I trust many of Singapore MD's readers came across this articletoday.
To be frank, I was taken aback by the number of foreign doctors being recruited - approximately 800 out of 1300 newly registered physicians.
I guess the MOH ( or MOHH as it's called these days ) deserves some credit for taking steps to ease the shortage ( though relative and far from absolute ).
But yet again, numbers aren't everything. Sticking your finger in a hole can plug a leak, but you still need to fix that damn hole.
And who oversees the quality of these foreign doctors? There used to be strict regulations on recognized universities / degrees, but it seems just about anyone can get their feet through the door these days.
Do they need to take a theory or clinical test before being accepted into the local workforce? I'm guessing no, since quite a few of the foreign MOs I work with can't take proper histories, do simple physical exams, read ECGs or x-rays, or interprete basic blood test results.
They're also not very productive, so you need approximately 2-3 of them to cover the workload of 1 competent junior doctor.
And there've been many near misses, so the supervising senior doctors also have their hands full.
With the recent implementation of the residency programme, the overall patient workload will become even more unequal, as residents have clearly stipulated patient numbers which MUST NOT be exceeded, leaving the extra cases to be distributed among the non-residents ( many of whom are now - say it with me - foreign-trained ).
I see a vicious cycle starting.
p.s. KTPH is now hitting full bed capacity in terms of admissions. I wonder if MOHH can get JGH's contractors to speed things up.
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4.3.3
Comments about colleagues
A doctor shall refrain from making gratuitous and unsustainable comments
which, whether expressly or by implication, set out to undermine the trust in a professional colleague’s knowledge or skills.
Can the author please kindly remove comments on foreign trained doctors being unable to take proper histories, do simple physical exams, read ECGs/X rays or interprete basic blood test results.
The author did not say 'all foreign-trained doctors'. S/he specifically wrote 'quite a few...foreign MOs'.
There's a big difference.
And being in the same situation as the writer of this entry, I think the situation deserves to be highlighted.
in addition, these comments may not be 'unsustainable' too.
The only remaining profession that has not been over run with foreigners is the legal profession.
No surprises why.
I think the key here that Singapore-MD-admin mentioned is about regulation.
In the US you need to pass exams to work there even if you are already a consultant from another country.
Maybe we should have something like that here, or maybe a mini-OSCE/clinicals for interested applicants so as to screen out those who are not up to scratch.
As a patient and paying customer, I am disappointed that often times I get foreign doctors when I go to the polyclinic. The chap doesn't even understand my Singapore accent sometimes, and I worry for the more elderly folks who have more need for subsidised healthcare than me.
Also, how does MOH ensure those foreign doctors are medically competent? In Singapore, my children would required stellar academic grades and clinical exposure before acceptance into med school. I don't thnink the standards for foreign med schools have that high quality standards.
The administrators can plug the hole quite simply by treating the local doctors better. Many of my local colleagues are just waiting for their bonds to finish so they can move out to the private sector. They have had enough of being messed around. If some administrators can learn to be more reasonable, they can save a lot of trouble by retaining the local doctors in the public sector and not having to travel to some of these exotic countries to poach their doctors. These 3rd world countries need their doctors and no one gains when these foreign doctors are poached (well, maybe apart from the administrators). By the way, I am talking about foreign doctors from certain countries. I am excluding doctors trained in USA, UK, etc from my comments for obvious reasons.
Im a singaporean studying in australia and I just attended a mohh/sgh residency program talk last week and it's disappointing to say the least. We have to sign a HO/MO contract before we're allowed to apply for the residency programs. That is to 'demonstrate our commitment to singapore'. This applies even if we don't take their grant. I thought I showed my commitment by serving NS. So I asked the sgh rep what happens if I sign on but fail to match to a program, he replied that I can try again the following year. A fellow medic asked how many spots they've got and the mohh rep replied 330. If nus takes 260 and duke-nus takes 50, that leaves 20 for us UK+AU? I wonder how many will have to 'try again next year'. Then comes the question of accreditation, it appears thay're still trying to woo ACGME so their reply was simply 'someone will accredit the programs'. That doesn't instill much confidence. The simple matter of fact is that mohh doesn't need/want us taking up spots in their precious residency programs, they need people to hantakaki in the polyclinics like all the foreign docs they poached. Their 80k grant won't lure anyone who's not going to come back anyway, it's just free money for those who're coming back because they want to or because they have no choice. Here's the kicker, the mohh rep said that our guarantor will be notified when the money's deposited into our bank account so that 'we don't blow it on a Ferrari'. In a few years 80k may not even buy us COE...
@Anon 19:05. I would strongly advise you to get your full registration with the AMC before thinking of coming to Singapore. If you get messed around by MOHH, you will be able to tender your resignation and return to Aust/NZ without problems. Some of my foreign-trained ex-colleagues came back as housemen without full registration with any medical council (e.g. GMC, AMC, etc) and are unable to get back into the overseas system because they do not have full registration. If you think $80k is tempting, you might want to consider the opportunity cost of working in Singapore. You will be earning a lot more in Australia (especially after you factor in 'overtime', which you will be doing a lot of in Singapore without getting paid).
Do speak to a few of your friends who have come to Singapore and find out what things are really like here. All the best!
I'm a Singaporean doctor who has left the Singapore system for good.
I studied in NUS. Biggest mistake of my life.
It is much better to study abroad and as the previous poster wrote to get full registration with the foreign medical body BEFORE coming back to Singapore.
Keep your options open. The Singapore degree is useless internationally. SMC registration is useless internationally.
However if you have a medical degree or medical registration from developing countries, Singapore will still recognize your qualifications and allow you to work without having to take any exams.
This is the difference. And it is a huge difference. In other developed nations, the professionals are given respect and privilege for their training. Foreigners who come in and want to work in the profession have to go to great lengths to prove their equivalent competency.
80k is a short term gain. Look at the bigger picture. Having said that, Singapore does need good doctors, so after getting your registration with the foreign body please do go back to help. Trust me it will open your eyes and you will learn a lot. After that it is up to you where you want to go.
A wiser option would be to do all your specialty training overseas then return to Singapore and become the head of one of the departments in the hospitals there. Foreign specialists from foreign developed countries always seem to be treated with more respect and awe for whatever reason.
They still send doctors overseas for HMDP right? You don't see USA residents sent overseas for training. There is no need to.
i do recall just before i started work, during the briefing of new incoming HOs by MOHH, that a MOHH rep said that the salary they are paying us a fair wage that conmmensurate with the market rate/average starting graudate pay.
they INSISTED that it was fair.
http://www.moe.edu.sg/education/post-secondary/
looking at this data, i beg to differ, for it seems i am one of the lowest paid fresh graduate now.
just a comment on the original article, I'm currently 1st yr at a uk medical school.
80k sgd is pittance, and can be earned back in 2-3 years working for the british ah ma instead of ah gong here.
starting pay for HO here, i believe, is around the 2.7 k level, with bonus etc etc comes to about 35k sing...in uk a first yr ho earns 23k pounds for 8-5, monday to fri, with additional 30-50% for on call and OT, moving to 28k pounds in 2nd year, again adding 30-50% to that for OT, and 32k pounds in the 3rd...
so in the end...i earn the same amount as in singapore. but just change the $ to £.
"As a patient and paying customer... when I go to the polyclinic."
LOL.
http://www.asiaone.com/News/Education/Story/A1Story20100504-214079.html
HO from Malaysia get 6k a month
I think this is a fair salary as first year lawyer only get 5k and other graduates start at 2-3k
Of course, HK pay more but we cant compare all the time.
Indeed true. I had a visit to the hospital once due to wrist fracture. I simply cannot understand what the indian doctor(who is a foriegner) is trying to say. I was then referred to another chinese doctor (a foreigner also). We had to communicate in Chinese because his English is a total goner.
Regards to the productivity, both the Indian and Chinese doctor stared at my x-ray and spend another 30 minutes discussing before inviting a local senior doctor. The next minute, i was getting my wrist casted.
I find it hilarious that the 1st year UK student dosent take into account the high british taxes, especially for foreigners and especially since the VAT just gone up.
Speaking as a 4th year medical student, the NHS, although good in theory, is crap in practice, and perhaps you will rethink your decision to work here again.
Singapore is always still home, no matter how terrible the system may be. Im keeping my optimism up vis a vis this temporary influx of foreign doctors. I am convinced that when the new LKC medical school starts, we can soon start to meet the demand with our own locally produced doctors and perhaps there will be a sort of re licensing CME exam that would weed out the incompetent doctors that do not meet our system's requirments.
Last but not least, i guess that this period of transition is not easy for Singapore Medicine, but given time, things will definitely improve.
@M4
You certainly have a lot of faith in the LKC med school. But may I ask who is going to train the huge intake of med students (and later junior doctors)? A previous article has already told us that almost 70 senior doctors left for private practice last year. Countless more non-specialist doctors have gone out to join one of the private healthcare groups. Who is going to train these students? The graduate from some obscure foreign university??
I was trained in the the UK and have worked in the NHS as a junior doctor. I agree that the NHS leaves much to be desired and ever since the Labour government tried to be too smart by meddling with the Royal Colleges' training of doctors, things have been going downhill. But comparing practicing medicine in both countries, you still get better training in the UK - much better. This is not saying a lot about Singapore. Also, my take home pay (i.e. after taxes) as a house officer in the UK is still a lot more than my take home pay as an MO in Singapore.
Finally, you may want to find out about how MOHH treats it's doctors - speak to your friends in Singapore.
Anyway, you might like to seriously consider staying on to get your full GMC registration and FY2 signed off first before coming back to Singapore. In that case, if you don't like it here, you will be able to try somewhere else like Australia and NZ even if you do not want to go back to the UK. Best wishes!
@M4
Even taking into account the Brit tax rate which is 20% at that bracket(£2440-£37500 per annum), and Singapore's tax rate which is 8.5% at that bracket ($30k to $40k), the pay is still much higher.
One of the reasons I decided to study in london instead of disrupting NS (very tempting) to YLLSOM was due to the world renowned status of the uni i'm in, the high standards of training, and of course the flexibilty to work overseas.
We might even be in the same uni, who knows :P
M1@ 00:26
Extracts from my research paper :)
United Kingdom
Singaporean medical students studying in UK can choose to stay in UK for postgraduate training. They would earn a basic salary and will be paid a supplement if they work more than 40 hours and/or work outside the hours of 7am-7pm Monday to Friday. In the most junior hospital trainee post (Foundation Year 1) the basic starting salary is £22,412 (S$45814). This increases in Foundation Year 2 to £27,798(S$56,824). For a doctor in specialist training the basic starting salary is £29,705(S$60,722). If the doctor is contracted to work more than 40 hours and/or to work outside 7am-7pm Monday to Friday, they will receive an additional supplement which will normally be between 20% and 50% of basic salary. This supplement is based on the extra hours worked above a 40 hour standard working week and the intensity of the work.
This means that Singaporean medical students working in UK would earn more if they had stayed in UK even though the tax rate in UK is higher since the starting base salary for houseman (equivalent to Foundation Year 1) is about S$34,970. By offering a pre-employment grant, it makes it more attractive to return to Singapore to work.
Australia
Singaporean medical students studying in Australia will be paid
a base salary of A$60,000 (S$76,837) if they chose to remain in Australia.
New Zealand
Singaporean medial students studying in New Zealand will be paid a base salary of NZ$52,800 (S$51,336) if they chose to remain in New Zealand
Hi,
I'm a MOT who has been in the system for a couple of years.
When I first became a doctor >5 years ago, fewer registered doctors meant that each doctor had to cover more patients and shoulder greater responsibility. This also meant that we had much greater learning opportunities in terms of procedures and management of patients.
With the influx of foreign doctors, while the workload has lessened conserably, there are also much fewer opportunities to have hands-on practise of procedures under senior guidance.
How many MOs today can perform a lumbar puncture or knee aspiration independently? Things are becoming very sad when the core skills of us juniors are depleted because there are not enough cases to go around.
Secondly, with the transfer of our administration to MOHH, it is unbelievable how shabby the treatment of junior doctors has become. Emails are unanswered, there is often a delay in the payout of salaries and call pay. We are made to go through the tedious process of paying for our own courses first and chasing MOHH for reimbursement... etc
For one thing, the pay of junior doctors has been reduced across the board. While in the past, I gather that a 2nd year MO used to earn about $4300-4500/month, the figure has been reduced by $300-500. Let's not even start talking about yearly bonus payouts.
My peers and I didn't become doctors for money, but when faced with the prospect of making so much more money in the private sector with lesser work, is it any wonder that many people are leaving as soon as their bond is up? Even for those in the public sector, not a few doctors dabble in stocks and shares or moonlight as locums to supplement their income.
I can see a particular pattern developing. Flood the public healthcare sector with doctors irregardless of quality. To make up for the extra doctors, depress the pay of all doctors (after all MOHH has a monopoly in the public sector). Practise differential treatment of juniors by making non-residents pick up the slack for residents. Mass-factory produce specialist even though many of the problems seen at the specialist clinics today could be easily dealt with by a competent GP.
Flood the market with specialists from the residency programme (just like the GP market is flooded today), and hopefully bring the price of seeing a specialist down through market forces.
Yet, history shows us that healthcare doesn't obey the convenional laws of supply and demand.
Isn't the current policy of recruitment such a far cry from past when the supply of doctors was strictly limited to prevent supply-induced demand?
I fear that we have swung way too far in the opposite direction...
@ anon 17 January, 2011 11:01
The difference between UK and AU, as far as I understand, is that UK guarantees PGY1/2 hence registration while AU doesn't. AU is facing a shortage of PGY1 spots in all states so not all of us can stay. AMA recently said that they'll try to guarantee all medics an intern spot by 2013, we'll see how that goes.
The base salary you quoted varies between states and is before tax, I'd say its a good average though. I was talking with my friends here and none of us are interested in the PEG if we're able to stay in AU. In fact, some of them dread SG so much that they're going through the hassle of USMLE.
anon 14 January, 2011 19:05
Just a small comment,
If workload is reduced since there are more doctors (local or overseas), shouldn't pay be reduced to reflect this?
If you want high pay, you must be prepared to work harder like your seniors in the past:)
"If you want high pay, you must be prepared to work harder..."
How much one gets paid is not dependent on how hard one works, but by how much one's work is valued. Or costed. Subtle but important difference, that...
I am a houseofficer within the system. a non-resident to be exact.
I am watching the healthcare system slowly, but surely deteriorate before my very eyes.
The administrators can choose to believe they are doing the right thing, by ignoring the feedback coming right from the ground.
They can turn a deaf ear, after all they aren't the ones suffering, and at the end of the day if their quotas and deadlines are met, they will leave the office at 5pm SHARP. not to mention the 2 hour long lunch breaks.
In time to come the main workforce of the healthcare industry will be manned by foreigners.
Till then, complain as much as you want, but you are going nowhere.
Trust me. i know. i am from the system. The system owns your $500k ass.
I'm just sad that morale is so low at all levels within the public healthcare system. As students, watching our seniors leave for private practice, or choose to suffer within the public system is a wake up call to the realities of practicing medicine in Singapore.
I think all doctors want to serve the public given a chance to do so, but looking at how badly the senior doctors are treated in the system, you don't really aspire towards their roles. The senior doctors are doing a great amount of public service.. both to the public and within the medical fraternity.
It may take 5 years or more to train a doctor, but quitting the profession or doing something else, or going into the private sector just takes moments.
A doctor's job is not just seeing patients. It's also about educating the public, educating the juniors, fighting for changes in legislature that benefit our patients, fighting for funding for new initiatives, staying current to advances in medicine and doing clinical research.
We're not some production line worker that you pay by the piece. When you fall sick you would probably want as much medical attention, and as much SENIOR medical attention as you can get. I don't think any patient will want less than the best treatment and treatment supervision.
Cry all you want.
In the end. We know who controls everything. Those that voice out here have no say.
Those that do have a say, can't be bothered with what those here have to say.
In terms of choosing a career in Singapore you have to ask yourself what Singapore really is all about. What is Singapore as a country good for? Renowned for? What is the main driver of the economy in Singapore? What is the focus of Singapore? How is the budget allocation in Singapore?
After a while you just have to admit that in Singapore healthcare is viewed as a waste, a drain of resources and whatever means is possible kept at the lowest cost to the country.
Stay on and be a doctor, serve the people and shut up, change profession or go overseas to practice (won't be easy but it is possible).
It is all up to you. I made my choice and have absolutely no regrets!
Absolutely, we should screen medical students from the start and only accept those who are willing to work for the interests of the patients rather than their own.
Over the years, I have noticed my doctors increasingly more concerned about their own welfare rather than the patient's welfare.
Eg.
1. closing clinics on the dot and rejecting patients.
2. refusing to allow patients to repeat medicine and forcing them to consult them and earning consultation fees.
3. refusing to do housecalls or demanding hundreds of dollars to visit patients.
I can name more but you can get the picture.
Black doctors, white doctors as long as they can treat the patients well are good doctors.
"... as long as they can treat the patients well are good doctors."
I would have thought that it's the doctors who can make the patients well who are good doctors.
Haha :)
To quote Dr. Gregory House from the totally unrealistic hit TV series:
"What would you want, a doctor who holds your hand while you die, or a doctor who ignores you while you get better? I guess it would particularly suck to have a doctor who ignores you while you die."
The last anonymous thinks he's choosing doctors like he chooses maids. He even has a criteria list. Among maids there's also English-speaking, and non-English speaking. I'm sure you know which maid costs more. It's up to you which doctor you want if you can afford to pay. If you can't pay and still complain, of course the good public docs will get pissed off and leave. You think you're the only 'employer' in the market?
1. closing clinics on the dot and rejecting patients.
2. refusing to allow patients to repeat medicine and forcing them to consult them and earning consultation fees.
3. refusing to do housecalls or demanding hundreds of dollars to visit patients.
Hmmm in other countries like Australia and Canada they do all the above.
1. Patients are seen only on appointment basis in most clinics. If the appointment list is full for the day you have to schedule for another day. If it is an emergency you are advised to head to the hospital emergency room. If you are at the clinic and it is an emergency they will attend to you. But generally people know they should call in before going to the clinic. It is all transparent. No bending over backs to patient's whims and fancies. It is not about money. It is about making the best choices for patients. Respect the time other patients have scheduled with the doctor. If the doctor accepts more patients it means he is "eating" into each patient's time which is not fair. Respect for the doctor's time. Going to the clinic at closing time seems to be a habit of Singapore patients (FT local or not). What part of closing time don't people understand?
2. In other countries there is NO SUCH THING AS REPEAT MEDICINE. You get your prescriptions filled at the pharmacy where a pharmacist attends to you. IF you don't have a prescription you can't get any medicine. Only in Singapore do doctors dispense medicine making it seem like a visit to the doctor is to buy medicine like you buy stuff from 7 Eleven so why need to pay consultation right? Management of chronic diseases is not just about taking your medicine. There are other things to monitor.
3. A doctor's time is precious. For the doctor a professional to take the time and effort to take himself away from his office and his other patients to attend to a housecall is not a simple easy task. Hundreds of dollars in Singapore? In other countries it would be thousands.
Moral of the story fellow doctors, is that in Singapore the respect for doctors as professionals is not there. We are treated like service staff. Medicine pill counter sales staff. When the occasion favors, they will accuse doctors of being greedy. Or they will throw the book at them saying they should be caring more about patients than money.
Who created all these misconceptions? Well it is everybody. Doctors included because many played along for the sake of money as rightly accused.
So there is no more respect. Patients don't trust the doctor to be doing the right and best thing for them. Doctors don't trust patients to be asking things for the right reasons. A lot of dislike for each other. In such an environment it is neither pleasant nor conducive to practise medicine.
In Singapore it has come to a stage where if someone pays another money, then the latter is the former's servant of some sort who has to pander to their whims and fancies all for the sake of "customer service".
Where is the mutual respect for one another?
Just because one has to pay the doctor to see the doctor, does it mean the doctor is a greedy bastard and cannot command respect if he disagrees with the patient on a professional basis?
Just a side comment about KTPH / hospital in northern side.
I vaguely recall reading in the news about a month or two ago regarding a new hospital in Seng Kang area?
This comes about as a surprise. I believe our last public hospitals before KTPH was either NUH or CGH. That's like >10 years ago. In the short spate of the last 2-3 years, MOH has suddenly 'dawned' upon the idea that with the booming population rise in the last decade or so, we need new hospitals.
Given that KTPH is relatively new and already we're looking at having another nearby hospital at Seng Kang area, is KTPH's capacity for the northern region under-estimated again?
Hmm......
Oh yeah I can fully understand what Anonymous 18 Jan 22:27 wrote. The expectations of doctors has gone way up while at the same time the respect for doctors has gone down.
1. Patients coming to clinic at closing time - the vast majority of patients are relatively well, eg URTI or eczema. Quite a few will have this condition for some time but will choose the exact moment (closing time) for a consult. And they are not apologetic about it, it is as if because they are paying for it, we had better serve him/her.
2. Quite a few patients will not ask for MC in the good mannered way, but will instead say "Doc, I need 2 days MC ok?"
3. In the middle of the consult and their handphone rings, they actually continue their phone conversation, leaving me speechless.
4. Some of them will take the queue number, go elsewhere and run various errands/eat and when return, expect to get seen as soon as possible.
5. Armed with information from the internet or friends (Which may not be applicable to the patient's clinical condition), request (as well as demand) for investigations/medications which may not be appropriate for the said patient.
6. And others who have a clinical condition that needs to be worked up with further investigations for proper diagnosis, but for some reason does NOT want to have the investigations but STILL wants to know exactly what is going on.
There are quite a few other examples but no point writing down everything. I agree that we are treated like service staff. The patient is no longer a patient but a customer. But I'm sure we all know that already, don't we?
Once upon a time, a Singaporean minister (I think) said, "Healthcare is firstly about politics, then economics, and lastly about health."
anybody here who can pass the Singapore MBBS final exams/MRCP/FRCGP exams will not doubts kill the the Australian Medical Council exams.
why waste one's time putting in so much time and energy in MRCGP when you can do the AMC exams, which will virtually help one to gain a foothold into the Australian Healthcare system.
all u need to do is to have a chat with the newly qualified specialists/GPs on what the current market conditions are like.
http://www.amcexams.com/examdetails.htm
Crap, it seems like we are all dooooooomed, all this ominous writings have made me reconsider coming back to my beloved Singapore.
Especially since the remuneration and hours and training are much better in the top hospitals here in UK..
I guess the only enticing factor left is the shorter specialists training duration compared to Australia or UK and the ease of getting into these training posts locally as a graduate from a top UK medical school versus as a international graduate competing for quota-ed positions in UK
The last thing about this issue of Healthcare manpower in Singapore - who takes care of the welfare of doctors? Are there unions? (Like the British Medical Association we have in UK)
Something needs to be done to stem the deterioration of the system. And with the right determined and concerted effort via the white, i mean right channels, perhaps something can be done to stem this decay
M4, good that you are starting to see some of the realities and leave sentiments aside.
Yes you are right about it being harder to get into a specialist training program in UK vs you being "a graduate from a top UK medical school" getting into Singapore's training programs.
Ask yourself why this is so? You might want to consider getting the hard part out of the way at the beginning than to get into the Singapore training program easily, spend all that effort training and then get STUCK in Singapore because no other country would recognize your credentials as equivalent. On the other hand if you are a specialist from UK you will have to problems coming to Singapore to work at the same level from the very moment you land in the country.
In Singapore there are no unions. Period. When I mean unions I mean them as they are meant to be. Not just by name. No unions. Especially not for doctors.
Actually in most first world countries they are rather strict when it comes to assessing physician credentials and ability. For instance even with UK training you probably have to challenge the USMLE and MCCQE LMCC exams for USA and Canada if you wanted to practice. Which is no different from doctors from Singapore. But the point I am making is that Singapore will welcome you with open arms as long as you are a doctor trained from a country where the name is recognizable.
So don't worry too much about coming back to Singapore. If you really want to, it is just a matter of when, not if. And when you come back, at which stage of your training will impact your future in Singapore greatly.
Think carefully. If Singapore is in need of well trained specialists will 80k be enough to entice them? Singapore is in need of junior doctors to do the leg work.
There will never be anything done to stem the "problem" because it doesn't impact anybody but a small minority of people called "healthcare workers". The measures in place keep costs low and maintain high efficient competent healthcare delivery which is beneficial to the people. But of course at the cost of healthcare workers treated poorly, and paid inferiorly compared to other first world nations. Why would the government change the system to benefit the few and risk the wrath of the majority public? Strict laws also ensure that doctors cannot go on strike and cause unrest. They will be severely dealt with.
From a lay person's point of view I should be very happy and should just be concerned with whether this influx of foreign trained doctors keeps the quality of healthcare good. But instead we see many patients kpkbing about everything and even saying it is expensive etc. It is expensive because taxes are not high in Singapore and the government does not spend a lot of the budget on healthcare and so the people have to pay out of their own pockets. No fault of the doctors and nurses. But often they are made the bogeymen as "greedy doctors" trying to earn "so much".
How much does a doctor earn these days? Compare that to the lawyers and bankers? The decline started 10 years ago. Now it is starting to be felt.
Hi all
I came across this interesting job advertisment
http://jobs.zhaopin.com/P2/CC2970/6881/J902/502/CC297068811J90250290000.htm?f=ss
职位月薪：1000-50000元/月
Soon we can have sufficient drs in Singapore and provide affordable care for all :)
M4 at 11:41
UK Training is recognised around the world. Residency in Singapore is currently only recognised in Singapore.
You get paid more, work less, better training.
Is there any comparison?
You paid the premium for medical school overseas. Leverage on that.
M4:
I am a local grad surrounded by foreign grads who have returned to the system. And every single day they are regretting their choice. Quite a few of them have chosen to quit the system, and return to UK/aus/even Malaysia to train.
Think hard.
Options for local grads :
1) Persevere
2) Quit medicine
3) Commit Suicide
Options for foreign grads :
1) Persevere
2) Quit medicine
3) Quit Singapore and practice medicine overseas
4) Commit Suicide
UK trained doctors who are keen to work in australia can be comforted that they do not need to sit for the rigourous Australian medical council exams in order to gain full unconditional registration in australia.
lots of UK trained doctors (malaysian and singaporean passport holders) are heading down south.
It does seem that the grass is greener down south. Do, however, assess other important factors such as the unmatched conveniences one can find in Singapore (transport, internet and telecom services, banking facilities, glorious food varieties), families and friends that one will certainly miss dearly with long distances apart, and certainly one cannot take for granted the excellent quality, reasonable and easy access to medical and dental care you can get (I speak with sincerity and from experience here). I still get practically all the medical and dental needs taken care of and medications filled during trips back to S'pore as the doctors and dentists have all been very helpful and accomodating in view of my limited time in Singapore. Have been down south here nearly 3 years and the experience has taught me a great deal about the many things that are working well but have often been taken for granted back home - the high level of efficiency (queuing is the norm here for practically everything), the readily accessible services and much cheaper cost of almost everything (unlimited internet access, cheap telecom, food, etc ).
Anon@17:37. You are absolutely right. However the majority of Singapore locals who see doctors take all that for granted and demand even MORE! And they treat the doctors like their slaves.
Which would you rather have? To be abused day in day out for doing a good job? Or to be treated with respect for doing your job?
Sad to say, this mentality seems to permeate the society...not only the way doctors are treated but educators and others too. Just saddens me to hear that medical and dental professionals want to leave, hoping for a better work environment elsewhere.
I really hope those in authority and who can do something are aware of what happens at the ground and be bothered enough to take action to curb the exodus of well trained doctors and dentists whom they have selected among the best and put through years of training, instead of just plugging the holes by replacing the numbers. I think it does not help either when patient-centricity with all its good intentions becomes misconstrued and the patient thinks he's the master!
From observations, doctors down south are certainly better protected by their peers and senior colleagues, not to mention the healthcare system which will not hesitate to take action to stop patient abuse. Can't understand why we can't learn from these systems that have worked well to protect professionals who are critical to the wellbeing of the nation.
What I can truly say is things do and will improve over time as a doctor becomes more senior; as respect will increase with seniority. Not all is lost too, as there must be patients who do respect their doctors, are grateful for all the medical care they receive and treat the doctor-patient relationship as sacrosanct. Also, practising medicine is a lot less uncertain and litigious in Singapore than in some of these countries.
Nice Try
Dont paint such a good picture of Australia. At least in SIngapore, we take in most medical graduates as housemen.
No internships for foreign medical
By Jonathan Pearlman, For The Straits Times
SYDNEY: Foreign medical students in Australia are being hit hard by a growing shortage of internship places at hospitals here, leaving them unable to practise in this country after graduating.
Many of the hundreds that were affected last year, suggested a recent survey, were not aware that they would not be guaranteed training spots until they arrived, and say they would have studied elsewhere had they known earlier.
Fearing that this will drive many fee-paying international students elsewhere, local universities are now considering sending their graduates to other countries to do their internship, including Singapore.
'A shortage of internship places looms and new positions must be provided,' University of Sydney's dean of medicine Bruce Robinson told The Sydney Morning Herald. 'We have had a very patronising attitude to South-east Asia for some time. I think there is actually some enthusiasm that Australia might recognise we have something to learn from them.'
anonymous 26.1.11 1021 hrs
at the end of the day, the aussie health care system will miraculously cough up some extra intern slots, as it has always been doing (it has been happening since my student days - *yawn* ). Don't forget that Australia spends a big portion of its GDP on healthcare, which makes someone's look like a puny piece of breadcrumb ;)
with the recent queensland floods, it is likely that they will need more doctors to run the small rural hospitals.
the extra students are likely to be sent to work in these small rural units, something which they have to get used to.
If they are not happy, they can always choose to do it somewhere in the far far north where they will find the on calls very shiok shiok ;) - and in no time, they akan nagis ibu bapa.
at the end of the day, if they don't want to stay in australia, they are free to go whereever they want to.
anon 24 jan 1737 hrs
i live in melbourne and i do have regular access to my favourite malaysian nasi padang/prawn noodle.
at the end of the day, i do make more after taxes and have more savings in my bank account, plus the excellent quality of life.
over here, no cilents will dare to shout at me in the emergency department unlike in sgp, ie' DOCTOR, I WAIT LONG LONG YOU KNOW'.
over here in australian, clients with non life threatening conditions will guai guai and keep their mulut tutup (mouth shut).
what suits me may not suit u. my 50 cents worth
If anyone quotes stuff about other countries from the Straits Times, you can sure that person has probably never lived in that country.
In Singapore it is simple. Everyone takes care of themselves. The people who can do something about it will only do something about it if it is part of their KPI.
In other words, if looking after the welfare of doctors in Singapore is not going to get any administrator promoted you can bet your sorry ass they won't bother.
What gets administrators promoted?
I think it is simple to break down into broad categories
1) Increasing profits (hardly anything to make doctors earn more or have better work hours)
2) Raising profile of the organization (usually something that benefits the customers which can lead into point 1)
And so there you have it.
Which is why administrators have been doing the following :
1) JCI (see point 2)
2) ISO (see point 2)
3) Recruiting foreign doctors (see point 1)
4) Cheaper ,faster, safer , better (see point 1 & 2)
5) Focus on patient centred approach, customer service quality (see point 1 & 2)
I can't see how reducing doctors stress levels, increasing doctors pay, protecting doctors dignity against demanding awful customers would fit into points 1 & 2.
And so there you have it. Forget it. Don't waste time hoping SOMEONE ELSE will make life easier or better for you.
Your fate is in your hands. You decide what you want to do within the confines of what you can do.
anon 26 jan 1031 hrs:
we all know who u are and who u are working for.
we know u have written in another similar forum too under a particular monicker.
anyway, it is the call of doctors if they want to stay put or make a move overseas if conditions in singapore don't suit them.
some people choose to move back to sgp as they have families, rich partners, rich inheiritance or rich in laws waiting for them. if this is the case, we have to respect it.
we do also have to respect the wishes of those who choose to leave and not label them as being 'quitters'
Hello, I am an OTD and general surgeon from Africa. Passed the MRCS. I am interested in dong a 3 year HSF training in Cardiothoracic surgery in singapore.
Can I get admission into an HSF program? What is the pathway and application process?
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