医院授权申请书

1.1 Please submit the following documents with your application:

• Completed application form (Admission Privilege)
• Recent Photo
• Copies of certificates: Medical / Dental School qualifications, Internship, Residencies, and Fellowships.
• Curriculum vitae
• A copy of your Hong Kong Medical Registration Certificate, and your current Annual Practicing Certificate for Hong Kong;
• A copy of your Specialist Registration Certificate, if applicable
• Evidence of good clinical training and experience (in particular relating to special procedures); and preferably have supervised training in a recognized institution for a minimum of 5 years post fellowship.
• Medical Professional Indemnity Insurance Coverage and a current valid receipt from your insurer
• Signed reply slip of PHA Code of Practice
• Signed form for Release of Medical Protection Society Membership Information Pre- Authorization Letter
• The names of three Referees & Three Reference Forms / Letters
• If you are also applying for special procedure privileges, documentation of your experience in regard to the particular procedure must be provided

** Granting Hospital privileges or not and revocation of said privileges are at the discretion of the Credentialing Committee and Hospital Administration. **

1.2 Professional References

The Hospital requires this Reference Form to be completed, together with the Reference Letter, as part of your application process. This constitutes your authority to provide information about your character and professional abilities, favorable or otherwise, directly to Hong Kong Adventist Hospital – Stubbs Road.

Names of three Referees, together with their mailing addresses / Email addresses / FAX numbers are required. One of the referees must be a physician who is practicing in the same specialty as the applicant. 

1.3 How to submit the documents to the Hospital

Please contact the Medical Affairs Office (Direct phone: (852) 2835 0581) for a copy of the Application Form, or download the Application Form from the below paths.

Completed Application Forms, together with all documents listed under paragraph 1.1 should be returned to the Hospital Medical Affairs Office at 4C, La Rue Building, Hong Kong Adventist Hospital – Stubbs Road, 40 Stubbs Road, Wanchai, Hong Kong. (By FAX (852) 2574 6001 or Email (medicalaffairs@hkah.org.hk) 

1.4 Application result notification

Application processing normally takes 8-10 weeks. A letter will be sent by post to the applicant, informing them of the Hospital’s decision.

Each doctor is required to send copies of their annual renewal Practicing Certificate and Medical Professional Indemnity Insurance Coverage to the Hospital, in order to update the Hospital’s Doctor Database. The Hospital formally updates all doctor’s personal data every three years. Doctors are also required to inform the Hospital in writing, whenever there is any change in their personal or professional data.

Doctors are advised to study the Hospital information & guidelines for applicants, prior to making application.

• Medical Staff By-Laws, Rules and Regulations  { pdf format }

Download - Application Forms for

1. Admission privilege { pdf format }
2. Gastrointestinal Endoscopy Privilege { pdf format }
3. Minimally Invasive Surgery Privilege { pdf format }
4. Robotic Surgery Privilege { pdf format }

5. Guidelines for Robotic Surgery Privilege (General Surgery) { pdf format } and Sample – Certificates { pdf format }

6. Guidelines for Robotic Surgery Privilege (Orthopaedics & Traumatology) {pdf format } and Sample – Certificates {pdf format }

7. Guidelines for Robotic Surgery Privilege (Urology) { pdf format } and Sample – Certificates { pdf format }

Other forms

• Code of Practice of PHA { pdf format }
• Reference Form { pdf format }
• Release of Medical Protection Society Membership Information Pre-Authorization Letter { pdf format }