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26-11-2019, 08:00 AM
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Quote:
Originally Posted by Unregistered
What are the current issues with the residency system? (Other than there are not enough consultant posts?)
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No problem actually.
Bst/ast has a lot of inefficiencies and train too few and too slow
1) inefficiency
After completing bst, you must go find your own ast. If there is no ast position available, you had to wait and serve as a service reg until ast position opens.
With residency is through train. No need go worry abt bst and ast. Once you are R1 u usually can go to R5/6 without issue. Residency is more efficient, (no year loss as service reg).
2) planning and bidding for postings
Furthermore during bst, you had to plan your postings and bid for mopex.
In residency system, the postings are preallocated to you. Failure to bid successfully for a certain mopex delays completion of bst.
3) initiative needed
Bst and ast needs more initiative from the trainee.
residency is actually very structured. U get a program directors. Bst ast you have to fend for yourselves
4) opportunities for training
It was harder to get into bst/ast than residency. As there was lesser slots than now
5) job opportunities
Residencies are easier to get in. Bad thing is residency numbers are centrally controlled. Central planning means they will overrecruit. And at end of 5 years, u will find no job coz they opened too much positions. But at least it was easy to get into residency
AST is employed by hospital. So a hospital dept knows exactly how much manpower it needs. So you get a job at the end. but a hospital may underproject and you may lack specialist if the seniors decide to move to pte en-masse.
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26-11-2019, 08:53 AM
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Quote:
Originally Posted by Unregistered
No problem actually.
Bst/ast has a lot of inefficiencies and train too few and too slow
1) inefficiency
After completing bst, you must go find your own ast. If there is no ast position available, you had to wait and serve as a service reg until ast position opens.
With residency is through train. No need go worry abt bst and ast. Once you are R1 u usually can go to R5/6 without issue. Residency is more efficient, (no year loss as service reg).
2) planning and bidding for postings
Furthermore during bst, you had to plan your postings and bid for mopex.
In residency system, the postings are preallocated to you. Failure to bid successfully for a certain mopex delays completion of bst.
3) initiative needed
Bst and ast needs more initiative from the trainee.
residency is actually very structured. U get a program directors. Bst ast you have to fend for yourselves
4) opportunities for training
It was harder to get into bst/ast than residency. As there was lesser slots than now
5) job opportunities
Residencies are easier to get in. Bad thing is residency numbers are centrally controlled. Central planning means they will overrecruit. And at end of 5 years, u will find no job coz they opened too much positions. But at least it was easy to get into residency
AST is employed by hospital. So a hospital dept knows exactly how much manpower it needs. So you get a job at the end. but a hospital may underproject and you may lack specialist if the seniors decide to move to pte en-masse.
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This is gonna sound like a stupid question. But why can’t they just increase the number of consultant jobs? It’s not like you need people to train Consultants, more Consultants = more people to train trainees in the respective specialties = more people get to move up, wouldn’t that solve the issue and more Consultants per ward would mean better care? Or is the problem of more Consultants akin to the idea of printing money, if you print more money, the money gradually becomes devalued such like Consultants becoming less valued, they start having pay cuts since there are so many of them.
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27-11-2019, 12:23 AM
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Quote:
Originally Posted by Unregistered
This is gonna sound like a stupid question. But why can’t they just increase the number of consultant jobs? It’s not like you need people to train Consultants, more Consultants = more people to train trainees in the respective specialties = more people get to move up, wouldn’t that solve the issue and more Consultants per ward would mean better care? Or is the problem of more Consultants akin to the idea of printing money, if you print more money, the money gradually becomes devalued such like Consultants becoming less valued, they start having pay cuts since there are so many of them.
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I'm the guy in Canada.
There isn't a "need" for the sinkie govt to hire more consultants. Just train them and then they go private.
Flood the market with consultants and specialists. That will create more competition and lower prices.
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27-11-2019, 06:23 PM
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The government has always been stressing on the importance of primary/holistic care and the importance of good family physicians/internist. However, I don't seem to sense that in daily practice.
When I am doing GM posting, we seem to be referring the whole world for all the minor problems that pt has, and pt can end up with 4-5 tcus on discharge.
Currently doing Ed, now getting loads of referrals for minor complaints from gps/polyclinic (eg blood sugar 20, dizziness etc)
Anyone has any thoughts on this?
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27-11-2019, 10:18 PM
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Quote:
Originally Posted by Unregistered
The government has always been stressing on the importance of primary/holistic care and the importance of good family physicians/internist. However, I don't seem to sense that in daily practice.
When I am doing GM posting, we seem to be referring the whole world for all the minor problems that pt has, and pt can end up with 4-5 tcus on discharge.
Currently doing Ed, now getting loads of referrals for minor complaints from gps/polyclinic (eg blood sugar 20, dizziness etc)
Anyone has any thoughts on this?
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It is called Taichi.
How many years since you finished med school? The longer you are the more you will realize EVERYTHING the "experts" say is the complete opposite of what is reality
Here's a tip. If you dont want to get complaints from patients just do what
t they want and ask as long as it isnt illegal and or lethal
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27-11-2019, 11:25 PM
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I am currently a mo finishing my bond soon (end of next year)
Failed to get into residency after couple of attempts, so thinking of becoming a gp. Has done postings in medicine and some of the subspecs, Ed.
Was wondering how easy/difficult is it to get a job with some of the private gp chains in singapore? (Eg raffles, healthway, one care etc..) I don't have locum exp unfortunately.
- noted that some of these chains are publishing job positions on online portals (sma job portal) and on their website, but just curious, how difficult is it to get these jobs?
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28-11-2019, 12:48 AM
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Quote:
Originally Posted by Unregistered
I am currently a mo finishing my bond soon (end of next year)
Failed to get into residency after couple of attempts, so thinking of becoming a gp. Has done postings in medicine and some of the subspecs, Ed.
Was wondering how easy/difficult is it to get a job with some of the private gp chains in singapore? (Eg raffles, healthway, one care etc..) I don't have locum exp unfortunately.
- noted that some of these chains are publishing job positions on online portals (sma job portal) and on their website, but just curious, how difficult is it to get these jobs?
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You shouldn't even be asking this sort of question. Why does it matter "how difficult" or "how easy"?
If you want to get a job, go apply for it. If you get the job offer you can always turn it down or negotiate start dates etc.
From experience in 2004-2010 I would say it is not difficult at all. However be prepared to be doing the evening and weekend shifts to start. Or even better the late night to midnight to overnight shifts. From what I have heard the GP market has become EVEN MORE competitive in the last 9 years.
Here are some tips I learned as a GP in sinkieland
1) Always do what the patient wants. The practice guidelines mean nothing to patients. And a happy patient will never complain even if you didnt do the best "medicine" according to guidelines. Whereas if you followed guidelines to a T and the patient is pissed you still have to answer to the complaint. Remember unhappy patients ALWAYS love to falsify allegations and make you out to have done worse things than you actually did.
2) It's all about $$$. So forget about moral and ethics. Customer is king. Happy customer = happy boss = happy bank account = happy you. (yes maybe your conscience takes a hit but then it is just YOU that might be unhappy). Unhappy customer means EVERYONE will be upset. So throw the conscience under the bus.
3) Despite what the guidelines say about antibiotic resistance and polypharmacy, sinkies love their medicine. Going to see the GP is to get medicine not to listen to you lecture them on guidelines. One very senior GP said to me, when you order char kway teow or whatever if you didn't say you didnt want chili you will get chili. You have to say you DON'T WANT CHILI. Same with antibiotics. Also best to give one medicine for every symptom. That makes you a good doctor who has listened to the patient. One for fever. one for cough. one for phlegm. One for sore throat. One for stuffy nose. One for runny nose. And of course antibiotics.
4) It is more about being friendly and being able to ******** rather than medical skills.
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28-11-2019, 10:25 PM
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Is a principal RP like equivalent to a school principle in terms of seniority? Hmm..
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29-11-2019, 02:01 AM
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Quote:
Originally Posted by Unregistered
Is a principal RP like equivalent to a school principle in terms of seniority? Hmm..
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No. School principal is more like the Chairman of Medical Board
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29-11-2019, 03:30 PM
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Quote:
Originally Posted by Unregistered
Is a principal RP like equivalent to a school principle in terms of seniority? Hmm..
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More like a master teacher.
Moe got a teaching path, non leadership role.
Teacher > senior teacher > master teacher
Similarly in Hosp, we got a pure clinical path, non specialist role
Resident physician > senior rp > principal to
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