Why It Matters

Training more generalist docs

When it comes to Singapore's increasing number of elderly, it seems as though one doctor is rarely ever enough - a cardiologist for heart trouble, a neurologist for Parkinson's disease, and so on.

But with so many doctors involved, is there any one person that can be said to understand the big picture?

This has led the deans of Singapore's three medical schools to highlight the importance of training more "generalists" - rather than specialists. Apart from general practitioners and family physicians, this also refers to recognised specialities such as geriatric medicine and palliative care

The problem is that for many young doctors, these vocations may hold little interest. Many gravitate to more high-profile, better-paying specialities such as surgery. How do we change their minds, such that their preferences align with the nation's needs?

The first thing is to do something about pay.

Even in the public sector, the "proceduralists" - such as surgeons - tend to draw higher salaries.

But it also means changing attitudes. Said Dr Loke Wai Chiong, who is Deloitte South-east Asia's healthcare sector leader: "Specialities such as geriatrics and palliative medicine can be viewed as 'depressing' because they deal with older patients. (Some may) have many different diseases, all potentially exacerbating each other, with no chance of a complete cure."

A similar issue is being faced by the legal community, with lawyers eschewing criminal and family law for the more lucrative commercial sector.

So the Singapore University of Social Sciences' law school was opened this year to take in mature students, which may include paralegals, law enforcement officers and social workers, who show interest in practising criminal and family law.

Maybe a similar approach can be taken in medical education with a small number of mature aspirants, with an interest in geriatric and palliative care, given the chance to fulfil their dreams of becoming doctors - or at least help to lighten the burdens of those already in the field.

A version of this article appeared in the print edition of The Straits Times on August 11, 2017, with the headline 'Training more generalist docs'. Print Edition | Subscribe