me+SH (September 2009) by me+SH

September-October 09

A SingHealth staff publication

Teacher. Mentor. Friend.

Prof Ng Han Seong’s lesson on mentorship

President’s Challenge 2009 Powered by smiles

Duke On Campus

Duke-NUS GMS Opens Its Doors

INSIDE!

Your copy of the Grant Calendar 09/10.

Special Features

Contents • Foreword by Prof Soo Khee Chee • On The Cover

01-02 me+YOU

04-07 A new class of great doctors

18-19

• • • • • • • • •

SingHealth-President’s Challenge 2009 Pulse of SingHealth 2009 Memories of Vicker’s House Leadership Development in SingHealth Ride for Hope 2009 Farewell to Peter Saunders Vibrant Campus – NHC Perfusionist Vibrant Campus – SEMC Senior Research Associate SingHealth Academy Residency Programme

03-14

me+GROUP • • • •

A new class of great doctors 60 seconds with our mentors Pharmaceutical Society of Singapore awards CPIP Project - A quicker heart lifeline

15-26

me+SPOTLIGHT

Operation Smile

• At Home With…Dr Kenny Sin • Book Review • Hear it from the Experts

27-32

SingHealth Editorial Team Tan-Huang Shuo Mei Amelia Champion Katheryn Maung Jeanie Cheah Arthur Wong Mediactive Editorial and Design Team Lyon Low Florence Long Sher Maine Wong Mediactive Pte Ltd 65 Ubi Crescent #06-07 Hola Centre Singapore 408559 T: 6846 4168 | F: 6846 4768 info@mediactive.com.sg www.mediactive.com.sg

me+SingHealth or me+SH 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. Do check out me+SH Online (http://mysinghealth/Singhealth/ MeSH) and me+SH Flash in your emailbox too!

me+LIVING • The lighter side • me@SingHealth - Operation Smile

34-35

me+SMILES • Medical milestones in history

me+HORIZON

Patients. At the Heart of All We Do.

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) 059/03/2009

Those Who Can,

me+YOU

Teach

good healthcare system is closely linked to teaching. A good doctor is also a teacher and a mentor who leads by example.

There is excitement in being a teacher and you will be refreshed by sharing values and skills with others. An educational focus will create a scholarly and intellectually stimulating environment. It is exciting to be a teacher because you also learn from your students. The exchange that takes place is a process that brings renewal. The recent launch of the SingHealth Academy will create more opportunities for this exchange to take place. On 28 September, the Duke-NUS Graduate Medical School officially opens its new premises on campus. This will stimulate a new appetite for learning in students as well as our doctors who serve on the faculty. The integration of a medical school, that has research as an intrinsic part of its curriculum, into our clinical setting will create a rich biomedical environment that has total focus on patients. me+SH takes a timely look at education. In this issue, you get to read about the wonderful tradition of mentoring that SingHealth has. One of the most important things that mentoring enables is the transmission of values to the next generation and the ones that follow.

Prof Soo Khee Chee Assistant CEO, Research & Education, SingHealth Director, NCCS Vice Dean, Clinical and Faculty Affairs, Duke-NUS GMS Visiting Senior Consultant, Department of Surgery, SGH Professor of Surgery, Yong Loo Lin School of Medicine, NUS

Together, we will create this academic environment of scholarly pursuits and active learning to transform our campus into the Centre of Learning for Biomedical Sciences.

â&#x20AC;&#x153;Real education should educate us out of self into something far finer; into a selflessness which links us with all humanity.â&#x20AC;? ~Lady Nancy Astor

me+YOU

A Show of

On The Cover Kaneswary Kandasamy, Senior Nurse Manager, CGH

Good Mentorship

me+SH pays homage to our excellent mentors in SingHealth as we journey towards Academic Medicine. A/Prof Goh Siang Hiong, Deputy CMB (Ambulatory), CGH Senior Consultant, Accident and Emergency, CGH

Patrick Ker, Senior Principal Occupational Therapist, SGH

When I was a medical student, our seniors who were housemen and medical officers all took the time to guide us through procedures. We were made to appreciate that we, as medical students, were important members of the ward teams.

The best thing about being a mentor is feeling the satisfaction of helping someone succeed.

The best thing about being a mentor is seeing my students excel and score achievements in their nursing roles. This also reflects well on me as having provided them with good guidance.

Prof Tan Cheng Lim, Associate Dean, Emeritus Consultant, KKH The best thing about being a mentor is to know that one is appreciated and that the knowledge one is imparting will be of benefit to a generation of doctors who will be our future leaders.

Dr Phua Ghee Chee, Consultant, Department of Respiratory and Critical Care Medicine, SGH Iâ&#x20AC;&#x2122;m happy to see my students grow in knowledge, ability and confidence; and to know that one day, they will pay it forward and be teachers and mentors to their juniors.

With the 10K Smiles Project, SingHealth-President’s Challenge 2009 fun(d)-raising is guaranteed to make you smile from cheek to cheek.

ne of the most beautiful things in the world is a smile. It also happens to be one of the most contagious. In this year’s President’s Challenge, you can play your part in changing the lives of our beneficiaries with a donation and a smile.

me+GROUP

Powered By Smiles President’s Challenge 2009 Fun Facts SingHealth’s “Healthcare, I Care!” celebrates President’s Challenge 10th anniversary! Fund target: $200,000. Fun target: 10,000 smiles. Donate a smile at www.singhealth.com.sg/PC09 or at any “Smiles On The Go” station. Community outreach services include health screenings, workshops and excursions for our beneficiaries.

If you would like to make a difference, give us a big smile today or volunteer your services by sending an email to groupcomms@singhealth.com.sg. For the latest event updates, please visit www.singhealth.com.sg/PC09

Smiles

Photo Challenge! Here’s another reason to smile! Guess the number of photos that make up this collage! Send your answer to groupcomms@ singhealth.com.sg by 30 Oct 2009 to win Canon portable photo printers!

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A New Era— Transforming Care Excerpts from GCEO’s Staff Address by Prof Tan Ser Kiat

We live in a world that’s continuously evolving, and change is perhaps the only constant. While SingHealth has enjoyed growth and success over the years, we have to be alert to the changing healthcare landscape, be initiators and leaders of change, and break new grounds to improve healthcare in Singapore. As we forge ahead to transform the care we deliver, our objectives must be clear and focused. These, in essence, are: • Excellence in our 3 Pillars of Mission • Recognising, Recruiting and Retaining Talent • Advancing in Academic Medicine

Excellence in Our 3 Pillars Clinical Care Our primary mission is to ensure that our clinical services are of the highest quality, relevant to our patients and up to their expectations. Our ongoing focus needs to be on reducing wait times and improving patient satisfaction. It will require a multi-prong approach to improve clinical care coordination and service delivery. To provide consistently high standards in a fast changing environment, we also need to continue to strengthen our framework of clinical governance across the cluster, and leverage proven technology to ensure patient safety and prevent errors.

Research

Education

Igniting and nurturing the Spirit of Inquiry are critical in our quest for new knowledge to find cures and further medicine. We have made several changes to our research setup last year, and we now have a robust framework in place—with a common cluster-wide Institutional Review Board (IRB), SingHealth Experimental Medicine Centre (SEMC), Tissue Repository, Investigational Medicine Unit (IMU), and essential infrastructures and facilities—to spur our next phase of growth. We complement, collaborate and cooperate with our partner, the Duke-NUS Graduate Medical School to ensure that the discoveries made in the labs are translated into useful clinical care, i.e., from Bench to Bedside and back to the Bench to resolve new problems found at the Bedside, in a virtuous cycle of improvement in care. Our collaborations draw on the expertise and strengths of both organisations and I am excited about what our teams will achieve together.

Our focus on Education ensures that there is a continuous flow of excellent healthcare professionals to carry the torch to higher levels with each successive generation. As a group, we have a rich heritage in healthcare education. This is now further reinforced through our partnership with Duke-NUS GMS, and our new SingHealth Academy working in tandem with the shop-floor—our clinical, nursing and allied health departments—to build a vibrant and dynamic academic community. Through the SingHealth Academy, we have two major programmes to complement the excellent training activities by our institutions: 1. The SMU & SHS Graduate Diploma in Healthcare Management and Leadership—to train, hone and equip high-potential leaders. 2. New Residency Programme starting in 2010—to better train future generations of specialists through a well-designed and structured education curriculum with a more efficient system of monitoring and assessment—compared to the traditional British model based on the Master-Apprentice method.

Recognise, Recruit, Retain Talent is critical—our people bring out the heart and soul of our organisation. To recruit and retain talent, we need a fair and robust system of measuring performance, recognising the right talent and incentivising staff. Historically, our performance has been measured on financial achievements. As a public-funded organisation, we have now started on the journey towards a more balanced and meaningful performance management system which will be implemented in phases over the coming years. This will fundamentally incentivise and reward our institutions and staff to work towards our Public First Mission and goals in Academic Medicine. Building capacity and capability for a strong healthcare workforce becomes an urgent priority as our population increases and ages. Current staffing at our institutions is insufficient and we need to rapidly beef up our manpower resources to take on the new challenges before us. Succession planning is another major priority. Building the leadership pipeline is key to the survival of any excellent organisation. As a group, we are rolling out a structured leadership programme for staff across all levels and institutions. This will support our plans at identifying, grooming and nurturing excellent and passionate people to lead our institutions forward into the next era.

Our People—Catalyst of Growth Others 4%

Medical 12%

Ancillary 20%

Admin 10%

16,000-strong multi-disciplinary, multi-national, and multi-generation team Nursing 40% Allied Health Proffessionals 14%

Expectation of performance for base pay

Academic Medicine is about continuously pursuing improvement in healthcare for patients through a virtuous cycle of research driving better clinical service, delivered by excellent professionals through Education. In its ideal state, it creates a dynamic “eco-system” where our people and efforts flourish.

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Advancing in Academic Medicine

To advance in Academic Medicine, we need the right staff in the right place who can contribute in their areas of competence. SingHealth will be introducing a new Clinician Career Model, to enable our clinicians to pursue different interests and passions in clinical service, research and teaching.

Clinician Agreed Portfolio (Roles)

Teaching

Clinician Clinician Educator Clinician Investigator

Clinician Leaders

Clinician Scientist Teaching is a privilege and pride of any clinician. Minimum requirement is an estimated 2% of time or 1hr/week

• Academic pursuits and clinical success are synergistic and interdependent • Recognition and reward for performance in all three areas • Faculty appointments in academic medicine This new career model provides varied opportunities of growth and development for our doctors in academic medicine. In their chosen role, they will have the time and opportunity to excel.

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Teaching Appointments

Teaching Faculty

49% of clinical appts with Duke-NUS and YLL-SOM

Total number of Faculty Appointment & Adjunct = 972

Specialist 51%

Faculty Appointment + Adjunct 49%

NUS-YLL SOM 763

140

DUKE-NUS 209

Personalised and Genomic Medicine could be the “new cheese” of tomorrow. I am confident that we can build upon our strengths in translational medicine and discover even more new cheese for ourselves. Our journey has already begun. If you look around, the campus is now rapidly being transformed. Parts of it have been completed while others are at various stages of construction. I ask that you bear with us for the temporary inconveniences caused during this stage of rapid construction.

Our close partnerships with DukeNUS GMS and the Yong Loo Lin (YLL) SOM will further spur our staff towards greater excellence in education and research, creating an intellectual and scientific milieu in our midst. For our Nurses and Allied Health Professionals, take heart that you are not left out. Our nurses can now look forward to greater career opportunities in Clinical Specialisation, Education and Management. Similarly, our Allied Health staff can look forward to expanded career tracks to pursue clinical research and education, and play a key role as we transform ourselves into a reputable AMC.

One Thing That Must Not Change

Break New Grounds The healthcare landscape in Singapore is rapidly evolving and we will need to have the courage and fortitude to change in order to remain relevant. Let us seize the opportunities before us and set out to create new avenues of progress.

In closing, I would like to remind all of us that while we must be leaders of change to thrive in an evolving environment, there are some things that should not and must not change—these are our values, our principles and our firm conviction in Public Service.

As we remain committed to serving the public, four fundamental principles must prevail: • Public first—all else comes second • Serve the interests and welfare of the people • Respect for all—to build a great and cohesive team • Humility—a key virtue from the key motto of the KE VII College of Medicine: Not pride of knowledge but Humility of Wisdom. In serving the public, we all need to have the Compassion to Serve and Passion to Excel. I invite you to join me and SingHealth in our journey of transforming healthcare for Singaporeans. For the full speech, please refer to ePulse of SingHealth—SingHealth Desktop Portal http://mysinghealth To request a copy of the GCEO’s video presentation, please email groupcomms@ singhealth.com.sg

ePulse—Thank You For Your Feedback This year, due to the H1N1 mitigation efforts, we had the opportunity to explore the web medium to bring the GCEO’s Staff Address to everyone. ePulse—an interactive microsite with full video slideshow as well as feedback channels—was launched on the SingHealth intranet for all staff in mid August.

I didn’t like it

Can be improved

Better than expected

This is cool!

Overall Feel

4.7%

14.1%

21.9%

59.4%

Content

3.1%

7.8%

54.7%

34.4%

Ease of Navigation

3.2%

15.9%

46.0%

34.9%

Loading Time

6.3%

10.9%

50.0%

32.8%

Convenience 3.1%

3.1%

45.3%

48.4%

It is an innovative way to present GCEO’s speech through the intranet. Not all of us are able to be present for his speech. This way I am aware of the progress in SingHealth as an institution.

Growing Stronger and Better, Year on Year Improving Clinical Care and Quality Met 91% of CQ indicators %

100%

80%

88%

90%

100%

93%

90%

FY08 Overall

91% 84% 85%

83%

FY07 Overall

83%

74% 69%

70%

69%

60%

50% 40% 30% 20% 10%

CGH

KKH

SGH

NCC

NDC

NHC

NNI

SNEC

SHP

GROUP

Bringing New Discoveries from Bench to Bedside More than $150 million in competitive research grants in FY08

Increasing presence in high impact factor journals $150.2

Millions $160

700 $7.98 $71.75

$140 $120

$20 $14.97

$57.8

$49.1

$45.6

$45.7 $30.75

$26.18

$31.13

$37.35

$0.02 $42.89

$20.17

$19.41

$17.93

$20.40

FY2002

FY2003

FY2004

$80.4

$69.7

$63.1

$80

$40

600

18 135

500

$100

$60

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Progress Snapshot

$1.22 $46.08

$0.26 $61.19 $70.44

300 200

$22.44

$18.94

Infrastructure Grants

Research Grants

FY2005 FY2006 FY2007 FY2008 Development Grants

8 39 259

4 48 236

6 77

13 142 10 133

440

Healthcare professionals trained FY 07 53,353 FY 08 57,984

Keeping Healthcare Affordable SingHealth Group Procurement saved $145 million since 2001

Growing in Giving

Philanthropic donations: $130 million Raised for annual President’s Challenge: $1.3 million

457

411 378

296

Y2001

Y2002

JIF < 3.5

Y2003 JIF 3.5 - 9.99

Y2004

Y2005

Y2006

Y2007

JIF ≥ 10

Infrastructure Grants— NMRC IBG & EG and one off Grant for IMU and Research Tower Research Grants— NMRC IRG/EDG/NIG, BMRC, Collaborative Grants (SBIC, SIgN, SSCC etc), TCR, NRF CRP, Institutional grants, SHF, Industry. Development Grants— CSA, STaR Investigator, NMRC Research Fellowship, SHF CS/MG/STF

Leading in Healthcare Education

18 170

100 0

FY2001

441

400

10 171

ePulse is an effective way to reach to everyone in communication as not all are able to attend a presentation. It gives an opportunity to revisit and to gain understanding of the text. It’s a positive approach. Thank you.

Y2008

me+GROUP 08

Memories of

icker’s V House

Come 2010, the Vicker’s House Nursing Hostel will make way for the new heart centre. While the physical building may fade into the annals of time, memories of the hostel remain timeless. me+SH reminisces with nurses who have stayed at Vicker’s.

fficially opened in July 1953, Vicker’s House was established as a nurses’ hostel to meet the demands of an increased intake of student nurses who were required to stay in during the training period. Nursing education was conducted at Preliminary Training Schools (PTS). The first PTS was established in 1941 at SGH. The School of Nursing was later built on the site of the old Maternity Hospital, providing future nurses with better training and classroom facilities. 56 years later, 33 retired nurses from the nursing alumni reminisced about their former hostel in a Nursing Alumni Tea Reception. Between those who attended and the many more who once called Vicker’s House their home, the nursing hostel will forever be a place overflowing with fond memories.

me+GROUP

Sisterhood

“Staying together in the hostel for years had bonded us close to one another. Till today, after more than 40 years, we can still call upon one another for help anytime, or to share in each other’s joy.” - Rohana Ibrahim, PTS 33

Eggs

“Sometimes you would get your eggs for night shift and then rush off to the wards, forgetting that you still carried raw eggs in your pocket. When you bent over a patient or leaned over the nurses’ station, you would suddenly find yourself covered in egg!” - Tan Soh Hiang, PTS 27

Staying out late “The hostel used to be locked by 10pm. If we came back too late we would go to the wards and change into our uniforms and come back with the night shift nurses for supper.” - Ho Mooi Mooi, PTS 42

Hostel life “No visitors were allowed beyond the sign. When they came, the Ah Ma (caretaker) would yell for the hostelite that they came to visit.” - Angeline Heng, PTS 33

Food

“We used to buy cockles and eat them with lots of chilli. They were very fresh. The Ah Ma would help us cook them.” - Janet Chan, PTS 36

Special thanks to Sister Gin Cheng Yam, Deputy Director, Nursing, SGH Operating Theatres, and Toby Huynh, Curator, SGH Museum, for their help in this article. Visit the SGH Museum to know about the history of our illustrious Campus. Open daily from 10am to 8pm (except Mondays and public holidays). Admission is free.

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No More

Accidental Leaders Leadership Transition Programme Details Pre-Programme Workshop (360 Feedback + Coaching)

10 ip ersh d a Le LP) nal atiomme (O s i n OrgaProg ra Days egy 3 trat to S n i g ip in ersh nge: ision • V ing Cha s & Lead art ead • L ads, He He llence egic Exce ng Strat lliance i A anag ip & • M rtnersh aduate Pa Gr are SHS althc ship MU- a in He Leader S + plom nt & Di geme a Man

Leaders in SingHealth are always the right people cut out for the right job. This is the promise of the new Leadership Development Programme that started in September.

t started with an anecdote – one that brought back troubled memories of struggle and uncertainty to many of our current leaders: “Though I was honoured to take on a new leadership role, it was venturing into new territory for which I was not prepared. We had to learn it the hard way, along with a lot of heartaches. We were literally thrown in at the deep end and had to swim or sink,” said Prof Tan Ser Kiat, GCEO, SingHealth.

“There was no formal training structure or empowerment system for new leaders then; and many of us had little basic management skills.”

With the benefit of his experience, Prof Tan empathises with leaders thrown into the deep end and is all for preparing for a smooth transition. This led to the introduction of the Leadership Development Programme. Made up of three core programmes – Emerging Leadership (ELP), ship r e Performance Leadership (PLP), and Organisational Leadership (OLP) – d Lea LP) e c P ( n the curriculum will also be complemented by supplementary Leadership a me or m Perf rog ramDays & Programmes that help leaders fill in competence gaps in specific areas, and n P 5 tatio men e High Potential Leadership Programmes such as the recently launched SMUl p d m gic I corecar t e t a SingHealth Graduate Diploma in Healthcare Management and Leadership r S t n • S lanced nageme a Ba (featured in our June 2009 issue). lM ncia tals a n e i c At the helm of the Leadership Development Programme is Tay Sin Hwa, • F r Hospi xcellen fo sE n Director, Organisational Development, SingHealth: t o i n t eme pera • O t Manag uccess “There needs to be a smooth leadership transition – one len rS • Ta oring fo where professions have common leadership competencies ent • M with a network of leaders leveraging on each others’ strengths in a shared culture that promotes collaboration and ip er sh) d improvement.” a P Le ing me (EL g r The focus on leadership in SingHealth is set to produce Em eo g ra m ays al Pr 5 D fession leaders who are appointed based on rigorous assessments of Pro ing ps their leadership competencies. g a i n nt a e sh • Mela t ion na gem ss a e R M Proc ict onfl ivation C • ot ls Skil he M • T encing ersity s flu Div Team • In aging ng n a inni • M ding W uil • B

For more information on the Leadership Development Programme and other available courses, visit http:// mysinghealth/singhealth/corporateoffice/corporatehr/training

+upplementary S ship der Lea mmes gra Pro

he event, held on 29 August 2009, saw 40 medical students cycling alongside cancer-stricken wheelchair athlete Dr William Tan, in a bid to raise $100,000 for needy patients of seven public healthcare institutions—SGH, KKH, CGH, NCCS, NUH, TTSH and AH. Organised by students from the Yong Loo Lin School of Medicine, National University of Singapore, in partnership with SingHealth Foundation, “Ride For Hope” was flagged off at Ang Mo Kio Hub by guest of honour, Health Minister Khaw Boon Wan. The cyclists made six stops in total, all situated within the participating public hospitals. They were warmly welcomed by representatives at each SingHealth hospital. To help them keep up with their caloric needs, they were plied with energy bars, fruits, and isotonic drinks. At SingHealth hospitals, a limited edition of Dr William Tan’s book No Journey Too Tough was sold to step up the fund-raising for our needy patients. Dr Tan’s willpower for turning adversity into advantage is inspiring and the book provides many important and interesting lessons that can help us realise our potential. The organisers are grateful for the support that the event has Health Minister Khaw Boon Wan speaking garnered. with Dr William Tan at the flag off

Farewell to

Peter Saunders departed on 16 August 2009

humorous and helpful colleague and a happy family man—this is how colleagues who have worked with Peter Saunders remember him. Peter, Deputy Director, Technology Development, SingHealth Office of Research, passed away on 16 August. In his work capacity, he oversaw the protection and commercialisation of Intellectual Property (IP) assets of SingHealth Institutions. Prior to joining SingHealth in February 2005, Peter spent more than 25 years in research including research planning and coordination, IP management and technology transfer in the United Kingdom and Japan. He was also a member of the IP Sub-Committee of the Intellectual Capital Working Group (ICWG), under the Biomedical Sciences Executive Committee (BMS Exco) in Singapore, since November 2006. At SingHealth, Peter was the guardian of our locally developed technologies and he helped our researchers to protect IP arising from their work. As a former scientist, he was able to understand and bridge the gaps between scientists and administrators, which went a long way in ironing out work processes. SingHealth is greatly saddened by the loss of Peter Saunders, and he will very much be missed by those who worked closely with him. He leaves behind his wife, two children aged four and six years, and his elderly mother.

me+GROUP

Ride For Hope 2009

me+GROUP

Heart and Lung Controllers

Hardly any heart surgery patient thanks their perfusionist, but they should. By Sher Maine Wong

n the operating theatre all attention is focused on the cardiac surgeon as he fixes a heart. The heart has been stopped so he can do his work. Away from the bright lights and the operating table, perfusionist Teng Siew Yan sits in a corner operating a machine. For the 90-minute duration of the operation, she is the patient’s heart and lungs, as she regulates the patient’s entire blood supply which has been diverted into her heart-lung machine. “In a way the patient’s life is in my hands,” says Ms Teng, an executive perfusionist at the National Heart Centre Singapore (NHCS). The heart-lung machine (HLM) revolutionised cardiac surgery in 1953 by allowing surgeons to operate on a non-beating heart. In Singapore, the heart-lung machine was first used in 1967 at Tan Tock Seng Hospital. By the 1980s, Laboratory Technicians (LTs) were trained to operate the machine on their own and by 1989, they were designated perfusionists. Ms Teng is part of a team of 12 perfusionists. Siew Yan (second from right) with her team

Perfusionists monitor blood flow and also administer medications directly into the patient’s blood stream during cardiac surgery when the heart is stopped. Blood travels through a tube to the heart-lung machine where it is infused with oxygen and filtered before being pumped back to the aorta. As such, perfusionists require technical knowledge not only of the machine but also of the human body. Singapore perfusionists require a science degree before they can train to become one. It is a challenging profession. Says Ms Teng: “Heart surgery is always evolving, it’s not stagnant. There are new techniques we have to learn.” For instance, operating a heart-lung machine during a robot-assisted surgery, where a machine is used to perform surgery while being controlled by the surgeon. However the greatest challenge, in Ms Teng’s words, is “reviving a collapsed patient by initiating cardiopulmonary bypass in the shortest possible time.” The greatest satisfaction comes when patients walk out of the hospital. “When we have very sick patients who recover very well, I feel very happy for them, and I’m glad that I had a role to play in it.” She doesn’t even mind that the patient doesn’t know.

The Perfusion Profession— a journey of 40 years

1967

Singapore performed its first case of open heart surgery with a heart-lung machine.

1976

LTs operate the HLM under supervision of anaesthesiologists. LT John Ng simplified the HLM extracorporeal circuit and its preparation, and introduced the Hemochron for heparin monitoring. The latter shortened operating time and reduced the number of post-operative bleeding incidents in patients.

1980s

LTs were trained to operate the HLM on their own, with focus on Coronary Artery Bypass Graft operations.

1989

LTs were officially re-designated as Perfusionists at Singapore General Hospital (SGH) and the team was later transferred to NHCS when the centre became autonomous in 1999.

1990s

Introduction of new techniques and long term pre- or post-operation Extra-Corporeal Membrane Oxygenator (ECMO) support.

2000s

Expansion of perfusion services to other disciplines and hospitals as requests for perfusion or ECMO support in paediatric operations or inter-hospital transfers of very sick cardiovascular patients increased.

2004

Accreditation of NHCS by the Australasian Board of Cardiovascular Perfusion.

Currently, NHCS has a team of

perfusionists.

Besides supporting the cardiothoracic surgeons in their work, the team also provides services to SGH and other hospitals in Singapore.

There are now at least

perfusionists in Singapore. Most of them have at least a degree with some old timers who might be diploma holders. Training is on-the-job.

DES became SEMC in 2008 as it took on a cluster-wide role in providing comprehensive translational research expertise and facilities to scientists studying diseases at a molecular or cellular level through animal models. The endpoint of such research is to accelerate healthcare outcomes.

In full gear: Automatic cage changing system at work.

Analysing micro-CT data

Smooth Operator

The SingHealth Experimental Medicine Centre is one of the lesser explored places on SGH Campus. me+SH takes a peek at what Irene Kee, the centre’s Senior Research Associate, does. By Jeanie Cheah

rene Kee has an unusual job, one that straddles two vastly different facets of operations. As Senior Research Associate at the SingHealth Experimental Medicine Centre (SEMC), she provides technical support to researchers working on drug tests leading to the pre-clinical phase, thereby traversing the human and animal world on a daily basis. Irene works closely with researchers and veterinarians in research projects and surgeries. In the operating theatre, she takes on the role of a scrub nurse or anaesthetist when needed. She also works with veterinary staff to provide post-surgery care to animal research subjects. The smooth running of research activities depends very much on Irene and her colleagues, who help to ensure that ethical guidelines and standard regulations are adhered to strictly. Another aspect of her work entails the duties of operations manager where she oversees the day-to-day coordination at SEMC and ensures that the equipment and facilities are in proper working condition. Irene will be playing

a leading role in SEMC’s move to the new pathology building in 2011. With her background in biomedical science, and a first job working in the department of orthopaedic surgery at the National University Hospital, Irene always reckoned she would spend more time in the laboratory than in an administrative office. Now she spends an equal amount of time juggling both lab work and the management of facilities and equipment. In 1995, Irene joined the Department of Experimental Surgery (DES) at Singapore General Hospital (SGH) and has been with the SingHealth family ever since. It has proven to be the turning point of her career in healthcare. She has seen DES evolve into being the first academic animal research facility in Singapore to be fully accredited by the Association for Assessment and Accreditation of Laboratory Animal Care International. “In the nineties, not many people here were aware of the importance of research. In fact,

Dr Bryan Ogden, who recently assumed the post of Director at SEMC has this to say: “I have seen how research has helped benefit humans while I was at Oregon Health & Sciences University and the Oregon National Primate Research Center, and it is gratifying. SEMC has an important role to play in helping researchers get the most out of animal models in a humane and ethical framework. “We have highly qualified personnel and well-established infrastructure to support projects to the highest international standards. Regulations are well developed in Singapore. This is a conducive environment for researchers especially with government support for research available at all levels.” Studying vasculature structure through the microscope.

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few of my peers had heard of a job like mine. All they knew was that I worked in a lab,” recalls Irene.

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Emp wering

the Resident

Graduate medical education at SingHealth moves forward with its new residency program. Lydia Ng and Michelle Lam from SingHealth Academy explain how.

“The objective is two-fold: Firstly, to provide the US Residency platform for our Duke-NUS Graduate Medical School (GMS) Doctor of Medicine graduates to proceed on to specialist training and secondly, to improve on our present training in the Basic Specialty Training and Advanced Specialty Training (AST) mode to a system based on formal ownership and formative assessments, driving quality into the process—thus being inclusive of our Yong Loo Lin (YLL) Bachelor of Medicine and Bachelor of Surgery graduates as well.” True enough, adoption of the US program is based on a vision to provide the best graduate medical education environment for SingHealth. Residents go through substantive education that would translate into six competencies with a desired outcome of improved clinical competency and ultimately, higher quality patient care. As the biggest sponsoring institution in Singapore for the program, the US Residency Program is a milestone for SingHealth’s medical education. SingHealth Academy has been supporting the education leadership in collaboration with MOH and ACGME to prepare the program for its launch. It seems like the next time we catch American television medical dramas, we will be reminded of our own doctors going through a similar residency training program.

merican medical dramas Grey’s Anatomy and Scrubs captured our hearts as we watched the passionate lives of medical residents being played out on television. Sometimes, the shows echo reality and the lives of junior doctors as they train at our healthcare institutions. The drama-reality similarities will increase come May 2010 when graduate medical education in SingHealth incorporates a residency program under the US model. Minus the drama found in the shows, residency would then move from our current British-based Specialist Training system to take on a similar American-style residency approach. This is part of the Ministry of Health (MOH)’s initiative to advance local medical education. Although the British system had served the medical sector well for years, the US model has many positive elements to further the cause. The US Residency Program is founded on a structured training framework and education curriculum, adopting established standards from the American What is residency? Council for Graduate Medical Education (ACGME). It is It is a form of post-graduate medical education where medical graduates practise a specific branch of medicine under the a rigorous system designed on a formative model for supervision of fully-trained physicians in a clinical setting. quality training.

Fast Facts

A key feature is in its evaluation methods— an ongoing monitoring system to assess residents’ skills from time to time, ensuring a continual review of learning progresses. This differs from the current system, which utilises a summative method where assessments accumulate in intermediate and final exams. The US-styled continuous evaluation makes up an efficient method of training as consistent assessments empower residents to learn, improve and eventually attain certification more effectively. A/Prof Colin Song, SingHealth’s Group Director of Education and Designated Institutional Officer for the US Residency Program, recognises the need for this shift: “Our British-based programme has served us well, but we run into the danger of being left in the backwater of healthcare education if we depend only on time-tested traditions. Instead, we must innovate and adapt the best practices from around the world to our advantage.”

Who is the program for? Duke-NUS GMS and NUS YLL School of Medicine graduates.

Core Competencies: 1. 2. 3. 4. 5. 6.

Patient Care Medical Knowledge Practice-based Learning & Improvement Interpersonal & Communication Skills Professionalism Systems-based Practice

SingHealth will add a seventh core competency—Faculty Development—to equip individuals with leadership and administration skills, and increase teaching competencies necessary for passing on of the healthcare education baton.

Medical Specialties in 2010: • • • • • • •

Internal Medicine General Surgery Paediatrics Pathology Psychiatry Preventive Medicine Emergency Medicine

Graduate Medical School As Duke-NUS officially opens its much anticipated new premises on 28 September 2009, me+SH retraces the steps leading to the making of this pioneer education institution.

The vision: to develop SGH Campus into a worldclass medical hub and an outstanding academic medical centre.

By Jeanie Cheah

Photo by Tony

Tay

The right ingredients: clinical excellence and strong research and educational capabilities.

he search for the missing piece in the jigsaw began way back in the eighties, not long after the Faculty of Medicine relocated to the National University of Singapore’s Kent Ridge Campus in 1986. But it was to take almost a decade before a worthy partner was found to start the second medical school in Singapore. Duke University in Durham, North Carolina, one of the most prestigious higher education institutions in the world, signed a memorandum of understanding to collaborate on a graduate medical school in the heart of Outram in the year 2003. Out of that memorandum came the Duke-NUS Graduate Medical School with the backing of three stakeholders – the Ministry of Education, the Ministry of Health and the Ministry of Trade and Industry. SingHealth also played an active part in the process that brought a graduate medical school to our midst. Said Group CEO Prof Tan Ser Kiat, “We reviewed models of medical education in our search for an education partner, and Duke University had the attributes we were looking for. It had the reputation for producing a robustly different breed of physicians well-versed in both scientific enquiry and clinical skills. And a significant proportion of its graduates carry on in the research arena to push the borders of clinical excellence.” The Duke University School of Medicine with its strong education and research capabilities was what SingHealth needed to complement its strength in the clinical setting. Equally important

me+SPOTLIGHT

The Case for

The missing piece in the jigsaw: a tertiary medical institution with the right attributes.

was the difference the American model of medical education had to offer. What Duke brought to the table was a graduate programme, unlike the local undergraduate programme. It meant that students who were enrolled would already have completed a basic university degree. This has obvious advantages: the maturity of students both emotionally and “My heartiest congratulations intellectually, and their to the team at Duke-NUS. strong motivation for I have no doubt that our strong taking on medical partnership will continue to education. flourish, and I look forward A graduate medical to the promise of an exciting school with a strong future for medicine this brings.” clinical research GCEO Prof Tan Ser Kiat programme and a worldclass reputation would not only serve SingHealth well in our pursuit of academic medicine. It would attract students, both local and international, of a high calibre. And Duke-NUS has done just that since it began enrolling students here in 2006.

Progress Report The Singapore model has taken on the curriculum that sets Duke apart from other medical schools – its research which is essential in the training of

me+SPOTLIGHT 16

“A student on the Duke-NUS graduate medical programme has the opportunity to gain hands-on practice at our hospitals, where we have a wide variety of specialties and patient volume that they can gain good exposure and fully benefit from. The curriculum is very dynamic and students are integrated into the clinical and patient care environment very early. It is definitely an exciting time both for the students and the faculty to be part of this pioneering collaboration.” A/Prof Lim Shih Hui Senior Consultant Neurologist, NNI-SGH Campus Clinical Associate Professor, YLL School of Medicine, NUS Associate Professor, Duke-NUS GMS

academic clinicians and the cross disciplinary approach. The full-time and adjunct faculty here, largely made up of SingHealth clinicians have also had a part in shaping the curriculum. In the words of Prof Ranga Krishnan, Dean of Duke-NUS, “The school here at Singapore is unique. It is one of the first ones that has taken a very good curriculum, and imparted or brought in a new way of learning. The word here is learning, not teaching.” This different model of medical education is not the only form of diversity and dynamism Duke-NUS has brought to SGH Campus. Its presence has helped to generate an academic buzz, and a spirit of camaraderie that is palpable at the various gatherings such as its regular TGIF and the networking session for incoming students organised by SingHealth.

“Duke-NUS has gone beyond our expectations in bringing value to SingHealth and to Singapore. Not only has it fulfilled the promise to bring in top faculty members such as Professors Sanders Williams, Ranga Krishnan and Patrick Casey from Durham, it has admitted quality students from many parts of the world,” said Prof Tan. “Our applicant pool continues to be very strong. For our first intake in 2007 we enrolled 26 students. In 2008 we enrolled 48 and in 2009 we added 56. We anticipate keeping class size about the same to enhance individual and team learning,” added Dr Craig Stenberg, Associate Dean, Student Affairs and Admissions at Duke-NUS. About half of the latest cohort of 56 are international students. The increasing number of

students from distant shores is evidence of how well and fast Duke-NUS has built its reputation across the globe. The school has also given the local research landscape a boost. It is home to top-notch researchers and some of the world’s most sophisticated biomedical research facilities. Beyond conducting research at its own premises, partnership with SingHealth gives the faculty staff and students of Duke-NUS access to other specialised research support facilities at the Group’s institutions. The Chronobiology and Sleep Laboratory, where studies are made on the mechanisms that govern human circadian rhythms such as the sleep-wake cycle, is housed at SGH. As Duke-NUS officially opens its new premises on 8 College Road on 28 September 2009, SingHealth celebrates the return of its rich tradition of excellent medical education that started at Outram more than a century ago and a partnership that strengthens the practice of academic medicine.

“I am on my first attachment at SGH and I have been made to feel an important part of the SGH Campus. It is really encouraging to be warmly welcomed by the healthcare professionals on campus, and to have teachers and supervisors who are clearly interested in helping us learn. There is also a lot of curiosity about the Duke-NUS programme from the doctors, nurses and especially the patients, who notice the crest on our white coats and want to know where we are from and our skills set.” Kizher Shajahan Mohamed Buhary, now in his 2nd year at Duke-NUS

me+SPOTLIGHT 17

Duke-NUS student and SingHealth faculty networking

“The entry of the DukeNUS Graduate Medical School is about producing different breeds of doctors; doctors who are prepared to think out of the box, doctors who are prepared to commit themselves to discovering new ways and means of treating what I sometimes call untreatable diseases of today.”

Catalyse Research with Duke-NUS Duke-NUS & SingHealth

Basic

SINGHEALTH’S RESEARCH FOCUSED AREAS —closely aligned to clinical strengths

Translational Clinical

Cardiovascular and Metabolic Diseases

Infectious Diseases

Neurosciences

Oncology

Ophthalmology Immunology

DUKE-NUS Signature Programmes • • • • •

Cardiovascular & Metabolic Disorders Emerging Infectious Diseases Cancer and Stem Cell Biology Neuroscience and Behavioral Disorders Health Services Research

GCEO Prof Tan Ser Kiat

Establishment of Duke-NUS Graduate Medical School Apr 05 Ceremony in Singapore to formalise Duke and NUS partnership

Mar 08 Duke-NUS, Lien Foundation and NCCS set up the Lien Centre for Palliative Care–Asia’s pioneering institution for palliative care research and education.

Aug 05 Prof Sanders Williams named inaugural dean Sep 05 First meeting of Duke-NUS governing board

Sep 06

Groundbreaking

Aug 07 First 26 Duke-NUS students begin classes Photo by Tony Tay

Jun 03

Signing of MOU between Duke and NUS

Aug 06 Admission

for first Duke-NUS class of 26 students

Jul 05 Establishment of interim campus at SGH

Jan 07 Duke-NUS receives S$80million to grow biomedical research initiatives from the estate of the late Tan Sri Khoo Teck Puat

Aug 07 White Coat Ceremony for first student cohort

Aug 08 Duke-NUS faculty garners Young Scientist Award 2008

Sep 09 Official Opening of Duke-NUS Graduate Medical School

me+SPOTLIGHT

A New of

lass

Great Do

Great doctors are made, not born. me+SH pays tribute to a succession of outstanding medical educators who spend their lives passing on their knowledge and unwavering professionalism, to nurture a whole new class of great doctors. By Sher Maine Wong

he greatest mentors are not necessarily the nicest ones. Prof Ng Han Seong should know: He does not try to be nice. What he is, is exacting. Think of him, if you will, as a shifu: A traditional Chinese master who employs discipline and reprimand to keep his disciples in line. “He is a very old-fashioned shifu, in a knock-your-knuckles kind of way,” said A/Prof Chow Wan Cheng, one of his mentees who now heads the SGH Department of Gastroenterology and Hepatology. “But we accepted the school of tough love because that is how we achieved exceptional standards of patient care,” said Dr Daphne Khoo, another of Prof Ng’s mentees who heads the SGH Department of Endocrinology. It is not only the credentials of his mentees – many of whom are now holding leadership positions – which is testimony to Prof Ng’s effectiveness as a teacher. Prof Ng, who is Chairman of the Medical Board and Emeritus Consultant to the Department of Gastroenterology and Hepatology, SGH, has just received a National Outstanding Clinician Mentor Award from the Ministry of Health. This award is the state’s highest accolade for individuals who have contributed substantially in the training of young

clinicians and clinician scientists A challenge, however, is how through mentorship. today’s medical students are a “I think I owe it to all my different breed. “Some come for colleagues and students, who have class in their slippers and Starbucks given me all the opportunities to coffee and when they come in late, I contribute and make a difference,” want to vomit blood,” said Prof Ng, said Prof Ng, who speaks in soft good-naturedly. measured tones and chuckles often On a more serious note, with the occasional “lah” thrown in Prof Ng adds that mentors and for good measure. teachers nowadays have to ensure Great mentors like Prof Ng have that students know how to use a crucial role to play in Singapore’s technology without losing sight of healthcare system. As Health what it means to be a doctor. He Minister Khaw Boon Wan said, “All said: “The young ones have many strong institutions have a critical more choices, new drugs, new mass of role models, who coach gadgets. And while all sorts of tests and mentor the young. They provide are available, they have to interpret the deep roots from which we get these tests and connect them with the new shoots, branches, flowers the patient’s complaint. and fruit.” (When he launched the “The challenge in teaching them book To Sail Uncharted Seas in is for them to imbibe what I call 2005.) the good old values: the personal Imparting domain knowledge is touch, respect, communication with a given. What Prof Ng excels at is patients, accountability and even a honing professionalism, or what he little bit of altruism.” calls the “soft skills”. “Sympathy, empathy, communication. These cannot be learnt from textbooks,” said Prof Ng. “We also have to teach our young ones about governance and standards, to be accountable and responsible, even in something as basic as being Prof Seah Cheng Siang (Front row, 4th from right) was mentor to on time.” Prof Ng Han Seong (Back row, 2nd from right)

me+SPOTLIGHT

ctors

The Mentor’s Mentor It may be hard to imagine Prof Ng as a newbie, but he has vivid memories of his days in medical training with his mentor, the late Prof Seah Cheng Siang. “I was quite shocked when I joined the famous MUIII unit,” said Prof Ng, referring to the SGH medical unit which Prof Seah headed. “I saw a dry iron which was used to iron case notes so that they would all be neat and flat with no dog ears; and a paper cutter, so that all the notes of varying sizes can be trimmed neatly to the same size. Prof Seah also made it clear that the dots in the temperature charts, had to be right in the middle of the squares and the dots had to be even.” Patients’ lockers were exactly six inches from the bed and the ends of the pillows, which the cases did not cover, had to be turned to face the wall. There was a point to all this. “It may sound petty but it was all about maintaining standards and discipline,” said Prof Ng, who has, in over 30 years of teaching, sought to transmit the same strict values to his students. Although Prof Seah never outrightly praised Prof Ng – “in those days if the teachers don’t scold you it is equivalent to a distinction!” – he was bestowed the greatest honour when Prof Seah fell ill in his old age. “I had the priviledge of looking after him when he was sick,” said Prof Ng, quietly. “What bigger honour can there be than to look after your mentor? In a way it was the best recognition I could have hoped for.”

Prof Ng— a nurturing but strict mentor

me+SPOTLIGHT

dis

The

Prof Ng Han Seong’s most important lessons were often the unspoken ones.

here is an unspoken tradition in the SGH medical unit where A/Prof Chow Wan Cheng was once a newbie – that following ward rounds, all the medical staff would gather in the kopitiam and the most senior staff in the room would pay for everyone’s drinks.

“As the most junior staff, you would never have a chance to pay for your tea,” said A/Prof Chow. “You can only pay for the next generation.”

Associate Professor Chow Wan Cheng Senior Consultant and Head, Department of Gastroenterology and Hepatology, SGH

She likens it to her passion for mentoring young doctors. “I have to pass on, to the next generation, the knowledge which mentors like Prof Ng Han Seong has passed to me, because that is the only way I can pay them back.” From the time Prof Ng first asked A/Prof Chow “why she wanted to be a doctor”, even before she became a medical student, to the time they coauthored a medical research paper together, he has had a profound influence on her career. She is not only a famed clinician who has won numerous awards for

her research in the hepatitis virus, but also a much-loved mentor known for her “open-door” policy and nurturing hand. Said A/Prof Chow on Prof Ng’s influence: “It’s not so much what he said, but what I saw. I saw how he was approachable to all his patients and how he loved to impart knowledge.” As a mentor, A/Prof Chow strives to be one who teaches through both words and deeds: “Mentoring is not just about the passing on of knowledge, but also about values, good ethical principles and behaviour.” Dr Tan Hui Hui, a consultant in her department, said: “I could see that she sets very high standards for herself and is very kind and compassionate to her patients. She is also very astute in her clinical acumen. She helps me with my career development and I have a sense that she is someone who really cares for me. It’s much more personal.”

me+SPOTLIGHT

sciples

Dr Daphne Khoo Senior Consultant and Head of Endocrinology, SGH; Director, Clinical Governance and Quality Management, SingHealth

ontribution to the public sector as well as expecting and demanding the best from staff—although Professor Ng Han Seong never explicity said these to Dr Daphne Khoo, they had a profound effect on her. “People like Prof Ng and Prof Seah Cheng Siang would have made fortunes if they moved to the private sector, but they chose a different path,” she said. “It was ingrained in us, therefore, that there were more important things than money. They also instilled a sense that nothing but the highest standards were acceptable and pushed us to be the best that we could be. Sometimes this drove us to accomplish things which we did not think ourselves capable of.” Which is why Dr Khoo, who has been described as a caring mentor, continues to put her heart into coaching, guiding and constantly challenging her staff. “Sometimes I think I am very hard on them but that’s because I feel some of them are truly capable of achieving greatness in medicine if they only tried harder. I sometimes feel it is sad nowadays that we so often settle for competent mediocrity.” She found herself deeply inspired by Prof Ng whom she

calls a “brilliant teacher”: “He had a gift of making you fall in love with medicine such that you didn’t mind spending whole days and nights working because the field was so fascinating. The whole department had a tremendous level of intellectual curiosity.” She continuously attempts to imbue that enthusiasm in her juniors. One of Dr Khoo’s former medical students and mentees, Dr Loh Lih Ming from the Department of Endocrinology, SGH, said: “She was a very conscientious teacher who spent a lot of time with her medical students.”

Dr Loh appreciates how Dr Khoo cared for the junior staff beyond just imparting clinical knowledge. “She had regular after-round teas during which time she made it a point to know our backgrounds and was very good at picking out our individual strengths and weaknesses. As a mentor, she’s the sort that if you had a plan or ambition, she would help to facilitate the way for you.” However, Dr Khoo acknowledges that being a mentor today is different from a generation ago: “In the past, senior staff would ask us to stay back till 9pm so they could teach us from 7-9 pm after the clinical work was completed. I don’t think this would be acceptable nowadays to either the senior or the junior staff.”

me+SPOTLIGHT 22

6Mentors

Seconds With Our

Lee Yuen Mei talks to SingHealth educators and gets them to tell us about their passion in teaching.

Find out how our mentors apply lessons from the classroom to their own house and children on page 32!

Dr Chua Yeow Leng Senior Consultant, Cardiothoracic Surgery, NHCS What are some of your best memories as a student or trainee? For me, my mentors stood out the most. When I was a third year medical student, my tutor, Prof Robert Pho (currently at NUHS) was trying to teach us green stick fracture that happens in young children. So he made us go outside to find a green stick that was still very moist, afterwhich he broke it to demonstrate that it did not make a clean break, similar to what a green stick fracture is.

Dr Goh Siang Hiong Deputy CMB (Ambulatory), CGH Senior Consultant, Accident and Emergency, CGH What are some of your best memories as a student or trainee? It was being able to interact with other students from different faculties on campus as well as being an important member of the ward team during our hospital attachment training and being able to participate in the care of patients. Our seniors, who were housemen and medical officers, took the time to guide us through procedures such as inserting chest tubes, central lines, stitching and also setting drips and taking blood. Sadly, the camaraderie between seniors and medical students are less treasured nowadays as there is no more “medical” hostel to bond in.

Your experiences with your students? Most of them are too shy and dare not come forward to ask for patients’ permission to examine them. They read widely but do not get to see patients and join in the medical teams. So while they are strong in theory, they lack opportunities for practical application of their knowledge.

Your experiences with your students? As trainings are conducted on patients, it is very sombre and we have to be very cautious. I have even suspended my trainees before because they were not doing the right thing. It is very painful to do that but these are the people who will eventually be managing patients independently on their own. There are a few phases in a doctor’s life: The first phase is learning, then trying to do it properly, mastering the skill and developing something new. The final stage is bringing up the next generation and seeing them surpass you. The best thing about the public system is that we produce people doing really tremendous work now. That’s why we really have to invest in people.

What are some of your best memories as a student or trainee? A small error was made in preparing morphine syrup for an elderly patientâ&#x20AC;&#x201D;the medication was dispensed in correct therapeutic doses but short of the syrup that gives it a sweet taste. Although there were no medical implications, my preceptor still scolded me sternly. I held my tears till the end of the day when I sobbed non-stop on the way home. This incident truly ingrained in me the commitment to error-free dispensing, something which serves me well to this very day.

Your experiences with your students? Upon graduation, my pre-registration students are already well-trained academically but lack the practical experience. When I train them, I focus more on communication skills and application of theoretical knowledge. One of my favourite teaching activities is role-play where I can assess whether my students have internalised my teachings, so I can guide them accordingly.

Dr Chew Ming Tak Director and Senior Consultant, Department of Orthodontics, NDC What are some of your best memories as a student or trainee? I would say that the camaraderie and friendship, made in the first two years, were memorable, before we were hit by deadlines and schedules. As for mentors who have left their mark, it has to be my teacher who guided me through my postgraduate programme and my PhD endeavours. I must say his philosophy on education and mentoring molded the way I approach teaching today.

Dr Ian Yeo, Consultant, Vitreoretinal Service, SNEC What are some of your best memories as a student or trainee? The houseman years were the toughest, mentally; not from the work but the sight of patients young and old dying before you. I was awe-inspired and amazed by the knowledge of all those whom I was fortunate to have the chance to work with. The lessons you learn from your many teachers on how to deal with death, help patients manage their pain and prepare them for the inevitable, were important life lessons for me. With these lessons from my early years in medicine, I learnt to be humble in my own knowledge and understand the limitations we have as doctors. I aim to treat my patients as my friends and relatives as this will instill in me the importance of doing the best for everyone.

Your experiences with your students? The support you give to all your patients can make a big difference to their livesâ&#x20AC;Ś and you feel enriched and rewarded by this. I hope I can instill some compassion in my trainees and motivate them to have passion in all that they do.

Nidu Maran Shanmugam Advance Practice Nurse (Orthopaedics), SGH What are some of your best memories as a student or trainee? When I was a student attached to SGH pediatrics, I was uneasy dealing with death. My first encounter was the death of a child â&#x20AC;&#x201C; when the child passed on, I became emotional, as I had been nursing the child for some time. Through this lesson, I learnt that seeing and facing death are part and parcel of the profession. Managing it is important; you cannot get too emotionally attached to the patients.

Your experiences with your students? As I work with mature postgraduate students, I try to remind myself that as their teacher, my function is to assist them in whatever way I can throughout their learning journey; to give them a slight push when they are lagging behind or to give a pat on the back when they are flying. Whatever judgments or decisions made regarding the student or the programme should not deviate from the intention of helping the student in his/her learning journey.

Your experiences with your students? When I get new nurses, I will always conduct an induction programme to cater to the mixed breed of nurses from different educational backgrounds coming together. I feel really happy when I see their progress. Although some may be slower at the beginning, I am glad to see them pick up, move on and do well in their professions now.

me+SPOTLIGHT

Ms Goh Chin Chin, Clinic Pharmacy Manager, SHP-Pasir Ris

me+SPOTLIGHT

Up Close

With The Participants

me+SH speaks to some participants on their experiences in SingHealth.

Teaching in a

Global Classroom

Participants from India’s public healthcare returned with high hopes of applying the knowledge gained from the Temasek Foundation-SingHealth Training-of-Trainers Initiative. By Arthur Wong

n a collaborative effort with the Catholic Health Association of India (CHAI) to enhance healthcare and hospital management in North India, SingHealth took on the task of conducting a three-day workshop for participants from the public healthcare sector of Chandigarh, India. Selected to undergo training to become master trainers, the participants had already completed a strategic healthcare leadership and training-of-trainers workshop in Chandigarh before coming over to Singapore. Upon completion of the course in Singapore, the participants will then return to India to conduct training courses and pass on the knowledge they acquired at SingHealth to other healthcare professionals. Dr Thalakkotur Lazar Mathew, project director for the initiative and project director of CHAI, sees this as a vital first step to a continually improving professional relationship between the two countries: “This initiative is empowering certain people to be trainers, and they in turn can train other people. There will be a ripple effect in how to use modern technology in the healthcare system and how we can benefit from the experience in SingHealth in a special way. “We see great potential in emulating Singapore’s successful model of healthcare. This is only the beginning of a meaningful collaboration that will bring healthcare standards in India to greater heights.” Mentored in the areas of healthcare economics, health technology assessment, and procurement by SingHealth and Duke-NUS professionals, the participants were eager to learn and came prepared with case studies and questions for their trainers. Their three-day workshop culminated to a panel discussion on change management and healthcare leadership with SingHealth representatives Mr T K Udairam, CEO, CGH; Dr Wong Yue Sie, Group COO, and Dr Jeremy Lim, Chairman Advisory Committee, Centre for Health Services Research. Upon returning to India, the participants will then conduct their own training-of-trainers workshops, and will contribute to the training of 150 individuals yearly on evidence-based decision-making in healthcare management. They will also form a strategic policy-planning unit that encourages hospital leaders to objectively evaluate competing medical approaches, and enhance the quality of healthcare offerings in India. Over the next two years, the initiative is slated to benefit more than 500 participants from healthcare institutions in North India, marking yet another milestone for SingHealth in the betterment of healthcare education.

Vipin Kumar Koushal Medical Superintendent, Common Medical College, Chandigarh Background: I manage a group of hospitals, looking after everything from the materials to managing the requirements of patients and staff. The biggest problem we face is overcrowding. We want to increase the efficiency of the staff, and hope to learn much about that from our visit here.

Lessons Learnt: We learnt more about health technology assessment, which is very important in the healthcare field. It allows me to make more efficient decisions in our field of work. The workshop enables us to conduct our own classes and transfer our knowledge to others. As Dr Mathew said, this is only the beginning, and we have to continue to grow this relationship. The workshop was very well conducted – excellent and very informative. We gained a lot of new skills and knowledge. It has definitely taught us about how they do things here, and I think the trainers learned from us as well. We exchanged best practices, which makes this a good partnership.

Dr Ashok Kumar Medical Administrator, Postgraduate Institute of Medical Education & Research, Chandigarh Background: I look after the entire hospital’s services, planning the coordination among staff in our institutes, and utilising all available resources to provide the best medical care to our patients. Right now, there is often mismatch of resources among patients and staff, coupled with the ever-present problem of overcrowding. SGH is a big hospital, and I think we can learn much from their experiences to improve our healthcare and services.

Lessons Learnt: We shared our experiences working in the different institutes and hospitals, and I found that the problems are largely the same. However, we both have different ways to deal with the problems. SingHealth uses evidencebased medicine as a tool to solve the problems, and I hope that I can apply the same in our institutes in India. When you deal with things in a scientific way, it will be easier for effective decisions to be made.

e+SH congratulates our two pharmacists who received the prestigious Pharmaceutical Society of Singapore (PSS)-Shire Hospital Pharmacist of the Year Award and the Professor Lucy Wan Outstanding Pharmacist of the Year Award at the 20th Singapore Pharmacy Congress. Ms Lee Soo Boon, Senior Principal Clinical Pharmacist, SGH, was given the PSS-Shire Hospital Pharmacist of the Year award for her excellence in hospital excellence. Dr Andrea Kwa Lay Hoon, Senior Principal Clinical Pharmacist, SGH, was awarded the Professor Lucy Wan Outstanding Pharmacist Award, the highest award given by PSS to Singapore pharmacists who have excelled in their area of pharmacy practice.

Singapore

Health Your premier source of trusted news and updates from SGH and other SingHealth institutions.

• News to help you navigate the healthcare system • Scientific discoveries and medical breakthroughs • Features on health issues • Expert opinions and reviews • Financial guide to health • Beauty, wellness and recipes • A section in Chinese

Grab your first copy in November.

me+SPOTLIGHT

Outstanding SingHealth Pharmacists recognised

me+SPOTLIGHT 26

A quicker

heart lifeline Minutes spent restoring blood circulation using a heart-lung machine can mean life or death for heart failure patients. A team from the National Heart Centre Singapore managed to quicken the process. ECLS Team in NHCS

Inter-hospital transfer

t used to take over one hour for heart failure patients to get hooked up to a lifesaving heart-lung machine at the National Heart Centre Singapore (NHCS) to restore their blood circulation. Now a team of six, led by Ms Anne Hoo, a senior perfusionist at the centre’s cardiothoracic surgery department, has managed to cut down the time of extracorporeal life support (ECLS) by as much as half. In the past, help for these patients— who are referred to NHCS from Tan Tock Seng Hospital (TTSH) and Changi General Hospital (CGH) – was delayed due to transportation, response times and various other factors. What the team did was to use the Clinical Practice Improvement Programme (CPIP) methodology to recommend changes. Their recommendations included: • Downsizing the cart which holds the lifesaving equipment so it can even fit into a car, and the team can

quickly travel to the hospitals where they are needed. In the past the cart could only fit into an ambulance or a MaxiCab (a van-like taxi) which can be hard to locate during peak hours. • Simplifying the workflow, so the perfusionists who operate the heartlung machine can go straight to the hospital where they are needed instead of having to first report back to NHCS. • Training other doctors and nurses, apart from the perfusionists, to set up the machine so preparation time is shortened. The team managed to cut down the waiting time for patients referred from TTSH by 27.9 per cent, and those from CGH by 46.2 per cent. CPIP is organised by SingHealth Clinical Governance & Quality Management. For more information, visit http://mysinghealth/Singhealth/ CorporateOffice/QM/Programmes/cpip.

National Heart Centre Singapore Inter-hospital ECLS Support Service Workflow After Office Hours: Monday-Friday (1730-0800) Public holidays and weekends (24hrs)

Referral for Extracorporal Life Support (ECLS) Perfusionist on call

Ventricle Assist Device (VAD) Consultant

Activate Coordinator

Call Secondary Perfusionist

Nurse Manager activates backup Registrar to cover Cardiothoracic Surgery Intensive Care Unit (CTSICU)

Yes

Registrar on call to Respond?

Medical Officer on call

Call transport. Bring ECLS cart from CTSICU (Preparation Room). Pick up at Block 5, Waiting Area Bay.

At the Referral hospital, surgeon assesses patient

Abandon procedure

ECLS Requirement?

Yes

Set up & prime ECLS circuit. Initiate ECLS.

Sin

me+SH catches up with Dr Kenny Sin, a cutting-edge cardiac surgeon and a down-to-earth educator who is inspired by the past and a heartfelt dedication to bring healthcare here to the next level. By Sher Maine Wong

he old-fashioned terrace house was rather difficult to find, given that it was nestled within a quiet cul-de-sac behind a peeling fence that was covered with lush Allamanda vines. Looking at the unpretentious home, you wonder if you’ve got the right address to one of Singapore’s top heart surgeons. Then a white car turns into the driveway – a lovingly and meticulously maintained 26-year-old Mercedes to be exact. Out strides Dr Kenny Sin, Head and Senior Consultant of the Department of Cardiothoracic and Vascular Surgery at the National Heart Centre Singapore (NHCS), in bicycle shorts and shirt. “Sorry to keep you waiting,” he states, with a smile and a firm handshake.

Valuing the old A researcher, academic professor and clinician known for his skill in adult cardiac procedures like coronary artery bypasses and complex open reconstructions of the aorta, Dr Sin is also one with a love for antiquity. “I appreciate things which were made in the days when people were proud of their work and which lasted for many years. I guess you can call me a conservationist, a champion for quality goods which people were proud of making,” he says. Subtle vintage touches are evident around his home. A worn nut brown 30-something-year-old piano sits in the living room – “I bought that secondhand when I was a junior medical officer” – and he owns a vintage hi-fi system. Dr Sin’s penchant for the value of old things is reflected in his work; certainly not in the use of technology or surgical techniques, but in something far more profound: appreciating old lives. Just as the good doctor takes care of his vintage possessions, he also wishes people would value their folks more. It is a timely observation, given that an increasing number of elderly are suing their offspring because the latter will not or cannot support them. “It’s very sad. There’s an occasional attitude that when it’s not economical to repair the heart, the old ones might as well go home and quietly fade away. The elderly think they are disposable beyond a certain age even when they are relatively healthy, and the young may not help much in trying to dispel that myth,” says Dr Sin. In his 20 years of practice, he has observed that people are becoming less caring of their elderly parents and relatives. “In the past they used to camp outside the operating theatre. Nowadays, we increasingly see a lot of patients who are left totally

me+LIVING

At Home With… Dr Kenny Original

me+LIVING 28

“

A researcher, academic professor and clinician known for his skill in adult cardiac procedures like coronary artery bypasses and complex open reconstructions of the aorta, Dr Sin is also one with a love for antiquity.”

alone in the hospital during their stay. Their relatives are too busy with other priorities to spend time with them in hospital, and are often not even interested to ask me much about their surgery. There seems to be an erosion of traditional Asian family values with the newer generation. We just have to accept it, this is the way this generation is going.” It may be a tad controversial to say so, but Dr Sin, whose businessman father and retired teacher mother are living in Malaysia, does not mince his words. This trait is evident from his point of view towards various topics. On the need to engage the medical students he teaches, he shares: “It’s important to engage them in a lesson, rather than to have them read something in a book or attend the lecture half-asleep thinking of their boyfriend or girlfriend.” On the need to make healthcare institutions a safer place for patients, he opines: “It’s not buy one, get one free, whereby the patient comes in for a procedure and leaves with an MSRA infection.” (Methicillin-resistant Staphylococcus aureus—MRSA—is a contagious, antibiotic-resistant infection.)

On the lack of donor hearts in Singapore, he says: “Transplants depend on donors, people have to die before someone else can get the heart; and in Singapore not many people die young because it is such a safe country unlike some cities in the US for example, where you have young people dying from road traffic accidents or violence.”

Looking to the future No matter how good artificial devices are, they are, in his words, “not perfect”. That remains a challenge in Singapore where an ageing population means that there will be many more worn down hearts which need replacement. Heart pumps require patients to lug around a battery device like a luggage trolley. “Patients are tied to the device and that compromises their quality of life,” notes Dr Sin. “One day we may have a pump that is good and small enough without patients having to carry a cumbersome console around.” But what keeps him up at night nowadays is not clinical work, which is a given. Instead he thinks about

A captivating educator

g • Head and Senior Consultant, Department of Cardiothoracic and Vascular Surgery, NHCS. • Director of the Quality Management Department and the Vascular Laboratory, NHCS. • President of the Singapore Cardiac Society. • Appointed Adjunct Assistant Professor by Duke-NUS Graduate Medical School since August 2007. Also part-time academic staff with the Faculty of Medicine at the National University of Singapore and Nanyang Polytechnic. • Co-author of numerous papers and abstracts and participated in various research projects and clinical trials. For example, he is the principal investigator in an ongoing study examining the efficacy of alternative anticoagulants (blood thinners) in patients.

He is also busy as a part-time academic staff with the Faculty of Medicine at the National University of Singapore and Nanyang Polytechnic as well as an Adjunct Assistant Professor at the Duke-NUS Graduate Medical School. He tries not to be boring. For instance, his past lessons have seen him whip out a water pump, the sort used at home to change the water in fish tanks, and asked his students: “Imagine we are having an epidemic of heart failure. We have to save the world and have no other resources but this. Evaluate this device and see if it can do the job.” When you look confused, he throws up his hands and says: “The pump is like the human heart, isn’t it? It sucks blood on one side and pumps it out the other side. There’s a filling chamber with two valves to connect to the artery and the vein; when you pump harder, there is higher pressure. The students must understand how the heart works to do this activity.”

Leisurely pursuits With a full plate on his hands – he is involved in the new Heart Centre building, is president of the Singapore Cardiac Society, and has been burning his weekends travelling for conferences – time is a luxury. Add to that, he has three boys to raise: A pair of 12-year-old twins preparing for their Primary School Leaving Examination and their 11-year-old brother. He used to go cycling, bowling and fishing with his sons, but time has, in recent months, become even more of a scarcity. When asked what he would do if he had one full day to himself, he ponders: “I’d probably just potter around the house.” His DIY touches are evident around the house, which is also home to an enthusiastic dachshund, a whole load of fish and a lobster. The simple water feature at the car porch is home-built. The back garden is an oasis of herbs, bird’s nest ferns and a variety of flowering plants where birds and butterflies love to visit. A small pond with colourful carp adds to the charm. It is where the boys enjoy spending time learning about nature, tending to their small plants, and collecting butterfly eggs for hatching. “We fixed this garden up ourselves, we didn’t get any contractors,” adds Dr Sin, waving at his handiwork. His voice held the barest hint of pride, as if he had just told you that he had successfully performed a groundbreaking surgery.

me+LIVING

standards. He is the Director of the Quality Management unit at NHCS. “Our job is to make the workplace a safer place for patients and staff,” he explained. “Part of that is diagnosing a potential problem before it becomes an issue. That also means enhancing our services.” One example is how the unit managed to shave off the time taken for a heart failure patient to get hooked up to a life saving heart-lung machine at NHCS, to restore their blood circulation. “It makes a difference,” says Dr Sin. “It saves lives where people might have died otherwise.” Research is the lynchpin of medical breakthrough, and Dr Sin makes sure he stays on top of the field as he is involved with various research projects. One of the current ones involves studying the use of alternative anticoagulants in patients as part of a multi-centre international study. Another recently completed project where he was co-investigator, was in probing the treatment of ischaemic heart disease and heart failure and questioning what is the best treatment.

me+LIVING

The Innovator’s Prescripti n

A Disruptive Solution For Healthcare

Health Minister Khaw Boon Wan called a business school guru’s book on reforming healthcare one of the most insightful and practical books he has ever read. Dr Jeremy Lim reviews author Clayton Christensen’s work.

f one is not particularly inclined to plough through Christensen’s book which he co-authored with a physician and a hospital CEO, permit me to share the main thesis in a much simplified and admittedly somewhat simplistic fashion. Building on concepts from his previous work on “market understanding that mirrors how customers experience life”, Christensen describes the notion of a ‘job’ which customers hire products or services for. Hence the milkshake which, in the morning, serves to alleviate the boredom of a long drive to work without messing up the car, is also the milkshake which, in the afternoon, is the balm to soothe the guilty father’s conscience when he purchases one for his children. In the first instance, the job the milkshake is hired for needs a thicker milkshake punctuated by bits of fruit or nuts to increase the excitement quotient. In the second, the milkshake is a convenient penance and the milkshake should be less viscid so that the gleeful child can gulp it down as quickly as possible and spare the father an agonising wait. Making the job easier or simpler to do, Christensen says, can increase ‘success’ by as much as 30-70 per cent.

3 ‘Jobs’ for the Healthcare System Bringing this insight into healthcare, Christensen argues that the job that patients hire the health system for can be conceptualised in three main categories: To find out what is wrong (Diagnosis), to get fixed (Treatment) and to live as normally as possible with a chronic disease (Disease Management). He further stresses the point that hospitals and healthcare providers today try to do all three simultaneously in the same

structure and this is responsible for much of the inefficiencies and consequent high costs. Christensen then goes further to encourage healthcare providers to disaggregate their resources and reassemble them into three groupings to do the three jobs separately that patients hire health systems for. Finding out what is wrong is a ‘Solution Shop’ conceptually not dissimilar to a management consultancy and requires the best and most innovative minds from multiple disciplines working together. Fixing the identified problem (usually surgically) is then a role that ‘Value Adding’ providers should embrace using modern management tools such as Lean and Six Sigma to drive out inefficiencies and minimise expensive variance. Finally, Disease Management is best done by a ‘Network’ of providers, actively involving the patients themselves and Christensen holds up Kaiser Permanente California as the closest real life example of his ideal provider. However, re-organisation of the health system in this manner would be short-lived without reform of healthcare financing and Christensen urges different models for the three. The ‘Solution Shop’ should be reimbursed on a ‘feefor-service’ model, the ‘Value Adding’ provider funded on a ‘fee-for-outcome’ model and the ‘Network’ reimbursed on a capitated model (fixed payment per enrollee into the practice). Christensen argues that when the diagnosis is unclear, a ‘fee-for-service’ model, while expensive upfront, will encourage multiple specialists to work together to pinpoint the correct diagnosis and identify the appropriate treatment. A precise diagnosis will allow targeted therapy and obviate a trial and error approach, ultimately saving many dollars in the long run. A ‘fee-for-outcome’ system on the other hand, once the diagnosis is certain with providers absorbing the costs of complications, forces careful selection, pre-operative optimisation and meticulous post-operative care. Finally, in a ‘Network’ funded on a capitation model, providers are paid

This book is a MUST READ for anybody who cares about the future of our healthcare system and specially so for those who are in positions of influence to introduce changes. There is a chapter relevant to everyone in healthcare. For me in Education, this book is timely as SingHealth is about to embark on a challenging journey to introduce USResidency programs for Specialist Medical training.

Dr Jeremy Lim is currently on secondment to the Ministry of Health as Senior Consultant in the Primary & Community Care Division. This article was first published in SMA News.

Ms Neo Chia Reei

The book is very thought-provoking. I would recommend reading at least the first two chapters where he states that there are essentially three types of business models â&#x20AC;&#x201C; solution shops, valueadded process businesses and facilitated network businesses. He also discusses his concepts of intuitive medicine, empirical (evidence-based) medicine and precision medicine. Intuitive medicine is dependent on clinical skills and therefore costly since

General Manager, SingHealth Academy

physicians are required. Once the clinical problem falls into the empirical and even more so, the precision medicine realm, less skilled and therefore cheaper providers should be able to treat them. The book makes you really think about how healthcare, from the economic perspective, is actually quite illogical and inefficient. Dr Daphne Khoo Senior Consultant and Head of Endocrinology, SGH

me+LIVING

regardless of whether patients consume healthcare resources. Hence they will be incentivised to keep costs low, to innovate with physician extenders, telemedicine initiatives and so on to keep patients healthy and out of expensive outpatient clinics and away from even more expensive hospital beds. Are these theories applicable to Singapore? How will doctors practise and be organised in future? How will medical students be prepared for this very different future? I donâ&#x20AC;&#x2122;t know the answers, but I do know that serious efforts are being made at governmental level to thoroughly digest and assimilate these concepts into our healthcare system where relevant. Christensen is proposing changes that will fundamentally alter the organisation and practice of medicine. As the medical profession, we owe it to ourselves and future generations to engage fully in this debate and working with policy makers, so as to actively shape the future of medicine in Singapore.

me+LIVING

Hear it from

th e

Ex p er t s

From Classroom

To Home

They may be great teachers and mentors, but can they translate their classroom wisdom into parenting tips? Our SingHealth mentors tell us how.

A/Prof Goh Siang Hiong Deputy CMB (Ambulatory) and Senior Consultant, Accident and Emergency, CGH Dr Ian Yeo Consultant, Vitreoretinal Service, SNEC I feel that teaching children is very different and yet similar from mentoring a doctorâ&#x20AC;&#x201D;while both need care, attention and direction, you need to apply all of them in different styles. You need to lead by example and be the best role model that you can be.

Ms Goh Chin Chin Clinic Pharmacy Manager, SHP-Pasir Ris My parenting style is firm, but sincere. This motivates them to learn. I praise my children whenever they follow instructions or do right, but punish them when they choose to disobey. Personally I believe clear communication causes one to understand and appreciate better. When I am mentoring, I will make sure that the trainees understand me by using quizzes to assess their learning and maintain open communication. At home, I try my best to speak clearly (tone and message) to my children, be it teaching or giving instructions. I am glad they learn well and are very communicative at a young age. More often than not, they know the right values from wrong as I use examples to teach and test them.

I try to be patient, and let them try something on their own first before coming up with my own suggestions.

Dr Chua Yeow Leng Senior Consultant, Cardiothoracic Surgery, NHCS I let them do what they want to do and let them pursue what they want to learn. But whenever something significant happens, I will seize that learning opportunity and teach them using real life examples. Children are very different from trainees: Training has to be very focused as they zoom in on a particular skill. I have to ensure that my children develop to their full potential: I only teach them life skills like swimming or cycling, and then let them expand their minds on their own.

Dr Chew Ming Tak Director and Senior Consultant, Department of Orthodontics, NDC I believe my approach to parenting is similar to that in teachingâ&#x20AC;&#x201D;playing the role of a teacher at home, I assist them in their learning journey, compliment them when they have done well and nudge them along when they are lagging behind.

me+SMILES

Picture Match

Where

on earth is this?

an you identify the various SingHealth places featured in the photographs? If you think you can, flip over to page 36 and answer this issueâ&#x20AC;&#x2122;s quiz. Movie passes to be won!

me+SMILES

me@SingHealth

In her every day work, Dr Angeline Lai manages patients with genetic and paediatric conditions, both in the inpatient and outpatient clinics. With a special area of interest in chromosomal disorders and dysmorphology, she strongly believes in the importance of providing medical care and social support for children and families with genetic conditions. For more information on volunteering with Operation Smile, please email Ms Rachel Woon at rachel.woon@operationsmile.org or visit www.operationsmile.org.sg/ volunteer.

Dr Angeline Lai, Head and Senior Consultant, Genetics Service, KKH, shares her experience in bringing smiles to children with facial deformities.

nder the hot Cambodian sun, a team of 30 medical volunteers from Operation Smile made their way to Kampong Cham, a small village in Cambodia. Among the 30-member team were 14 volunteers from KKH. Comprising surgeons, paediatricians, anaesthetists, nurses, medical photographers, speech therapist, and medical recorders, they worked closely with other medical team members from the US, Ireland and Cambodia to provide medical evaluations and repair facial deformities. In the five days that they were there, they saw more than 90 patients. “It was the hot season in Cambodia, which made our post-op ward feel more like a sauna! There were various types of beetles and cockroaches in our hotel room, and even in the wards,” said Dr Lai as she recalled her first impression of the village. Operation Smile, as it is aptly named, sees its mission in mobilising a world of generous hearts to heal children’s

smiles and transform lives across the globe. Offering repairs to childhood facial deformities including cleft lips and cleft palates, Operation Smile volunteers have to date treated more than 130,000 children and young adults all around the world. Like many of the volunteers, Dr Lai lends her medical expertise to aiding Operation Smile’s goal of changing lives one smile at a time. As the paediatrician on this mission, her main responsibility was to screen the patients before surgery to ensure that they do not have any underlying medical problems. In the post-operative period, Dr Lai worked with KKH and local Cambodian nurses in the postoperative wards to make sure that the patients are recovering well. Apart from working in the operating theatre and wards, Dr Lai also played a part in education to prevent future cases of facial deformity. “While interacting with the patients and local medical staff, I realised that

there was a low level of awareness about the protective benefits of preconceptional and prenatal folate supplements,” she said. Her solution—work with local volunteers to develop an educational pamphlet so that families can reduce their risk of having another baby with cleft lip or palate and train local medical students on folate supplementation. Dr Lai places a lot of emphasis on teamwork, “Despite coming from different countries and cultures, we were all able to cooperate and work together. Sharing a common goal—to do our best for the patients—was the main motivation.” And it didn’t take long for Dr Lai to realise that the village was full of smiles because of their efforts. “All it took to lift the heart was an Or Khoune (thank you in Khmer, the native tongue) chimed with a smile and clasped hands, from the patients and their families at the end of their stay. “It is really good for the soul and something you will not regret.”

me+HORIZON

Medical Milestones

In History

2007

2003

Medical Education On SGH Campus In recent years...

The roadworks for the SingHealth Academy were paved when the board approved SingHealth’s request to set up an educational collaborative framework. An MOU between Duke University and the National University of Singapore led to the establishment of Duke-NUS Graduate Medical School, which opened its doors on SGH Campus on 28 September 2009.

1941

From not too long ago...

1905

From a little further back in time…

Look back to see how the culture of medical learning started and evolved through the years. Here are some of the more memorable milestones.

Preliminary nursing school established in SGH. It then developed into the School of Nursing in 1956. Nursing education has since been shifted to polytechnics.

Singapore’s first medical school, the Federated Malay States & Straits Settlement Medical School, was set up in a female lunatic asylum at Sepoy Lines. The building was later renamed King Edward VII Medical School, and then King Edward VII College of Medicine. With Dr G D Freer as the first principal, the medical school’s inaugural intake consisted of a total of 23 students— nine Chinese, six Eurasians, five Tamils, one Malay, one Ceylonese and one European.

THIS ISSUE’S QUIZ:

Based on the numbered pictures in the “Where on earth is this?” section of The Lighter Side (p.34), can you match the places listed below to the photographs? a Staff Gym toilet at Bowyer Block b SGH Learning Centre at Level 18, Connection One c The Private Children’s Clinic at KKH d Brain Suite at Block 3, Level 2 e SingHealth experimental medicine centre’s facilities at Sembawang f Hyperbaric Centre g Vicker’s House h Kitchen area at LIFE Centre

Please email your answers (together with your name, designation, institution, department and contact number) to me.sh@singhealth.com.sg by 20 October 2009. The lucky winners will each receive a Golden Village Movie Pass worth $28.

Here are the answers to the last ISSUE’S quiz: Q1. What other missions have SingHealth volunteers gone on besides the 2004 tsunami? Ans: Pakistan Quake in October 2005, West Java Quake in May 2006, Cyclone Nargis in Myanmar in May 2008, and Yemen floods in 2008. Q2. How many clinical trials have SingHealth institutions conducted in the last five years? Ans: 550 Q3. What is the title of the book launched at the Nurses’ Day celebrations this year? Ans: Wound Management Guide for Healthcare Professionals.

And here are the three lucky winners!

1. Shanti d/o Velayuthan, Dental Surgery Assistant, NDC 2. Adeline Tay, Pharmacy Manager, SHP 3. Chia Li Leng, Lead Clinical Research Associate, SingHealth Office of Research

Each of them will receive a Golden Village Movie Pass worth $28! me+SH will be contacting the winners shortly with prize collection details.

Your

Have an

opinion?

We want to hear from you! Are you a wizard of words? Do you have a keen eye for capturing images? Would you like to use me+SH as an outlet to express your thoughts and expressions? If so, we welcome your contributions! Send your comments, feedback, story ideas, photos and even videos to me.sh@singhealth.com.sg Be sure to check out me+SH online (http://mysinghealth/singhealth/mesh), as well as me+SH on Facebook!

SINH00076-090727-008-AH-Poster_FA_p.pdf

CMY

8/27/09

12:26 PM