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Academic Medicine in Singapore

Academic medicine is currently grappling with the problem of whether the triple-threat academician is a species threatened with extinction in the 21st century, given...

Experience with a Nine-step Policy Dealing with Requests for Medically Inappropriate Interventions for Cancer

Although great strides have been made in treating cancers, a significant number of patients still reach the point at which no curative treatment is...

The Sixth SGH Lecture—Singapore: A New Venice of the 21st Century

Venice is one of the legendary cities of the world. Its beauty and physical setting make Venice unique. For almost 800 years, from 1000...

Foregoing Life Support in Medically Futile Patients

The origins of withholding medical support are found in ancient times. More than two millennia ago, Hippocrates (460 to 361 BC) stated that the...

Nitric Oxide in Septic Shock: Directions for Future Therapy?

In 1980, Furchgott and Zawadzki demonstrated that the relaxation of isolated arteries to acetylcholine required the presence of endothelial cells. This response was mediated...

Critical Care Medicine in the Western Pacific Region

The Western Pacific region includes a very diverse group of countries varying in their culture, economic development and per capita income, disease prevalence and...

Critical Care—The Worldwide Perspective

Although special areas for postoperative patients existed 50 years ago, the modern specialty of Critical Care began during the polio epidemic of the 1950s....

Malaria Requiring Intensive Care

Malaria is an important and common infectious parasitic disease globally. It is associated with significant morbidity and mortality, especially in endemic areas. This article is...

A Retrospective Study of Near-drowning Victims Admitted to the Intensive Care Unit

Drowning victims suffocate from submersion. This may lead to immediate death or, if they survive, brain damage if significant cerebral hypoxia is present. This article...

Ergotism and Vascular Insufficiency: A Case Report and Review of Literature

Toxicity from ergot and its derivative is well known. Great epidemics occurred during the middle ages due to consumption of rye contaminated with the...

Plasma Vitamins A, C and E in the General Population of Singapore, 1993 to 1995

The current disease pattern in Singapore (an island state of 3.3 million people composed of 76% Chinese, 14% Malays, 7% Asian Indians and 3%...

Medicine and Surgery—History, Change and Challenge

Mr Koh Yong Guan, guest-of-honour; Dr Tan Ser Kiat, Master, Academy of Medicine; Dr K C Tan, Chairman, Chapter of Surgeons; Dr Robert Jalleh...

Current Continuing Medical Education Provision in Singapore

It was in 1994 that as an overseas fellow of the College, I received a letter from Dr Peter Toghill, Director of Continuing Medical...

Early 21st Century Professional Practice: Change and Challenge

Today is a day of rejoicing for all of you, graduates, parents, relatives and loved ones. I can share in your joy and also...

9th Seah Cheng Siang Memorial Lecture: Gastric Cancer—Where are we now?

The last two decades have witnessed dramatic changes in the understanding of gastric cancer: a rapid decline in global incidence, its association with Helicobacter...

New Treatment and Research Strategies for the Improvement of Care of Cleft Lip and Palate Patients in the New Millennium

I have chosen as the title of my keynote address “New Treatment and Research Strategies for the Improvement of the Care of Cleft Lip...

Intravital Microscopy for the Study of the Microcirculation in Various Disease States

It is more than 150 years ago when the first detailed description of intravital microscopy was given by Waller, demonstrating in the frog tongue...

Young Investigator’s Award: Induction of Apoptosis Following Traumatic Head Injury in Humans

The outlook for sufferers of severe head trauma is extremely poor. Some 20% of patients died before significant treatment can be administered, and nearly...

8th Seah Cheng Siang Memorial Lecture: New Antithrombotic Agents

The tremendous interest in finding new anti-aggregating agents stems from the preeminent role that platelets play, not only in haemostasis and thrombosis, but also...

3rd Yahya Cohen Lecture: The Role of the Myofibroblast-Like Cell in Hepatocellular Carcinoma—Host Defence?

It is indeed a great honour for me to be named the third Yahya Cohen lecturer and I would like to express my deepest...

9th Chapter of Surgeons’ Lecture: The Orthopaedic Surgeon: Historical Perspective, Ethical Considerations and the Future

The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in...

1998 Distinguished Academician Lecture: Hepatic Resection— A Western Perspective

Although debridement of portions of liver that prolapsed through war wounds was recorded from distant times, attempts at resection of a solid liver tumour...

1998 Runme Shaw Memorial Lecture: Somatic Evolution of Cancer

The interpretation of cancer as a somatic evolutionary process involving genetic mutation followed by selection, goes back to the early years of this century....

14th Gordon Arthur Ransome Oration: Continuity and Change

Deputy Prime Minister Lee Hsien Loong, Datuk Dr Yeoh Poh Hong, Dr Chee Yam Cheng, distinguished guests, ladies and gentlemen, I am deeply honoured...

The Future of Medicine from the Standpoint of the Practising Paediatrician

From the time of recorded history of medicine, the doctor whether he be the ancient healer or the modern medical practitioner, the doctor had...

Design of Phase I and II Clinical Trials in Oncology and Ethical Issues Involved

Drug development is costly and time-consuming in terms of economic, patient and research resources. An integrated effort involving academia, industry, and regulatory authorities is...

Evaluating Drugs from Cradle to Grave—Evolving Systems for a Complex Activity

Are medicines dangerous chemicals or life enhancing agents? The answer is ‘Both of those things, often at the same time, and worse in the...

Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Dinner—Learn the Past, Ensure the Future

I am delighted to share this celebratory occasion with you. It is a time for congratulations all round not only to our new Fellows...

Response by the Representative of Inductees, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—A Call to Patient Advocacy

I count myself fortunate to be allowed to join the ranks of the Academy. On behalf of my fellow inductees, may I extend a...

Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—The EQ & IQ of Specialist Doctors

First, let me warmly welcome you to this pristine auditorium with its well preserved ceiling architectural details. Probably none of the new Fellows is...

8th SGH Lecture: Genomics, Talent and the Development of the Life Sciences Industry in Singapore

In a few months’ time, one of the most significant advances, possibly the most significant advance ever in the history of biology and medicine,...

3rd Tan Tock Seng Hospital Oration: The Changing Fabric of Medicine—An Ethical and Social Revolution

The legacy of Tan Tock Seng Hospital began with the founding of the Pauper Hospital in Pearl’s Hill in 1844. This article is available only...

Management of Growth Arrest with Tissue-engineered Cells

Before I go on to the scientific aspects of my talk, I would like to pay tribute to Dr Yahya Cohen. Dr Cohen was...

10th Chapter of Surgeons’ Lecture: The Challenges in Surgery—Past, Present and Future, and in Search of the 4Cs

Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the...

Opening Address by Dr Chee Yam Cheng, Master, Academy of Medicine, Singapore at the 33rd Annual Combined Surgical Meeting on 4 November 1999 at the COMB Auditorium

It is a pleasure to be present with you all at your 33rd Annual Combined Surgical Meeting for 1999 with less than 60 days...

Funding and Future Diagnosis Related Group Development

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

Clinical Pathways or Case Management

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

Getting Clinicians Involved: The Australian Experience

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

The 4th Tan Tock Seng Hospital Oration: Challenge for the Medical Profession in the 21st Century

I am greatly honoured to speak at the 4th TTSH Oration following such distinguished luminaries like Dr Chew Chin Hin, Dr Chen Ai Ju...

Book Review

The above is a textbook of medicine written by Singapore doctors and published in Singapore. It is difficult not to be over-enthusiastic about it...

The Practice of Foregoing Life Support in the Critically Ill “Old Old”: A Singapore Perspective

Studies on the foregoing of life support (FLS) in North America, Europe and Australia have shown diversity in terms of the incidence, decision-making process...

Alternate Modes of Financing Health Care Technology

Alternative financing of health care delivery is one of the most vexing problems facing medicine today. Intensive care in many ways is a perfect...

2nd Chapter of Paediatricians Lecture: The Future of Paediatrics in Singapore

When I was first invited to give this 2nd Chapter of Paediatricians Lecture by the Chapter, my obvious answer was no. I could think...

10th Seah Cheng Siang Memorial Lecture: Going Places—A Rheumatological Odyssey

I am greatly honoured to deliver the 10th Seah Cheng Siang memorial lecture. I came into direct contact with Professor Seah in January 1965...

5th Yahya Cohen Lecture: Angiosomes and Extension of Skin Flaps—Anatomic Study and Clinical Implications

I would like to express my gratitude to the Chapter of Surgeons and the Academy of Medicine, Singapore for the honour of presenting this...

11th Chapter of Surgeons Lecture—The Art of Letting Go

These observations were made by a Persian mathematician some 900 years ago. His sentiments are self-evident but no less easy to accept especially for...

15th Gordon Arthur Ransome Oration: A Journey of Care—Mission Impossible?

I am deeply honoured by the invitation to deliver the 15th Sir Gordon Arthur Ransome Oration. This article is available only as a PDF. Please...

The Runme Shaw Memorial Lecture 2000—Treating VIPs in Washington

My lecture is about people, power, illness, and the patient-physician relationship. It is the personality of the politician or official, the ego elevation conferred...

12th Chapter of Surgeons Lecture: Shifting Paradigms in the Management of Breast Cancer—A Surgical Perspective

The recorded history of breast cancer management spans four millennia. This story about breast cancer management is also one about change, about resistance to...

Gemella Empyema Cured without Antibiotics: A Case Report

Gemella are gram-positive anaerobic bacteria that rarely produce serious human infections. We describe a case of thoracic empyema that occurred in an elderly Chinese...

The Clinician Meets the Computer—Uneasy Bedfellows

Information technology has become a cornerstone of civilization as we know it. In its broadest definition, information technology encompasses all forms of technology required...

Leveraging on Information Technology to Enhance Patient Care: A Doctor’s Perspective of Implementation in a Singapore Academic Hospital

Information technology (IT) has become truly pervasive in everyday life; however, in the field of medicine, we have yet to fully harness its full...

Internal Medicine

It has taken a long time to plan for this November issue in Internal Medicine. The topic is so wide and often neglected as...

5th Tan Tock Seng Hospital Oration: Advances for Life

I am honoured and privileged to have been invited to deliver the 5th Tan Tock Seng Hospital (TTSH) Oration at the Opening of your...

6th Yahya Cohen Lecture: Visual Experience During Cataract Surgery

What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress...

The Bone and Joint Decade 2000-2010

With the ageing population, degeneration of joints and osteoporosis and the resultant disability pose big public health problems in many countries of the world....

General Medicine—Revisited, Rejuvenated, Revitalised and Reemphasised

“The irresistible swing towards medical specialisation has brought advantages for patients but arguably this has gone too far.” It is time to review the...

A Countrywide Approach to the Control of Non-communicable Diseases—The Singapore Experience

In the area of health, the last two decades has seen a decline or eradication of deadly diseases, such as smallpox and polio, the...

Causes for the Evolution of Case Management and the Development of a Working Model in an Acute Care Hospital in Singapore

In 1999, significant changes to the healthcare funding structure were introduced to public sector hospitals in Singapore. This was the advent of casemix-based funding...

Evidence-based Medicine: The Key to Guidelines, Disease and Care Management Programmes

Health care in America and the rest of the industrialised world continues to reinvent itself at an ever-accelerating rate. The societal pressures for high...

National Disease Management Plans for Key Chronic Non-communicable Diseases in Singapore

Like most other newly industrialised economies, Singapore has undergone a rapid epidemiological transition over the last 50 years. Chronic, non-communicable diseases have replaced infectious...

Chronic Disease Management: Challenges for Clinicians and the Way Forward

The healthcare, financial and social burden of chronic diseases, such as diabetes mellitus, coronary heart disease, asthma, chronic obstructive airway disease, hypertension, chronic depression,...

Measuring Health-related Quality of Life in Singapore: Normal Values for the English and Chinese SF-36 Health Survey

Advances in diagnosis and therapy in the second half of the 20th century have lead to impressive improvements in survival for patients with many...

Should Ethical Issues in Biotechnology Research be Decided by Physicians-Scientists or by Lawyers?

As with clinical practice, the practice of biomedical research is a moral activity. We have to think about what we should do, not just...

Is Healthcare Competition Healthy?

There are many problems which all Health Ministers worry about. But we can generally boil them down to one common problem: “money no enough”. This...

Neonatology In Singapore: The Way We Were, The Way Forward

Over a span of 35 years of my working life, I have witnessed the growth of, and also grown together with, neonatology in Singapore....

Significance of the Lateral Epiphysis of the Acetabulum to Hip Joint Stability

Developmental dysplasia of the hip (DDH) remains one of the most difficult disorders to understand and treat in Paediatric Orthopaedics. The aetiology have not...

Craniofacial Anomalies: Clinical and Molecular Perspectives

Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia,...

Autoimmune Liver Disease in Children

Autoimmune liver disorders are inflammatory liver diseases characterised histologically by a dense mononuclear cell infiltrate, including plasma cells, in the portal tract (Fig. 1)...

HIV/AIDS in Children

The human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) epidemic in Asia has grown from a handful of cases to a major...

Patterns and predictors of sound levels in hospital rooms

Dear Editor,      Excessive sound levels in the hospital can impair the work performance of healthcare professionals and affect patient well-being.1 Previous studies have also...

Inaugural College of Obstetricians & Gynaecologists Lecture: Recent Developments in Obstetric Care and Maternal Fetal Medicine in Singapore

Has it done any good to pregnancy outcome as promised? This article is available only as a PDF. Please click on “Download PDF” on top...

Citation on Dr Andrew Chew Guan Kuan for Admission to Honorary Fellowship on 19 August 2004

It is indeed a great pleasure and honour to present to you Dr Andrew Chew Guan Khuan, who is already a Fellow of the...

Citation on Sir Donald Irvine – 17th Gordon Arthur Ransome Orator

It is my pleasure and privilege to introduce Sir Donald Irvine as the 17th Gordon Arthur Ransome Orator. This article is available only as a...

Address by Master, Academy of Medicine, Singapore at the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine and Induction Ceremony

It is my pleasure to welcome you to the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine with participation of the Hong Kong...

1st College of Physicians Lecture: The Role of Internal Medicine as a Specialty in the Era of Subspecialisation

It humbles me to accept the invitation to give this lecture, the First College of Physicians Lecture, titled “The Role of Internal Medicine as...

15th Chapter of Surgeons Lecture: Surgeon of the New Millennium – Surgeon, Scientist and Scholar

Next year, we celebrate a hundred years of medical education in Singapore. We have come a long way since 1821 – from a small,...

Standards and Revalidation or Recertification

In my Gordon Arthur Ransome Oration and other papers, I have described the nature and development of patient-centred professionalism, the key features of which...

Continuing Professional Development – a Surrogate for Recertification?

The Hong Kong Academy of Medicine is a statutory body set up in 1993 with the objectives of fostering the development of postgraduate medical...

Teaching and Learning of Professionalism in Medical Schools

There is now worldwide consensus that the elements of medical professionalism need to be enhanced and explicitly taught in medical schools. Medical schools in...

The Challenge of Teaching Professionalism

For the past 25 years, professionalisation, industrialisation, large-scale infusions of technology into the healthcare system and consumerism, to name a few factors, have definitely...

2004 Runme Shaw Memorial Lecture: Professionalism – A Concept in Need of Nurturing

It is a great honour to be invited to deliver the Runme Shaw Memorial Lecture. I am grateful to the Runme Shaw Foundation for...

17th Gordon Arthur Ransome Oration: Patient-centred Professionalism

When sickness strikes we all need doctors. People everywhere know that the quality of medical care can affect the outcome and possible consequences of...

The Role of Public Health and Occupational Physicians in the New Millennium

I want to thank the Chapter and organisers for honouring me with this kind invitation to speak to you. This millennium is only 4...

Flap Prefabrication – The Bridge Between Conventional Flaps and Tissue-engineered Flaps

Flap prefabrication is one of the most exciting areas in Plastic Surgery because of its bridging role between conventional reconstructive surgery and tissue engineering....

Refining Clinical Practice: Transforming Science Research into the Art of Medicine

I am humbled by the invitation given to me by Changi General Hospital to deliver this lecture at your 5th Annual Scientific Meeting with...

14th Chapter of Surgeons Lecture: Back to Basics

I am happy to be among old friends. As surgeons, we share a kindred spirit. I wish to thank the Academy for the honour...

Extended-spectrum Beta-lactamases in Clinical Isolates of Escherichia coli and Klebsiella spp. in a Singapore Hospital: Clinical Spectrum

Extended-spectrum beta-lactamases (ESBLs) in gram-negative bacillary pathogens are a growing and important problem in hospital practice and it is tied to extensive use of...

Routine Microbiological Screening in Septic Patients in a Cardiac Surgical Intensive Care Unit

Compared to in-hospital patients, patients treated in an intensive care unit (ICU) have the highest risk of contracting an infection. The risk correlates well...

Medical Education in Asia: Is it a Time for Optimism?

Asia, the largest continent, is also an immensely diverse region with countries that vary in their socio-economic status, degree of urbanisation and health and...

Issues and Priorities of Medical Education Research in Asia

Medical schools traditionally rest on the “three-legged stool” of research, education and service. Hence, medical teachers are sometimes referred to as “triple-threat academicians”. This article...

Genital Herpes in a Sexually-transmitted Infection Clinic in Singapore: A 1-year Retrospective Study

Genital herpes simplex virus (HSV) infection is a commonly notified sexually transmitted infection (STI). Genital herpes can be caused by both herpes simplex virus...

Professionalism: Looking For Your Blind Spots

In 1996 a major breakthrough was reported in the medical literature. A 5-week ectopic pregnancy was re-implanted into the uterus via the cervix, and...

Methodological Aspects of Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) has a long history but its efficacy is not as well-documented as one would hope. Proof of efficacy has to...

A Practical Way of Research in Chinese Medicine

Chinese medicine individualises its treatment plan and practice and refutes any general law. Therefore, Chinese medicine practitioners do not have the tradition of research. This...

Complementary and Alternative Medicine, and Traditional Chinese Medicine: Time for Critical Engagement

Practice outside of mainstream or conventional medicine has always been an important part of public healthcare in some countries, particularly in the developing world....

3rd College of Physicians’ Lecture – Translational Research: From Bench to Bedside and From Bedside to Bench; Incorporating a Clinical Research Journey in IgA Nephritis (1976 to 2006)

In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the...

16th Seah Cheng Siang Memorial Lecture – The Changing Face of Cardiology Practice, Training and Research in Singapore

Professor Seah Cheng Siang was one of the most illustrious physicians of his era. During his professional career, he held the following positions: Head,...

Student Academic Committees: An Approach to Obtain Students’ Feedback

The shift of medical curricula from a traditional subject based to an integrated module-based system can be seen in many medical schools worldwide. The...

Curricular Trends in Malaysian Medical Schools: Innovations Within

Medical educators continue to evaluate and introduce innovations into their curriculum with the objective of achieving appropriate outcomes for their graduates so that they...

A Problem-Based Learning Pathway for Medical Students: Improving the Process Through Action Research

Problem-based learning (PBL) is a student-centred, self-directed, integrated and contextual mode of learning. It has been widely perceived by many to confer advantages in...

A Simple Instrument for the Assessment of Student Performance in Problem-based Learning Tutorials

Assessment can be done in a variety of ways, for many purposes, and for different populations. It can occur at the classroom level, programme...

An Online Evaluation of Problem-based Learning (PBL) in Chung Shan Medical University, Taiwan – A Pilot Study

The goal of problem-based learning (PBL) is to motivate students to develop self-learning skills in a small group. PBL embraces principles of good learning...

Evidence-based Medicine in Clinical Curriculum

Evidence-based medicine (EBM) is “the conscientious, explicit, and judicious use of the best evidence in making decisions about the care of individual patients.” Considering...

Leadership and Professionalism Curriculum in the Gross Anatomy Course

Healthcare delivery systems worldwide are currently undergoing significant changes to create resilient learning organisations that are able to adapt with ever-increasing speed to shifting...

Constructing Multiple Choice Questions as a Method for Learning

Students in general and medical students in particular are often described as “strategic learners”, but in reality many become superficial learners out of necessity...

Computer-based Versus Pen-and-paper Testing: Students’ Perception

Computer-based testing (CBT) has gained popularity as a testing modality, with large-scale professional examinations such as the United States Medical Licensing Examination (USMLE) adopting...

Curriculum TIPS For All of Us

Medical education is a lifelong learning process. Just as we remind our students and ourselves that the practice of medicine is a lifelong process...

3rd FY Khoo Memorial Lecture – Education, Professionalism, Outsourcing and the Future of Radiology

Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become...

Community-associated Methicillin-resistant Staphylococcus aureus: Overview and Local Situation

The emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA) isolates from the community that are distinct from their archetypal healthcare-associated counterparts (HA-MRSA) marked a...

Translational Research – A Multidisciplinary Approach

Translational research aims to convert laboratory discoveries into therapeutic gains for patients – in oncology, drug development is a prime example. This multifaceted process...

A Complex, Contagious, Evolutionary Habit

Yawning is often noted in medical seminars and conferences – be they surgical, orthopaedic, gastroenterological, endocrinological or neurological. Yet, this condition receives little coverage...

Amendment of the Human Organ Transplant Act

Kidney transplants have been carried out in Singapore for more than 35 years, with the first cadaveric kidney transplant operation performed on 8 July...

Interesting In- and Outpatient Attendances at Hogwarts Infirmary and St Mungo’s Hospital for Magical Maladies

With the return of “You Know Who” (YKW) and the rise of Death Eaters, injuries amongst both muggle and wizarding folk (MF and WF)...

The Doctor’s Multi-instrument Tool of the Future?

It is just another day in 2020, except that the eyes of the medical world are eagerly awaiting the latest invention to be revealed:...

Relationship Between Item Difficulty and Discrimination Indices in True/False-Type Multiple Choice Questions of a Para-clinical Multidisciplinary Paper

Multiple-choice questions (MCQs) are used more and more in departmental examinations or as comprehensive examinations at the end of an academic session. They may...

10th Yahya Cohen Memorial Lecture: Clinical Predictors in Obstructive Sleep Apnoea Patients with Computer-assisted Quantitative Videoendoscopic Upper Airway Analysis

Obstructive sleep apnoea (OSA) is a common disease, which is estimated to affect up to 2% of middle-aged women and 4% of middle-aged men.1...

New Treatments for Atopic Dermatitis – Facts, Comparisons and Uncertainties

Atopic dermatitis is associated with asthma and allergic rhinitis, and presents with a typical morphology and distribution. Eighty-four per cent of cases of atopic...

Towards a Global Educational Matrix for Tomorrow’s Health Systems

Society supports medical schools expecting them to produce physicians who can improve both the health of the population as well as the health system...

Harnessing the IT Factor in Medical Education

In this digital age, we are constantly inundated with breathtaking images worthy of an Ansel Adams photograph or a Zhang Yimou film. Is it...

A Systems Approach to Teach Core Topics across Graduate Medical Education Programmes

Core curricula including Ethics, Medico-legal issues, Socioeconomics, and Quality Improvement (QI) are relevant and significant for graduate medical education programmes, regardless of specialty. A...

World Federation for Medical Education Policy on International Recognition of Medical Schools’ Programme

There is an increasing need for international quality assurance of medical education. However, there are no present mechanisms for international recognition of medical educational...

Quality Management of Medical Education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany

In Germany, medical education is an undergraduate programme for which the students applying at the “Zentralstelle für die Vergabe von Studienplätzen” (ZVS); the final...

Supporting Learners who are Studying or Training Using a Second Language: Preventing Problems and Maximising Potential

Travel and immigration are vibrant aspects of the international medical and educational field. Patients are increasingly mobile and finding healthcare professionals in a foreign...

Development of a Tool to Evaluate Health Science Students’ Experiences of an Interprofessional Education (IPE) Programme

A shortage of healthcare professionals and resources in rural areas is well documented. These workforce shortages necessitate new models of healthcare in rural areas...

Step-2 Thai Medical Licensing Examination Result: A Follow-up Study

The Center for Evaluating and Accrediting Medical Competency of the Thai Medical Council has established the regulation that Thai medical graduates matriculated as of...

Does Team Learning Motivate Students’ Engagement in an Evidence-based Medicine Course?

Team-based learning (TBL) is a well-defined instructional strategy that has generated considerable interest within the medical education community because of its potential to promote...

A Survey of Medical Students’ Perceptions of the Quality of their Medical Education upon Graduation

Founded in 1934, Tehran University of Medical Sciences School of Medicine (TUMS-SoM) is the oldest modern medical school in Iran. It has the most...

The Learning of 7th Year Medical Students at Internal Medical – Evaluation by Logbooks

In 1945, Taihoku (Taipei) Imperial University was renamed the National Taiwan University and the Japanese teaching system was replaced with a system implemented by...

Use of Knowledge-sharing Web-based Portal in Gross and Microscopic Anatomy

The extensive use of and the rate at which medical technology is becoming an integral force in medicine has impacted on the way in...

Assessment of Psychometric Properties of a Modified PHEEM Questionnaire

In Sri Lanka, after a 5-year medical undergraduate curriculum, graduates from the medical faculties undergo a one year mandatory internship or housemanship, 6 months...

Medical Education in a Flat World

In 2005 Thomas Friedman published the international best-seller The World is Flat: A Brief History of the Twenty-First Century. He asserted that as the...

Objective Structured Clinical Evaluation Should Not Only Be a Test of Clinical Skill

The Objective Structured Clinical Examination (OSCE) was originally a test (or summative assessment) specifically of clinical skills, using standardised patients (SP), anatomical models and...

Standard Setting in Student Assessment: Is a Defensible Method Yet to Come?

To validate any “adjective”, be it for living or non-living, a criteria or standard is needed. Globalisation, mobility of doctors and the rising number...

Innovative “Case-Based Integrated Teaching” in an Undergraduate Medical Curriculum: Development and Teachers’ and Students’ Responses

In Asia, the challenges facing medical education are similar across different countries. The learning process is still problematic with large classes, and most of...

Singapore’s Proposed Graduate Medical School – An Expensive Medical Tutorial College or An Opportunity for Transforming Singapore Medicine?

The government recently announced its intention to set up a second medical school at the Outram Campus. Duke University has been invited to help...

Should Singapore have a Second Medical School?

Singapore has had only one medical school since 1905. This medical school, the Medical Faculty in the National University of Singapore (NUS), currently takes...

The Teaching of Pathology

The teaching of Pathology began in 1905 with the founding of the King Edward VII College of Medicine. There was no Chair of Pathology...

Assessment of Medical Graduates Competencies

Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. The major aim of undergraduate...

Evidence-based Medicine (EBM) for Undergraduate Medical Students

The practice of evidence-based medicine (EBM), which integrates individual clinical expertise with the best available evidence from systematic research, demands a set of skills....

Transudates in Malignancy: Still a Role for Pleural Fluid

According to Light’s criteria, an exudate is defined by at least one of the following: a total protein pleural fluid to serum ratio greater...

The Singapore Years and Subsequently

As a small-town upcountry Malay boy, Singapore was to me a great big city when I first arrived in 1947 to join the King...

Brachytherapy – One Man’s Meat, A Personal Journey in Radiation Oncology

Dr Tan Kim Ping, Chairman for the Dr FY Khoo Memorial Lecture, Ladies and Gentlemen – It is a signal honour for me to...

Retinal and Cardiovascular Diseases: The “Common Soil” Theory

There is increasing evidence that retinal and cardiovascular diseases share a “common soil”. Risk factors for cardiovascular disease, such as hypertension, diabetes, hyperlipidaemia and...

4th FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup – The Past, The Present and The Future

Thank you Madam Chairman. First, I would like to thank the Singapore Radiological Society and the College of Radiologists, Academy of Medicine Singapore for...

Self-directed Learning in Health Professions Education

More than 600,000 new citations were published in MEDLINE in 2005; this raised the total number of indexed citations to more than 14 million...

3rd College of Paediatrics and Child Health Lecture – The Past, the Present and the Shape of Things to Come…

In the post-war days of the 1950s, Singapore children were faced with problems of malnutrition and infectious diseases. There was poverty, overcrowded housing and...

Sir Gordon Arthur Ransome (1910-1978) – His Teaching Style and His Legacy

Sir Gordon Arthur Ransome was born in Salop, England, in 1910.1 He came to Singapore in 1938, where he taught and practised medicine for...

Translating the Family Medicine Vision into Educational Programmes in Singapore

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. Modern day FM began its existence as...

Erysipelothrix rhuseopathiae Septicaemia with Prolonged Hypotension: A Case Report

Erysipelothrix sp. is a gram-positive, non-spore forming bacterium that was first isolated by Robert Koch. It has the unusual ability to infect a large...

The Hospitalist Movement – A Complex Adaptive Response to The Hospitalist Movement – A Complex Adaptive Response to Fragmentation of Care in Hospitals

Healthcare systems are complex adaptive systems. They are capable of self organisation through interacting agents that adapt to changes to the internal and external...

Medication Use in the Transition from Hospital to Home

Hospital discharge can be a complex and challenging time for physicians and patients alike. Patients are being discharged sooner, often in the process of...

Family Medicine Education in Singapore: A Long-standing Collaboration between Specialists and Family Physicians

In the US, Canada and Australia, the postgraduate training of family physicians (FPs) involves the attachment of family medicine (FM) trainees to specialist departments,...

Bridging the Gap between Primary and Specialist Care: Formidable Challenges Ahead

The strong guiding hand and deep pockets of the state have brought about the growth of hospitals and national specialist centres while leaving the...

Clinical Skills in Final-year Medical Students: The Relationship between Self-reported Confidence and Direct Observation by Faculty or Residents

In clinical medical education, instructors train students in their medical knowledge and clinical skills. Medical educators also aspire to develop students’ self-confidence in medical...

The Role of Electrophysiology in the Diagnosis and Management of Cervical Spondylotic Myelopathy

Cervical spondylosis is an extremely common condition managed by both physicians and surgeons in daily clinical practice. Cervical spondylotic myelopathy (CSM), resulting from longstanding...

Demands and Challenges of Modern Medicine

I am deeply honoured by the invitation to deliver the 16th Tun Dr Ismail Oration and I wish to thank the Master and Council...

Happenings in Histopathology – A Post-World War II Perspective

During the past few decades, there have been many significant developments in the practice of histopathology, the specialty that is also referred to as...

A Brief History of the Chapter of Psychiatrists

The Inaugural Meeting of the Chapter of Psychiatrists and Chapter of Pathologists, Academy of Medicine, was held on 5 December 1986 at King’s Hotel.1,2...

Take a Bao if You Are Not Superstitious

Superstition, defined by Webster’s dictionary as “a belief or practice resulting from ignorance, fear of the unknown, trust in magic or chance, or a...

Tumour Interstitial Fluid Pressure May Regulate Angiogenic Factors in Osteosarcoma

Solid tumours have states of raised interstitial fluid pressure (IFP) that cause significant changes to their physiology.1-3 We have previously shown that human osteosarcomas...

Surgical Training – The Challenge of Change

President of the College of Surgeons, distinguished guests, friends, ladies and gentlemen. It is a great honour and a unique privilege for me to...

Preparedness for Terrorism: Managing Nuclear, Biological and Chemical Threats

Preparedness for terrorism in the 21st century includes addressing the management of nuclear, biological and chemical (NBC) terrorism events. Understanding the terrorist threat and...

5th College of Surgeons Lectureship: Surgery beyond Scalpels

The training of surgeons composed of two aspects: (1) Clinical skill and competence; (2) The ‘soft’ skill and ‘art’ of surgery. With the gradual...

The Evolution of Radiology from Paraclinical to Clinical

I would like to thank the Academy of Medicine and the Singapore Radiological Society for giving me the honour of delivering this year’s F...

Evaluation of Intensive Care Unit-acquired Urinary Tract Infections in Singapore

Urinary tract infection (UTI) is one of the most common types of nosocomial infections encountered in the inpatient settings including intensive care unit (ICU)....

Medical Professionalism in the Internet Age

Medical professionalism encompasses the conduct and practices of physicians, both as individuals and as a collective organisation. Professionalism enhances the trust and confidence of...

3rd College of Surgeons Lecture — Bringing up Surgeons

I am greatly honoured to be given the privilege of delivering the 3rd College of Surgeons Lecture, especially when I have retired from surgery...

Developing the “NUS Tummy Dummy”, A Low-Cost Simulator to Teach Medical Students to Perform the Abdominal Examination

Simulators may be used to provide adequate exposure to learning experiences that allow clinical skills to develop, that is, allow medical students and trainees...

12th Yahya Cohen Memorial Lecture – The Cellular and Molecular Basis of Radiation-induced Sensori-neural Hearing Loss

Radiation-induced sensori-neural hearing loss (SNHL) has long been recognised as a complication of radiotherapy (RT) for head and neck tumours, if the auditory pathways...

11th Yahya Cohen Memorial Lecture – An In vivo Comparative Study of the Ability of Derived Mesenchymal Stem Cells in the Treatment of Partial Growth Arrest

It has been my greatest pleasure and honour to accept this, the 11th Yahya Cohen Memorial Lectureship on the anniversary of a half century...

Challenges and Pitfalls in the Introduction of Pharmacogenetics for Cancer

Pharmacogenetics, by definition, refers to the study of genetic differences in metabolic pathways which can affect an individual’s responses to drugs in terms of...

7th College of Physicians Lecture — The Changing Face of Medicine, Medicine – Past, Present and Future

When we think about medicine, just like we do about other things in life in the past and the present, we usually reflect on...

15th Yahya Cohen Memorial Lecture – The Relationship between the Air-bone Gap and the Size of Superior Semicircular Canal Dehiscence

Superior semicircular canal dehiscence (SSCD) can result in a characteristic constellation of vestibular and auditory features, including autophony, oscillopsia, and vertigo, and characteristic eye...

Maternal and Fetal Best Interests in Day-to-Day Obstetrics

When we discuss maternal and fetal best interests in an ethical context, we have to deliberate on the morality of healthcare, including the morality...

The Ethics of Responding to a Novel Pandemic

“A man without ethics is a wild beast loosed upon this world.” -Albert Camus (1957 Nobel Prize for Literature) As the microscopic ‘wild beasts’ of infectious...

An Approach to the Ethical Evaluation of Innovative Surgical Procedures

Innovative surgery is perhaps best defined as “a novel procedure, a significant modification of a standard technique, a new application of or a new...

Hospital Policy on Medical Futility — Does it Help in Conflict Resolution and Ensuring Good End-of-Life Care?

The concept of medical futility has been present since antiquity, and traditionally marked the shift in the primary goal of care to providing physical...

5th Chao Tze Cheng Memorial Lecture—Recent Developments in Informed Consent

The question of informed consent is a concern of recent origin and has engaged the mind of the medical profession here for only some...

7th Tan Tock Seng Oration: Surgical Excellence at TTSH—100 Years on and onward

Mr SR Nathan, our guest of honour, Mr Gan Kim Yong, Minister for Health, Madam Kay Kuok, Chairman of NHG Board, Board members, colleagues,...

8th FY Khoo Memorial Lecture 2012 —Why Radiologists Need Philosophy

Firstly, I wish to thank the Singapore Radiological Society and the College of Radiologists, Singapore for deeply honouring me with the invitation to give...

6th College of Surgeons Lecture The Philosophy of Balance: The Art of Healing

With the rise of high tech medicine, and emphasis on the scientific aspects of medicine, there is danger that we may lose the balanced...

Is Cost-Effective Healthcare Compatible with Publicly Financed Academic Medical Centres?

Nearly all legislation involves a weighing of public needs as against private desires; and likewise a weighing of relative social values. —Louis D Brandeis As a...

Cognitive Aspect of Diagnostic Errors

It was an unusually busy ward round. The newly promoted registrar was keen to review the patients handed over to him. But there were...

2013 Runme Shaw Memorial Lecture: Clinical Applications of Stem Cells in Modern Medicine—21st Century and Beyond

The rapid advancement of biomedical research in the recent years was propelled by a series of groundbreaking technological inventions and breakthrough discoveries. In this...

22nd Gordon Arthur Ransome Oration: Is Medicine Still an Art?

Distinguished guests and colleagues in medicine, I am deeply honoured to have been invited to deliver this 22nd oration in honour of Sir Gordon...

Academic Medicine Education Institute (AM∙EI): Transforming the Educational Culture of Health Professionals

In 2010, Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth) launched an initiative to improve the lives of patients by combining their...

Diagnosing Bacteraemia Early in Older Adults

Sepsis is a prevalent and important cause of morbidity and mortality in the general population. Approximately 750,000 patients in the United States alone develop...

24th Seah Cheng Siang Lecture: Seeing Better, Doing Better—Evolution and Application of Gastrointestinal (GI) Endoscopy

Man’s innate curiosity to study the internal organs of the human body dates back to the time of Hippocrates where basic speculums were invented...

Factors and experiences associated with unscheduled 30-day hospital readmission: A mixed method study

Readmission leads to a greater demand for healthcare services, especially hospital beds, and contributes to the rising healthcare costs.1,2 With estimated one-third of the...

Potentially avoidable readmissions: Understanding drivers and technology-enabled solutions

Hospital admissions places high resource demands on the health system, and is a major cost-driver in Singapore and globally.1-3 Admissions have and will continue...