Sunday, June 10, 2007

The Calling

June 6, 2007; ST Forum
To raise professional standards, perhaps law and medicine should be postgraduate courses

I WANT to thank Mr George Lim Heng Chye for highlighting the importance of professionals adopting high ethical standards and values in the discharge of their duties ('Vital that we reinforce good industry practices to uphold our clean image'; ST Online Forum, June 6).

The Singapore Medical Council (SMC) has a clear Ethical Code that 'represents the fundamental tenets of conduct and behaviour expected of doctors practising in Singapore. The Ethical Guidelines elaborate on the application of the Code and are intended as a guide to all practitioners as to what SMC regards as the minimum standards required of all practitioners in discharge of their professional duties and responsibilities in the context of practice in Singapore'.

Since the days of the old Raffles College and King Edward VII College (a forerunner of the National University of Singapore) in the 1920s, the then college accepted Upper Sixth graduates and later GCE A-level holders in its medical school to pursue a medical course. Likewise the Law Faculty accepted Higher School Certificate (HSC) and now A-level holders in its law school.

Perhaps the admission committee and selection board of our local universities need to make a paradigm shift in admission criteria from their erstwhile and present policy of admitting young A-level holders and polytechnic graduates to law and medical schools in view of the rogue lawyers and wayward doctors who have surfaced recently.

In this regard, it would be good to study the criteria United States universities have adopted in admitting students to their law and medical schools. To be considered for admission to study for the Juris Doctor degree, an applicant must have a bachelor's degree awarded by a regionally accredited US college or university or equivalent degree from a recognised non-US institution. He must also have taken the Law School Admission Test (LSAT) within the past three years.

Most Ivy League universities require candidates to be well versed in a wide range of subjects, such as English, philosophy, mathematics, government, history, economics, literature, sociology, psychology, natural sciences and the classics. This is because these non-law subjects are all believed to provide exposure to intellectual tasks encountered in the study of law.

Competition to get into law school is intense as each year there are more applicants than places. Law schools usually look for specific courses in the applicant's transcript (political science, philosophy, sociology and history). However, they are more interested in the well-rounded individual than the young specialist. Some law schools also look for applicants with quantitative courses such as economics, business, mathematics and finance. The thinking is that once out of law school, the graduate will deal with the business world daily and will need to understand it thoroughly.

US medical schools usually look for applicants who have clearly demonstrated an aptitude in the biological and physical sciences but not to the exclusion of the humanities and social sciences. Applicants need good passes in biology, chemistry, physics, mathematics, expository writing (writing skills are deemed important for the study and practice of medicine) and statistics.

Harvard Medical School states specifically that candidates must have 'completed at least 16 hours in literature, languages, the arts, humanities and the social sciences and become familiar with computers'. Most medical schools require applicants to be good in English (grade B or better) and 'English As a Second Language' is not acceptable.

Perhaps our local universities should make law and medicine a postgraduate course and only those with a first degree (including those from seminaries) need apply to these prestigious schools. Hopefully, a more stringent selection process and interview will reduce the number of unscrupulous professionals churned out by the universities in recent years.

Heng Cho Choon

I agree, to a certain extent, with what this writer has suggested about making medicine a postgraduate course. (Not being a lawyer, my comments refer only to Medicine). Not so much because I think it would "reduce the number of unscrupulous professionals churned out by the universities in recent years", but because I think that the tender age of 18 is too young for the average teen to make a firm decision about what he/she wants to do with the rest of his/her life.

I can almost hear the collective groans of doctors-to-be at the thought of an additional 4 years of undergraduate study before med school + residency +/- fellowship. I know there will be added cost, & with the so-called shortage of doctors in Singapore, it would take a longer time to train a fully qualified doctor.

However, I think that the additional pre-requisites of the humanities & social sciences would not only make for more well-rounded doctors, but the extra years of study would also add much needed maturity to potential doctors, & perhaps give them the chance to make the right decision with regards to their career path. At 18, many are still not emotionally mature; with the added years of studying something else in addition to the sciences, it could make the difference & produce doctors who can truly regard their profession as a calling.


Anonymous said...

Actually the local education system has already been tweaked such that JC students now have to take what is known as a contrasting subject, that which is outside the student's main academic area of specialization. so for instance if you were in the science stream, you would be required to take a discipline related to the humanities and the arts (eg literature). i believe getting exposed to a wide range of disciplines whilst still young should be encouraged because this imbues students with multiple perspectives.

also it may be true that 18 may not be a ripe age to make a decision as major as determining one's future career. but if we were to seriously consider this, then university should not even be for 18 or 19 year olds. besides, i guess for one to truly realize one's calling or whether a certain profession is suitable, one would actually have to experience it.

sg med student said...

hmm..2 or 3 more yrs after jc..i may not have chosen medicine

aliendoc said...

sg med student: I am sure you are not the only one who feels this way!

nofearSingapore said...

Hi aliendoc:
I agree with you that 18 years is too young to decide one's future.
Very few teenagers really know where their passions and talents lie ( esply in Sg's pressure-cooker system).
Those of my vintage ( mid-40's) really became doctors by default.
Academically inclined students get into Science classes and those with above average A levels choose Medicine/Dentistry almost as a matter of fact.
For most of us it is like the old notions of marriage. Get married first then fall in love.
For us it was become doctors first- having passion for doctoring is something we think about later. Those who find out they don't have passion for it, just give it up and just use it to bring the bacon home whilst pursuing their real passions on the side.
The US system is in a way wasteful of resources but then those who ultimately make it as MD's really really want it and their work show ( most of the time).

Dr.Huang Shoou Chyuan

tan ah kow said...

Why do we have so many foreign docs in our polyclinics??

aliendoc said...

Thanks for your comments, Dr Huang, you got it, spot on.

tan ah kow: Simple. Because the polyclinics are short of doctors & have to look outside of Singapore to staff their clinics.

igakunogakusei said...

Firstly, I profoundly disagree that making medicine a postgraduate course will necessarily mean that doctors will have more scruples. There will always be bad hats and I am of the opinion that more education only transforms a rogue into a more educated rogue.

Secondly, I think the answer is to introduce flexibility, rather than enforce a streamline, as always. The introduction of the Duke postgraduate medical school is a good start as there is now the option for students to take on medicine as a postgrad. What we need is for 18 year olds to become more aware of what medicine truly entails as a profession, delusions(of grandeur) about the profession, and how it entails lifelong learning. They can then choose to apply for medicine as an undergraduate if they are sure of what they want, or choose to do something else and apply later should they still want to do medicine later on. It is not disadvantageous to do a basic degree first, because, let's face it, medics aren't trained to do much more than be medics. I doubt it will be easy switching careers after having being trained as a medic. The important thing is for both postgrad and undergrad medicine to be seen as equally favourable.

To achieve this, Singapore should perhaps consider the Intercalated BSc system of medical education in the UK. Essentially, most medics in the UK take a year out to do a BSc which may be medicine/biology-related, or may just be a humanities subject (Law, Psychology, etc). The postgrad medics are not required to do this, but can do an IBSc should they want to. This is also advantageous to undergrad medics, because they get a BSc partway through medicine, and can opt to pursue an alternative career if they find themselves to be unsuitable for the job. Some of my ex-classmates here in Cambridge have become investment bankers and consultants with McKinseys because they wanted to. Some of them have even returned to medicine after a year or two!

aliendoc said...

Good suggestion, iggy!

And yes, I know what you mean abt the scruples thing. I too do not think that making medicine (or law, for that matter) a post-grad course would reduce the number of inethical doctors & lawyers!