The Singapore Ministry of Health (MOH) through its company, MOH Holdings Pte Ltd, has put up a tender asking for a proposal for the “Appointment of a Recruitment Agency to Provide Services for the Recruitment of Doctors in India“.

The tender was put up earlier this month on 6 Sep. It closes next month on 10 Oct.

MOH Holdings (MOHH) is the holding company of Singapore’s public healthcare clusters – National University Health System, National Healthcare Group and Singapore Health Services.

On its website, the company said:

“Sharing the Ministry of Health’s vision to champion a healthy nation and ensure that our people live well, live long and with peace of mind, our role is to enhance public healthcare sector performance by unlocking synergies and economies of scale.”

In its tender document, it said that MOHH “intends to recruit doctors from India to work as Medical Officers in Singapore.” It said that the recruitment agency needs to “participate in and assist with” MOHH’s recruitment trips to India. The responsibility of the agency is to source viable doctors from India.

MOHH added that it hopes to recruit 60 Medical Officers from India annually from 2022 to 2024, with the option to extend “this project” for an additional year to 2025. In other words, MOHH wants to recruit as many as 240 Indian doctors from this tender project over 4 years.

In a separate tender, MOH is looking for recruitment agencies to provide services for a period of two years to hire medical staff such as nurses from overseas, not limited to India.

Number Of Approved Medical Universities In India Shrinks

MOH is going ahead with the recruitment of Indian doctors despite the fact that the number of Indian medical universities approved by the Singapore Medical Council (SMC) has been drastically reduced over the years.

The recognition of Indian medical schools by the Singapore authorities started after Singapore and India signed the Comprehensive Economic Cooperation Agreement (CECA) in 2005 between Indian PM Manmohan Singh and Singapore PM Lee Hsien Loong. On the 2006 SMC Annual Report, it proudly stated:

By the end of 2008, the number of approved Indian medical schools had gradually increased to 9.

Then in 2009, one of the universities was quietly removed from the list through a government gazette. It was the “Maulana Azad Medical College, Delhi University” which was removed from the approved list on 30 Oct 2009. No explanation was given. Since then, there were only eight medical schools from India recognized in Singapore:

However, on 18 Apr 2019, MOH suddenly announced that it would reduce the number of recognized foreign medical schools with effect from 1 Jan 2020. Only 2 Indian medical schools are left on the approved list:

Presumably, the 240 Indian doctors MOH would like to recruit would be coming from these two schools.

Would Singapore Get The Cream Of The Crop From India’s Medical Workforce?

It’s common knowledge that the medical education system in India is frequently filled with fraud and scandals. Top medical schools like the All‑India Institute of Medical Sciences (AIIMS) in New Delhi is no exception.

For example, in 2011, fraud was discovered in AIIMS’ entrance exams. A medical doctor who graduated from AIIMS together with others had been running a racket manipulating the answer sheets. Candidates would pay the gang several hundred thousands rupees to cheat in AIIMS’ entrance exams.

In 2014, AIIMS landed itself in a controversy over embezzlement of funds to the tune of 1 billion rupees. The revelation came after the Indian Health Ministry conducted an audit of AIIMS’s records over the past 5 years. It found that AIIMS had not refunded at least 530 million rupees to poor patients, who paid for various tests and treatment in advance. Irregularities were also found in the receipts for special procedures undertaken by patients. Furthermore, AIIMS had procured goods worth more than 330 million rupees without issuing any tenders.

In an investigative report, Reuters documented the full extent of fraud in India’s medical-education system. It found, among other things, that more than one out of every six of the country’s 398 medical schools has been accused of cheating. Rigging entrance exams or accepting bribes to admit students are common occurrences in India. Paying bribes – often in the guise of “donations” – to gain admission to Indian medical schools is widespread, as even the Indian Health Ministry admitted.

However, despite the negative news surrounding its medical graduates, India has nevertheless been the world’s largest source for immigrant physicians — particularly English-speaking OECD countries — since its independence.

Top Five Countries of Destination for India-Trained Doctors, 2014-16

According to data from OECD, United Kingdom had 18,953 India trained doctors in 2021, which is significantly more than any other source country, the second being Pakistan at 8,026. This trend had persisted for decades.

The foreign doctors who managed to find work in UK, would also be well-paid, with the average annual pay for a general practitioner in UK’s National Health System said to be £65,070 to £98,194 in 2022.

Now going back to Singapore, Dr Paul Tambyah, a senior consultant at the Singapore’s National University Hospital, who was speaking in his personal capacity at a forum back in 2017, shared that junior doctors had told him that every time they complain about conditions in public hospitals, the administrators don’t seem perturbed by it.

The public hospital administrators were said to have warned junior doctors who complained that they can be replaced with someone from the south or south-east Asia who is willing to work for S$3,000 a month (or annual salary of S$39,000 including the 13th month).

In support of the description made by Dr Tambyah, Singapore publication, Rice Media recently published an article talking about how young local doctors in the country are drained and gaslit through their work, with toxic working culture in hospitals and gaslighting via feedback when complaints from doctors are being made.

Suppose the shortage of medical doctors is due to poor working culture on top of the supposedly low pay. What quality of doctors would Singapore be expecting to be hired through its recruitment scheme in India with competition coming from those OECD countries such as the UK?

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