Young docs urged to veer away from specialising

More 'generalists' in fields like family medicine, geriatrics needed to serve ageing population

More places have been allocated to train "generalist" doctors in recent years, as part of a nationwide push to grow manpower in this area to cater for a greying society.

More places have been allocated to train "generalist" doctors in recent years, as part of a nationwide push to grow manpower in this area to cater for a greying society.

This year, one in five residency places offered was for family medicine, advanced internal medicine or geriatrics, said a Ministry of Health (MOH) spokesman in response to queries from The Straits Times.

This is a marked increase from 2013, when the number of residency openings in these specialities made up only 12 per cent of the total.

Doctors in these disciplines are considered generalists because they do not focus on a single organ or body part.

Instead, their emphasis is on treating patients as a whole - especially those with multiple overlapping medical conditions who would typically be seen by more than one specialist.

"These specialities will be more and more in demand with our ageing population and training places for these specialities should grow further," the ministry spokesman said, adding that MOH will continue to monitor the situation and "calibrate the training pipeline for different groups of specialities" to meet Singapore's healthcare needs.

But national needs may not always match what aspiring doctors want, hence there is also a need to urge more of them to work in these fields. In a speech to medical students last month, Associate Professor Benjamin Ong, MOH's director of medical services, stressed the importance of young doctors stepping up to fill these roles.

"We should not be in (medicine) for prestige, financial rewards or fame," he said. "We should not seek to be a super-specialist when there is limited demand for such capabilities, or choose a speciality primarily because it gives us a good work-life balance."

According to the Singapore Medical Council's latest annual report, there were 13,478 registered doctors last year.

Four in 10 were specialists. These include more general specialities such as geriatrics, but exclude fields such as family medicine.

The public also needs to recognise the value of primary care, said Associate Professor Nicholas Chew, who is group chief education officer for the National Healthcare Group (NHG). The group - which runs Tan Tock Seng Hospital, among other institutions - is one of the largest healthcare clusters in Singapore.

"Over the years, we have de-emphasised the role of the generalist," Prof Chew said.

But the conditions of patients "now are highly complex... and often there is nobody better to care for them than generalists".

NHG had 132 residency spots this year, about a quarter of which were allocated to generalist fields.

And at the National University Health System, the number of family medicine residency slots has doubled since the programme first started in 2011. It did not give more details.

Dr Sabrina Lau, who is a senior resident at NHG's geriatric medicine residency programme, said she chose this field because she valued having plenty of face-time with patients.

"I wanted to be a central provider for them, rather than managing only one aspect," said the 27-year-old. "I find that it transcends all disciplines."

Dr Charmaine Kwan, who graduated from SingHealth's family medicine residency programme last year and now practises at Tampines Polyclinic, said that the job allows her to see the breadth of what medicine has to offer.

"I like the variety and I like that when I am seeing my patients, they are still living in their own houses - rather than staying in a hospital," she said.

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A version of this article appeared in the print edition of The Straits Times on September 21, 2017, with the headline Young docs urged to veer away from specialising. Subscribe