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How is life as a doctor in Singapore?

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  #4181 (permalink)  
Old 25-08-2022, 08:03 PM
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Npnt. I can also say I work at shs. For each pt , we get $5 extra. So keep us motivated

Show me ur iras returns or notice of assessment
Hahaha how to show you I cannot upload here right.
Why donít you ask any of your friends who are MMed FPs now to show you?

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  #4182 (permalink)  
Old 25-08-2022, 08:59 PM
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Hahaha how to show you I cannot upload here right.
Why donít you ask any of your friends who are MMed FPs now to show you?
aiya, dun bother about him
just some sore locum

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  #4183 (permalink)  
Old 28-08-2022, 10:20 AM
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Can I ask for some advice as a new mopex in ops (started jul this year). I have 3 main enquiry.

1) is it true that sometimes our consult is purely just about helping navigating the healthcare system or administrative in nature? (Given that we are the only route to subsidized care). A few examples
A) I had a healthcare worker (fellow hospital doctor) who did a screening test and ferritin is noted to be high. He said that he have already liased with the relevant specialist (haem and gastro) and just need the referral straight (so he can subsidized care)
B) another pt brought her 4 year son to see gp for abdominal pain. Gp referred him to paeds Surg as he found a left inguinal hernia. I examined pt, I don't find any hernia and the abdominal pain has resolved.

These are 2 examples I can remember among many others who come asking for referral because their gp told them to. Pt came as they want subsidized care.
Another huge group is those pts coming to ask for screening (e.g fbc/kidney function, left, tft, etc) even though they have NO symptoms.

Just checking in such cases, do we simply acede to their request, or do we have to reassess the cases ourselves?

2) this is regarding clinical consultation and our documentation. Do we have to clinically assess/examine and document all the presenting complaints that patient mentioned? (As most pple know ops pts tend to have multiple complaints). For example,
A) pt come in review of their chronic disease which is stable, but towards the end of consult complained about knee pain with no preceding trauma. He can still walk normally and there is no swelling/effusion from a quick glance.
- Can I just reassure him with some painkillers, basic advice about activity modification (as most common cause is OA), and return advice. (But without taking a full history and doing a full knee exam, and without documenting anything about the knee pain)

B) other typical case is urti pts for example. Most of them complain about fever, headache, and generalized tiredness/lethargy. Most cases, we can attribute that to the urti and the viral illness itself. In such cases, are we still expected to do a Neuro exam, take a brief history of the headache, and document all these down? And of course the tiredness as well, taking a hx will probably take up at least 5-6 min lol.
- to be fair, most documentation is templated nowadays, but definitely the consult will be longer if we start doing these things.

3) this is about documentation of return advice.
- do people actually write down exactly all the things they tell pt to look out for
- I usually just write "return if symptoms not better/worsening, unwell or any concerns/any parental concerns (for kids)
- I assume this should cover most things from a medicolegal perspective right? (Of course depending on the acute complaint, the exact thing I tell pt can differ, but there is no way to create a template for all the specific return advice)

Sorry know it's a bit strange to ask these here, but I find it a bit awkward to ask these questions to my hod/seniors in ops, especially since I don't know them well. You are usually alone in a consult room in ops, there is no reg like in hospital setting (usually in hospital, mos like myself direct these queries to the team reg)

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  #4184 (permalink)  
Old 28-08-2022, 02:00 PM
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Originally Posted by Unregistered View Post
Can I ask for some advice as a new mopex in ops (started jul this year). I have 3 main enquiry.

1) is it true that sometimes our consult is purely just about helping navigating the healthcare system or administrative in nature? (Given that we are the only route to subsidized care). A few examples
A) I had a healthcare worker (fellow hospital doctor) who did a screening test and ferritin is noted to be high. He said that he have already liased with the relevant specialist (haem and gastro) and just need the referral straight (so he can subsidized care)
B) another pt brought her 4 year son to see gp for abdominal pain. Gp referred him to paeds Surg as he found a left inguinal hernia. I examined pt, I don't find any hernia and the abdominal pain has resolved.

These are 2 examples I can remember among many others who come asking for referral because their gp told them to. Pt came as they want subsidized care.
Another huge group is those pts coming to ask for screening (e.g fbc/kidney function, left, tft, etc) even though they have NO symptoms.

Just checking in such cases, do we simply acede to their request, or do we have to reassess the cases ourselves?

2) this is regarding clinical consultation and our documentation. Do we have to clinically assess/examine and document all the presenting complaints that patient mentioned? (As most pple know ops pts tend to have multiple complaints). For example,
A) pt come in review of their chronic disease which is stable, but towards the end of consult complained about knee pain with no preceding trauma. He can still walk normally and there is no swelling/effusion from a quick glance.
- Can I just reassure him with some painkillers, basic advice about activity modification (as most common cause is OA), and return advice. (But without taking a full history and doing a full knee exam, and without documenting anything about the knee pain)

B) other typical case is urti pts for example. Most of them complain about fever, headache, and generalized tiredness/lethargy. Most cases, we can attribute that to the urti and the viral illness itself. In such cases, are we still expected to do a Neuro exam, take a brief history of the headache, and document all these down? And of course the tiredness as well, taking a hx will probably take up at least 5-6 min lol.
- to be fair, most documentation is templated nowadays, but definitely the consult will be longer if we start doing these things.

3) this is about documentation of return advice.
- do people actually write down exactly all the things they tell pt to look out for
- I usually just write "return if symptoms not better/worsening, unwell or any concerns/any parental concerns (for kids)
- I assume this should cover most things from a medicolegal perspective right? (Of course depending on the acute complaint, the exact thing I tell pt can differ, but there is no way to create a template for all the specific return advice)

Sorry know it's a bit strange to ask these here, but I find it a bit awkward to ask these questions to my hod/seniors in ops, especially since I don't know them well. You are usually alone in a consult room in ops, there is no reg like in hospital setting (usually in hospital, mos like myself direct these queries to the team reg)
1A) the fellow doc is hypochondriac. Ferritin high then high, not likely hematochromatosis. Whatís the iron sat? He Caucasian? Donít think is chronic inflammation too. But nvm we accede to his request.

1B) this case i will refer. But coz is my paeds exp insufficient. Coz 4 years old Iím not 100% confident abt undescended testes etc. in view that i do not good experience in young kid hernia. Nv touch enuff young balls. Better be safe than sorry. Coz another GP say got, so need a specialist to clear.

FBC baseline and a baseline Creatinine not unreasonable. You can also screen for DM and LDL cholesterol. I mean because ops lab tests prices arenít really that subsidised. So ya you got money to pay, we do Lor.

Headache from viral illness is common. Unless got red flags, altered consciousness, neck pain, photophobia kind, and young age.

Old age is the slurred speech, asymmetry or that gut feeling lah. Hahaha we got queue to clear but musnt miss things.


If prescribe painkiller need to examine abit.
Cause the flow is examination ó> diagnosis ó> prescription
If you give prescription need to examine

Alternatively is donít document, ask him come back again for another visit if pain doesnít resolve. I usually will do a quick palpating, extend the knee, feel for crepitus. If chronic like a few months, then give some painkiller *5 days max, return advice and lose weight


3) we must clear queue. So just write return advice given haha. But overall is your attitude do you think patient will complain. If you think he will complain, you must write more.
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  #4185 (permalink)  
Old 29-08-2022, 12:39 AM
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Quote:
Originally Posted by Unregistered View Post
Can I ask for some advice as a new mopex in ops (started jul this year). I have 3 main enquiry.

1) is it true that sometimes our consult is purely just about helping navigating the healthcare system or administrative in nature? (Given that we are the only route to subsidized care). A few examples
A) I had a healthcare worker (fellow hospital doctor) who did a screening test and ferritin is noted to be high. He said that he have already liased with the relevant specialist (haem and gastro) and just need the referral straight (so he can subsidized care)
B) another pt brought her 4 year son to see gp for abdominal pain. Gp referred him to paeds Surg as he found a left inguinal hernia. I examined pt, I don't find any hernia and the abdominal pain has resolved.

These are 2 examples I can remember among many others who come asking for referral because their gp told them to. Pt came as they want subsidized care.
Another huge group is those pts coming to ask for screening (e.g fbc/kidney function, left, tft, etc) even though they have NO symptoms.

Just checking in such cases, do we simply acede to their request, or do we have to reassess the cases ourselves?

2) this is regarding clinical consultation and our documentation. Do we have to clinically assess/examine and document all the presenting complaints that patient mentioned? (As most pple know ops pts tend to have multiple complaints). For example,
A) pt come in review of their chronic disease which is stable, but towards the end of consult complained about knee pain with no preceding trauma. He can still walk normally and there is no swelling/effusion from a quick glance.
- Can I just reassure him with some painkillers, basic advice about activity modification (as most common cause is OA), and return advice. (But without taking a full history and doing a full knee exam, and without documenting anything about the knee pain)

B) other typical case is urti pts for example. Most of them complain about fever, headache, and generalized tiredness/lethargy. Most cases, we can attribute that to the urti and the viral illness itself. In such cases, are we still expected to do a Neuro exam, take a brief history of the headache, and document all these down? And of course the tiredness as well, taking a hx will probably take up at least 5-6 min lol.
- to be fair, most documentation is templated nowadays, but definitely the consult will be longer if we start doing these things.

3) this is about documentation of return advice.
- do people actually write down exactly all the things they tell pt to look out for
- I usually just write "return if symptoms not better/worsening, unwell or any concerns/any parental concerns (for kids)
- I assume this should cover most things from a medicolegal perspective right? (Of course depending on the acute complaint, the exact thing I tell pt can differ, but there is no way to create a template for all the specific return advice)

Sorry know it's a bit strange to ask these here, but I find it a bit awkward to ask these questions to my hod/seniors in ops, especially since I don't know them well. You are usually alone in a consult room in ops, there is no reg like in hospital setting (usually in hospital, mos like myself direct these queries to the team reg)
You know yourself the answers.

Yes part of the work of OPS is subsidized care referral centre.


As for the need to properly address "by the way" medical concerns - in the event of any mishap or medicolegal investigation the lack of any assessment and documentation will expose you to massive disadvantage. Basically not documented means not done. And not done is definitely not done.

Your example of knee pain as the by the way medical concern reduces the risk of something for sinister but the risk is not 0. I am sure if the patient said by the way I get chest pain tightness SOB everytime I climb stairs would you just brush it away?

Knee pain could be osteosarcoma. Could be DVT. You never take hd never examine is at your own risk.

Uncortunately medicine is like that. Cross fingers hope nothing goes wrong.
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  #4186 (permalink)  
Old 29-08-2022, 06:33 PM
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Default Locum pay?

Hello, I am currently in an industry where I can command $130/hr, good WLB, like locum level freedom. No bonus not full staff benefits either, but the $ is good enough. Not going to reveal too much but it is pretty iron rice bowl as well. However I am thinking of making the career switch to medicine. I know many might tell me itís not worth it, but letís just say taking my current pay command of $130/hr, how much does locum pay actually compare? Public/private diff? I know they say if youíre going into medicine for the money, you are going in for the wrong reasons. To be clear, I am not. Am truly passionate about doing medicine, but I just wanted to do some math and financial calculations. TIA.
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  #4187 (permalink)  
Old 29-08-2022, 08:44 PM
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Hello, I am currently in an industry where I can command $130/hr, good WLB, like locum level freedom. No bonus not full staff benefits either, but the $ is good enough. Not going to reveal too much but it is pretty iron rice bowl as well. However I am thinking of making the career switch to medicine. I know many might tell me itís not worth it, but letís just say taking my current pay command of $130/hr, how much does locum pay actually compare? Public/private diff? I know they say if youíre going into medicine for the money, you are going in for the wrong reasons. To be clear, I am not. Am truly passionate about doing medicine, but I just wanted to do some math and financial calculations. TIA.
You sound like very passionate want to help people. But then ask about money and WLB?

Are you mad? You know the answer already. You are way better off where you are now

If you want to help people do sone volunteer work when you feel like it better
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  #4188 (permalink)  
Old 29-08-2022, 08:49 PM
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Hello, I am currently in an industry where I can command $130/hr, good WLB, like locum level freedom. No bonus not full staff benefits either, but the $ is good enough. Not going to reveal too much but it is pretty iron rice bowl as well. However I am thinking of making the career switch to medicine. I know many might tell me itís not worth it, but letís just say taking my current pay command of $130/hr, how much does locum pay actually compare? Public/private diff? I know they say if youíre going into medicine for the money, you are going in for the wrong reasons. To be clear, I am not. Am truly passionate about doing medicine, but I just wanted to do some math and financial calculations. TIA.
You Earn $130 per hour now.
Follow the following steps to have a gd career
Quit your job
Sell your house
Sell your belongings
Donate all the money to charity
Take a loan to study medicine
Owe huge amount of money
Only when you are in debt you can complete residency
If not you will quit
Earn 130per hour as a consultant at the end of your residency . You r back to square 1 but u r now wiser
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  #4189 (permalink)  
Old 30-08-2022, 01:05 AM
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You Earn $130 per hour now.
Follow the following steps to have a gd career
Quit your job
Sell your house
Sell your belongings
Donate all the money to charity
Take a loan to study medicine
Owe huge amount of money
Only when you are in debt you can complete residency
If not you will quit
Earn 130per hour as a consultant at the end of your residency . You r back to square 1 but u r now wiser
In order to only select the most sincere and purest of hearts they should make doctors a very lowly paid position. Or maybe only charity. No salary. Patients give ang pow pay whatever they want like the old days.

Otherwise you get crazy nonsense like this.
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  #4190 (permalink)  
Old 07-09-2022, 10:38 PM
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can anyone share where to find locum jobs besides locumsg( very little slots)
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