HKMLE Part I: Licensing Examination Content
Part I of the Hong Kong Medical Licensing Examination (HKMLE) is the written, knowledge-based component of the Medical Council of Hong Kong's licensing process. It uses single-best-answer multiple-choice questions in two papers, and must be passed before the clinical and practical parts. No itemized syllabus is published, so revise by system and by presentation, at the depth expected of a doctor who has completed the undergraduate curriculum and can safely recognise and start managing common and emergency presentations in Hong Kong.
What the content covers
Expect the full undergraduate range: medicine, surgery, orthopaedics and traumatology, obstetrics and gynaecology, paediatrics, psychiatry, anaesthesia and intensive care, radiology, pathology, community and family medicine, ENT, ophthalmology and dermatology. Ethics, law and public health are woven through rather than isolated. Local material matters: notifiable diseases, tuberculosis, hepatitis B, the Hong Kong childhood immunisation schedule, controlled drugs, the Mental Health Ordinance, consent and confidentiality, and Coroner referrals.
How the questions are built
Most items are short vignettes. Usually one or two details discriminate the answer - an abnormal vital sign, a drug history, a travel history, an age cut-off. Expect "most likely diagnosis", "most appropriate next step", "most appropriate investigation", mechanism and risk-factor items. Management questions test the first safe step, not the definitive specialist step.
Worked example
A 70-year-old man with atrial fibrillation on warfarin presents with melaena and blood pressure 92/58 mmHg; INR is 4.8. What is the most appropriate next step?
A. Oral vitamin K 10 mg B. Intravenous vitamin K plus prothrombin complex concentrate C. Fresh frozen plasma alone D. Stop warfarin and observe E. Urgent colonoscopy before correcting coagulopathy
Answer: B. Haemodynamic compromise makes this a major bleed. Vitamin K alone takes hours; PCC replaces factors II, VII, IX and X within minutes and is standard for warfarin-related major bleeding. FFP needs large volumes and acts more slowly. Endoscopy follows resuscitation and reversal. The mark turns on "unstable plus anticoagulated equals immediate reversal", not on naming the bleeding site.
Traps that cost marks
- Giving the correct diagnosis when the stem asks for the next step, or vice versa.
- Overlooking a single negative (no fever, normal neurology) that rules out the obvious answer.
- Choosing a true statement over the best one - all five options may be plausible.
- Applying UK or US thresholds where Hong Kong practice differs.
- Answering ethics and law items from intuition rather than the relevant Hong Kong statute.