Tomorrow's Medicine, Issue 6 - February 2014
With an increasingly ageing and expanding population, plus new developments to increase healthcare capacity, our nation needs a growing and reliable stream of quality clinicians as contributors to a world-class healthcare system.
Developing this medical talent pool is SingHealth Residency, the largest sponsoring institution in Singapore with more than 600 residents enrolled in 34 programs to date. These specialist programs range from internal medicine to general surgery, pediatrics, family medicine and the surgery subspecialties. They are structured to train junior doctors as competent specialists in their chosen field.
“SingHealth Residency plays an important educational and training role in nurturing the next generation of doctors, our residents. We strive to develop highly-skilled medical leaders who are innovative and self-directed learners with a strong sense of ethics and compassion,” said Associate Professor Lim Boon Leng, Designated Institutional Official of SingHealth Residency.
SingHealth is a rich training ground for residents with the collaboration of two hospitals, SGH and KKH, five national specialty centres, nine polyclinics and a community hospital, along with major participating site Changi General Hospital. The vibrant case-mix of wide complexity provides comprehensive clinical training and opportunities for growth.
Since SingHealth Residency’s inception in 2010, its intake and program numbers have grown. It started with six programs and 63 residents. In 2011, the number of residents increased fourfold to 234 and the number of programs increased by seven to a total of 13.
In 2013, the number of residents soared to 670 while the number of programs reached a total of 34. SingHealth Residency also draws on a dedicated faculty of more than 1,000 SingHealth clinician-educators, who focus on teaching excellence and mentorship.
Prof Lim said the numbers are healthy and on track to reach their five-year projection of 1,000 residents by 2015. He also expects to see the numbers increase exponentially year-on-year, with surges in intake due to factors such as the new Lee Kong Chian School of Medicine.
Yet, numbers do not tell the whole story, as quality is just as important as quantity. Benchmarking against international standards, SingHealth has sought accreditation with the Accreditation Council for Graduate Medical Education International (ACGME-I), an international body that assesses graduate medical programs according to an established set of criterion and principles.
SingHealth Residency now has 24 ACGME-I accredited programs, the most comprehensive in Singapore. This includes the ten new SingHealth Medical Senior Residency Programs for advanced specialist training which received their first accreditation in December.
Said Prof Lim, “The support of the various heads of departments and senior management was crucial in attaining this standard. At the end of it, we are concerned about producing better quality doctors for our patients.”
Dr Yeo Khung Keong, Consultant at NHCS and Senior Residency Program Director for Cardiology, said, “The ACGME-I accreditation signifies a landmark in our ability to deliver high quality education to our trainees. It ensures that our residents come out well-trained to a standard; certified and well-equipped to treat patients.”
Dr Yeo added that accreditation is just one qualifier of success, and that the Residency Program’s success is also through its building of core competencies to enhance the effectiveness of doctors in various domain areas. This creates holistic, allrounded healthcare practitioners who are adept at both the nuts and bolts of Medicine – the knowledge and skills – as well as its softer side, including patient communication and professional integrity.
“It is not enough for our trainee to just follow the textbook to the letter but not the spirit of the programme. Unless our clinicians possess professional traits and values such as integrity and compassion, things can go very wrong,” remarked Dr Yeo.
In its evolution, SingHealth Residency has seen several improvements. One of them is having the respective specialities working together more collaboratively. Christine Neoh, an Institutional Coordinator, said, “We have also learnt how to work as a team among the different hospitals and institutions and different working cultures. A passionate faculty ensures good leadership.”
Of significance is also the increased involvement of residents in steering the quality of their own education. Recently, the SingHealth Residents’ Committee led the Student Internship Bootcamp initiative, which aimed to help medical students ace their Student Internship Programs. It drew some 400 medical students over three sessions.
Other initiatives such as the Centre for Resident and Faculty Development (CRAFD)’s Residents as Future Teachers (RAFT) program as well as CADENCE, a peerteaching and mentorship initiative, point towards Residents taking on greater directorship in their own welfare and educational needs.
Mok Ziying, an Assistant Institutional Coordinator for the Office of Resident Affairs shared, “The feedback from the bootcamp was very good, with residents being able to better relate to the difficulties that medical students might face. It also saw residents from various specialities coming together to teach – practising how to teach – as well as being vested in the next generation.”
Residents have also come together across disciplines for social initiatives such as volunteerism and SingHealth Residency Games, where faculty and residents strengthen bonds beyond the clinical setting. Added Prof Lim, “Residents are actively leading initiatives to address their own needs better. They are also our best strategy as ambassadors to engage new medical students.”
In the quest for quality, more improvements are in the horizon for SingHealth Residency. The Graduate Medical Education (GME) office is working towards decentralising programme ownership to the respective Academic Clinical Program (ACP) specialties.
This will lead to the GME office playing a more supervisory role with the ACPs advancing their own interests and pipelines. This focused approach will also give residents access to better opportunities such as educational, training, research sponsorship and opportunities from the ACPs; in addition to what the GME currently offers.
Prof Lim said, “The Residency Program has come a long way, but there is more to go before it reaches a steady state. With the addition of new hospitals like the Sengkang General and Community Hospitals, the demand for a sustainable system of compassionate and competent doctors remains.”