Statesman I

After the morning round today, I had the last breakfast with the upper GI team. We were not in a hurry, therefore, the team had some deep talks on the change of medical training system in Singapore, which puzzled our consultant AS very much.

To give you some background information first. Singapore training used to be a British system, in which registered doctors could receive basic training and advanced training for around 3 years respectively after they completed the housemanship in public hospitals. The trainee would firstly be screened to enter the basic training programme, and then examined before they enter the advanced training programme. In this case, incompetent doctors would be advised to quit the programme, leaving the able trainees in the stream. After the advanced training, the doctors could become associate consultants or consultants in 2 to 3 years time

As a result, the pyramidal hierarchy is made: only the cream of the cream could receive adequate training and climb to the top of it.

Since few years before, however, the story did not remain the same. The authority decided to change the British system into a American one: After the graduation, all doctors are allowed to choose the specialty they want as a resident (or registrar) provided that the hospitals provided training posts. The hospitals are supposed to provide a 5-year training to the residents for an examination, so they are enabled to specialized in their field. Should they pass the examination, they will become associate consultants or consultants in 2 or 3 years.

In short, the pyramid no longer exists since the intermediate exams for the basic trainee to the advanced training programme disappeared. All the residents would receive the training necessary for the specialist examinations.

I could not help sweating as I listened to our consultant. (To be continued)