our Chief E xaminer Dr. Ip Pang Fei thenintroduced to us the format of our ConjointE xaminat ion and the roles of the TraineeExaminers in the Exam, followed by a briefdiscussionon theMCQPaperandthe typesofquestionspreferred,andtheAngoffmethodofstandardsetting. Hecarriedon todiscuss the

typesofquestionsandgaveexamplesofgoodand bad questions, and presented the matrixof the questions that would cover all aspectsofFamilyMedicine.Healso informedusaboutstandardizationand typesof standard settingmethods. Moreover, he introduced to us theKappascorewhichreflectstheconsistencyofthemarkingexaminers.

Dr.BillyChui,ourOSCEcoordinator,describedtoustherationale,standardizationandtheclinicalratingformsofourOSCE.Healso informedtheaudience about how to calculate the score ofindividualcandidatesand thepassingscoreofeachofthecases.

Trainee Examiners were invited to write upquestionsandpassthemdirectlytotherespectivecoordinators to enrich the Case Bank of theConjoint Examination. All Trainee Examinerswereencouraged tonotedown the importantdaysoftheExaminationincludingtheExaminers’Wor k shops , Rehear sa l and OSCE. Ac t i veparticipationindifficultcases,suchasbeingrole-playersofthelongcase,wasstronglyencouraged.

Thepresentationwas followedbyan informaldiscussionwhereweacquaintedourselveswitheachother.All theTraineeExaminers foundthisworkshopvery informative.Boardmembersalsoagreed that this was very helpful to both theTraineeExaminersandtheBoard.

Dr.ChanYuSangBoardMemberBoardofConjointExamination

Groupphoto Dr.ChanHungChiuintroducingthepurposeofConjointExamination

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S"Council Member-On-Duty" (CMOD) System

DearCollegemembers,

Wearestillprovidingthisalternativechannelofcommunicationforyoutoreachus.Doletushaveyourideasandcommentssothatwecanfurtherimproveourservicestoallthemembers.

Forthismonth, from15thJunetill14thJuly,2010,Dr.DanielWSChuandDr.ChanKinLingwillbetheCouncilMembersonduty.Pleasefeel freetomakeuseofthischanneltovoiceyourdoubts,concerns,queries,andcommentsaboutanythingrelatingtoourCollegeandFamilyMedicine. YoucanreachusbycontactingourCollegeSecretariatbyphone:25286618,by fax:28660616,orbyemail:[email protected],wewillgetintouchwithyoudirectlyassoonaswecan.

Dr.TonyCKLeeCo-ordinator,CMODSystem

Dr.DanielWSChu Dr.ChanKinLing

TheCouncilapproved,onrecommendationof theMembershipCommitteeChairman, the followingapplicationsformembershipinMay 2010withCouncilMeeting:

Transfer from Associate Membership to Fellowship

Dr. HO Kai Tin 何佳鈿

Dr. TSANG Wai Mun 曾慧敏

Suspension of Associate Membership

Dr. LAM Ding Yee, Amy 林定儀

Dr. LAM Tung 林冬

Resignation of Non-HKSAR Membership

Dr. JONG, Irene 楊怡林

Associate Membership (New Application)

Dr. CHENG Ying Wai 鄭英偉

Dr. SIU Chi Ming 蕭志明

Reinstatement of Associate Membership

Dr. CHENG Hei Wan 鄭曦雲

Dr. NG Yiu Kong 伍鐃江

Student Membership (New Application)

Mr. LI Chi Wai 李智威

Resignation of Associate Membership

Dr. CHENG Kin Keung 鄭健強

Dr. LOK, Zara Lin Zau 駱靈岫

Membership Committee News

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TheBoardofExaminationhas identifiedaneedincandidateswhomaybenefit fromformingastudygroupinpreparingfortheFellowshipexamination.Inresponse,theCollegewillfacilitatetheformationofstudygroupsforcandidateswhootherwisearewithoutformalgroupsupport.AdvicetothegroupsfromvariousBoardsincludingBVTSandBoardofEducationwillbeaccessibleshouldtheneedarises.

Aim: 1.tofacilitatememberswhohavedifficultiesinformingstudygroups

2.toidentifyimprovementareasofmembersinsittingfortheFellowshipexamination

3.tofacilitategroupmemberstoupdateskillsandknowledge

4.tocoordinatehelpfromexperiencedfellowsandteachers

Membership: OpentoallCategory2candidates.

InterestedmemberspleasesendinthefollowingdetailsandfaxtotheCollegesecretariatat28660981.Asmembershipmaybe limited,pleaseapplyearlyandweshallcall for the firstmeetingassoonaspossible.

Application Form:

Name/ Age/ Sex

Contact Tel: Email address:

Graduation Place and Year

Year planned to sit for the Conjoint Exam

Year attempted Conjoint Exam

Institutional training No / Yes: no of years

Hospital experience No / Yes: no of years and types

Other academic experience e.g. Diplomas, Masters, other Fellowships

Areas that you think you may benefit from facilitation

1.2.3.

Facilitation for Category 2 candidates of Fellowship Examination to form study groups

Classified Advertisements

PositionsVacant

TheUniversityHealthServiceofTheHongKongPolytechnicUniversityrequiresaMedicalOfficer.Duties:provideprimaryhealthcare,healthcounselling,promotehealtheducationandperformadministrativeduties.Qualifications:registrablewithTheMedicalCouncilofHongKongandfluencyinspokenEnglishandCantonese.AhigherqualificationinInternalMedicineorFamilyMedicineisanadvantage.PostspecificationandapplicationformareavailablefromtheHumanResourcesOffice(Homepage:http://www.polyu.edu.hk/hro/job.htm,Email:[email protected],Fax:27643374).Applicationclosingdate:10July2010.

Community-basedtrainingcentreatMaOnShanislookingforenergetictraineewhowishestoadvancecareeronFMandMusculoskeletalmedicine.PleasecallDr.Ipat76666078.

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RNERExecutive Corner

Throughouttheseyears,ourCollegehasgrownfromasmallassociation intooneof theConstituentCollegesof theHongKongAcademyofMedicine,comprising fourBoardsandtenCommittees. ItwouldbeinterestingtoknowmoreaboutthedifferentBoardsandCommittees,whicharecentraltothedevelopmentofourCollegeandtheFamilyMedicinepracticeinHongKong.Startingfromthisissue,FPLinkswouldintroduceeachBoardorCommitteeinaquarterlymanner.

Board of Conjoint Examination

List of Members

Chairman : Dr.ChanHungChiu

Members : Dr.IpPangFei (ChiefExaminer) Dr.BillyS.H.Chui (OSCECoordinator) Dr.KennyKung (MCQCoordinator) Dr.LauHoLim (KFPCoordinator) Dr.BarryT.F.Bien Dr.ChanLaam Dr.DicksonY.S.Chan Dr.WinnieW.Y.Chan

Ex-officio : Dr.GeneTsoi (President) Dr.MaryKwong (Vice-President,GeneralAffairs) Dr.LawTungChi (HonorarySecretary)

BoardofCensors : Prof.CindyLam (ChiefCensor) Dr.StephenFoo (Censor) Dr.DonaldLi (Censor)

(Fromlefttoright:Mr.PatrickWu,Ms.CrystalYung,Dr.ChanLaam,Dr.LauHoLim,Dr.IpPangFei,Dr.ChanHungChiu,Dr.BillyS.H.Chui,Dr.DicksonY.S.Chan,Dr.WinnieW.Y.Chan,Ms.TeresaLiu)

The Board of Conjoint Examination meets regularly to discuss and make decisions on issues relating to the Conjoint Fellowship Examination. It plans and conducts the Conjoint Fellowship Examination in Family Medicine with the Royal Australian College of General Practitioners (RACGP) since 1987. It recommends the successful candidates, after approval by our College Chief Censor, to our Council for election to HKCFP Fellows.

The Examination is designed to evaluate the competence of the candidates in regard to their knowledge, skills and attitudes in General Practice/Family Medicine. A good understanding of the principles and methods of Family Medicine is emphasized. Skills in problem solving, communication, practice management, physical examination, and office procedures are to be tested. Candidates are expected to practise continuous, comprehensive, co-ordinated, patient-centred, and anticipatory care.

The Examination consists of two parts: Written Segment and Clinical Segment. Different segments test different areas of the candidate's competence in regard to their knowledge, skills and attitudes in Family Medicine and carry different weighting to the total score of the Examinations. The Written Segment includes Multiple Choice Questions (MCQ) and Key Feature Problems (KFP), and the Clinical Segment is conducted in the form of Objective Structured Clinical Examination (OSCE). The written and clinical examinations usually take place in September and October/November respectively every year.

The Board always strives to ensure the validity and reliability of the examination. In order to maintain the standard of the examination, training workshops and rehearsal sessions for the examiners are organized regularly. Suggestions from members are always welcomed and appreciated.

TB’s Special Medical Instruments: Part II

Last time Ihavesharedwithyoumyexperience inusing theMacroviewotoscopeand theDigitalmacroviewotoscope.ThistimeIhavesomemoreinterestinginstrumentstotalkabout.

III. Panoptic ophthalmoscope

This instrument looks likea telescope,and isdesignedtovisualizethefundi throughundilatedpupils (Fig1). Withaverycomplexsystemofoptical reflectionandrefraction,youareable toseethe fundiwithanamazinglylargefieldwithouttheneedforpupildilation.Whenexaminingtheeyesofchildrenandteenagers,youwillbeshockedbytheclarityandthelargefieldofviewofthefundi. Youcanactuallyseethepulsationoftheretinalarteriesattheopticdiscs!

Whenexaminingtheeyeswiththepanopticophthalmoscope,arubber“eyepiece”isrequiredtokeeptheinstrumentattherightdistancefromthepatient’seye,andtoavoidaccidentallybumpingthepatient’seyewiththescopeduringtheexamination.Whenusingthetraditionaldirectophthalmoscope,youneedtoadjustthefocusaccordingtothedegreeofshort-sightednessor long-sightednessofboththepatientandyourself,anddifferentpatientswillneeddifferentfocusadjustment. However,whenusingthis instrument,youonlyneedtoadjustthefocustocorrectyourownrefractiveerror,anditwillbereadytoexaminemost,ifnotall,patients.Furthermore,astheinstrumentismuchlargerthanthetraditionalophthalmoscope,theobserver’sfacewillnotbetooclosetothepatient’sface,andyoucanuseyourdominanteye(usuallyrighteye)toexaminebotheyesofthepatient.Thisisespeciallybeneficialfordoctorssufferingfromamblyopia.

Thisinstrumentisexcellentforinspectingtheopticdiscs.Whenusingatraditionalophthalmoscopetolookattheopticdisc,usuallyyouwillnotbeabletoseethewholeopticdiscatonetime,andyouwillneedtokeeplookingaroundtheopticdisctogetanestimationofthecup-discratio.Withthepanopticophthalmoscope,youcanseethewholeopticdiscinonego,evenifthepupilispinholesizedorinthepresenceofmoderatecataract.

Examining theopticdisc isquite important in theGPsetting. Inpatientspesentingwith severeheadache,Iwillalwayslookforthepresenceofpapilloedema;andbeforeIprescribeorcontinuetricyclicantidepressants,Iwillalwaysusethisinstrumenttoseethecup-discratio,andwillreferallpatientswithraisedCDratiototheophthalmologisttoruleoutglaucoma.

However,thisinstrumentalsohasitsdrawbacksandlimitations:

1) Whenusingthepanopticophthalmoscopeinaverycoldconsultationroom,afteroccludingthepatient’seyewiththerubbereyepiece,thewarmthandwatervapourfromthepatient’seyewillleadtoformationoffogsonthelens.Thesamewillalsooccurontheobserver’ssideifthedoctor’seyeiscloselyattachedtotheobserver’seyepiece.Youmayneedtofinishtheexaminationbeforethefogforms.

2) Togetalargerfieldofview,theobservershouldtakeofftheirglassesandfittheeyetotheobserver’seyepiececlosely. Therefore, it isnothygienictosharethe instrumentamongdoctors. Althoughtheshort-sightednessor long-sightednessofthedoctorcanbereadilycorrectedbyadjustingthefocus,doctorswithhighdegreeofastigmatismmaystillgetaslightlyblurredvisionwhenusingthisinstrumentwithoutglasses.

3) Thebrightnessof the image is lowerwhencomparedwith traditionalophthalmoscope. Whenexaminingpatientswithcataractsandsmallpupils,theimagemaybecometoodimandblurred,andwhatyoucaninspectwithconfidencewouldbetheopticdisconly.

4) Thesizeofthefieldofviewactuallydependsonthesizeofthepupil.Childrenandteenagerusuallyhaveverylargepupils,andthefieldofviewcanbeaslargeas3opticdisc’sdistance.However,thepupilsusuallybecomessmallerwhenpeoplegetolder,andwhencombinedwiththepresenceofcataracts,thefieldofviewwillbemuchsmaller.Hereisthedilemma:thepanopticophthalmoscopeisdesignedfor inspectingthefundithroughtheundilatedpupils,butcommoneyediseasessuchasDMretinopathy,age-relatedmaculardegenerationor retinalveinocclusionusuallyoccurs intheolderagegroup,andthis instrumentcannotgiveyouclearimagesduetosmallpupilsandthe

Dr. TB Chan, Higher Trainee, New Territories East Cluster

Fig1:Panopticophthalmoscope,eyepieceattached

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Idecidedtobuythis instrument(Fig2)afterencounteringdifficultieswhenperformingsyringingoftheearsformypatients.Earsirrigationisaneasyprocedurebutisperformedblind,andweusuallyneedtouseacrocodileforcepstoloosenthewaxtofacilitatetheirrigation,ortoremovetheloosenedwaxafterirrigation.Thetraditionalotoscopehasaremovablemagnifyinglens(Fig3);toremoveapieceofearwaxinthecanal,youcanremovethelens,passthecrocodileforcepsthroughtheholetograsptheearwax,andthenmovethewholesystemout.Withthismethod,youwillneedtovisualizetheearcanalthroughasmallholewithoutmagnification,andyoumayneedtotakeouttheotoscopewiththecrocodileforcepstogethermanytimeswhileremovingmanypiecesofearwax.

Asthismethodistootroublesome,Ihavetriedtoremovethewaxwithouttheotoscope,byaskinganhealthcareassistant(HCA)toshinealightintotheearcanal;However,thedirectionofthelightisusuallysuboptimal forvisualizingthe insideof thecanal,andthehairs intheearcanalwillobscuretheviewsignificantly.

Ilearnedaboutthis“Lumiview”whenreadingthefamousbook“Practicetips”byJohnMurtagh.ThisisessentiallyastandardheadlightforENTprocedure,plusapairofbinocularmicroscope(Fig2). Asyouwillexpect,the“binocular”microscopecangiveyouathree-dimensionalview,topreserveyourspatialsensationanddepthperceptionwhenperformingmedicalprocedures insidevarious lumenofvaryingsize. Thedepthoffocus isquite large,andobjectsplacedat7-15 inchfromthemicroscopewillbeinfocus. However,themagnificationisonly1.5x,andIwasquitedisappointedwiththiswhenI firsttriedusingthisinstrument.However,afterusingtheLumiviewinmydailyclinicalpractice,Ithinkthisdegreeofmagnificationisgoodenoughinmostsituations.

WhenusingtheLumiviewthefirsttime,youwillneedtoadjusttheinter-pupillarydistance. Everytimeafterputtingtheinstrumenttoyourhead,youneedtoadjustthedirectionoftheheadlight,tomakesurethelightshinesonanobjectplacedatcomfortableexaminationdistance(Iusuallyputupmyownthumbtoadjustthelight).Youcanflipthebinocularmicroscopeupwhenyoudonotneedit.

WiththisLumiview,Iamnowabletoremovetheearwaxonmyown.Togetridoftheearcanalhairsandtokeeptheearcanalvisiblewithoutstretchingthepinnacontinuously,Icansimplyputinalargecalibreearpieceandperformtheproceduresthroughthelargehole.

IalsousetheLumiviewtoinspectthenostrilsandtheoralmucosallesions(Fig4).YoucanactuallyusethisLumiviewforanymedicalproceduresrequiringgoodvision,suchasremovalofverytightandtinystitches. Oneimportantthingtonoteisthat,thisheadlight istoostrongforeyeexamination,andyoushouldnevershinethelighttowardspatient’seyes.

Doctorsinterestedintheseinstrumentscangetmoreinformationfromthesupplier(www.umedco.com).

Sofar Ihave introducedtoyoufourmedical instruments,whicharequite“hightech”andexpensive.NextissueIwillsharewithyousomecheaperbutalsointerestingtools.

“Submissions of articles to Trainee Column with up to 1200 words are always welcome. Gift vouchers will be given as a token of appreciations for good works if the articles are selected for publication. Email: [email protected]”

presenceofcataracts. Theopticdiscsandthebloodvesselsmaybetheonlystructuresthatyoucaninspectwithconfidence.SofarIdon’tdaretousethisinstrumenttoscreenforDMretinopathyroutinely,butIamstilloccasionallyabletodetectmoreadvancedcasesofDMR.

Overall,Ithinkthisisagoodinstrument,butweneedtobearinmindthedrawbacksandlimitationswhenusingit.

IV. LumiView Portable Binocular Microscope

Fig2:LumiviewPortableBinocularMicroscope

Fig3:Traditionalotoscope.Themagnifyinglensisremovable,but thehole is toosmall forproceduresinsidetheearcanal.

Fig4:UsingtheLumiviewandanasalspeculumtoinspectthenostrils.

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TheBoardispleasedtoannouncethattheDiplomaCourseinFamilyMedicine(DFM)organizedbyTheHongKongCollegeofFamilyPhysicianswillcommenceinJune2010.

ThecourseconsistsofFIVEmodules.ModulesI&IIwillbedeliveredbyLocalDistanceLearning.ModulesIII,IV&Vconsistoflectures,seminars,tutorials,workshopsandclinicalattachments.ThewholecourserequiresONEyearofpart-timestudies.

Detailsofthecourseareasfollows:

1. Objectives:

i) Toprovideknowledgeable,pragmaticandstructuredteachinginFamilyMedicineformedicalpractitionersii)Toencourageprofessionaldevelopmentofpractisingmedicalpractitionersandtoprovidean intermediatesteptofellowship

qualificationsinFamilyMedicineiii)ToimprovestandardsandqualityinthepracticeofFamilyMedicine

2. *Syllabus:

ThecourseconsistsofFIVEcompulsorymodules.Doctorsgraduatedfromthecourseareexpectedtohaveacquired:

i) CurrentconceptsaboutnatureofFamilyMedicineii) Knowledgeandskillsinconsultation,counsellingandproblemsolvingiii) Knowledgeandskillsincommonpracticeproceduresandemergencycarerequiredforgoodqualityfamilypracticeiv) UnderstandingstowardstheroleofFamilyDoctorsasgatekeepersof thehealth-caresystemand inprovidingcost-effective

primarycaretothecommunity

Module I – Principles of Family Medicine (Distance Learning)Aims: 1.LearnconceptsofFamilyMedicine 2.UnderstandtheroleandscopeofaFamilyDoctorContents: DefinitionofFamilyPhysicians,FamilyPhysicians’Functions,CoreValuesofFamilyMedicine,Consultation,FutureofFamily

Medicine

Module II – Common Problems in Family Medicine (Distance Learning)Aims: 1.Enhanceconsultation,communicationandproblemsolvingskills 2.GainknowledgeincommonchronicdiseasesinFamilyMedicineContents: SelectedtopicsfromClinicalPsychology,DiabetesMellitus,LowBackPain,COPD,AtopicEczema,Elbow Mass,FacialRashes,HealthPsychology,AllergicRhinitis,Urethritis,UrineIncontinence,etc.

Module III - Essentials of Family Medicine (Structured Seminars and Tutorials) Aims: 1.StrengthenknowledgeinFamilyMedicine 2.UnderstandthepotentialgrowthofFamilyMedicine 3.DevelopresearchandteachingskillsinFamilyMedicineContents: PracticeManagement,CareofElderly&ChronicIllnesses,AnticipatoryCare,ClinicalAudit&QualityAssurance,Introduction

toFamilyTherapy,Research&TeachinginFamilyMedicine,EvidenceBasedMedicineandCriticalAppraisal

Module IV - Clinical Updates (Updates and Clinical Attachment)Aims: Acquirein-depthknowledgeandpracticalskills inselectedspecializedareasincludingMedicine,Surgery,Geriatrics,ENT,

Orthopaedics&Traumatology,Accident&EmergencyMedicine,InfectiousDiseasesandDermatologyContents: FIVEUpdateseminarsandONEclinicalattachmentonselectedspecialties includingMedicine,Surgery,Geriatrics,

ENT,Orthopaedics&Traumatology,Accident&EmergencyMedicine, InfectiousDiseasesandDermatology (subjecttoavailability)

Module V - Practical Family Medicine (Practical Workshops)Aims: Enhancepracticalandcommunicationskills inFamilyMedicinebyPracticalWorkshops inselectedareas includingCPR,

ConsultationSkills,CounsellingSkills,Women’sHealth,OrthopaedicInjectionandMusculo-SkeletalMedicineContents: 5compulsoryand1electivePracticalWorkshops inselectedareas includingCPR,ConsultationSkills,CounsellingSkills,

Women’sHealth,OrthopaedicInjectionandMusculo-SkeletalMedicine

Module III & V will be scheduled in Saturday and Sunday afternoons

3. Articulations:

TheCourseallows (uptoa fixedmaximumpercentageof theCourseunits)articulationsorcross recognitionofpreviousFamilyMedicinetrainingprogrammesthatprovidelearningunitsequivalenttothatoftheabovesyllabus.Participantswhowishtoapplyforsucharticulationshavetosubmitevidenceofrelevanttrainingtogetherwiththeirapplication.Thegrantingofarticulationsishowever,completelyatthediscretionanddecisionoftheBoardofDFM.

4. *Schedule:

The whole course requires ONE year of part-time studies.

JunetoSeptember2010 ModuleINovember2010toJanuary2011 ModuleIIJuly2010toMay2011 ModuleIII,IV&VMay2011 FinalExamination

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MedicalPractitionerwithfullregistrationinHKSAR

6. Teaching Staff:

ApanelofexperiencedacademicmedicalprofessionalsinFamilyMedicine,hospitalspecialistsandexperiencedFellowsorTrainersofHKCFPwillbeinvitedtoteachintheprogramme.

7. Teaching Medium:#English(Cantonesemaybeusedinsomeseminars,workshopsandclinicalattachments)

8. Course Fees:

Wholecourse:HK$25,000formembersofHKCFPHK$50,000fornon-members(A discount of HK$3,000 for early birds who apply on/before May 15, 2010)

In addition, the first 10 General Practitioners in Hong Kong who enroll successfully with the Diploma course on/before the deadline will enjoy further course fee reduction of HK $2,000.

IndividualModules: Members Non-membersModuleI(DistanceLearning–PrinciplesofFamilyMedicine) $3,000 $6,000ModuleII(DistanceLearning–CommonProblemsinFamilyMedicine) $3,000 $6,000ModuleIII(StructuredLectures&Seminars) $2,000 $4,000ModuleIV(Updates&ClinicalAttachment) $2,600 $5,200ModuleV(PracticalWorkshops) $3,600 $7,200

All fees must be paid upon application and before commencement of the course. Fees paid are NON-TRANSFERABLE and NON-REFUNDABLE.

9. Awards/Credits:

i) ADiplomainFamilyMedicineissuedbyHKCFPwillbeawardedtocandidateswhohavesatisfiedalltherequirementsandhavepassedalltherequiredassessmentandtheFinalExamination.

ii)TheDiplomaisaQuotable QualificationofTheMedicalCouncilofHongKong.iii) 50CMEand10CPDcreditpointswillalsobeawardedtocandidatesatsatisfactorycompletionof theCoursebytheQA&A

CommitteeofHKCFP.

10. Application Procedures:Application is now open.

AcompletedapplicationformmustbereturnedtoTheHongKongCollegeofFamilyPhysicianswiththefollowing:

i) PhotocopyofthecurrentAnnualPracticingCertificateii) Arecentphotooftheapplicant(passportsize)iii) Asigned“DisclaimerofLiability”iv) Anapplication feeofHK$200bycrossedchequepayable to“HKCFPHoldingsandDevelopmentLimited”.This fee isnon-

refundable.v) ACourseFeeofHK$25,000 (orHK$50,000 ifnon-member)bycrossedchequepayableto“HKCFPHoldingsandDevelopment

Limited”.Thisfeeisnon-refundableunlesstheapplicationisunsuccessful.

Everysuccessfulapplicantwillbenotifiedbyanofficialletterofadmission.

InformationandapplicationformsareobtainableattheCollegeorcanbedownloadedattheCollegewebsite(http://www.hkcfp.org.hk).Memberswhowerenotadmittedinthecoursein2009havetosendintheirapplicationagainiftheywanttostudythecoursethisyear.PleasecontacttheCollegesecretariat,MsWinnieaLeeat28610220foranyqueries.

11. Application Deadline: June 24, 2010

12. Comments From Former DFM Graduates

- TheContentisusefulindailypractice.Icanhavehands-onpracticalskills.Icanpolishmycommunicationskillsduringthelectures&workshops.

- IcanunderstandtheroleofFamilyPhysiciansasgatekeepersofhealth-caresystemandbetterknowabouttheirroleinthesociety.Ialsoacquiretheskillsoncriticalappraisal.

- Therearesessionsofclinicalupdatesforupdatingknowledge.ModuleI,II&IIIcouldhelpimprovingmyknowledge.ModuleI,II&IIIcouldimprovemyunderstandingofFamilyMedicine.Sessionsinconsultationareinvaluableinimprovingmycommunicationskills.

Dr.AuChiLapChairmanTheBoardofDFM

*Coursesyllabusandschedulemaybesubjecttochangewithoutpriornotification

#CantoneseandEnglishwillbeusedasthelanguageforteachingandexamination.

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TheBoardispleasedtoannouncethattheCertificateCourseinFamilyMedicine(CFM)organizedbyTheHongKongCollegeofFamilyPhysicianswillcommenceinJune2010.

ThecourseconsistsofFOURSegments.SegmentIwillbedeliveredbyLocalDistanceLearning.SegmentsII, III&IVconsistoflectures,seminars,tutorialsandworkshops.ThewholecourserequiresSIXmonthsofpart-timestudies.

Detailsofthecourseareasfollows:

1. Objectives:

i)Toprovideknowledgeable,pragmaticandstructuredteachinginFamilyMedicineformedicalpractitionersii)Toencourageprofessionaldevelopmentofpracticingmedicalpractitionersandtoprovideanintermediatesteptoattain

diplomaqualificationsinFamilyMedicineiii) ToimprovestandardsandqualityinthepracticeofFamilyMedicine

2. *Syllabus:

ThecourseconsistsofFOURcompulsorysegments.Doctorsgraduatedfromthecourseareexpectedtohaveacquired:

i) CurrentconceptsaboutnatureofFamilyMedicineii) Knowledgeandskillsinconsultationiii) Knowledgeandskillsinsomecommonpracticeproceduresrequiredinfamilypracticeiv) UnderstandingstowardstheroleofFamilyDoctorsasgatekeepersofthehealth-caresystemandinprovidingcost-effective

primarycaretothecommunity

Segment I – Principles of Family Medicine (Distance Learning)Aims: 1.LearnconceptsofFamilyMedicine 2.UnderstandtheroleandscopeofaFamilyDoctorContents: DefinitionofFamilyPhysicians,FamilyPhysicians’Functions,CoreValuesofFamilyMedicine,Consultation,Futureof

FamilyMedicine

Segment II- Essentials of Family Medicine (Structured Seminars and Tutorials) Aims: 1.StrengthenknowledgeinFamilyMedicine 2.UnderstandthepotentialgrowthofFamilyMedicineContents: PracticeManagement,CareofElderly&ChronicIllnesses,AnticipatoryCareandIntroductiontoFamilyTherapy

Segment III - Clinical Updates (Updates)Aims: ToacquireupdateknowledgeinvariousmedicalspecialtiessuchasMedicine,Surgery,Geriatrics,ENT, Infectious

DiseasesandDermatologyContents: THREEUpdateseminars

Segment IV - Practical Family Medicine (Practical Workshops)Aims: EnhancepracticalskillsandconsultationskillsinFamilyMedicinebyPracticalWorkshopsinsomeselectedareasContents: OrthopaedicInjectionandConsultationSkills

Segments II, III & IV will be scheduled in Saturday and Sunday afternoons

3. *Schedule:

ThewholecourserequiresSIXmonthsofpart-timestudies.

JunetoSeptember2010 SegmentIJulytoNovember2010 SegmentsII,III,IV

4. Admission Requirements:

MedicalPractitionerwithfullregistrationinHKSAR

5. Teaching Staff:

Apanelofexperiencedacademicmedicalprofessionals inFamilyMedicine,hospitalspecialistsandexperiencedFellowsorTrainersofHKCFPwillbeinvitedtoteachintheprogramme.

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#English

(Cantonesemaybeusedinsomeseminarsandworkshops)

7. Course Fees:

HK$8,000formembersofHKCFP

HK$16,000fornon-members

All fees must be paid upon application and before commencement of the course. Fees paid are NON-TRANSFERABLE and

NON-REFUNDABLE.

8. Awards/ Credits:

i) ACertificateinFamilyMedicineissuedbyHKCFPwillbeawardedtocandidateswhohavesatisfiedalltherequirements.

ii) Exemptionofrelevantsegments/modulesifsuccessfulcandidateswishtoproceedfurtherwiththeirstudiesleadingtothe

DiplomaofFamilyMedicineawardedbyHKCFP(Quotablequalification).

iii) 10CMEand6CPDcreditpointswillalsobeawardedtocandidatesatsatisfactorycompletionoftheCoursebytheQA&A

CommitteeofHKCFP.

9. Application Procedures:

Application is now open.

AcompletedapplicationformmustbereturnedtoTheHongKongCollegeofFamilyPhysicianswiththefollowing:

i) PhotocopyofthecurrentAnnualPracticingCertificate

ii) Arecentphotooftheapplicant(passportsize)

iii) Asigned“DisclaimerofLiability”

iv) AnapplicationfeeofHK$200bycrossedchequepayableto“HKCFPHoldingsandDevelopmentLimited”.Thisfeeisnon-

refundable

v) ACourseFeeofHK$8,000(orHK$16,000ifnon-member)bycrossedchequepayableto“HKCFPHoldingsandDevelopment

Limited”.Thisfeeisnon-refundableunlesstheapplicationisunsuccessful.

Everysuccessfulapplicantwillbenotifiedbyanofficialletterofadmission.

Informationandapplication formsareobtainableat theCollegeor canbedownloadedat theCollegewebsite

(http://www.hkcfp.org.hk).PleasecontacttheCollegesecretariat,MsWinnieaLeeat28610220foranyqueries.

10. Application Deadline: June 24, 2010

Dr.AuChiuLap

Chairman

TheBoardofDFM

*Coursesyllabusandschedulemaybesubjecttochangewithoutpriornotification

#CantoneseandEnglishwillbeusedasthelanguageforteachingandexamination.

"Submissions of articles to News Corner with up to 500 words are always welcome. Gift vouchers will be given as a token of appreciations for good works if the articles are selected for publication. Email: [email protected]"

Pregnancy and Diagnostic Imaging

AyoungladyrecentlypresentedtotheAccidentandEmergencyDepartmentofTuenMunHospitalwithabdominalpain.Althoughshementionedhermenstrualperiodwasdelayed,anX-raywasperformedafteraurinepregnancytestreturnedtobenegative.However,onthenextday,ahomeurinetestshowedthatshewaspregnant,whichwasconfirmedbyaprivatepractitionerwhomwarnedheraboutpossibilityoffetalabnormalityandofferedanoptionofterminationofpregnancy.ThepatientwasdistressedandlaunchedacomplaintagainsttheHospitalAuthority.HowevertheHospitalAuthoritycommentedthataplainX-rayhadalowamountofradiationandthatitshouldbesafe.1

Althoughthesafetyofradiationexposureduringpregnancyisacommonconcern,amissedordelayeddiagnosisofaseriousdiseasecanposeagreaterriskthananyhazardassociatedwithionisingradiation,sohowwouldionisingradiationaffectthefoetusduringpregnancy?

Firstly,weneedtoknowthebasicunitofmeasuringradiationdoses.Oneradistheenergytransferof100ergspergramofanyabsorbingmaterial:

1rad=1000mrad=0.01gray(Gy)=0.01sievert(Sv)=1rem(roentgen-equivalentman)

Examples2:

Procedure

CXR(PA) Cervical Dental CTofchest CTof LSspine

IVU Barium

spinex-ray x-ray (plain) abdomen(plain) x-ray enema

mradexposed <1 <1 0.01 30 250 400-600 400-900 700-1600

InUnitedStates, theaverageperson isexposedtoaneffectiveradiationdoseofaround360mradwhole-bodyexposureperyearfromallsources(naturalandman-made).3TheUSNuclearRegulatoryCommissionrecommendsthatoccupationalradiationexposureofpregnantwomenshouldnotexceed500mradduringtheentireperiodofpregnancy.Therearenostudiesinhumanstoevaluatetherisksofionizingradiation;mostdataarebaseduponcasereportsandextrapolationofdatafromsurvivorsoftheatomicbombinHiroshimaandtheChernobylaccident.

Theoccurrenceofdeleteriousconsequencesdependsuponthegestationalageatthetimeofradiationexposure,thedoseofradiationandcellularrepairmechanisms.Cellulardamagecausedbylowlevelsofradiationexposureisusuallyrepaired.Thethresholdofradiationdoseatwhichanincreasedriskofcongenitalmalformationsoccurshasnotbeendefinitivelydetermined,butcurrentevidencesuggeststheriskisincreasedatdosesabove10rad,whereastheriskbetween5and10radislessclear.Thereisnoevidenceofanincreasedriskoffetalanomalies,intellectualdisability,growth restriction,orpregnancy lossatdoses less than5 rads.Concerning the risk fordevelopingleukaemia,thecarcinogenicpotentialof lowlevelradiationiscontroversialbutthegeneralconsensus isthatthisriskisnotlikelytoexceed1in1000childrenperradofexposure4andtherearenoincreasesinoncogenicriskforexposureslessthan20rad.

Duringthefirst14daysafterconception,theembryoeithersurvivesundamagedorisresorbed,termedthe“allornone”phenomenon.Afoetaldoseof100radwill likelykill50%ofembryos.Theriskofdevelopingmalformationsandmental retardation ismore likelywhenthere isexposuretoadoseof10radsorabovebefore16weeksofgestation,5after16weeks,thethresholdisevenhigherasthefoetusisrelativelyresistanttoteratogeniceffectsofionisingradiation.HowaboutMRI,whichuseselectromagneticradiowavesratherthanionisingradiation?Possibleriskfromheatingoftissueandinductionoflocalelectricfieldsandcurrentsofconcern,buttherearecurrentlynoreportedharmfuleffects fromMRI.TheNationalRadiologicalProtectionBoardadvises thatMR imagingbeavoided in the firsttrimestersincethereis limitedexperienceassessingsafetyduringorganogenesis,however,goingbacktobasics,wehavetobalancetherisksversusbenefitsofaparticularprocedure,andtoclearlycommunicatethesewithourpatients.

Compiled by Dr. Chun-Kong Yip

References:1. SingtaoNews,30/5/2010

2. BenturY.Ionizingandnonionizingradiationinpregnancy.In:Maternal-fetaltoxicology,2nded,Koren,G(Ed),MarcelDekker,NewYork,1994,p.515,andGuidelinesondiagnosisandmanagementofacutepulmonaryembolism.TaskForceonPulmonaryEmbolism,EuropeanSocietyofCardiology.Eur Heart J 2000;21:1301.

3. Lazarus,E,Debenedectis,C,North,D,et al.Utilizationofimaginginpregnantpatients:10-yearreviewof5270examinationsin3285patients--1997-2006.Radiology2009;251:517.

4. ACOGCommitteeOpinion#299:GuidelinesforDiagnosticImagingDuringPregnancy.Obstet Gynecol2004;104:647.

5. www.bt.cdc.gov/radiation/prenatalphysician.asp

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Allergic Rhinitis and Rhinosinsusitis

Dr. Francis W T LeeMember, Board of Education

(Disclaimer:Alladviceandsharinginthemeetingarepersonalopinionsandbearnolegalresponsibility.Allpatients’identitiesarekeptconfidential.)

Fromlefttoright:Dr.StephenFoo,Dr.GaryYipandDr.FrancisLee

(ThisarticlewaswrittenwithreferencetoabstractofthelecturebyDr.GaryWKYipon5May2010inEatonHotel,sponsoredbySanofi-Aventis,withadditionalinformationfromtextbooksandliterature)

IntroductionIngeneralpractice,wefrequentlyencounterpatientswithrunnynose,sneezingandotherupperairwaysymptoms.Mostofthemprobablyhaveanupperrespiratoryinfection.However,theymayactuallybesufferingfromallergicrhinitis.

Otherdiseasestoconsiderinclude:vasomotorrhinitis,sinusitis,non-allergicrhinitiswitheosinophiliasyndrome(NARES),atrophicrhinitis,andnasalpolyposis.Otherco-morbidconditionsincludeblockageintheEustachiantube,andanomaliesintheanatomyofthenoseandpara-nasalsinuses.Thereisstrongassociationofallergicrhinitiswithasthmaandatopicdermatitits.

Certaindrugsmaycauserhinitissymptoms,e.g.angiotensionconvertingenzymeinhibitors,phosphodiesterase-5inhibitors,alpha-receptorantagonists,non-steroidalanti-inflammatoryagents,andaspirin.

Othercausesofdisturbednasalfunctionincludecysticfibrosis,ciliarydyskinesia,hypothyroidismandWegener’sgranulomatosis.

Diagnosis of allergic rhinitisMostcasescanbediagnosedclinically. Identificationofanysuspicioustriggeringoraggravatingfactors,e.g.exposuretoallergensisimportant.Familyhistoryofatopy,co-existingasthmaandotitismediashouldalsobeconsidered.

Sensitivity tests to allergensManyallergenshavebeenidentifiedsuchasinsects,mites,housedust,cockroach,animalsandpets,pollens,moldsandchemicals.Theallergensundertestcouldbeadministeredviaseveralroutes:subcutaneous,nasal,sublingualandoral.Thetestisperformedifdesensitizationorimmunotherapyareconsidered.

PathogenesisExposuretoallergentriggersachainofreactionsinmastcells,T-cellsandeosinophils.Thereisreleaseofhistamine,leukotriene,interleukin-4,interleuline-5,prostaglandin,plateletaggravatingfactorandotherchemicals.ProductionofIgEintheBcellcausesafeedbackloopreactioninthemastcell.

Management(1) Avoidanceofallergens(2) Pharmacotherapy(3) Waterorsalinelavage(4) Immunotherapy(5) Surgicaltreatment

AntihistaminesareselectiveantagonistofH1receptor.Sideeffectsincludesedationandanticholinergicactivity.Thesecondgenerationantihistaminesdonotcrossthebloodbrainbarrierandarelesssedating.Theseincludefexofenadine, loratidine,dexloratidine.Anticholinergicsideeffects, likedrymouthandboweldisturbance,alsooccurbutmaybeless.Antihistaminenasal spraye.g.azelastine, is alsoavailableandeffective.Cetirizineandazelastinemaycausedrowsiness.

O r a l d e c o n g e s t a n t s i n c l u d e p s e u d o e p h e d r i n e ,phenylpropranolamineandphenylephrine.Localpreparationsinclude oxymetazoline, zylometzoline, naphazoline andphenylephrine.Sideeffects includepalpitations,restlessness,insomnia,headacheandhypertension.Onehastopayspecialattentiontoreboundeffectandrhinitismedicamentosa.

Intranasalsteroidsinhibitearlyandlatephaseallergicresponse,cellularresponseandIgEaction.Theyhavegoodsafetyprofileandaresuperiortooralhistaminesanddecongestants.Theymaynotbeneededinmilderformofallergicrhinitis.TheyareeffectiveinNARES,polyposisandsinusitis.Theonsetofactionisdelayedand

goodcomplianceisimportant.Themostfrequentsideeffectsarenasalirritation(10%)andblood-stainednasaldischarge(2%).

Oralcorticosteroidshave limited indicationsandareused insevererhinosinusitis,rhinitismedicamentosa,andobstructivenasalpolyposis.Theyshouldbeusedforashortperiodandtaperedoffassoonaspossible.

Othermedicationstoconsideroraddonincludeipratropium,leukotriene inhibitorsuchasmontelukast,andcromoglycate.Ipratropiumactsbyanticholinergicactionand iseffective inrelievingrhinorrhoea.Intranasalcromoglycateactsbypreventingmastcelldegradation,andiseffectivewithoutserioussideeffects.

Management of sinusitis or rhinosinusitis(1) Antibiotics.Manycasesareviral.Even inbacterialcases,

evidenceofuseofantibiotics isnotconsistent. Incaseantibioticsareconsidered,forexample,iftherearepurulentsecretions,maxillaryor frontalpain,thedrugofchoice ispenicillin.Incaseofpenicillinallergyornon-responsiveness,t r imetho pr im /su lphamethoxa zo le, mac ro l id e s o rcephalosporins canbeused.Durationof treatment iscontroversial.Itcanbeafewdaystotwoweeks.

(2) Oralandtopicaldecongestantsshowsymptomaticreliefbutthereisnoevidenceontheclinicalcourseofsinusitis.

(3) Ant ihis tamines have proven ef f icac y dur ing acuteexacerbationsinallergicpatientswithrhinosinusitis,buthasnoefficacyinnon-allergiccases.

(4) Mucolyticsareoftenusedasadjuvantagentsbut thereis no evidence that treatment is beneficial. There areisolatedcontrolledstudiesconfirmingefficacy insomephytotherapeuticagents(extractsfromplants).

(5) Topicalsteroidsusedwithantibioticssignificantlyimprovesymptomsofacutesinusitis.Steroidsarealsoeffective innasalpolyposis.Durationoftreatmentinthisconditionis6to12months.

(6) Antifungalagentsareusefulonlyininvasivemycosisintheimmunocompromised.Inthenon-invasiveform,functionalsurgeryandlocalorsystemicsteroidareconsidered.

Nasal EndoscopyThisisveryusefulinevaluatingtheanatomyandlesionsinthenoseandsinuschannels,includinganatomicaldeviations,polypsandtumours.Conditionsofthemucosaandsecretioncanalsobeassessed.

Functionalendoscopicsinussurgery(FESS)isaminimallyinvasivetechnique.The rationale liesonunderstanding thenormalmucosalciliaryflowinthesinuses.Ittargetsatcriticalareaswithlesionsandaimsatpreservingthenormalfunctionalmucosa.

Note of thanksThewriterwishestogivespecialthankstoDr.GaryYipforhisadviceandmaterialsforthisessay.

ASSESSMENT ENHANCEMENT COURSE FOR FAMILY PHYSICIANS 2010

Organizer : AssessmentEnhancementCourseSub-committee,BoardofEducation,HKCFP

Tutors : FamilyMedicineSpecialists,FellowsofHKCFPandRACGP

Supervisors : Dr. Wong Ka Wah and Dr. Chan Chi Wai

Co-ordinator : Dr. Peter Anthony Fok

Objectives : 1. To improveclinicalknowledge,problemsolvingandconsultationskills throughdifferent

workshops

2. To improvephysicalexaminationtechniqueandclinicproceduralskills throughhands-on

experience

3. Toprovideopportunityfor inter-professionalcommunicationandsocialnetworkexpansion

throughselfhelpgroups

4. Toimprovetimemanagementthroughsimulatedexamination

Venue : DukeofWindsorSocialServiceBuildingandHKAMJockeyClubBuilding

Date : 6months’coursestartingfromApril2010

Course Structure : Thecourseconsistsof4maincomponents:

1. Seminars

2. Workshops

3. Self-helpGroupSupport

4. MockExam

SeminarsandWorkshopshavebeenarrangedonSaturdayafternoons(2:15p.m.to5:15p.m.)

Accreditation : Upto15CMEpoints(Category4.4)&5CPDpoints(Category3.15)forthewholecourse

Course Fee : Members :HK$3,200(WholeAECcourse)

HK$900(Spotadmissionforeachseminarorworkshop)

Allchequespayableto“HKCFP Education Ltd”.

AllFeesreceivedarenon-refundableandnon-transferable.

Capacity : 50doctorsmaximum

Enrolment : Enrolmentisnowopen.PleasecalltheCollegeSecretariat,MsDickieLam,at28610220fordetails.

Successfulapplicationswillbeinformedlater.

Disclaimer : Allcasesandanswersaresuggestedbyourtutorsonly.Theyarenotmodelanswersforany

assessment/examination.

Remarks : BoardofEducationhasorganizedaPost-AEC training course forcategory2candidateswho

haveenrolledinAEC.

Assessment Enhancement Course 2010Timetable for Workshop

Date Topics Venue

Apr24,2010(Sat)2:15–5:15p.m.

Introduction 4/F & 8/F, Duke of Windsor Social Service Building, Wanchai

Jun12,2010(Sat)2:15–5:15p.m.

Approach to Physical Complaints 4/F & 8/F, Duke of Windsor Social Service Building, Wanchai

Jul10,2010(Sat)2:15–5:15p.m.

Problem Solving Skills 4/F & 8/F, Duke of Windsor Social Service Building, Wanchai

Aug14,2010(Sat)2:15–5:15p.m.

Viva Practice: Enhance Interprofessional Communication

4/F & 8/F, Duke of Windsor Social Service Building, Wanchai

Sep11,2010(Sat)2:15–5:15p.m.

Proper Physical Examination & Common Clinic Procedures

4/F & 8/F, Duke of Windsor Social Service Building, Wanchai

Oct2,2010(Sat)2:15–5:15p.m.

Mock Exam HKAM Jockey Club Building, 99 Wong Chuk Hang Road, Aberdeen

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Practice Management Training Course

Part A: Lecture part Part B & C: Practical part

Introduction:

Practicemanagementisveryimportanttoanypracticingdoctorsirrespectiveofwhetheryouarepracticinginpublicorprivatesetting. It isoneofthequalityassuranceaccrediteditemsandanareatoassessafamilymedicinespecialist'scompetency.Tomastersuchknowledgeandskillcanpreventtheforeseeablemedicalandlegalrisksandfacilitateourdailypracticemoreeffectivelyandefficaciously.

Dates : 26 June (Saturday), 17 July (Saturday), 25 July (Sunday) & 8 August (Sunday), 2010

Time : 2:00 – 4:00pm

Venue : 8/F, Duke of Windsor Social Service Building, 15 Hennessy Road, Wanchai, HK. (subject to change)

CME/ CPD Points : HKCFP: 2 CME Points for each session (Cat 4.3)

MCHK: 2 CME Points for each session

Up to 2 CPD Points (Subject to submission of satisfactory report of Professional Development Log)

Language : Mainly English (Cantonese when required)

Part A: Lecture Learning Hours: Total 8 hours (2 hrs x 4 sessions)

Lecture 1) Physical Setting and Insurance

Introduction : Dr. Tsoi Wai Wang, Gene

Speaker : Dr. Yuen Chung Lau, Natalis

Guest Speaker : Dr. Teoh Ming Keng

Chairman : Dr. Lee Wan Tsi, Francis

Contents : Rules&regulationsrelatedtosetupaclinic(MedicalCouncilrequirement&InlandRevenueDepartment requirement);Office,nurseanddoctor’s insuranceand indemnity (LabourDepartmentrequirement&MedicalProtectionSocietyrequirement);ProfessionalsupportandIndemnity fordoctors (deliveredbyDr.TeohMingKeng);Generalclinicdesign (Reception/shroff,consultationroom,dispensary,waitingroom,medicalrecordetc);Diagnosticequipment&varioustreatmentfacilities;EmergencycareinGPsetting,protocol&incidencereport.

Lecture 2) Effective Clinic Operation & Management

Speaker : Professor Li Kwok Tung, Donald

Chairman : Dr. Chan Yin Hang

Contents : Staff recruitment, job description and training; Medical record, confidentiality anddocumentation inGPsetting;Age/Sex,diseaseregister,qualificationassurance,accountingsystem,sickleaveandmedicalreport.(computer&manualSystem);Laboratorytestfiling,callbacksystemandreferralsystem;Clinicalaudit,research&teachinginGPsetting.

Lecture 3) Management of Pharmacy, Dispensary and Dangerous Drug

Speaker : Dr. Ip Kit Kuen, Andrew

Chairman : Dr. Tong Siu Man

Contents : DangerousDrugOrdinance;Howtoorganizeandmanagethedispensary;Drug labelingcriteria;Properdispensing;Medicineandvaccinationstock&storage.

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Lecture 4) Infection Control and Occupational Safety

Speakers : Dr. Lam King Hei, Stanley, and Dr. Lam Tak Man, Catherine

Chairman : Dr. Chan Chi Wai, Edmond

Contents : Infectioncontrolmeasures inclinic (ventilation,fevercohort,PPE&handhygiene);Commondisinfectedandsterilization itemsandprocedure;Medicalwastemanagement;OccupationSafetyandHealth(OSH);Incidencereportandinfectiousdiseasereport.

Course Fee : Members : HK$1,200 for Lecture Part (whole course)

HK$500 (spot admission for each lecture)

Eachparticipantdoctorisallowedtobringalonghis/herclinicassistantsasevidencedbycontractorconfirmationletter.TheCoursefeeforeachclinicassistantwillbeHK$1,200perperson.

Award : Candidates, who have successfully completed 4 lectures, will be issued a letter to certify of attendance with the name of the candidate by Board of Education, HKCFP. The names of clinic assistants attended can be inserted on request.

WelcometoallmemberswhowouldliketojointhePartA:Lecturepartonly.MemberswhohaveinteresttojointhePartB:Workshop,havetoenrollwithSecretariatofBoardofEducationafterhavingcompletedthe4lectures.

Part B: Workshops

PartB:Workshopsfortheparticipatingdoctorandclinicassistants

Language : Mainly Cantonese (English when required)

Part B - Workshops (3 hours for each workshop)

Workshop 1 : Communication skill for doctors to improve rapport and avoid litigation

Contents : Doctor-patient relationshipandboundaries;Howtodealwithdifficultpatients,heart-sinksyndrome;Managingmedicalmishaps;opendisclosure;Essentialpoints inavoidinglitigation&howtofacelitigation.

Workshop 2 : What clinic assistants (& doctors) should know and avoid in practice management

Contents : Clinicassistants–patient&doctorrelationshipandboundaries.Roleofchaperon;Toassistthedoctor inprovidingmedicalcaretoclinicpatients incommonclinicprocedures;Telephonemanagement;Howtodealwithangrypatients;Howtohandlecomplaints, learning fromcomplaints,complaintsprotocol.

Course Fee : HK$1,200 per person for each workshop (OnlyopentothosewhohavecompletedtheLecturePartwithcertifiedletter)

Award : A letter tocertify theattendanceof theparticipantwillbe issuedbyBoardofEducation,HKCFPforeachworkshop.ThenamesofclinicassistantsattendedcanbeinsertedonrequestforWorkshop2.

Part C: Practice Visit

Course Fee : HK$2,400 for each visit (at least 2 visits – assessment visit and audit visit). Those fail in the audit visit have to undergo the cycle again until passed. (OnlyopentothosewhohavecompletedallLecturesandWorkshops)

Award : Theparticipantdoctorwhohaspassed thePracticeVisitwillbe issuedaCertificateofcompletionoftheTrainingCourseofPracticeManagement,whichisvalidfor3years,byBoardofEducation,HKCFP.

Renewal of the Certificate will be issued only after passing the audit visit again. Those who fail in the audit visit have to undergo the cycle of 2 visits – assessment visit and audit visit again, until passed.

Registration will be first come first served. For registration or any enquiry, please call the College secretariat, Ms Dickie Lam at 2861 0220. All cheques are payable to “HKCFP Education Ltd”. Please mail the cheque to 8/F, Duke of Windsor Social Services Building, 15 Hennessy Road, Wanchai, H.K. All fees received are non-refundable and non-transferable.

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11 July 2010 Sunday

Update Seminar on Cardiovascular Thrombosis Disease

TopicsandSpeakers:

1. From Hypertension to PCI

Dr. Kwok Miu Fong Specialist in Cardiology

2. Anti-platelet Treatment in PCI – Old & New

Dr. Lee Pui YinSpecialist in Cardiology

3. ACS, What We Can Do in the Critical Hours

Dr. Wong Wing KwongSpecialist in Cardiology

4. Updates on Atrial Fibrillation Management

Dr. Chan Ngai YinAssociate Consultant, Princess Margaret Hospital

Chairman Dr. Yeung To LingTheHongKongCollegeofFamilyPhysicians

Time 1:00p.m.–2:00p.m.BuffetLunch2:00p.m.–5:00p.m.Lectures&Discussion

Venue Ballroom,2/F,LanghamHotel,8PekingRoad,Tsimshatsui,Kowloon

AdmissionFee MembersNon–membersHKAMRegistrants

FreeHK$300.00HK$150.00

Allfeesreceivedarenon-refundableandnon-transferable.

Accreditation 3CMEPointsHKCFP(Cat.4.4)3CMEPointsMCHKUpto2CPDPoints(SubjecttosubmissionofsatisfactoryreportofProfessionalDevelopmentLog)

Language LecturewillbeconductedinEnglish.

Registration Registration will be first come first served.Please reserve your seat as soon as possible.

Sponsoredbysanofi-aventis Hong Kong Ltd.

Bristol - Myers Squibb (Pharma) HK Ltd.

ENT Clinical Attachment

TheBoardispleasedtoannouncethattheENTUnitoftheChineseUniversityofHongKongwillorganizeENTClinicalAttachment forCollegemembers.Theaim is toupgradetheirskills inpatientcare.TheProgrammewillbeheldoneveryTuesdayorFridayfrom2:15p.m.-5:15p.m.Thewholeattachmentconsistsof8weekly sessions.Acertificateofattendancewillbe issuedonsatisfactorycompletionoftheattachment.

Registrationisopentoallmembersonafirstcomefirstservedbasis.Thecapacityislimitedtotwomemberspersession.

Venue PrinceofWalesHospital,2/F,ENTCounter,LiKaShingSpecialistClinic,NorthWing,PrinceofWalesHospital

CourseFee HK$2,600

Accreditation Upto15CMEpoints(Category4.8)&5CPDpoints(Category3.16)forthewholeattachment

Registration PleasecontactMsWinnieaLeeat28610220forregistration.

3 July 2010 Saturday

Board of Education Interest Group in Dermatology

Aim Toformaregularplatformforinteractivesharinganddiscussionofinterestingdermatologicalcasescommonlyseeninourdailypractice

Theme Skin Tumours

Speaker Dr. Chan Shu YuSpecialistinDermatology&Venereology

Co-ordinator&Chairman

Dr. Wong Nai MingTheHongKongCollegeofFamilyPhysicians

Time 1:00p.m.–2:15p.m.Lunch2:15p.m.–4:00p.m.ThemePresentation&Discussion

Venue 5/F,DukeofWindsorSocialServiceBuilding,15HennessyRoad,Wanchai,HongKong

AdmissionFee MembersNon–membersHKAMRegistrants

FreeHK$300.00HK$150.00

Allfeesreceivedarenon-refundableandnon-transferable.

Accreditation 2CMEPointsHKCFP(Cat.4.3)2CPDPointsHKCFP(Cat.3.15)2CMEPointsMCHK

Language LecturewillbeconductedinEnglishandCantonese.

Registration Registration will be first come first served.Please reserve your seat as soon as possible.

Note Participants are encouraged to present own cases for discussion.Please forward your cases to the Co-ordinator via the College secretariat 2 weeks prior to meeting.

SponsoredbyGalderma Hong Kong Limited

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Private Video Recording is not allowed. Members, who wish to review the lecture, please contact our secretariat.

Monthly video viewing Sessions –

MonthlyvideoviewingsessionswillbescheduledonthelastFridayofeachmonthat2:30–3:30p.m.at8/F,OldCollegePremises,DukeofWindsorSocialServiceBuilding,15HennessyRoad,Wanchai,HongKong.

June’s session:

Date 25June,2010(Friday)

Time 2:30p.m.-3:30p.m.

Topic Common Urological Symptoms & their Management in Substance Abuser – Professor Ng Chi Fai

Admission FreeforMembers

Accreditation 1CMEPointHKCFP(Cat.4.2)1CMEPointMCHKUpto2CPDPoints(SubjecttosubmissionofsatisfactoryreportofProfessionalDevelopmentLog)

Language LecturewillbeconductedinCantonese.

July’s session:

Date 30July,2010(Friday)

Time 2:30p.m.-3:30p.m.

Topic Skin Diseases of the Hands & Feet – Dr. Lee Tze Yuen

Admission FreeforMembers

Accreditation 1CMEPointHKCFP(Cat.4.2)1CMEPointMCHKUpto2CPDPoints(SubjecttosubmissionofsatisfactoryreportofProfessionalDevelopmentLog)

Language LecturewillbeconductedinCantonese.

Community Education ProgrammesOpenandfreetoallmembersHKCFPCMEpointsaccreditation(Cat5.2)

Date/Time/CME Venue Topic/Speaker/Co-organizer Registration

17 July 2010 (Sat)2:15–3:45p.m.2CMEpoints

LectureTheatre,G/F,BlockF,UnitedChristianHospital,KwunTong,Kowloon

CME Course for Health Personnel 2010 – Management of Breast LumpsDr.ChanWingWaiHongKongMedicalAssociation(KECN)&UnitedChristianHospital

Ms.GaryWongFax:35135548

17 July 2010 (Sat)2:30–4:30p.m.2CMEpoints

TrainingRoomII,1/F,OPDBlock,OurLadyofMaryknollHospital,118ShatinPassRoad,WongTaiSin,Kowloon

Refresher Course for Health care Providers 2009/2010 – Common Problems Managed by PodiatristMs.JaneLeeOurLadyofMaryknollHospital&HongKongMedicalAssociation

Ms.ClaraTsangTel:23542440Fax:23276852

Structured Education ProgrammesFreetomembersHKCFPCMEpointsaccreditation(Cat4.3)

Date/Time/CME Venue Topic/Speaker(s) Registration

15 Jun 10 (Tue)

5:30–8:00p.m.3CMEpoints

AB1028,1/F,MainBlock,TuenMunHospital

Clinic Staff Training and Substance Abuse in AdolescenceDr.KwokVincciandDr.LeeKaiFai

Ms.ChanTel:24686813

17 Jun 10 (Thur)


Room614,AmbulatoryCareCentre,TuenMunHospital

Shoulder PainDr.HoChunYuandDr.SzeLungYam

Ms.ChanTel:24686813


Room041,21/F,PamelaYoudeNethersoleHospital

Guidelines on Handlings of Dangerous DrugsDr.MakWingHang

Ms.KwongTel:25956941

22 Jun 10 (Tue)



How to Improve Appointment and Call Back SystemDr.ChuTsunKit

Ms.ChanTel:24686813

23 Jun 10 (Wed)



Medical InsuranceDr.MokKwanYeung

Ms.ChanTel:24686813

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Multi-mediaConferenceRoom,2/F,BlockS,UnitedChristianHospital

Practical Dietary Management for DM, HT, Obesity and HyperlipidaemiaMs.TinaChan

Ms.CordyWongTel:35133087


LectureTheatre,6/F,TsanYukHospital

Common Symptom Complaint – Fatigue, WeaknessDr.WongSumLok

Ms.ManChanTel:25892337


LiKaShingSpecialistClinic,3/F,SeminarRoom,PrinceofWalesHospital

Individual Patient’s Health Risks-recognition and ManagementDr.ChingKinYu

Ms.PeonyYueTel:26323480

24 Jun 10 (Thur)



Prevention of ObesityDr.SoChiKinandDr.KwokVincci

Ms.ChanTel:24686813

29 Jun 10 (Tue)



Patient EmpowermentDr.ChowChongKwan

Ms.ChanTel:24686813

30 Jun 10 (Wed)



Skin Malignancy and Its Common PitfallDr.SzeSiuLam

Ms.ChanTel:24686813



Impact of the Development of Chinese Medicine to the Health Care SystemDr.YiuKwanandDr.LiMingYin




Mx of Common Urological Problem at Primary Care LevelDr.SimonWong


6 Jul 10 (Tue)



Research in FMDr.HungChiBun

Ms.ChanTel:24686813

7 Jul 10 (Wed)



FM Training in Different CountriesDr.HoTszBun

Ms.ChanTel:24686813



1. Adolescent Psychological ProblemsDr.KwanSzeSing2. Substance Abuse in AdolescenceDr.PatrickCheungandDr.LamWaiChung




EuthanasiaDr.CheungChiHong,David



LiKaShingSpecialistClinic,3/F,SeminarRoom,PrinceofWalesHospital

Care of Patients with Parkinsonism DiseaseDr.YauChiFai

Ms.PeonyYueTel:26323480

8 Jul 10 (Thur)



Health and Illness BehaviourDr.ChowChongKwan

Ms.ChanTel:24686813

13 Jul 10 (Tue)



Difficult ConsultationsDr.ChowChongKwan

Ms.ChanTel:24686813

14 Jul 10 (Wed)



Case Base DiscussionDr.ChanYinHang

Ms.ChanTel:24686813



Common Symptoms in DermatologyDr.YipWingYiandDr.HungWaiShan




How to Help Patient to Quit AlcoholDr.ChowChunWing,Stephen


15 Jul 10 (Thur)



How to Improve Patient Non-ComplianceDr.WongHingLamandDr.LeeKarFai

Ms.ChanTel:24686813

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Red : Education Programmes by Board of Education

Green : Community & Structured Education Programmes

Blue : Clinical Attachment / Certificate Course / ARC

Purple : College Activities

Sunday Monday Tuesday Wednesday Thursday Friday Saturday13 14 15

5:30 – 8:00 p.m.StructuredEducationProgramme

16 17

4:00 – 7:00 p.m.StructuredEducationProgramme9:00 p.m.CouncilMeeting

18 19

2:15 -4:30 p.m.CommunityEducationProgramme2:30 – 4:00 p.m.InterestGroupinNeuro-musculoskeletal

20

2:30 – 5:30 p.m.InfoSeminaronOSCESegment

21 22

1:00 – 3:30 p.m.ARBs–AcrosstheCardiovascularContinuum5:30 – 8:00 p.m.StructuredEducationProgramme9:00 p.m.BoardofDFMMeeting

23


24

4:00 – 6:00 p.mStructuredEducationProgramme9:00 p.m.BoardofConjointExaminationMeeting

25

2:30 – 3:30 p.m.VideoSession9:00 p.m.DFMIntroductionSession

26

2:00 – 3:30 p.m.PracticeManagementTrainingCourse

27 28 29


30


1 2 3

1:00 – 4:00 p.m.InterestGroupinDermatology

4

3:00 p.m.1stExaminerTrainingWorkshopforOSCE2010

5 6


7


8


9 10

2:15 – 5:15 p.m.AssessmentEnhancementCourse

11

1:00 - 5:00 p.m.UpdateSeminaronCardiovascularThrombosisDisease

12 13


14


15

4:00 – 6:00 p.m.StructuredEducationProgramme9:00 p.m. CouncilMeeting

16 17

2:00 – 4:00 p.m.PracticeManagementTrainingCourse2:15 – 4:30 p.m.CommunityEducationProgramme

18 19 20 21 22

9:00 p.m.BoardofConjointExaminationMeeting

23 24

25

2:00 – 4:00 p.m.PracticeManagementTrainingCourse

26 27 28 29 30

2:30 – 3:30 p.m.VideoSession

31

Dr.AlvinChanDr.EdmondChanDr.ChanManLiDr.ChanTingBongDr.JudyChengDr.AnitaFanDr.FungHoiTik,HeidiDr.KennyKungDr.AlfredKwongDr.DorothyLawDr.MariaLeungDr.NgaiKaHoDr.SinMingChuenProf.MartinWongDr.WongYuFaiDr.YipChunKong,Sam

Chief Editor :

Dr.WendyTsui

Deputy Editor

Dr.CatherineNg

Deputy Editor :

Dr.NatalieYuen

Editorial Board Members :

Section Coordinator (Oasis)

Section Coordinator (Feature/ Trainee Column)

Section Coordinator (After Hours)

Section Coordinator (WONCA Express)

Section Coordinator (Photo Gallery)

Section Coordinator (News Corner)

FP LINKS EDITORIAL BOARD 2010

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THE HONG KONG COLLEGE OF FAMILY PHYSICIANS Family Physicians Links · 2015-10-02 · 1 Message from the President THE HONG KONG COLLEGE OF FAMILY PHYSICIANS Family Physicians Links