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Message from the PresidentIssue 90August 2011
1
THE HONG KONG COLLEGE OF FAMILY PHYSICIANS
Family Physicians Links
INSIDE THIS ISSUE
01 MessagefromthePresident
02 CollegeNews:
02 ConfermentCeremony201103 CMOD,BoardofVocationalTrainingandStandardsNews,
ClassifiedAdvertisements04 ConjointExaminationNews
05FPLinks–LogoCompetition06 BoardofDiplomainFamilyMedicine–Lectures
0718thHongKongInternationalCancerCongress
08Feature:InterviewwithProfessorGabrielLeung,JP,UndersecretaryforFoodandHealth,onPrimaryCareDevelopmentinHongKong
10 Oasis:HappinessisaJourney
11 NewsCorner:ScreeningofOvarianCancer/BeneficialEffectofSmokingCessationonOperativeOutcomes
12 LearningPointsfromBoardofEducation
13 BoardofEducationNews
16 CollegeCalendar
OnJuly21,2011,Iattendedthe45thAnnualSingapore Malaysia Congress MedicineInductionComitia&CongressOpeningas one of the Hong Kong Academy ofMedicine (HKAM)delegates.Dr. theHon.YorkChow,GBS,JP,ourSecretaryforFoodandHealth,wasconferred theHonoraryFellowshipof theAcademyofMedicine,Singapore (AMS).Dr.Chowalsodeliveredthe20thGordonArthurRansomeOration“BridgesandGapsinHealthcare”.OnJuly22,2011,theHKAMdelegatesattendedtheJointCouncilMeetingofAMS,AcademyofMedicineofMalaysia(AMM)andHKAMtoshareexperienceonourpostgraduatespecialisttrainingandcontinuousprofessionaldevelopmentprograms.
AMS, similar toHKAM, isaprofessionalinstitutionofmedicalanddentalspecialistsforpostgraduate specialist trainingandcontinuous professional development.TheAcademyhasCollegesandChaptersofAnaesthesiologists,DentalSurgeons,EmergencyPhysicians,ObstetriciansandGynaecologists, Paediatrics and ChildHealth,Physicians,Radiologists,Surgeons(including Orthopaedic Surgeons and
Otorhinolaryngologists),Ophthalmologists,Pathologists,PublicHealthandOccupationalPhysicians,andPsychiatrists.However, theCollegeofFamilyPhysicians isaseparateinstitution.FamilyMedicine isneitheroneofthe39specialtiesnorsub-specialtiesofAMS.This isalsosimilar toAMM.WeareindeedfortunateinHongKongtobeoneoftheconstituentCollegesofHKAM,withourspecialskills inholisticcarerecognizedbyourotherspecialistcolleagues.Weshouldthereforealwaysremindourselvestodeliverthehighestpossiblestandardsofcaretoourcommunity.
Dr. the Hon. York Chow and HKAM delegates
Group photo with HKAM delegates
Presidents of Fraternal Colleges at AMS Induction Comitia
2
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S Conferment Ceremony 2011
By Dr. Chiu Chi Fai, BillyChairman, Internal Affairs Committee
Successful Candidates in the Exit Examination
Successful Candidates in the Conjoint Examination
Successful Candidates in DFM
Thisyear therewere thirtycandidatesconferred theFellowshipofHKCFPandtwenty-sixcandidatesconferredtheFellowshipofRACGP.Onbehalfof theCollege’sfamily,Iwouldliketowelcomeandcongratulateallofyou.Thewayaheadwillbechallengingandrewarding.
Forty-fourfellowswereawardedtheExitcertificateandninecandidateswereawardedtheDiploma inFamilyMedicine.Congratulationsagaintoallofyou.
Iwouldalso liketocongratulateProfessorCindyLamwhowasawardedanHonoraryFellowshipthisyear.HercontributiontoFamilyMedicinehasbeenenormous.
ItwasourfirsttimetohaveDr.KennyKungasourpublicorator,whichisanextremelyimportantpositiontomaketheconfermentsuccessful. Iwould liketoexpressmyheartfeltgratitudeandappreciationforhishardwork.Iwouldalso liketotakethisopportunitytothankagainDr.AllenNgaiastheCoordinator,MarshallingOfficers(Dr.ChanChiWai,Dr.WongChakTong,Dr.KoWaiKit,Dr.MariaLeung)andUshers(Dr.CatherineNg,Dr.PangSiuLeung,Dr.CindyCheungandDr.JennyWang)forall
theirexcellentcontributions. Isincerely lookforwardtoworkwithallofyouinthefuture.
Lastbutnot least,myheartfeltappreciationgoes toCrystal&allofourcolleaguesofthesecretariat,tohaveplayedanimportantroleincoordinatingandorganizingthewholeevent, fromvenue togownarrangement,manpowertorundown,allthehardwaretosoftware……indeed,everything!Thanksverymuchforalltheeffortmadebythecollegesecretariat.
3
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Reminder: Application for Recommendation for Exit Examination
Reminder: Submission of Training Logbook for Certification of Completion of Basic Training
Board of Vocational Training and Standards News
ToallHigherTrainees,
Forthosewhopreparetosit forexitexaminationin2012,pleasesubmittheapplicationlettersandthechecklistsforrecommendationforexitexaminationbefore30 September 2011.
Late applications will not be entertained.
Shouldyouhaveanyenquires,pleasecontactourCollegeExecutive,Ms.CarmenChengat25286618.
HigherTrainingSubcommittee
BVTS
ToallBasicTrainees,
Forthosewhohavecompletedfour-yearbasicvocationaltraining,pleaseberemindedofyourapplicationsforCertificateofCompletionofBasicTrainingwithin3monthsofcompletionoftraining.Otherwise,youarerequiredtopaytheannualtrainingfee.
Shouldyouhaveanyenquires,pleasecontactourCollegeExecutive,Ms.CarmenChengat25286618.
BasicTrainingSubcommittee
BVTS
"Council Member-On-Duty" (CMOD) System
DearCollegemembers,
Wearestillprovidingthisalternativechannelofcommunicationforyoutoreachus. Doletushaveyour ideasandcommentssothatwecanfurtherimproveourservicestoallthemembers.
Forthismonth,from15thAugust2011to14thSeptember2011,Dr.CheungManKuenandDr.BillyChiuwillbetheCouncilMembersonduty.Pleasefeel freetomakeuseofthischanneltovoiceyourdoubts,concerns,queries,andcommentsaboutanythingrelatingtoourCollegeandFamilyMedicine.YoucanreachusbycontactingourCollegeSecretariatbyphone:25286618,byfax:28660616,orbyemail:[email protected],wewillgetintouchwithyouassoonaswecan.
Dr.TonyC.K.LeeCo-ordinator,CMODSystem
Dr.CheungManKuen Dr.BillyChiu
Classified Advertisements
Full-time,half-day& locumdoctorswanted inGP.Attractiveremunerationandflexiblehours.Interested,please contac t Dr. LI at 9662 3540 or email [email protected]
HavenofHopeChristianServiceinvitesapplicationsforFull-time/Part-timeFamilyPhysician.Basicsalaryplusvariablepay.
Interestedpartiespleasesende-mailtose@hohcs.org.hkorcontactMs.Liubyphoneat27033230.
Full-time GP/ Locum/ Specialists wanted 九龍商場鋪,WelcomeJointInvestment.Transparent&generousBonus + Excellent Prospect. Dr. Kam 3165 [email protected]
PositionsVacant
FT/PT/LocumFamily Physician(min.3years’experience)forpracticesofUnitedChristianNethersoleCHSinNTW/NTE/Kowloon.Pleasee-mailresumewithexpectedsalary-Ms. Law : [email protected]
4
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S Board of Conjoint ExaminationReport on OSCE 2011 Information Seminar for Candidates
The InformationSeminaronOSCEsegmentwasheldon26th June2011.The room
waspackedwith25candidates (Cat I:23,Cat II:2)andmembersfromtheBoard–the
Chairman,theOSCECoordinatorandtheSecretariat.
TheseminarstartedwithawarmwelcomebyourChairmanDr.ChanHungChiu.Dr.Chan
explainedtothecandidatesthehistory,preparationandthesecuritymeasures inour
examination.
Dr.ChuiSiuHangBilly,ourOSCECoordinator,presented informationconcerningthe
examinationanddemonstrated2DVD recordingsof two role-playcandidateswith
differentlevelsofperformancetothecandidates.
Wepresentedthemarkingschemeandwentthroughthesettingofthedomainsofeach
case.Wealsoexplainedthemarkingrationalebehindusingessentialpoints todivide
betweenpassandfailforaparticulardomainineachquestion.Thecandidatesweregiven
achancetomarkthescenariowiththerespectivekeyfeaturechecklistthemselvesand
understandhowtoassessaparticulardomainandhowtoachieveapasscriteriaineach
particulardomain.
On thewhole therewere lotsof interactionand theatmospherewas friendly.The
candidateswereenthusiasticandtherewere livelydiscussions.Feedback formswere
distributedandtheir feedbackwaspositive.Lookingat the feedbackstatistics,most
candidatesbenefitedfromthisseminarandfounditveryuseful.Themajorityofattendees
agreedthattheseminarhelpedtheirOSCEpreparation,andprovidedusefulinformation
regardinghowtheirperformancewillbeassessed.
Insummary,theafternoonwasfruitfulforboththecandidatesandourBoardMembers.It
ishopedthattheadditionalinformationgainedbycandidateswillhelptranslatetheirhard
workintosuccessinafewmonthstime!
Dr. Chan introducing the history, preparation and security of theexamination.
Dr. Chu i p resent ing the examinat ion in fo rmat ion to the candidates.
5
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ENTER THE FP LINKS LOGO DESIGN COMPETITION
for a chance to have
YOUR WORK AS THE SYMBOL OF FP LINKS and WIN $2,000 of VOUCHERS!
Your challenge is to design a logo that represents FP links, the College newsletter of the Hong Kong College of Family Physicians.
FP links has the following missions:• To disseminate the College News to College members;• To report news of various College Boards and Committees;• To provide a channel for dissemination of information or articles related to Family Medicine,
either clinical or non-clinical;• To act as a bridge for communication between members and the College.
The inaugural edition of FP links was published in March 2004
WE NEED A NEW LOOK!Your logo should meet the following criteria:• Embody the characteristics and identity of our College newsletter;• Be clear and appropriate for a medical newsletter;• Be your own original piece of work;• Be flexible enough to work across a range of material, including online and print;• Submitted in jpg format (size preferably <5MB).
Submit your logo by 30 September 2011 to [email protected], and remember to include:• An explanation of what your logo represents;• Your title, name, email address, mailing address, and daytime phone number.
All entries will be acknowledged and once received, will become the property of FP Links. They will be judged by the FP Links Editorial Board and the competition winner will be announced via FP Links
and the College website. The winner will also be contacted individually by our staff.
If you have any queries about the logo design competition, please contact Ms. Carmen Cheng at 2528 6618.
NOW GO AND GET DESIGNING!5
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6
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Topics and Speakers :
Dates Topics Speakers
27 Aug 2011 (Sat) Module V – Consultation Skill Workshop I Dr. Au Chi Lap
3 Sept 2011 (Sat) Module V – Consultation Skill Workshop II Dr. Chan Chi Wai
17 Sept 2011 (Sat) Module V – Orthopaedic Injection Workshop Dr. Lau Hoi Kuen
Co-ordinator : Dr. Wong Pak Hoi Member,TheBoardofDiplomainFamilyMedicine,HKCFP
Venue : CouncilChamber,Room802,8/F,DukeofWindsorSocialServiceBuilding,15HennessyRoad, Wanchai,HongKong
Time : 2:30p.m.–5:00p.m.LectureandDiscussion
Accreditation : 3CMEPointsHKCFP(Category4.3) 3CMEPointsMCHK
Registration Fees (Pleasetickasappropriate):
Dates Topics HKCFP Member Non-member
27 Aug 2011 (Sat) Module V – Consultation Skill Workshop I HK$200 HK$400
3 Sept 2011 (Sat) Module V – Consultation Skill Workshop II HK$200 HK$400
17 Sept 2011 (Sat) Module V – Orthopaedic Injection Workshop HK$500 HK$1,000
Capacity : 20 Doctors
Registration : 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 Holdings and Development Limited”. Please mail the cheque to Rm 802, 8/F, Duke of Windsor Social Service Building, 15 Hennessy Road, Wanchai. All fees received are non-refundable and non-transferable.
Board of Diploma in Family Medicine (DFM) - Lectures
To: HKCFP,Room802,8/F,DukeofWindsorSocialServiceBuilding,15HennessyRoad,Wanchai,HongKong.
(Fax:28660981)
DearSir/Madam,
Iama*Member/Non-MemberoftheHongKongCollegeofFamilyPhysicians.(*Pleasedeleteasappropriate)
Iwouldliketoattendlecture(s)ofModule V atCouncilChamber,Room802,8/F,DukeofWindsorSocialServiceBuilding,
15HennessyRoad,Wanchai,HongKong.
Name :
Tel No. :
Email :
Date :
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8
FEAT
URE Interview with Professor Gabriel Leung, JP, Undersecretary for
Food and Health, on Primary Care Development in Hong Kong
Dr. Wendy Tsui, Specialist in Family Medicine, Hospital AuthorityProfessor Martin Wong, Specialist in Family Medicine, the Chinese University of Hong KongDr. Catherine Ng, Specialist in Family Medicine, Hospital Authority
ItisourgreathonourtohaveProfessorGabrielLeungsharinghisviewsontheprimarycaredevelopmentinHongKong.Apartfrombeingheavilyinvolvedinthesettingandimplementationofourhealthcarepolicy,ProfessorLeungisalsoapioneerinthefieldsofPublicHealthandFamilyMedicine.
What are the biggest challenges in providing primary care in Hong Kong?
StrategicplanningonprimarycaredevelopmentinHongKonghasonlybeeninitiatedintherecentfewyears.Thisisalreadyquiteaninnatechallengeamongus.However,Ibelievethatwiththeheartfuleffortsofourcolleagues,speedyandgoodpolicydevelopmentcanbeattainedafterawideconsensusisestablishedinthecommunity.
ThehealthcarefinancingmodelofHongKongisdifferentfromthatofothercountries,andpeopleneedtopayoutof theirownpockets forhealthservices.Withsuchamodelofhealthcarefinancing,developing a whole-person, continuous care,withelementsof familycareandcomprehensivepreventive initiatives is another challenge. So,one importantstepweneedtomove forward isto findasuitablemodelofhealthcarefinancing,which can promote primary care developmentwithaFamilyMedicineconcept.Simplyhavingaslogantopromotetheconceptofcontinuouscare,preventionandchronicdiseasesmanagement isnotenough.Thereshouldbereformsintheservicedeliverymodel,which is indeedourgoal for thenextseveralyears.Tostartwith,inthepublicsector,thereshouldbecoordinationofservicesdeliveredbyFamilyMedicineSpecialistClinicsandGeneralOutpatientClinics.Anotherdevelopment is toestablishcommunityhealthcentres,withpossiblecollaboration and coordination of health careprovidedbyChineseMedicineClinics,ElderlyHealthCentres,Men’sHealthClinics,Women’sHealthClinics,StudentHealthServiceandMaternityandChildHealthCentres.Thesearerelativelysimpleastheyinvolvemainlyservicetransformation,andthegovernmentandtheHospitalAuthorityareworkingcloselyonthis.Apartfromthat,thegovernmentisalsomeetingnon-governmentorganizationswhichcurrentlyofferone-stophealthservicesdeliveredbypersonnelotherthandoctors.Asfortheprivatesector,establishingagoodnetworkisimportant.Wecanlearnnetworkingfromthesuccessstoriesfromothercountries. Ibelieveelectronichealthrecordsimplementationwillhelpinthisdevelopment.
“Submissions of articles to Feature with up to 1200 words are always welcome. Gift vouchers will be given as a token of appreciation if the articles are selected for publication. Email: [email protected]”
Healthcare financing reform isabigchallenge.Currently, health care financing in Hong Kongincorporates the concepts of point of care onepisodicbasisand fee-for-servicedelivery.Thisisactuallynot themodel inothercountrieswithsuccessfulprimarycaresystems.Ourfutureservicedeliverymodelshouldpromotepatient-centredcare,andthemostsuitablemodelofhealthcarefinancingshouldbedevisedfromthat.Thisisourintermediatetolongtermgoal.
Our vocational training in Family Medicine places lots of emphasis on clinical skills. Hence, our trainees may not have in-depth knowledge about primary health care concepts. How to attract young trainees to join the field of primary care?
The formationofprimarycare teamsshouldbecompetency based. We should focus on whatcompetenciesweneed,ratherthanwhatspecialtiesweneed.PrimarycareismorethanFamilyMedicinealone.Withmorepeoplehavingapassioninprimarycare,pocketsandclustersofexpertisewilldevelop.Whensuchmomentumiscreated,moretraineeswillbeattractedforsure.Factorslikefutureprospects,jobnatureandreturnsaffectthechoiceofspecialtiesofmedicalandnursinggraduates.However,someyoungtraineesmayneedtrueexperiencebeforetheycanfindtheirrightpath.
Rewardingprimarycareproviders is important.This should not only be limited to health careprofessionalsperformingcomplexprocedures.Inoverseascountries, there isawidediversityofservicesprovidedbyprimarycareprofessionals.Somereceivesubspecialtytraining.Havingdiversity
Professor Gabriel Leung in his of f ice, with Dr. Wendy Tsui (right), Dr. Catherine Ng (left)
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isagoodmeanstoattractpeople.Yet,westillneedtorewardprimarycareproviderswhomaynothaveperformedcomplexclinicalprocedures,buthaveputineffortindiseasepreventionandhealthpromotion,theoutcomeofwhichmaynotbeeasilynoticeable.Providerremunerationisanothermediumtolongtermgoalweneedtoworkon.
How do you feel about the role of public sector in primary care provision, especially when apparently more resources have been invested in secondary and tertiary care?
Primarycaredevelopmentisa longjourney.Yet, Iamstilloptimisticabouttheprospects.EstablishingthedepartmentofFamilyMedicineandPrimaryHealthcare inthepublicsector isalreadya largebreakthrough.Everyspecialtyis important,butweneed toprioritize theserviceneeds.Thepublicsector isnot supposed todominate themarketshare inprimarycare.Rather, ithas the roleoftrainingprovision,prototypesettingandservicemodeltesting,andultimatelypromotingtheservicemodelwhichsuitsHongKongtootherstakeholders,includingtheprivatesector.Hence,thepublicsectorshouldplacemoreemphasisonquality,withquantitybeingthesecondarygoal.Infact,theprivatesectorhavegoodpotentialtotakeupthatquantity,asthemarketisnotsaturatedyet.Oneshorttointermediatetermgoal for thepublic sector is toestablishagoodqualityhealthcaremodel.However, Ialsounderstandthat itmaynotbetranslateddirectlyto theprivate sector,whichmayhavedifferentcharacteristics. It is important thatweshareandlearntogether.Onesuccessfulexampleisthepublic-private-interfaceprojectinTinShuiWai,whichformsagoodfoundationinprimarycareintheterritory.Tomakethispossible,mutualtrustbetweenthepartieswithoutbeingprejudicialisimportant.Weshouldgohand-in-hand,understandeachother’sdifficulties,andmovestep-by-steptowardsbettercollaboration.
patients.Themostusefulpreventivecareisrepetitivereinforcementofhealthylifestyle,andgraspingtherightmomentforofferingadvice,suchassmokingcessationanddietaryadvice.As forscreening, Iwouldliketostressthatsomescreeningtestsareappropriate,but somearenot.Actually, somescreeningtestsevendomoreharmthangood.HerewefacetheInverseCareLawagain:Peoplearedoingtoofrequentandtoomuchscreening.Thereisalsoethicalriskthatdoctorscanchargemorewhenmorescreeningtestsarearranged.PrimarycarefinancingshouldbaseonwhatservicescanincorporatetheprinciplesofFamilyMedicine.Bestresearchshouldbetranslatedintobestpractice.Asanincentive,itisgoodtoofferremunerationtoprivateandpublicdoctorswhoprovidequalitypreventivecare.
What will be the primary care development in the next five or ten years?
Forshorttomediumtermdevelopment,wehopethatagoodservicemodelcanbetranslatedtotheprivatesector.Asformediumtolongtermdevelopment,healthcarefinancingisanotherimportantissuetoworkon.Primarycarewillalsoneedtoaccommodatethechangingsocialenvironmentwithmorechronicdiseasepopulationgettingolder,theMainlandandHongKonghavingcloser relationship,andmoremovementofelderlyandretireesbetweenthetworegions.
How do you feel about our college’s role in primary care? Are we heading in the right direction?
Ihavealwaysbeensupportingyourcollege.Therearemoreandmoremembersandfellows,and itiswellrecognizedbyoverseascollegesandotherspecialties.Ifthereiswidermembershipbase,yourcollegewillplayanevenmore important role inprimarycare.
Wewould like toexpressour sincere thanks toProfessorLeungforhisprecioustimeandsharing.
Professor Gabriel Leung: “The future of primary care in Hong Kong is full of challenges so we need to join hands together.”
Professor Leung with Dr. Wendy Tsui (right), Professor Martin Wong (left)
What is the essence of preventive care?
Preventivecareisnotequaltoscreening.Itisaboutestablishing a long term relationship with the
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Happiness is a Journey
We convince ourselves that life will be better after we get married, have a baby, then another. Then we are frustrated that the kids aren't enough and we'll be more content when they are. After that we're frustrated that we have teenagers to deal with. We will certainly be happy when they are out of that stage. We tell ourselves that our life will be complete when our spouse gets his or her act together, when we get a nicer car, are able to go on a nice vacation, when we retire. The truth is, there's no better time to be happy than right now.
If not now, when?
Your life will always be filled with challenges. It's best to admit this to yourself and decide to be happy anyway. One of my favorite quotes comes from Alfred D Souza. He said, "For a long time it had seemed to me that life was about to begin - real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life". This perspective has helped me to see that there is no way to happiness. Happiness is the way. So, reassure every moment that you have. And treasure it more because you shared it with someone special, special enough to spend your time...and remember that time waits for no one...
So stop waiting until you finish school, until you go back to school, until you lose ten pounds, until you gain ten pounds, until you have kids, until your kids leave the house, until you start work, until you retire, until you get married, until you get divorced, until Friday night, until Sunday morning, until you get a new car or home, until your car or home is paid off, until spring, until summer, until fall, until winter, until you are off welfare, until the first or fifteenth, until your song comes on, until you've had a drink, until you've sobered up, until you die, until you are born again to decide that there is no better time than right now to be happy.
Happiness is a journey, not a destination.
Thought for the day:
Work like you don't need money,
Love like you've never been hurt,
And dance like no one's watching.
http://www.inspirationallane.com/ThanksgivingInspirationalStories3.htm
(本欄資料由 心靈綠洲--個人成長及危機處理中心 提供，特此鳴謝。)
“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]”
Screening of Ovarian Cancer
Ovariancanceristhe7thleadingcauseofcancerdeathamongHongKongwomen1,andsymptomsassociatedwith
ovariancancerarerathernonspecific.Accordingtoacase-controlstudy,commonsymptomsincludeabdominal
pain(53%),abdominaldistension(36%),lossofappetite(21%),andurinaryfrequency(14%).2
Thus,screeningtoolssuchastumormarkershavereceivedconsiderable interestastheyarenon-invasive,easily
repeatedovertime,andrelatively inexpensivecomparedto imagingstudies.CA125 isthemostwidelystudied
biochemicalmethodforscreeningofovariancancer.SerumCA125valuesareelevatedinapproximately50%of
womenwithearlystagediseaseandinover80%womenwithadvancedovariancancer.3
However,CA125levelsarealsoelevatedinaround1%ofhealthywomenandvaryduringthemenstrualcycle. It
isalso increasedinbenignandmalignantconditionssuchasendometriosis,uterine leiomyoma,cirrhosis,pelvic
inflammatorydisease,pleuraleffusionandcancersoftheendometrium,breast,lung,andpancreas.
Apartfromtumormarkerchecking,imagingsuchastransvaginalultrasoundhasalsobeenused.Itssensitivityand
specificityrangefrom80-100%and94-99%,respectively,butitisoperatordependent.3
TheovariancancerscreeningarmoftherandomizedProstate,Lung,Colorectal,andOvarianCancerScreening
(PLCO)trial intheUnitedStatesstudiedtheeffectofscreeningbycombinationofbothCA125andtransvaginal
ultrasound.Therecentdatapublishedearlierthisyearfoundthatscreeningaverageriskwomenwithannualserum
CA125 levelsandtransvaginalultrasounddid not decrease mortality from ovarian cancer and caused harm
forwomenwhowerescreened.PLCOrecruited78216womenaged55to74yearswhowererandomizedtoeither
annualscreeningorusualcarebetweenNovember1993andJuly2001.Theinterventiongroupreceivedannual
screeningwithCA125for6yearsandtransvaginalultrasoundfor4years,withamaximumfollowupfor13years
(median:12.4years).Ovariancancerwasdetectedinmorewomeninthescreeningthanusualcaregroup(5.7vs
4.7per10,000personyears)buttherewasnosignificantdifferenceinthestageofovariancancerdetected,or in
cancer-specificoroverallmortality.However,15%ofwomenwhohadsurgeryforafalsepositivefindingatscreening
experiencedat leastoneseriouscomplication.4This trialstrengthensprior recommendationsNOT toscreen
averageriskwomenforovariancancer.
References:
1. HongKongCancerRegistry,HospitalAuthority2008.
2. BMJ2009Aug25;339:b2998.
3. CarlsonKJ,SkatesSJ,SingerDE.Screeningforovariancancer.AnnInternMed1994;121:124.
4. BuysSS,PartridgeE,BlackA,etal.EffectofScreeningonOvarianCancerMortality:TheProstate,Lung,Colorectaland
Ovarian(PLCO)CancerScreeningRandomizedControlledTrial.JAMA2011;305:2295.
Beneficial Effect of Smoking Cessationon Operative Outcomes
Smokingisawell-knowncardiovascularriskfactorandiscarcinogenic. Italsocompromiseswoundhealing. Ina
recentmeta-analysisof6randomizedtrialsand15observationalstudies, itwasfoundthatsmokingcessation is
associatedwitha41%relativerisk reductionforpreventionofpostoperativecomplications including impaired
woundhealingandpulmonarycomplications,andeachweekofcessation increasedthemagnitudeofeffectby
19%.The longer the period of smoking cessation, the more significant the decrease in the incidence of
postoperative complications.
Reference:
1. AmJMed.2011;124(2):144.
Compiled by Dr. YIP Chun Kong, Sam
NEW
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Interest Group in Dermatology - The 25th Meeting on 2nd July 2011
Dr. So Chi KinCollege Member
Theme :Papulo-squamous Eruption
Speaker :Dr.LoKuenKong,DermatologistinPrivatePractice
Moderator :Dr.WongNaiMing,Co-ordinator,BoardofEducation
Dr.LoKuenKong,HonoraryClinicalAssociateProfessorofthetwomedicalschoolsandHonoraryConsultantDermatologistofQueenMaryHospital,KwongWahHospital,QueenElizabethHospital,spoketousonclinicalapproachtomanagementofcutaneouspapulo-squamouseruptions.
Learning points:Cutaneouspapulosquamouseruptionsincludecutaneousscalingdisorderswithscalingpapules,plaquesandpatches,withborderssharplydemarcated.
Commonpapulosquamouscutaneousdiseasesincludepsoriasis,pityriasisversicolorandsuperficial fungal infection,seborrhoeicdermatitis,andpityriasisrosea.
Lesscommonpapulosquamouscutaneousdiseasesincludesecondarysyphilis,discoidlupuserythematosus,lichenplanus,parapsoriasis,mycosisfungoides,andpityriasisrubrapilaris.
PsoriasisPsoriasisisaninflammatoryrashwithincreasedepidermalproliferation.Therashesarecharacterizedassharplydemarcated,erythematouspapulesandplaqueswithsilveryscaling.Scalp,nails,coveredareas,extensoraspectsof limbsarecommonlyaffectedareas.Systemicmetabolicchangescanbepresent.Psoriasiscanbeclassifiedasacuteorchronic,generalizedorlocalized,pustularornon-pustular,stableorunstable,withorwithoutarthropathy.Thecommonesttypeischronicnon-pustularplaquetypepsoriasis.
OptionalinvestigationsforpsoriasisincludeBP,pulse,BMI,urinalysis,CBP,fastinglipid,glucose,LFT,RFT,ANF,RF,hepatitisBmarkers,X-raychest,X-raysfortheinvolvedjoints,skinbiopsy,andpustuleswabforC&ST.
TopicaltherapiesforpsoriasisincludeDithranol(anthralin),vitaminDderivative,calcipotrieneointment,moderatelypotenttopotenttopicalsteroids,retinoid(tazarotenegel),sulphur,salicylate,andemollients.
PhototherapywithnarrowbandUVB(313nm),photochemotherapywithPUVA (psoralenswithultravioletA)are treatmentoptionsforpsoriasis.Systemicretinoid,acitretin,systemiccyclosporine,methotrexate,andbiologicsarealsoalternativetreatmentoptionsofchoice.Howeverphototherapyisinconvenientforpatientswhoneedtowork.
Psoriasisisachronicconditionthatwaxesandwanes(oftenwithoutcompleteremission).Thereisnocurebutonlycontrol.Themajorityoftheselesionsarenotlifethreateningbutsocialstigmatizingandphysicallydisabling.Arthritis,erythroderma,andgeneralizedpustularpsoriasisaremoreseverecomplications.
Pityriasis versicolor & superficial fungal infectionCutaneoussuperficialfungalinfectionsincludedermatophyteinfection-tineapedisandtineamanuum,tineacorporis,tineacruris,tineafaciale,tineaunguium,andtineaincognito.Othersuperficialfungalinfectionsincludepityriasisversicolor,piedra(trichosporosis),andcandidiasis.
Pityriasisversicolor iscausedbya lipophilicyeast,Pityrosporumorbiculare–hyphal formcalledMalassezia furfur. It isusuallyasymptomatic papulosquamous or maculosquamous, tan orerythematousorhypopigmented,circular,well-demarcatedlesion.Hypopigmentation ismoreobvious insummer– theyeast isamonoamineoxidaseinhibitorandpreventtanningofinfectedskin.Chest,back,neck,armsarecommonlyaffectedparts.Thedifferentialdiagnosesincludepityriasisrosea,seborrhoeicdermatitis,guttatepsoriasis,vitiligo,andsecondarysyphilis.
Thediagnosisofpityriasisversicolorcanbemadebyscrapingofscaleonmicroscopicslidecoveredwith20%KOHwithpresenceofhyphae.
Theappearanceofsporesandhyphaeisreferredtoas“spaghettiandmeatballs”.Wood’slampexaminationcanalsobeusedfordiagnosis.
Selenium lotionor shampoo,ketoconazole shampoo, topicalimidazolecream(clotrimazole,econazole,ketoconazole,miconazole),ketocoanzaole200mgoritraconazole200mgdailyfor1weekaretreatmentoptions.Patientsareadvisedtohaveexercise-inducedsweatingafteroralantifungalforoptimaltreatmenteffect.
Seborrhoeic dermatitisSeborrhoeicdermatitiscommonlyaffectsthescalpbutcanalsoaffectears,face,sternalarea,axilla,interglutealarea,andthegroin.Thecauseisunknownbutpityrosporumovaleplayssomeroles.
ItiswidespreadinAIDSpatientsandthosewithParkinson’sdisease.Treatmentsforseborrhoeicdermatitisincludefrequentshampooingwithmedicatedshampooswithseleniumsulfidesolution,tarshampoo,zincpyrithioneshampoo,ketoconazoleshampoo,and10%cetrimideshampoo.Topicalsteroidwithweakpotencyispreferred.Topicalketoconazolecream,pimecrolimuscreamandtacrolimusointmentcanalsobeused.
Pityriasis roseaThecauseofpityriasisroseaisunknownthoughitissuspectedtoberelatedtoHumanherpesvirus6(HHV-6)orHumanherpesvirus7(HHV-7).Itpresentswithheraldpatch;thelargestofthelesionsrangefrom2-5cmovalerythematousdiscretelesionresemblingapatchof“ring-worm”likelesion(precedegeneralrashby2-10days,withacollaretteoffinescalingaroundtheedgesofthelesion).
ItmainlyaffectsyoungadultsonchestandtrunkalongLanger’slinesofcleavageintheskin.“Christmastreebranches”patternoverthebackmaybepresent.Atypicalcasespresentwithlesionsinaxillaeandgroinonly,referredtoasinversepityriasisrosea.Newgeneralizedsmallerlesionscontinuetoappearfor3weeks.Usuallytheentirerashdisappearswithin8weeks.Rarevariantscanpresentasrecurrentandlonglastingrash.
Differentialdiagnosesincludepityriasisversicolor,drugeruption,secondarysyphilis,psoriasis,seborrhoeicdermatitis,lichenplanusandparapsoriasis.
Concerningthemanagement,in-depthconsiderationfordifferentialdiagnosesisimportant.Reassuranceconcerningthenon-contagiousnatureandraritytobecontractedagainisimportant.Symptomatictreatmentusingoralantihistamineforitchiness,hydrocortisonecreamorointmentandemollienttodryflakyscalyrash,andNBUVBcanreduceseveritybutdiseasedurationmaynotbealtered.
Next MeetingThenextmeetingwillbeonSaturday3rdSeptember2011.TheguestspeakerisDr.ShihTaiCho,SpecialistinDermatology&Venereology.HewillspeaktousonCommonMis-diagnosis.
Allmembersarewelcomeandencouragedtopresenttheircasesandproblemsfordiscussionsorroleplay.Pleasesendyourcasestooursecretariat ([email protected])2weeksbeforethedateofpresentation.
(Disclaimer:Alladviceandsharinginthemeetingarepersonalopinionsandbearnolegalresponsibility.Allpatients’identitiesarekeptconfidential.)
Dr.StephenFoo&Dr.LoKuenKong
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Workshops on Office Minor Surgical Procedures
Dates : 16 November 2011 (Wednesday) 19 November 2011 (Saturday)
Organizers & : Department of Surgery, Our Lady of Maryknoll HospitalCourse Directors Dr. Meng Chia Shing, William Consultant in charge, Dept. of Surgery, Our Lady of Maryknoll Hospital
The Hong Kong College of Family Physicians Dr. Kwong Bi Lok, Mary Chairlady, Board of Education, The Hong Kong College of Family Physicians
Co-ordinator : Dr. Chan Wan Yee, Winnie Board Member, Board of Education, The Hong Kong College of Family Physicians
Time : 1:30 p.m. - 3:30 p.m.
Venue : Conference Room, 1/F, Outpatient Building, Our Lady of Maryknoll Hospital, 118 Shatin Pass Road, Wong Tai Sin, Kowloon.
Contents : 1. Lecture 2. Live demonstration of various minor OT procedures 3. In vitro hands-on practicum - Local anaesthetics / digital nerve block - Office minor OT Surgical instruments / sterilization technique - Suturing skills - Proctoscopy + banding / injection of haemorrhoids - Injection of keloid scar - I&D abscess - Simple excisions - Wedge excision of ingrown toenails
For those who are interested in starting off simple minor procedures in own practice, or as a refresher course
Course Fee : HK$ 500.00 for the whole course All cheques payable to “HKCFP Education Ltd”
Enrolment : Please call Ms. Yvonne Lam at 2861 0220 for details. Registration will be first come first served. (To register please mail in the reply slip below with your cheque)
Award : A “Certificate of Attendance” will be awarded to those who have attended both sessions
Accreditation : 2 CME Point HKCFP (Cat. 5.2) per afternoon session
REPLY SLIP
To: HKCFP, Room 802, 8/F, Duke of Windsor Social Service Building, 15 Hennessy Road, Wanchai, H.K.
I would like to attend “Workshops on Office Minor Surgical Procedures”.
Enclosed please find the cheque (made payable to HKCFP Education Limited) being payment as Course Fee.
Date & Time Topics
Please sign if you wish to attend Enrolment Deposit
Name: __________________________________________ Tel: _________________________ Date: __________________________
Email: _________________________________________________________ Cheque No. : _________________________________
3 September 2011 SaturdayBoard of Education Interest Group in Dermatology
Aim Toformaregularplatformforinteractivesharinganddiscussionofinterestingdermatologicalcasescommonlyseeninourdailypractice
Theme Common Mis-diagnosis
Speaker Dr. Shih Tai ChoSpecialistinDermatology&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.
Please wear a surgical mask if you have respiratory tract infection and confirm that you are afebrile before coming to the meeting. Please wear an appropriate dress code to the hotel for the scientific meeting. Private Video Recording is not allowed. Members, who wish to review the lecture, please contact our secretariat.
Monthly Video Viewing Session
MonthlyvideoviewingsessionswillbescheduledonthelastFridayofeachmonthat2:30–3:30p.m.at8/F,DukeofWindsorSocialServiceBuilding,15HennessyRoad,Wanchai,HongKong.
August’s session:
Date 26August,2011(Friday)
Time 2:30p.m.-3:30p.m.
Topic Sports Medicine, Sports Science: Current Practice – Dr. Eric Chien
Admission FreeforMembers
Accreditation 1CMEPointHKCFP(Cat.4.2)1CMEPointMCHKUpto2CPDPoints(SubjecttosubmissionofsatisfactoryreportofProfessionalDevelopmentLog)
Language LecturewillbeconductedinEnglish.
September’s session:
Date 30September,2011(Friday)
Time 2:30p.m.-3:30p.m.
Topic New Era in Managing Anxiety Disorder– Dr. Kwan Ka Lik
Admission FreeforMembers
Accreditation 1CMEPointHKCFP(Cat.4.2)1CMEPointMCHKUpto2CPDPoints(SubjecttosubmissionofsatisfactoryreportofProfessionalDevelopmentLog)
Language LecturewillbeconductedinEnglish.
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
On-Going Events organized by Board of Education
Pleaseberemindedthattherewillbealectureon“UpdatesinManagementofDepressiveDisorder”ByDr.LeeWingKingandDr.ChiuSiuNingon21August2011.Pleaserefertoourcircularorcall28610220fordetails.
Community Education ProgrammesOpenandfreetoallmembersHKCFPCMEpointsaccreditation(Cat5.2)
Date/Time/CME Venue Topic/Speaker/Co-organizer Registration
10 September 2011 (Sat)2:30–4:30p.m.2CMEpoints
TrainingRoomII,1/F,OPDBlock,OurLadyofMaryknollHospital,118ShatinPassRoad,WongTaiSin,Kowloon
Refresher Course for Health Care Providers 2011/2012 – Radiation - medically and non-medically related in daily practiceMr.NelsonLamOurLadyofMaryknollHospital&HongKongMedicalAssociation
Ms.ClaraTsangTel:23542440Fax:23276852
BOAR
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Structured Education ProgrammesFreetomembersHKCFPCMEpointsaccreditation(Cat4.3)
Date/Time/CME Venue Topic/Speaker(s) Registration
24 Aug 11 (Wed)
2:15–4:45p.m.3CMEpoints
AB1038,1/F,MainBlock,TuenMunHospital Health Care Delivery System in Hong KongDr.MokKwanYeung
Ms.ChanTel:24686813
2:15–5:15p.m.3CMEpoints
Multi-mediaConferenceRoom,2/F,BlockS,UnitedChristianHospital
Update of Management of HyperlipidaemiaDr.SiuPuiYiandDr.KwanSzeSing
Ms.CordyWongTel:35133087
5:15–7:15p.m.2CMEpoints
LectureTheatre,6/F,TsanYukHospital Eye EmergencyDr.IanWong
Ms.ManChanTel:25892337
25 Aug 11 (Thur)
2:15–5:15p.m.3CMEpoints
Auditorium,G/F,TseungKwanOHospital Update of Management of HyperlipidaemiaDr.SiuPuiYiandDr.KwongLokSee
Ms.CordyWongTel:35133087
4:00–6:00p.m.2CMEpoints
Room614,AmbulatoryCareCentre,TuenMunHospital
SubfertilityDr.HoTszBun
Ms.ChanTel:24686813
5:00–7:00p.m.2CMEpoints
Room41,2/F,PamelaYoudeNethersoleEasternHospital
Chinese Medicine in Hong KongDr.WongYuFai
Ms.KwongTel:25956941
31 Aug 11 (Wed)
2:15–4:45p.m.3CMEpoints
AB1028,1/F,MainBlock,TuenMunHospital Smoking CessationDr.SzeSiuLamandDr.LauLaiNa
Ms.ChanTel:24686813
2:15–5:15p.m.3CMEpoints
Multi-mediaConferenceRoom,2/F,BlockS,UnitedChristianHospital
Rational PrescribingDr.YiuKwanandDr.SiuMingYing
Ms.CordyWongTel:35133087
5:00–7:30p.m.3CMEpoints
LiKaShingSpecialistClinic,3/F,SeminarRoom,PrinceofWalesHospital
Practical Solution-Focused Approach and Risk Assessment Made VERY SimpleDr.ChangLikChee
Ms.SusannaTongTel:26323480
5:15–7:15p.m.2CMEpoints
LectureTheatre,6/F,TsanYukHospital IncontinenceDr.WongChunWing
Ms.ManChanTel:25892337
1 Sep 11 (Thur)
2:15–5:15p.m.3CMEpoints
Auditorium,G/F,TseungKwanOHospital Rational PrescribingDr.ManFungYiandDr.KwongSheungLi
Ms.CordyWongTel:35133087
4:00–6:00p.m.2CMEpoints
Room614,AmbulatoryCareCentre,TuenMunHospital
Nurse Specialist/ Advanced Practising Nurse ServiceDr.LaiSiuWai
Ms.ChanTel:24686813
5:00–7:00p.m.2CMEpoints
Room41,2/F,PamelaYoudeNethersoleEasternHospital
Diabetes UpdateDr.KwanWingYan,Wendy
Ms.KwongTel:25956941
7 Sep 11 (Wed)
2:15–4:45p.m.3CMEpoints
AB1028,1/F,MainBlock,TuenMunHospital Emergency Cardiac Problems in General PracticeDr.LiShunHoi
Ms.ChanTel:24686813
2:15–5:15p.m.3CMEpoints
Multi-mediaConferenceRoom,2/F,BlockS,UnitedChristianHospital
Application of Musculoskeletal Medicine in your Clinical PracticeDr.AndrewIp
Ms.CordyWongTel:35133087
5:15–7:15p.m.2CMEpoints
LectureTheatre,6/F,TsanYukHospital Journal ClubDr.AnitaFan
Ms.ManChanTel:25892337
8 Sep 11 (Thur)
2:15–5:15p.m.3CMEpoints
Auditorium,G/F,TseungKwanOHospital ICPC CodingDr.LaiKitPing
Ms.CordyWongTel:35133087
4:00–6:00p.m.2CMEpoints
Room614,AmbulatoryCareCentre,TuenMunHospital
Environmental Hazards & Drug PoisoningDr.MokKwanYeung
Ms.ChanTel:24686813
5:00–7:00p.m.2CMEpoints
Room41,2/F,PamelaYoudeNethersoleEasternHospital
Management of Anxiety – Psychiatrist’s PerspectiveDr.ChoyLamWai,Karen
Ms.KwongTel:25956941
14 Sep 11 (Wed)
2:15–4:45p.m.3CMEpoints
AB1038,1/F,MainBlock,TuenMunHospital Substance AbuseDr.CheukTatSang
Ms.ChanTel:24686813
2:15–5:15p.m.3CMEpoints
Multi-mediaConferenceRoom,2/F,BlockS,UnitedChristianHospital
ICPC CodingDr.FungHoiTik
Ms.CordyWongTel:35133087
5:00–7:30p.m.3CMEpoints
LiKaShingSpecialistClinic,3/F,SeminarRoom,PrinceofWalesHospital
Practical Counselling Skill Part 2 (Therapy for Psychological Problem)Dr.ChangLikCheeandDr.MayMiao
Ms.SusannaTongTel:26323480
5:15–7:15p.m.2CMEpoints
LectureTheatre,6/F,TsanYukHospital Review of FM TrainingDr.KoWaiKit
Ms.ManChanTel:25892337
15 Sep 11 (Thur)
2:15–5:15p.m.3CMEpoints
Auditorium,G/F,TseungKwanOHospital Approach to Patients with Psychosomatic SymptomsDr.YeungSzeWaiandDr.FanWingChi
Ms.CordyWongTel:35133087
4:00–6:00p.m.2CMEpoints
Room614,AmbulatoryCareCentre,TuenMunHospital
Critical AppraisalDr.LeungHoiLik
Ms.ChanTel:24686813
5:00–7:00p.m.2CMEpoints
Room41,2/F,PamelaYoudeNethersoleEasternHospital
Clinical Audit in Family MedicineDr.LeungPuiSha
Ms.KwongTel:25956941
BOAR
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25
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26
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27
2:30 - 4:30 p.m.SpecialtyBoardPre-ExitExamWorkshop(NewCSA)2:30 - 5:00 p.m.DFMModuleV-ConsultationSkillWorkshopI
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2:30 - 5:00 p.m.DFMModuleV-OrthopaedicInjectionWorkshop
18
9:30 a.m. - 12:30 p.m.ConjointWrittenExamination2011-KFPSegment
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7:00 p.m. SocialDinnerGathering(BVTS)
25
9:30 a.m. - 1:00 p.m.ConjointWrittenExamination2011-MCQSegment
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2:30 - 3:30 p.m.BoardofEducation-VideoSession
1
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