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How is life as a doctor in Singapore?

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  #2521 (permalink)  
Old 08-08-2021, 03:38 PM
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Is fm residency really worth doing for people planning to Do gp work in the future?
I am currently a fm resident going through a surgical (orthopaedic) rotation. Unfortunately I am posted to 1 team (spine) for the whole duration of the posting. Personally I don't see much learning value (I mean you don't need 3 months of spine to learn about back pain/neck pain in a fm context) and the spine surgeries (e.g tlifs) have totally no relevance to FM.
Was wondering if it would be better to just quit and join as a ops rp (for the remainder of my bond) before becoming a private gp eventually?

My understanding is that mmed has no value in the private sector, hence my focus is on the learning, how can I maximise the learning for the remainder of my bond so that I can become a competent gp in the future.

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  #2522 (permalink)  
Old 08-08-2021, 05:57 PM
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Is fm residency really worth doing for people planning to Do gp work in the future?
I am currently a fm resident going through a surgical (orthopaedic) rotation. Unfortunately I am posted to 1 team (spine) for the whole duration of the posting. Personally I don't see much learning value (I mean you don't need 3 months of spine to learn about back pain/neck pain in a fm context) and the spine surgeries (e.g tlifs) have totally no relevance to FM.
Was wondering if it would be better to just quit and join as a ops rp (for the remainder of my bond) before becoming a private gp eventually?

My understanding is that mmed has no value in the private sector, hence my focus is on the learning, how can I maximise the learning for the remainder of my bond so that I can become a competent gp in the future.
Ortho spine not useful. Hand and knee can be useful.
But do learn a bit of h&l. (But rmb to take consent)

Tbh most Precious postings are eye, ent, derm.

Gen surg and med no value.
Ops rp is just service. See rubbish.

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  #2523 (permalink)  
Old 09-08-2021, 12:55 AM
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Ortho spine not useful. Hand and knee can be useful.
But do learn a bit of h&l. (But rmb to take consent)

Tbh most Precious postings are eye, ent, derm.

Gen surg and med no value.
Ops rp is just service. See rubbish.
Why is OPS rubbish? Biggest part of GP work is communications/sales. Ability to connect with patients find common ground small talk make their experience happy and pleasant make them like you. Often by saying what the patients want to hear
Agree with what they have heard and read regarding their condition

Best is to locum. All the EBM stuff in hospital and even OPS is not really tha
t important in GP land. Dont believe me? Try "convincing " anti vaxxer for covid to go for vax. Vs agree with anti vaxxer it is their personal choice. It is the same with antibiotics for cold and flu. Patients who refuse pharma medication for everything. You will meet them cos they get no understanding ans care at hospitals and OPS.

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  #2524 (permalink)  
Old 09-08-2021, 09:07 AM
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Try "convincing " anti vaxxer for covid to go for vax. Vs agree with anti vaxxer it is their personal choice. It is the same with antibiotics for cold and flu. Patients who refuse pharma medication for everything. You will meet them cos they get no understanding ans care at hospitals and OPS.
Long term effects of Covid vaxx are unknown.
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  #2525 (permalink)  
Old 09-08-2021, 11:16 AM
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Is fm residency really worth doing for people planning to Do gp work in the future?
I am currently a fm resident going through a surgical (orthopaedic) rotation. Unfortunately I am posted to 1 team (spine) for the whole duration of the posting. Personally I don't see much learning value (I mean you don't need 3 months of spine to learn about back pain/neck pain in a fm context) and the spine surgeries (e.g tlifs) have totally no relevance to FM.
Was wondering if it would be better to just quit and join as a ops rp (for the remainder of my bond) before becoming a private gp eventually?

My understanding is that mmed has no value in the private sector, hence my focus is on the learning, how can I maximise the learning for the remainder of my bond so that I can become a competent gp in the future.
Singapore's nascent FM residency training is understandably subpar as it's very much in it's infancy with primary care as the bulwark of a nation's healthcare system a new concept locally (Singapore healthcare system is still very much specialist-driven). They should have adopted the Australian RACGP training programme which is world renowned for producing specialist GPs able to act as mini-specialists in all specialities due to the need to be able to practice independently in remote areas. Canada is another country with superior FM training but it's demographics are less like Singapore's compared to Australia
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  #2526 (permalink)  
Old 09-08-2021, 11:17 AM
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Singapore's nascent FM residency training is understandably subpar as it's very much in it's infancy with primary care as the bulwark of a nation's healthcare system a new concept locally (Singapore healthcare system is still very much specialist-driven).

They should have adopted the Australian RACGP training programme which is world renowned for producing specialist GPs able to act as mini-specialists in all specialities due to the need to be able to practice independently in remote areas. Canada is another country with superior FM training but it's demographics are less like Singapore's compared to Australia.
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  #2527 (permalink)  
Old 09-08-2021, 12:55 PM
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Originally Posted by Unregistered View Post
Is fm residency really worth doing for people planning to Do gp work in the future?
I am currently a fm resident going through a surgical (orthopaedic) rotation. Unfortunately I am posted to 1 team (spine) for the whole duration of the posting. Personally I don't see much learning value (I mean you don't need 3 months of spine to learn about back pain/neck pain in a fm context) and the spine surgeries (e.g tlifs) have totally no relevance to FM.
Was wondering if it would be better to just quit and join as a ops rp (for the remainder of my bond) before becoming a private gp eventually?

My understanding is that mmed has no value in the private sector, hence my focus is on the learning, how can I maximise the learning for the remainder of my bond so that I can become a competent gp in the future.
It really depends on your main goal at the end of the day.
If your main goal is just to be a salaried GP, or open your chain of clinics.
Clock the hours, see patients, go home, feed your family for the next 30 years.
MBBS +/- GDFM is enough.
Chains are happy to pay you $13-14k to clear the patients even with MBBS.
Patients will see you regardless of your academic qualifications provided you are a decent communicator and you don't prescribe rubbish multivitamins anyhow for dizziness (my wife with normal diet / BMI got this from the rubbish GP near my house).

If you are unsure... It's always to get an MMed first since you are already on track to getting it.
MMed prepares you to be a family physician at a different level.
It's not just to see your patient's one issue and kick them out of the door.
You learn to manage various issues holistically, and equips you to manage various conditions that most MBBS / GDFM graduates would rather refer on.
It also allows you to climb up the ranks in the public sector (OPS, Comm Hosp, FM departments in restructured hospitals...).
It allows you to take on teaching roles, administrative / management roles to make a difference in FM in the public sector.

So at the end of the day, ask yourself what really matters and what you see yourself doing in the long run.
As somebody else posted, FM is in a rather nascent stage at present.
Why not equip yourself to be a part of building FM to be a credible and reliable first line / primary care in Singapore?
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  #2528 (permalink)  
Old 09-08-2021, 06:41 PM
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Singapore's nascent FM residency training is understandably subpar as it's very much in it's infancy with primary care as the bulwark of a nation's healthcare system a new concept locally (Singapore healthcare system is still very much specialist-driven).

They should have adopted the Australian RACGP training programme which is world renowned for producing specialist GPs able to act as mini-specialists in all specialities due to the need to be able to practice independently in remote areas. Canada is another country with superior FM training but it's demographics are less like Singapore's compared to Australia.
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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  #2529 (permalink)  
Old 09-08-2021, 10:00 PM
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Originally Posted by Unregistered View Post
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.

I think what the OP meant was that gps can do more in overseas country, especially in rural areas where access to tertiary centres are more limited. (For e.g delivery of babies, minor surgical procedures etc. For e.g when I was a med student in UK, one of the gps that I was posted to could do carpal tunnel release)
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  #2530 (permalink)  
Old 09-08-2021, 10:39 PM
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Originally Posted by Unregistered View Post
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.
.
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.)
.
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.
.
- 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)
.
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)
.

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
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