In October 2023, SMA organised its annual meeting with Dr Liem Yew Kan (Executive Director, Healthcare Manpower, MOH Holdings [MOHH]) where a range of issues concerning junior doctors (JDs) was discussed. The meeting was attended by the SMA Doctors-in-Training (DIT) Committee members, MOHH officials, and student leaders from the various medical societies.
We share here a summary of the discussions that took place during the meeting.
National medical manpower planning
A brief overview of the principal considerations behind medical manpower planning was provided. MOHH shared that there are currently approximately 800 house officers (HOs), 3,000 medical officers (MOs; 1,500 residents and 1,500 non-residents), and 900 senior residents (SRs) under MOHH's employment. There has been a steady rise in the number of JDs from 2017 to 2022, and as of 2023, all training positions for HOs have been filled. However, the national fill rate across JD positions stands at 80%. MOHH shared that the manpower pool will continue to be expanded to meet the requirements of Woodlands Health Campus, Eastern General Hospital and Alexandra Hospital, as well as to enable the 24/80/1 work hour model (ie, a maximum stretch of 24 consecutive hours, cap of 80 hours per week, and at least one rest day per week) across the board over the next five years. MOHH acknowledged that competition for training positions (eg, residency and hospital clinician programmes) will likely increase further as a result.
Junior doctor support initiatives
SMA and MOHH both shared about the initiatives each has put in place, and the potential synergies and areas of collaboration.
Transportation claims system
An independent audit revealed a high volume of erroneous transport claims in the past year, majority of which arose from commutes undertaken "just out of window" (ie, right after 6.30 am or right before 10 pm). MOHH shared that a revision to the corporate transport policy is in the works to minimise erroneous claims and also prevent abuse. While acknowledging the limitations of the current system, SMA is supportive of retaining the Grab corporate account system, as it significantly reduces the administrative overheads of manually filing for transport claims. SMA opined that the compliant majority should not be "punished" for the deeds of the wrongdoing few and highlighted that JDs ought to be given the opportunity to explain themselves before they are subject to disciplinary action for potential misdeeds.
Medical memos supporting fitness to practise
SMA shared concerns from various doctors, particularly those who had declared psychiatric conditions, who had been requested by the Singapore Medical Council (SMC) to obtain a memo from their physicians supporting their fitness to practise, which could cost up to $600, even if obtained from a public healthcare institution specialist. Given that fitness to practise is an employment matter, SMA asked if MOHH could bear the costs for these memos, for both existing and prospective (ie, fresh graduates yet to commence their contract) employees.
MOHH responded that:
- MOHH would cover the costs of these memos, as long as doctors were willing to declare their condition to MOHH, during pre-employment checks or at earliest notice. Notification could be done using a simple memo stating the diagnosis and recommendations on fitness to practise.
- It was important for both SMC and MOHH to be kept informed about JDs' medical conditions as it might affect whether it would be appropriate for them to be rotated to specific postings.
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Sensitive medical information would be handled with confidentiality and shared only on a need-to-know basis. MOHH is obliged to inform SMC if it has concerns about a doctor's fitness to practise.
New MME CME requirements
In light of the SMC's new mandatory five-point CME requirement for medical ethics that can only be fulfilled by attending programmes hosted by the three professional bodies, SMA shared that it would cater to JDs through its SMA Centre for Medical Ethics and Professionalism (CMEP) programmes. From January 2024, SMA CMEP offers Mandatory Medical Ethics (MME) programmes to all SMA Members free of charge, as their Membership fees are used to subsidise the cost of running the programmes and its hosting platform, WizLearn. MME programmes will be available to non-Members, but (1) are limited to only live webinars and not asynchronous WizLearn modules due to hosting platform subscription constraints, and (2) registration for these webinars would cost approximately the same as SMA Membership. SMA and MOHH agreed that JDs could be encouraged to join SMA to fulfil their CME requirements for the practising certificate renewal process.
About us
The SMA DIT Committee advocates for JDs and medical students, and runs a wide range of initiatives to support them in becoming competent, confident and compassionate healthcare professionals. The Committee has spoken up about on-call allowances, leave for National Service call-ups and the float system, among other issues. More recently, we have provided recommendations on key issues such as working hour caps, postgraduate training opportunities and JD engagement. On top of this, the Committee operates the SMA JD Helpline, publishes the SMA HO Handbook, conducts workshops for JDs and co-organises the SMA National Medical Students' Convention.
If you are keen to get involved with SMA DIT efforts, please write in to ilj@sma.org.sg. You can visit https://bit.ly/SMA-DIT to find out more regarding the SMA DIT Committee, and join our Telegram channel @HelpOurJuniorDocs to stay up to date regarding our various initiatives.
