Policy on training doctors didn't take hospitals' needs into account

I empathise fully with Dr Kenny Ching Hwee Seong's frustration regarding the Ministry of Health's (MOH) flip-flopping policy on the training of doctors (Oversupply of specialists is result of policy failure; Sept 23).

Young lives and careers are beingaffected, with no clear direction or security.

As a past associate programme director of the residency programme at a restructured hospital, I can confirm that this system is geared solely towards rapidly churning out specialists, with, in my opinion, no other advantage over the British system it replaced.

Ironically, shortly after its inception, this itself contributed to a shortage of well-trained specialists in restructured hospitals, as it resulted in a mass exodus by those who found the system too flawed and onerous to work with, including many associate programme directors.

The importing of numerous foreign specialists to fill this gap has undoubtedly contributed to the current oversupply, as many have since contributed enough to merit staying on.

Contrary to the MOH's views in 2008, many specialists did not think there was a shortage under the old system, as the specialist training committees had worked closely with the hospitals and ensured that the number of training positions was closely aligned to each hospital's projected needs for the coming years.

With this system, there was neither a shortage nor oversupply for more than 20 years.

The introduction of the residency programme, which many of us argued against, disrupted this fine-tuned balance, as hospitals were forced to suddenly take in more than double the number of specialist trainees across the board annually.

Regrettably but predictably, many who were enticed by restructured hospitals' annual recruitment roadshows to enter specialist residency training now face an uncertain future with insufficient jobs.

Fully trained senior specialists in the restructured sector facing the prospect of increasing pay cuts and more invasive performance assessments are also more likely to migrate to the private sector.

There are already many generalists and specialists, like myself, in the private sector who are happy to set aside time to see subsidised patients.

In the long run, the MOH should engage their services instead of trying to churn out or import more of either.

Andrew Yam (Dr)

A version of this article appeared in the print edition of The Straits Times on September 28, 2017, with the headline 'Policy on training doctors didn't take hospitals' needs into account'. Subscribe