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How is life as a doctor in Singapore?

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  #2611 (permalink)  
Old 23-08-2021, 12:06 AM
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What's wrong with ordering mri as long as they pay out of own pocket.
I never stopped anybody from driving Toyota bmw or merc as long as they pay out of own pocket
I never stopped anybody from eating at restaurant as long as they can pay for themselves even though they should be cooking at home to save money.

However if they are susidized, then mri needs to have a valid indication.
You see doctors see things in moral black or white. "Lousy GP". "GP only where is specialist"?

Follow guidelines or else you are lousy dr.

In fact medical school trains drs this way. Follow guidelines. Order tests only when guidelines say there is a need. Save money and resources.

It is all good in a world of paternalistic medicine. But this is no longer the case especially in pte sector.

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  #2612 (permalink)  
Old 23-08-2021, 12:21 AM
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From the way u write, I can already say u are one of the lousy gp. And really one of the reason why I think untrained gp like you should not be allowed to continue practicing independently and tainting patient expectation of doctors.

Your MRI example is a lousy one. Even if the pat complain and finds that u deny a patient a MRI for a 3 day hx of back pain but eventually turn out to be a rare tumour , u will not be medically neligent unless there are other signs that points to something sinister. Because u lack training , you have no idea what is going on and all you can do safely is transfer the burden of care to someone else. So lousy medically that you don't even dare to standby your own assessment . You don't even deserve a MBBS. My apn can probably do a better job than you. If u had been properly trained, u would have know that such pat often have thier own ideas and expectations, most of them dun really want the MRI, they just want reassurancre. U really think even with insurance,any of them want to take time off work, go visit a specialist , sit inside a machine for few hours, visit specialist again, then deal with the insurance agent to claim money? Pls la.


If you give a patient just what he wants, u are essentially not doing your job. Your backpain example is not uncommon, many Indian and PRC patient request for it. If u just sit at your desk and try to reassure the pat he is ok, of cse he don't believe. Do a full physical, teach them some back self physio, give proper safety netting advice. 90 percent of such patient all understands and no one pushes u for a MRI. The remaining 10 percent no choice, they have their agenda and u refer and confirm all come back normal.
From the way you write you are a young punk MO who has no idea what practicing medicine is really like and will likely get many complaint letters because you think you know what patients want without actually asking them. What a joke.

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  #2613 (permalink)  
Old 24-08-2021, 02:50 PM
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From the way you write you are a young punk MO who has no idea what practicing medicine is really like and will likely get many complaint letters because you think you know what patients want without actually asking them. What a joke.
I agree with this. Even YP MOS nowadays should know that in their medical school training - you ask the patient about their ICE (insight concern and expectations). Your management should to a certain extent address their expectations. Guidelines are one thing , forcing them down patients throats without empathizing with them is another.

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  #2614 (permalink)  
Old 24-08-2021, 11:03 PM
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May I just add that back pain is just a really bad example.
Most doctors including spine surgeons have no clue what's happening.
Traditional approach to back pain is taught by orthopaedic surgeons who are just interested in ruling out cauda equina, PID and radiculopathy, and couldn't care less unless the patient wants surgery. If you've ever worked in a spine clinic you will know what I mean.
Back pain management is multi faceted, and hence the need for guidelines to form some basis for management, along with managing the ICE of the patient.

So there is no point debating about either extremes.
OP said - guidelines only for mmed doctors, no point reading it.
another guy says - just do what the patient ones, manage ICE.
we all know the truth is somewhere in between.
know what the rules and guidelines are, and gain enough experience and clinical acumen to bend the rules when required.
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  #2615 (permalink)  
Old 24-08-2021, 11:23 PM
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May I just add that back pain is just a really bad example.
Most doctors including spine surgeons have no clue what's happening.
Traditional approach to back pain is taught by orthopaedic surgeons who are just interested in ruling out cauda equina, PID and radiculopathy, and couldn't care less unless the patient wants surgery. If you've ever worked in a spine clinic you will know what I mean.
Back pain management is multi faceted, and hence the need for guidelines to form some basis for management, along with managing the ICE of the patient.

So there is no point debating about either extremes.
OP said - guidelines only for mmed doctors, no point reading it.
another guy says - just do what the patient ones, manage ICE.
we all know the truth is somewhere in between.
know what the rules and guidelines are, and gain enough experience and clinical acumen to bend the rules when required.
Agree with you. Obviously you are someone with experience dealing with real patients.
At the end of the day, patient autonomy trumps. As physicians we try to give our professional assessment and plan of management. Sometimes the patient agrees sometimes they dont. We are always tasked to find the "common ground". But frankly speaking if there is a total difference in opinion, it is still best to go with the decision of the patient. As long as it does no harm.
What kind of facility you practice in also heavily influences what is done which can be very different between a GP clinic, a specialist pain clinic, a spine surgeon's office, an interventional pain management specialist.
Be respectful of every doctor's situation and opinions. I find the profession is too quick to disparage other doctors.
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  #2616 (permalink)  
Old 26-08-2021, 08:04 AM
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Was surfing internet post-call when I found that Perth hospitals are looking to hire international doctors. s://7news.com.au/lifestyle/health-wellbeing/wa-offers-cash-to-overseas-doctors-nurses-c-3648341

Heard their ho pay is A$100k already, regs must be A$200k? I just checked, there is no covid in Perth unlike Sydney. 5 hours direct flight from Singapore. Anyone keen to apply?
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  #2617 (permalink)  
Old 26-08-2021, 11:13 AM
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Was surfing internet post-call when I found that Perth hospitals are looking to hire international doctors. s://7news.com.au/lifestyle/health-wellbeing/wa-offers-cash-to-overseas-doctors-nurses-c-3648341

Heard their ho pay is A$100k already, regs must be A$200k? I just checked, there is no covid in Perth unlike Sydney. 5 hours direct flight from Singapore. Anyone keen to apply?
Singapore doctor qualifications will not qualify. Sorry man.
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  #2618 (permalink)  
Old 27-08-2021, 04:00 AM
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Was surfing internet post-call when I found that Perth hospitals are looking to hire international doctors. s://7news.com.au/lifestyle/health-wellbeing/wa-offers-cash-to-overseas-doctors-nurses-c-3648341

Heard their ho pay is A$100k already, regs must be A$200k? I just checked, there is no covid in Perth unlike Sydney. 5 hours direct flight from Singapore. Anyone keen to apply?
s://.medicalboard.gov.au/registration/international-medical-graduates/competent-authority-pathway.aspx

Burst your bubble.

They only want drs from
1) UK
2) Canada
3) USA
4) NZ
5) Ireland

Singapore cannot. In the early days SG GPs could take the FRACGP or MRCGP as part of their training. But later MOH found too many SG GPs migrating to Australia to work because Oz recognizes those qualifications as equivalent to their own.

This is why Singapore GPs and FMs DO NOT TAKE ANY foreign exams. The Singapore MMed Fam Med is what they take. And MOH refused to work with the Oz and UK Colleges to have reciprocity for the qualifications. So thank MOH for effectively restricting all Singapore FMs to only being able to work in Singapore.
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  #2619 (permalink)  
Old 27-08-2021, 10:46 AM
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s://.medicalboard.gov.au/registration/international-medical-graduates/competent-authority-pathway.aspx

Burst your bubble.

They only want drs from
1) UK
2) Canada
3) USA
4) NZ
5) Ireland

Singapore cannot. In the early days SG GPs could take the FRACGP or MRCGP as part of their training. But later MOH found too many SG GPs migrating to Australia to work because Oz recognizes those qualifications as equivalent to their own.

This is why Singapore GPs and FMs DO NOT TAKE ANY foreign exams. The Singapore MMed Fam Med is what they take. And MOH refused to work with the Oz and UK Colleges to have reciprocity for the qualifications. So thank MOH for effectively restricting all Singapore FMs to only being able to work in Singapore.
Dun anyhow la.

Firstly the competent authority pathway is to recognise equivalent internship experience for general registration. Singapore was actually recognised till moh ask them not to recognise it.
You can still go there to work with limited registration upon doing the AMC exams and upon completing an internship equivalent of some surgical, medial and a&e rotation, gain full registration.
A bit more hoops to jump but highly doable.

Also, not moh refuse to work. It's racgp gradually restricting their recognition. A m.med fm done before 2010 was fully transferable to a a fracg without further assessment. Gradually as they have more and more local gp, the m.med was accorded as partially equivalent and u need to pass the local exam. Now I believe the fcfp is still transferable ( might be wrong) to Australia. It is definitely transferable to New Zealand though.
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  #2620 (permalink)  
Old 27-08-2021, 11:07 AM
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Dun anyhow la.

Firstly the competent authority pathway is to recognise equivalent internship experience for general registration. Singapore was actually recognised till moh ask them not to recognise it.
You can still go there to work with limited registration upon doing the AMC exams and upon completing an internship equivalent of some surgical, medial and a&e rotation, gain full registration.
A bit more hoops to jump but highly doable.

Also, not moh refuse to work. It's racgp gradually restricting their recognition. A m.med fm done before 2010 was fully transferable to a a fracg without further assessment. Gradually as they have more and more local gp, the m.med was accorded as partially equivalent and u need to pass the local exam. Now I believe the fcfp is still transferable ( might be wrong) to Australia. It is definitely transferable to New Zealand though.
Dun anyhow la

s://.racgp.org.au/education/imgs/fellowship-pathways/fellowship-programs-for-imgs/practice-experience-program/practice-experience-program-specialist-stream/eligibility

Qualifications assessed as Substantially Comparable (family medicine training)
Canada
Hong Kong
Ireland
Malaysia!
Malta
NZ
UK


Qualifications assessed as Partially Comparable
Netherlands
Spain
Sweden
USA


Qualifications assessed as Not Comparable
Belgium
Germany
India
Kenya
Latvia
Nigeria
Philippines
Poland
SINGAPORE! MMED FAM MED
South Africa
Sri Lanka
Switzerland
UK MRCGP-INT

Singapore really lose face lumped with all those countries

I am surprised Malaysia is top tier..
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