Students of the NUS medical school are being put through a clinical curriculum that gives increased emphasis to geriatric medicine. This is aimed at turning out doctors who are able to competently care for the increasing number of older people in the Singaporean population.
Forecasting, identifying and then preparing its graduates for emerging and future medical and healthcare challenges and roles is something that the School, established 110 years ago this July, believes is key to its ability to fulfill its mission as the fountainhead of Singapore’s medical workforce.
From dysentery, kernicterus and malaria in the early years of Singapore, to SARS, bird flu, heart disease, cancer and diabetes today – the range of health issues tackled by graduates of the NUS medical school over the course of more than a century is a medical journey that parallels and traces Singapore’s metamorphosis from a British colony in the 1900s to the modern city it is today, notes the Dean of the School, Dr Yeoh Khay Guan.
As Singapore grew, developed and prospered, the forerunner of the National University of Singapore similarly evolved. It is an integral part of the country’s biomedical initiative, collaborating with other research-focused institutions here, like the Agency for Science, Technology and Research, the National Research Foundation and the Biomedical Research Council on innovative and important discovery work that will benefit Singapore’s population health and that of Asian societies in general.
Alumni, the Core of Country’s Healthcare System
While technology’s role as an enabler allows the Yong Loo Lin School of Medicine today to ramp up its educational and research missions, the medical school hews closely to its founding vision – to train doctors for Singapore. Today, the School’s graduates comprise the backbone of Singapore’s healthcare system, with many in leadership roles, adds Dr Yeoh. “The great majority of doctors in Singapore are our graduates. We’re proud of the health system and the standards that our graduates have built.” A number of alumni have gone further, having been appointed to high public office, with a President, a Speaker of the House, three serving Cabinet ministers and a succession of Directors of Medical Services at the Ministry of Health at last count.
Training Tomorrow’s Healthcare Professionals Today
An immediate challenge however is the population health issues presented by Singapore’s growing numbers of senior citizens and the concomitant increase in age-related diseases. It has led the School to overhaul its undergraduate and postgraduate medical and nursing curriculum, expand its faculty teaching numbers and invest heavily in educational technology. The aim is to give the 300 young men and women who enrol in the MBBS as well as the 100 enrolled for the Bachelor of Nursing degree programmes every year a sound clinical foundation so that these doctors and nurses of the future are able to operate effectively in tomorrow’s setting.
Rooted in the Community
Working with a multicultural population that will consist of a large number of aged people means NUS Medicine graduates must possess more than clinical knowledge. Strong people skills are essential to communicate sensitively and effectively with their patients. Empathy has to be a key trait of a doctor’s demeanour, says the Dean. It is something that selectors look out for during admission interviews for the MBBS, where every candidate has a resume that includes sterling academic records.
“It’s not just about the competent delivery of medical care. That is expected. Our graduates have got to have the DNA, the values of the School pulsing in them. We want doctors who understand what a privilege it is to serve, and whose care for their patients is motivated by compassion and respect.”
It is a value that he wants NUS Medicine students to be bred on in their formative years at the School, whose establishment was due in large part to the generous support of the local community in the 1900s. “Singapore’s early pioneers helped set up the medical school. We must always remember how we came to be and understand that the NUS medical school owes its birth to the people of Singapore and it’s the people that we serve. That is our responsibility and privilege, it is the fundamental purpose of our existence as an institution of higher learning and it is also what sets us apart,” says Dr Yeoh, who graduated in 1987.
The bonds between the School and the Singaporean community have been accentuated and strengthened in recent years through health screenings that cater to the residents of rental HDB apartments, lower-income families as well as the elderly. These yearly screenings are organised and led by medical students, who are also joined by their counterparts from Nursing and the Social Sciences as well as Dentistry in recent times. Residents whose screening tests require further investigation are then referred to polyclinics for follow-up treatment and attention.
The Patient in the Centre
The importance that the School places on inculcating a compassionate and competent approach to the practice of medicine is emphasized in the Longitudinal Patient Exposure programme as well as the medical ethics modules that all medical students undergo. The first lets students spend time with patients, interacting with and observing them through an extended period of time, in the community, while the sessions run by the School’s Centre for Biomedical Ethics help deepen students’ understanding of the issues that healthcare professionals grapple with in the course of their work and which centre on the patient’s wellbeing.
This focus on the patient shapes the undergraduate curriculum at NUS Medicine. It is constantly reviewed and updated to ensure that students are fully equipped and prepared to function effectively and independently and also as members of integrated care teams attending to the complex and varied needs of patients. Adds Dean Yeoh: “We make sure our students are trained rigorously and training is aligned and contextualised for Singapore’s needs. We’re constantly innovating and incorporating best-evidence pedagogies into the learning environment, such as collaborative learning, inter-professional education, team training, embedding our students in healthcare teams in hospitals and clinics, and using technology and simulation to enhance learning.”
Insightful Learning
To teach well, one must first learn well. For an institution dedicated to the advancement of medical knowledge, that translates into a lively research environment that features key programmes – undertaken in collaboration with research institutions and universities – in diseases afflicting the population, such as dementia, cancer, heart disease and diabetes. Another major research effort – Growing Up in Singapore Towards Healthy Outcomes or GUSTO – studies the effects of nutrition and the environment upon babies in their mothers’ wombs. Each of these programmes has produced new knowledge that is adding to and in some cases, revolutionising the way the disease is being perceived and approached clinically and from population health perspectives.
The quality education and head-turning research at NUS Medicine has not gone unnoticed – and the School has been consistently ranked as one of Asia’s leading medical schools by Quacquerelli Symonds and the Times Higher Education World University Rankings. But rankings do not tell much about what makes a medical school unique or special in the eyes of the nation and community that it serves. Nor do they remind people about its raison d’etre.
That is the responsibility of the men and women who teach and learn there, and who help shape Singapore’s own unique approach to the practice of medicine as well as the planning and delivery of healthcare. And so, as the NUS medical school looks to the next 100 years, its work to turn out doctors with “heart and soul” remains a constant. Says Dean Yeoh, “When all is said and done, we would like our students to be physicians with a big heart, the sort of doctors you and I would want to look after us when we need medical care.”
