This opening speech was first delivered at the MOHH x SMA House Officer End of Year Dinner held on 1 December 2023.
Dear colleagues, I stand before you here today, almost 30 years after completing my house officer (HO) posting. I remember even today the culture shock I experienced during my first week as a HO.
On the first day of my housemanship, I dutifully reported to work at 6 am. I thought it would be alright having to start work early; at least I could go home at 5 pm. In the office, I saw numerous bundles of yet-to-be-summarised case notes left over by the previous batch of HOs. "Surely this was somebody else's problem," I thought. I was all ready to go home after completing my clinical duties, when the ward sister told my fellow HOs and me that the case notes were now our problem and we had to summarise them. In the old days without electronic medical records, this meant that we had to hand-write the discharge summary, arrange case notes in order and staple them together. Both my fellow HOs and I did not go home until 10 pm that day.
I knew night calls would not be easy. In addition to clerking emergency cases, I had to manage medical emergencies as well as perform routine tasks such as the setting of intravenous (IV) plugs, doing hypo-count monitoring, giving IV medications, as well as doing ECGs using old-style suction cup electrodes that always left marks on the patient's chest.
There was one time when I was called to see a patient who had collapsed. The patient was unresponsive with no pulse; my CPR training kicked in and I started CPR – with mouth-to-mouth resuscitation. The nurse assisting me was appalled by my hygiene standard. It was only after we had abandoned the CPR that she told me that there was such a thing called the air viva that I could use for CPR.
In the good old days, becoming a HO was a baptism of fire. We were not briefed on what to expect or how to survive the posting. Things are hopefully different now.
Support for doctors in training
The SMA Doctors-in-Training (DIT) Committee aims to advocate for and support HOs as well as other doctors in training. The Committee engages the Ministry of Health, MOH Holdings (MOHH) and the sponsoring institutions regularly on matters important to junior doctors (JDs).
Additionally, the SMA DIT Committee runs multiple resources for doctors in training.
SMA JD Helpline
The SMA JD Helpline is a Telegram chatbot that consolidates useful resources JDs may require to navigate through their formative years in the wards, including mental health resources, the SMA HO Handbook and the Singapore Medical Council Handbook on Medical Ethics. SMA volunteers are also available via the helpline, for JDs who need to speak with and confide in someone or seek advice.
SMA JD workshops
The SMA JD workshops focus on facilitating the challenging transitions from medical student to HO, or from HO to "baby MO". The workshops cover general principles on how to approach undifferentiated complaints with limited information, time and resources, and the new roles and responsibilities that JDs are expected to undertake at each phase of their training.
SMA CMEP
The SMA Centre for Medical Ethics and Professionalism (CMEP) provides educational resources on medical ethics and professionalism relevant to medical practice for all doctors. Starting from 2024, JDs who are SMA Members will be able to fulfil the new mandatory medical ethics continuing medical education points requirement through SMA CMEP programmes without charge, as part of their Membership privileges.
SMA DIT 101 app
SMA will be launching in 2024 an app that is planned to be pre-installed on all corporate mobile phones provided for JDs. The app will have a range of reference resources that JDs can consult on the go regarding common processes and tasks they undertake. It will also incorporate the "Ask Me Anything" portal, through which JDs can raise concerns or send in questions to SMA.
Closing
We are extremely grateful to MOHH for facilitating the enrolment of HOs as SMA Members, and look forward to continuing our engagements with HOs through events such as tonight's dinner.
We hope that you will see the value of SMA Membership and continue as Members with us, even as you advance on your journey as doctors in training. With that, I hope that the rest of your HO posting will be fulfilling and enjoyable, and all the best for Postgraduate Year 2.