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23-12-2021, 05:06 PM
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Quote:
Originally Posted by Unregistered
Think this (capability) is very subjective. For e.g do you think a surgeon should know how to manage hypertension?
Reason why I say this is that gps in Singapore come from many different backgrounds.
You walk in to a clinic, you could be seeing a experienced gp who went through residency, completed mmed and fellowship. Alternatively you could be seeing a nsf locuming who only has 1 year of mo experience, or someone who has done orthopedic all their life as mopex and decided to quit and go gpland after failing to get into ortho residency once their bond end
They obviously have different levels of competence, hence their management and threshold to refer would also be very different..
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which is why GPs should be phased out and not allowed to work independently. it's painful and probably expensive but experience from countries all show good development of the primary care landscape from there.
we still operating in the developing world model of not enough doctor and allowing the registered doctor to open shop but have expectations of a developed country primary care results.
I dare say polyclinic operate to world class standard but overall markers of a good primary care system bogged down by the inefficiency of the private gp of which is 3000 strong. if upskill them , actually sg primary care will be very strong.
haha..nationalised healthcare ba.
that said, some true blue gp quite good lei. I got transfer memo that showed good knowledge of CDM.
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23-12-2021, 11:09 PM
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Quote:
Originally Posted by Unregistered
which is why GPs should be phased out and not allowed to work independently. it's painful and probably expensive but experience from countries all show good development of the primary care landscape from there.
we still operating in the developing world model of not enough doctor and allowing the registered doctor to open shop but have expectations of a developed country primary care results.
I dare say polyclinic operate to world class standard but overall markers of a good primary care system bogged down by the inefficiency of the private gp of which is 3000 strong. if upskill them , actually sg primary care will be very strong.
haha..nationalised healthcare ba.
that said, some true blue gp quite good lei. I got transfer memo that showed good knowledge of CDM.
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But drs like to highlight the bad. The best dr is themselves. Good things seldom highlight.
Like I said it is a toxic profession. It is the culture. Find fault. M&M. Good work who cares thats your job you are supposed to do. Good CDM managrment ever give MO A grade?
Toxic.
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24-12-2021, 08:31 AM
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Quote:
Originally Posted by Unregistered
But drs like to highlight the bad. The best dr is themselves. Good things seldom highlight.
Like I said it is a toxic profession. It is the culture. Find fault. M&M. Good work who cares thats your job you are supposed to do. Good CDM managrment ever give MO A grade?
Toxic.
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in every profession, everyone diss each other. Coder will say someone codes rubbish.
engineer will say other people design sucks. my dad is a retired chef ( normal kind) and when i bring him to eat at higher end chinese restaurant, he also critise mah. Profession is not toxic, human beings generally are haha.
The problem for general practice and family medicine practice in sg is that the standard is from MBBS to FCFP level and 3000 of them are actually at the MBBS level.
Infact some of the older MBBS probably degenerate to Bsc level liao. The other day one GP still started aspirin for primary prevention for one of my patient. Its a 20 year ago out dated information.
I still standby my above stand, once and for all, make sure all GP upgrade to proper FP level. Gov to mass subsidise GP to take care of chronic condition with 50 to 80 bucks per visit. Can get subsidised meds delivered from your local polyclinic pharmacy.
Make GDFM much much harder than what it is now.
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24-12-2021, 10:18 AM
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Quote:
Originally Posted by Unregistered
in every profession, everyone diss each other. Coder will say someone codes rubbish.
engineer will say other people design sucks. my dad is a retired chef ( normal kind) and when i bring him to eat at higher end chinese restaurant, he also critise mah. Profession is not toxic, human beings generally are haha.
The problem for general practice and family medicine practice in sg is that the standard is from MBBS to FCFP level and 3000 of them are actually at the MBBS level.
Infact some of the older MBBS probably degenerate to Bsc level liao. The other day one GP still started aspirin for primary prevention for one of my patient. Its a 20 year ago out dated information.
I still standby my above stand, once and for all, make sure all GP upgrade to proper FP level. Gov to mass subsidise GP to take care of chronic condition with 50 to 80 bucks per visit. Can get subsidised meds delivered from your local polyclinic pharmacy.
Make GDFM much much harder than what it is now.
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i think we should open slot ie unlimited slots for FM residency.
Like in America or UK or Aussie. U must complete gp training or FM residency
The problem now is not enough spaces.
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24-12-2021, 11:06 AM
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Quote:
Originally Posted by Unregistered
in every profession, everyone diss each other. Coder will say someone codes rubbish.
engineer will say other people design sucks. my dad is a retired chef ( normal kind) and when i bring him to eat at higher end chinese restaurant, he also critise mah. Profession is not toxic, human beings generally are haha.
The problem for general practice and family medicine practice in sg is that the standard is from MBBS to FCFP level and 3000 of them are actually at the MBBS level.
Infact some of the older MBBS probably degenerate to Bsc level liao. The other day one GP still started aspirin for primary prevention for one of my patient. Its a 20 year ago out dated information.
I still standby my above stand, once and for all, make sure all GP upgrade to proper FP level. Gov to mass subsidise GP to take care of chronic condition with 50 to 80 bucks per visit. Can get subsidised meds delivered from your local polyclinic pharmacy.
Make GDFM much much harder than what it is now.
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More like Uniquely Singapore la. Nasty rude Singaporeans. Kiasoo Kiasee.
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24-12-2021, 03:09 PM
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Quote:
Originally Posted by Unregistered
i think we should open slot ie unlimited slots for FM residency.
Like in America or UK or Aussie. U must complete gp training or FM residency
The problem now is not enough spaces.
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since when are FM training spots unlimited in those countries ? Might not be as competitive as other specialties but is always demand > supply. You will eventually get in if u try hard enough or in auzzie case, willing to go rural enough
FM training in SG actually quite siong and difficult to coordinate cos about 2.5 years in hospital. I think the system cannot absorb more than 100 trainees per year. You try to coordinate the m.med clinical exam for more than 100 trainees see how u cope. Only internal med exams is larger but they have only 5 cases.
If u ask me, we should extend it to 5 years. Extend some important core rotations like gen med, geriatrics, community hospital, paeds A&E to half a year. Intermediate exams at year 3 to 4. Final 2 years at registrar level work, u choose between polyclinic, academic registrar or community hospital followed by a exit exam, come out straight SAB registration.
Some of my residents told me they have been applying for few years before getting in. They are decent enough and i'm pleasantly surprised actually.
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24-12-2021, 09:49 PM
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What are the most competitive specialty to get into nowadays?
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25-12-2021, 11:30 AM
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Quote:
Originally Posted by Unregistered
What are the most competitive specialty to get into nowadays?
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IM (internal medicine)
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25-12-2021, 02:46 PM
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Quote:
Originally Posted by Unregistered
What are the most competitive specialty to get into nowadays?
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only non doc will ask this.
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25-12-2021, 03:43 PM
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Merry Christmas to all! Hope everyone is working hard on shift and at your clinics!
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