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The Team That Sticks Together, Stays Together



In this issue of Medical Students Connect, we turn the spotlight on SingHealth Urology Residents, who are known to share a tight camaraderie. Residents from the programme speak of the easy banter between colleagues, close mentor-mentee relationships and, most importantly, the well-oiled machine that is the SingHealth Urology team.

We speak to SingHealth Urology Residents to find out about what a day in their life is like, what to expect in urology training, and some memorable cases they have taken on.

What Are SingHealth Urology Residents Really Like?

Now, as a Physician Faculty for the SingHealth Hand Surgery Residency Programme, Dr Chew sees himself as a coach whose role is to give Residents direction and help them work toward their goals. “A good mentor is one who is interested in developing the trainee as a whole person — not just the medical or surgical aspect, but also their personal lives. This would make for a better overall surgeon who has a level head, a steady heart and a good pair of hands,” he explains.

Dr Kenneth Chen, a Year 5 Senior Resident declares with a laugh that Urology Residents are known to be fun-loving and adventurous. Most Residents and surgeons in the department possess a healthy sense of humour, says Kenneth. In fact, his jolly peers are one of the reasons that cemented his decision to join SingHealth’s Urology Residency Programme. He says: “I met some awesome people in the department during my medical officer posting.”

Apart from the fun stuff, Urology Residents are keen learners. Reading up and studying cases ahead of class is common in the department. On the job, they are just as eager to learn. Dr Lim Yong Wei, a Year 4 Urology Senior Resident says: “The programme trains us to be comfortable with performing a variety of urology procedures. When shadowing our seniors, we watch closely and absorb as much as we can. We continue to analyse each case in our heads so we can repeat the procedure for similar cases in future.”

Urologists do not just work within their specialty. Dr Jay Lim, a Urology Year 5 Senior Resident explains: “During surgery, urologists are frequently called on to assist in cases involving other specialties.” The work during clinic hours is fairly ad-hoc, so Urology Residents have to work together to fill in the gaps in clinical, operational, administrative and emergency services. “We know that we can depend on each other to go above and beyond the call of duty in order to provide quality care to our patients,” says Jay.

Life as a SingHealth Urology Resident

It is no secret that Residency training is tough. The clinical workload that SingHealth’s Urology department undertakes is the highest among all specialities, which adds to the challenge. Apart from surgeries, clinic-based duties are a key feature of the SingHealth Urology Residency Programme.

“A positive attitude is a must,” says Jay, who goes on to detail his jam-packed schedule as an example. “A typical day starts at 7.00am with reviews during the ward rounds, and ends in the evening after exit ward rounds are done, to check that every patient is comfortable and doing well,” he says. Clinic duties typically begin around 8.30am, with allocated shifts at the outpatient clinic, endoscopy room and Operating Theatre. In addition, Residents also participate in the daily morning ward meetings, mortality and morbidity meetings, multi-disciplinary X-ray meetings, and journal club presentations to keep up with the latest developments in research.

The SingHealth Urology Residency Programme is categorised as a Surgery-in-General sub-specialty. Yong Wei breaks down the programme set-up to explain how training is done. The programme has two phases. The Junior Residency phase comprises an exciting two years doing attachments at the Urology department of the hospital that Residents are assigned to. “We go through a rotation that exposes us to various specialties, including General Surgery (GS), Paediatric surgery, Anaesthesiology, and critical care medicine. This allows us to learn the basic principles of surgery, and perioperative care.” He adds that there is also the opportunity for an elective three-month attachment to a related surgical posting, such as uro-gynaecology, colorectal surgery or plastic surgery.

The next phase is when Junior Residents get promoted to Senior Residency, and begin their urology training proper. Four years of training follows, with rotations among the various urology sub-specialty teams: general urology, transplants, female urology, endourology surgery and advanced uro-oncology surgery. “We also get to do a six-month stint out of urology, in either GS or colorectal surgery so that we can learn new skills from our colleagues,” says Yong Wei.

The Culture of SingHealth Urology

All three Urology Residents we spoke to stressed the importance of teamwork.

The Urology department is a busy place with inpatients and outpatients coming through the doors for procedures and surgeries. Without a team that rallies together, important information about a patient’s condition can be overlooked—which may happen if individuals work independently and do not communicate with their colleagues.

Yong Wei recalls a case he and his team had taken on. The patient, who had emphysematous pyelitis, suddenly felt unwell while at the Emergency Department. Yong Wei recounts the incident animatedly: “While we were trying to stabilise her for transfer to the high-dependency area, she collapsed!”

Yong Wei and his team kicked into action instantly. While one doctor resuscitated and stabilised the patient, the rest made the call to carry out a cystoscope, and to insert a ureteric stent to decompress her infected system. Thanks to the team’s quick thinking and seamless cooperation, the patient recovered and was transferred to the normal ward after a week, and discharged after three weeks.

The Million Dollar Question: Why the SingHealth Urology Residency Programme?

“The work at the urology department is stimulating and fast-paced, no doubt about that,” says Kenneth.

“The high case load we get at Singapore General Hospital ensures plenty of opportunities for Residents to learn and apply their skills,” he notes. To hone their skills, Urology Residents are encouraged to keep track of the latest developments in evidence-based medicine through journal clubs. Training in SingHealth also aims to develop well-rounded clinicians who not only excel in their field, but who possess soft skills that help them survive different scenarios at work, from conflict resolution and problem-solving, to breaking bad news to a patient’s family.

Kenneth also highlights the importance of those who can enhance the Residents’ experience of the programme. He says: “It definitely goes a long way when we know that the Faculty always makes an effort to seek our feedback and opinions on how training can be improved. It is comforting to know that my views matter, and that I can actively shape my learning journey during the Residency.”

From Us to You

The Residents offer wise words for aspiring urologists, and those considering whether to join the SingHealth Urology Residency Programme. Yong Wei says that anyone interested in the Programme must be prepared to be a team player. Jay backs this up, saying: “Working in a surgical team like Urology, you learn that the team can only be as good as the weakest member.” He adds: “You learn very fast that leaving someone behind is never a smart move. Helping your fellow Residents improve and your juniors get up to speed will help you survive—and thrive!”.