MOH committed to growing local core of doctors, nurses

MOH's Reply

The Straits Times, 7 December 2015

MOH committed to growing local core of doctors, nurses

We refer to recent letters in The Straits Times on developing our healthcare professionals. The Ministry of Health (MOH) is committed to growing a strong local core of healthcare professionals to meet the increasing needs of our ageing population (“How are foreign doctors selected?” by Mr Francis Cheng, “Work to retain public-sector docs” by Mr Ho Kar Kaye and “Not easy to attract medical teaching staff” by Ms Ada Chan Siew Foen; all published on Nov 27, and “Shortage of doctors? Train more Singaporeans locally” by Ms Maria Loh Mun Foong; Nov 25).

Through joint efforts by MOH and the Ministry of Education, the local medical intake has increased by about 29 per cent, from 350 to 460 between 2012 and this year, and is expected to grow to 500 eventually. Over the same period, the local nursing intake increased by 17 per cent, from 1,550 to 1,820. We need to expand our local healthcare manpower pipelines in a calibrated and gradual fashion. This enables us to maintain the quality of training for students in healthcare programmes, and avoid straining the training resources of our public healthcare institutions. MOH and our public healthcare institutions also protect time for experienced healthcare professionals to train the next generation, with outstanding educators recognised, for example, through the National Medical Excellence Awards.

The Pre-Employment Grant (PEG) was introduced in 2010 to attract Singaporeans studying medicine overseas to return to practise locally. As at March this year, 615 PEGs have been awarded. All overseas-trained doctors, including foreign doctors, need to meet the Singapore Medical Council’s stringent registration requirements before they can practise here.

MOH takes a holistic approach in our efforts to enhance retention of our healthcare professionals. We worked with public healthcare institutions to implement a new pay framework for public sector doctors in 2012. The revised framework better recognised the complex roles they play in public healthcare. Many of these roles are unique to the public sector, offering our doctors a fulfilling career that allows them to manage more challenging clinical cases, nurture future generations of doctors, undertake research to improve patient care, and take up leadership positions in their organisations. For nurses, the Care Package launched last year introduced, among other initiatives, two rounds of pay increases and a new Assistant Nurse Clinician role to enhance clinical competency and recognition for experienced nurses. Almost 400 nurses have been promoted into the role as of July this year.

Public healthcare institutions have also put in place measures to improve the work environment for our healthcare professionals, such as adopting IT to minimise administrative workload. MOH is also working with these institutions to redesign care delivery processes in tandem with the evolving needs of our ageing population.

Lim Bee Khim (Ms)
Director, Corporate Communications
Ministry of Health

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Forum Letters

The Straits Times, 27 November 2015

How are foreign doctors selected?

With the increase in the number of foreign doctors in the public sector, I wonder what the selection criteria are for recruiting such medical professionals ("Number of foreign doctors rising in public sector"; Monday).

The quality of doctors is critical.

Are the selection criteria on a par with those for locals?

Which foreign medical schools are recognised?

Who oversees the recruitment? What safeguards are there to ensure that these foreign doctors are as safe and reliable as local doctors?

The Ministry of Health (MOH) has offered to pay up to $50,000 a year for the final three years of study for overseas Singaporean medical students.

However, monetary enticement is not the only solution. Well-to-do families that can afford to send their children overseas may not need the money.

Instead, the MOH should chart out the career paths for these students, such as when they can expect to be promoted.

Many specialists leave the public sector not so much because of the pay but because of the endless paperwork, heavy workload and tedious work process.

Some of the specialists I know also cited their dissatisfaction with changes to the public healthcare system over the years.

Instead of increasing the number of foreign doctors, the MOH must stem the exodus of public-sector doctors.

Public-sector doctors may also stay if they are appreciated more.

Francis Cheng

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The Straits Times, 27 November 2015

Work to retain public-sector docs

The answer to our shortage of doctors does not lie in training more of them ("Shortage of doctors? Train more Singaporeans locally" by Ms Maria Loh Mun Foong; Wednesday).

As the shortage is in the public sector, not the private sector, the questions we should ask are: Why is there a shortage of local doctors in the public sector, and why is the sector unable to retain these doctors?

Perhaps the career advancement prospects are too slow or lacking within the public sector.

Doctors may feel it is more lucrative to work in the private sector, which may also provide them with a better work environment.

Ways should be found to retain local doctors in the public sector, such as offering them the best of both worlds - giving them the flexibility to work in private practice while still in the public sector.

Better career advancement pathways can also be created for junior and middle-level staff.

Ho Kar Kaye

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The Straits Times, 27 November 2015

Not easy to attract medical teaching staff

Ms Maria Loh Mun Foong raised a good point when she noted that the vast majority of our overseas medical students study in foreign universities because they could not get admission to a local university ("Shortage of doctors? Train more Singaporeans locally"; Wednesday).

So, the question is, if our local universities increase the number of places for medical students, does it mean that standards will be lowered?

Quantity does not necessarily equate to quality in medical education. Do we have a sustainable pool of excellent teaching staff and experienced clinicians to cater for an expanded pool of medical students?

It is easy to build more buildings and facilities to train medical students. However, it is not an easy task to attract suitable and committed medical teaching staff.

One also needs to consider the ratio of teachers to medical students here.

Although Ms Loh meant well in suggesting that we reduce our dependence on foreign-trained doctors, the fact of the matter is that there may be factors that do not support the increase in the number of medical students in the local universities.

Ada Chan Siew Foen (Ms)

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The Straits Times, 25 November 2015

Shortage of doctors? Train more Singaporeans locally

It is disconcerting to note that, even with the increase in intake of medical students by our local universities, Singapore is still facing a shortage of doctors ("Number of foreign doctors rising in public sector"; Monday).

To plug the gap, we are looking to foreign doctors and encouraging Singaporeans in overseas universities to return here to work.

These measures have some shortcomings, as compared to having more Singaporeans trained here.

Our reliance on foreign doctors, especially those who are not conversant in our local languages, makes doctor-patient communication challenging.

Even with an interpreter bridging the language divide, subtle nuances may be lost in translation. Patients may also not be comfortable with discussing their medical conditions via an interpreter.

Also, will doctor-patient confidentiality be breached with the presence of an interpreter?

As it takes time for foreign doctors to gain an understanding of the cultural practices and taboos of the various ethnic groups, misunderstandings may arise in the interim.

Foreign doctors are also more likely to leave Singapore, and this higher turnover may affect patient care and lead to loss of institutional knowledge and skills gained here.

Instead of enticing Singaporeans to return after their medical studies abroad, it makes more sense for more of them to be trained by our own institutions in the first place.

The vast majority of our overseas medical students study in foreign universities because they could not get admission to a local university. Their families have to spend large sums of money to send them overseas. After having trained overseas, they would have to adapt to our healthcare system.

We may also lose many of them to the countries in which they have trained, thus exacerbating our dearth of doctors.

I hope that more places can be made available to Singaporeans in medical schools here, so that we can train a larger core of local doctors and rely less on foreign doctors in our healthcare system.

Maria Loh Mun Foong (Ms)