[metaslider id="5280"]

Related Articles

Congenital cytomegalovirus infection: Advocating for screening and education

Cytomegalovirus (CMV) infection is the leading non-genetic cause of congenital neurosensory hearing loss in children, accounting for 21% of cases of hearing loss at...

Epidemiological trends and outcomes of children with aural foreign bodies in Singapore

Aural foreign bodies (FBs) commonly present to the emergency department (ED) worldwide. Children represent the majority of the population, believed to be due to...

Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore

The Coronavirus Disease 2019 (COVID-19) has affected almost all geographies in the world since 2020. Many countries have imposed strict isolation measures to contain...

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...

Management Training in Critical Care Medicine

Critical care medicine as a specialty has grown rapidly, both clinically and academically, over the past 25 years. In the USA, certification of competence...

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...

Survival after Cardiopulmonary Resuscitation in the General Wards—The Results of a Dedicated “Code” Team

Cardiopulmonary resuscitation (CPR) is widely practised for cardiopulmonary arrests with variable success. The initial intention was to defibrillate patients with ventricular fibrillation after acute...

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%...

Disseminated Penicillium marneffei Infection: A Report of Five Cases in Singapore

Penicillium marneffei is a dimorphic fungus that can cause infection in immunocompromised hosts. Reports on infection with this organism were initially uncommon, but after...

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...

Clinical Drug Trials: Practical Problems of Phase III

There has been a rapid increase in clinical trial activity in Singapore and other parts of Asia. Randomised clinical trials are the “gold standard”...

Theory and Practice in Continuing Medical Education

A physician’s education in medical science represents a continuum of several interrelated phases. It starts with medical school, passes through brief housemanship year, and...

Deep Vein Thrombosis after Total Knee Replacement

Western literature reports a very high incidence of deep vein thrombosis in its population especially after orthopaedic surgery. In total knee replacement without prophylaxis,...

Introduction of Problem-based Learning in a Traditional Medical Curriculum in Singapore—Students’ and Tutors’ Perspectives

The National University of Singapore was started in 1905. Since then, it has trained many generations of medical practitioners. This article is available only as...

Quality Assurance of Problem-based Learning (PBL): The Hong Kong Experience

The Faculty of Medicine of the University of Hong Kong (HKU) was established in 1887 and its curriculum has been run in a traditional...

Clinical Reasoning Learning Sessions

Many medical schools worldwide have made the shift toward problem-based learning (PBL) medical education. Some of them employ these new techniques in only part...

Is Problem-Based Learning a Quality Approach to Education in Health Sciences?

Since the pioneering adoption of problem-based learning (PBL) by McMaster University in medical education more than three decades ago, increasingly more medical schools around...

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...

A Retrospective Study of Melanocytic Naevi at the National Skin Centre

Melanocytic naevi are benign proliferation of melanocytes of congenital and acquired types which usually appear during adolescence or early adult life. Naevi are of...

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...

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...

The Bone and Joint Decade 2000-2010: For Prevention and Treatment of Musculoskeletal Disease

The theme of this issue of the Annals, Academy of Medicine at the beginning of the year is suitably on osteoporosis. Osteoporosis, with its...

Validity and Reliability of the EQ-5D Self-report Questionnaire in Chinese-speaking Patients with Rheumatic Diseases in Singapore

Health-related quality of life (HRQoL) refers to patients’ perceptions of their own functioning and well-being. HRQoL is increasingly being used as a primary or...

Eight-year Outcome of Very-low-birth-weight Infants Born in KK Hospital

The outcome of very-low-birth-weight (VLBW) premature babies with birth weights of <1500 g has remained an area of great concern for both parents and...

Severe Acute Respiratory Syndrome (SARS) — 150 Days On

The Severe Acute Respiratory Syndrome (SARS) has been identified as a new clinical entity in the year 2003. It was on 12 March 2003...

Eating Disorders in Singapore: A Review

Anorexia nervosa, bulimia and binge-eating disorder are the three best described ‘eating disorders’. All three are predominantly disorders of women with the core symptoms...

Youth Suicide and Parasuicide in Singapore

The World Health Organization defines suicide as an act with a fatal outcome that is deliberately initiated and performed by the person himself or...

Stress among emergency medicine residents during the COVID-19 pandemic: A qualitative study

Dear Editor, The COVID-19 pandemic has disrupted medical education1,2 and distressed clinicians.3,4 Understanding the impact of this pandemic on emergency medicine (EM) residents’ experience of...

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...

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...

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...

Behcet’s Disease: Experience in a Tertiary Rheumatology Centre in Singapore and a Review of the Literature

The only published study on Behcet’s disease in Singapore by Tan E et al (34 patients at the National Skin Centre) found that only...

How Much do Diabetic Patients Know About Diabetes Mellitus and its Complications?

Diabetes mellitus (DM) is a common and growing healthcare problem in Singapore with a prevalence of 9% in 1998. Since the 1990s, the Ministry...

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...

Characteristics and Acute Rehabilitation of Guillain-Barré Syndrome in Singapore

The Guillain-Barré syndrome (GBS) is an acute, frequently severe evolution of a demyelinating inflammatory polyradiculopathy with an autoimmune pathogenesis. In developed countries, GBS is...

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...

Book Review

These are challenging times for medical schools as the frontiers of knowledge have expanded enormously and rapidly in recent years. In order to keep...

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...

Familial Risk of Allergic Rhinitis and Atopic Dermatitis among Chinese Families in Singapore

Family history has been shown to be a risk factor for the development of allergic rhinitis (AR) and atopic dermatitis (AD). However, the increase...

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...

Early Dengue Infection and Outcome Study (EDEN) – Study Design and Preliminary Findings

Dengue fever/dengue haemorrhagic fever (DF/DHF) is a re-emerging disease that is endemic in the tropical world. It is caused by 4 closely-related dengue viruses...

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....

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...

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...

SARS in Singapore – Predictors of Disease Severity

Severe acute respiratory syndrome (SARS) is a recently defined illness caused by a novel coronavirus. The outbreak in Singapore originated from Hong Kong via...

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...

The Clinical Predictors of Hypertension and Sleepiness in an Asian Population with Sleep-disordered Breathing

Sleep physicians have only recently began to learn much about the epidemiology of sleep-disordered breathing (SDB) from large, well conducted prospective community-based studies. These...

Addressing Issues of Maldistribution of Health Care Workers

The movement of people from one place to another has shaped today’s political, social and economic world and continues to be a major influence...

Facilitation of Students’ Discussion in Problem-based Learning Tutorials to Create Mechanisms: The Use of Five Key Questions

An important aspect of problem-based learning (PBL), particularly in the early years of the undergraduate medical, physiotherapy, nursing and dental courses, is teaching basic...

Assessing Professionalism in Early Medical Education: Experience with Peer Evaluation and Self-evaluation in the Gross Anatomy Course

The professional role of physicians implies a commitment to upholding social order by providing strong leadership, good moral judgement, and the ethical practice of...

What do You Mean by “Satisfactory”?

There were 2 questions which initiated this research. One became the title of this paper; the other was a concern that the integration of...

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...

5th College of Physicians Lecture – A Physician’s Odyssey: Recollections and Reflections

Allow me to thank you Mr President and your Council for asking me to deliver the 5th College of Physicians Lecture. Your President has...

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...

Attitudes of First-year Medical Students in Singapore Towards Older People and Willingness to Consider a Career in Geriatric Medicine

With the exponential increase in the elderly population in Singapore, the training of young physicians of tomorrow in the care of elderly patients will...

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 Future of Medical Education: The Second 100 Years

This is a proud year for the medical profession in Singapore, as we celebrate 100 years of medical education. As the oldest faculty in...

The NUS MBBS-PhD Programme: Nurturing Clinician-Scientists for Tomorrow

The MBBS-PhD programme is a significant milestone in medical education in Singapore. In July 2000, the Faculty of Medicine, National University of Singapore (NUS)...

The Medical Students’ Societies and Medical Students’ Publications

For a very long time, King Edward VII (endearingly abbreviated “KE”) was synonymous with the medical school and its associated hall of residence. The...

A Century of Medical Students’ Activities (Medical College Union/Medical Society)

On 3 July 1905, the Straits and Federated Malay States Government Medical School was started with the objective of training the local men and...

The Teaching of Radiology

A record of Diagnostic Radiology would be incomplete without reference to Wilheim Roentgen, who discovered the rays that he could not comprehend; hence, X-rays....

History of Psychiatric Education in Singapore

While medical education in Singapore has a hundred-year history, the teaching of psychiatry became salient only in the last quarter of the century. In...

One Hundred Years of the Teaching of Medicine in Singapore

In 2005, the Medical Faculty of the National University of Singapore (NUS) will commemorate the 100th year of its founding. The Straits and Federal...

The Evolution of Teaching and Learning Medical Microbiology and Infectious Diseases at NUS

The Straits and Federated Malay States Government Medical School was founded in 1905. Dr Chen Su Lan, 1 of the 7 graduates in the...

In vitro Activities of Antifungal Drugs Against Yeasts Isolated from Blood Cultures and Moulds Isolated from Various Clinically Significant Sites in Singapore

Fungaemia carries with it high mortality rates and appropriate as well as timely antifungal therapy has been shown to be life saving. Amphotericin B...

Antimicrobial Resistance: A New Beginning and the Need for Action

In this issue, the articles (historical, original and review papers) highlight the extent and problem of antimicrobial resistance in Singapore. The authors should be...

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...

The Media and Suicide

Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former...

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...

Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme

Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM)...

Sleep Disorders: Sleepless in Singapore

Sleep disorders are common afflictions in both the paediatric and adult populations, increasingly recognised as major public health concerns. Recently, the Institute of Medicine...

The Teaching of Anatomy: The First Hundred Years (1905-2005)

When the Straits and Federated Malay States Government Medical School opened its doors on 3 July 1905 in what was to be the historical...

A Doctor’s Duty is to Heal the Unhealthy: The Story of Tun Dr Mahathir Mohamad

Mahathir Mohamad was born in 1925 in Alor Setar, Kedah. In 1947, after living through the turbulent times of the Second World War, he...

The First Graduates in 1910

The Medical School in Singapore was founded on 3 July 1905; it was named the Straits and Federated Malay States Government Medical School. It...

Milestones of the Medical School and Medical Progress of Singapore over the Past 100 years

1905: The Medical School started off in an old female lunatic asylum on the site of the general hospital at Sepoy Lines.1 Called the...

Concurrent Chemoradiotherapy followed by Surgery in Locally Advanced Squamous Cell Carcinoma of the Oesophagus: A Single Centre Experience

Carcinoma of the oesophagus is a relatively uncommon malignancy in Singapore and incidence rates have been declining since 1968. A total of 506 cases...

Acceptance of Prophylactic Surgery and Chemoprevention of Cancer in Singapore – A Survey

The Singapore healthcare philosophy aims to establish a healthy population through preventive healthcare programmes and public health education. Public education usually emphasises the adverse...

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...

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...

Seeing the Wood for the Trees: Approaches to Teaching and Assessing Clinical Pharmacology and Therapeutics in a Problem-based Learning Course

Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced by advances in molecular modelling, the molecular genetics...

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,...

Impact of the Singapore National Asthma Program (SNAP) on Preventor-Reliever Prescription Ratio in Polyclinics

According to the World Health Organization/Global Initiative on Asthma (WHO/GINA) report on the global burden of asthma, Singapore is an intermediate-risk country for asthma...

Concerns, Perceived Impact and Preparedness in an Avian Influenza Pandemic – a Comparative Study between Healthcare Workers in Primary and Tertiary Care

The danger posed by emerging infectious diseases has become greater in the past few years with the World Health Organization (WHO) warning that the...

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...

Some Milestones: Specialist Education, Training and Assessment in Singapore

First, let me thank the Master and Council, Academy of Medicine, for inviting me to speak at this celebration of the Academy’s 50th Anniversary....

Concomitant Use of Midazolam and Buprenorphine and its Implications Among Drug Users in Singapore

Benzodiazepines (BDZs) (commonly known as “sleeping pills”) are routinely and successfully used in the treatment of sleep and anxiety disorders. However, studies have indicated...

From a “Generalist” Medical Graduate to a “Specialty” Resident: Can an Entry-level Assessment Facilitate the Transition? Assessing the Preparedness Level of New Surgical Trainees

Undergraduate medical education is considered a continuum leading into postgraduate training and ultimately medical practice.1 To this effect, it has been suggested that measures...

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...

A Brief History of Pathology and the Chapter of Pathologists

A history of the Chapter of Pathologists would be incomplete without a history of the specialty of Pathology in Singapore. Pathology is in fact...

From the Chapter of Physicians, Academy of Medicine, Singapore to the College of Physicians, Singapore

The transformation of the previous Chapter of Physicians, Academy of Medicine, Singapore to the current College of Physicians, Singapore in 2004 was the outcome...

From the Chapter of Anaesthetists to the College of Anaesthesiologists, Singapore

The arrival of Sir Stamford Raffles in 1819 herald the birth of western medicine in Singapore. Doctors were then sent here from Britain. These...

Academy of Medicine, Singapore – The Next Twenty-Five Years (1982-2007)

The Academy of Medicine was founded in 1957 as the professional corporate body of medical and dental specialists in Singapore. From a modest beginning...

Epidemiology, Management and Treatment Outcome of Medulloblastoma in Singapore

Medulloblastoma (MBL) is the most common type of malignant brain tumour in childhood. It belongs to the group of tumours known as primitive neuroectodermal...

Impact of Various Continuing Medical Education Activities on Clinical Practice – A Survey of Malaysian Doctors on its Perceived Importance

Continuing medical education (CME) plays an indispensable role in the clinical practice of any doctor. The practice of evidence-based medicine today,1 or any meaningful...

Timing of Hospital Presentation After Acute Cerebral Infarction and Patients’ Acceptance of Intravenous Thrombolysi

Intravenous thrombolysis in acute cerebral infarction has been proven to be efficacious in improving functional outcome if given within 3 hours from stroke onset.1...

Demographic and Clinical Features of 150 Pathological Gamblers Referred to a Community Addictions Programme

Pathological gambling has been defined as a persistent and recurrent maladaptive gambling behaviour that disrupts personal, family and work life. The diagnosis is not...

Successful Rehabilitation With Cochlear Implant in Post-irradiation Induced Hearing Loss in Nasopharyngeal Carcinoma Patient

Nasopharyngeal carcinoma (NPC) is a common disease in Asia.1 Radiotherapy is the mainstay of treatment. Following radiotherapy, complications like profound sensorineural hearing loss may...

Characteristics of Medical School Graduates who Underwent Problem-Based Learning

Problem-based learning (PBL) is one of the medical education strategies to promote continuous active and self-directed learning.1,2 Our medical school implemented PBL in 1990...

A Prospective Cohort Study on the Impact of a Modified Basic Military Training (mBMT) Programme Based on Pre-enlistment Fitness Stratification Amongst Asian Military Enlistees

Basic military training (BMT) is seen as a vital initiation phase into military service when new recruits are conditioned to the rigours of military...

The Challenges of “Continuing Medical Education” in a Pandemic Era

Although pandemics of influenza have occurred (albeit rarely, i.e. once every few decades) for more than 3 centuries, recent outbreaks of H1N1 and H5N1...

Where the Elderly Die: The Influence of Socio-Demographic Factors and Cause of Death on People Dying at Home

The subject of place of death was brought to the forefront of the medical community in July 2004 when 2 important publications were released;...

Trends in Importation of Communicable Diseases into Singapore

Singapore is a city-state in Southeast Asia, with a total population in 2007 of 4,839,400, of which 3,642,700 (75.3%) are Singaporean residents. The remaining...

Acceptance of Information and Communication Technologies for Healthcare Delivery: A SingHealth Polyclinics Study

Information and communication technologies, such as internet portal and short message system (SMS), are increasingly used in healthcare delivery worldwide.1,2 Typically, these technologies are...

The Pedagogical Value of a Student-run Community-based Experiential Learning Project: The Yong Loo Lin School of Medicine Public Health Screening

Experiential learning brings medical students out of the comfort zone of learning in their classrooms to acquire and apply knowledge and skills in an...

Timing of Arrival to a Tertiary Hospital after Acute Ischaemic Stroke – A Follow-up Survey 5 Years Later

Intravenous tPA is a proven treatment for acute ischaemic stroke. However as it has to be given in a narrow time window from symptom...

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...

Survey of Healthcare Workers’ Attitudes, Beliefs and Willingness to Receive the 2009 Pandemic Influenza A (H1N1) Vaccine and the Impact of Educational Campaigns

Since the first positive 2009 pandemic influenza A (H1N1) case was reported in Singapore on 26 May 2009, the country saw an exponential rise...

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...

Diagnostic Accuracy of Anthropometric Indices for Obesity Screening Among Asian Adolescents

Obesity or excess body fat is strongly associated with enhanced risks of morbidity and mortality, and its prevalence is rapidly escalating worldwide. Despite these...

Emerging Trends in Breastfeeding Practices in Singaporean Chinese Women: Findings from a Population-based Study

The health benefits of breast milk have been well documented, with positive implications for infants’ metabolic, immunologic, respiratory and digestive health. The World Health...

Health-related Quality of Life is Associated with Diabetic Complications, but not with Short-term Diabetic Control in Primary Care

Type 2 diabetes mellitus is a major chronic disease globally. With increasing life expectancy, long-term complications of diabetes mellitus leading to significant morbidity and...

Quality of Life in Pathological Gamblers in a Multiethnic Asian Setting

Pathological gambling is categorized under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) as an impulse control disorder not elsewhere classified....

Causes of Death in Hospitalised Human Immunodeficiency Virus (HIV)-infected Patients at a National Referral Centre in Singapore: A Retrospective Review from 2008 to 2010

The advent of the highly active antiretroviral therapy (HAART) era has greatly reduced the mortality and incidence of new diagnoses of acquired immune deficiency...

Causes of Death and Factors Associated with Early Death Among Human Immunodeficiency Virus (HIV)-Infected Persons in Singapore: Pre-Highly Active Antiretroviral Therapy (HAART) and Peri-HAART

Since the first case of human immunodeficiency virus (HIV) was diagnosed in Singapore in May 1985, a total of 4845 cases and 1389 HIV/acquired...

Melanoma: Differences between Asian and Caucasian Patients

Cutaneous melanoma is the most common cause of mortality amongst skin cancer in Caucasian populations and incidence rates per 100,000 patient years vary between...

Two Strategies to Intensify Evidence-based Medicine Education of Undergraduate Students: A Randomised Controlled Tria

Knowledge and skills of evidence-based medicine (EBM) can be taught by many methods, such as role modeling evidence-based care, using evidence for clinical medicine...

Overcoming Barriers to Mammography Screening: A Quasi-randomised Pragmatic Trial in a Community-based Primary Care Setting

Breast cancer is the leading cancer among women in Singapore, accounting for 29% of all cancers occurring in women between 2006 and 2010. Evidence...

Hoarding in an Asian Population: Prevalence, Correlates, Disability and Quality of Life

Hoarding is defined as the acquisition of, and inability to discard items even though they appear to others to have no value, leading to...

Clinical Outcome and Cost Comparison Between Laparoscopic and Open Appendicectomy

Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention. The traditional operation of choice was the open...

Osteogenic Sarcoma in Children and Young Adults

Osteogenic sarcoma (OS) is a primary malignant tumour of the bone, derived from primitive bone-forming mesenchyme and characterised by the production of osteoid tissue...

Single Centre Experience of Transjugular Liver Biopsy in 152 Patients

The first reported case of liver biopsy was recorded in 1883 by Ehrlich. Since then, the technique of liver biopsy has been modified tremendously...

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...

Projecting the Number of Older Singaporeans with Activity of Daily Living Limitations Requiring Human Assistance Through 2030

Similar to other developed countries in Asia, including Japan, South Korea and Taiwan, the population of Singapore is ageing rapidly. In 2011, 9.3% of...

Determinants of Health-Related Quality of Life Among Community Dwelling Elderly

Singapore is experiencing an unprecedented age shift as the post-war baby boomers turn 65 years in 2012. Currently there are 378,700 people aged 65...

A Review of Back Injury Cases Notified to the Ministry of Manpower from 2011 to 2012

Work-related low back disorders consist of both low back pain (LBP) and low back injuries. They are a significant and increasing problem all over...

Mentorship in Academic Medicine: A Catalyst of Talents

The field of medicine is complex. Its interwoven structure of clinical practice, medical education and biomedical research, coupled with intricacies of the health system,...

Fasting during Ramadan and Associated Changes in Glycaemia, Caloric Intake and Body Composition with Gender Differences in Singapore

Muslim individuals worldwide participate in obligatory abstinence from oral consumption of medications, food and liquid during the fasting month of Ramadan. Fasting during Ramadan...

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...

“Are Medical Students’ Views of an Ideal Physician Eroding? A Study on Perceived Qualities of a “Role Model” Doctor Before and After Housemanship and between Two Cohorts Five Years Apart “

Role modeling has been reported as an increasingly prominent teaching need and strategy in the field of medical education. This aspect of training helps...

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...

Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases

Over the past few decades, the introduction of laparoscopic surgery has been the biggest game changer in abdominal surgery.1 However, although the first laparoscopic...

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...

Laparoscopic liver resection: Global diffusion and learning curve

Laparoscopic liver resection (LLR) is being utilised with increasing frequency worldwide, as initial concerns about the safety and feasibility of LLR, such as the...

Health professions education in pandemics and epidemics: A proposed framework for educators

The COVID-19 pandemic has disrupted healthcare systems and health professions education (HPE). There are few frameworks to help educators manage HPE before, during and...

Assessing the Content Validity of the EQ-5D Questionnaire Among Asians in Singapore: A Qualitative Study

EQ-5D is a tool to measure and value health status. It is a standardised questionnaire that comprises 2 components: a Descriptive System (DS) on...

Transcatheter Aortic Valve Implantation in Singapore: Reflecting on the First Decade

Transcatheter aortic valve implantation (TAVI) has markedly changed the way aortic valve stenosis is treated. It is 18 years since the first patient was...

Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children

Singapore confirmed its first case of COVID-19 on 23 January 2020 in a Chinese national from Wuhan, and its first paediatric case on February...