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Old 04-02-2010, 06:38 AM
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Default Working in Singapore as a doctor - the real deal!

There is a lot of truth in all that slave of medicine and dempsey said about working conditions for the junior doctors in Singapore (in the post for salary 2007). Kudos to them for speaking up. And yes, sleep deprivation has been linked to impaired concentration, no one can credibly dispute that. Annual leave? Plenty but you can't take them because someone else is already on leave.

Singapore has been on a recruitment drive to recruit foreign doctors for an extremely long time, yet they are still very short of doctors, especially doctors they are hoping to target (who received their medical education from first world countries). When something is such a hard sell, you have to wonder why. Just like the old adage: ďWhen something is sounds too good to be true, it is too good to be true.Ē You donít see Cambridge or Oxford going overseas on recruitment drives, do you?

Actually, I think the issue here is not the salary. The overall take home salary (ie, after taxes) are comparable to what a junior doctor (HO, MO, registrar) with similar experience would earn in Australia. But, a junior doctor in Australia works much less hours, and when you break down to hourly pay, the doctors in Singapore earn much less. Besides, essentials like houses and cars are far cheaper in Australia so your standard of living is much much better than in Singapore.

I think the issue is about working conditions (likened to slavery by slave of medicine) and respect. The vast majority of the junior doctors working in Singapore are Singapore graduates bonded to the system for 5 years(because of their NUS study bond). Like it or not, they have to stay because most of them cannot afford the very large sum they have to pay back to break the bond. When one is bonded, they lose bargaining power. Like it or not, they have to accept whatever conditions get imposed to them. They do not dare to speak up because they may get bullied for 5 years if they do. And also because of the fact that they are paid by the month not by the hour, they are forced to put in a lot of extra hours. I know hospitals which have daily meetings that start at 7am and MOís have to attend. And for MOís to have to come back alone every Sunday for routine ward rounds, thatís totally uncalled for, I think. I remember a posting I did where I did not get a single day off for 2 months. Yup, I worked 60days in a row. As someone said, even maids get a compuslory day off.

And since these are the set working conditions in Singapore, the foreign grads also have to work under the same conditions. Many many foreign grads have come back to work in Singapore, then left again when they realised what they really got themselves into. If someone borrowed money from loansharks and are now subjected to their harrassments, why should you come along and be subjected to the same harrassment? Totally unnecessary. But it is a pity that these foreign grads have wasted time & effort exploring what they think is greener pastures, only to realize that the grass in Singapore is actually wilted!

I think if the seniors make us feel appreciated and try to acknowledge the hardship that the juniors go through, it does go a long way. Rather than think ďIíve been through it so you must go through it tooĒ. It may not actually change the conditions, but it makes us feel better about it. Many people are not driven by money, but by job satisfaction.

In terms of trainee positions, I canít say there is a bias against foreign grads. However, if no one knows you, youíre less likely to be selected for a job than another doctor who have worked here and is known to the seniors. Itís human nature. Even if you are on the selection panel, youíre more likely to pick someone you know, than someone you donít know isnít it?
For foreign grads who come back to Singapore, there are also hurdles like the fact that you have to form new friendship, you donít have anyone to advise you re which postings not to choose, what to look out for etc, you have no one to confide in about work worries, because you donít have any close trusted friends. You really have to start over again in far more aspects of your life than you think.

If you are prepared to work extremely hard and forget totally about work-life balance, then yes, Singapore can be the place for you. But for many people like me, work-life balance is very important. Working about 60-80 hours a week does burn you out after awhile, and sooner than you think! And think about it, if you put in 60-80hrs a week of hard work where you are right now, your chance of becoming very successful is very good, maybe even better than Singapore!

There is another issue Ė the SMC. Even though they state on their website that Singaporeans who are foreign grads can apply for full registration after two years, in reality there are a lot of people who, for no apparent good reason, are not given their full registration after two years (MOís whose performance have been consistently graded good, never made any clinical mistakes, never had complaints made against them!)Ö and the first indicator of a ďpoorĒ performance was when full registration is rejected after two years. The best thing is, they donít give you a reason why full registration is rejected! Your SMC assessment reports are not shared with you. It is likely a ploy to keep foreign grads trapped in the public system, because the foreign grads have no study bond. So foreign grad Singaporeans, be very aware! You may want to rethink your decision to come back if you think you can get full registration after two years! The actual fact is that youíre likely to be trapped in stifling working conditions for longer than you think!

As for foreign consultants who want to work in Singapore, the reality is that your hands will be severely tied with the conditional registration Ė which stipulates where you can work, how many hours you must work etc. You can forget about flexibility or locum work. You have to start all over again, and if you really think about it, youíre probably better off spending those few years building your career in where you are right now, and starting over.
The bottom line is, if you graduated from a first world country like UK, Australia, USA, youíre really MUCH better off staying put, because the working conditions and living conditions, quality of life (for yourself and your family) are far better in these countries, and spend the time/effort establishing your practice where you are. I canít say the same for doctors who currently come from the third world countries, because living conditions are probably better in Singapore compared to those third world countries and they do stand to gain by coming.

Just my opinion of course, from someone who's worked in Singapore, and overseas!
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