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The Complete Guide To Seeing An ENT Specialist In Singapore (2021)

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Portrait of Dr Eng Cern Gan
Dr Eng Cern Gan

July 8th, 2018· 5 min read

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I just want to be prepared...

Friends, families and even fellow doctors often ask me how they should go about seeing an Ear, Nose & Throat (ENT) specialist in Singapore.

Many are not even aware that ENT as a surgical speciality even exists! Although I end up seeing them myself most of the time, they often have many questions. These include questions about the costs of seeing an ENT specialist or the need for a subspecialist for their condition.

As an ENT specialist with more than 10 years of experience in this field, I hope this article will shed some light for those in search of an ENT specialist in Singapore.

What is an ENT specialist?

a doctor checking a patient in his clinic

ENT specialists are surgeons trained in the field of Ear, Nose, and Throat. They also have expertise in the Head & Neck region (medically known as Otolaryngology or Otorhinolaryngology).

Other commonly used terms to describe an ENT specialist include “otolaryngologist” or “otorhinolaryngologist”. (Oto = ear, rhino = nose, laryngo = voice box or throat).

The most commonly used medical term to describe an ENT Department in the hospital is “Otolaryngology Head & Neck Surgery” - I know, it's quite a mouthful!

How does one become an ENT specialist in Singapore?

a row of doctors taking notes

It takes five years of medical school in NUS to become a doctor. A newly graduated doctor then works as a Houseman or Intern for one year in the public hospital. Thereafter, he or she becomes a medical officer.

As ENT is a highly competitive surgical speciality, most ENT "trainee wannabes” would have spent some time rotating through various ENT departments in Singapore as non-trainee medical officers.

In Singapore, the ENT residency is a 5-year postgraduate surgical residency program. The ENT resident (also known as “trainee”) has to go through vigorous training, assessments and exams throughout the 5 years.

The ENT resident becomes a “Senior Resident” (previously known as “Registrar”) when they fulfil the training requirements. They also need to pass an annual national ENT exam by NUS at the end of the 2nd year.

The ENT resident becomes an ENT Specialist when they fulfil the necessary training requirements. They need to pass the annual “Exit” exam at the end of the 5th year of training.

What is the difference between an Associate Consultant, a Consultant, and a Senior Consultant?

These are titles that are unique to the public hospitals in Singapore and, I believe, in Hong Kong too.

After fulfiling training requirements and passing the "Exit" exam, ENT residents can be appointed as an "Associate Consultant".

Next, after being an "Associate Consultant" for at least 2 years, they can be promoted to a “Consultant”.

After approximately five years of being a “Consultant”, they can be promoted to a “Senior Consultant”.

The promotion depends on factors such as:

  • duration of service
  • research activity
  • administrative roles
  • the teaching of medical students and ENT residents, and
  • work ethic

Associate Consultants, Consultants, and Senior Consultants are fully qualified Specialists. Private hospitals do not award such titles.

However, when some specialists leave for private practice, they retain the titles that were awarded to them while they were in public hospitals. The most commonly used title to describe a specialist in a private hospital is a Consultant.

Are ENT doctors physicians or surgeons?

ent surgery in an operating theatre

Patients are often surprised that an ENT specialist can perform surgeries too!

For most specialities, there is a “Physician” and a “Surgeon” counterpart. For example, Neurologist (Brain Physician) and Neurosurgeon (Brain Surgeon), Cardiologist (Heart Physician) and Cardiothoracic Surgeon (Heart Surgeon), Nephrologist (Urinary Tract Physician) and Urologist (Urinary Tract Surgeon).

Physicians and surgeons often manage overlapping conditions in each field.

ENT Specialists manage both the medical and surgical aspect of ENT conditions. This is similar to how Eye Specialists manages both medical and surgical conditions of the eye.

The types of ENT surgeries range from minimally invasive endoscope- and microscope-guided surgeries to open head & neck surgeries and robotic surgeries.

How do I see an ENT specialist as a subsidized patient?

doctor writing on desk

You need to be either a Singaporean or a Permanent Resident of Singapore to be seen as a subsidized patient in public hospitals.

You will also need a referral letter from:

  • Polyclinic (a Singapore government-subsidized GP clinic)
  • Accident and Emergency Department (if your ENT condition is serious enough)
  • SAF Medical Officer

What is the difference between seeing an ENT Specialist in a public versus a private hospital?

As for most medical and surgical specialities, the difference between seeing an ENT specialist in the public or private sector in Singapore comes mainly down to:

  1. Cost
  2. Convenience and time
  3. Overall patient experience

1. Cost

It generally costs more to see an ENT specialist in a private hospital compared to that in a public hospital.

The table below provides only an estimate of the range of fees charged based on information available on the internet and from a few ENT Departments at public hospitals. (Fees updated as of 2015).

Consultation:

Public Hospitals

Private Hospitals/Clinics

Subsidised Patient

Private Patient

First Consultation

SGD 35-60

SGD 100-150

SGD 100-220

Follow-up Consultation

SGD 30-50

SGD 70-120

SGD 80-150

Nasoendoscopy (Scope through the nose):

Public Hospitals

Private Hospitals/Clinics

Subsidised Patient

Private Patient

First Scope

SGD 50-125

SGD190-400

SGD 290-500

Follow-up Scope

SGD 0-20 (within the first 6 months of the first scope)*

SGD 0-50 (within the first 6 months of the first scope)*

SGD 100-200

*Subsequent scopes after 6 months of the first scope will be charged as a “first scope”

OR (for those who want the full details, here you go - prices were obtained in Sept 2016)

Private

Public

First scope (Medisave claimable)

Subsequent scope (non-medisave claimable)

First scope (Medisave claimable)

Subsequent scope (non-medisave claimable)

NUH

SGD 197

SGD 50 (within 1 year)

SGD 50

SGD 20 (within 1 year)

TTSH

SGD 350

SGD 36 (within 6 months)

SGD 128

SGD 17 (within 6 months)

KTPH

SGD 370

SGD 20 (within 6 months)

SGD 125

SGD 10 (within 6 months)

SGH

SGD 364.87

SGD 5 (for cost of nozzle if used)

SGD 119.35

SGD 5 (for cost of nozzle if used)

CGH

SGD 260

Nil (within 6 months)

SGD 90

Nil (within 6 months)

Private Hospitals

First scope (Medisave claimable)

Subsequent scope (medisave claimable)

First Scope

SGD 290-500

SGD 100-200

2. Convenience and time:

adults waiting to see a doctor in waiting room

The waiting time to be seen in a subsidized ENT clinic in the public hospital can be between two weeks to three months from the point of referral.

A subsidized ENT clinic can have between 80 to more than 100 patients in a session (morning or afternoon). Only a handful of medical officers, Registrars and ENT Specialists see the patients. Hence, the waiting time in the clinic can be long (1 to 2.5 hours).

Private patients can “walk-in” to the clinic and make a direct appointment with the ENT clinic. They may need a referral letter from a GP as required by some insurance companies for medical reimbursements.

The waiting time to see an ENT specialist as a private patient in a public or private hospital is usually shorter (usually less than 2 weeks).

As the number of patients seen per ENT specialist in a private clinic is fewer than that seen in a subsidized clinic, the waiting time to see an ENT specialist is also significantly shorter. It is rarely more than one hour in most private clinics, especially in private hospitals.

3. Overall patient experience

a. Seeing different doctors vs the same doctor

patient in bed talking to doctor and nurse

As a subsidized patient, you do not get to choose the doctor whom you wish to see. It is also likely for a subsidized patient to see a different doctor each time in their follow up clinic visits.

The ENT medical officers and Registrars do rotate between the different public hospitals in Singapore. All subsidized patients have an overall ENT specialist in charge.

He or she will usually vet or review the cases seen by the medical officer or Registrar.

In a private ENT clinic, you get to choose the ENT specialist who you wish to see and your subsequent follow-up clinic visits will be with the same ENT specialist.

Most patients feel that this provides a more “personalized” experience and they do not have to repeat their medical history with a different doctor at each follow-up visit.

A better doctor-patient rapport can be established in a private ENT clinic.

b. Less time vs the luxury of time

an hourglass with sand

Unfortunately, due to the packed schedule in a subsidized clinic, the luxury of time is often not available for lengthy consultations (except in the case of serious ENT conditions such as cancer or severe infections).

In a private clinic, as the clinic schedule is usually not as busy as that in a subsidized clinic, the ENT Specialist can often afford to spend more time explaining the conditions and treatment plans.

c. Endoscope tower vs no endoscope tower

Private ENT clinics are usually equipped with an endoscope tower. This enables patients to see live videos and pictures of their nasendoscopy (scope through their nose and throat).

Most nasendoscopies in subsidized ENT clinics are done without the endoscope tower. Hence, no pictures or videos will be taken.

Some public hospitals do have a common room with an endoscope tower for patients with significant findings on their nasendoscopy to have their scope pictures or videos recorded.

However, as this is a common or shared facility, the patient may have to wait to get their scope pictures or videos taken.

What conditions are managed by an ENT specialist?

lump in a woman

The answer is not as simple as just ear, nose, and throat conditions.

Most ENT specialists manage many other conditions. For example, giddiness and vertigo, snoring and sleep apnoea, head & neck lumps and bumps (including lumps in the mouth, tongue, and throat region).

They also look at growths on the salivary glands (e.g. parotid, submandibular, sublingual glands, and minor salivary glands) and thyroid nodules.

Are all ENT specialists the same?

doctor consultation with a patient

All ENT specialists can manage about 80-90% of ENT conditions.

However, as with most other medical and surgical disciplines, there have been significant advancements in medical and surgical knowledge and technology within the ENT field.

Most ENT specialists in Singapore do undergo an additional 1-2 years of overseas training in renowned centres (often known as fellowships) to subspecialise in a specific area within ENT.

The seven known ENT subspecialties are:

1. Otology and Neurotology (Ear Subspecialist)

2. Rhinology and Endoscopic Skull Base Surgery (Nose & Sinus Subspecialist)

3. Laryngology (Voicebox Subspecialist)

4. Head & Neck Surgery (Head & Neck Subspecialist)

5. Pediatric ENT (Children’s ENT Subspecialist)

6. Sleep Medicine (Subspecialist in snoring and obstructive sleep apnoea)

7. Facial Plastic (Subspecialist in plastic surgery of the face, including “nose jobs” aka Rhinoplasty)

Most ENT specialists can manage the majority of general ENT conditions considered “bread & butter” well.

These common ENT conditions include sensitive nose (rhinitis), sinusitis, tonsillitis (infection of the tonsils), ear infections, snoring, and obstructive sleep apnoea. It also includes uncomplicated head & neck lumps (e.g thyroid nodules).

However, relevant ENT subspecialists may be able to manage more complex conditions better. For example, a patient with a large head & neck cancer should see a Head & Neck Subspecialist.

Likewise, a patient with a complex sinus anatomy, who had failed previous sinus surgery and are considering revision sinus surgery or who has severe nasal polyps should consider seeing a Rhinologist.


Read more: The Essential Guide To Paediatric Sleep Apnea in Singapore (2020)!


Is the cost of your ENT consultation and treatment insurance or Medisave claimable?

insurance policy and bank book

This depends largely on your type of insurance, the level of coverage provided, and whether there exclusions of certain medical conditions.

In general, if there is a need to undergo a nasendoscopy (scope through the nose and throat region under local anaesthesia), the cost of the consultation, scope and medications can be Medisave claimable (up to SGD 250 in most public hospitals and up to SGD 550 in some private ENT clinics).

A nasendoscopy is considered a Day Surgery procedure with a Table Code of 1A.

The cost of the consultation, scope, investigations, and medical treatments may be insurance claimable when a nasendoscopy is performed for patients with a private medical insurance plan with a rider to cover deductibles.

Some private ENT clinics offer direct billing to the insurance companies (ie no payment from the patient – often called “cashless” or “e-filing”) for patients who have undergone a nasendoscopy in the clinic.

Who is the best ENT specialist for you?

hearing aid in an elderly person

All ENT specialists in Singapore have to be accredited by the Singapore Medical Council and the Ministry of Health of Singapore. Of course, there are strict criteria to be met.

Hence, you can be assured of their qualifications. There are some doctors with a Diploma in ENT. This is NOT the same as a specialist qualification which requires a much longer training period.

There is no such thing as “the best ENT Specialist in Singapore”. The correct question to ask is who is the right ENT Specialist for you. To help you decide, you may take these factors into consideration:

1. Public vs Private (Pros/cons of each as mentioned earlier)

2. Training and qualifications of the specialist

3. The relevance or need for a subspecialist for your condition (if you are unsure, just ask your GP or the ENT specialist himself/herself!)

4. Experience

5. Professionalism and conduct of the doctor

6. Feedback from patients

Finally, you may also send an enquiry to the ENT specialist whom you wish to consult to clear any concerns that you have before visiting the clinic.

Through his or her response, you can also gauge how comfortable you are with him or her. Most of the time, the only way to determine if the ENT specialist is the right one for you is after the initial consultation.

You should leave the consultation room with a clear understanding of your condition and be given a treatment plan and options.

You should have ample time to ask questions during the consultation and should never feel shy or intimidated to do so!

Ultimately you have to decide if the specialist is someone who you are comfortable with, who is competent, and who has your interests at heart. Hope this helps and all the best!


Have a different perspective with this article to seeing an ENT specialist.


Dr Gan Eng Cern is an ENT Specialist at Mount Elizabeth Novena Specialist Centre (A Specialist Centre for Sinus, Snoring & ENT), and is also a Senior Clinical Lecturer at the National University of Singapore. He obtained Subspecialty training in Nose and Sinuses and has a passion for the treatment of snoring and Obstructive Sleep Apnoea (OSA). Dr Eng Cern enjoys jogging regularly to keep his spare tyres under control.


I hope that you've found this guide useful, and perhaps gained more insight into the application process. Most of the admissions-related information (admin and logistics wise) can be found on the official NUS Faculty of Dentistry website.

To help yourself out, you should take note of what people look for when they look for a dentist.

This article was written by Dr Eng Cern Gan and published on Wednesday, 25 January 2017. Human medically reviewed the article on Wednesday, 25 January 2017. The last update was made on Friday, 18 September 2020.

Disclaimer: Opinions belong to the author and not to the platform.

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