Oversupply of specialists is result of policy failure

It is surprising that the Ministry of Health (MOH) is now shifting the onus of meeting the shortage of "generalists" on to the doctors, suggesting that doctors should either not specialise in certain fields or forgo specialisation altogether (Young docs urged to veer away from specialising; Sept 21).

There is also the suggestion that the shortage is, in part, due to doctors not practising medicine according to an idealised set of moral standards.

The scenario painted is very far from the truth.

As recently as 2008, the MOH put on record that there is a lack of specialists here, and there is a need to produce more of them.

For instance, in an article published by the Singapore Medical Association in January 2008, the then assistant chief executive officer of the National Healthcare Group wrote: "We are in need of more specialists in Singapore."

This need for more specialists was the main reason for the adoption of the American residency system as the basis for medical training here in 2010.

The American residency system is notably different from the British and Australian systems in that it has a pre-determined structure that, in theory, allows specialisation to be accomplished within a set period of time.

This suggests that more specialists can be produced in a shorter time, compared to the other systems.

Indeed, as a consequence, Singapore has seen a dramatic increase in the number of specialists among the doctors' ranks.

Hence, it is not only surprising but also disappointing that the MOH is now pushing the onus on to doctors and their personal motivations.

A short seven years after the system was implemented, we are already seeing exactly the problems as predicted.

While no policy is perfect, it is unhelpful that instead of acknowledging failure and seeking a remedy to the problems, the MOH has chosen to obscure the issues at hand.

Kenny Ching Hwee Seong (Dr)

A version of this article appeared in the print edition of The Straits Times on September 23, 2017, with the headline 'Oversupply of specialists is result of policy failure'. Subscribe