Interview by Yuki Lei
During a plenary session of the Legislative Assembly (AL) on Friday, Health Bureau (SSM) Director Alvis Lo Iek Long said he expects medical graduates to face employment pressure in the next three years – in response to which a medical graduate admitted in an interview with the Post yesterday, “I feel that the reward for my hard efforts is not proportional”, while lawmaker-cum-physician Chan Iek Lap pointed out that the government’s free healthcare policy has also made it difficult for private clinics and hospitals to recruit and retain doctors and nurses.
During Friday’s Legislative Assembly plenary session, Dr Lo said that he expects over 600 medical graduates each year from 2025 to 2027 across 15 healthcare professions, including 150 medical graduates and 230 nurses annually. He added that, given the current growth in healthcare demand, the supply “doesn’t seem capable of absorbing the large demand for doctors”.
Fierce competition for medical posts
To pursue her dream of becoming a doctor, Chan, a local woman, like all medical graduates, stood out among numerous competitors six years ago and successfully enrolled in Sun Yat-sen University in Guangzhou to study clinical medicine. Little did she know, this would only be the beginning of a long journey filled with internships and examinations before she could be qualified to practise.
As a medical graduate last year, Chan acknowledged that the pressure to find employment has always been significant, primarily due to the increasing number of graduates. She said: “More and more of them are piling up every year, especially since the COVID-19 pandemic of the past few years when vacancies have not been opening up. Now, a new group of entrants has to compete with those already in the field, but the number of available jobs is very limited”. However, she was quick to add that there was a need for human resources within local hospitals. Currently working as an intern at a local hospital, Chan said: “…Staff often need to schedule their shifts, doctors in the inpatient department have to take turns supporting the emergency services, and they must work extra shifts at weekends”.
Facing the saturation of the medical profession in Macau, as she sees it, Chan pointed out that this was not only happening at the public Conde de São Januário Hospital Centre, but also at the private Kiang Wu Hospital: “Many general practitioners are actually waiting for the opportunity of specialist training. However, due to the restrictions of the local Health Professionals Council’s specialist training programme, many graduates can only take up positions as general practitioners (GPs), resulting in fierce competition for positions, but the hospitals remain short-staffed, and there’s even a succession gap in human resources”.
Expressing her “disquiet” about employment difficulties and the development of “big health”, Chan noted that the implementation of the new system has intensified competition between existing doctors and new recruits. Additionally, she said, the sudden changes in the development of a new industry (big health) had not allowed enough time for local professionals to advance, with the government prioritising the acquisition of non-local talents, which, she argued, further reduced employment opportunities for locals: “Rather, it is the lack of corresponding developmental foundations that affects the career direction of each individual in such an environment”.
Lawmaker calls for ‘good breeding ground’ for medical graduates
Speaking to the Post yesterday morning at his office in Zape, Dr Chan said that the specific conditions of the medical profession make it difficult for doctors and nurses to switch to other professions, resulting in relatively limited employment options, especially in a small city like Macau. He said: “For the past seven and eight years, more and more [medical] graduates have been returning [to work in Macau], but it has become increasingly difficult for them to enter the field…One graduate I know even switched to working as a food delivery rider”.
Dr Chan pointed out that tackling the surplus of medical graduates in Macau requires a larger healthcare base. However, he added, unlike Hong Kong’s population of seven million, Macau’s limited patient pool restricts the demand for more doctors: “Historically, 40 years ago, the first group of doctors who returned to Macau faced fewer challenges.”
Citing SSM Deputy Director Kuok Cheong U, who has told reporters recently that the government will not recruit a large number of doctors due to quota constraints, Dr Chan pointed out that local staffing levels are primarily based on retirements and resignations, making it very challenging to bring in new recruits: “A doctor might work for 30 to 40 years, leaving little room for advancement for newcomers”.
He emphasised the collaborative efforts of the community to create a favourable environment for young people to fully realise their talents in healthcare professions: “How can we, through the efforts of all parties, endeavour to provide these medical graduates with a good breeding ground so that they can join local healthcare-related professions and explore their own talents?”
Dr Chan underlined that he was not asking the government to absorb all young people into public or private hospitals, but instead to provide a favourable environment, pointing out that while the government’s free healthcare policy was particularly important during the pandemic, it has also further affected the viability of the private healthcare sector: “Nowadays, people are accustomed to free healthcare, leading to a misconception that seeing a doctor costs nothing, which affects their choices”. For private medical institutions, the government’s support for healthcare organisations was insufficient and their development was similarly constrained, he said, suggesting that the government allocate part of the resources for healthcare services to private clinics to facilitate the balanced development of public and private healthcare services.
In response to criticisms regarding the presence of a large number of non-local doctors in Macau, Dr Chan said that these doctors are specialists and “should not be too competitive vis-à-vis the young local doctors nowadays”. He pointed out that the complexity of Macau’s laws and regulations restricts the development of local doctors: “In Macau, doctors must complete one year’s internship and pass examinations before qualifying to practise, and then face competition for admission as specialists, which makes the training process even harder and more time-consuming”. He again called on the government to shorten the training period for specialists.
Lawmaker-cum-doctor Chan Iek Lap poses after yesterday’s interview with the Post at his office in the Macau Chamber of Commerce (ACM) Building in Zape. – Photo: Yuki Lei
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