We have experienced both the British and American specialist training systems (MOH reviews doctors' training to become specialists; Oct 1). Both have their strengths and weaknesses.
Smaller specialities do not benefit from the American residency system at all, as they are too sub-specialised and have too few trainers.
On the other hand, family medicine training has benefited greatly from the systematic approach of the American system. It allows the family medicine residents to have wide exposure to all the disciplines. It also introduces them to administration and business knowledge.
Every country and society has its own unique set of medical conditions and practices. Importing a training system wholesale will pose many challenges.
Therefore, the new training system planned by the Ministry of Health (MOH) must be contextualised to Singapore.
For instance, very few general practitioners here see their patients in tertiary or community hospitals.
When GPs visit their patients in hospital, they are mere visitors and play no part in the management of the patients. So, we can do away with community hospital postings in our residency training.
Similarly, in a small city state like ours, we do not have any need for secondary hospitals. When we review the balance of primary and tertiary care, we should examine the relevance of community hospitals here.
Additionally, even as the MOH places more emphasis on the training of generalists, it should not discourage doctors from training to be specialists and sub-specialists.
In an efficient and effective health system, all doctors play an important part. Each one is like a different part of a human body, having its own unique role. Together, all the disciplines will cover the breadth and depth of medical science to help the public.
Senior Minister of State for Health Chee Hong Tat has also spoken on the Joint Commission International accreditation of our public institutions.
This has its merits, but as we are not a major player in medical tourism, it brings little benefit.
Hospitals should focus on their core business of treating patients, and not on pursuing awards. A focused localised auditing system may be more useful.
Leong Choon Kit (Dr)
