Choosing to Be A Doctor in Singapore

You are about to complete medical school and now you find yourself wondering: Where should I do my Residency training? In Singapore or overseas?

Our SingHealth Residents - Dr Ada Ng, Obstetrics & Gynaecology Resident and King's College Alumna, and Dr Hong Rilong, Internal Medicine Resident and Monash University Alumnus, share their experiences in choosing their Sponsoring Institution (SI) and specialties, and offer a unique perspective on returning home for Residency.

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​Dr Ada Ng	​Dr Hong Rilong

1.You are now in year 6 and Year 2 respectively. Use three words to sum up how life has been thus far in SingHealth Residency.

Dr Ng:

1. Tough: Residency training is hard work. But there's always an end in sight.
   
2. Reflection: Reflecting on what went right and what could be improved is key to one's growth as a clinician. Every case you go through will have its own learning points if you take time to think it through.
   
3. Gratitude: I am thankful for seniors who are ever willing to teach; friends and colleagues, with whom I've shared tears and joy at work; not forgetting my patients, who constantly teach me how to be a better clinician.

​ ​Dr Ng with colleagues from her first posting at KK Women's and Children's Hospital

Dr Hong:

1. Challenging: Heavy patient workload, coupled with Residency-related projects and high expectations from the Faculty and colleagues. These can be difficult, but they also challenge me to strive for excellence. 
   
2. Family: During my preparation for PACES exams, many seniors sacrificed their personal time to tutor and guide me. Peers stayed back to practice with me, and even offered emotional support when I felt like giving up. I am immensely grateful for this caring family of colleagues, and I am inspired by my seniors to pay it forward someday. 
   
3. Empowering: SingHealth's Internal Medicine Residency programme is led by an open-minded and forward-thinking team. The core Faculty is supportive of Resident-led initiatives, which has led to our participation in events like Cadence (MRCP PACES preparation), Project HOPE (House Officer Preparation Exercise), SIP Bootcamp etc, where we get to share our knowledge and experiences with our juniors, paying it forward. 
   

​Dr Hong with his colleagues at Cadence and Project HOPE team mates

2. Share three tips with our medical students on choosing their future Sponsoring Institution (SI) and specialty?

Dr Ng:

1. Each SI has a different culture. It is important to ensure that you are happy working in that environment. 
   
2. Keep an open mind. If you are unsure of where you would like to be, take your time to observe the culture, know the people and the career opportunities.
   
3. Be very certain about your decisions. Sometimes it may be too early for you to make a decision about your SI or which Residency programme you want to join. Take your time to learn about the SI and programme; observe the culture and know the people. Don't be pressured by your peers in your choice.
   

Dr Hong: 

1. Do not rush into making a decision. Take some time to work in the SI and gain an understanding of their working culture.
   
2. Begin with the end in mind. Get to know the training positions and subspecialty programmes available. Consider carefully if your end goal is achievable at the chosen SI and programme. 
   
3. Speak to current Residents in your desired programme to understand the structure and breadth of the training programme. A robust training programme will provide the tools for you to become a better doctor, and a SI that is supportive of their Residents will likely provide high quality and enjoyable training programmes.   

3. Transitions are hardly easy – relocating back home after being in a foreign country and system for years must have been difficult. What were your considerations in returning to Singapore for your Residency training?

Dr Ng: Personally, there were several considerations:

• Firstly, the question of where I would like to settle down in the long run.  
  
• Secondly, would I enjoy moving around UK every one to two years for specialty training? Staying on for my training would entail shifting houses or long hours of commuting, as opposed to working in Singapore, where everything is more accessible. Moving around different regions in the EU would also mean a constant change of colleagues and friends.
  
• What is my preferred choice of specialty - surgical or medical? The choice of specialty has played a key factor in my decision, as the EU's directive on working hours significantly affects a surgical trainee's progress.
  
• Lastly, financial planning also needed to be considered as the income earned overseas and locally is different. 
  

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​Dr Ng with her friends from Kings' College	​Dr Ng with her family who visited in London

Dr Hong: For me, the decision to return was part of a bigger question – "What do I want out of life?" This made me ask myself the next question, "Apart from pursuing Medicine, what are my other priorities and purposes in life?"

Personally, family was an important consideration. The distance from home invariably meant missing out on important milestones and being present in the day-to-day lives of my loved ones.

I have also always been passionate about serving our people. Despite training overseas, I returned to Singapore every summer holiday to do student attachments at SGH. During my stints, I enjoyed forming deep connections with my patients. Moreover, I realised I could value-add to our local healthcare system with the experience I had gained from studying overseas.

Finally, I've always enjoyed practicing Medicine - it is more than a job, it is my hobby. The caseload in Singapore is higher, and being a smaller country, most of our government hospitals provide some form of tertiary care. This would offer rich learning opportunities for me to hone my clinical skills and delve deeper into sub-specialty work.

With these goals and passions being best achieved in Singapore, my choice is clear.

​Dr Hong having a meal with his family	​Dr Hong with his colleagues at work

4. What was the hardest part about deciding to return to Singapore for Residency training after graduating from medical school?

Dr Ng: It was hard for me to decide to leave London after I graduated from medical school. Returning to Singapore would mean having to start from scratch in terms of learning the nuances of the Singapore healthcare system, and enduring the uncertainty of whether I would be able to get into the specialty that I hoped to join. 

Dr Ng with her friends from Kings' College

Dr Hong: It was difficult to give up the perks of working in Melbourne; shorter working hours, a more competitive salary and supportive working environment. Beyond these things, it was hard to leave the familiarity of the system, the people, and more importantly, the philosophy of practice.

​Dr Hong with his friends from medical school in Melbourne

5. What were the biggest struggles that you faced when transitioning into Residency training in Singapore? 

Dr Ng: The acronyms and antibiotics names in Singapore and SingHealth felt like a completely foreign language to me. Thankfully, I had patient ward nurses and fellow House Officers (HOs) to teach me the lingo, and guide me through the protocols and ordering sets. 

In my first week of work, I had to call various specialties for blue letters and I encountered three registrars, who told me off for being unfamiliar with the processes. One of them even hung up on me, which left me feeling demoralised and in tears. But it was through these experiences that I learnt how to improve the quality of my blue letter referrals. 

Today, as a senior Resident, I still get snappy and irritated replies over the phone, but my advice is learn to be a 'tough cookie' and take it all with a pinch of salt. This way, you will be able to push on through the transition period.

Dr Hong: I had to deal with the differences in healthcare systems and therapeutic guidelines, as well as being unfamiliar with the IT systems between Singapore and Australia. Thankfully, this transition was not too jarring for me, as I had already gained some understanding of the local system during my summer student attachments.

Hence, I would encourage overseas graduates and students to consider applying for attachments prior to coming back to Singapore. This would help you greatly for your transition back home!