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Originally Posted by Unregistered
What's Ur basis for saying the sg residency is subpar? Did u train in both? Any measures done objectively in any studies anywhere? Didn't Ur racgp training teach u anything about evidence based statement?
If not, then dun bring your amdk sense of superiorty here and snub local pls. Study a few years overseas then come here and blow. If so pro, no need go overseas to study medicine Liao la. Just pass Ur racgp exam and feeling top of the world is it ? Hello...still a gp nia. What world renowned for producing mini specialist and specialist gp. Self glamourising , desperate for recognition and need for validation to be call a specialist? The racgp is still a 3 year program like almost everywhere else in the world.
Giving duodart for bph does not make u urologist. Able to deliver a baby does not make u an obesterician. Able to cut out some bcc and scc out does not make you a dermatologist.
FM training is not about acting as mini specialist. It's a broad based discipline. What mini specialist..unless u tell me u can do a angioplasty for the guy with stemi in the rural area, repair the triple AAA etc.
I'm proud to be a generalist trained by the sg fm residency. I dun need to call myself a mini specialist or be recognised as one and certainly doesn't need a racgp curriculum to serve the needs of the sg population well.
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I do feel that Singapore GPs/FM are less skilled compared to our overseas counterpart, mainly due to the geography and structure of our healthcare landscape. (disclaimer: I am a local grad, currently FM resident, that has never been trained overseas.)
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The Biggest reasons for this in my opinion is the ease of accessibility to tertiary care in the local context
- For e.g
> which GP in Singapore will deliver a baby when the tertiary obstetric centers (
NUH/KKH) are at most 30 min away
> even for simple surgical procedures like abscess/removal of lumps, most GPs dont do it (I know some do, but most, esp those in OPS dont and simply refer them on)
> I mean we are all taught how to perform delivery (of babies) and I&D during residency training, but if you don't practice it, you will become deskilled eventually.
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- There is also a tendency to over refer patients.
I mean when I was running clinics during my rotations in ortho, ED, I do encounter many referrals which are inappropriate in my opinion
- For e.g referring asymptomatic patients with BP of 170-180 systolic or BSL of 18 (when it is measured post prandial) to ED
- Referring patients with mild OA knees/2 week history of back pain (with no radiculopathy) to Ortho (Hip/knee and spine respectively)
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Of course there are also other reasons in play such as
- the nature of our patients in general (most of them do tend to prefer consulting specialists/hospital based care)
- the structure of our healthcare funding system
> most people prefers inpatient care as they can utilize their medisave. (There is a cap on medisave use for outpatient care)
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I dont think our residency program is bad, but I do feel that there is a limit to what GPs can do in singapore.
I personally dream to practice FM in a different country (preferably in rural town) but unfortunately impossible nowadays due to covid situation