Passion is Key to Becoming a Good Doctor

Assoc Prof Lim Boon Leng served as the SingHealth Designated Institutional Official (DIO) for six years, officially stepping down and passing the baton on to the new DIO, Assoc Prof Tan Hak Koon, on 1 June 2018.

Assoc Prof Lim is an inspiring figure, well-liked by many Faculty and Residents. He was a key driver in leading SingHealth Residency through a period of growth and transformation. His passion for Medicine and nurturing the next generation has also led him to kickstart many new initiatives and constantly refine the way Residents are trained at SingHealth. We spoke to Assoc Prof Lim to learn more about his personal journey in medicine and as DIO.

When did your interest for Medicine start and how did your choose your medical specialty?

My interest in Medicine actually started during my secondary school years, when I discovered that I had a strong interest in Chemistry and Biology. After A Levels, I naturally chose to pursue Medicine. At the time, I was very interested in Surgery, as my hands are fairly nimble, and I can 'think on my feet'. I applied for it as my first choice and received my surgical traineeship after National Service (NS). Instead of jumping straight into Surgery, I decided to do my first posting in Anaesthesiology. I thought it would be a good chance to learn basic clinical skills, especially acute clinical skills and resuscitation, while rotating through all the surgical disciplines to see which specialty or subspecialty I wanted to do.

It was purely by chance that I fell in love with Anaesthesiology. Senior clinicians who mentored me during that time saw my passion for the specialty and encouraged me to take it up. I like Anaesthesiology because it is a good mix of medicine and surgery. It actually requires a lot of hand skill, such as when putting in the airway, intubating the patient, inserting arterial and central venous lines, and performing spinal and epidural anaesthesia.

Describe your most memorable experience as DIO.

The most memorable and stressful period was in 2012, when I first took on the role of DIO. Our Residency Programmes were undergoing evaluation for Accreditation Council for Graduate Medical Education-International (ACGME-I) accreditation that year—and they had to be completed within three months after taking over as DIO! Thankfully, we passed. Three years later, in 2015, we again had to contend with re-accreditation assessments and accreditation for all the medical subspecialty Senior Residency Programmes. We managed to clear it all with three years' accreditation. SingHealth Residency also successfully attained a four-year institutional re-accreditation. We did very well in that.

I am also proud of the advances we have made in the Residents' Overall Satisfaction Index. During my initial years as DIO, the SingHealth Overall Satisfaction Index was below the national average. When ACGME-I surveyed the Residents in 2015, for the first time, we went above the national average—a result that we have managed to sustain over the next three years. To me, that is a sign that we have done something right, and that Residents are having a fulfilling learning journey with us.

I also initiated the in-house SingHealth Residency Leadership Programme (SRLP), which was launched in January 2017. Each year, SingHealth grooms 10 to 12 Chief Residents under the national Singapore Chief Residency Programme (SCRP). However, this number is insufficient for our Resident population of more than 1,000. The SRLP is intended to build a larger pool of Chief Residents with leadership potential. To date, we have selected 35 Chief Residents under this programme. This year, we have opened the programme to other professionals groups, such as dentists and pharmacists, to strengthen interprofessional learning.

What has been the biggest change in SingHealth Residency since you started as DIO?

There is a more structured curriculum, supervision and assessment framework in place. This was a team effort that was achieved step-by-step. We looked into Residents' well-being and their duty hours. We made sure there was protected training time to attend lectures and workshops. We also encouraged Faculty to go for faculty development courses to learn how to teach more effectively, how to give constructive feedback that helps our Residents.

These efforts did not happen overnight; we had to address many problems at their roots and I am thankful I had the support of senior management and a good team of administrators.

What advice would you give to medical students so that they can better prepare themselves to enter SingHealth Residency?

As a medical student, your top priority is to pass your medical exam and graduate from medical school. Thereafter, you need to be honest with yourself as to which specialty truly interests you. Do not choose a specialty based on the potential financial returns, or because it seems to have a better work-life balance. All specialist trainings are tough. If you do not like it, it is only going to be tougher. When you do a posting, and spend a lot of time there, and yet you are not counting the hours—that is where your true passion lies. When you follow your passion, you will perform better.

When you enter Postgraduate Year 1 (PGY1), my advice is to focus on building up a basic foundation of clinical practice skills. During this period, you can refine and develop your critical thinking, identify your strengths, and continuously improve your professional and clinical skills/acumen.