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How is life as a doctor in Singapore?

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  #4351 (permalink)  
Old 03-11-2022, 03:04 PM
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Dont see specialists coming to this place to bitch and criticize their underlings or colleagues. Only the FPs and GPs. Dont even see specialist residents complain also.
Can see where the unhappy drs are. Earn low pay. Work very hard. No satisfaction. Dead end field. Jin ke lian
That is true as unfortunately there is no barrier to entry for gps in Singapore.

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  #4352 (permalink)  
Old 03-11-2022, 03:17 PM
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Dont see specialists coming to this place to bitch and criticize their underlings or colleagues. Only the FPs and GPs. Dont even see specialist residents complain also.
Can see where the unhappy drs are. Earn low pay. Work very hard. No satisfaction. Dead end field. Jin ke lian
To be fair many surgical resident quit for gpland or asthestics also, but I agree most of them don't come here and rant, they just quit lol

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  #4353 (permalink)  
Old 03-11-2022, 08:23 PM
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Thank you for the wall of text
There are 2 things being discussed.
The one u reply to is the lack of knowledge on some of the ops rp and gdfmer and the opinion that they should really not be allowed to practice independently.
Collegiality is not about sweeping things under the carpet by the way. You make a mistake, you should still be counselled and if repeated ..disciplined.
Like you say, u are a resident, u haven't been around long enuff in ops to see how jialat some of the rps are

Cannot afford medicine? And u just take the word for it?
Merdeka? Pioneer? Understand what is sd1 and sd2. Some med like Metformin cost 1.1 per week. Use those.
First thing u need is to ask the uncle he smoking ( literally) or not. I have uncle say no money but smoke a pack a day and drink 2 cans a night.
Ask what is their financial burden. Maybe its real, 1k salary need to feed demented mother , low iq son. Then he might qualify for car giver grant. Did u explore that? Or u just no money ah uncle? Want see social worker or not? Dun want ah .ok lor. Case close. Decline due to financial reason. Decline MSW.
Aiyah...I dunno the pattern of junior doctors meh? Other times they need to understand save pennies , waste pounds later on to rationalise their spending.

Fixed belief is another thing I can ramble on...really got such patient. It's true. How do u overcome it? Got ways and techniques one. Some really idiots no choice but given enough time most patient will listen to you.

Dun wax lyrical about shared decision to me. I wrote the paper on that. This works only if the patient fully understand what is going on. Did u make sure he really understand the sequale of this silent disease?
How sure are you? If someone ask him later and he cannot fully answer, u have failed liao and this is not a shared decision making. It's actually neligence. Shared decision making is very very hard one.
=====
i am a doctor, above is not my job to dig

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  #4354 (permalink)  
Old 03-11-2022, 09:16 PM
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=====
i am a doctor, above is not my job to dig
Then forever stay a noob.


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  #4355 (permalink)  
Old 03-11-2022, 10:42 PM
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Can tell who are the salaried employee drs in public shake leg see a few pt here and there talk big let underlings do the heavy lifting

And the ones who have worked in the real world setting.
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  #4356 (permalink)  
Old 04-11-2022, 08:01 AM
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Everyone want cheap , want good , want fast. Where got? only paper talk time got.
Yes, import doctors from overseas lo.
They come initially very gilat. But as with all humans, after a while do the minimum.
Esp when u pressure them.
each patient 10 minutes
- have to find out reason for encounter. Sometimes many many reasons. Other times reason not clear.
- examine
- explain results
- explain management
- answer every other by the way questions
- order medication request
- arrange next TCU / blood test
- type notes

all in 10 minutes. 45 times a day.
while some patients really can finish in 10 minutes, a lot cannot
some cases super complex, other times patient also need time to digest what you are telling them.

End up lower skillset doctors cope by chin chye do
' decline titiration, cont meds, see 3/12 with bloods'

leaving it to the next doctor to stare at a Hba1c of 10%, HB 10, rotting foot wound and depression.
healthier SG?
pls la, equip the workforce with the ability to do their job first.
Fire all the useless RPs from whatever 3rd world countries.
Give each properly trained M.med level FP 15 minutes each patient and let the patient seen the same doctor most of the time.

other countries FP is all 3 years training. GP in australia and UK is the m.med FP in singapore. Singapore GP is just a MO level doctor in other countries, they are not even allow to practice independently.
But if you don't allow gdfmers to practice independently,
1) what's the gdfm for then? (Who will still take it?)
2) most gps outside would close down. Which means that everything will be on ops, and the mmeder gps outside. Do you think they can handle the load of sg population? (From the recent covid pandemic, looks difficult)
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  #4357 (permalink)  
Old 04-11-2022, 08:04 AM
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You don't know what you don't know. A well trained fp has mastery of the consult and can do a lot in 15 minutes. Usually this is the m.med fp who while preparing for the clinical really really learn how to handle the complex consult. Fcfp level even more complex. They throw pages of discharge summary at u to figure out what to do in 10 minutes.
A while ago I had a gdfm colleague saying m.med nia, what's so difficult, like gdfm , so he went to do.
Till date , mcq 2nd time already haven't pass. I arm chio always.


I've seen gdfm fp give nitrofurantoin for male UTI, some more that fellow has ckd.
Wrong on so many levels. My resident do that...I will really slap them.
Lots of gdfmers also cannot manage diabetes well. To them it's about upping oral med till cannot , recommend insulin, patient reject , case close. Even simple things like checking when patient take glipizdr they also dunno. Diet history also dun take. Many a times I dun even increase oah dose but just changing the medication administration timing, hba1c improve liao. My resident come to me without checking diet and how meds are taken I will really lecture them
26 year old boy BP 160/80, to start amlodipine for hypertension and arrange hypertensive panel 2 months later. Turn out patiet had lupus nephritis, egfr 15 nia. Like hellow...use some brains can or not. Not all hypertension is essential hypertension lei.
But if you don't allow gdfmers to practice independently,
1) what's the gdfm for then? (Who will still take it?)
2) most gps outside would close down. Which means that everything will be on ops, and the mmeder gps outside. Do you think they can handle the load of sg population? (From the recent covid pandemic, looks difficult

*Sry was meant to reply to this post.
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  #4358 (permalink)  
Old 04-11-2022, 12:26 PM
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But if you don't allow gdfmers to practice independently,
1) what's the gdfm for then? (Who will still take it?)
2) most gps outside would close down. Which means that everything will be on ops, and the mmeder gps outside. Do you think they can handle the load of sg population? (From the recent covid pandemic, looks difficult)
You can still practice independently without GDFM, as long as you are fully registered can liao.
the original plan was to phase out the MBBS GP. When they create the FP register, they allow long time GP to grandfather in without any extra qualifications. The eventual plan was that only M.med can open clinic straight away or GDFMers with > 6 years of primary care experience.

Covid struck and pple also never follow thru.
Anyway, some light la, GDFM exams getting harder. This year they have to take the same MCQ exams as mmeder and they actually hire SPs already. Standards are getting tougher.
hopefully primary care doctor standard rises.
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  #4359 (permalink)  
Old 04-11-2022, 12:28 PM
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But if you don't allow gdfmers to practice independently,
1) what's the gdfm for then? (Who will still take it?)
2) most gps outside would close down. Which means that everything will be on ops, and the mmeder gps outside. Do you think they can handle the load of sg population? (From the recent covid pandemic, looks difficult

*Sry was meant to reply to this post.
Dont worry that FP can single handedly solve everyone's health issues. Lol!
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  #4360 (permalink)  
Old 04-11-2022, 08:44 PM
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Someone posted they locum In GPland and earn 98k per month?
How the hell man
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