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news V O L . 5 0 N O . 6 | J U N E 2 0 1 8 | M C I (P) 0 5 0/ 0 1 / 2 0 1 8
news
CON T E N T S
Vol. 50 No. 6 2018
EDITORIAL
BOARD
Editorial 23 A Glimpse into the Past –
04 The Editor’s Musings Medicine in Singapore (Part 12)
Editor A/Prof Cuthbert Teo
Dr Tan Yia Swam
Dr Tan Yia Swam
Deputy Editors 26 Hospital’s Duty of Care:
Dr Tina Tan
Dr Tan Tze Lee
Annual Dinner Recent Developments
05 SMA Annual Dinner 2018 and Implications
Editorial Advisors Sylvia Thay
A/Prof Daniel Fung Dr Loke Hsi-Yen
A/Prof Cuthbert Teo
Dr Toh Han Chong 10 President’s Welcome Address
Members Dr Lee Yik Voon
Dr Chie Zhi Ying
Dr Jayant V Iyer 12 Citation for Minister Gan Kim Yong
Dr Jipson Quah
Dr Lee Yik Voon
Dr Jonathan Tan
Dr Jimmy Teo
Dr Alex Wong 13 Guest of Honour's Speech
Minister Gan Kim Yong
EX-OFFICIOS
Dr Lee Yik Voon
Dr Lim Kheng Choon
Council News
EDITORIAL 16 18th MASEAN Conference 2018
OFFICE Nurul Faizzah Mohd Azmi
Senior Manager
Sarah Lim 17 Highlights from the
Assistant Manager Honorary Secretary SMA CMEP – Health Law
Sylvia Thay Dr Lim Kheng Choon 28 What You Need to Know about
Editorial Executive SMC Disciplinary Proceedings
Jo-Ann Teo Christopher Chong
Event
ADVERTISING AND 19 Are You Prepared for a
PARTNERSHIP
Digital Health Future? AIC Says
Li Li Loy
Tel: (65) 6223 1264 Dr Zubin J Daruwalla 31 Primary Care Pages (PCP):
Email: adv@sma.org.sg The 'Google' for Your Primary
Care Needs
PUBLISHER Insight Agency for Integrated Care
Singapore Medical Association 20 Fellowship Matters: How to Get
2 College Road Level 2,
Into a Good One? (Part 3)
Alumni Medical Centre
Singapore 169850 Dr Lee Ser Yee, Dr Chai Shu Ming and Calendar
Tel: (65) 6223 1264 Dr Chan Chung Yip 32 SMA Events Jul-Sep 2018
Fax: (65) 6224 7827
Email: news@sma.org.sg
URL: https://www.sma.org.sg
UEN No.: S61SS0168E
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Opinions expressed in SMA News reflect the
views of the individual authors, and do not
necessarily represent those of the editorial
board of SMA News or the Singapore Medical
Association (SMA), unless this is clearly
specified. SMA does not, and cannot, accept
any responsibility for the veracity, accuracy
or completeness of any statement, opinion or
advice contained in the text or advertisements
published in SMA News. Advertisements of
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in SMA News may not be reproduced on any
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transmitted by any means, in whole or in part,
without the prior written permission of the
Editor of SMA News. Requests for reproduction
should be directed to the SMA News editorial
office. Written permission must also be
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editorial
Close friends and followers of SMA
News would be aware that I was
I have been following the news and
discussions on increasing healthcare Tan Yia Swam
overseas in France for the past eight costs, insurance changes and also
months or so. After the delivery of investigations into claims. How can Editor
my third child, the kids and I took we, as a society, be mature enough
off to join my husband on his Health not to try to game the system, and
Manpower Development Plan trip, overcome the mentality of “since I’m Dr Tan is a consultant at the Breast
and I had a taste of being a SAHM 100% covered, I might as well get Department of KK Women’s and
(stay-at-home-mum). I want to thank everything checked while I’m here”? Children’s Hospital. She continues to
Tina and Tze Lee for holding the fort How can we, the medical profession, juggle the commitments of being a
while I was away; I must also thank our protect patients and ourselves from doctor, a wife, the SMA News Editor and
very capable staff, Sylvia and Jo-Ann, such abuse? Should we take back the the increased duties of a mother of three.
for continuing to produce the monthly ownership and control of costing and She also tries to keep time aside for
issues despite tight deadlines. finances from administrators? herself and friends, both old and new.
While overseas, we experienced their These are just some food for
local healthcare – hubby as a provider, thought. We can surely do better, but
and us as patients when we brought the only if we put in the effort to effect
baby for vaccinations. We have returned the changes.
with a deeper appreciation of the pros At the SMA Annual Dinner
of Singapore healthcare, but also with last month, the SMA Honorary
some thoughts on aspects which we Membership was conferred on
could adopt. Also, we no longer take Minister for Health Mr Gan Kim Yong.
the efficiency and convenience of our The SMA continues to work closely
everyday living in Singapore for granted. together with the Ministry and other
In Singapore, we are fortunate professional bodies to improve
to have easy access to medical care, healthcare services and we look
including GPs, polyclinics and even forward to more collaborative projects
specialists. The locally imposed key and honest discussions on current
performance indicator of a waiting issues that affect the profession.
time not exceeding two weeks for Enjoy, and do write in to us at
a first visit to a specialist clinic is news@sma.org.sg if you have an
remarkable. However, we need to opinion, a joke or an interesting
take care to use this system wisely. hobby to share!
04 JUN 2018 SMA News
ANNUAL DINNER
Text by Sylvia Thay, Assistant Manager
Regent Hotel's Royal Pavilion Ballroom medical schools, medical professionals Guest of Honour, Minister Gan Kim Yong.
quickly filled with friendly chatter from a variety of specialties, SMA Mr Gan was appointed the Minister for
and laughter as the SMA Annual volunteers, partners and stakeholders. Health in 2011, and has contributed
Dinner got off to a perfect start on the In his welcome address, our newly greatly to the development of the
evening of 12 May. Held in recognition elected SMA President, Dr Lee Yik Voon, healthcare landscape since. With the
of exceptional accomplishments by welcomed all SMA Members, guests Healthcare 2020 Masterplan in place,
members of the profession, the Dinner the Ministry has launched many public
and friends to the Dinner and shared
this year was graced by Guest of Honour, initiatives to improve accessibility of
a quick review of the challenges the
Minister for Health Mr Gan Kim Yong, healthcare for Singaporeans. In Mr
Association and profession have faced
and distinguished guests including Gan’s speech after being conferred the
in the past year, before ending off
Senior Minister of State for Health and Honorary Membership, he highlighted
with encouragement for the medical
Environment & Water Resources, Dr Amy the importance of a cohesive and
fraternity to support and help one
Khor; Senior Minister of State for Health collaborative relationship among the
another as changes in the healthcare
and Transport, Dr Lam Pin Min; Permanent Ministry, professional bodies, and medical
landscape continue (see page 10).
Secretary for Health, Mr Chan Heng professionals in order to provide holistic
Kee; Director of Medical Services, A/Prof healthcare for the nation. The citation for
Benjamin Ong; and Member of Parliament, SMA Honorary Membership Mr Gan and his speech can be found on
Dr Chia Shi-Lu. Dinner guests included This year’s recipient of the SMA Honorary pages 12 and 13, respectively.
medical students from the three local Membership was none other than our
Showing appreciation
Amid the delectable dishes served,
Dr Lee Yik Voon again took to the stage
to introduce the members of the 59th
SMA Council. He also presented tokens of
appreciation, on behalf of the Association,
1
to Dr Wong Tien Hua (immediate past
SMA President) and Dr Charles Tan
(member of the 57th and 58th SMA
Council) for their work in SMA.
Legend
1. Dr Lee Yik Voon, Minister
Gan Kim Yong and
calligrapher Mr Kee Meng
Cheng pose for a photo
with the calligraphy scroll
presented to Minister Gan
on the occasion of his
conferment of the SMA
Honorary Membership
Jun 2018 SMA News 05
The SMA Merit Awards are presented
to show appreciation and recognition
for doctors who have contributed
significantly to SMA, the medical
profession or to social service in the
community. This year's awards were
presented to Dr Goh Wei Leong and Adj
A/Prof Samuel Victor Rajadurai.
Dr Goh, a GP, is the co-founder and
chairman of HealthServe, a non-profit
organisation that seeks to serve the
disadvantaged migrant workers in
Singapore. In addition, Dr Goh is one
of the founders of Linking Hands
and the current chairman of board
for Operation Mobilisation’s Mercy
Teams International. He was also an
Adj Assistant Prof of Family Medicine,
Department of Medicine at NUS Yong
Loo Lin School of Medicine.
2 A/Prof Samuel is currently a senior
consultant in the Department of
Neonatology at the KK Women’s
and Children’s Hospital. He was an
Adj Prof of Paediatrics at Duke-NUS
Medical School and a visiting professor
to Tianjin Central Hospital, China.
Presently, he is the vice-president of
the Perinatal Society of Singapore and
chairman of the IPOKRaTES Group in
Singapore. He was also the founding
director of the National Expanded
Newborn Screening Programme.
3
4
5
6
06 JUN 2018 SMA News
7
The SMA Long Service Awards were
also presented during the Annual Dinner
to 12 recipients who have contributed
greatly to SMA’s work over the years.
Ten-year Long Service Awards
Dr Devanand Anantham: SMA Centre
for Medical Ethics and Professionalism
(CMEP) since 2008; SMA Ethics
Committee since 2007.
Adj A/Prof Ang Tiing Leong: Singapore
Medical Journal (SMJ) Editorial Board
since 2008.
Dr Chang Haw Chong: SMJ Editorial Board
from 2008 to 2018.
A/Prof Mahesh Choolani: SMJ Editorial 8
Board since 2008.
A/Prof Gerald Chua Seng Wee: SMA CMEP
since 2008.
Prof Fong Kok Yong: SMJ Editorial Board Legend
since 2008 to 2018. 2. Dr Wong Tien Hua receives his token of
Dr Benedict Tan Chi Loong: SMJ Editorial appreciation
Board since 2006. 3. Dr Charles Tan receives his token of
appreciation
SMA Secretariat Long Service Awards 4. Dr Goh Wei Leong, SMA Merit Award recipient
Ms Mellissa Ang: five years of service. 5. Adj A/Prof Samuel Victor Rajadurai, SMA
Merit Award recipient
Ms Margaret Chan: ten years of service. 6. Long Service Award recipients with Dr Lee YV
Ms Siti Nurhuda Bte Mohd Sulaiman: 7. SMA Secretariat Long Service Award
five year of service. recipients with Dr Lee YV
8. Mr Chan Heng Kee shares a light moment
Ms Denise Tan: five years of service.
with Ms Kuah Boon Theng during the dinner
Mr Tan Kie Chuan: five years of service. 9. "Thumbs-up" for the Dinner
9
11
10
14
Recognising research efforts Finally, Dr Asogan Aravind Barathi
received the third prize on behalf of
Producing a high-quality research
his team, which produced the paper
paper is no easy task, and the SMJ Best
Research Paper Awards seek to recognise “Concordance between core needle
the conscientious efforts authors and biopsy and surgical specimen for
researchers put into their papers. This oestrogen receptor, progesterone
year, the teams that produced the top receptor and human epidermal
three papers, selected from 61 original growth factor receptor 2 status in
papers published in SMJ in 2017, each breast cancer”.
received a commemorative trophy and
certificate which were presented by SMJ
Editor-in-Chief A/Prof Poh Kian Keong.
The top prize was awarded to the
paper “Prompt use of mechanical
cardiopulmonary resuscitation in out- 15
of-hospital cardiac arrest: the MECCA
study report”. The award was received
by Prof Venkataraman Anantharaman
on behalf of his team.
Representing the team, Dr Mythily
Subramaniam received the second prize
for the paper “Gender differences in
major depressive disorder: findings from
the Singapore Mental Health Study”.
08 JUN 2018 SMA News
Lucky Draw Winners
Dr Giles Tan Ming Yee
12 EDOX Ultra Slim Hand-winding
Watch sponsored by Crystal Time
13 Pte Ltd, worth $2,124.
Ms Sally Lim
iPhone X Space Gray 64GB
sponsored by Summit Planners
Pte Ltd, worth $1,648.
Dr Simrita Khurana
Before the evening ends novita AirCare Pro Air/Surface
Besides the accolades and awards Sterilizer NAS12000 sponsored by
presented over the evening, guests novita Singapore, worth $1,899.
were seen seizing the opportunity
to catch up with colleagues, juniors
and seniors, over and in between the Legend
delightful courses served for the evening.
10. SMJ Best Research Paper Award recipients
Many also interacted with the Guest of with SMJ Editor-in-Chief, A/Prof Poh Kian Keong
Honour, Minister Gan Kim Yong, and our
11. Invited guests from Medical Association of
distinguished guests, before they departed South East Asian Nations with Minister Gan and
for the evening. Even as the Dinner drew Dr Lee YV
to a close, joyous laughter and cheers were 12. Dr Lam Pin Min pose for a shot with fellow
heard as guests bade each other farewell, doctors
till the next SMA Annual Dinner. 13. A/Prof Benjamin Ong shares a delightful
moment with Dr Tan Cheng Bock and Dr Chong
SMA thanks our lucky draw prize Yeh Woei
sponsors: Crystal Time Pte Ltd, Summit
14. Dr Amy Khor and Prof Aline Wong smile for
Planners Pte Ltd and novita Singapore. the camera
The 59th SMA Council would like to thank 15. Students and representatives from the three
all guests for taking the time to join us for local medical schools capture the evening with
an evening of collegiality. Minister Gan
ANNUAL DINNER
PRESIDENT’S
Text by Dr Lee Yik Voon
I am delighted to bid you a very warm Our fraternity has long enjoyed The introduction and implementation
welcome to our Annual SMA Dinner. Let us a reputation for excellence. Moving of CorpPass for business owners, the
take this wonderful opportunity to relax forward, we need to address the need equivalent of SingPass for individuals
and catch up with friends and colleagues, to embrace possible new care models required in accessing e-services of
network and make new friends. and advancements in medicine, and various government organisations
health technologies that offer enhanced like MBS@Gov, requires us to allocate
The healthcare landscape is
changing rapidly and we are faced healthcare services. We also need to resources to adopt these new measures
with some long-term trends that come equip ourselves with resources to keep which offer advantages over the
with an ageing population and rising up with the Digital Economy. existing SingPass. Though we do
incidences of chronic diseases. The We appreciate that many doctors are recognise the importance of being
current life expectancy averages 82 increasingly challenged in managing adaptable, these require our clinic staff
years and by 2030, the percentage of their resources in the new landscape. In to learn to do things in a new way.
our population aged 65 and above our current work environment, doctors Then there is the Enhanced Screen
is expected to double to 20%. Our and their clinical staff are faced with for Life (SFL) programme – an improved
task is to meet these challenges in a mounting administrative work that version of the age-old SFL. As with
sustainable manner and to increase the takes a toll on both manpower and any new measure, glitches do happen,
overall healthcare capacity. time. Let’s take a look at last year, 2017. especially when timelines are short,
Legend
Third row (from left): Dr Bertha Woon Yng Yng, A/Prof Nigel Tan Choon Kiat, Dr Ng Chew Lip, Dr Tan Yew Ghee, Adj Prof Tan Sze Wee, Dr Wong Chiang Yin,
A/Prof Chin Jing Jih, Dr Chong Yeh Woei, Dr Tammy Chan Teng Mui, Dr Daniel Lee Hsien Chieh, Dr Anantham Devanand
Second row (from left): Dr Benny Loo Kai Guo, Dr Ng Chee Kwan, Dr Chan Sing Kit, Dr Low Lip Ping, Dr Tan Cheng Bock, Prof Foo Keong Tatt, Dr Tan Tze Lee,
Prof Chee Yam Cheng, A/Prof Cheong Pak Yean, Dr Wong Tien Hua, Dr Lim Kheng Choon
First row (from left): Prof Low Cheng Hock, Prof Chew Chin Hin, Dr Lee Suan Yew, A/Prof Benjamin Ong, Dr Lam Pin Min, Dr Lee Yik Voon, Mr Gan Kim Yong,
Dr Amy Khor, Mr Chan Heng Kee, Dr Chia Shi-Lu, Prof Tan Cheng Lim, Prof Aline WongAs a solo GP/family physician, I need
to incorporate all this into my clinic
workflow and it is no mean feat or an
easy walk in the park. I work closely with
the MOH, Agency for Integrated Care,
Integrated Health Information Systems
and other stakeholders and even then,
I do encounter lots of challenges that
need to be ironed out so that our
fellow doctors will have a seamless
implementation of the new healthcare
measures in their workflow.
That brings me to the main
subject of my address this evening –
communication. Today, we are well
connected through various channels,
including chat groups on our personal
smartphones that keep us abreast of
the latest news and MOH guidelines,
and how we can adapt our workflow to
embrace the new changes. But is this so
for those colleagues who stay rooted in
Dr Lee Yik Voon the four walls of their second home –
their medical clinic? They are often left
out in their silos and the last to know of
and glitches have happened on the Care Network (PCN), where GPs are the latest developments in the healthcare
path of adopting new schemes to grouped to form a network to share landscape. Some stay away from the chats
help our patients. I recall a lapse in the resources and provide better and more because they do not have the time and
Community Health Assist Scheme (CHAS) holistic team-based care to their patients may not see the advantages of gaining
claims portal on the launch day of the with funding from MOH. Certainly, this information through these channels.
Enhanced SFL implementation which had was to achieve better outcomes for our What I hope we can do, as a start,
consequences on pending claims. patients’ chronic illnesses. is to help such colleagues, friends
Mapping of clinic services with the In 2018, PCN was rolled out and or classmates by introducing and
Healthcare Services Act (HCSA) was various groups are currently still learning encouraging them to join our chat groups
another exercise that we undertook when the ropes. and our weekday lunch talks. They can
MOH moved from premise-based clinic choose to be passive listeners in the chat
licencing to service-based clinic licencing. The MOH Healthcare Claims Portal group and catch up with information at
(MHCP) has now been introduced en their leisure, but I do hope that they see
There were changes in the National
masse. This improved portal is able the value in keeping in touch. We need
Adult Immunisation Schedule as more
to handle both CHAS and Medisave to be more united and help one another
vaccines were included and patients were
claims while previously there were two face all the changes in our healthcare
able to make use of Medisave and thus
separate portals with different owners. landscape, some of which are regulatory.
the need to submit notifications to MOH.
For HCSA and the National The SMA dinner is also about
Of course, much attention was given
towards the end of last year to the Electronic Health Record, MOH has accolades and awards. We give due
suspicion that doctors were splitting organised many engagement sessions recognition to the best papers for our
fees and violating the Singapore Medical with doctors from both the public publication – the Singapore Medical
Council’s Ethical Code and Ethical and private sectors, including both Journal, our long-serving staff and
Guidelines 2016 when doctors engaged specialists and GPs, and I understand volunteers and outstanding merit
third-party administrators (TPAs). That that this is still ongoing. awards for exemplary professionals.
was because doctors needed to pay a Next month, we can expect further Our highest award is the SMA
percentage of the fees collected to TPAs enhancements to Medisave and Flexi- Honorary Membership. This year’s
for referring patients to the clinic. Medisave where there will be an increase recipient is Minister Mr Gan Kim Yong,
One of the promising initiatives in the quantum per year but with more for whom I will now proceed to deliver
towards the year end was the Primary restricted use. the citation.
Jun 2018 SMA News 11ANNUAL DINNER
Text by Dr Lee Yik Voon, SMA President
The SMA Honorary Membership is the including medical practitioners, allied Mr Gan has been helming the Ministerial
highest honour that the Association health professionals, professional bodies Committee on Ageing (MCA), which
confers to individuals who have made like SMA, and medical health insurers, to spearheads Singapore’s promotion of
significant contributions to the medical work together in building a sustainable healthy living for its ageing population.
profession or to the nation. It is a great healthcare system for our future. The MCA explores matters such as
privilege and honour for me to read the Many public initiatives such as the active ageing and employability, aged
citation for Minister for Health, Mr Gan Community Health Assist Scheme care infrastructure, quality aged care
Kim Yong, who is the Honorary Member (CHAS) and MediShield Life have been and manpower development, so that
elected into the SMA this year. launched over the last eight years Singaporeans would enjoy quality care
Mr Gan’s career began with the under Mr Gan’s watch, in hopes of more efficiently and effectively. Since
Administrative Service with the Ministry increasing Singaporeans’ healthcare 2016, Mr Gan has been focusing on
of Trade and Industry, as well as the coverage and offering them a greater the threats that non-communicable
Ministry of Home Affairs, in 1985. He left peace of mind. We are also heartened diseases such as diabetes pose for
the civil service in 1989 for the private that Mr Gan and the Ministry have Singapore through a nationwide
sector before joining politics in 2001, echoed SMA’s all-time belief that fee campaign: the War on Diabetes. Mr Gan
when he was then elected as Member guidelines are crucial for healthcare would be translating his knowledge
of Parliament. Mr Gan subsequently costs to be better managed across and expertise towards an international
became Minister of State for Education the industry, which would be for the stage with his appointment to
and Minister of State for Manpower in benefit and welfare of our patients. the World Health Organization’s
2005. During his tenure as Minister for Independent High-Level Commission
Under Mr Gan’s leadership, the
Manpower from 2008 to 2011, Mr Gan on Non-communicable Diseases in his
Ministry of Health has revisited
personal capacity.
recognised and launched initiatives that the organisational structure of our
reflected the importance of enhancing healthcare clusters as well as reinforced Mr Gan is a great leader with
productivity among Singapore’s most hospital and community healthcare foresight who has played a major role
valued resource, our workforce, to infrastructure over the years, with in the transformation of our healthcare
remain relevant in today’s competitive resources being dedicated to ensure ecosystem to meet the nation’s ever-
global market. that primary care is readily available changing needs. It is because of the
to Singaporeans. Polyclinics and support and vision of leaders such
Mr Gan was appointed as the Minister
community hospitals have been built as Mr Gan that all industry partners,
for Health in 2011. He has since been
and are continually being developed to including SMA, would be able to
focusing on definite measures towards
support the Singapore population, while collaborate and build a dynamic and
the actualisation of the Healthcare
private GPs are working closer with each resilient healthcare system for current
Masterplan 2020 – the Government’s
other to offer subsidised team-based and future generations of Singaporeans.
strategy to ensure accessibility, quality
care in the community through the Fellow SMA Members, guests, ladies
and affordability of healthcare. Mr Gan
Primary Care Networks. and gentlemen, it is my honour to
has emphasised the importance for all
parties involved in providing good and With the belief that Singaporeans present to you, SMA Honorary Member,
affordable healthcare for Singaporeans, should take ownership of our health, Mr Gan Kim Yong.
12 JUN 2018 SMA NewsANNUAL DINNER
SPEECH
Text by Minister Gan Kim Yong
I am honoured to be conferred the SMA in the formation of its recommendations.
Honorary Membership this evening The HITF was an industry-led initiative
and I thank the Association for this which made several recommendations
honour. I would like to think that this to better manage rising healthcare
is not so much a result of my personal costs and insurance premiums. A key
efforts but rather a reflection of the recommendation is the setting of fee
close collaboration and partnership benchmarks to guide doctors and
between the Ministry of Health (MOH) patients. We have since appointed the
and healthcare professionals. I would Fee Benchmarks Advisory Committee, led
like to thank my colleagues in MOH for by Dr Lim Yean Teng. The Committee is
their hard work and all the healthcare expected to release its recommendations
professionals both in the public by the second half of 2018.
healthcare institutions as well as in private Another example was SMA’s role
practice for working with us in providing in the Ministry’s review of charging
high-quality care for our patients. practices adopted by some managed
care companies and third-party
SMA’s contributions in shaping administrators (TPAs). Through
healthcare policies consultations with professional bodies
such as the SMA, the Academy of
With a network of over 8,000 members Medicine Singapore, and the College
from the public and private sectors, of Family Physicians Singapore, and
as well as younger and more industry associations like the Life
experienced practitioners, SMA Insurance Association, steps were
has been a representative taken to engage the third-party service
of the medical community providers and doctors. The TPAs
in engaging the Ministry eventually revised their contracts with
in issues of interest to the doctors and enhanced transparency of
healthcare practitioners and fee arrangements.
patients.
I am also grateful for the SMA’s
For example, SMA made role in assisting the Ministry in the
significant contributions implementation of important measures
as a member of the Health on the ground, such as the Public
Insurance Task Force (HITF) Health Preparedness Clinics (PHPC)
Guest of Honour Minister Gan Kim Yong
Jun 2018 SMA News 13Dr Lee Yik Voon presenting the token of appreciation to our Guest of Honour, Minister Gan Kim Yong
scheme. This scheme was part of MOH’s Record and telemedicine practices. This Singapore’s efforts to strengthen social
efforts to partner primary care clinics two-way communication has enabled a and healthcare, manage healthcare costs
to better care for patients during public collaborative partnership effort between and encourage healthy living. I believe
health emergencies, such as the haze the Ministry and SMA to better address SMA can contribute positively by sharing
situation in 2015. With SMA’s help to emerging healthcare challenges. with the medical fraternity the need for
encourage its members to sign up, we care transformation and work together
were able to mobilise more than 630 Further collaboration between with us as we embark on this journey.
participating PHPCs to see around MOH and SMA: Beyond The challenges ahead will be great but I
50,000 haze-related attendances. Their Healthcare 2020 am confident that through the Ministry’s
participation ensured that children, the collaboration with our stakeholders
elderly and Singaporeans from lower- We rolled out the Healthcare 2020
like the SMA, we can work together to
and middle-income groups had access Masterplan in 2012 to add capacity,
build a good, affordable and sustainable
to timely and affordable treatment for improve affordability and enhance care
healthcare system for all Singaporeans.
haze-related conditions. quality in Singapore. MOH has been
working hard to see this vision into
fruition and also to plan beyond 2020. Conclusion
SMA as a voice of the medical
profession To ensure that our healthcare system On this note, I would like to thank the
is sustainable beyond 2020, three Association for its contributions thus far,
SMA has also provided valuable feedback
paradigm shifts need to be made in and for the award of Honorary Member. I
to MOH on the views and concerns of
our delivery of healthcare. These shifts look forward to the opportunities ahead
medical practitioners on the ground,
are reflected in the “Three Beyonds” – in working with the SMA. Congratulations
including those surrounding emerging
Beyond Hospital to Community, Beyond to all awardees tonight and I wish you all
healthcare challenges. These included
Quality to Value, Beyond Healthcare to a wonderful evening.
postgraduate medical training and
residency, the National Electronic Health Health. These will define the direction of Thank you.
14 JUN 2018 SMA News18 th
council news
Masean
Conference 2018
Text by Nurul Faizzah Mohd Azmi, Executive, Singapore Medical Journal
The 18th Medical Association of South
East Asian Nations (MASEAN) Conference
was held from 2 to 5 May 2018 at the
Hilton Hanoi Opera in Hanoi, Vietnam.
This year’s meeting, hosted by the
Vietnam Medical Association (VMA),
was attended by delegates from the
national medical associations (NMAs)
of Indonesia, Malaysia, Myanmar, the
Philippines, Singapore, Thailand and
Vietnam. The SMA delegation comprised
Dr Lee Yik Voon (Secretary General,
MASEAN), Dr Tammy Chan (Treasurer, 1
MASEAN), Dr Wong Tien Hua, A/Prof
Mahesh Choolani (Secretary General,
Conference highlights
MASEAN Group of Journals [GoJ]) and
the secretariat team. There were two topics for this year’s
scientific symposium. SMA and a few
Handover of chairmanship other NMAs presented on the first topic:
“Impact of Third-Party Administrators
The highlight of the Conference was the on Healthcare Practices in Your Home
opening ceremony, which was graced Country”, and discussed strategies to
by Vietnam’s Deputy Prime Minister Vu deal with issues arising from managed
Duc Dam and World Medical Association care schemes. The remaining NMAs 2
President Dr Yoshitake Yokokura. After two looked into the regulations of medical
years of serving as the MASEAN Chairman, registration in their respective countries
Prof Saranatra Waikakul of the Medical and proposed improvements to their Legend
Association of Thailand handed the current licencing practices. 1. A/Prof Mahesh Choolani (standing, second
MASEAN Medallion over to VMA President from right) together with the office bearers and
Prof Nguyen Thi Xuyen, symbolising the representatives of the MASEAN Group of Journals
Next MASEAN meeting
handover of chairmanship. 2. Prof Saranatra Waikakul handing over the
We thank the VMA for hosting this event MASEAN Medallion to Prof Nguyen Thi Xuyen
Improving quality of ASEAN and look forward to the 18th MASEAN 3. SMA delegates with Dr Ihsan Oetama
medical journals Mid-Term Meeting, to be held in the (second from right) from the Indonesian
Philippines in 2019. Medical Association
The MASEAN GoJ held their third
business meeting, during which the
representatives from the journals 3
discussed plans to increase journal
visibility and improve the quality of
the reviewers’ work, in order to boost
citations and better the overall quality
and standing of MASEAN journals. VMA
also hosted a half-day medical writing
and peer-reviewing workshop endorsed
by the Asia Pacific Association of Medical
Journal Editors, which was attended
by approximately 100 participants.
16 JUN 2018 SMA NewsCOUNCIL NEWS
Report by Dr Lim Kheng Choon
Dr Lim is the
Meeting with DMS historical reasons for its creation, the current
manpower and talent within the secretariat,
Honorary Over the past months, the SMA Doctors-
Secretary of and future plans and financial sustainability
in-Training (DIT) Committee has received
the 59th SMA of the Association, the council voted for the
requests from medical students and
Council. He removal of the post of Executive Director
is currently residents for more information on the
effective from May 2018. The Council greatly
an associate direction of the residency programme. The
appreciates the effort and contributions by
consultant DIT Committee met up with the Director
at Singapore
our current and past Executive Directors in
of Medical Services A/Prof Benjamin
General Hospital. making SMA what it is today.
Ong on 25 May 2018 to address some
of these concerns. A/Prof Ong provided
insights into the Ministry of Health’s (MOH) The Courage Fund
concerns regarding our ageing population The SMA Council re-nominated Prof
and with it, the changing disease patterns Low Cheng Hock to represent SMA as a
and the need for our healthcare system Director of The Courage Fund Limited, for
to transform and adapt to the generalists’ a three-year term from 1 April 2018 until
broad competencies rather than the 31 March 2021.
narrow specialists’ silos. The Courage Fund was initially set
A/Prof Ong shared on the plans to up in 2003 through a fund-raising effort
increase the emphasis on generalist to provide relief to SARS victims and
competencies among younger doctors, healthcare workers. The balance of the
which include a compulsory postgraduate Fund was then put into an endowment
Year 1 before application for residency and fund, which can be drawn upon in the
building “broad-based” rotations, such as event of SARS resurgence or other public
geriatrics, into specialist training. Issues health emergencies. Annual interest
discussed also include how to engage income of the endowment fund is used to
private practitioners in this new landscape, support the Healthcare Humanity Awards.
the increasing numbers of doctors trained
and hired to meet the needs of the system, 12th Annual Health Insurance Asia
and how to balance the swing towards On 9 May 2018, SMA 1st Vice President
generalist training without compromising Dr Wong Tien Hua gave a presentation at
our edge in specialist training. the 12th Annual Health Insurance Asia.
Most importantly, A/Prof Ong Dr Wong spoke on the topic of medical
emphasised the importance for the fee benchmarks, providing a background
profession to stay together, adapt and meet of SMA’s previous Guideline on Fees,
the nation’s healthcare needs. Younger information asymmetry, patient and
doctors would need to be competent in doctor perspectives, recommendations
their clinical skills and widen their network of the Health Insurance Task Force and
to engage colleagues in primary care and the upcoming MOH Fee Benchmarks.
family practice, so that community-based
care can be efficiently managed. World Family Doctors’ Day
SMA participated in the celebration of
SMA Executive Director the World Family Doctors’ Day on 19 May
The SMA Council recently conducted a 2018, organised by the College of Family
review regarding the role and functions Physicians Singapore. We wish to take
of the Executive Director within the this opportunity to salute the work of all
SMA Secretariat. Taking into account the family physicians in Singapore.
Jun 2018 SMA News 17The Annual National Jointly organised by:
Medico-Legal
Seminar 2018
M Hotel Singapore, Ballroom Level 10
Day 1 (6 October 2018) Day 2 (7 October 2018)
8.30 am to 4.45 pm | 4 CME Points 8.30 am to 12.15 pm | 2 CME Points
FINISHING WELL LAW & ETHICS OF
The Medical, Ethical and Legal Aspects of ORGAN TRANPLANTATION
Dying with Dignity in Singapore Today
8.30 am Registration 8.30 am Registration
9 am Opening Address Brain Death
9 am Man-made entity or real phenomenon? Can we
The Coroner’s Act ever be wrong?
9.10 am
Why doctors need a thorough understanding
Human Organ Transplant Act (HOTA)
9.40 am
The Death Certificate – Pitfalls to be Avoided After 31 years, has it come of age?
9.40 am
Even after death, the doctor’s duty does not end
10.20 am Tea Break
10.10 am Morning Tea Break
Practical Legal Issues in the Practice of
Advance Medical Directive (AMD) Act 10.50 am
10.40 am Organ Transplantation
Making it work for society and patients
11.30 pm Panel Discussion – Views from all sides
Advance Care Planning (ACP)
11.10 am
Past. Present. Future 12 pm Closing
Panel Discussion – Advance Medical Directive
11.40 am MLS/ AMS/
(AMD) Act and Advance Care Planning (ACP) Registration Fees NON-
SMA SAL/LSS
(amount is inclusive of GST) MEMBER
12.15 pm Lunch member member
Mental Capacity Assessment When the Full Package (6 and 7 October) $300 $360 $420
End is Near
1.45 pm Day 1 (6 October) $220 $250 $270
The roles of the Lasting Power of Attorney and
Court-Appointed Deputy Day 2 (7 October) $140 $170 $200
2.15 pm Questions and Answers For Doctors and Dentists who are
employed under MOHH and/or any
2.30 pm Local Data on End of Life
public healthcare institutions under
MOHH Employment
When Comfort Care becomes Foremost the MOHH Group, this seminar will
3 pm Withholding and withdrawal of life support; the be funded by MOHH based on your
different faces of palliative care completed attendance.
3.30 pm Panel Discussion – Tough calls in the final days Early Bird Registration Rates! Sign up NOW!
(Valid from 1 June to 31 August 2018)
4.30 pm Closing
Seminar topics may be subject to change
Target audience:
Allied Health Professionals • Healthcare Professionals (Clinical & Non-Clinical)
Hospital Administrators • Legal Professionals
For more information and registration for this seminar, please contact Jasmine Soo at email:
jasminesoo@sma.org.sg or tel: 6223 1264, or check out our website at https://www.smacmep.org.sg.Are You Prepared for a
EVENT
Digital Health
Text by Dr Zubin J Daruwalla
Future?
In the transformative era that we live in and educational afternoon. Dr Wong insights based on current guidelines, rules,
today, the healthcare industry is rapidly started by very eloquently giving a bird’s regulations and upcoming legislations, all
evolving with digital health undoubtedly eye view of the digital health, and in of which were captured as part of a soon-
at the forefront. In Singapore, we are particular, telemedicine landscape in to-be-released report by our team.
fortunate to have forward-thinking Singapore before summarising both While the potential risks associated
leaders and initiatives like the Ministry the NTG and SMC ECEG from a clinical with digital health and the practice of
of Health’s formation of a “regulatory point of view. This was followed by my telemedicine may seem daunting, let
sandbox” on a backdrop of guidelines talk on “The Evolution of the Healthcare us all be urged to remember the words
such as the National Telemedicine Industry and the Transformative Future”, of Hippocrates in that we should, “First,
Guidelines (NTG) and Singapore Medical which touched on the past, present do no harm.” And in doing so, let us all
Council’s (SMC) Ethical Code and Ethical and future of healthcare delivery as work together in embracing a safe digital
Guidelines (ECEG). However, with the we know it. Actual local, regional and health future for Singapore.
constant and exponentially increasing rate global use-cases were also included in
of conceptualisation, advent, trialling and the session. Subsequently and just prior
to the tea break, clinician, entrepreneur Legend
implementation of new technologies in the
realm of digital health, how do we ensure and founder of MyDoc, Dr Vas Metupalle, 1. Panellists for the afternoon. L to R:
that patient safety is not compromised? shared and discussed some real and A/Prof Raymond Chua, Dr T Thirumoorthy,
Dr Vas Metupalle, Mr Muralli Rajaram, Dr Zubin J
recent clinical virtual consultations he
In an attempt to answer this and Daruwalla (moderator), Dr Wong Tien Hua, Dr Tan
had conducted, catching the interest of a Tze Lee, Mr Harris Shum and Dr Tan Chi Chiu
the many other questions our local
number of clinicians in the audience.
doctors, as well as other allied health
professionals have, the afternoon of The afternoon ended with what was a
Saturday 7 April 2018 saw our PwC South highly anticipated panel discussion. The Dr Daruwalla is the head of
East Asia Consulting healthcare team, panel comprised a number of renowned healthcare for PwC South East
in collaboration with SMA, co-host an and very well-respected representatives Asia Consulting and leads the
event entitled “Embracing a Safe Digital from the Ministry of Health, College of healthcare consulting team in
Health Future for Singapore” at the Family Physicians Singapore, SMA Centre the region, while remaining
a practising clinician with
Health Promotion Board Auditorium. for Medical Ethics and Professionalism,
an interest in orthopaedics,
The event, kindly sponsored by MyDoc, SMC Medical Ethics Committee and NTG and an advisor to a number
a local and home-grown digital health Review Committee, MyDoc, SMA, Medical of start-ups in the digital
platform, was an immense success with Protection Society, and Straits Law (a health and medical education
more than 100 attendees, a majority local law practice with vast experience in spaces. A healthcare thought
medico-legal cases). While panellists as leader and strong believer
of whom were locally practising
in collaboration, he hopes to
doctors. The introduction and opening well as the audience were challenged as bridge the gap between the
address by Dr Wong Tien Hua, then they covered a number of contentious clinical and corporate sides of
SMA President, set the tone for what issues, the collaborative effort resulted in a healthcare.
was to be an enjoyable, insightful generation of informative and educationalINSIGHT
Text by Dr Lee Ser Yee, Dr Chai Shu Ming and Dr Chan Chung Yip
Part 3 – How do I get in?
This is the final instalment of the series on “How to get into a good fellowship”. The first two instalments dealt with the importance
of a fellowship, how to get started on the process and the multiple factors to consider in choosing one. In this final part, we provide
some insights into how to improve one’s chances of getting that prized fellowship position and how to deal with the potential
curveballs that life might throw your way.
How to optimise my chances?
1
Now that you have shortlisted a few
top choices, it is time to do everything
you can to get in. For starters, a good
curriculum vita (CV) is your basic
requisite.1,2 It is CV, CV, CV, and some
luck. While your surgical skills or clinical
competence are important (only your
closest colleagues or seniors would
know how good you really are), it is
not readily apparent to the fellowship
director or the selection committee
miles away. However, most can read,
evaluate and discern between an
excellent and a mediocre CV. In other
words, a decent CV is the minimum
ticket for a shot at an interview.
Letters of recommendation and a
list of references serve as a testimony of
one’s work ethics and performance. It
lends a voice of validity and credibility this case, it is often immediately clear if (AQ) are all measures of an individual’s
when a senior vouches for someone; the referee has truly worked with you or ability in different aspects, and each
it generally helps if the referee is a knows you well. plays a part in determining success in
respected member of the community many aspects of our daily life.3,4,5 I will
Some programmes require a personal
or profession, or even a well-known argue that the latter two are probably
statement. This is a good idea in the
or reputable physician or professor. more important in the process of
form of a letter of interest or email of
However, it should be from people who attaining the choice position and doing
intent even if the programme does
know you well and with whom you well in the fellowship, respectively.
not ask for it. This serves as your initial
have worked before; not just a famous Simply put: IQ gets you through school,
self-introduction and provides insight
professor who is a mere acquaintance. It EQ gets you though work and AQ
into the interests and motivation
is evident and it lends more weight when gets you through life. This is especially
that you have for the programme. It
someone truly knows you well and writes pertinent in the interview process
is also notably the only place before
in a manner that reflects that, rather than regardless of its form: be it via video-
the interview where you would have
a mere standard run-of-the-mill template conferencing, phone calls or face-to-face.
some degree of latitude to express
of a recommendation letter, even if it First impressions do count, probably
is from a “lesser-known” mentor. It is your intention or highlight your unique
more than most will admit or realise. It is
also not uncommon that the selection characteristics and qualities.
also not uncommon that the preliminary
committee might choose to speak to Intelligence quotients (IQ), emotional decisions about which fellow to award
the referee directly for more insight; in quotients (EQ) and adversity quotients have already been made by the group
20 JUN 2018 SMA Newsor the individual fellowship director
with the interview only serving as the 2
final confirmation or “tie-breaker”. It
differs according to the scenario, ranging
from the most basic of things to more
subtle nuances. A panel interviewing
an international or foreign candidate
may place heavy emphasis on how well
he can communicate or how proficient
his command of the local language is.
Whereas for a local candidate (where
it is assumed that language would
not be a barrier), the emphasis may
be on a different matter, such as the
candidate’s future job plans or research
experience. In other words, fellowship
directors will use it as an opportunity to
evaluate applicants for non-cognitive
skills and assess “red flags”.6,7 Besides
having the proper interview etiquette,
it is important to understand who you
will be speaking to and research as
much as you can about the interview
panel, if the information is available to
you. In other words, be prepared.8 For
example, someone who interviewed especially so in the heavyweight enough to be working with me on a
me once cited: “You can’t possibly know academic institutions where research daily basis and entrust their patients in
the world’s literature but you must capabilities are highly valued. Get the my care?” Understanding one’s strengths
know your own centre’s… or at least the basic requirements settled early. As and weaknesses is the key. Very few
current and best level of evidence to an international applicant aiming for possess the “Trifecta” of excellence
date.” The last thing one should do is to a matched fellowship in the US, you in medicine (ie, clinical or surgical
try to outsmart an expert in a particular should have the necessary credentials technical excellence, a strong research
field or topic. and qualifications on-hand (eg, United and training background, and the
It is painfully important to be realistic States Medical Licensing Examination elusive and enigmatic “X-factor”). The
about your chances. Generally, the better and Education Commission for Foreign “X-factor” can be hard to qualify; it could
or more reputable the fellowship is, the Medical Graduates). A background be a winning personality, an endearing
more popular and competitive it will of research fellowships in similar or demeanour, a comfortable and likeable
naturally be. I often quote the 100: 10: 1 reputable institutions may stand one face, or good public speaking skills.
ratio (ie, 100 applicants will apply, but in good stead as well. The fact is, many But more often than not, it is a winning
only about 10% will get an interview successful candidates were actually combination of these natural or
for that one position).1 If you do not rejected in their first application, but acquired soft skills and talents.
realistically think you have a “decent decided to spend their year doing Go! You have gotten the interview or
shot”, then it might be more worthwhile research in the institution of interest or you have a feeling that your chances are
to concentrate your efforts and resources its equivalent. This would allow both high. Hit the ground running. Nothing
elsewhere and optimise your efforts parties to know one another well and pleases the faculty more than genuine
there. Besides asking around, having a if it fits, it will place them in good stead interest, an infectious energy and drive
survey of the calibre or the “standard” of for the next application, or at least get in doing work for the department, be it
the past or the recent graduating fellows a gleaming reference, more experience a new project or a grant. It will be even
will provide some gauge of the minimum and perhaps a few more publications better if one has an awarded grant ready
entry criteria of the programme. under their belt. to go in the institution of the fellows’
Get set. One needs to ask oneself choice; or has a project already planned
Be ready, get set and go! these brutal questions. “What will make and running before the fellowship
Be ready. Readiness in terms of having me special enough to be considered starts. A word of caution: one should
a PhD or a double Masters on hand and eventually accepted? What will also not be overly ambitious as most
often impresses fellowship directors, make them happy and comfortable clinical fellowships are hectic and can be
Jun 2018 SMA News 21physically and mentally exhausting. You or not well managed. Social, cultural or Be open to new ideas, take notes, learn
should not risk not finishing something professional frictions and frustrations are and absorb – take in what’s good and
you started or promised. A mentor not uncommon in the stressful hospital leave what’s not. Try to make yourself
advised me during my exit interview at environment. One has to be prepared better and just as importantly, try to
the end of my fellowship – “There are to work at it, in order to make the best make them better too and improve the
only 24 hours a day; pace yourself, do out of the situation or be prepared fellowship for the future generations
not burn out.” to cut your losses and try for another to come. Be the best version of
fellowship, if time and resources permit. yourself as you are an ambassador for
I got it! What do I do now? Should one interrupt the fellowship and your home country and institution.
quit, you should be professional about it, Avoid burnout.
It is never too early or late to prepare. It and aim to be fair to the host institution
is important to settle your work, family Obtaining a choice fellowship
as they may not able to cope with the position is as much an art as a science,
and personal matters properly and loss in manpower or have a replacement
leave things in good order. Arrange and maybe some luck. Many factors,
in time. Practise due judgement in such some more obvious and objective,
for a trusted colleague to care for your tricky situations, handle the separation some softer and more subtle, can all
patients who still need follow-up or care as amicably as possible and try not to influence the outcome in one way or
when you are away, always do a proper burn any bridges in the process. another. Good luck!
handover and explain to your patients
where possible. Do not leave loose ends Conclusion
at work or at home. Sell the car and
Acknowledgments
One should note that the fellowship We would like to thank our departments
lease out your apartment if necessary.
is just the beginning of a lifelong and institutions for providing us the
Tell your friends and family, and have
learning process and as such does not support and opportunities to further
conversations about the anticipated
guarantee mastering a subspecialty. our training. Last but not least, we want
period when you will be away for
You will encounter yet another to take the opportunity to express our
training. Put in place contingency learning curve beyond fellowship years
plans and work out the “in-case-of- deepest gratitude to our loved ones,
as a newly minted consultant caring friends, colleagues and mentors who put
emergency” scenarios. for your patients, perhaps with your up with us, and made our training easier
It is also good to arrive a couple team of residents and own fellows to and worthwhile. You know who you
of weeks before the actual start date. train. I have learnt that fellowship is are… thank you.
This allows you to acclimatise and not finishing school but just another
familiarise yourself, as well as to settle step in our journey in the mastery
any administrative details, so you can of surgery. Family and friends are Legend
be ready to hit the ground running important especially in those tough 1. Dr Lee SY with his parents outside Memorial
on the first day of work. If possible, training years as they help remind you Sloan Kettering Cancer Center (MSKCC)
arrange to spend some hours each what you were there for. They make the 2. MSKCC Advanced Surgical Oncology
day with the team, orientate yourself tough days better and good days great. Fellowship Class of 2012–2104
with the institution grounds and its
surroundings, as well as have a gauge
of the work culture and the patients References
you will be caring for. Set realistic goals 1. Joshi AR, Vargo D, Mathis A, et al. Surgical Residency Recruitment-Opportunities for Improvement. J Surg
and work towards them. Once you are Educ 2016; 73(6):e104-10.
there, soak it all in; it goes by faster than 2. Egro FM, Blecher NA, Gimbel ML, Nguyen VT. Microsurgery Fellowship Selection Criteria: A National
one realises. Enjoy the fellowship, learn, Program Director Survey. J Reconstr Microsurg 2017; 33(3):206-10.
absorb and makes friends. Enjoy the 3. Arora S, Ashrafian H, Davis R, et al. Emotional intelligence in medicine: a systematic review through the
different living environment, explore context of the ACGME competencies. Med Educ 2010; 44(8):749-64.
and cherish the experience. 4. Stoltz PG. Adversity quotient at work: Adversity Quotient @ Work Make Everyday Challenges the Key to
Your Success-Putting the Principles of AQ into Action. HarperCollins Publishing, Inc, 2000.
Oh no, this is not working out... 5. Stoltz PG. GRIT: The New Science of What it Takes to Persevere, Flourish, Succeed. ClimbStrong Press, Inc,
Sometimes, despite our best intentions, 2015.
research and planning, things might not 6. Makdisi G, Takeuchi T, Rodriguez J, Rucinski J, Wise L. How we select our residents--a survey of selection
work out well and the fellowship does criteria in general surgery residents. J Surg Educ 2011; 68(1):67-72.
not pan out as expected, sometimes due 7. Burkhardt JC. What can we learn from resident selection interviews? J Grad Med Educ 2015; 7(4):673-5.
to circumstances beyond our control. 8. Stephenson-Famy A, Houmard BS, Oberoi S, et al. Use of the Interview in Resident Candidate Selection: A
Perhaps your expectations were not met Review of the Literature. J Grad Med Educ 2015; 7(4):539-48.
22 JUN 2018 SMA News1
INSIGHT
Photo: Alumni Association Southern Branch
A Glimpse
into the PastMedicine in Singapore (Part 12)
After WWII
This is the twelfth instalment of a series on the history of medicine in Singapore.
Text by A/Prof Cuthbert Teo, Editorial Advisor
After the medical school opened, the College’s sports field was converted appointed the officer-in-charge of the
Federated Malay States (FMS) Hostel into an annex of the FMS Hostel for 14 Library. The Dental School also set
was also re-opened. Some other places students, and was called the Stables. up a small library around that time.
for accommodation were acquired (In 1953, the Dunearn Road Hostel The rehabilitation of the Pharmacy
for students. The first to be converted opened to replace the Paterson Road School was particularly difficult
was the Lay Superintendent’s Quarters Hostel. In 1955, both FMS and TTSH because the laboratory had been
for 11 students, then the Sepoy Lines hostels were demolished.) stripped of all benches and equipment
Golf Club for 25 students. In 1947, the by the Japanese, and had been
Tan Tock Seng Hospital (TTSH) hostel The Medical Library, which had been converted into a cold room, which
was opened for 100 students. An left intact during the war years, was was dismantled in 1947. That same
old bungalow on Paterson Road was reopened and shifted to the ground year, a young Mahathir bin Mohamad
converted for 36 pre-clinical students. floor of the College of Medicine entered the portals of the King Edward
In 1948, a Japanese building in the Building in 1947. Mr George Ee was VII College of Medicine, where Tun Dr
Jun 2018 SMA News 23Photo: Health Sciences Authority
Photo: Health Sciences Authority
2 3
Mahathir was to meet his future wife, part of the work under this heading from carbon dioxide poisoning was
Tun Dr Siti Hasmah bte Haji Mohd Ali. was in connection with the numerous also investigated. Analysis of the
In 1949, Prof EK Tratman described in fatalities which followed the drinking atmosphere of the hold soon after the
volume 86 of the British Dental Journal of illicit spirits. Many samples of Liquor accident showed the composition to be
a previously unrecorded anomalous coloured and flavoured to simulate Carbon dioxide 10.7 per cent, Oxygen
form of mandibular premolar, first the ‘Whisky’ and ‘Brandy’ produced 8.3 per cent, and Nitrogen 81.0 per
described by Mr MO Leong, LDS, at an under the Nipponese regime proved cent. Experiments showed that oranges
August 1946 meeting of the Malayan on analysis to contain from 18-34% kept in a closed space produced, by
Dental Association. by volume of Methyl Alcohol. In only respiration, a greater concentration
one instance was mixture of Ethyl of carbon dioxide than this, with a
Major CL Southall, who took charge
and Methyl Alcohol found. It is almost corresponding decreased in oxygen,
of the Government Analyst Department
certain that the Methyl Alcohol was within 24 hours. In this instance, the
in 1945, described his frustration
looted from Japanese supplies during oranges had been stowed so as to
of trying to restart the department
the recent period of disorganisation. leave a well in the middle of the hold,
and his account gave a glimpse of No deaths of Methyl Alcohol among
the ravages wrought on the local in which the vitiated atmosphere
Service Personnel have occurred since accumulated and into which the
population by the war.1 the third week in October, but civilians
asphyxiated men descended.”
“The Japanese removed most of the deaths continue indicating that this
apparatus to the College of Medicine. poisonous liquor is still on sale. During In 1951, Brooks wrote: 3 “In last
I regret I have been unable to obtain the course of this work, a rapid method year’s report, reference was made
permission from the Military to recover of detecting with certainty as little as to an unidentified alkaloidal poison,
this, nor have I been permitted to 0.001 cc Methyl Alcohol in 5 cc blood which had been twice encountered
inspect it to enable me to prepare a or C.S.F. was perfected. Atropine, Tuba and which had on the second occasion
list of what replacements should be resin, Morphine and Caustic alkali were caused the death of 2 and the acute
ordered. In consequence work has the only other poisons detected in illness of 3 Chinese women. The poison
been carried out under what I consider viscera specimens.” was in both cases derived from a
are quite unnecessary handicaps. The The activities of the Government root. This year the same alkaloid was
majority of the former Asiatic staff Analyst Department were brought found in two more fatal poisoning
have returned to duty. The Chinese back in full swing under successive cases, both Chinese men, in neither
assistants are in fair health. I wish to able leaderships – M Jamieson (1946 of which was there any history of how
place on record my appreciation of to 1949), AC Brooks (1950 to 1952), the drug had been administered or
their efficient work and cheerfulness AW Burtt (1953 to 1955) and A Jackson its source. This poisonous alkaloid has
in spite of their personal difficulties (1956 to 1958). The ability of the now been identified, both by its colour
over housing, transport and food Department to analyse for poisons reactions and by its absorption curve
prices. The Indian assistants are all in appears to be quite sophisticated. in the ultra violet as that occurring in
very poor health and are incapable In 1947, Jamieson wrote: 2 “A case of Gelsemium elegans (Benth), a plant
of sustained effort. No improvement accidental poisoning of great interest, apparently well known in Hong Kong,
is to be expected under prevailing in which 4 men entering a ship’s hold but not hitherto encountered here.”
conditions. Toxicology: The greater to unload a cargo of oranges died In the post-war years, with the advent
24 JUN 2018 SMA NewsYou can also read
