I.1Introduction

The six-year Vocational Training Programme in Family Medicine of the Hong Kong College of Family Physicians (hereafter referred to as the Programme) began in January 1995. It consists of 4 years of Basic training and 2 years of Higher training. The aim of the Programme is to prepare doctors to provide high-quality specialist care to the community as a family physician.

1. Basic Training (four years)
   
   A minimum period of four years is considered necessary for the basic training in Family Medicine because this discipline has a broad knowledge and skill base. It also requires extensive clinical exposure in order to develop the necessary attitudes appropriate for a primary care physician. Two of the four years are hospital based and two years community based. The hospital and community based basic training can be done in any order.

2. The Conjoint H.K.C.F.P./R.A.C.G.P. Fellowship Examination
   
   The written segments of the Conjoint H.K.C.F.P./R.A.C.G.P. Fellowship Examination can be taken after satisfactory completion of at least two years of basic training. The clinical segments can be taken on satisfactory completion of four years of basic training.

3. Higher Training (two years)
   
   The higher training consists of at least two years of supervised independent practice.

   Each trainee will be supervised by a clinical supervisor in Family Medicine throughout the two years of training. The clinical supervisor and trainee do not need to work in the same practice. There will be regular contacts between the clinical supervisor and the trainee to provide training and advice on patient care, practice management and professional development.

4. Documentation of Training
   
   The trainee has to keep a detail training logbook which records all his/her training postings, work experience, training activities with clinical supervisors, structured educational programmes attended, certified check-lists of knowledge and skills, learning portfolio and other educational activities. The learning portfolio should consist of six-monthly learning plans and learning activities. The training logbook is reviewed by the clinical supervisors and mentors periodically. Formative assessment and feedback on the training between the trainee and his/her clinical supervisor should be recorded in the training logbook. The training logbook or the checklist of training endorsed by the clinical supervisors has to be submitted to the Board of Vocational Training and Standards for assessment annually and at the end of Basic and Higher Training.

I.2Enrolment to Training

1. An intending trainee must be a fully registered medical practitioner in Hong Kong.

2. An intending trainee must be a current full or associate member of the Hong Kong College of Family Physicians.

3. A trainee must have completed 4 years of Basic Training or equivalent and has a recognised higher qualification in Family Medicine before enrolling into Higher Training.

4. An intending trainee must apply to the College for enrolment to the Programme and pay the prescribed fee to the College.

5. The application for enrolment into training has to be supported by a clinical supervisor of the Programme. The intending trainee has to be working in an accredited training centre to enroll into Basic training.

6. Credits may be given to previous relevant experience at the discretion of the Board of Vocational Training and Standards.

I.3 Certification of Completion of Training

The trainee needs to apply in writing to the Board of Vocational Training and Standards for certification of completion of training. The application must be accompanied by all the supporting documents. All the following criteria must be satisfied before the trainee can be certified for completion of training in Family Medicine:

1. Satisfactory completion of Basic Training:-
   1. A minimum period of two years (or equivalent) of accredited hospital based training.
   2. A minimum period of two years (or equivalent) of accredited community based training.
   3. Certification of acquisition of all the basic knowledge and skills listed in the Basic Training Logbook by the responsible clinical supervisors.
   4. Regular attendance at an approved structured educational programme.
   5. Satisfactory evaluations by the clinical supervisors.

   6. Completion of all the relevant sections in the Training Logbook.

2. Satisfactory completion of Higher Training:-
   1. A minimum of two years of community based higher training under regular supervision of a clinical supervisor and a mentor in family medicine.
   2. Certification of acquisition of all the knowledge and skills listed in the Higher Training Logbook by the responsible clinical supervisors.
   3. Regular attendance at an approved structured educational programme.
   4. Completion of the relevant sections in the Training Logbook.

   5. Satisfactory evaluations by the clinical supervisor.

3. Recommendation by the Board of Vocational Training and Standards and approval by Council of the Hong Kong College of Family Physicians.

I.4Accreditation of Training Centres

A. Community Based Training Centres

A community based medical practice may apply to the Board of Vocational Training and Standards for accreditation as a training practice of the Programme if it satisfies all the following criteria:-

1. An application is submitted to the Board of Vocational Training and Standards by a senior member of the practice.

2. The practice must be providing community based health care services. The workload must be sufficient but not excessive to provide the trainee with a balance between range of clinical experiences and protected time for education.

3. The Center must provide a structural training programme that meets all the requirements and standards for the relevant specialty as determined by the Board of Vocational Training and Standards.

4. The practice as a whole should agree to have a trainee working in the practice under the conditions required by the Programme.

5. The practice must have the necessary facilities and opportunities for training. Adequate patient records must be kept.

6. The practice should have a collection of up-to-date and relevant reference books and journals.

7. At least one senior member of the practice is qualified and appointed as clinical supervisor in the relevant specialty and committed to provide training to trainees in Family Medicine.

8. A separate consultation room must be available for the trainee in the same practice as the clinical supervisor.

9. Recommendation by two or more members of the Board of Vocational Training and Standards after an assessment visit to the practice.

10. The practice agrees to periodic, at minimum once every five years, re-assessment visits by one member authorized by the Board of Vocational Training and Standards.

11. Each training centre must submit to the Board of Vocational Training and Standards updated lists of its clinical supervisors and trainees annually.

A hospital or hospital unit may apply to the Board of Vocational Training and Standards for accreditation as a Hospital Based Training center in the Programme if it satisfies the following criteria:-

1. An application is submitted to the Board of Vocational Training and Standards by a co-ordinator of training in the hospital or hospital unit.

2. It must have the necessary facilities and opportunities for training.

3. It agrees to comply with all the training requirements of the Programme.

4. At least one senior member, with the necessary qualifications of each of the Specialty units to be accredited, is committed to provide training to trainees in Family Medicine.

5. Recommendation by two or more members of the Board of Vocational Training and Standards after an assessment visit.

6. It agrees to periodic, at minimum once every five years, re-assessment visits by one member authorized by the Board of Vocational Training and Standards.

7. The center should have a collection of up-to-date and relevant reference books and journals.

8. Each training centre must submit to the Board of Vocational Training and Standards an updated list of its clinical supervisors and trainees annually.

Accreditation may be withdrawn from any centre by the Board of Vocational Training and Standards if the Board is of the opinion that the centre has not fulfilled any of the criteria. List of accredited hospital units, and training family practices of the Programme is updated annually. Current updated list of training centres can be obtained from the College Secretariat.

I.5Appointment of clinical supervisors

A. Appointment Criteria

A potential training supervisor may apply to the Board of Vocational Training and Standards (BVTS) for appointment as a training Clinical Supervisor in the relevant specialty if he/she:-

1. possesses one or more higher qualifications in the relevant specialty that is/are approved by the HKCFP.

2. is a Fellow of the Hong Kong Academy of Medicine or a specialist registered with the Medical Council of Hong Kong and has a minimum of 2 years local experience in the relevant specialty within 5 years immediately prior to his/her appointment.

3. is willing to fulfill the roles of a clinical supervisor as required by the Board of Vocational Training and Standards.

B. Responsibilities and Roles of Clinical Supervisors

The clinical supervisor:

1. helps the trainee to acquire the knowledge and skills required by the Programme.

2. closely supervises the trainee's daily work.

3. devotes the equivalent of no less than 3 hours a week in educational activities for basic trainee(s) under his/her supervision.

4. is responsible for certifying whether the trainee has acquired the knowledge and skills required by the Programme by completing the appropriate checklists in the Training Logbook.

5. visits and assesses the trainee's practice at least once every six months during Higher Training.

6. assesses the trainee's performance in consultations regularly, by sit-in consultations or review of video-taped consultations.

7. ensures that the trainee is participating in an approved structural educational programme.

8. submits a formative assessment report on the performance of the trainee to the Board of Vocational Training and Standards at the end of each hospital based rotation or annually for community based training.

9. is prepared to participate in Trainer Training activities.

10. is expected to attend training information session upon his/her appointment.

I.6Election to Fellowship and Membership of the Hong Kong Academy of Medicine

A. Fellowship of the Hong Kong Academy of Medicine

A candidate may be nominated by the Council of the Hong Kong College of Family Physicians for election to Fellowship of the Academy of Medicine (Family Medicine) if he/she:-

1. has been certified to have completed the six-year Vocational Training Programme in Family Medicine by the Hong Kong College of Family Physicians.

2. has passed the intermediate examination (Conjoint HKCFP/RACGP Fellowship Examination) and the Exit Examination of the HKCFP.

3. is an active Fellow or Member of the Hong Kong College of Family Physicians.

4. is willing to uphold the aims and objectives of the Hong Kong College of Family Physicians.

5. is willing to uphold the aims and objectives of the Hong Kong Academy of Medicine.

6. is recommended by members of the Council of the Hong Kong College of Family Physicians.

B. Membership of the Hong Kong Academy of Medicine

A candidate may be nominated to be a member of the Hong Kong Academy of Medicine (Family Medicine) if he/she:-

1. is a trainee in the Vocational Training Programme in Family Medicine.

2. has completed at least three years of vocational training in Family Medicine.

3. has passed the written part of the Conjoint H.K.C.F.P./R.A.C.G.P. Fellowship Examination.

4. is willing to uphold the aims and objectives of the Hong Kong College of Family Physicians.

5. is willing to uphold the aims and objectives of the Hong Kong Academy of Medicine.

6. is recommended by members of the Council of the Hong Kong College of Family Physicians.