me+SH (Sep-Nov 2010)

SEPTEMBER — NOVEMBER 2010 IN THIS ISSUE

BUILDING ON OUR FOUNDATION, INVESTING IN OUR FUTURE

A SingHealth Staff Publication

Transforming the Face of Education An EPIC in the Making

SingHealth on Facebook f Join our social network today!

Charging Forward in Our Academic Medicine journey GCEO Prof Tan Ser Kiat's annual staff address

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Special

CONTENTS

me + Living

16 Transforming the face of education

28 At home with Dr Patrick Casey

19 Teaching life’s valuable lessons

31 Wise up on sugars and starch – The GI factor

20 Enabling nurses to go the distance

32 Battling cancer with nutrition

21 Giving doctors a specialist edge

33 Healthcare financing

22 Stirring the passion of junior doctors

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23 Cultivating Dr Leaders

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24 Pioneering Duke-NUS culture

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01 Guest Editor - Dr Edwin Low

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02 Pulse of SingHealth 2010 Building on our foundation, investing in our future

Sm me + Smiles

06 An EPIC in the making 08 IMU to advance clinical research 10 Dispensers of knowledge 12 Inspirational patient - Father knows best

34 More than just flying kicks and punches

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13 Heart transplant lynchpin 14 Eye on education 25 iTag innovations 26 Nurses’ day: a celebration by the numbers

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26 Nursing greatness

Hr me + Horizon

27 Highest honour for our nurses 36 me+SH contest

SingHealth Editorial Team Tan-Huang Shuo Mei Amelia Champion Katheryn Maung Arthur Wong Stephanie Jade Arlindita

Pepper Global Alvin Ee Ariel Chew Michael Koek Candice Tang 75B Pagoda Street Singapore 059234 Tel: +65 6221 1286 Photography for education and home features: A Pixels Photography Pte Ltd Copywriters: Monica Lim and Sher Maine Wong

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me+SingHealth or me+SH (pronounced /mesh/) represents who we are in SingHealth—as intertwining threads conveying synergy and complementing one another to form a beautiful fabric. me+SH links you to the action in all of SingHealth and around the healthcare industry.

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All rights reserved. Reproduction in whole or part is prohibited without the written permission of SingHealth and the publisher. The views and opinions expressed or implied in the publication are those of the authors or contributors and do not necessarily reflect those of SingHealth and the publisher. Whilst due care has been exercised, both SingHealth and the publisher do not accept responsibility for errors in advertisements or articles, unsolicited manuscripts, photographs or illustrations.

MICA(P) 094/04/2010

Guest Editor

Starting on Our

Journey Forward The journey of a thousand miles starts with a single step, as the saying goes.

With the many new initiatives in recent years and many more new ones to follow in the next few, we are indeed in exciting times in our Academic Medicine journey. The establishment of the Duke-NUS Graduate Medical School brings back medical education to our SGH campus. The opening of the SingHealth Investigational Medicine Unit and the construction of the SGH Pathology Building supports our goal of building a vibrant culture of academia and scientific curiosity that we can call our own.

In Pulse of SingHealth, the annual staff address, GCEO Prof Tan Ser Kiat gave us CHARGE! as our direction in the decade ahead. Always keeping in mind that patients are at the heart of all we do, we realise that all these efforts aim at one outcome: synergy in research and education to improve patient care.

Everyone has a role to play in making this journey possible. To facilitate that, new career tracks are implemented to expand and enhance the roles of Clinicians, Nursing Staff, and Allied Health Professionals.

We know that our strength comes from our people, and we recognise and reward them for excellence. To build capacity and capability of our people and ensure we each have the right knowledge and skills to excel in each of our roles, SingHealth has in place numerous educational and training programmes for all groups of staff and will continue to expand our educational armamentarium for the many opportunities ahead.

DR EDWIN LOW Group Director, Strategic HR, SingHealth

I believe that we should always keep learning and we are never too old to learn – whilst I was doing my Masters in Public Health at the age of 41, I had many fellow students who were in their fifties to encourage me. Be inspired in your own learning journey by this issue’s special feature on our Education mission.

Group Director, Office of Academic Medicine, SingHealth

So join us on this exciting journey and see how YOU can contribute to our direction forward in the journey of Academic Medicine.

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PULSE OF SINGHEALTH 2010

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PULSE OF SINGHEALTH 2010 BUILDING ON OUR FOUNDATION, INVESTING IN OUR FUTURE

SingHealth GCEO Prof Tan Ser Kiat

GCEO Prof Tan Ser Kiat delivered the annual staff address, Pulse of SingHealth, on 13 October 2010 at the MOH Auditorium. In the address, Prof Tan brought us back to the early days of SingHealth’s journey and shared more about plans in Academic Medicine. s SingHealth celebrates our 10th anniversary, it’s time to take stock of our decade of achievements.

Most would agree we’ve come very far. In just ten years, we have established new standards of care.

All the hospitals in the SingHealth cluster are JCI-accredited and we have etched numerous firsts in the medical annals, such as Asia’s first heart and liver double transplant and the first stem cell transplant following the introduction of the

Singapore Cord Blood Bank – the only public cord blood bank in Asia.

the single-minded commitment to serving our patients better.

In research, we have clinched many international awards and embarked on many clinical trials that have benefitted patients. On the education front, we have continued our strong teaching legacy, a role which has been amplified with our partnership with Duke-NUS.

As we celebrate our coming of age, we also mark the start of our journey towards becoming a leader in Academic Medicine with a strategic partnership with the Duke-NUS Graduate Medical School. In a way, it’s fitting that we commemorate the event by renewing our commitment to our mission and vision, which have been repackaged for greater impact.

Across the cluster, our current staff number stands at 20,000 strong, double what we had ten years ago, all sharing

WHAT is Academic Medicine?

In simple terms, Academic Medicine refers to medicine practised in academically oriented hospitals, where research is pursued not as an end in its own right but to enable better patient care and teaching.

WHY Academic Medicine?

Our Pursuit of Academic Medicine is to Improve Patient Care and aims to achieve: ➥ Continuous improvement in clinical outcomes ➥ Uplifting of healthcare standards and quality ➥ Improvement in general health and well-being of the population Typically, Academic Medical Centres consist of medical schools and their closely affiliated or owned clinical facilities and professional schools. There are approximately 125 such complexes in the US. SingHealth’s partnership with Duke-NUS forms the catalyst for our growth into Academic Medicine.

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PULSE OF SINGHEALTH 2010

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OUR MISSION IN SIX STRATEGIC THRUSTS

SERVICE

C Capability & Capacity Building

EDUCATION

H Holistic & Integrated Care

A Academic Clinical Divisions

RESEARCH

R

G

Residency & Education Initiatives

Grow & Deepen Research

E Excellence in All We Do

CHARGE! FORWARD INTO A NEW DECADE OF GROWTH Aptly describing SingHealth’s approach towards the next ten years, the acronym crystalises our direction forward.

CAPABILITY & CAPACITY BUILDING

RESIDENCY & EDUCATION INITIATIVES

New Leadership Development Framework Becoming an employer of choice Filling manpower gaps

HOLISTIC & INTEGRATED CARE

Build on our strong teaching legacy Attract best young talents and retain top minds in Medicine Faculty development to build competency Success in the ACGME-I accreditation on 26-29 October 2010

Appropriate siting of care Support Age Friendly Care programmes 1 Patient, 1 Record Integration of Care Services Establishment of SingHealth Comprehensive Transplant Centre

ACADEMIC CLINICAL DIVISIONS

Academic pursuits and clinical success are synergistic and interdependent Roll out over 9 – 12 months Faculty appointments at Duke-NUS Recognition & reward for performance in all areas Bring out synergies across our triple mission for best outcomes for patients

GROW & DEEPEN RESEARCH

Grow careers of researchers and increase share of research grants Partnering Duke-NUS from basic research to translational medicine and clinical trials Strengthen industry collaborations Create a vibrant culture of academia and scientific curiosity

EXCELLENCE IN ALL WE DO

Everyone a Quality Champion and driving quality improvements through the EPIC programme Achieve International Benchmarks and JCI Accreditation Reward excellence through awards – launch of the Singapore Health Quality Service Award (Jan 2011) and the SingHealth Excellence Awards (Mar 2011)

LEADERSHIP DEVELOPMENT FRAMEWORK A Leadership Development Framework will be put in place, linking leadership training and leadership competency gaps. A systematic approach will ensure that we have the right people in the right job at the right time.

COMPETENCY ASSESSMENT ➥ 360 degree feedback on employee leadership behaviour DEVELOP TALENT POOL ➥ Common learning roadmap for supervisors to better plan training for staff

LEARNING ROADMAP ➥ Organisational Leadership Programme (OLP) for senior management ➥ Performing Leadership Programme (PLP) for new and upcoming HODs ➥ Emerging Leadership Programme (ELP) for emerging leaders

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PULSE OF SINGHEALTH 2010

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EVERYONE HAS A ROLE IN ACADEMIC MEDICINE ACADEMIC CLINICAL DIVISIONS The SingHealth & Duke-NUS partnership brings new synergies to academic pursuits and clinical success. Joint appointments enable a cross-fertilisation of ideas and expertise while the newly formed Research and Education Institutes will cut across academic departmental structures for shared objectives and resources.

Duke-NUS Board

SingHealth Board

Academic Medicine Oversight Council

Academic Medicine Executive Committee

Medical School (Education)

SingHealth Institutions (Health Services)

SingHealth & Duke-NUS Joint Appointments

CLINICIAN CAREER MODELS

➥ Focuses on Clinical Excellence ➥ Dedicates at least CLINICIAN 90% of time for PRACTITIONER clinical practice

Clinician Investigator ➥ Focuses on clinical research excellence ➥ Dedicates between 10%-50% of time or research

➥ Clinical and Teaching Excellence CLINICIAN EDUCATOR

➥ Dedicates at least 30% of time for teaching

CLINICIAN RESEARCHER

Clinician Scientist ➥ Focuses on research excellence ➥ Dedicates between 50% or more of time for research

Teaching continues to be part and parcel of every clinician’s responsibility BETTER QUALIFIED NURSES IN EVERY TRACK REDEFINING ROLES OF NURSES IN ACADEMIC MEDICINE: ➥ strengthen career tracks in nursing education, clinical specialisation and research ➥ increase career advancement opportunities to become Nurse Educators, Nurse Clinician, Nurse Managers, Advanced Practice Nurse ➥ enhance pay for degree-qualified nurses

Director of Nursing Level 3

Level 2

Level 1

Asst Director (Mgt)

Asst Director (Edu)

Advanced Practice Nurse*

Senior Nurse Manager

Senior Nurse Educator

Senior Nurse Clinician

Nurse Manager

Nurse Educator

Nurse Clinician/APN

Management

* Masters in Nursing (Clinical)

Education

Senior Staff Nurses & Staff Nurses

Clinical

Staff Nurse Ethel Lim, SGH, with patient, Mr Dudley Dragon

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PULSE OF SINGHEALTH 2010

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ALLIED HEALTH CAREER TRACKS ATTRACTING & RETAINING TALENT IN THE ALLIED HEALTH PROFESSIONS ➥ By investing some $7 million through our Talent Development Fund and MOH Reinvestment Fund in scholarships for Allied Health staff ➥ Through the Health Manpower Development Programme

EXPANSION OF CAREER TRACKS ➥ Widen opportunities for growth and movement into specialty areas

Ms Ho Jia Lei, Radiographer, NNI and Ms Valerie Ann Manlapaz, Medical Technologist, NHCS

Clinical Generalist/ Management

Clinical Specialist

Clinical Research

Clinical Education

Advanced Tier AHP Manager

Advanced Tier AHP Specialist

Advanced Tier AHP Research

Advanced Tier AHP Educator

PhD or Equivalent for researcher only

Principal AHP I/ Manager Principal AHP I/ Manager Principal AHP II/ Manager

Principal AHP Researcher I

Principal Specialist AHP I Masters’ or Equivalent

Principal AHP Educator I

Masters’ or Equivalent

Principal Specialist AHP II

Principal AHP Researcher II

Principal AHP Educator II

Service AHP I

Service AHP II

Visit the ePulse of SingHealth multimedia microsite to tune in and download the full GCEO’s staff address and videos on what the vision and mission mean to our staff http://mysinghealth/epulse2010

AHP I

AHP II

RENEWING OUR COMMITMENT symbolic launch of abridged vision & mission

Email feedback and comments to gceo@singhealth.com.sg Look out also for your commemorative Post-it pad for every staff!

Vision: Defining Tomorrow’s Medicine

For the symbolic launch of the abridged Vision and Mission, we commissioned a young, up-andcoming local artist, Justin Lee, to create an interactive work of art with our SingHealth leaders.

Justin’s artistic style synergises heritage and tradition with aspirations for the future.

Mission: Care to Heal, Educate to Empower, Innovate to Advance Artist Justin Lee, Chairman of SingHealth Peter Seah, and DCEO Prof Ivy Ng

BY MONICA LIM

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AN

EP C IN THE

MAKING

BY MONICA LIM AND ARTHUR WONG

The EPIC programme will combine existing quality initiatives under one single umbrella for more integrated outcomes that will benefit patients. uality improvement efforts are not mere frills in healthcare institutions – they can mean the difference between life and death.

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on the entire system and process in the hospital. EPIC brings about larger scale, more impactful changes that improve this system for our patients,” she says.

We all know that quality has always been a hallmark of the SingHealth Group. But now, there are plans to take it even further. The catalyst for this is aptly named EPIC, which stands for Enhancing Performance, Improving Care.

Everyone can be a champion of quality. EPIC covers three different levels of training, including EPIC Champion for Heads of Departments, EPIC Professional and EPIC Implementer.

Championed by A/Prof Daphne Khoo, Director of the SingHealth Clinical Governance & Quality Management (CGQM) department, the EPIC programme is a concerted effort to embrace all quality schemes and training under one umbrella for more integrated outcomes.

For A/Prof Khoo and her team, EPIC was formed to serve one main purpose.

“In Healthcare, our ultimate goal is to benefit the patients. And their experiences are really dependent

EPIC Implementer is an evolution of the current Clinical Practice Improvement Project (CPIP) into a more holistic approach. The new model of improvement does not limit the solution to just one method and it enables the team members to better understand the different facets of the project.

New improved modules have also been introduced into the EPIC Professional programme, which includes W.E. Deming’s System of Profound Knowledge - Understanding Variation and Psychology; System Thinking and

Theory of knowledge - Model for Improvement; Statistical Process Control for analysing data; Strength Deployment Inventory; Ladder of Inference; Edward de Bono’s Six Thinking Hats and Lateral Thinking.

EPIC plans to train 100 to 150 participants a year.

Meanwhile, CGQM also hopes that more will come to understand how EPIC can achieve more impactful outcomes and on a larger scale in driving the quality movement for the SingHealth Group.

Engaging the expertise of the Associates in Process Improvement (API), the EPIC programme got off to a good start with its maiden EPIC Professional training completing its run in September this year following a successful EPIC Implementer training earlier in May. API is an American group of improvement consultants who conduct the Institute for Healthcare Improvement’s Improvement Advisor course and are author of “The Improvement Guide”.

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EPIC PROGRAMME STRUCTURE

EPIC CHAMPION

EPIC PROFESSIONAL

EPIC IMPLEMENTER

EPIC IMPLEMENTER (EI): This three-day course equips staff with the tools and techniques to implement quality projects, as well as help them understand and contribute to the quality culture within SingHealth.

As an added resource, by November 2010, a pocket guide will be produced and distributed to Heads of Departments and staff who have undergone quality training, as a handy reminder of quality tools and techniques.

The driving force for EPIC is Andrew Tan, Manager of CGQM. He and his team have come up with a three-year road map for the programme and have been hard at work spreading the importance of enhancing performance and improving care.

EPIC PROFESSIONAL (EP): Trains improvement professionals to be teaching faculty and quality ambassadors, as well as to drive quality programmes and facilitate quality projects.

He clarifies why he is so passionate about quality.

“I joined SingHealth CGQM because our contribution to quality is related to a human life. That is what really counts.”

And with the effort put in by him and his team at CGQM, the EPIC programme hopes to bring about new innovations from SingHealth professionals that will improve the level of healthcare received by our patients.

EPIC CHAMPION (EC): Helps Heads of Departments understand the overall programme structure, learning roadmaps, methodologies and roles to instill a positive quality culture within SingHealth.

For more information on SingHealth quality improvement training, kindly contact: SH.CGQM@singhealth.com.sg

“I joined SingHealth CGQM because our contribution to quality is related to a human life. That is what really counts.”

– Andrew Tan, Manager, CGQM

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IMU TO ADVANCE CL N CAL

RESEARCH

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t is an undisputed fact that clinical trials are important for the discovery of treatment for diseases and for new drug developments.

With the current global trend that gives more and more focus to the East, Asianbased research becomes more significant.

Previously, early phase medical research had largely taken place in US and Europe, which means the results tend to be skewed towards developed countries with a Caucasian patient base.

In a giant leap forward for research, the S$20m SingHealth Investigational Medicine Unit (IMU) was launched on 30 July 2010 by Minister for Health Mr Khaw Boon Wan at SingHealth. IMU is the largest early phase clinical research unit in Singapore, with trained specialist staff, a dedicated 32-bed facility including two beds in DukeNUS’ Chronobiology Lab, the first in Southeast Asia.

IMU allows more synergy between clinical care, research and innovation in SingHealth. Since doctors at hospitals participating in clinical trials have to be at the

forefront of their medical specialty, it stands to reason that patients treated at these hospitals receive better care and achieve better health outcomes, something that has been borne out of a 2008 US study. In addition, patients who have not responded to any other forms of treatment can access trial treatments or new treatments that have emerged from clinical trials.

IMU has several advantages, not least of all, the high quality of research and expertise of researchers at SingHealth. With over 40 medical disciplines and high patient numbers across SingHealth institutions, as well as a ready pool of 1,000 healthy subjects in the volunteer database, IMU has a robust support framework for conducting clinical studies.

IMU offers a conducive platform for the development of thought leadership among clinicians by giving them the opportunity to grow a deeper understanding of their chosen specialty. Sue Tee, Director of Clinical Trials Development at SingHealth details the type of support IMU gives to clinicians,

BY MONICA LIM

Sue Tee (centre), Director of Clinical Trials Development, with the IMU team

“Besides the physical facilities, IMU provides manpower support such as Clinical Research Coordinators and Research Nurses. This relieves much of the coordination and administration work from investigators, allowing them to focus on their research.

We hope that more investigators will recognise the benefits and run their trials through IMU.” As Prof Soo Khee Chee, SingHealth Deputy CEO (Research & Education) succinctly put it, “This collaboration will enable us to fulfil Singapore’s mission of being the preferred research partner to global pharmaceutical companies and contract research organisations.

Overall, the IMU’s goal is to nurture local academic research that will shape tomorrow’s medicine.”

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me+SH speaks to two clinicians from the Department of Medical Oncology, National Cancer Centre Singapore (NCCS) - Dr Daniel Tan, Associate Consultant and Dr Choo Su Pin, Consultant - to find out their take on the recent establishment of IMU. WHAT DOES THE IMU MEAN FOR YOU AS CLINICIANS? Dr Choo: It’s excellent because now we have access to a dedicated Phase-1 setup within a hospital with beds and staff available. We have been doing Phase-1 trials for a while in a general chemotherapy unit but that is not the ideal setup as we couldn’t really provide the extra monitoring that Phase-1 patients need.

Dr Tan: It provides us with a platform to run trials of higher complexity because we can coordinate blood investigations, novel imaging techniques and biopsies. This facility gives us assurance to resource intensive trials.

DO YOU CURRENTLY HAVE ONGOING CLINICAL TRIALS IN THE IMU? Dr Choo: I have two phase-1 trials, testing the combination of existing medication and new cancer drugs for the first time.

The patients require intensive monitoring and are required to stay under IMU’s observation for drug reactions and blood tests.

Dr Tan: A trial on drug combination is about to start. It has been under

Dr Daniel Tan, Associate Consultant, DMO, NCCS

discussion for the past year, and draws together expertise from NUS, Duke-NUS, SGH, our industry partners and NCCS. I anticipate more trials in the coming months and hope to keep the momentum.

IN YOUR EXPERIENCE CONDUCTING TRIALS BOTH OVERSEAS AND LOCALLY, WHAT ARE THE OBVIOUS ADVANTAGES OF SINGAPORE?

Dr Choo Su Pin, Consultant, DMO, NCCS

multidisciplinary teams and a wide range of specialty services. With supportive regulatory and funding bodies, coupled with the exciting opportunities in drug development as well as the efficient healthcare system, we are uniquely positioned to develop early phase trials as a niche area.

Dr Choo: Because everything is within reach in Singapore, we can get things done quickly. Specimens are at most transported between, say, SGH to NUH, which is only a 15-minute drive.

We should maximise and capitalise on these strengths and establish better collaborations.

“With supportive regulatory and funding bodies, coupled with the exciting opportunities in drug development as well as the efficient health care system, we are uniquely positioned to develop early phase trials as a niche area.”

Dr Tan: We have excellent

-Dr Daniel Tan, Associate Consultant, NCCS

IMU is located in Singapore General Hospital Block 7, Level 7.

It consists of 30 licensed hospital beds, 2 chronobiology laboratory suites, 3 consultation rooms, screening rooms, and 7 dedicated clinical trial coordinators and research nurses.

In September 2010, there were 18 ongoing clinical trials in IMU and 3 have been completed. There are 5 more to start soon.

40% of trials in IMU were investigatorinitiated and led by local clinician-scientists.

IMU IN NUMBERS

1000 healthy volunteers are currently in the IMU database.

As at September 2010 there were 17 Principal Investigators conducting trials in IMU.

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Dispensers f Kn w edge

BY MONICA LIM

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f you think that pharmacists merely dispense medication, think again. In today’s context, pharmacists contribute to patient care with their invaluable medical knowledge as teachers, researchers, counsellors and service deliverers.

With this enlarged job scope, it became necessary to put in place a more comprehensive model of training and development to ensure that pharmacists are able to remain proactive and relevant in their profession.

In April 2009, a new pharmacy competency framework was launched at SGH in response to these evolving needs. Adapted from the Competency Development & Evaluation Group (CoDEG), a network of researchers, practitioners and academic pharmacists, the General Level Framework (GLF) has been used in the UK, Europe and Australia

and validated in hospital and community practice.

What sets the GLF apart from other development models is its systematic way of documenting service delivery and performance of junior pharmacists. Pharmacists receive peer assessments across four groups of competencies, namely Delivery of Patient Care, Clinical, Professional and Research. They are graded on a four-point scale for each competency, forming a measurable gauge of performance.

A baseline assessment is done at the start of the junior pharmacist’s career at SGH, after which an assessment is done every four to six months. The results speak for themselves - from June 2009 to April 2010, the proportion of pharmacists who had met more than 75% of standards rose from 52% to 89%.

“GLF is a whole teaching structure. It allows for development needs to be identified and training to be customised for specific individuals.”

– Mr Lim Mun Moon, Deputy Director, SGH Pharmacy

Across all major competencies, average standards increased.

According to Mr Lim Mun Moon, Deputy Director of Pharmacy at SGH, the GLF does not just bring about a more structured form of appraisal.

“GLF is a whole teaching structure.

It allows for development needs to be identified and training to be customised for specific individuals.”

Each clinical group is mentored by preceptors who are senior pharmacists at SGH. Junior staff rotate to a different clinical group every four months, allowing them to acquire in-depth knowledge while under supervision. Those not meeting the grade are monitored and provided with the necessary guidance. This is in contrast to the old system where junior staff learn on the job from their seniors in an unstructured manner.

Mr Lim Mun Moon, Deputy Director, SGH Pharmacy

After two years, when a junior

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pharmacist is found to have consistently met competency standards, he or she will move on to the Advanced Level Framework (ALF) which also lays down a comprehensive set of guidelines aligned to pharmacists’ career pathways. For instance, if one wanted to pursue a Pharmacy Clinician-Scientist track, one would

need to attain Mastery level in Leadership and Research whereas the Pharmacy Practice Manager track requires a Foundation level in Research but a Mastery level in Building Working Relationships.

The response to the new system has largely been positive, with most pharmacists welcoming the focus on

learning and development. In fact, all of the other institutions in the SingHealth cluster have adopted the GLF and ALF. For Mr Lim, the benefits of the new framework are clear. “We are able to achieve more consistent levels of practice which translate into better and safer care for patients.”

GENERAL LEVEL FRAMEWORK (GLF) DELIVERY OF PATIENT CARE COMPETENCIES Patient Consultation Gathering Information Provision of Medication Drug Specific Issues Discharge Facilitation & Patient Education Risk Management & Service Improvement

CLINICAL COMPETENCIES Knowledge Problem Solving

PROFESSIONAL COMPETENCIES Personal Working as part of a team RESEARCH COMPETENCIES Critical Evaluation Identifies gaps in the evidence base Research evidence into practice

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SingHealth Inspirational Patient Award 2010

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FATHER KNOWS BEST

BY CONSTANCE NONIS

fter learning that he had diabetes in 1993, Mr Khoo Kay Lock became a changed man.

With the support of his elderly father who also has diabetes, Mr Khoo made many changes to his life to turn his health around.

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He has kept his illness under control – the successful outcome of a strict diet and exercise that he wants to share with other people suffering from diabetes.

According to Senior Staff Nurse Woo Yuen Kau of Bedok Polyclinic, Mr Khoo’s willingness to share his experience with other newly diagnosed patients at the Diabetic Support Group of Bedok Polyclinic has been viewed positively by other patients. “Not only did the other newly diagnosed patients relate to how he felt and thought when he was first diagnosed, they were also encouraged by his stories of how

he has adopted a new lifestyle. His experience is an impetus for them to take control of their own medical condition,” she said.

Just as some new patients have difficulty accepting the diagnosis that they have diabetes, Mr Khoo similarly reacted to his diagnosis in 1993 in disbelief.

However, his father was a great source of comfort.

Also suffering from diabetes, his father assured him that having the disease wasn’t the end of the world, and that it could be controlled with proper diet and exercise.

Encouraged, Mr Khoo, who used to eat whatever and whenever he liked, began to be more careful about his food. He no longer ate two bowls of rice. Most difficult for him, though, was having to give up drinking alcohol which can cause blood sugar to rise. It was an activity

that the former taxi driver shared with his friends.

But his sacrifices paid off. Not only did he manage to overcome the initial setback, he has also been able to keep his illness under control.

“Not only could the other newly diagnosed patients relate to how he felt and thought when he was first diagnosed, they were also encouraged by his stories of how he has adopted a new lifestyle. His experience is an impetus for them to take control of their own medical condition.”

– Senior Staff Nurse Woo Yuen Kau, SingHealth Polyclinics – Bedok

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HE

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TRANSPLANT

Lynchpin Kerk Ka Lee is a transplant coordinator at the National Heart Centre Singapore. And she is at the centre of the heart transplant process.

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o see warm blood course into the chambers of a newlyimplanted heart, and to see it slowly come to life as it starts beating, is always a magical moment.

For Ms Kerk Ka Lee, however, it is just the middle milestone in a long but satisfying process.

As Manager of Heart and Lung Transplantation at the National Heart Centre Singapore (NHCS) - which is the only place where you can get a heart transplant done in Singapore - she is responsible for ensuring that proper evaluation of the heart and the patient is carried out before the transplant, and that the patient is well taken care of after the procedure.

In Singapore, heart diseases are among the top three causes of hospitalisation, and one out of three deaths here are due to heart disease or stroke.

it is, I then alert the team.”

She also has to inform the organ recipient. “Sometimes I may not have the luxury of time to wait for the test results, and see if the organ is suitable. So I will call the recipient, tell them to go to the hospital and wait.”

It can be said that she is the administrative pin who holds the different pieces of the transplant fabric together.

Typically, about 20 medical staff are activated in a singleorgan transplant procedure and meetings are held before every transplant to run through the process. “A transplant is really a multi-disciplinary team effort,” said Ms Kerk.

She also does coordination for lung transplants and helps to monitor patients who may be on the waiting list for a donor heart and are using mechanical hearts in the interim.

Ms Kerk’s job involves mobilising the different parts of the transplant team, including surgeons, nurses, pharmacist, anaesthetists, once she learns that there is a donor heart available.

Starting out as a nurse, Ms Kerk became a transplant coordinator and joined the Heart/Lung Transplant Programme at NHCS in 2002 when she decided she wanted more regular working hours instead of having to work shifts.

Calls can come in at anytime, including in the middle of the night.

The unit gets about 30 donor calls a year. “When a call comes, I have to make arrangements to investigate the heart or lung, to see if it’s suitable. If

She has found the job immensely fulfilling. Unlike when she was a nurse, she keeps tabs on transplant patients even after they leave the hospital, and sometimes they call her up to ask her for health advice.

Ms Kerk Ka Lee and the Heart-Lung transplant team

“For them it’s a long road to recovery which also involves lifelong medication and compliance to an active lifestyle,” she said.

She added: “These patients awaiting transplant, when they come in, are really very sick.” A transplant is only offered as the last option when medical therapy fails. “Sometimes, while waiting for a transplant, we lose the patient.”

“So to see their health restored, walk out of the hospital and go back to society to work, makes me feel very proud.”

In July 2010, SingHealth started efforts to align all our transplant programmes into one integrated service.

Learn more about SingHealth's Comprehensive Transplant Services at www.singhealth.com.sg/PatientCare/SingHealth-Transplant

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EYE ON

EDUCATION

BY MONICA LIM

ducation is one of SingHealth’s three pillars of excellence, and at the Singapore National Eye Centre (SNEC), it is being refreshed and prioritised with the recent restructuring of its Training and Education (T&E) arm.

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The man at the helm of the department, Dr Ian Yeo, expounds: “The pillar of education is often overlooked because it doesn’t have any direct output. Yet, it is significant because it feeds into the other two pillars of clinical and research. Without trained professionals, we won’t have quality clinical care or research outcomes.”

SNEC is already widely considered as the premier eye centre in Southeast Asia, employing about two-thirds of the nation’s eye doctors. In terms of T&E, it offers an attractive proposition combining some of the best surgical and training facilities with a strong clinical team spanning all ophthalmic subspecialties.

Dr Yeo, who is also a Senior Consultant in SNEC’s Cataract and Comprehensive Ophthalmology Service, hopes to strengthen the focus on training and education further so that SNEC can

continue to be a source of eye care experts for generations to come. With its staff strength increased from two to eight, the department has taken sure and steady measures in preparation for the tasks ahead.

MAKING LEARNING MEANINGFUL The biggest change that the SNEC will be facing is the impending revised Ophthalmology Residency Program commencing in July 2011. The move to a program guided by the Accreditation Council for Graduate Medical Education International (ACGME-I) will see significant shifts in the curriculum and pedagogy, including a more structured training framework, emphasis on formative and summative assessments throughout the year, as well as more interaction and engagement between the trainer and the resident.

At the heart of the five-year Residency Program is a more personalised teaching process which can only result in more meaningful education for the

Dr Ian Yeo (centre), head of Training & Education Department, SNEC

residents, something that Dr Yeo is all for.

For a start, the Residency Program will have an intake of five to six residents a year and gradually increase over time. Meanwhile, efforts are underway to beef up the talent pool supporting the Residency Program, including the recruitment of resident-physicians and service registrars, to free up time for doctors, allowing them to concentrate on their subspecialties and teaching responsibilities.

No stone will be left unturned.

Doctors will participate in ongoing training to learn how to teach under the purview of ACGME-I, covering areas such as learning objectives, assessment and ranking methods.

Eventually, the goal is to have over 30 dedicated doctors on the core and teaching faculty of the Residency Program, providing a comfortable oneto-one doctor-resident ratio.

After completing their residency, the T&E department will assist the residents in their subspecialisation fellowship choices. This is where the doctors hone their skills in their chosen subspecialty, either locally or overseas. The T&E department will continue to engage the doctors while they are away and also help prepare for their eventual return to the centre.

This is something Dr Yeo treats with utmost gravity. He says with conviction, “I don’t believe there is a lousy doctor, just an unguided one. If we can understand the individual ability of each doctor, we can nurture them to an appropriate role in SNEC.”

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Vibrant Campus

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changing legacy of teachers. For him, seeing his residents do well is most gratifying, to know that he has done his part in preparing them.

This is no lip service – when he was just a registrar, he did not want his juniors to struggle like he did and went the extra mile to teach them on his own time. For his efforts, he was pleasantly surprised by the SNEC Best Teacher Award in 2001 and remains the youngest recipient of the award to date.

KNOWLEDGE-SAVVY, TECH-SAVVY Fully embracing the philosophy that learning should be continuous and lifelong, the T&E department also facilitates a wide spectrum of education activities under the banner of “CCC” which stands for Continuing Medical Education (CME), Courses and Conferences. From the extensive subspecialty courses and lectures by specialists to international meetings and symposiums, these programmes underscore the reputation SNEC has cultivated as a centre with a breadth and depth of ophthalmic expertise unmatched by many.

leveraged to reduce the administrative workload and improve productivity. It has also been called on to bridge the generation gap. By enlisting popular social networking applications such as Facebook and Twitter to attract residents, the T&E department is staying relevant to a generation that has grown up in a tech-savvy world.

TRANSFORMING LIVES American historian and author Henry Brooks Adams once said, “A teacher affects eternity; he can never tell where his influence stops.” From speaking with Dr Yeo, it is clear that he believes whole-heartedly in the potentially life-

Majority of the participants are from regional countries looking to upgrade their knowledge and skills, while some are local eye doctors keen to study the latest technique or usage of new equipment. As part of their outreach efforts, SNEC sends doctors to countries such as Indonesia and Vietnam to teach their peers and share knowledge, incentivising collaboration between neighbours.

The responsibilities of the T&E department do not end there. It supervises all who walk SNEC’s hallways to learn, whether they are clinicians, doctors or medical students on attachment, overseas students undergoing their electives, or students on observations. On top of that, the department also handles all the dayto-day administrative duties involving residents, such as rounds and call rosters covering the wards, clinics and Ophthalmology A&E. IT is a valuable enabler and has been

Today, this affable head of department has an open-door policy and insists on being called “Ian” by everyone, his rationale being that all the doctors will become senior consultants one day.

Leading by example, he dedicates some 50% of his time to teaching and he hopes he can help shape the culture of teaching and nurturing in SNEC. “We all remember fondly some clinician who taught us”, Dr Yeo explains his dedication, “and we’re all here today in some way because of our teachers. In the same light and tradition, I want SNEC to build its academic foundation so that it can continue to groom future generations of outstanding ophthalmologists.”

TRAINING AND EDUCATION

Residency Program

Fellowships (local and overseas)

Attachments, observations, electives

Administration (call roster, rounds)

CME, Courses, Conferences

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TRANSFORMING

THE FACE OF

EDUCATI N

BY MONICA LIM & WONG SHER MAINE

In our pursuit of Academic Medicine in partnership with Duke-NUS, education has received an added boost at SingHealth. We speak to three drivers of education in SingHealth to find out their take on the role of education in SingHealth’s Academic Medicine journey.

“TEACHING IS A WAY FOR DOCTORS TO GIVE BACK TO THE COMMUNITY.” – PROF COLIN SONG Group Director, Education and SingHealth Designated Institutional Official, SingHealth Residency Head & Senior Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery, SGH

M

edical education at the SGH campus dates back over a century to 1905 when Singapore’s first medical school, the King Edward VII School of Medicine, was established. From 1982 however, this formal medical education was shifted to Kent Ridge under the purview of NUS Faculty of Medicine and over the years, a perception that teaching was secondary to clinical work started to develop.

For Prof Colin Song, the establishment of Duke-NUS at the SGH campus in 2007 heralded a long overdue revival of medical education at SGH. “Teaching is part of our heritage,” he explains. “Every doctor has the innate ability to teach since we all have to help educate patients about their health.

We just need to draw out these natural abilities and rediscover the importance of teaching.”

A new milestone in SingHealth’s learning journey is the launch of the SingHealth

Residency Program. It is a departure from the traditional one in that it has a formalised teaching structure and is characterised by ongoing assessments.

The program trains doctors in six competencies – patient care, medical knowledge, practice-based learning & improvement, interpersonal skills and communications, professionalism, and systems-based practice. SingHealth also added a star competency: Faculty Development.

After every rotation, there is a formative assessment of the resident, which enables progress to be regularly tracked.

Those found not meeting expectations can be easily identified and helped with remediation.

There are currently 14 Residency Programs, each comprising a Program Director, Core Faculty Members and Physician Faculty Members who each dedicates a certain amount of time to teaching. A Program Coordinator helps with the administration.

The SingHealth Residency Program also offers a formal framework for faculty development as well as for residents, which was not as well established in the old system, to recognise the teaching contribution of the faculty staff. Doctors undergo teaching competencies training, and are directly compensated for their teaching time, as they meet clearly laid out KPIs. Faculty development is also a means to meet educational demands in terms of new developments in teaching and training of the future health care providers requiring a higher order of skills and to be valuable contributors to our pursuit to be a leader in Academic Medicine.

The partnership with Duke-NUS is a necessity that allows us to understand residency training in depth and get guidance from our Duke University partners in developing a topgrade Residency Program for SingHealth.

This has generated renewed interest in education among doctors, much to Prof Song’s delight. “It’s encouraging to see how many doctors have indicated a passion for teaching,” he says with obvious enthusiasm. “The scale of our operations is limited only by our imaginative collectivity. With a fresh injection of ideas, we can set new standards for medical education.”

WHO HAS INSPIRED YOU IN YOUR OWN LEARNING JOURNEY? This would have to be the late Professor Bert Myburgh, Head of Surgery at University of the Witwatersrand group of teaching hospitals in Johannesburg, my alma mater. His lecture style was so captivating that his classes were always well attended. He was very well read and I was inspired by how he seemed to always have some new information to share. He made such an impact on me that he became my role model, and I continually aspire to acquire new knowledge to pass on.

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“EDUCATION IS THE TOOL FOR CHANGING MINDSETS. IT EMPOWERS.” – DR EDWIN LOW Group Director, Office of Academic Medicine, SingHealth Group Director, Strategic HR, SingHealth Visiting Consultant, Hyperbaric & Diving Medicine Centre, SGH

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cademic Medicine is a buzzword that has permeated SingHealth of late, but what is it really? To put it simply, it is the integration of education and research with clinical service to improve healthcare.

The focus on education and research is what differentiates Academic Medicine from traditional medicine which had typically emphasised clinical service above all else.

Dr Edwin Low, Group Director, Office of Academic Medicine and Group Director, Strategic HR, explains: “The pursuit of Academic Medicine is a journey. It is not education and research for their own sake but for better patient care.”

“The scale of our operations is limited only by our imaginative collectivity. With a fresh injection of ideas, we can set new standards for medical education.”

– Prof Colin Song

The vehicle for education under the Office of Academic Medicine is the SingHealth Academy, which Dr Low regards as the change agent for SingHealth, leveraging on education to build up staff competencies.

The Office of Academic Medicine also steers SingHealth’s partnership with Duke-NUS, a collaboration that has yielded great synergies, forged by shared values and objectives for research, education and Academic Clinical Divisions (ACD). The ACD, which will be rolled out over the next one year, lays the foundation for the Academic Medicine journey at SingHealth.

The Leadership Development Programme is another important complementary initiative that has been introduced to equip people to lead and show them how they can play a role in SingHealth’s vision for Academic Medicine. In Dr Low’s eyes, everyone is a leader. He quips, “whether you are leading a project or a department, you have to make decisions on how to motivate, how to work in a team, how to resolve conflicts and so on.” Comprising three levels of courses - Emerging Leadership (ELP), Performance Leadership (PLP) and Organisational Leadership (OLP) - the Leadership Development Programme helps

“The pursuit of Academic Medicine is a journey. It is not education and research for their own sake but for better patient care.”

– Dr Edwin Low

equip staff with leadership skills at a level that is appropriate to their roles and responsibilities.

For Dr Low, the biggest challenge in the pursuit of Academic Medicine is to instill the very critical spirit of inquiry in all SingHealth staff.

“Academic Medicine involves everyone in healthcare, whether it is doctors, nurses, allied health staff or administrators,” he asserts. “We need to help everyone understand and support what we are trying to achieve, and see the value of ongoing training and improvement towards this goal.”

WAS THERE ANY PARTICULAR TEACHER WHO INSPIRED YOU? I was in the UK training for my anaesthesia exams which typically had a low passing rate of about 25%. During the year I was there, an RAF obstetric anaesthesiologist consultant volunteered to set up a course for us trainees about to sit for the Part 3 exam. Every morning at 7.30am, he would set us mock papers and drilled us on exam techniques.

That year, seven out of eight students passed the exam, an unprecedented number. It just takes one doctor to make a difference.

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“HEALTHCARE EDUCATION CONTINUES TO CHANGE RAPIDLY AND WE HAVE TO CHANGE OUR METHODS OF TEACHING FOR BETTER OUTCOMES.” – MR TAY SIN HWA Director, SingHealth Academy

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hen Mr Tay Sin Hwa took over the reins of SingHealth Academy on 1 July 2010, he found that it was organising numerous training programmes and events but there was a lack of focus. Mr Tay expounds, “We need to remember that SingHealth Academy is here to contribute towards SingHealth’s vision of Academic Medicine – our training and events need to reflect this.”

In a survey done in January 2010, 50% of staff and 60% of doctors indicated that their workload did not allow them the time to go for training. This is of huge concern to Mr Tay. If doctors and staff do not have time to upgrade their skills and keep up with the rapidly evolving advances in medical and healthcare knowledge, this could result in deteriorating clinical services and diminished capabilities.

This is where technology comes into the picture. SingHealth Academy’s five-year plan is to establish the ideal solution of blended learning, which is a multi-faceted combination of e-learning platforms and smart classroom methods to complement face-to-face teaching in a classroom setting.

Mr Tay envisions SingHealth Academy developing expertise and rapport with SingHealth educational institutes so that it can become the training institution of choice. To achieve this, staff double up as internal consultants to manage accounts and serve the institutions as project experts. In this manner, Mr Tay hopes to provide more proactive and personalised service which would include being able to assess the needs of each institution and deliver the right tools, whether they be customised training, publications, or even in-house designed programmes.

“SingHealth Academy and our partners work in unison to groom and nurture future generations of healthcare professionals, just as a good watch is passed down from generation to generation.”

“If staff do not have time to attend training, we must find a way to bring training to them,” persists Mr Tay.

His plan seems to be on the right track so far, with already some

SingHealth Academy is here to contribute towards SingHealth’s vision of Academic Medicine – our training and events need to reflect this.”

– Mr Tay Sin Hwa

institutions entrusting their training programmes to SingHealth Academy, so that they may be extended to more participants within the cluster.

“SingHealth is like a well crafted watch,” Mr Tay describes. “In order for a watch to keep perfect time, the many parts inside need to work together in precision. SingHealth Academy and our partners work in unison to groom and nurture future generations of healthcare professionals, just as a good watch is passed down from generation to generation.”

WHICH TEACHER INSPIRED YOU IN YOUR OWN LIFE? In secondary school, I hated chemistry and so developed a bad attitude towards it. No surprises that I did badly in the subject. Instead of admonishing me, my teacher Mr Ling approached me and gave me one-on-one lessons after school.

He was very patient and personalised all the concepts for me. It ignited my interest - I didn’t realise chemistry could be so interesting! I began studying in earnest and eventually did well in it. From there I realised that there are no poor learners, we just need great teachers.

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ESTHER LIM Head Medical Social Worker and Family Therapist Singapore General Hospital

Ms Esther Lim teaches at the SGHPostgraduate Allied Health Institute’s ASIST programme on how to help people who are suicidal.

T

forgiving, he was discharged, and a year later sent a card to Ms Lim with one poignant line written on it: “I’m still alive.”

The 40-something chief executive officer had landed himself at SGH after failed suicide attempts via drug overdose, alcohol poisoning and wrist slashing, because he had gambled and lost huge sums of money overnight.

It is a story Ms Lim, now Head Medical Social Worker and Family Therapist at SGH, often repeats to those she teaches at the SGH-Postgraduate Allied Health Institute (SGH-PGAHI). Lecturing on the topic of suicide intervention, she conducts two to three two-day training sessions in a year.

he patient was so determined to die. He told Ms Esther Lim that his only regret was that he did not make a deeper cut on his wrist.

Ms Lim, then a junior medical social worker, was unsure of what to do. At the time in 1995, about 30 suicidal patients turned up at the hospital every month. This was her first encounter with a suicidal patient.

“His tears kept falling,” recalled Ms Lim. “On a suicidal measurement scale of zero to 10, 10 being the most serious, I would have scored him a nine.”

Nothing that Ms Lim, who had previously attended a two-day suicide intervention workshop, said could change his mind. In desperation, she tried a different strategy.

“I asked him if he’s spoken to his wife about his debts so that she won’t blame herself after he dies.

“Since you have so made up your mind to kill yourself, there is no real hurry right?”

Ms Lim recounted.

It worked. The man’s wife proved

“It has been very satisfying to be able to help people who are on the frontline,” said Ms Lim. “Backed by the strong support from PGAHI, my team and I are able to focus on teaching, improve on the quality of it and to train more people in suicide intervention.”

The doctors, nurses, police officers, teachers and counsellors who attend her class all come across suicidal people in their line of work. Ms Lim, who attended a special suicide intervention course in Canada in 1999, teaches them how to help these people.

Satisfaction is when students - like a police officer who applied what she learnt in class to persuade a teenager to step away from a 15th floor ledge - tell her she helped them to save lives.

“She even thanked her police commander for sending her to the course!” said Ms Lim.

SGH - POSTGRADUATE ALLIED HEALTH INSTITUTE (SGH-PGAHI)

ABOUT THE ASIST PROGRAMME Applied Suicide Intervention Skills Training (ASIST) is an internationally recognised certificate training workshop.

Founded by LivingWorks Education Inc, Canada, ASIST is the most widely used, acclaimed and researched suicide intervention skills training in the world. Set in an interactive and practice-oriented learning environment, workshop participants acquire the essential skills to intervene and prevent the immediate risk of suicide. PGAHI has a local pool of experienced certified trainers who conduct this two-day workshop regularly.

SGH - POSTGRADUATE ALLIED HEALTH INSTITUTE (SGH-PGAHI) Established in 2003, SGH-PGAHI enhances patient care by providing courses for allied health professionals that either advance their specialist clinical skills training or bridge competency gaps for practice in Singapore for those recruited from non-traditional sources.

Annually, SGH-PGAHI offers more than 45 courses and at least 1200 training places across a comprehensive range of allied health disciplines. Course offerings include workshops, multidisciplinary symposiums, clinical attachments and Certification programmes. These courses are developed and taught either by SGH allied health clinicians or in partnership with external local and overseas faculty and established institutions. www.sgh.com.sg/pgahi

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ETHEL LIM Staff Nurse, Ward 45 (MICU) Singapore General Hospital

E

very medical professional has a story to tell of patients who make a profound impact on their lives. For Ethel Lim, 22, she will never forget a young cancer-stricken teacher on her deathbed who befriended her.

Studying in Australia proved to be lifechanging. Apart from having her first taste of truly independent living, the course was an eye-opener.

For Ms Lim, one of the highlights of the degree was the research module.

“Previously I did not know much about research-based work. In my time there I learnt a lot about how to enquire and methodically research topics”

“She was in her mid-20s, at the peak of her life, and had been teaching for a few months when cancer struck,” recalled Ms Lim, who was serving her Nanyang Polytechnic clinical attachment at the time. “She told me to do what I set out to do, and to finish it well. She The SingHealth never had the chance.”

The patient died. But her words cemented Ms Lim’s desire to go far in her chosen profession.

Alice Lee Institute of Advanced Nursing helped Ethel Lim to fulfil a dream.

With her passion in intensive care, Ms Lim’s knowledge from her degree came right into use back at the SGH MICU where she worked.

With her nursing diploma warm in hand, Ms Lim, who topped her polytechnic cohort two years in a row, quickly applied to the SingHealth Alice Lee Institute of Advanced Nursing (IAN) for a scholarship to study for a nursing degree in Sydney in 2009.

“When patients come, the nurses are the first line of contact. I now have the knowledge and skills needed to be confident when working in the ICU and with giving the best care that I can to my patients,” explained Ms Lim.

“I’m thankful that Prof Lim (Prof Lim Swee Hia, SingHealth’s Director of Nursing) is very supportive of continuous learning and gives us so many opportunities,” said Ms Lim. “I would not have been able to go without the scholarship, and with my financial worries taken care of I could fully concentrate on my studies.”

Ms Lim now plans to take up an advanced diploma in critical care. Ultimately, she wants to focus on training young nurses.

“I like teaching,” said Ms Lim. “In a way I was partially influenced by the teacher who died from cancer. Like her, I aspire to teach.

She didn’t have time to finish it, but I can.”

SINGHEALTH - ALICE LEE INSTITUTE OF ADVANCE NURSING (ALICE LEE IAN)

Established in 1997, SingHealth Alice Lee IAN is dedicated to enhancing nursing skills and promoting excellence in lifelong learning among nursing professionals.

It is the first institute of advanced nursing to be established in a hospital in Singapore.

Courses offered include Certification courses, Specialisation programmes, a Fellowship programme, and Nursing management courses up to postgraduate doctorates in Nursing. Educational tours to various countries are available for selected SingHealth nurses.

Clinical attachments and supervision are provided to nursing students from NUS, Nanyang Polytechnic, Ngee Ann Polytechnic, and ITE. It is a Workforce Development Agency (WDA) Approved Training Organisation for ancillary Healthcare providers.

SingHealth Alice Lee IAN is the first in Asia and only the third country out of the United States to be accredited by the Accreditation American Nurses Credentialing Centre (ANCC) as a Continuing Nursing Education Provider. The accreditation has been extended to February 2013.

Over 8200 nurses were trained in 2009 alone. It has trained over 2000 overseas participants from 60 different countries from 2005 –2009. www.sgh.com.sg/Education/Alice-Lee-Institute-ofAdvanced-Nursing

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Giving doctors a

specialist edge Coming to the SGH Postgraduate Medical Institute for a clinical attachment proved to be an eye-opening experience for Australian doctor Ian Cheung.

A

ustralian doctor Ian Cheung’s experience in Singapore could prove to be life-changing.

Four months into a six-month clinical attachment stint with the SGH Postgraduate Medical Institute (PGMI), the 34-year-old orthopaedic surgeon has not only learnt a whole new suite of technical skills, he has been wowed by the facilities and people he has met.

“It has been a fantastic experience,” said Dr Cheung, who was based at the Logan Hospital in Queensland, Australia.

“Predominantly, it has made a huge difference in my spinal training. I can say a lot of my surgical techniques come from here.”

He is an orthopaedic surgeon who chose to come to SGH to hone his surgical skills because of its reputation as a major centre in the region, both in terms of surgical expertise and its modern facilities. “Quite a few people back home told me about PGMI,” said Dr Cheung.

“I also heard there was a high volume of work here, and that would expose me to DR IAN CHEUNG Fellow, Orthopaedic Surgery Singapore General Hospital

to the junior staff and house officers.

During his PGMI orientation, he was invited to attend a staff appreciation ceremony. “I saw that it was part of the SGH culture to recognise and appreciate people. That’s exceptional.”

He added: “I find that people here are very friendly and hardworking. Then there are the supervisors who run busy clinical practices but who also do research, train and teach. There is a lot for me to look up to.”

a fair bit of spinal surgery.”

Some of the areas he got to work in during his clinical attachment include deformity correction and spinal injuries caused by infection and trauma.

He was also highly impressed with the orthopaedic diagnostic centre, which tracks clinical outcomes in an objective manner and is the only one of its kind in Singapore.

“It is a very efficient set-up with a lot of good data. I hope to take bits and pieces of that back with me, in that I may take data from patients before and after operations to analyse my own surgical outcomes,” he said.

On his return to Australia, Dr Cheung plans to build further the training he’s had here and will be attached as a Clinical Fellow at Wesley and Princess Alexandra Hospitals in Brisbane.

What has also made his stint memorable is the people, from the supervisors who teach him, in his words, “the tricks of the trade”,

SGH - POST GRADUATE MEDICAL INSTITUTE (SGH-PGMI)

Established in 1994, SGH-PGMI is committed to promoting postgraduate medical education and clinical training of medical professionals.

It has a rich portfolio of programmes, from Clinical Skills Training, Scientific meetings, and Telemedicine.

SGH-PGMI also nurtures education educators and clinician researchers through E-learning and didactics programmes such as Faculty development and Medical Pedagogy.

The institute also collaborates with renowned institutes to promote knowledge and expertise sharing such as Duke, Duke- NUS, Stanford and Cheongam University.

The collaborations extends to Resident exchange and Fellowship opportunities for foreign medical specialists.

To date, its programmes have successfully trained over 400 foreign doctors representing 30 nationalities.

Its motto is the Latin “Melius Medicus Scientius”, meaning “The better doctor is the learned one”. www.pgmi.com.sg

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Stirring the Passion of

Junior Doct rs J

ust four months into the SingHealth Residency Program, Dr Lee Guo Zhang, 27, became star-struck.

For under the program’s training structure, he got to work with Associate Professor Koo Wen Hsin, who heads the National Cancer Centre’s department of Medical Oncology.

Said Dr Lee, who had just completed his housemanship in May and wants to specialise in Internal Medicine, “A/Prof Koo is amazing, truly my role model. I was astounded by how humble he is even though he is a very senior doctor.”

In just one instance, Dr Lee witnessed A/Prof Koo, who personally conducted a digital rectal examination of a cancer patient, crush a paper towel before wiping the patient’s buttock. When Dr Lee asked why, A/Prof Koo replied that crushing the rough towel would make it a little softer and more comfortable for the patient.

“I find it inspiring, how he treats our patients,” said Dr Lee. “Indeed, the Residency Program is run by a whole

DR LEE GUO ZHANG Medical Officer, Internal Medicine Singapore General Hospital

group of senior doctors who are not just great clinicians but are experienced teachers. It is my privilege to be taught by them.”

A/Prof Koo is a core faculty member of the SingHealth Residency Program, which started in May this year.

It is a new program in the postgraduate medical education system that boasts of a structured training framework, continuous formative assessment and a dedicated core faculty who get protected time for residency training.

It was these factors that attracted Dr Lee, who graduated from the Yong Loo Lin School of Medicine, when he chose to go with the Residency Program. “I’m glad I made that choice. I will become a better clinician in a shorter time. The Residency Program is a very well-rounded course and is focused on what I need to learn in order to specialise in Internal Medicine, he said.

What he has truly enjoyed, apart from the great teaching, is talking to and listening

Dr Lee Guo Zhang chose to join the SingHealth Residency Program and in just four months he has been thoroughly inspired.

to the patients as he makes his ward rounds. He has also discovered that he is particularly interested in caring for older patients.

SINGHEALTH RESIDENCY

The first batch of residents started the program in May 2010.

The program offers structured postgraduate education for all medical school graduates based on established standards advised by the Accreditation Council for Graduate Medical Education International (ACGME-I) that can be completed within 3-5 years.

SingHealth residency programs include a Transitional Year and medical specialties in Emergency Medicine, Internal Medicine, General Surgery, Pathology, Pediatrics, Orthopedics, Ophthalmology, Obstetrics & Gynecology, and others. We are also the participating site for Preventive Medicine and Psychiatry.

SingHealth is the largest sponsoring institution (SI) for the Residency Program in Singapore. www.singhealth.com.sg/SingHealthResidency

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DR TAN TENG HONG Senior Consultant, Paediatric Cardiology KK Women’s and Children’s Hospital

The SingHealth-SMU Post Graduate Diploma in Healthcare Management and Leadership prepares doctors to be leaders too.

D

r Tan Teng Hong is an expert in treating children with heart diseases. But up until last year, when confronted with a set of financial figures he admits he was sometimes lost.

“I would say OK, it looks alright, and sign my name,” said Dr Tan, 41, a senior consultant of cardiology services at the KK Women’s and Children’s Hospital’s department of Paediatric Subspecialties.

“I realise I was not formally trained in this area.”

Enter the SingHealth-SMU Post Graduate Diploma in Healthcare Management and Leadership course.

Dr Tan was nominated by his boss to join the pioneer batch of a class of 35 comprising not only clinicians but also nursing managers and allied health professionals from various hospitals and healthcare institutions in Singapore, including heads of department and deputy directors.

For nine months, these healthcare experts met for business classes on

Fridays and Saturdays every other week at the SMU. They absorbed lectures conducted by experts from the SingHealth Academy, the dedicated Healthcare education arm of SingHealth, and the Singapore Management University’s Office of Executive Education.

Course highlights for Dr Tan include learning how to understand a financial statement – “in one exercise we had to critique a proposal that involved a financial statement” – hearing from media experts like Straits Times veteran health correspondent Salma Khalik on how to deal with the media, and hearing from SingHealth GCEO Prof Tan Ser Kiat on ethical issues.

Networking is another plus. He got to study with leaders from other institutions, and hobnob with movers and shakers like Prof Tan during tea breaks.

“Before, I would never had the chance to discuss ethics with Prof Tan. The course gave us a lot of opportunities,” said Dr Tan. He has also made firm friends, going on a recent holiday to Hokkaido

with his family and the families of two other classmates.

Dr Tan graduated top of his class, and has strongly recommended his peers and juniors to go for it.

Said Dr Tan: “It has opened up my mind.

From reading only clinical journals before, I find myself reading business magazines like The Economist.”

SINGHEALTH-SMU POST GRADUATE DIPLOMA IN HEALTHCARE MANAGEMENT AND LEADERSHIP

The first intake of students was in 2009.

It is a customised programme aimed to provide clinicians and healthcare professionals with business knowledge and skills in healthcare management and business leadership.

The curriculum covers subjects such as Global Healthcare Landscape, Strategy, Customer Value Delivery, Financial Management, People Management, and Ethics & Governance.

The course is covered in 160-180 hours.

24 (L-R): Pamela E-Wei Gopal, Chia Ghim Song, Karen Nadua, Vincent Tay Students, Pioneer batch, DukeNUS Graduate Medical School

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The pioneer batch from Singapore’s first Postgraduate medical school reflect on how they helped to shape the school’s culture.

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t is not often that university students get a chance to enjoy regular lunch meetings with their Dean and forge a path that others will follow. But that is what the pioneering class of the Duke-NUS Graduate Medical School have done: Blaze a trail.

Mr Vincent Tay, who received his bachelor’s degree in Pharmacy from NUS, said it best: “As the pioneer class, the greatest opportunity that I took up was in having a clean slate to build new possibilities. As the school builds up a comprehensive list of programs for the students, I believe our class had gone on to explore uncharted territories locally and overseas.“ What they have collectively built up, with support from the management and academic staff, is a collaborative culture where they are free to think, speak up and take action.

Even though the school was brand new with no track record, they were drawn to its unique educational model. Ms Pamela E-Wei Gopal entered with a Masters in Biomedical Engineering from NTU and will be graduating along with her peers next year. She said, “I was excited about studying in a school that combines the best of both the American and

Singapore education systems.”

Students also relish the opportunity to dedicate their third year in the school to research. Ms Karen Nadua who hails from the Philippines and has a Bachelor’s degree in Life Sciences from NUS agrees: “the unique education curriculum had improved my critical thinking and presentation skills.”

“After interacting with the children and bonding with them, it made me realise that grave and debilitating illnesses such as cancer not only impact the patient alone but also the caregivers and their immediate loved ones. This is something I will bear in mind as I progress in my medical training.”

DUKE-NUS GRADUATE MEDICAL SCHOOL SINGAPORE (DUKE-NUS)

Some of the other firsts the cohort have experienced include atypical classes which consist not of topdown lectures but group learning sessions where they solve challenges as a team, providing feedback to help shape the school’s curriculum, seeding events like the inaugural Duke-NUS Vertical Challenge which are set to become part of the university’s tradition and provide humanitarian aid.

Since 2007, Duke-NUS offers a medical training program for degree holders based on Duke University School of Medicine’s model of education.

Mr Chia Ghim Song, who holds a Masters degree in Electrical & Computer Engineering from Cornell, took part in one such project.

The medical student who is also a father of 1, helped organise a camp for the children of cancer patients.

In this 4-year course, students dedicate an entire year to independent study and research projects.

The program aims to produce highly trained clinicianscientists: specialist medical professionals whose expertise is also based on medical and clinical research. Students are actively engaged in learning through TeamLEAD sessions, that assesses them both individually and as a team, designed to help students become self-directed learners

Said Mr Chia, on Camp Simba, which was a joint project organised by students from Duke-NUS and the Yong Loo Lin School of Medicine:

The construction of the new 11-storey Duke-NUS building, situated within our SGH campus, was completed in 2009.

The majority of Duke-NUS’ local faculty comprises SingHealth’s physicians, and SingHealth’s senior executives play an active role in the school at all levels.

The first batch of Duke-NUS medical students will graduate in May 2011.

It is Singapore’s only tie-up with an American University to start a medical school. www.duke-nus.edu.sg

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Sl me + Spotlight

iTAG INNOVATIONS

The Innovative Technology Application Group (iTAG) helps to materialise innovative technology in SingHealth. From making our work simpler to improving the way our patients are taken care of, the sky’s the limit for creative minds at SingHealth. Here’s a look at a few innovations that made a difference: RHEUMATOID ARTHRITIS SYSTEM (RAS) Innovators: Department of Rheumatology and Immunology, SGH What it is: The electronic system allows doctors to target and treat specific areas of the body suffering from Rheumatoid Arthritis. It does so by enabling fast and precise data entry to derive useful indices such as the Disease Activity Index (DAS28), Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI).

How it helps: Before the RAS, doctors were only able to derive the DAS28 after complex calculations that took up a fair bit of their time. Those precious minutes are now saved with the use of the RAS. Using the new system, clinicians can now calculate the score of DAS28, SDAI and CDAI rapidly and precisely.

Patients can be easily registered and their date edited quickly and effectively, using illustrated charts to treat target areas and improving patient care.

Patients’ results can also be printed out and shared with their loved ones to chart their progress and encourage family involvement.

E-LEARNING FOR SUNRISE CLINICAL MANAGER 5.0 Innovators: Department of Cardiology, NHCS What it is: The interactive e-learning platform allows clinicians to be trained and re-trained on how to effectively use the Sunrise Clinical Manager (SCM), an electronic health management system that was implemented in SingHealth institutions as part of the Mission for Improving Clinical Outcomes (MICO) initiative, outside of a classroom setting.

How it helps: Clinicians can now relearn at their own pace to acquire the knowledge in using the SCM. With the e-learning platform being available outside of the classroom setting, training time, costs and valuable resources can also be saved.

3D WAY FINDING KIOSK AT CGH Innovators: Changi General Hospital with G Element Pte Ltd What it is: The kiosk allows patients to find their way around the hospital through intuitive and easily recognisable interfaces.

How it helps: With the objective of helping patients find their clinics and wards easily, the team at CGH set out to develop a 3D-way finding system using real-world textures to provide an interactive and easily recognisable view of the hospital interior.

Available in the four official languages, the kiosk also provides wheelchair access routes and information on doctors for the patients. A visitor to CGH can now explore the hospital virtually.

It is also harder to get lost in the hospital thanks to the carefully designed interface brought about through invaluable feedback from the hospital based on interaction with patients and visitors on the ground.

You can download the 3D wayfinder app for iPad and iPhone from http://m.conveno.com/?v=cgh

The interactive e-learning provides hands-on training on a simulated SCM interface.

Clinicians new to the SCM can also access the module in a step-by-step order, ensuring that they do not miss the core modules when learning the application.

Whether it be doctors new to the system or those who want a refresher course, this innovation enables learning to be done at an easier and more convenient pace.

To find out more, send an email to itag@singhealth.com.sg

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Sl me + Spotlight

Nurses’ Day: A Celebrati n

by The Numbers With a superstar cast, a hero-minister and the full throttle of Harley Davidsons, this year’s SGH Campus party was a blast. Here’s a breakdown of our 2010 Nurses’ Day celebrations!

31,175

visits to the SingHealth Facebook page during the monthlong festivities!

1,062 votes cast for the three

50 awards, scholarships and prizes

Nurses’ Day Video Contest finalists!

given out on stage to outstanding nurses!

1,000 flowers given out to our

200 photos of the main event

nurses courtesy of the Rotary Club of Queenstown!

posted onto our facebook page!

superheroes in costume entertained our nurses at the main event!

4

2 proud winners of the 2010

pages dedicated to our lovely nurses in a special Sunday Times Supplement!

President’s Award for Nurses! (Read on for their interviews!)

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1 noble profession that we

L VE and ADMIRE!

Nursing Greatness The noble profession of nursing turns up the glam as Elaine Ng, Assistant Director of Nursing at CGH win the Singapore Women’s Weekly’s Great Women of Our Time Award in the Health/Sport/Wellness Category! me+SH finds out her reactions.

How does it feel to be winning the award?

“I feel simply elated! It’s one of the recognition that came as a surprise.

I have never dreamed that a nurse would have been nominated for this glamorous award. This recognition has also affirmed my aspirations to fulfill my responsibilities in and contribute to the nursing profession to the best of my abilities.”

What was it like being in a glamour shot?

Being shot that way was a great experience for me. For all the awards that I have received, I’ve always worn my uniform and jacket. I was like Cinderella – someone who is being transformed in less than 30 minutes.”

How did your colleagues react to seeing you in the magazine?

My colleagues were very surprised and excited to see me dressed up in that manner. They could not recognise me until I spoke. One of the doctors even tried calling my name from behind to see if I would respond.

Right: Elaine got glammed up for her special feature in the August issue of Women’s Weekly.

f

Catch the full interview with Ms Ng on the SingHealth Facebook!

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Sl me + Spotlight

Highest Hon ur for Our Nurses

BY SHER MAINE WONG

This year, SingHealth nurses took two of the three President’s Award for Nurses, the highest state accolade for nurses. me+SH finds out how they reacted when they received the news.

ENGAGING VETERAN MS LIM SUH FEN, 52, Assistant Director of Nursing, National Heart Centre Singapore Ms Lim Suh Fen was at the SGH Bowyer block when the missive came from her bosses: We need to come and see you now.

SingHealth Group Director of Nursing, Associate Professor Lim Swee Hia, and Medical Director of the National Heart Centre Singapore, Associate Professor Koh Tian Hai, met her at the Bowyer Block where they handed her a letter.

The news for Ms Lim was short and sweet: She had won a President’s Award for Nurses.

“Really, they were so serious I thought they were going to tell me I had lost my job!” laughed Ms Lim. It is a job she has been doing for 35 years.

Noteworthy accomplishments include setting up the Singapore Heart Centre Ambulatory Service and winning a string of awards including the Excellent Service Star Award in 2009 and a National Day Commendation Award in 2005.

“This President’s award is the most prestigious award I have received. I feel very proud and honoured,” said Ms Lim.

said Ms Lim. Even if she was rushing off for a meeting, she would stop in her tracks to attend to small matters which she feels she has to put right.

“If I see a chair that is not straightened, I will fix it. If I see that a counter is very crowded, I will help out. If I see a patient grumbling, I will attend to him,” she said.

In one high-profile instance of “being engaged”, Ms Lim, together with Associate Professor Koh Tian Hai, persuaded the Health Minister Mr Khaw Boon Wan to go through a coronary angiogram to ascertain the extent of his heart disease when initial tests hinted at the condition.

She said: “I feel that if I don’t settle it there and then, something will happen.

A high level of engagement can help patient outcomes.”

GUNGHO TRAILBLAZER MR NIDU MARAN SHANMUGAM, 34, Advanced Practice Nurse, Singapore General Hospital Mr Nidu Maran Shanmugam, is a stand-out demographic amongst nurses. As an Advanced Practice Nurse (APN) his outstanding contribution to nursing has already won countless awards.

Currently she is overseeing the planning, reconfiguration of usage and workflow designs of the new Heart Centre.

He was one of the first orthopaedic APN in Singapore, whose close rapport with patients won him several “Service with a Heart” awards and an EXSA STAR award in 2005.

She is also leading a team of 65 nurses and Administrative Staff at NHCS. While hers is a high-level post, she continues to attend to patients and is very hands-on.

“I try to be as engaged as possible,”

Mr Nidu, who is vice-chair of SGH’s Nurse Research Council, has conducted research studies which have won several accolades at national and international meetings.

As a trainer, he is involved in developing training programmes for nurses so they can provide specialty care for orthopaedic conditions.

The latest feather in his cap, however, the President’s Award for Nurses, was the most unexpected.

“After the interview with the judging panel, I kept saying that there was no hope for me,” recounted Mr Nidu. “Past winners are very experienced nurses who have done so much more. I stand in their shadow. I have only been in nursing for 14 years and no one at this age has won it.”

To his utter shock, he did. He now goes down in the history books as the youngest winner of this prestigious award.

Mr Nidu’s desire to serve goes beyond healthcare. In the past year, he has been giving back to the community as a grassroots leader. He organises activities for children and teenagers with behavioural issues.

He says his wife, a secondary school teacher, sometimes asks him, “Why are you so keen on serving? What is going to stop you?”

“I tell her I don’t know! I cannot explain!” said Mr Nidu.

He shares, however, that it was at Riverside Secondary School where his leadership skills flourished. “It was a new school and everything had to be started from scratch. I was the founding Chairman of the school band, where I played trombone and euphonium.”

In the next five years, the go-getter intends to get his PhD in nursing.

He said: “I want to build on the knowledge of nursing, and hopefully inspire other nurses to join the profession.”

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At home with...

Dr Patrick Casey Dr Patrick Casey is one of the pioneers of the Duke-NUS Graduate Medical School. He tells me+SH how the school has come so far so fast.

BY SHER MAINE WONG

F

or a man who grew up on a farm in South Dakota, Patrick Casey has gone the distance, literally and in his professional life.

He is a world-renowned biomedical researcher and is now Senior ViceDean of Research at the Duke-NUS Graduate Medical School in Singapore, thousands of kilometres from where he was born.

Dr Casey was parachuted in to Singapore in 2005 from the renowned Duke University Medical Centre in the US where he was a senior staff member, to help set up Singapore’s second medical school, a collaboration between the National University of Singapore and Duke.

“This job is different. Every day in the last five years presents a new challenge to get the institution off the ground,” said the genial Dr Casey, whom everyone in the office calls “Pat”.

He is justifiably proud of how far the school has come in a short time. Located within the grounds of the Singapore General Hospital, the impressive new 11-storey building comes equipped with key education and research facilities and is home to a growing number of staff, faculty and over 200 students.

The pioneer batch of students, who all enter the school armed with a university degree or more, graduate next year.

Dr Casey, who talks fondly of the days in 2005 when there were four staff working from “not even interim, but interim-interim facilities”, said: “Essentially we have completed the start-up period, we are almost a mature organisation now!”

The school did well because, in Dr Casey’s words, the management team were strongly supported by both NUS and Duke University.

“We had good governance models but very few of our decisions were second-guessed. Everytime we needed something to happen, it seemed like the board, stakeholders and management would find a way to make it happen.”

Then there was how SingHealth stepped up with what Dr Casey calls a “groundswell” of support in providing the right people to train the students.

“Our second year was when SingHealth really came in. At that point, we had no faculty. If SingHealth had not supported us, SGH and the KK Women’s and Children’s Hospital in particular, in freeing up the doctors, (the school) would have collapsed.”

His top priorities now? “We want to make sure that the stakeholders feel this investment has paid off.”

“The challenge now is to make sure we build something that has longevity, that continues to excite people with freshness in terms

“The challenge now is to make sure we build something that has longevity, that continues to excite people with freshness in terms of how we grow our programmes, how we continue to connect to the biomedical and medical landscape,”

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At home with

into a taxi, dropping their daughter off at the Chinese International School, then getting off at their workplace.

Dr Casey heads up to the 11th floor and Assistant Professor Wang to her 7th floor laboratory.

Said Dr Casey: “Up until recently, before we started work, you would find us at Bengawan Solo at the SGH Block 7 at 8am every morning, to have our kopi and pastry breakfast. For 15 minutes, we talk about how we’d deal with our day.” Nowadays they patronise the newlyopened cafe on the school premises.

With the children, the favourite family activity is to go hiking in the parks at least once every weekend. “We are an outdoor family,” said Dr Casey.

His personal favourite are the trails at MacRitchie Reservoir because of the reservoirfronting boardwalks, and the treetop walk, but the family have probably traipsed along every hiking spot in Singapore: Bukit Timah Hill, Lower Pierce Reservoir, East Coast Park, West Coast Park, Mount Faber, the Botanic Gardens.

Typically, each hike of about 3 km to 4 km, lasts 1 to 2 hours.

of how we grow our programs, how we continue to connect to the biomedical and medical landscape,” said Dr Casey.

“We also want to continue building an institution that all the stakeholders feel is adding value.”

Apart from administration, Dr Casey is also spending time on his research work which focuses on cancer biology.

He started a laboratory with his wife, Assistant Professor Mei Wang, and had recently started another laboratory of his own.

“Being a researcher is critical to me. It not only gives me credibility in that I am still doing research myself but mostly I still get a great deal of satisfaction in finding new things and making contributions on the research front,” said Dr Casey. There is real passion behind his words. When he first decided to come over with his family in 2005, he did not expect to stay for more than three years.

But the thrill in watching the school grow has proven to be addictive. Of course, there were other perks.

“We check out the maps on the National Parks Board website, see which are the ones we haven’t tried and we map out our route,” said Dr Casey.

Will he stay on in Singapore?

At the time, coming here presented Dr Casey’s entire family with an opportunity: Dr Casey to start the school, his Chinese clinician wife to go back to doing research, and his two children to embrace their Asian roots.

Said Dr Casey, on his 15-year-old son Kyle and 7-year-old daughter Jodi: “They were growing up like American kids. I wanted them to grow up feeling that they are a part of both American and Chinese cultures.”

Now, not only are the two children conversant in Chinese, Dr Casey says that living in Singapore has been good for the family.

A comfortable morning routine involves Dr Casey and his wife hopping

“A transition point for us is coming up, when our son goes to college in 2012,” he said. Depending on where Kyle, who is now studying in the NUS High School, decides to study, the family may have to re-locate.

“We’ll want to be affiliated to Duke-NUS in the long term, but whether our base shifts back to the US in 2012, I couldn’t answer yet.”

It’s clear, however, that Dr Casey would be very pleased to stay on in Singapore and continue his work at Duke-NUS. “There could be many leadership opportunities for me in the US. But none of them would involve building something from scratch.”

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HealthXchange

Lv me + Living

Wise up on

suga s and starch – the GI Fact r

What is GI? How do we apply it in our diet? Do we really have to avoid high GI food?

Health Xchange provides the answers.

The Glycaemic Index (GI) is a numerical way of describing how the carbohydrate in foods influences blood sugar levels. It ranks food based on how fast they break down and release sugars into a person’s bloodstream.

ADVANTAGES OF LOW GI FOODS

1. Consumption of low GI foods will release less insulin into the blood stream since there is no spike in blood sugar. Low GI foods are best for most people most of the time because they are less inflammatory and reduce the risk of disease such as coronary heart disease, obesity and type-2 diabetes.

2. Since low GI foods do not cause a spike in blood sugar, they may be used to help people with diabetes improve their blood sugar level. However, a person with diabetes will still need to consider the total amount of carbohydrate they consume per day.

3. Some studies have shown that low GI foods have a higher satiety value, keeping hunger at bay for longer. Choosing low GI foods may be useful in a weight reduction diet.

ARE LOW GI FOOD HEALTHIER THAN HIGH GI FOOD?

SHOULD YOU AVOID HIGH GI FOODS ENTIRELY?

A food’s GI value was never meant to be the only standard by which it is judged as fit to eat. A lower GI value does not mean that food is a healthier choice. A low GI food can be high in fat, for example potato chips have a lower GI value (54) than potatoes baked without fat (85).

GI should be used within the context of a healthy, prudent diet.

No, you can have a smaller portion of the high GI food or team it up with a very low GI food like rice porridge with beans.

High GI foods may be useful for people with diabetes during a hypoglycaemic episode. A high GI food will raise blood sugar level faster.

In sports nutrition, high GI foods provide a quick supply of glucose for immediate use and immediately after exercise. A high GI food may maximise glycogen storage for future use. Both low and high GI foods are being used to help athletes achieve peak performances.

LOW TO INTERMEDIATE GLYCAEMIC INDEX HIGH GLYCAEMIC INDEX • White bread • Wholemeal bread • French loaf • Rice crackers • Jasmine rice

• Glutinous rice • Potato • Tapioca • Cornflakes • Rice porridge • Watermelon

• Pita bread • Basmati rice • Pastas • Noodles • Sweet potato • Yam • Peas and beans

• Traditional wholegrain oats • Pearl barley • Muesli • Apple • Orange • Bananas

Source: Dietician Service, SingHealth Polyclinics

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HealthXchange

me + Living

BATTLING CANCER WITH

NUTR TI N Cancer patients have special nutrition needs and concerns whilst undergoing therapy, and beyond. Good nutrition is important at every stage of cancer treatment and understanding this important aspect of self-care well can help patients cope better during their cancer treatment.

THE SPECIALIST:

Chang Yok Ying, Pharmacist, National Cancer Centre Singapore My aunt is going for her chemotherapy for her cancer very soon, and I want to make sure she gets good nutrition during her therapy, Q: What kind of food, fruits and drinks can she consume during this period of time?

A: During chemotherapy, encourage her to eat well and not to worry too much about restricting her diet to ‘healthy foods’. This will enable her to maintain a good blood profile with adequate platelets, albumin, neutrophils, and others that will help her undergo her treatment with minimal breaks in-between.

Q: Can she take supplements?

A: Try to obtain vitamins like vitamin C from whole foods like fruits. This is to prevent overdose of vitamin C,

which may affect the efficacy of the chemo drug. If she wants to take a supplement, she may want to choose a multivitamin with dosages not more than 100% of Recommended Daily Allowance (RDA).

Q: Is there any food she really needs to avoid? Some folks are saying avoid chicken, mushroom and coconuts?

A: Avoiding chicken could be a Chinese medicine concept. There are no evidence-based reports that recommend not eating chicken. No problem with eating mushroom and coconut either.

She may do well to limit the intake of oily foods as there are studies that show that restricting oil / fat intake reduces the risk of recurrence of the cancer and increases survival and success of treatment among breast cancer patients undergoing therapy.

Q: Is it advisable to go for TCM and TCM medication like lingzhi

a few days before or after the chemo session?

A: Taking lingzhi during chemotherapy may increase the risk of bleeding.

After she has completed all cancer therapy, she may take lingzhi as a health supplement as it is known to have anti-tumour effects.

Q: I was recommended manuka honey for the dry throat during Nasopharyngeal Cancer (NPC) treatment. Recently, someone told me that Jarrah honey is equally good. Is this true?

A: Honey has antibacterial and antifungal properties that may help in preventing infection. The high osmolality, low pH and hydrogen peroxide in honey contribute to this antibacterial property. The difference between Manuka and Jarrah honey lies in the types of flowers from which the bee obtains nectar to make honey. You may try both types to see which is more helpful. Do not take honey in excessive amount due to the sugar content, especially if you are diabetic.

Q: I was also told never to eat grilled and barbecued food, because it is carcinogenic. Is that true? Are there any other foods that should be avoided?

A: A ‘good’ diet would be one that is balanced i.e. contains a good mix of vegetables and meat, with no overly sweet, salty and oily foods.

Preferred cooking methods would be steaming, boiling and stir-frying rather than deep frying, grilling, or baking.

Subjecting animal protein to high heat during deep-frying, grilling, barbecuing, or baking will create heterocyclic amines which are carcinogenic. Minimise eating such foods but do not be too stringent on food choice during cancer therapies.

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HealthXchange

me + Living

Hea thcare

Financin g Singapore offers universal healthcare coverage to our citizens, with a financing system anchored on the twin philosophies of individual responsibility and affordable healthcare for all. This is done by implementing different tiers of protection – subsidies, Medisave, Medishield, Eldershield, and a whole host of private insurance options.

To clarify any confusions and concerns, HealthXchange partnered Financial Alliance to answer some common queries.

THE SPECIALIST:

Chew Hock Beng Chartered Financial Consultant, Chartered Financial Underwriter, Financial Alliance Pte Ltd My main concern is what coverage I can get for both treatment cost and any loss of income should I get a serious problem like cancer or heart attack/heart failure.

you must enroll yourself in one of the Medishield Integrated H&S Plan that allows you to pay the premium using your Medisave.

Currently, 5 life insurers carry this product: NTUC Income, GE Life, AIA, AVIVA and Prudential.

disability income plan. Some insurers even allow the policyholders to make multiple claims during his/her lifetime, subject to policy provisions.

If the CI plan can complement your H&S coverage to pay for expenses incurred outside hospital and is able to replace your income during this period of hardship and also reduce your financial stress, this could be the most appropriate and suitable plan that you are seeking for.

But take note that every plan comes with a price tag. Not only do you need to assess the cost and benefits of the plans, you also need to fully understand the features & medical terms involved.

To find the most suitable coverage, I suggest that you talk to an advisor who has represents multiple insurers.

View full Questions and Answers to these topics at: www.healthxchange. com.sg/askthespecialist

As for the loss of income, there are 2 ways to approach this need:

(1) Get yourself insured with a Critical Illness (CI) insurance “Take note that every plan plan which pays you the sum comes with a price tag. Not assured in a lump only do you need to assess sum upon the the cost and benefits of the diagnosis of any plans, you also need to fully of the covered illnesses (usually understand the features & 30 illnesses)

Q: What is the best plan that I must sign up for to cover this?

One which does not make me pay unnecessary premiums, medical terms involved.” yet has comprehensive (2) The other is cover for such problems, especially to be covered by a Disability Income something like cancer, where the (DI) plan which pays you a monthly cost is apparently very high and income when you are totally unable borne for a long term? to work due to sickness or injury A: The best way to cover your treatment cost is to be insured While both approaches adequately by a Hospitalisation & have its pros and cons, Surgical (H&S) plan. the claim for CI insurance plan is more straightforward. A continuous If you are a Singapore Citizen or PR, proof of disability is required for

Health Xchange’s ‘Ask The Specialists’ Forum is an online interactive forum where members can send in questions to be answered by specialists from across the SingHealth Group.

The forum focuses on different topics each month. Register for free at www.Healthxchange.com.sg to get alerted of new topics every month!

Upcoming Topics: All about skin problem Health Disease 101 Are you feeling depressed?

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Sm me + Smiles

MORE THAN JUST

FLYING KICKS AND PUNCHES

BY ARTHUR WONG

WHAT IS TAE KWON DO? Tae Kwon Do is the Korean Martial Art of Self – Defense that incorporates the use of every limb of the body to defend and counter-attack in a form of unarmed combat to defend oneself.

It encompasses advance techniques and applications of the arms and legs to overpower an attacker with the use of movement, blocks, strikes and kicks. However, these are not the only attributes in Tae Kwon Do. It also cultivates the spiritual aspect and the noble moral principles of life. Developing strong virtues of etiquette, modesty, self-control, perseverance and an indomitable spirit.

D

on’t judge a book by its cover, unless you’re talking about Mohamed Basheer. With a large build and a tall stature, you’d think that he’s a private security guard or martial arts powerhouse.

And right you would be - Basheer is a Second Dan senior instructor with the Singapore Tae Kwon Do Academy. Under his tutelage is a class of 20 enthusiastic students with age ranging from as young as 6 years to spirited 40 year-olds.

years, culminating in his numerous participations in competitions. His most memorable win would be when he had to take on an opponent similar in stature – the heated battle resulted in the two fighters tiring themselves out, but Basheer emerged victorious after proving his superior strength and aggressiveness.

“Above all, Tae Kwon Do teaches me discipline and self-control, and it is these values that I hope to pass on to my students,” he said.

But to the passionate volunteer instructor of ten years, age is never a problem when it comes to Tae Kwon Do. In fact, the 30-year veteran revealed that the masters in the Academy are sprightly despite their age.

“They have to know that martial arts is not to show off, pick fights or to prove that you’re better than someone else. Martial arts is supposed to train you to be humble and confident.”

“When you join, you join for life.

As you age, you may not be as fast or as flexible, but your power and technique will always be there,” said Basheer.

The discipline extends beyond Tae Kwon Do too. Basheer explains that in his job at KKH, he has learnt to be at peace and to give in to others without causing conflict.

The Technical Officer at KKH’s Biomedical Engineering Department picked up Tae Kwon Do in secondary school under the influence of legends like Bruce Lee and Chuck Norris.

Having worked in KKH for the past ten years, his discipline has seemed, and looks to continue, to guide him towards many fulfilling years at the hospital.

His love for Tae Kwon Do grew more passionate over the

To pick up Tae Kwon Do, simply visit the website for the Singapore Tae Kwon Do Academy for a list of available venues.

WATCH BASHEER IN ACTION! Basheer demonstrates an array of green f belt patterns and tells us about the different kinds of stances in Tae Kwon Do at the SingHealth Facebook page!

Do you have an interesting passion like Basheer?

We’d like to hear from you! Send us an email telling us about you and your interest, and be featured on me+SH!

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Hr me + Horizon

me+SH contest

1. HOW MANY BEDS ARE THERE IN IMU, INCLUDING THOSE IN DUKE-NUS’S CHRONOBIOLOGY LAB? a. 30 b. 32 c. 34

2. WHEN DID THE FIRST BATCH OF SINGHEALTH RESIDENTS START THEIR TRAINING? a. May 2010 b. January 2009 c. May 2009

?

3. WHERE DID YOU PICK UP THIS COPY OF me+SH FROM?

Three best answers will receive a $20 Borders voucher each.

Send us your answer to me.sh@singhealth.com.sg by 15 December 2010.

In the last issue we asked you, “Why do you love our nurses?” These people tell us great reasons why: HO AUN NAH, SENIOR STAFF NURSE, SGH “Nurses in the past were doctor’s assistants but now we take pride in our present success, achievements and recognition especially after past experiences in overcoming challenges like outbreaks. Nurses are lifesavers and curers with their ability to make a difference in people’s lives. With senior nurses contributing, nurturing, educating and inspiring young nurses to be future leaders, let us fly our Nurses’ flags up high.

Congratulations to our nurses for achieving Magnet Recognition!”

DESMOND LEOW, EXECUTIVE (PAEDIATRIC WARDS), KKH “I love our nurses because they have the passion to care without any complaints. I would like to wish all our nurses, Happy Nurses’ day and lastly thanks for being a nurse.”

NUR QUISTINA, SENIOR ENROLLED NURSE, NHCS “Nurses of Singhealth are professional individuals that demonstrate their knowledge and skills. In their interaction with patients and patient’s relatives, they show great empathy and sensitivity towards the issue involved. During the care of patients, nurses will not neglect their dignity and treat both patients and fellow colleagues with full respect and courtesy. Their selflessness and courage often draw a sense of marvel by the members of the public as the intellectual modern day Florence Nightingale!”

They will receive a $20 Borders gift card each. me+SH will contact the winners with prize collection details.

Get me+SH personally delivered!

Subscribe to me+SH by sending an email to me.sh@singhealth.com.sg with your name, institution, and delivery address by 15 December 2010.

Subscription will start from the December 2010 issue onwards.

ePulse of SingHealth GCEO’s Annual Staff Address straight to you!

Pulse of SingHealth 2010 Highlights t 3FWJFX PG 4JOH)FBMUI (SPVQ T QSPHSFTT BOE Charge! GPSXBSE JOUP B OFX EFDBEF PG HSPXUI t "DBEFNJD .FEJDJOF Why, How, Who? t /FX *OJUJBUJWFT Academic Clinical Programs, Clinician Career Models, Leadership Development, Staff Awards and Recognition t -BVODI PG 4JOH)FBMUIhT BCSJEHFE 7JTJPO .JTTJPO TUBUFNFOU

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