by Kok Ming Cheang
Few people in Singapore took notice of the recent decision by the Ministry of Health (MOH) and the Singapore Medical Council (a statutory board), when they announced the drastic reduction of overseas medical schools which local A-level students can go to further their education to become a doctor, approved by Singapore Medical Council (SMC) to practise in Singapore. This decision affects the future of quite a number of local A-level students (and some Permanent Residents) who are unable to clinch a coveted place in Yong Loo Lin School of Medicine at National University of Singapore, Lee Kong Chian School of Medicine at Nanyang Technological University (NTU) and Duke-NUS Medical School.
This means that from next year, Singaporean students hoping to practise medicine here will have 57 less overseas medical schools to go to further their ambition to become a doctor.
The rationale given by MOH and SMC that with expanding places for medicine in local universities and the need to maintain the quality of doctors here, this thoughtless decision is made.
It is a life-long dream of many parents who have children with excellent A-Level grades to be able to enter a recognised medical school to become a doctor, long regarded as the top profession. They know too well that to enter a local medical school is extremely difficult even though the children scored 4As. Many such talented local students were forced to study other subjects like engineering and the Sciences, out of no choice.
If the parents have the financial resources, they will send their sons and daughters overseas to one of the approved universities approved under the Medical Registration Act. Unfortunately for the less endowed students, their dreams will be shattered. They will see their rich fellow classmates going on to an overseas medical school to become doctors while they themselves are rooted here with a less prestigious profession.Not surprisingly, foreign parents too share the same sentiment.
What is exactly MOH’s Manpower Plan for Doctors and Medical Personnel?
It was as early as 2009 when the MOH made a policy decision to bring in more foreign doctors with qualifications not on the approved list of medical schools. These foreign doctors are granted “Conditional Registration” and require to undergo 2 years of supervision by senior doctors to determine their medical proficiency. They will be granted “Full Registration” upon successful period of supervisory training. In 2000, 170 medical practitioners were granted full registration, 114 conditional registration, 173 provisional registration and 252 temporary registration. Thirty two applicants who were on conditional registration were granted full registration in 2000. The number of Singaporeans with foreign qualifications granted Conditional Registration were only 35 compared to 79 non-Singaporeans, giving a total of 114 in 2000. Since then, the number of Conditional Registrations granted were mostly given to foreigners, and the trend is upward..
In a Straits Times article by Salma Khalik (“Singapore has record 13,006 doctors“), she wrote: “With a greater need for healthcare professionals as Singapore’s population grows and ages, the authorities have been actively recruiting foreigners to fill the gap.”…”Nearly 20 per cent , or 2366 of the doctors working here are foreign ones, with most of them in the public sector. Only 201 foreign doctors are in private practice.”
From SMC Annual Report 2017 (the latest available), there were 6517 in public sector and 4542 in private sector, giving a total of 11,059. For Conditional Registration (mostly foreigners with foreign qualifications not on the approved list of SMC), 2022 in public sector and only 138 in private sector or total 2016.
Even more revealing is that of the 2022 doctors on Conditional Registration, 509 were Singapore citizens, 493 were PRs and 1020 were non-residents, totaling 2022 in the public sector. Only a handful of those with Conditional Registration were in private sector, an indication that the private healthcare sector took a cautious approach in recruiting foreign doctors with qualifications from non-recognised foreign medical schools which the government gladly took on. The total number of medical practitioners at the end of 2017 was 13, 944, an increase of 938 doctors over 2016.
The MOH (and probably SMC), are either insincere in its Medical Manpower plan to nurture more local students to become doctors or their Plan has gone terribly wrong and certainly against the interest of parents who want to see their children becoming doctors. Even more serious is that they are now questioning themselves, the wisdom of their decision to open Singapore medical healthcare sector to an influx of foreigners with medical education of doubtful academic standards.
They find short-cuts to achieve their numbers by bringing more and more foreign-educated doctors with qualifications that may not be equivalent to the academic rigors of NUS and NTU medical schools.
They opened Singapore’s healthcare to foreign doctors with medical qualifications from Pakistan, Sri Lanka, India, People’s Republic of China, among others. In the 2019 approved list of medical schools, 6 were removed from India (probably keeping 3), one from Pakistan (none left), 4 from People’s Republic (probably none left), among others.
(Note: Above data was based on two ST reports which presented incomplete or different information)
The Straits Times article published on 19 April with its nice statement, “Number trimmed as local schools expand places for medicine and to maintain quality, raises serious. I question why they took so long to realise the quality of medical education in some countries is unacceptable and now removing them is the only option. It should be obvious for MOH and SMC that even with the expanded capacity of NUS, NTU and Duke-NUS for medicine, the current local medical students’ output is insufficient to meet Singapore’s demand.
Those A-grade A-level students who failed to enter the local medical schools and have no resource for overseas education, is a great loss of talent for Singapore. When the parents have no money to help their children to pursue their career in medicine, and the government simply resorted to importing foreign educated doctors under Conditional Registration, I feel this is a big let down by Health Miinister Gan Kim Yong and his predecessors.
Many Singaporean students educated in approved medical schools abroad, with some becoming medical specialists and consultants, have spurned the government incentive of offering pre-employment grants of up to $50,000 a year to pay for tuition fees for up to three years. A medical degree which takes five years to complete, followed by two to three years housemanship, would have cost parents more than half a million dollars (in UK). Such incentive is too little, too late. Singapore has lost the talent of our sons and daughters to those host countries which educated them.
There is certainly a leadership deficit in the Ministry of Health.
This was first published on Mr Kok’s Facebook page and reproduced with permission