The Tongan government says there needs to be better bridging programmes so that medical graduates returning from study in China can practice back home.
There are currently five staff at Vaiola hospital who studied in China but are yet to be registered as doctors.
The director of health, Siale 'Akau'ola, said the graduates needed to get adequate practical experience before being registered.
Dr 'Akau'ola said difficulties were also created when medical students had to have material translated from Chinese to English and then into Tongan.
"That's a huge gap as far as we can see. We have been talking with the Chinese authorities who are offering these scholarships to find a way of improving the way that we link their graduates with where they are working here in Tonga to make sure that they end up as safe as possible for the public to utilise."
Siale 'Akau'ola said staffing levels were also affected by having to supervise graduates during their practical work.
About 20 Tongan students are studying medicine in China.