What difficulties may overseas Singaporean medical students face when returning back to Singapore for work?

Doctor's Answer

Photo of Dr Dinesh VG
Dr Dinesh VG

General Practitioner

Hi there! Small disclaimer before I take a stab at this question: I am a local grad from YLL. Although I had clerkships in India, UK and US, and studied for over a year in Australia when I was younger, I am not an international medical grad (IMG). That being said, I was asked my thoughts on this and so am commenting based on my perspectives as well as experiences working with fellow IMG colleagues.

My colleague has already nicely summarised the 2 main points (1 and 2) here that come to mind personally. Among them I would emphasise that getting used to the culture is the main and major difficulty. As a returning Singaporean, you already have an advantage over other IMGs as you are already familiar with our culture (my paragraph of a disclaimer for example is a clear testament of our kiasu culture and the ruthlessness of our keyboard warriors’ online commentary).

Everything different about our work culture can be gathered by applying everyday Singapore culture to medical practice. For example, we as a society are very patriarchal and family-oriented. One of the striking differences one may notice is how informed consent is handled locally as a group activity with family members heavily involved – vs certain western practice settings which mainly focus on the (cognizant) individual’s preferences. The full extent of this is too complex for me to cover in a comment like this.

However, ultimately in medicine (and most things in life) no one will (should) ever find fault with you for something you were not taught and that you asked for help with. If ever in doubt, ask for help or to observe something being done before ever doing it yourself – whether the act of taking consent, or doing a procedure such as inserting a CVP line.

Going to work with the awareness that you are entering into a high-stress and unfamiliar environment, and conducting yourself appropriately to contribute best you can without risking patient care will serve you well enough to get by. To excel, make it a point to regularly follow-up on new lessons learnt with further reading, and remain curious about the practices and protocols you pick up along the way (don’t have to become a professor, but evidence based practice is essential).

Being yelled at and told off is part of any job, and you can be sure in the highly stressful environment that healthcare can be, you will face your fair share of this here and in any other country. I’m not defending this global practice, but rather raising awareness about this so no one gets caught by surprise. Just remember that when your leaders and mentors sometimes seem unreasonable or overly picky/punitive about minor details, it is often because they have learnt through their practice experience that those minor details are important to ensure a good quality of patient care. Do not take negative comments personally, but instead ask where you can improve the next time to learn and grow with experience.

Ultimately a positive attitude, keenness to contribute the best you safely can to facilitate patient care, and a willingness to be a lifelong learner will probably take you far in Singapore (disclaimer: speculation since I too am a junior doctor and nobody myself, but consistent with the advice my mentors have given me). And just to add on a note on the second point – as mentioned, networking opportunities can easily be gained through clerkships during long summer holidays.

I do not believe that knowledge gap is a major issue for anyone that followed up on their medical school readings, as the bulk of medical knowledge beyond fundamentals that are truly of value to practice is contextual and well, practical. The main caveats being that (1) certain conditions such as dengue that are prevalent here may not be as familiar due to epidemiological variations from your country of practice and (2) certain overseas courses do not include work placements leading to a steep learning curve during housemanship. But here and always, the lifelong learner attitude (as well as perhaps some holiday clerkships in Singapore) will serve us well.

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