Letters to the Editor
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Medical Officers' Column
- WORLDS APART : HEALTH ADMINISTRATION AND PUBLIC HEALTH
WORLDS APART: HEALTH ADMINISTRATION AND PUBLIC HEALTH
Every medical officer will face this question at one time or another - do I want to embark upon a training programme to be a specialist? If the answer is "Yes", then which is the right field to choose? Well, such are the difficult decisions that we have to make. Health Administration is just one of the many disciplines available, and I shall attempt to relate what the training entails.Objectives of the Training Programme
The objective of a structured training programme in Health Administration is to provide the trainee with the necessary skills to enable him to function effectively in Health Administration. In the course of his work, he should assimilate new knowledge and skills to complement his medical background. Examples of such new knowledge are:
This list is by no means exhaustive. These skills are developed through attending courses (which are charted by each individuals training development pathway), and more important, through the experience of our daily work.Structure of Training Programme
The Basic and Advanced training programmes comprise of 6 years of training:
Taking away the 1 year needed for the MMed (Public Health) course, the MO trainee still has 5 years of training, of which he can choose to do the following postings of 1 year duration (in any order):
Besides the hospital posting, and possibly the elective posting, the 1-year postings mentioned here are done in MOH HQ itself. The duration of 1 year allows the trainee to learn as much as possible about the type of work that the department handles, and also to complete his work and projects. Such yearly rotations of department will benefit the trainee by exposing him to the different fields of work in the Ministry.
The exit exam for Health Admin trainees is the MMed (Public Health) as this is the programme accepted by Public Service Division for recognition of the specialisation in Public Health/Health Administration. During this 1-year course, the trainee will study subjects like epidemiology, bio statistics, environmental health, economics, health policy and planning etc. These modules form an important core knowledge during our work as health administrators. As this is usually an international course, it provides an opportunity to meet doctors from other regional countries. Not only can the trainee learn from their experience, he can also establish ties that might facilitate the collaboration between ministries from the countries in future. Suffice to say that the course is definitely an enjoyable part of our training programme.
In his course of work in MOH HQ, the trainee is exposed to health policy and planning and healthcare management at the Ministry level. The 1-year hospital administration posting will allow him to experience the actual implementation of these policies, so that an operational perspective can be achieved. The trainee is usually posted as an administrator working under the Chairman of the Medical Board, or in the Clinical Affairs department. He will be involved in quite a fair bit of secretariat work for committees in-charge of the professional affairs of the doctors, liasing with MOH regarding policy implementation, and may even be handling patients complaints. He will also be involved in the day-to-day professional administration of the hospital. The purpose of this posting is to help the trainee develop a balanced view of the planning and operational aspects of health administration.
Upon completion of these 6 years of training, doctors will have the opportunity to pursue in his 7th year or after, a HMDP of one of the following or other relevant courses:
There will also be opportunity for practical attachments in overseas centres.Conclusion
Like most things in life, doing health administration has its pros and cons. The scope of training is divergent in nature, allowing one to learn new skills that are outside the medical profession. The kinder working hours might be an additional incentive as well. However, one has to be prepared that he might lose touch with the practice of medicine due to the heavy work commitments, although arrangements can be made to have weekly clinical sessions in the outpatient setting. One also has to acknowledge that Health Administration is not a widely accepted field among peers and fellow professionals yet, judging from their reactions when they found out about the training that I am undergoing.As taking up a traineeship is an enormous commitment in our professional careers, I would advocate the careful path of applying to do a health administration posting first, to discover whether the type of work is suitable for you, before actually applying for the traineeship. At the end of the day, regardless of what speciality you have chosen to pursue, the most important thing is that you truly enjoy what you are doing.
DR LAM KIAN MING
Dr Lam is currently into his first year as a basic trainee in Health Administration.
DO YOU KNOW ... YOUR LEAVE BENEFITS- PART 3 ?
(This is the last instalment of the 3 of which the first 2 instalments are published in the July and August issues.)
No pay leave
No pay leave may be granted to you to:
Half pay study leave
You may apply for half pay leave to study for a post-graduate qualification relevant to your work. Such leave is limited on one-twelfth of your completed service.
Full pay study leave
Full pay leave is granted for official training courses, post-graduate study awards and other scholarships.