January 12, 2010
It seems that even the usually well protected medical profession
is not spared the onslaught of foreigners these days. According to
Health Minister Khaw Boon Wan, two in three newly registered
doctors are “foreign-trained”.
Early last year, the Ministry of Health (MOH) announced that it
will be recruiting as many as 1,000 foreign-trained doctors into
the public healthcare sector to ease Singapore’s doctor
“shortage”.
Many of these foreign doctors are sent to work
in hospital specialties shunned by Singapore doctors such as
Geriatrics, General Medicine, Renal Medicine as well as
medical officers in polyclinics.
Foreign doctors now make up about 40 – 50 per cent of the
doctors in Singapore polyclinics. While the Malaysian doctors
encounter no difficulties in communicating with local patients, the
Indian and Filipino doctors will have to depend on translators when
they see non-English speaking patients, in particular the
elderly.
A key reason for the shortage of doctors in the public sector is
the low pay and long working hours. As all NUS medical graduates
are “bonded” with MOH, they are paid at well below market rates in
the public healthcare sector.
Unless one chooses to take up specialist training, most will
eventually leave to set up their own GP practices in the private
sector where it is more lucrative.
Their places will have to be taken over by foreign-trained
doctors which cost much less than a Singapore doctor. The monthly
pay of a final year medical officer is about $5,000. On the other
hand, a first year NTS (non-traditional source) medical
officer commands only between $2,500 – $3,000.
As public healthcare is heavily subsidized by MOH, it is
understandable that it has to keep manpower costs down to avoid
passing them to patients.
The trade-off for having more foreign doctors in the public
sector is that there may be a compromise in the quality of medical
care which is exacerbated by the heavy work load, language problems
and different training.
Health Minister Khaw Boon Wan told Parliament yesterday that
“with more and more foreign-trained doctors working in Singapore,
there is a need to monitor their performance and ensure they are up
to Singapore’s standards and are adapting well locally.”
The rising demand for doctors has been spurred by the growing
population contributed largely by the relentless influx of
foreigners in Singapore.
Despite the shortage of doctors in Singapore, the number of
places in NUS’s coveted medical school has not increased by much
and remains at around 250, an increase of only 50 compared to a
decade ago.
Every year, there will be some Singapore students who have to
study medicine overseas as they are unable to get a place in NUS.
We will not be so dependent on foreign doctors had NUS
increased its intake of medical students.
With more than 50 per cent of doctors practising in Singapore
being trained overseas, MOH will introduce measures to arm the
Singapore Medical Council (SMC) more powers to limit the practice
and conduct of new doctors entering the healthcare system.
Such a move will not be necessary if MOH had paid more attention
to the welfare of junior doctors to convince them they will have a
career, a future and most importantly, a life by staying put to
serve fellow Singaporeans in the public healthcare sector.