Commonwealth (UK)

Medical Education System

A Singapore Counterpart

Farid Abdul Hadi, MD

Lien Fellow of Palliative Medicine

(Internal Medicine)

Duke-National University of Singapore (NUS)

Why are we awake after sipping coffee?

What is Commonwealth?

• Previously called British Commonwealth, currently addressed Commonwealth Nations

• Intergovernmental organization, 54 members, former British Empire (except Cameroon and Mozambique)

• Countries with diverse social, political, and economic backgrounds are regarded as equal in status, and co-operate within a framework of common values and goals; promotion of democracy, human rights, good governance, operate within a framework of common values and goals; promotion of democracy, human rights, good governance, the rule of law, individual liberty, egalitarianism, free trade, multilateralism, and world peace carried out through multilateral projects and meetings, as well as the quadrennial games.

� More or less, their medical education system is somewhat similar

UK Undergraduate Med Curriculum

Singapore Med Education Curriculum

• National University of Singapore– Follow British medical education system

– A-Level Junior College (Pre-Uni) University of Cambridge Local Examination Syndicates (UCLES) � standard in Singapore

– 5-year undergrad medical study (3 preclin + 2 clin)

• Duke-NUS Graduate Medical School• Duke-NUS Graduate Medical School– Follow American medical education system

– Undergraduate degree (preferably American)

– 4-year graduate medical study (1 preclin + 2 clin + 1 research)

• Others– MD-Ph.D (6-year NUS or 7-year Duke-NUS)

– Extremely competitive

Doctor Career Options

• Research opportunity for every level of medical career, including students

• Pharmaceutical and health-allied industry a/wrecent advances in medicine bioinformatics, medical engineering, etc.medical engineering, etc.

• Administrative scheme; insurance, finance, etc.

• Public health sector; government, nongovernment, local, international, etc.

• Other career

• Medical specialty (more than 60 listed in UK)

UK-Singapore Local Medical Doctor Specialty

Clinician Milestone (Undergraduate Entry, Fastest Track)

Checkpoint Year UK Singapore

Med School

Undergrad Exam

OR PLAB1

Year 1 to 5 Undergraduate Medical School

Year 6 Housemanship/Internship Housemanship/Internship

Collegiate

Postgrad

BST2 Exam

Fell

ow

ship

/Re

sea

rch

Year 7 Medical Officer

Year 8 Specialty Registrar

Year 9

Fell

ow

ship

/Re

sea

rch

Year 9

Collegiate

Postgrad

AST3 Exam

Year 10 Specialty

Registrar/Associate

ConsultantYear 11

Year 12

Year 13

Year 14 to 22 Consultant

>Year 22 Senior Consultant

1) PLAB = Professional and Linguistic Assessment Board

2) BST = Basic Specialty Training, e.g. Membership of The Royal College of Physician (MRCP), Intercollegiate Membership of The Royal

College of Surgeon (MRCS), Membership of The Royal College of Ophtamology (MRCOpth.), etc.

3) AST = Advanced Specialty Training, e.g. Fellowship of The Royal College of Physician (FRCP), Fellowship of The Royal College of

Surgery (FRCS), Fellowship of The Royal College of

Conditions applied in commonwealth

• Like most foreign countries worldwide, commonwealth nations have

work-based training in hospitals

– Proportion: around 70% work, 30% academic

– Trainings in most hospitals, even privates (esp Australia), not only

those with med schools

– Teaching/mentoring (training to train) is a vital part to keep the chain – Teaching/mentoring (training to train) is a vital part to keep the chain

� EVERY doctor is teaching staff for postgraduate training

– Self-motivated skill and knowledge effort is extremely essential

– Training curriculum is organized in a nation-scale defined with

postgraduate BST and AST board exam

– All trainees are paid under general working scheme

• Indonesia used to has work-based training, but along with outnumber

proportion of med schools to teaching hospitals (teaching staffs) and

national scale curriculum, training is shifted to academic-based training

1-JOB/WORKING OPPORTUNITIES

2-MEDICALLY REGISTERED

Key elements for getting work-based postgraduate training in the

Commonwealth:

Medical Registration in UK for

Indonesian Medical Graduates

1. The Professional and Linguistic Assessment

Board (PLAB) test

2. Acceptable postgraduate qualifications

3. Sponsorship3. Sponsorship

4. Eligibility for specialist or GP registration

Refer to General Medical Council (GMC) United Kingdom:

http://www.gmc-uk.org/index.asp

PLAB Test• Note that you have to pass IELTS min overall 7.0, Speaking 7.0, listening

6.0, reading 6.0, writing 6.0 (www.ets.org)

• Documents translation � specified agents from GMC

• Internship in/outside UK is obligatory

• Part 1 – 200 Extended Matching Questions (£145)

– UK: London, Birmingham, Glasgow, or Edinburgh

– Overseas: Bangladesh, Egypt, India, Pakistan, Sri Lanka, Iran, West Indies, and South – Overseas: Bangladesh, Egypt, India, Pakistan, Sri Lanka, Iran, West Indies, and South

Africa

• Part 2 – OSCE, only in Manchester (UK) (£430)

• Must have guaranteed of job prospect in UK

• Sponsorhip scheme must also pass the PLAB test

• Courses

– UK Centre: www.pastest.co.uk

– Online Centre: www.onexamination.com (and many more)

Refer to GMC PLAB Guidelines

UK-Singapore Local Medical Doctor Specialty

Clinician Milestone (Undergraduate Entry, Fastest Track)

Checkpoint Year UK Singapore

Med School

Undergrad Exam

OR PLAB1

Year 1 to 5 Undergraduate Medical School

Year 6 Housemanship/Internship Housemanship/Internship

Collegiate

Postgrad

BST2 Exam

Fell

ow

ship

/Re

sea

rch

Year 7 Medical Officer

Year 8 Specialty Registrar

Year 9

Fell

ow

ship

/Re

sea

rch

Year 9

Collegiate

Postgrad

AST3 Exam

Year 10 Specialty

Registrar/Associate

ConsultantYear 11

Year 12

Year 13

Year 14 to 22 Consultant

>Year 22 Senior Consultant

1) PLAB = Professional and Linguistic Assessment Board

2) BST = Basic Specialty Training, e.g. Membership of The Royal College of Physician (MRCP), Intercollegiate Membership of The Royal

College of Surgeon (MRCS), Membership of The Royal College of Ophtamology (MRCOpth.), etc.

3) AST = Advanced Specialty Training, e.g. Fellowship of The Royal College of Physician (FRCP), Fellowship of The Royal College of

Surgery (FRCS), Fellowship of The Royal College of

Medical Registration in Singapore for

Indonesian Medical Graduates1. Full Registration

2. Conditional Registration � Recognized Postgraduate Degree

3. Temporary Registration

4. Provisional Registration � Recognized Basic Medical Degree

• The Singapore Medical Council (SMC) grants temporary registration to the following groups:following groups:

• Visiting experts here to perform medical or surgical procedures or conduct demonstrations on patients;

• Foreign-trained doctors here for training attachments, research or postgraduate training in approved institutions, e.g. in restructured hospitals. They will be designated as clinical fellows or clinical observers.

• Doctors without registrable qualifications to work in specialties/department where there is an acute shortage of doctors (Temporary Registration of Doctors in Areas of Need).

Refer to Singapore Medical Council (SMC):

http://www.smc.gov.sg

Options to work/training in Singapore

for Indonesian Medical GraduatesClinical field

1. Find postgraduate training opportunities in interested field after 3-yearworking experience following internship (new regulation, refer to SMC Temporary Registration Scheme). Sometimes the opportunities come along during the specialist training taken in Indonesia (e.g. in the middle of PPDS)

2. Find job opportunities in Areas of Need1 following at least 3-yearworking experience and/or having specialist degree in related field of

2. Find job opportunities in Areas of Need following at least 3-yearworking experience and/or having specialist degree in related field of medicine refer to SMC Temporary Registration for Service Provision in Areas of Need

3. Take specialist training in Indonesia as well as taking recognizable postgraduate BST degree (i.e. MRCS, MRCP, MRCS, DO-HNS, etc.) refer to SMC List of Recognizable Postgraduate Degree

4. Obtain 4-year MD or 7-year MD/Ph.D. program at Duke-NUS Graduate Medical School, provided passing the American Medical College Admission Test (MCAT) refer to www.amc.org

1) Emergency Medicine, Geriatric Medicine, Rehabilitation Medicine, Internal Medicine, Renal

Medicine, Neonatology, Paediatric Surgery, Cardiothoracic Surgery, and Child Development

UK-Singapore Local Medical Doctor Specialty

Clinician Milestone (Undergraduate Entry, Fastest Track)

Checkpoint Year UK Singapore

Med School

Undergrad Exam

OR PLAB1

Year 1 to 5 Undergraduate Medical School

Year 6 Housemanship/Internship Housemanship/Internship

Collegiate

Postgrad

BST2 Exam

Fell

ow

ship

/Re

sea

rch

Year 7 Medical Officer

Year 8 Specialty Registrar

Year 9

Fell

ow

ship

/Re

sea

rch

Year 9

Collegiate

Postgrad

AST3 Exam

Year 10 Specialty

Registrar/Associate

ConsultantYear 11

Year 12

Year 13

Year 14 to 22 Consultant

>Year 22 Senior Consultant

1) PLAB = Professional and Linguistic Assessment Board

2) BST = Basic Specialty Training, e.g. Membership of The Royal College of Physician (MRCP), Intercollegiate Membership of The Royal

College of Surgeon (MRCS), Membership of The Royal College of Ophtamology (MRCOpth.), etc.

3) AST = Advanced Specialty Training, e.g. Fellowship of The Royal College of Physician (FRCP), Fellowship of The Royal College of

Surgery (FRCS), Fellowship of The Royal College of

Options to work/training in Singapore

(broad spectrum)

Other fields

• Find the job opportunities in interested field (i.e. research fellows, pharmaceutical industries, insurance companies, or any fields).

Normally they require extensive working • Normally they require extensive working experience in respected fields with preferable master or Ph.D. qualification

• Note that Singapore is international hub with extensive planning in biomedical research and healthcare industry

MRCP

• It is ONE of of recognizable postgraduate degree in Singapore

• Considered as BST postgraduate degree, consist of Part 1, Part 2, and Part 2 Clinical Examination (PACES)

• Having at least 12-month clinical working experience

• Posted in internal medicine position, especially in • Posted in internal medicine position, especially in Commonwealth nations or places where supervised by FRCP-trained consultants/senior consultants

• Final specialty training must have reference(s) from FRCP-trained consultants for the past three years

• Part 1&2 costs £379 in UK and £536 in overseas centre

• PACES costs £595 in UK and £1200 in overseas (Singapore)

WORKING ADVANTAGE IN

SINGAPORE

Refer to Ministry of Health Singapore, Department of Health UK, and

Ministry of Manpower Singapore

MEDICAL TRAINING SELF-

DEVELOPMENT

Personal opinion and experience

ReferencesGeneral Medical Council (GMC) United Kingdom. Section Medical Registration – Professional and Linguistic Assessment

Board (PLAB). www.gmc-uk.org

Singapore Medical Council (SMC). Section Medical Registration – Full, Conditional, Temporary, and Provisional

Registration. www.smc.gov.sg

National Healthcare Group (NHG) Singapore. www.nhg.com.sg

Ministry of Health (MoH) Singapore. www.moh.gov.sg

Ministry of Manpower (MoM) Singapore. www.mom.gov.sg

Department of Health United Kingdom. www.dh.gov.uk

Frequently-Asked Questions (FAQ). Commonwealth Secretariat.

McKinnon, Don. 2008. "A Commonwealth of Values: a Commonwealth of incomparable value". The Round Table 97 McKinnon, Don. 2008. "A Commonwealth of Values: a Commonwealth of incomparable value". The Round Table 97

(394): pp. 19–28.

Chew, CH. 2005. Postgraduate Training in Singapore. Ann Acad Med Singapore. Vol.34:182C-189C

Dundee Medical School Curriculum Guidelines. www.dundee.ac.uk

Yong Loo Lin School of Medicine – National University of Singapore (NUS) Curriculum Guidelines. www.med.nus.edu.sg

Duke-National University of Singapore (Duke-NUS) Curriculum Guidelines. Section MD, MD-Ph.D. www.duke-nus.edu.sg

The Membership of Royal College of Physician (MRCP). All Section. www.mrcpuk.org

Times Higher Education Survey (THES). Section World Top Universities, Asian Top Universities, subsection Biomedical

Sciences and Life Sciences. Taken from QS. www.qs.com

Tan Tock Seng Hospital (TTSH). A member of National Healthcare Group Singapore. www.ttsh.com.sg

Personal materials property of Farid Abdul Hadi, MD. Lien Fellow of Palliative Medicine. Dover Park Hospice and Tan

Tock Seng Hospital, Singapore 2010.