Singapore

Training more generalist docs for ageing Singapore

More places have been allocated to train "generalist" doctors in recent years, as part of a nationwide push to grow manpower in these fields to cater for a greying society.

This year, one in five residency places offered were for family medicine, advanced internal medicine, or geriatrics, said a Health Ministry (MOH) spokesman in response to queries from The Straits Times.

This is a marked increase from 2013, when the number of residency openings in these areas made up only about one in 10 of the total.

Doctors in these disciplines are considered "generalists" because they do not focus on a single organ or body part.

Their emphasis is on treating patients as a whole - especially those with overlapping medical conditions who would typically be seen by more than one specialist.

"These will be more and more in demand with our ageing population and training places for these (fields) should grow further," the spokesman said, adding that MOH will continue to monitor the situation and "calibrate the training pipeline for different groups of specialities" to meet Singapore's needs.

But national needs may not always match what aspiring doctors want, hence there is also a need to urge more of them to work in these fields.

In a speech to medical students last month, MOH's director of medical services Benjamin Ong stressed the importance of young doctors stepping up to fill these roles.

"We should not be in (medicine) for prestige, financial rewards or fame," he said.

"We should not seek to be a super-specialist when there is limited demand for such capabilities, or choose a speciality primarily because it gives us a good work-life balance."

According to the Singapore Medical Council's latest annual report, there were 13,478 registered doctors last year.

Four in 10 were specialists.

This includes more "general" fields such as geriatrics, but excludes fields such as family medicine.

The public also needs to recognise the value of primary care, said Associate Professor Nicholas Chew, the group chief education officer for the National Healthcare Group (NHG).

The group - which runs Tan Tock Seng Hospital - is one of the largest healthcare clusters in Singapore.

"Over the years, we have de-emphasised the role of the generalist," Prof Chew said.

"But our patients now are highly complex... and often there is nobody better to care for them than generalists."

NHG had 132 residency spots this year, about a quarter of which were allocated to "generalist" fields.

And at the National University Health System, the number of family medicine residency slots has doubled since the programme started in 2011.

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