Newsletter December 1998

Contents

The President’s Message
Statement on Use of Unlabelled Drugs
Report from Education Committee
Report from Board of Censors
Examination Dates
New College Chamber
Approved Training Posts
Examination Successes
New Fellows and Members
Hospital News & Announcements
ASM in Anaesthesiology 98?
10th Anniversary?
Hospice Conference 99

A few major events have happened in the last few months. The Inaugural Examination for Diploma in Pain Management was held in October. Prof. M. Stanton-Hicks, a world-renowned expert in Pain Medicine and the Director of Pain Management at Cleveland Clinic was invited as our External Examiner. Three candidates sat and passed the Examination. Running a training and examination programme in Pain Management was a decisive move for the College. At present, not too many Anaesthesia Colleges around the world offers similar programmes, and even fewer of them requires an examination for awarding the diploma. This is a good starting point for our College to promote the standard and practice of Pain Medicine in Hong Kong. Prof. Stanton-Hicks gave a plenary lecture at the First International Congress of the Hong Kong Academy of Medicine entitled " Pain Free State: Is It Possible?". An entire symposium was also dedicated to Pain Management at the Congress. I am sure these would have increased the awareness for better management of pain in Hong Kong.

Those who attended the last Annual Scientific Meeting held in early December would surely agree with me that it was very successful. The Free Paper Session was most welcome. It served as a good channel for our colleagues to share their interests and research results. To further promote interests in research, College has set up a yearly Best Paper Prize for trainees. The anaesthesia simulator workshops and the TEE workshops have also been well received. On behalf of College, I would like to thank Dr. K F. Ng and his Organising Committee for their dedicated work in putting up such a successful meeting. The next Annual Scientific Meeting, which would be held in November 1999, will be even more exciting because this would form part of the celebration activities of the 10^th Anniversary of our College. Dr. John Liu has been appointed Chairman of the 10^th Anniversary Celebration Committee and he will work closely with Dr. P.P. Chen, Chairman of the ASM Organising Committee for the occasion. Presidents of overseas Colleges would be invited and a public exhibition on anaesthesia is being planned.

With the completion of the Headquarter Building of Academy of Medicine at Wong Chuk Hang Road, our College has moved into our permanent office at the Building. After years of discussion working out the financial implications, we have appointed an Administrative Assistant, Mr. Daniel Tso to man the College Chamber. This is another major developmental milestone for our College. The official address for our College has been changed to our new address at the Academy Building and enquiries from fellows or trainees can be directed initially to this Office.

The issue on "Unlabelled Use of Drugs in Anaesthesia" has aroused some concern recently when one of the manufacturers of preservative free morphine removed epidural administration from their list of indications. College Council debated heatedly on this issue and decided to look at it at a broader perspective instead of just focussing on epidural use of morphine. The un-labelled, off-labelled or un-licensed use of drugs refers to the prescription or administration of drugs for conditions that are not included on the list of indications in the package insert. Such use is not restricted to anaesthesia as it occurs in paediatrics and other disciplines as well. It reflects the failure of the package insert to reflect current clinical practice based on sound scientific evidence. When drugs are marketed, they have to fulfill a list of stringent requirements laid down by individual drug licensing authorities. The approved indications listed on the package insert are those who have met all these requirements. For a new indication to be approved on the drug insert after marketing, vigorous scientific data has to be submitted again to the licensing authorities. This is not always done as it involves time and resources. College Council felt that some kind of guidance on unlabelled use of drugs in anaesthesiology practice is necessary but even a very detailed guideline cannot spell out all the scenarios. After drawing reference from statements made by FDA and other professional organisations, College produced a "Statement on Unlabelled Use of Drugs in anaesthesia". Essentially such unlabelled use of drugs would be considered appropriate when it is based on adequate scientific data. The statement is published in this issue of the Newsletter.

Next year will be the election year for the College Council. All Officers and Council Members will retire and be eligible for renomination and re-election. Notices for open nomination will be sent out shortly. The future of the College is in your hands. I would encourage all of you to give it some thought and join the nomination exercise. College needs the support of all of you. Lastly, on behalf of the College, I would like to wish all of you a Merry Christmas, Happy New Year and a prosperous 1999.

Dr. CT Hung
President
December 1998

Statement on Unlabelled Use of Drugs in anaesthesia

 The term "un-labelled, off-labelled or un-licensed use of drugs" refers to the prescription or administration of drugs for conditions that are not included on the list of indications in the package insert. Medical practice often involves the rational use of approved drugs that is not listed in the package insert. Very often, such drug practices have been extensively studied and reported in medical literature. The decision for the unlabelled use of drugs must be based on adequate scientific data. The individual anaesthesiologist should understand the implications of such use. Only under these circumstances, the use of drugs for the unlabelled conditions can be considered appropriate.

Trainee Logbooks

At the recently held exit assessment, it was realised that some trainees are not making use of their logbooks efficiently. Logbooks do enable the Assessors to review the trainees' experience. However, it is also meant for the trainees and supervisors of training to review the trainees' exposure to different types of cases. This would enable deficiencies to be rectified promptly during the training period.

Requirement to be in training posts for additional training for admission to Fellowship ad eundem:

Some potential applicants for fellowship ad eundem, who has a recognised higher qualification, may require additional training to make up for the difference from the HKAM requirement of six years training. Please be reminded that as from January 1999, they will have to be in training posts for the time to be recognized. The limit of time allowed in Category A or B hospital need not be applied.

CME Record

30th June, 1998 was the end of the second year of the first three year CME cycle for Fellows admitted before 1st July, 1996. It was the end of the first year for Fellows admitted between 1st January, 1997 and 30th June, 1997. Fellows who have not sent in their CME record please do so as soon as possible. The Academy requires a report to be submitted. They will issue a reminder to Fellows who have less than 40 points during their first two years so that there is time for them to catch up the total of 90 points in three years.

For Fellows admitted between 1st July, 1996 and 31st December, 1996 and those admitted between 1st July, 1997 and 31st December, 1997, the second and first of your first CME cycle will be complete on 31st December, 1998. Please submit your CME record to the College.

Special Interest Group in Pain Management

The special interest group in pain management holds quarterly presentations. Each hospital that has a pain service takes turn to present. Four meetings have been held. The next meeting will be in March. Arrangement is being made for a neurologist from London to address the group together with a presentation by Pamela Youde Nethersole Eastern Hospital.

General Notes

All applications for HKCA Membership, Fellowship, Diploma in Pain Management or registration as Vocational Trainee and request for nomination to the Hong Kong Academy of Medicine shall be made to the Hong Kong College of Anaesthesiologists using the appropriate Application Forms. This Forms are available upon request to the HK College of Anaesthesiologists, through written letter to Room 807, Hong Kong Academy of Medicine Building, 99 Wong Chuk Hang Road, Aberdeen, Hong Kong, telephone call at (852) 2871 8833, fax at (852) 2814 1029 or email (www.hkca@edu.hk).

For HKCA Membership application, please use Form M.

For HKCA Vocational Training registration, please use the Registration Form for Vocational Training.

Note: only HKCA Members are eligible for registration as HKCA Vocational Trainee. However, an applicant can apply for HKCA Membership and Registration for Vocational Training simultaneously.

All applications are to be sent to the Hong Kong College of Anaesthesiologists at Room 807, The Hong Kong Academy of Medicine Building, 99 Wong Chuk Hang Road, Aberdeen, Hong Kong.

When such an application is received, the Administrative Assistant of the College will send a reply to acknowledge receipt of the application and perform an initial checking of the following documents:

1. Application Form M which is properly filled in and signed by the applicant and two Fellows of HKCA.

2. The Registration form for Vocational Training which is properly filled in and signed by the applicant as well as countersigned by the chief of services of the parent hospital concerned.

3. Certified photocopy of the applicant's primary medical qualification (e.g. MBBS, MBChB, LMCHK or other qualifications).

4. Certified photocopy of the applicant's license to practice medicine in Hong Kong.

5. Any supporting document as necessary.

After initial checking of the complete set of application forms and supporting documents, the Administrative Assistant will forward the applications to the Chairman of the Board of Censors for assessment, usually about ten days before the next Council Meeting. The Board will assess all applications collectively at monthly intervals. The Chairman (or the Hon Secretary of the Board in case the Chairman is not in town) will then circulate the photocopies of the Form M to all the Members of the Board of Censors for their comments. After receiving feedback from the Censors, the Chairman will make a recommendation to the Council.

After discussion at Council meeting, the following procedures will be carried out depending on the Council's decision:

1. Those applicants who are accepted as HKCA Members will be officially informed and debit notes for their membership fee will then be sent as well.

2. For those successful applicants who also apply for registration as HKCA Vocational Trainee, their registration forms will be forwarded to the Training Officer for processing.

3. For those applicants who are rejected, a letter of rejection will be sent stating the reason(s) of rejection.

For FHKCA (Anaesthesiology) application, please use Form F.

For FHKCA (Intensive Care) application, please use Form IC.

For Diploma in Pain Management (DPM) application, please use Form P.

For Nomination to FHKAM (Anaesthesiology), please use HKAM Nomination for Fellowship Form.

Note: only HKCA Members are eligible for FHKCA application. However, an applicant can apply for HKCA Membership and Fellowship as well as requesting for Nomination to FHKAM simultaneously.

All applications are to be sent to the Hong Kong College of Anaesthesiologists at Room 807, The Hong Kong Academy of Medicine Building, 99 Wong Chuk Hang Road, Aberdeen, Hong Kong.

When such an application is received, the Administrative Assistant of the College will send a reply to acknowledge receipt of the application and perform initial checking of the documents as listed:

Application form(s) which are properly filled in and signed by the applicant with the supporting signatures of two Fellows of HKCA. For those who request for FHKAM nomination, their consent for nomination (should their fellowship application is successful) is also signed.

HKAM Nomination for Fellowship Form (if requesting for nomination) which is properly filled in.

Certified photocopy of the applicant's primary medical qualification (e.g. MBBS, MBChB, LMCHK or other primary medical qualification).

Certified photocopy of the applicant's license to practice medicine in HK.

Certified photocopy of the applicant's higher medical qualification(s)

Supporting documents such as appointment letter, curriculum vitae (CV) with details of training and appointment(s).

After initial checking of the complete set of application forms and supporting documents, the HKCA Administrative Assistant will forward the applications to the Chairman of the Board of Censors for assessment, usually about ten days before the next Council Meeting. All applications are to be assessed by the Board collectively at monthly intervals. The Chairman or the Honorary Secretary of the Board (in case the Chairman is not in town) will then circulate the photocopies of the Application Form to all the Members of the Board of Censors for their comment. After receiving feedback from the Censors, the Chairman will construct a list of candidates who are eligible to attend the Exit Assessment interview. The Exit Assessment Panel, which is appointed by the Council, will then conduct the assessment and interview.

1. HKCA Administrative Assistant will notify the candidates to attend the next Exit Assessment. They are requested to bring along true copies of the following document for checking of authenticity:

1.1. Primary Medical Qualification(s).

1.2. License to practice medicine in HK.

1.3. Higher Medical Qualification(s) or in the case of HKCA Vocational Trainee who passed Final FHKCA Examination the letter informing them of passing the Examination from the College.

1.4. Supporting document for any clinical appointments they claimed in Form F

1.5. Training record(s):

1.5.1. In case of HKCA registered trainees, original copies of their log book, which is counter signed by the supervisor of training is required for inspection at the interview.

1.5.2. In case of applicants trained overseas, details of their training including appointment dates, whether the post is a recognized g post of an overseas anaesthesiologists college and other relevant details are to be submitted for assessment at the interview.

1.6. The applicant's Formal Project (of HKCA Vocational Trainee) or equivalent (overseas trainee) is to be submitted for inspection during the interview. Formal project is not required for FHKCA (IC) application.

2. Exit Assessment Fee shall be submitted at the interview:

2.1. Those applicants who are eligible for the Exit Assessment interview are subject to a charge of HK$ 5,000.00 (crossed cheque made payable to the Hong Kong College of anaesthesiologists).

2.2. Those applicants who had presented for or passed the Final FHKCA Examination are exempted from this payment.

After the Exit Assessment, the Panel will make recommendations to the Council.

After discussion at the Council meeting, the followings will be carried out according to Council's decision.

1. Those accepted as Fellows of the HKCA will then be officially informed and debit notes for their fellowship fee will be enclosed as well.

2. For those successful applicants who also request for nomination to FHKAM(Anaes):

2.1. The Chief Censor will sign at the HKAM Nomination Form for Fellowship to support the applicant's nomination to the Academy.

2.2. The nominee is requested to send a crossed cheque, made payable to the Hong Kong Academy of Medicine (of an amount as determined by the HKAM), to the HKCA Administrative Assistant.

2.3. The completed nomination form, supporting documents (certified true copies of the applicant's primary and higher medical qualifications) and payment shall then be sent to the Academy.

3.     For those applicants whose application is not successful, the College will notify them with a letter stating the reason(s) of rejection.

4. Any applicant who disagrees with the College's decision can make an appeal to the Council. The HKCA Appeal Committee will deal with all appeals accordingly.

For any queries, please don't hesitate to call the HKCA Administrative Assistant at (852) 28718833.

1.1. All applications should be sent to Hong Kong College of Anaesthesiologists at Room 807, the Hong Kong Academy of Medicine Building, 99 Wong Chuk Hang Road, Aberdeen, Hong Kong. Application Forms are available upon request at HKCA. For any queries, please call at HKCA office during office hour by telephone at (852) 28718833 or by fax at (852) 28141029.

1.2. Please always use BLOCK LETTERS to fill-in the application forms.

1.3. All FHKCA applications are subjected to an initial vetting for the eligibility to undergo Exit Assessment. Eligible applicants will then be invited to an interview with the College's Exit Assessment Panel. A charge of HK$ 5000.00 is required for those who are invited for the interview. All applicants who had presented for or passed the Final FHKCA Examination will be exempted from such charge.

2.1. Please use Form M for application.

2.2. Properly fill-in all the appropriate columns of the application form.

2.3. Obtain signatures from two Fellows of HKCA to support your application.

2.4. Attach a recent photograph on the space as indicated on the Form.

2.5. Remember to sign the application form before submission.

2.6. Enclose the following certified copies of supporting documents:

2.6.1. Primary Medical Qualification.

2.6.2. License to practice medicine in Hong Kong.

2.6.3. Letter of appointment to the current employment.

2.7. The Registration for Vocational Training can be submitted together with your membership application.

3. FHKCA(Anaesthesiology), FHKCA(Intensive Care) or Diploma in Pain Management (DPM) Applications

3.1. Only Members of HKCA can apply for Fellowship. Only Fellows of HKCA can apply for DPM.

3.2. Please use the appropriate Application Forms:

3.2.1. For FHKCA (Anaesthesiology), please use Form F.

3.2.2. For FHKCA (Intensive Care), please use Form IC.

3.2.3. For DPM application, please use Form P.

3.3. Properly fill-in all the appropriate columns of the application form, especially listing the details of current and previous training and appointments.

3.4. Obtain signatures from two Fellows of HKCA to support your application.

3.5. Attach a recent photograph on the space as indicated on the Application Form.

3.6. Remember to sign the application form before submission.

3.7. Enclose the following certified copies of supporting documents

3.7.1. Primary Medical Qualification.

3.7.2. License to practice medicine in Hong Kong.

3.7.3. Higher Medical Qualification(s) or letter of passing the Final FHKCA Examination.

3.7.4. Letter of appointment to the current employment.

3.7.5. Any supporting document as appropriates.

3.7.6. Formal Project or equivalent. FHKCA(IC) applicants are exempted from this requirement.

3.7.7. Log book or other records of training.

3.8. Your Curriculum Vitae with detailed information on clinical appointments and training.

3.9. Sign the consent on nomination to FHKAM at the bottom of the Application Form if you wish the College to nominate you to FHKAM(Anaes), should your FHKCA application is successful.

4. Nomination to Fellowship of the Hung Kong Academy of Medicine (Anaesthesiology)

4.1. Only Fellows of HKCA can request for Nomination to (Anaes)

4.2. Please use the 's Nomination Form for Fellowship.

4.3. Properly fill-in all the appropriate columns of the application form especially the details of current and of previous training and appointments.

4.4. Enclose the following certified copies of supporting document, this separate set of document (in addition to those listed in clause 3.7) will be submitted for the Academy's use.

4.4.1. Primary Medical Qualification (e.g. MBBS, MBChB, LMCHK or other qualification).

4.4.2. Higher Medical Qualification(s) or letter of passing the Final FHKCA Examination.

Note: Only Members of HKCA can apply for Fellowship and only FHKCA can apply for Nomination to FHKAM(Anaes). However, in order to avoid unnecessary delay, one can send in the applications for Membership, Fellowship and Nomination to FHKAM(Anaes) simultaneously.

Fellowship Examinations 1999

RELOCATION NOTICE

The Hong Kong College of Anaesthesiologists College Chamber has moved to : Room 807, The Hong Kong Academy of Medicine Building, 99 Wong Chuk Hang Road, Aberdeen, Hong Kong.

Any business related to the Hong Kong College of Anaesthesiologists, please contact our Administrative Assistant - Mr. Daniel Tso at :

Telephone Number - 2871 8833
Fax Number - 2814 1029
E-Mail Address office@hkca.edu.hk

List of Approved Training Posts

Dr. Leung, CC (QMH)
Dr. Wong, Cynthia (QMH)
Dr Chan, Simon (QEH)

The external examiner was Prof. M. Stanton-Hicks

CONGRETULATIONS!!

********************************

24 September 1998

Members

Dr LIM, Hwee Hwee
Dr LEE, Kam Suen Anna
Dr CHAN, Lina
Dr SUN, Chi Hong Nicholas
Dr LAM, Cheung Kwan Brain
Dr SIN, Lok Man, Raymond
Dr NG, Tse Choi

19 October 1998

Members

Dr LIM, Boon Kian
Dr CHAN, Hing Tsuen

16 November 1998

Members

Dr CHAN, Siu Man Simon
Dr CHENG, Chun Pong Benny
Dr MAN, Kwan Yin
Dr LEE, Hon Ming

Fellows in Anaesthesiology by examination

Dr JAN, Siu Kei Gordan
Dr CHOW, Yiu Tong
Dr SOON, Tak Che Nora

Fellow in Intensive Care ad eundem

Dr YAP, Hiu Yi Florence

Members

Dr FONG, Cheuk Ying Cherry
Dr UNG, Sze Man Eric
Dr GREER, Anne Elizabeth

ANNUAL SCIENTIFIC MEETING IN ANAESTHESIOLOGY 1998

Jointly organised by SAHK and HKCA

"Technology and Anaesthesia"

on 5-6 December 1998

at Royal Plaza Hotel, Prince Edward Road West, Hong Kong

ASIA PACIFIC HOSPICE CONFERENCE 1999