In a sleek, brightly lit clinic tucked away on the upper floors of Clementi Mall, 29-year-old physician Jeffrey Ong, wearing a white coat that brings out his tanned skin, looks perhaps a little too young to be helming the clinic for the day.
The bespectacled traditional Chinese medicine (TCM) practitioner admits that some plainspoken patients wonder whether he has enough substance.
"As I am young, some patients have questioned my abilities and skills," said Mr Ong, who works at Eu Yan Sang.
"I assure them of my qualifications and that I'm able to provide them with the proper treatment."
Number of TCM physicians under 40 years old in 2010.
Number of TCM physicians under 40 years old in 2015, according to the Ministry of Health.
He is among a growing breed of young TCM physicians in Singapore - a new generation of sinsehs who can code-switch between Mandarin and English, to explain TCM concepts using Western medical terms. Their numbers have swelled by 72 per cent since 2010.
Back then, there were 256 TCM physicians under 40 years old.
In 2015, the figure had reached 440, according to latest statistics from the Ministry of Health.
On the whole, older physicians still dominate the scene, given that 3,057 TCM practitioners were on the register at the end of 2015. Those under 40 make up about 14 per cent of the total, but they are a growing number.
A ministry spokesman said that "talent development is important to further strengthen the TCM sector, so as to better meet the evolving needs of the population".
A factor that has helped to pump in young blood was the introduction of the biomedical sciences and TCM double-degree programme at Nanyang Technological University (NTU) in 2005.
Students of the five-year course graduate with both a Bachelor of Science in biomedical sciences from NTU and a Bachelor of Medicine (Chinese medicine) from the Beijing University of Chinese Medicine.
About 304 students have graduated from the course so far, said Dr Goh Chye Tee, programme director for biomedical sciences and Chinese medicine, at NTU.
Some graduates go into careers such as biomedical research, but about half of them are practising Chinese medicine, he added.
GLOBAL APPEAL OF TCM
There are others, like Ms Ong Fang Ying, 29, who opt for a different educational route.
After completing her A levels, she went to China to study TCM at the Beijing University of Chinese Medicine.
"My friends were surprised, as it was an unconventional thing to do," she recalled. "But my parents were quite excited when I decided to go ahead. They bought me a lot of books, on topics like acupuncture."
She said she had been intrigued by TCM since she was about 15 years old and had sprained her ankle while playing basketball.
A visit to a TCM physician led to improvement that surpassed her expectations, she added.
Ms Ong also obtained a clinical master's degree in China. She spent a total of eight years there before returning to Singapore last year.
She now works at Raffles Chinese Medicine. Among her colleagues are five other physicians aged under 40.
Said Ms Ong: "I respect the TCM pioneers for laying the groundwork in Singapore. The field of TCM is vast and the younger physicians have their own set of skills to contribute."
They can play a significant role, given that TCM is gaining global recognition, she added.
At Raffles, Ms Ong sees many non-Chinese patients, including expatriates and tourists. Some ask for acupuncture treatment, while others have pain problems.
"Being bilingual, I can easily explain TCM to them in English," she said. "They are generally interested and make an effort to understand."
Physician Huan Chew Ting of Thomson Chinese Medicine agreed that being proficent in both English and Mandarin enables better communication with patients.
Ms Huan registered as a TCM practitioner in 2008 and has been practising here since 2014.
On top of a diploma from the Singapore College of TCM, she has a bachelor's and master's from Nanjing University of Chinese Medicine in China.
Having an understanding of how TCM can complement mainstream medicine paves the way for patients to "enjoy the best of both Eastern and Western medicine", said the 31-year-old Malaysian.
Headaches, for example, can be quelled with pain-relieving medication. But some people may still feel uncomfortable afterwards.
That is when TCM can come in, such as in the form of acupressure, to tackle any lingering discomfort, said Eu Yan Sang's Mr Ong.
HURDLES TO CLEAR
Still, the picture is not all rosy. For one thing, an invisible wall remains between the Chinese and Western medical fields here, and both sides do not routinely communicate with one another, said Mr Ong.
In Singapore, patients consult Chinese and Western doctors separately, and some doctors may raise objections with patients seeking TCM treatment, he added.
"There is a lack of interaction and it may be hard to understand each other's practice," he said.
He hopes this situation would improve and that both sides could embark on meaningful research to benefit patients.
The practice of Chinese medicine in the modern world has its inherent obstacles.
"One challenge is in explaining the diverse TCM terminology to patients, especially where it relates to one's body constitution and medical condition," said Ms Huan.
TCM is based on theories such as yin-yang, which refers to cooling and heaty elements; and meridians, which are channels through which qi (vital energy) travels in the body.
"These theories are unique to Chinese medicine and are foreign to patients who are mostly familiar with Western medical concepts," said Ms Huan.
This is why some patients might not understand the link between their ailments and certain daily habits, said Ms Ong.
In such instances, the physician has to "do more probing" to get to the root of the issue.
She added: "Younger physicians can do more to educate the public, particularly the English-speaking crowd."
Some disparities may also exist between some older and younger TCM physicians.
NTU graduates, for instance, have an extra degree in biomedical sciences, which gives them a different perspective in their practice.
On the other hand, the older physicians have plenty of clinical experience.
"But scientific knowledge can be learnt, while clinical experience can be accumulated," said Mr Ong, a graduate of the NTU programme, who registered as a TCM practitioner in 2014.
Therefore, both groups need not view each other as competition, he added.
Mr Ong said it is a positive sign that more young physicians are on board to help push things forward. "It is a good start, it shows that the younger generation is not letting the ancient art of TCM die."
Research grants, training and educational elective help raise TCM professional standards
New life appears to have been breathed into the field of traditional Chinese medicine (TCM) these days and not just because there are more younger physicians practising the age-old craft.
The Ministry of Health (MOH) started a $3-million TCM Research Grant in 2013 to encourage research and collaboration between TCM practitioners and mainstream medical researchers.
Five projects were awarded in the first grant call in 2014, said a ministry spokesman.
The next grant call is on from now till March, she said.
"Evidence-based research on the safety and effectiveness of TCM treatment is important," added the spokesman.
One such project, carried out by the Singapore General Hospital, examines the use of acupuncture to relieve pain during egg extraction for in-vitro fertilisation.
Other studies funded by the grant include one on using herbal medicine to treat constipation linked to irritable bowel syndrome, and another on whether acupuncture and herbal treatment are helpful in treating dry eyes.
Physicians and acupuncturists are being asked to attend lectures, seminars, courses, workshops and other training-related events on a voluntary basis.
This is part of the Continuing Professional TCM Education Programme (CTE) launched in 2013 to enable practitioners to keep pace with changes and to raise professional standards.
In 2015, 41.2 per cent of registered TCM practitioners took part in such training events, said the MOH, adding that 185 events were conducted by local accredited CTE providers.
On the education front, private TCM provider Eu Yan Sang (EYS) in 2015 started co-sponsoring an elective for medical students at the National University of Singapore (NUS).
Jointly developed by EYS and the Shanghai University of TCM, the elective aims to "provide medical students with an overview of the theory and practice of TCM and its role in integrative health care", said Ms Caryn Peh, EYS' managing director of clinic services.
It is the first structured TCM elective recognised by the Yong Loo Lin School of Medicine at NUS.
Under the four-week elective, students undergo training at the EYS Academy and Shanghai University of TCM in China, guided by experienced TCM physicians.
Said Ms Peh: "There have been positive responses from the undergraduates, with increasing applications and good testimonials."
Poon Chian Hui
Correction note: In our earlier story, we said the biomedical sciences and TCM double-degree programme at Nanyang Technological University (NTU) was introduced in 2010. It should be 2005.