IA Training Record 1/2 07.

11

HONG KONG COLLEGE OF PHYSICIANS

RECORD OF HIGHER PHYSICIAN TRAINING
IN __________________ SPECIALTY
To be completed every three months by Trainees

TRAINEE SUPERVISOR

Name M/F Name

Qualification (m/y) (__ m _y) Title

_____________________ (__ m _y)

INSTITUTION/DEPARTMENT/UNIT

PERIOD OF TRAINING From / / to / /

(DD/MM /YY) (DD / MM /YY)

TRAINING RECORD

(A) SERVICE WARD ROUNDS

(1) Daily ward rounds ·General beds No.

·Specialty beds No. Type
·Others (specify) No.
No.

(2) Consultation No.

(3) Weekly Grand Rounds Total Sessions

(B) OUTPATIENT SESSIONS

(1) General Medical sessions/month

(2) Specialty ( ) sessions/month
(3) Specialty ( ) sessions/month
(4) Specialty ( ) sessions/month

(C) SPECIAL SESSIONS

(1) Grand Rounds sessions/month

(2) Clinical Seminars sessions/month
(3) Journal Club sessions/month
(4) Radiology Meeting sessions/month
(5) Pathology Meeting sessions/month
(6) Others sessions/month

1
 IA Training Record 2/2 07.11

(D) DIAGNOSTIC & PROCEDURAL TESTS RECORDS Comments

(1) No.
(2) No.
(3) No.
(4) No.
(5) No.
(6) No.
(7) No.
(8) No.
(9) No.
(10) No.
(11) No.
(12) No.
(13) No.
(14) No.
(15) No.
(16) No.
(17) No.
(18) No.
(19) No.
(20) No.
(21) No.

(E) PARTICIPATION IN RESEARCH PROJECTS

(F) MEDICAL CONFERENCES ATTENDANCE/PRESENTATIONS

Supervisor

(Name) (Signature) (Date)

Note: Please ensure that you have completed your training logbook, which is to be reviewed by
your Programme Director every three months.

2
 IA Supervisor Evaluation 1/3 07/11

HIGHER PHYSICIAN TRAINING IN ________________ SPECIALTY

EVALUATION OF CLINICAL AND PROFESSIONAL COMPETENCE
For distribution to Members of Interim & Exit Assessment Boards
To be completed every six months or at the end of each training period lasting <six months

TRAINEE SUPERVISOR (Name & Position)

______________________________ __________________________________

QUALIFICATION (m/y) SPECIALTY PROGRAMME DIRECTOR

_________________________(__m__y) ___________________________________

_________________________(__m__y)

INSTITUTION/DEPARTMENT/UNIT PERIOD OF TRAINING

_____________________________________ ____/____/____ to ____/____/____

(DD/MM/YY) (DD/MM/YY)

EVALUATION

Please use the following 10-point Scoring System.

10 Outstanding
9 Excellent
8 Very good
7 Good
6 Fairly good
5 Definite pass
4 Borderline failure
3 Definite failure
2 Bad failure
1 Very bad failure
0 Exceptionally bad failure

1 Clinical judgement
0 1 2 3 4 5 6 7 8 9 10
2 Medical knowledge
0 1 2 3 4 5 6 7 8 9 10

3
 IA Supervisor Evaluation 2/3 07/11

3 Clinical skill:
Medical history
0 1 2 3 4 5 6 7 8 9 10

Physical examination
0 1 2 3 4 5 6 7 8 9 10

Diagnostic/procedural skill
Overall assessment
0 1 2 3 4 5 6 7 8 9 10

Particular diagnostic/procedural skill

(Please specify)
0 1 2 3 4 5 6 7 8 9 10
__________________________
0 1 2 3 4 5 6 7 8 9 10

0 1 2 3 4 5 6 7 8 9 10

0 1 2 3 4 5 6 7 8 9 10

0 1 2 3 4 5 6 7 8 9 10

0 1 2 3 4 5 6 7 8 9 10

0 1 2 3 4 5 6 7 8 9 10

4 Humanistic qualities
0 1 2 3 4 5 6 7 8 9 10

5 Professional attitudes
and behaviour 0 1 2 3 4 5 6 7 8 9 10

6 Commitment to continued
medical education and 0 1 2 3 4 5 6 7 8 9 10
scholarship

Conferences/Research/Publications (append details if necessary)______________________

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

7 Administrative ability
and leadership 0 1 2 3 4 5 6 7 8 9 10

8 Overall assessment
0 1 2 3 4 5 6 7 8 9 10

4
 IA Supervisor Evaluation 3/3 07/11

Comments

Has this evaluation been discussed with the trainee? Date __/___/__
Yes No (DD/MM/YY)

Has a copy of this evaluation been given to the trainee? Date __/__/__
Yes No (DD/MM/YY)

Supervisor Specialty Programme Director

Name __________________________ Name _________________________

Title ___________________________ Title __________________________

Signature _______________________ Signature ______________________

Date ___________________________ Date __________________________

Note: Supervisors please review the trainee’s logbook and ensure they have been completed in
order. Please submit the completed logbooks to the Programme Directors before Interim
Assessment process.

5
 IA Application 1/1 07.11

Hong Kong College of Physician s

(Incorporated in Hong Kong with limited liability)
Specialty _____________________________

Interim Assessment

Higher Physician Training (HPT) Application Form

All sections are mandatory

1. Surname 2. First name

3. ID Number _________________ (the first 4 digits)

4. Hospital ___________________ 5. Unit _____________________________________

6. Region *(Hong Kong / Kowloon / New Territories)

7. Date started Higher Physician Training

8. Concurrent or completed training in other specialties

*9. I shall take part in Interim Assessment in June / December 20__.

*10. I shall not be able to take part in Interim Assessment in June / December 20__ as I shall be
pursuing overseas study then.

11. Have you been rotated to a general medical unit of hospital with obstetric service for three
months during BPT or HPT (applicable only for trainees who start BPT from 1 July 2009
onwards)? *Yes/*No

Note *Delete whichever is inappropriate

____________________________________
Signature of Applicant Date

Note: Please ensure that you have submitted your completed logbook to your supervisor, for
onward transmission to your Programme Director before your Interim Assessment process.

6
 IA Individual Scoring 1/2 07.11

Hong Kong College of Physicians

Scoring Sheet for Interim Assessment
(To be kept by Specialty Board)

Specialty Board in _______________________

Date of Assessment_________________

Name of Candidate _________________________________ Hospital _____________ PD __________________________

Date started training: ____________ months (Minimum: 12 months in this Specialty)

Examiner 1 Examiner 2 Examiner 3 Supervisor’s score Formula for calculation

Name of Examiner Maximum score for each

examiner = 10
Signature
Total score = [(Scores of
Mark for Viva Examiners 1 + 2 + 3) x 3] + Total Score
Supervisor’s score = maximum
100

Topics 1. __________________________________________________________________________________________________________

2. __________________________________________________________________________________________________________

3. __________________________________________________________________________________________________________

Comment _____________________________________________________
Result (pass/fail) ________________________________ _____________________________________________________

7
 IA Individual Scoring 2/2 07.11

Hong Kong College of Physicians

Scoring Sheet for Interim Assessment
(To be kept by Specialty Board)

Specialty Board in AIM

Date of Assessment_________________

Name of Candidate _________________________________ Hospital _____________ PD __________________________

Date started training: ____________ months (Minimum: 12 months in AIM)

Examiner 1 Examiner 2 Examiner 3 CR1 CR2 S Formula for calculation

Name of Examiner Maximum score for each

examiner = 10
Signature
Total score = [(Scores of
Mark Examiners 1 + 2 + 3) + Total Score
(CR1+CR2+S)/3] = maximum 40

CR = Case Report score S = Supervisor’s evaluation score

Topics 1. __________________________________________________________________________________________________________

2. __________________________________________________________________________________________________________

3. __________________________________________________________________________________________________________

Comment: ___________________________________________________
Result (pass/fail) ________________________________ ___________________________________________________

8
 IA Assessment Board 1/3 07.11

HONG KONG COLLEGE OF PHYSICIANS

HIGHER SPECIALTY TRAINING INTERIM ASSESSMENT
IN ______________________ SPECIALTY
(To be kept by the Specialty Board)
To be completed by trainees

NAME________________________________________________________________________

QUALIFICATION MBBS/specify _________________ DATE____________________(m/y)

HKCP Intermediate Exam/MRCP/specify _______DATE_________(m/y)

MHKCP Yes/No

Basic Physician Training From ___________________ (m/y) To _______________(m/y)

Date of entry to higher specialty training in____________________ Specialty___________(m/y)

Concurrent or completed training in other specialties Yes/No Specify___________________

TRAINING RECORD Specialty _______ ___________

PERIOD _____________ to _____________, INSTITUTION ____________ _________

PERIOD _____________ to _____________, INSTITUTION ____________ _________
PERIOD _____________ to _____________, INSTITUTION ____________ _________
PERIOD _____________ to _____________, INSTITUTION ____________ _________

DATE OF INTERIM ASSESSMENT ________________________ (At least 12 months’ training in

each specialty is required before attempting Interim Assessment in that specialty. Interim Assessment in a
specialty must be passed at least 12 calendar months before Exit Assessment in that specialty .)

To be completed by Assessment Board

The scoring system is a 10-point system.

10 Outstanding
9 Excellent
8 Very good
7 Good
6 Fairly good
5 Definite pass
4 Borderline failure
3 Definite failure
2 Bad failure
1 Very bad failure
0 Exceptionally bad failure

9
 IA Assessment Board 2/3 07.11

1 TRAINING RECORD BOOK (LOG BOOK) & SUPERVISOR’S EVALUATION

0 1 2 3 4 5 6 7 8 9 10
Comments __________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

2 CLINICAL VIVA

 Clinical assessment
Questions
Topic _________________ Questions_________________________________________

Topic _________________ Questions_________________________________________

Topic _________________ Questions_________________________________________

3 ASSESSMENT SCORE (max score)(For all specialty boards other than AIM)

Supervisor Clinical Viva Total Status

Score Score Score (P Pass
(Maximum [(Maximum 10x3) x 3]=90 (Maximum BF Bare Fail
10) 100) F Fail)

4 TRAINEE’S COMMENTS

On the training programme

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

On the training facilities of the institution(s)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

5 RECOMMENDATION (For all specialty boards other than AIM)

Overall score  50, Pass; Satisfactory progress; to continue training programme

Comments____________________________________________________________
_____________________________________________________________________

10
 IA Assessment Board 3/3 07.11

Overall score  50 but ALL individual Scores of Examiners < 5; Bare fail; repeat
Interim Assessment after six months
_____________________________________________________________________
_____________________________________________________________________

Overall score ≥45-49; Bare fail; repeat Interim Assessment after six months
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Overall score  44; Fail; repeat assessment after an additional 6-month training
period.
Areas of deficiency and remedial actions:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Two consecutive bare fails A ‘Fail’ followed by a ‘Bare Fail’; repeat Interim
Assessment after an additional 6-month training period
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

> 2 consecutive failures A ‘Bare Fail’ followed by a ‘Fail’; repeat Interim

Assessment after an additional 12-month training period
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Deficiency in learning facilities of institution noted; actions recommended

_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Assessment Board

( ) Examiner 1 (Chairman)

( ) Examiner 2

11
( ) Examiner 3

12
 IA Assessment Board AIM 1/3 04.17

HONG KONG COLLEGE OF PHYSICIANS

HIGHER SPECIALTY TRAINING INTERIM ASSESSMENT
IN ______________________ SPECIALTY
(To be kept by the Specialty Board)
To be completed by trainees

NAME________________________________________________________________________

QUALIFICATION MBBS/specify _________________ DATE____________________(m/y)

HKCP Intermediate Exam/MRCP/specify _______DATE_________(m/y)

MHKCP Yes/No

Basic Physician Training From ___________________ (m/y) To _______________(m/y)

Date of entry to higher specialty training in____________________ Specialty___________(m/y)

Concurrent or completed training in other specialties Yes/No Specify ______________

TRAINING RECORD Specialty _______ ___________

PERIOD _____________ to _____________, INSTITUTION ____________ _________

PERIOD _____________ to _____________, INSTITUTION ____________ _________
PERIOD _____________ to _____________, INSTITUTION ____________ _________
PERIOD _____________ to _____________, INSTITUTION ____________ _________

DATE OF INTERIM ASSESSMENT _______________________ (At least 12 months’ training in

each specialty is required before attempting Interim Assessment in that specialty. Interim Assessment in a
specialty must be passed at least 12 calendar months before Exit Assessment in that specialty .)

To be completed by Assessment Board

The scoring system is a 10-point system.

10 Outstanding
9 Excellent
8 Very good
7 Good
6 Fairly good
5 Definite pass
4 Borderline failure
3 Definite failure
2 Bad failure
1 Very bad failure
0 Exceptionally bad failure

13
 IA Assessment Board AIM 2/3 04.17

1 TRAINING RECORD BOOK (LOG BOOK) & SUPERVISOR’S EVALUATION

0 1 2 3 4 5 6 7 8 9 10
Comments __________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

2 CLINICAL VIVA

 Clinical Assessment Questions

 Part 1 (scenario-based on diagnosis, investigation and management)

Questions______________________________________________

 Part 2 (interpretation of investigation results)

Questions____________________________

 Conference Questions_________________________________________

3 ASSESSMENT SCORE (max score) (for specialty board of AIM only)

Supervisor (S) and Clinical Viva Conference Status

Case Reports Score questions Total (P Pass
(CR1&2) [(Maximum 10x3]=30 (1 / 0 / Score BF Bare
Scores (Max 10) -1) (Maximum Fail
CR1 CR2 S 40) F Fail)

(CR1+CR2+S) =

3
CR = Case Report score S=Supervisor’s evaluation score

4 TRAINEE’S COMMENTS

On the training programme

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

On the training facilities of the institution(s)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

14
 IA Assessment Board AIM 3/3 10.19

5 RECOMMENDATION (For specialty board of AIM only)

Overall score  20, Pass; Satisfactory progress; to continue training programme

Comments____________________________________________________________
_____________________________________________________________________

Overall score  20 ,but ALL individual scores of examiner < 5. Borderline Fail, repeat
the assessment of Clinical Viva section with remedial actions recommended
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Overall score ≥ 16-19 Failure in 1 section: Failure in Clinical Viva section only
with score <15 AND pass in Case Report + Supervisor’s evaluation section with score
>5; Borderline fail; repeat the assessment of Clinical Viva section with remedial
actions recommended
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Overall score ≥ 16-19 Failure in 1 section: Failure in Case Report + Supervisor’s

evaluation section only with score <5 AND pass in Clinical Viva section with score >15;
Borderline fail; repeat the assessment of Case Report + Supervisor’s evaluation section
with remedial actions recommended
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Overall score ≥ 16-19 Failure in both sections: Failure in Clinical Viva section with
score <15 AND failure in Case Report + Supervisor’s evaluation section with score <5;
Borderline fail; repeat the assessment of both sections with remedial actions recommended
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Overall score  15 Failure in both sections; Fail; repeat assessment after an

additional 6-month training in AIM.
Areas of deficiency and remedial actions:

_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Two consecutive borderline fails A ‘Fail’ followed by a ‘Borderline Fail’; repeat

Interim Assessment after an additional 6-month training period
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

15
 IA Assessment Board AIM 3/3 04.17

> 2 consecutive failures A ‘Bare Fail’ followed by a ‘Fail’; repeat Interim

Assessment after an additional 12-month training period
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Deficiency in learning facilities of institution noted; actions recommended

_______________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________

Assessment Board

( ) Examiner 1 (Chairman)

( ) Examiner 2

( ) Examiner 3

16
 IA E&AC Report 1/1 07.13
Please use additional sheet as required

Hong Kong College of Physicians

Report on Interim Assessment
Specialty Board in ____________________________
(To be kept by E&AC Secretariat)

June/December 20___
Name of Hospital MBBS/ MRCP/ Basic Physician Training Date of Concurrent Training Overall Assessment Result
candidates MBChB HKCPIE Starting Score
Higher
Physician
Training
From To Duration Yes No (Specify Pass Bare Fail
(specify Fellowship of Fail
Specialty) other
Specialty)
(mm/yy) (mm/yy) (mm/yy) (mm/yy) (mm/yy)

Signature ____________________________

Name _________________________________

Board Chairman

Date__________________________________
17
 EA Application 1/2 06.19
Hong Kong College of Physician s
(Incorporated in Hong Kong with limited liability)
Specialty ___________________________

Exit Assessment

Higher Physician Training (HPT) Application Form

All sections are mandatory

1. Surname 2. First name

3. ID Number (the first 4 digits)

4. Hospital 5. Unit

6. Region *(Hong Kong / Kowloon / New Territories)

7. Date started Higher Physician Training ______

8. Information on concurrent or completed Higher Physician Training in other specialties

______

9. I hereby apply to undergo Exit Assessment in __________________in *June / December 20___.

(specialty)
Applicable to Exit Assessment to be held in June 20___: I confirm that by 14 October 20___ I will
have completed ___ months of Higher Physician Training in ___________.
Applicable to Exit Assessment to be held in December 20___: I confirm that by 14 April 20___ I will
have completed ___ months of Higher Physician Training in ___________.

10. Training experience in a general medical unit with obstetric consultations for a minimum of three
months during BPT or HPT (applicable to trainees who start BPT from 1 July 2009 onwards):
*Yes/*No

11. *I confirm that I shall submit my Dissertation before the date as specified by the Specialty Board and I
understand that failure to comply will automatically disqualify me for the Exit Assessment.

11.1 The title of my Dissertation is:

11.2 I do solemnly and sincerely declare that my Dissertation will comply with prevailing policies
regarding plagiarism and copyright protection. I acknowledge that the copyright of my
dissertation belongs to Hong Kong College of Physicians. My consent is hereby given to the
College to retain a copy of my dissertation, in written and/or electronic format, at the College
Secretariat and allow the public to have free access to the work for reference.

12. I shall not be able to take part in Exit Assessment in June / December 20__ as I shall be pursuing
overseas study.

13. I have taken extended leave of absence (that is, in addition to my entitled Annual Leave and Study
Leave) in the following categories during my Higher Physician Training period:
 Sick Leave - ________ weeks (from _______________ to ________________)
 Maternity Leave - ________ weeks (from _______________ to ________________)
 other types of Special Leave (please specify ____________________________________________)
- ________ weeks (from _______________ to ________________)
18
 Total duration of extended leave: _____ weeks
[Please be reminded that a Trainee who has a cumulative extended leave of absence in the above
category(s) of over 14 weeks during the training period is considered to have insufficient duration of
training and thus would need to defer the Exit Assessment.]

14. I hereby consent to the release of any and all information in any way pertaining to all my Exit
Assessment results to Hospital Authority (HA), Specialty Programme Director (SPD) and Chief of
Service (COS) or any government agency requiring the same whether or not listed above.

Note 1 *Delete whichever is inappropriate

2 Candidates who have to submit a Dissertation for Exit Assessment should refer to the Section
“Guidelines on Writing a Dissertation” in the Training Guidelines for instructions.

______________________________
Signature of Applicant Date

19
 EA Application 2/2 06/19

Application for Exit Assessment

TESTIMONIA L

Specialty in ___________________

To be completed by Trainers.

The College fully expect Trainers to refuse to sign testimonials for candidates whose training is considered to
be inadequate or who are regarded as being unfit in moral character or professional conduct to be admitted to
Fellowship. Should the candidate fail the examination badly, the College will notify the proposers and may
require evidence of further training before the examination can be taken again.

We certify from personal knowledge and repute that

FULL NAME OF CANDIDATE

is as regards character and professional conduct, a fit and proper person to be admitted a Fellow of the Hong Kong
College of Physicians, and also that he/she has had a period of training which complies with the most recent College
Guidelines.

Signature of Proposer (1) Date

Signature of Proposer (2) Date

Details of Proposer (1) Details of Proposer (2)

(Normally the Candidate’s Supervisor) (Normally the Candidate’s Chief of Service)

Name Name

Professional Professional
Appointment Appointment

Address _______________________________________ Address _______________________________________

______________________________________________ ______________________________________________

Relevant Qualification ______________________________ Relevant Qualification ______________________________

__________________________________________________ __________________________________________________

Please return to:

Examination Co-ordinator of each Specialty Board before 31 January or July each year.

20
 EA Dissertation 1/1 07.02

HONG KONG COLLEGE OF PHYSICIANS

Marking Sheet for Dissertation
(To be kept by the Specialty Board)

Specialty ______________________

Name of candidate ________________________________ Hospital _____________________

Name of supervisor ___________________ Exit Assessment Day______________________

Title of Dissertation

__________________________________________________________________

__________________________________________________________________

0 Exceptionally bad failure

1 Very bad failure
2 Bad failure
3 Definite failure
4 Borderline failure
5 Definite pass
6 Fairly good
7 Good
8 Very good
9 Excellent
10 Outstanding

0 1 2 3 4 5 6 7 8 9 10

Originality

Methodology
& Interpretation

Clarity of Presentation

Review of Literature

Overall Appraisal

Comments _______________________________________________________

_______________________________________________________

Name of Examiner _______________

21
 EA Individual Scoring 1/2 07.11

Hong Kong College of Physicians

Scoring Sheet for Exit Assessment
(To be kept by the Specialty Board)

Specialty Board in ___________________

Date of Assessment_________________

Name of Candidate _________________________________ Hospital _____________ PD __________________________

No. of months in ___________ training from Interim to Exit _________________________

Examiner 1 Examiner 2 Examiner 3 Examiner 4

Name of Examiner

Signature

Dissertation Appraisal Subtotal =  DAn

if n = 2 or
=DAn x 2/3
if n = 3
Dissertation Viva Subtotal =  DVn

Clinical Viva Subtotal =  CV

Total = DS + CVS

DA = Dissertation Appraisal
DV = Dissertation Viva
CV = Clinical Viva
DS = Dissertation Score
CVS = Clinical Viva Score
22
 EA Individual Scoring 2/2 07.02

Hong Kong College of Physicians

Scoring Sheet for Exit Assessment

Specialty Board in _____________________

Questions asked in Clinical Viva
1. _________________________________________________________________________________________________________________

2. _________________________________________________________________________________________________________________

3. _________________________________________________________________________________________________________________

4. _________________________________________________________________________________________________________________

5. ________________________________________________________________________________________________________________

6. _________________________________________________________________________________________________________________

Converted Score ________________________________ Comment _______________________________________________

Result (pass/fail) ________________________________ _______________________________________________

23
 EA Assessment Board 1/5 07.11

HONG KONG COLLEGE OF PHYSICIANS

HIGHER PHYSICIAN TRAINING
EXIT ASSESSMENT IN _________________ SPECIALTY
(To be kept by the Specialty Board)

NAME ____________________________________________________________________________

QUALIFICATION MBBS/specify ____________________ DATE ____________________(m/y)

HKCP Intermediate Exam/MRCP/specify ____________ DATE ______(m/y)

Basic Physician Training From ___________________ (m/y) To ___________________(m/y)

Date of entry to higher specialty training in ____________________Specialty______________(m/y)

Concurrent or completed training in other specialties Yes/No Specify ______________

TRAINING RECORD Specialty ________ ______

PERIOD ______________ to ______________, INSTITUTION ______________ ______
PERIOD ______________ to ______________, INSTITUTION ______________ ______
PERIOD ______________ to ______________, INSTITUTION ______________ ______
PERIOD ______________ to ______________, INSTITUTION ______________ ______
PERIOD ______________ to ______________, INSTITUTION ______________ ______
PERIOD ______________ to ______________, INSTITUTION ______________ ______

DATE OF ASSESSMENT ______________ Previous Exit Assessment: Nil/Date ________________

Interim Assessment: Date ______ Score ________

Please use the following 10-point Scoring System.

10 Outstanding
9 Excellent
8 Very good
7 Good
6 Fairly good
5 Definite pass
4 Borderline failure
3 Definite failure
2 Bad failure
1 Very bad failure
0 Exceptionally bad failure

24
 EA Assessment Board 2/5 07.11

1 TRAINING RECORD BOOK (LOG BOOK) & SUPERVISOR’S EVALUATION

0 1 2 3 4 5 6 7 8 9 10
Comments _____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

2 DISSERTATION ASSESSMENT
Title _________________________________________________________________________

______________________________________________________________________________

Dissertation appraisal score (max 20) ___________________

Dissertation viva score (max 20) _______________________

Questions _______________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Dissertation (max 40)

Dissertation Appraisal (max 20) Dissertation Viva (max 20)
DAmax=10 DAmax=10 DAmax=(10) DVmax=10 DVmax=10
DAtotal = DAn if n=2 DVtotal = DVn
Or
DAn x 2/3
if n=3
Total = DAtotal + DVtotal

Note: DA = Dissertation Appraisal

DV = Dissertation Viva

3 CLINICAL VIVA

 Clinical assessment, questions

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

25
 EA Assessment Board 3/5 07.11
Comments _____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

 Other assessment, questions

(ethical, humanistic qualities,
resource management etc)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Comments_______________________________________________________________________
________________________________________________________________________________
______________________________________________________________________________

4 ASSESSMENT SCORE (max mark)

Total Dissertation Score Clinical Viva Final Status

Appraisal Oral Score (Dissertation +
(20) (20) (60) Clinical Viva) Pass
Score
(100) Fail
2 Sections

If n = 3, Subtotal= Dissertation
Sub-total = Clinical Viva
 n = 3 x 2/3
Total = Total =

5 TRAINEE’S COMMENTS

On the training programme

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

On the training facilities of the institution(s)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

26
 EA Assessment Board 4/5 07.11
6 RECOMMENDATION
Score  50 + Passes in both sections.
Pass: Successful completion of training; for accreditation
Other Recommendation & Comments

___________________________________________________________________________
___________________________________________________________________________

Score  50 + Pass in one section & borderline fail in one section.

Pass: Successful completion of training; for accreditation
Other Recommendation & Comments

___________________________________________________________________________
___________________________________________________________________________

Score <50 (90-99% of section pass mark)

Borderline Fail in 1 section (Dissertation/clinical viva)
Bare fail. Repeat Exit Assessment in failed section in six months
Areas of deficiency and remedial action(s): Repeat Exit Assessment in the failed section
after an additional 6-month training in the relevant specialty.

___________________________________________________________________________
___________________________________________________________________________

Score <50 (90-99% of section pass mark)

Borderline Fail in 2 sections
Bare fail. Repeat Exit Assessment in failed section in 12 months
Areas of deficiency and remedial action(s): Repeat full Exit Assessment after an additional
12-month training in the relevant specialty.

___________________________________________________________________________
___________________________________________________________________________

Any Score (80-89% of section pass mark)

Fail in one section. Repeat Exit Assessment in six months
Areas of deficiency and remedial action(s): Repeat full Exit Assessment after an additional
6-month training in the relevant specialty.

___________________________________________________________________________
___________________________________________________________________________

Any Score (80-89% of section pass mark)

Fail in two sections. Repeat Exit Assessment in 12 months
Areas of deficiency and remedial action(s): Repeat full Exit Assessment after an additional
12-month training in the relevant specialty. Trainees should be exposed to trainers in
other institution(s) for six months.

___________________________________________________________________________
__________________________________________________________________________

27
 Any Score (<80% of section pass mark)
Bad Fail in one section. Repeat Exit Assessment in 12 months
Areas of deficiency and remedial action(s): Repeat full Exit Assessment after an additional
12-month training in the relevant specialty.

EA Assessment Board 5/5 07.11

___________________________________________________________________________
_________________________________________________________________________

Any Score (<80% of section pass mark)

Fail in two sections. Repeat Exit Assessment in 12 months
Areas of deficiency and remedial action(s): Repeat full Exit Assessment after an additional
12-month training in the relevant specialty, of which 6 months should be undertaken in
programmes and/or training centres specified by the Specialty Board.

___________________________________________________________________________
___________________________________________________________________________

Deficiency in learning facilities of institution noted; actions recommended

___________________________________________________________________________
___________________________________________________________________________

Assessment Board (at least one member should represent HKCP Council/Education &
Accreditation Committee/Examination Committee):

( ) Examiner 1 (Chairman)

( ) Examiner 2

( ) Examiner 3

( ) Examiner 4
____________________________________________________________________________________
( ) Examiner 5
____________________________________________________________________________________
( ) Examiner 6

28
 EA Individual Report 1/1 07.11
HONG KONG COLLEGE OF PHYSICIANS
REPORT ON HIGHER SPECIALTY TRAINING EXIT ASSESSMENT
(To be kept by Specialty Board and E&AC Secretariat)

Name of Candidate ___________________________________ Hospital _____________________

Specialty Board

Date of Assessment

Previous Exit Assessment No Yes Date

Interim Assessment Date Date

Score Score
MBBS (m/y)
HKCP Intermediate Exam (m/y)

Basic Physician Training From (m/y)to (m/y) Duration (yr)

Higher Physician Training From (m/y)to (m/y) Duration (yr)

Concurrent or completed training Specify _____________________________________________

in other specialties Yes/No

Assessment Score (max mark)

Total Dissertation Score Clinical Viva Final Status
Appraisal Oral Score (Dissertation +
(20) (20) (60)# Clinical Viva) Pass
Score
(100) Fail
Panel A Panel B Panel C 2 Sections
Dissertation
If n = 3, Subtotal= Panel D*
Sub-total = Clinical Viva
 n = 3 x 2/3
Total = Total =
* If necessary (for a few Specialty Boards only)
# The Assessment Board should discuss and provide written comments on gross discrepancies between different
examiners’ mark (ie ≥ 3 for each section or subsection)

Recommendation Successful completion of training for accreditation

Others:

Board Chairman Signature Date

(Block Letters)

29
 EA E&AC Report 1/1 10.02
Please use additional sheet as required

Hong Kong College of Physicians

Report on Higher Specialty Training Exit Assessment
Specialty Board in __________________
(To be kept by the E&AC Secretariat)
Date _____________

Name of Candidate Hospital Date of HPT Dissertation Clinical Viva Total Status
Completion (15 minutes) (45 minutes) Score (P: Pass
Individual  Oral  Subtotal for Individual Score**  Clinical [100] F: Fail in
Appraisal Appraisal Oral Dissertation Viva 2 sections /
Score* [20] [20] [40] A A B B C C Score dissertation
[60] / viva)

* If n = 3, Appraisal score =  n = 3 x 2/3 ** A = Panel A, B = Panel B, C = Panel C. Specific nature of Panels may be included in the boxes below.

Note 1 Normally, two examiners will read the dissertation. When the results of the appraisal are one failure and one pass, a third examiner will be required to read the
dissertation. The total marks given by the three examiners will then be multiplied by a factor of 2/3 to obtain the Dissertation Appraisal Score.
Note 2 Effective from December 2002, candidates who do not have to be examined in the Dissertation need only attend the Clinical Viva for 45 minutes. The total Clinical
Viva Score should be rounded up or down (0.5=1, <0.5=0) to the nearest integer

Signature

Name (Block Letters)

Board Chairman
Date

30
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