Physician's Pledge Affirmation Ceremony

02 May 2001

By Mr Lim Hng Kiang

Theme : The importance of professionalism & ethics in meeting the challenges of the future for doctors

Introduction

Dr Lee Suan Yew, President, Singapore Medical Council;

Distinguished Guests;

Ladies and Gentlemen:

It is my pleasure to be here with you this afternoon at this important event - the affirming of the Physician's Pledge by newly registered doctors.

Every profession has a code of conduct which its members are expected to adhere to and which forms the basis for self-regulation by the profession. For doctors, the perpetuation of the high ideals and noble traditions of the medical profession, which are founded on its code of medical ethics, is the main reason why doctors continue to be held in high regard by society.

Today's ceremony is therefore a very important one - an occasion for newly registered medical practitioners to solemnly re-affirm their commitment as physicians to serve their patients and humanity in a manner that is expected of all doctors. I congratulate the Singapore Medical Council for organising this annual event which serves to emphasise to all newly registered doctors, their responsibilities as members of this noble profession.

Rising public expectations

We have to be aware, however, that society itself is changing rapidly. For example, public expectations of service quality and efficiency have increased substantially over the years. The delivery of health care cannot be insulated from these trends.

Patients today are much better informed, and will become even more so in the future as the use of information technology and the Internet expands. Patients and their relatives will expect to be actively involved in decisions about their care. Many of them would not hesitate to question the doctor's clinical decisions, to complain about the standard of service and to stand up for their rights. Patients nowadays expect their doctors to devote more time during the consultation session to listen to their problems, giving due regard to their views, and showing consideration for their feelings and concerns.

It is critical that the medical profession responds appropriately and positively to these changes. A key component of this response should be the continual upgrading of the medical knowledge and skills of our doctors through Continuing Medical Education, so that the public will continue to have confidence that our doctors are keeping abreast of the rapid advances in medical practice. However, medical knowledge and skills alone will not be sufficient - more than ever, doctors will also need to communicate effectively with their patients and to treat them with compassion, concern and professionalism.

Meeting future challenges

I am happy to note that the medical profession in Singapore has been actively taking steps in this direction.

Firstly, more emphasis has been placed on training in communication skills, medical ethics and professionalism. For example, communications skills and medical ethics have been formally included as key educational objectives and important components of the NUS medical undergraduate curriculum. The Singapore Medical Association's Centre for Medical Ethics and Professionalism organises courses and CME programmes for doctors on topics of professionalism, medical ethics, health law, and practice management. Restructured hospitals are also conducting regular, in-house communications skills training for doctors and other medical professionals.

Secondly, the Medical Council has embarked on the process of reviewing its Ethical Code to update it and make it more relevant to the current medical practice environment. For example, with the pervasiveness of the Internet and its numerous applications in health care, new ethical guidelines are required for e-medical consultations and medical advertising.

Thirdly, over the past 2 years, the Medical Council has been working in partnership with the Academy of Medicine, the NUS Graduate School of Medical Studies, the College of Family Physicians of Singapore and the Singapore Medical Association, on expanding and coordinating Continuing Medical Education efforts for all doctors in Singapore. Continuing medical education activities are important channels for the transmission of new medical knowledge and skills. These activities may be in the form of lectures, seminars, scientific meetings, workshops and learner directed on-line programmes which have verifiable testing mechanisms that ensure that users attain the learning objectives. I am happy to note that the SMC and the professional bodies are working towards a more structured CME system that will be tailored to the professional learning needs of GPs and specialists.

New Training Guidelines for House Officers

The Medical Council has also been given the responsibility of approving hospitals and institutions for housemanship training under the new Medical Registration Act which took effect in 1998. A Task Force, set up by the Medical Council, has studied the current provisions for housemanship training and made a number of recommendations to the Council relating to the educational objectives of housemanship training, the supervision and assessment of House Officers, and the criteria for accreditation of clinical departments for House Officer training.

The Medical Council is currently in the process of implementing these recommendations. For example, the new batch of House Officers starting their first posting this year has been issued with a new training handbook containing the general and specific training objectives for House Officers, and a log-book for them to record their learning experience. This will enable their supervisors to better monitor their training, in relation to the educational objectives which have been established.

The assessment of a House Officer's performance, which in the past had largely been focused on their medical knowledge and clinical skills, will henceforth be expanded to include parameters such as communications with patients and relatives, integrity and compassion. The Medical Council, the NUS Faculty of Medicine, and the Ministry of Health will be closely monitoring the training of House Officers to ensure that the objectives of housemanship training are achieved. This is an important milestone in the training of our new generation of doctors.

Conclusion

Finally, I would like to conclude by conveying my best wishes to all the young doctors who are starting their careers as fully registered doctors and also to the other newly registered doctors in the audience.