Medicine and Ethics: Preparing the Young Minds

Sylvia Thay

What lies ahead for young medical students and doctors, as they watch multiple medico-legal cases unfold before their eyes?

The third SMA National Medical Students' Convention (NMSC) held on 31 August 2019 sought to tackle the current medico-legal climate worries with the theme, "Sailing the Seas of Medical Ethics and Law: Navigating the Winds of Ethico-Legal Changes".

Eager-eyed students from the three local medical schools congregated at the Lee Kong Chian School of Medicine's Learning Studio for the day's activities, purposefully put together to educate and guide the doctors of tomorrow. Mr Ng Ding Yi, programme director of the SMA NMSC, opened the Convention before elaborating on its purpose and theme. Following which, Dr Lee Yik Voon, SMA President, took to stage for his welcome address where he thanked Dr T Thirumoorthy for setting aside time to share his wealth of knowledge and industry experience with our medical students. In his address, Dr Lee also expounded on the four pillars of ethical medical practice: Autonomy, Justice, Beneficence and Non-Maleficence, setting the stage for the keynote address.

What every medical student needs to know

An increasingly common term being thrown around these days is "defensive medicine", and this was what Dr Thirumoorthy sought to address in his keynote message titled "The Current MedicoLegal Climate – What Every Medical Student Needs to Understand". He talked about the current medico-legal climate, the negative impact defensive medicine can have on doctors and patients, and how doctors are held accountable to the professional standards of medicine.

Dr Thirumoorthy reminded the students to aim to understand the issues at hand and ask themselves at the end of each work day if "their actions have indeed met the standards". He also inspired the students to practise leadership at the different levels (ie, individual/team, hospital and national policy) to effect change and move from a "blame and shame" culture to a fair and just one.

In closing, Dr Thirumoorthy left the students with an important reminder: "What we say and what we do must complement what we think".

Further discussions

Following the keynote address, a panel discussion was scheduled to provide a platform for students to seek advice from the panellists. Concerns brought up included issues surrounding professional accountability: whether it extends beyond medical work to the doctors' personal lives; what doctors can do if they observe senior doctors potentially practising defensive medicine; and future expectations on professional accountability.

Working in teams

For the team-based learning session, the students were sorted into teams and proceeded to read through and discuss the two case studies provided for the session.

Ms Yang Lishan, together with Dr Thirumoorthy, then led an invigorating discussion based on the teams' response to the case studies. The facilitators motivated the students to think a step further and reconsider the scenarios in depth to avoid making assumptions. Both students and facilitators voiced their questions and opinions with fervour, leading to much sharing on the different beliefs and understanding of the laws and circumstances.

Inter-school debate

Proposition team:

Cowan Ho, Clarissa Cheong, Thirrisha Murugan and Mo Jiahui

Opposition team:

Lee Hong Jing, Lim Lig Chuan Sean, Tan Ying Kiat and Marco Lizwan

The highlight of the day was the inter-school debate on the motion "Burnout among medical students is the responsibility of the individual".

Speakers from both the proposition and opposition teams took their turns and delivered their respective points and counters, garnering nods and murmurs of agreement for both sides of the coin. Was the onus truly on the individual, as the proposition team defined, since they are best placed to assess and eliminate the causing issues as doctors, or should the underlying systemic issues be resolved and managed by higher authorities? Both teams put up such convincing arguments that the audience soon looked conflicted about which side to support. One can't help but think that perhaps these students would do just as well as lawyers!

After some discussion, the judges, Dr Thirumoorthy, Dr Bertha Woon and A/Prof Marion Aw, announced the opposition team as the winner! Each team member received a 3MTM Littmann(r) Cardiology IVTM Stethoscope kindly sponsored by 3M Singapore and certificate from Dr Woon, while A/Prof Aw presented the certificates of participation to the proposition team members.

As the participants streamed out to lunch, many were still caught up in bunches comprising students from different schools, discussing the day's rewards and the various conundrums raised. It was an exhilarating day of learning for everyone indeed. We look forward to the next run of the SMA NMSC, and hope to see you there!

Much thanks are to be given to the many esteemed guests who set aside their precious time to make this Convention a success.

Keynote speaker

  • Dr T Thirumoorthy, Founding Director, SMA Centre for Medical Ethics and Professionalism

Panel discussion


  • Dr T Thirumoorthy
  • A/Prof Chin Jing Jih, Chairman, Medical Board, Tan Tock Seng Hospital; Past President, SMA
  • Dr Bertha Woon, Associate, Medical Protection Society of Singapore
  • Ms Kuah Boon Theng, Managing Director, Legal Clinic LLC


  • Dr Norman Lin, Past President, National University of Singapore Yong Loo Lin School of Medicine's (NUS Medicine) Medical Society

Team-based Learning

  • Ms Yang Lishan, Assistant Director, Team-based Learning Facilitator, Education Development, Office of Medical Education, Lee Kong Chian School of Medicine, Nanyang Technological University

Debate judges

  • Dr T Thirumoorthy
  • Dr Bertha Woon
  • A/Prof Marion Aw, Assistant Dean of Education, NUS Medicine