How is life as a doctor in Singapore?

Originally Posted by Unregistered

Btw empagliflozin can be first line.
Since 2019, ESC/EASD can be first line for empa for patients with high cv risk.

Sglt2i is critical.

Some of the ops rp not sure whether fm or not.
Seem to by pass sglt2i. Then go straight to sulphonylurea, not good.

Dude that guy so fat already, insulin resistance ++ , su and insulin will worsen the weight.

They shld keep up to date with the literature.

Like u say lo. High CV risk because added cardiovascular benefit.
Applicable to patient or not?
Nothing wrong with using su what. I rather a well controlled hba1c rather than some possibiliy phantom cardio benefit that might not apply to my patient. Sglt2 is a dollar per tablet lei. For my patient some of whom are cleaners or Ur admin staff making 1.x to 2.x k a month, it's not cheap. Some come in with valsartan, sglt2 , crestor AND fenofibrate given by their private gp and I go seriously?
Have some 良心la.

Originally Posted by Unregistered

Like u say lo. High CV risk because added cardiovascular benefit.
Applicable to patient or not?
Nothing wrong with using su what. I rather a well controlled hba1c rather than some possibiliy phantom cardio benefit that might not apply to my patient. Sglt2 is a dollar per tablet lei. For my patient some of whom are cleaners or Ur admin staff making 1.x to 2.x k a month, it's not cheap. Some come in with valsartan, sglt2 , crestor AND fenofibrate given by their private gp and I go seriously?
Have some 良心la.

Problem sometimes is private GP cut back some meds. Eg no fenofibrate. Tell patient diet changes. Use SU.
But when the patient admitted to GS for cholecystitis and have blue letter referral to In Med then the hospital int med dr might say why never control Triglycerides? Who still uses SU? Lousy GP!

You either follow EBM or you dont. There is no oh by the this is cheaper affordable EBM that one is way too expensive EBM. One reason why I went back to OPS after my stint as private GP.

EBM is way to go and is correct. But it is expensive. OPS system helps manage the cost part for the patient. I want to do my best for the patiet. Not merely what they can afford.

Originally Posted by Unregistered

Like u say lo. High CV risk because added cardiovascular benefit.
Applicable to patient or not?
Nothing wrong with using su what. I rather a well controlled hba1c rather than some possibiliy phantom cardio benefit that might not apply to my patient. Sglt2 is a dollar per tablet lei. For my patient some of whom are cleaners or Ur admin staff making 1.x to 2.x k a month, it's not cheap. Some come in with valsartan, sglt2 , crestor AND fenofibrate given by their private gp and I go seriously?
Have some 良心la.

we should try the european model where doctors just prescribe, then social security pays the medication dispensed by the pharmacist which is usually generic. Pharmacists will be happier too

Originally Posted by Unregistered

Actually how long after MMED (FM) can one start pursuing FCFPS to work towards consultant position ah

Right after if you like. No wait period per se.
but of cos logistically, your institution will decide if they wanna sponsor you right after.
Or they want you to prove your worth before committing to sponsor you.

people say ops encourages EBM.

But practicing EBM gets you discriminated against lol

in the end if you want to be a good doc, is how much politics you play.

Originally Posted by Unregistered

Like u say lo. High CV risk because added cardiovascular benefit.
Applicable to patient or not?
Nothing wrong with using su what. I rather a well controlled hba1c rather than some possibiliy phantom cardio benefit that might not apply to my patient. Sglt2 is a dollar per tablet lei. For my patient some of whom are cleaners or Ur admin staff making 1.x to 2.x k a month, it's not cheap. Some come in with valsartan, sglt2 , crestor AND fenofibrate given by their private gp and I go seriously?
Have some 良心la.

Valsartan is valid. Even in ops is also standard 2.
When I served in ops in 2015, it wasn't standard 2.
Sglt2i come to hosp we help u apply maf.
Plus u half tab, break off 25mg in 12.5mg, price is cheaper.
If cleaner maf sure pass

Rosuvastatin is definitely valid. But can be changed to atorvastatin 40mg if cost is of concern.
Fenofibrate is a bit effy unless tg is high. But well still quite standard

My parents were cleaners. I don't think cleaners deserve lousy care.

Originally Posted by Unregistered

Valsartan is valid. Even in ops is also standard 2.
When I served in ops in 2015, it wasn't standard 2.
Sglt2i come to hosp we help u apply maf.
Plus u half tab, break off 25mg in 12.5mg, price is cheaper.
If cleaner maf sure pass

Rosuvastatin is definitely valid. But can be changed to atorvastatin 40mg if cost is of concern.
Fenofibrate is a bit effy unless tg is high. But well still quite standard

My parents were cleaners. I don't think cleaners deserve lousy care.

Read in context Lan
The patient given those meds by private gp lei. Every months 200 plus bucks.
Come to me in ops cos cannot tahan paying so much.

Originally Posted by Unregistered

Read in context Lan
The patient given those meds by private gp lei. Every months 200 plus bucks.
Come to me in ops cos cannot tahan paying so much.

Do you realize what you are saying? So private GP practice EBM yes will cost more but in doing so is "bad" with no compassion? Whereas go to OPS where got MAF is cheaper same medicines is "good" from the OPS? Talking money more tham medicine.

Hi, I'm a doctor from indo. my bf is a local, what is the best path should i take to be able to work in sg? thanks for the kind advice.

how many years can one keep trying for residency? my cousin every yr keeps trying but cannot get, is it really that hard or she just cmi