How is life as a doctor in Singapore?

Originally Posted by Unregistered

That's quite absurd.
The system should be setup that passing MMed is the requirement
To finishing and passing residency.
It is how other countries do it.

As a current R3 resident, I actually agree to this. Make no sense to graduate from residency when one has no qualification.
I never understood why the exams is not held in June/july after residency ends and all of us have to wait till November to take the exams. (Of course program b timing will also need to be adjusted accordingly).

I think the term bridging program was designed simply because they don't know what to do with the residents after residency. (Coz when residency 1st started in 2010, there was no such thing- according to my preceptor, who was the very 1st batch of residents)

Originally Posted by Unregistered

As a current R3 resident, I actually agree to this. Make no sense to graduate from residency when one has no qualification.
I never understood why the exams is not held in June/july after residency ends and all of us have to wait till November to take the exams. (Of course program b timing will also need to be adjusted accordingly).

I think the term bridging program was designed simply because they don't know what to do with the residents after residency. (Coz when residency 1st started in 2010, there was no such thing- according to my preceptor, who was the very 1st batch of residents)

MOH controls it all that's probably why.
The priority is maintaining supply of drs for OPS.
Hence all the bond and stuff.
But they can probably do better with stable worforce management
If they simply introduced a system that says you must
Complete a recognized residency program in order to practice independently
So if anyone failed to complete residency then rhey cannot practice
Better than bond. Cannot afford to break!

Silly of MOH.

As for the old birds just grandfather them in and give them the qualificaiton
Maybe something like a Member of College of Family Physicians of Singapore
MCFPS.
Then can still have MMed as a higher level exam for those wanting to stay in OPS go to admin management levels etc.

Originally Posted by Unregistered

MOH controls it all that's probably why.
The priority is maintaining supply of drs for OPS.
Hence all the bond and stuff.
But they can probably do better with stable worforce management
If they simply introduced a system that says you must
Complete a recognized residency program in order to practice independently
So if anyone failed to complete residency then rhey cannot practice
Better than bond. Cannot afford to break!

Silly of MOH.

As for the old birds just grandfather them in and give them the qualificaiton
Maybe something like a Member of College of Family Physicians of Singapore
MCFPS.
Then can still have MMed as a higher level exam for those wanting to stay in OPS go to admin management levels etc.

Only problem with that is, I would say at least 80% of the current primary care workforce (including the young ones) have no post graduate qualification. If you stop them from practicing independently, many gps will close. Qn is can ops/public house all of them, and can ops alone handle the primary care workload of whole sg.

In private GP land, most cases are simple URTI, GE, migraine etc u don't need a MMed to see such simple cases.

Originally Posted by Unregistered

In private GP land, most cases are simple URTI, GE, migraine etc u don't need a MMed to see such simple cases.

Healthier sg coming. Planning to shift chronics to gp. Starting with htn/hld/dm, will probably start to include more on the cdmp list in coming years

Originally Posted by Unregistered

Healthier sg coming. Planning to shift chronics to gp. Starting with htn/hld/dm, will probably start to include more on the cdmp list in coming years

dont bank too much on it la.

Firstly GP in singapore is the equivalent of a registered medical officer in other countries.
In a lot of countries, they are not allowed to practice independently.
in SG , anyone can call himself a GP. Its not a protected tittle.
In commonwealth countries, GPs are the equivalent of our M.med FPs.

While there are GPs that are good, most cannot make it for chronic disease management.
remember, they go out because they cannot make residency, fail residency, fail exams etc
very few capable junior doctors aspire to be GPs.

Many of the groups like onecare, DA all hire those cannot make it juniors. Really, in a hospital system with guidance , senior to ask they already chui. Now go out they are independent liao. GG if u want ur chronic to be handled by them. Those GPs who did residency ain't too bad becuase at least for 3 years they got someone to teach them something, but the rest of the new young GPs cannot make it.

To have a healthier SG, u need to have a well trained primary care workforce first.
GDFM don't cut it. I teach it. The trainees has no farking idea what is going on because hospital medicine doesn't teach u outpatient primary pare. Then there are ur half-ass MO who was trying to get into ENT training for 5 years didn't make it who turn GP, they think they suddenly know how to treat chronic disease?

This problem of a half ass primary care work force is not unique to SG. Taiwan, Australia, NZ and UK all have it in the 70-80s. All of them choose the hard way to disallow untrained doctor to practice independently. It was painful initially, but it work eventually.

SG? we just kicking the ball down the road.

they should just revamp the whole training system for primary care doctors.
Turn M.Med straight into a 4 or 5 year program to train senior doctors.
If a MO want to turn primary care provider, apply for a preceptorship with a polyclinic of your choice -> train there for 2-3 years while doing a GDFM like module under the M.meders-> frequent workplace based assessment -> final exams to pass before u qualify for independent practice.
This builds a truly robust primary care network.

Normal GPs can handle the simple chronic cases. If it gets too difficult to control, we can just refer to the specialists. We are not paid enough to handle complex cases. Specialists are paid for that.

Probably Gp will see simple chronics , complex ones will be push to ops most likely

Originally Posted by Unregistered

Probably Gp will see simple chronics , complex ones will be push to ops most likely

Yes , they have no facility for complex chronics. patient wont travel far to see nurse counsellor on another day or location. OPS same day can do counselling immediately , can start insulin immediately.
Howe to start insulin if your counselling next week with community nurse or if you dont even stock insulin. How many GP will self teach inuslin- i doubt any. these will all refer to OPS

Originally Posted by Unregistered

Yes , they have no facility for complex chronics. patient wont travel far to see nurse counsellor on another day or location. OPS same day can do counselling immediately , can start insulin immediately.
Howe to start insulin if your counselling next week with community nurse or if you dont even stock insulin. How many GP will self teach inuslin- i doubt any. these will all refer to OPS

drp+dfs also , no one gna travel to do it another day, too troublesome, DM patient will stick to ops la , drp+dfs same day same building immediately. I even have GP pts wanna " transfer care " to OPS as they want to do DRP+DFS in OPS and see dr, do hba1c same day