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In conversation: Family physicians share insights on their career progression in Singapore

Brenda Lau, 22 Nov 2016
Dr. Lim Teng Hong
Family Medicine
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Dr. Tan Shi Ching
Family Medicine
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Medical graduates, young family physicians and GPs have many variables to consider when making career decisions.

MIMS sat down with Dr Tan Shi Ching and Dr Lim Teng Hong, two family physicians from Raffles Medical Group (RMG) — who have progressed from conditional doctors requiring supervision under the Singapore Medical Councils supervisory framework to physician leaders for a cluster of clinics within five years — to find out why they decided to join a group practice instead of setting up their own clinics.

Why a group practice instead of a clinic?

When asked why they chose RMG to begin their careers, both doctors noted that as Malaysian graduates from the UK, the most common options were to stay in the UK to specialise, return to Malaysia or come to Singapore.

Explaining what enticed him to join RMG, Dr Tan said that Raffles is the only large private healthcare group recognised by the Singapore Medical Council (SMC) as a learning institution and therefore approved to take in foreign trained doctors directly from institutions overseas as conditional doctors. The reputation of Raffles, its integrated model of practice, better earnings and career potential were also key factors that influenced his choice.

For those who studied medicine overseas and plan to work in Singapore, they have two main options. They can enter the private sector or the public sector and work for the Ministry of Health (MOH). Working in the public hospitals is mostly for those who wish to apply for specialty training, but there are no guarantees of traineeship given the tough competition for residency positions.

Said Dr Tan, “I chose to pursue family medicine as a career. I could have done this in the public hospitals, but this would have involved working the long institutional hours with no certainty of being accepted for residency in Family Medicine.”

“The alternative was to pursue training with an established group practice like Raffles, allowing me to practise medicine in a holistic fashion with like-minded doctors, including specialist colleagues from Raffles Hospital. As a conditional doctor in my early years with Raffles, I had the benefit of having a support network. Senior doctors were orientating me to the way medicine is practised in Singapore and provided the much needed guidance for my growth, so for me, the choice was obvious," explained Dr Tan.

Advantages of staying with a large group

After four years under Raffles supervision as required by the SMC, Dr Tan was granted full registration status. The possibility of embarking out on his own can now become a reality. However, Dr Tan realised that, “it would bring with it financial risks as well as additional operational and administrative work that I am not keen on. I would rather focus on seeing patients.”

Some may think that GPs have more freedom when running their own clinics, instead of a corporate setting where they have to clock in their hours. Dr Lim disagrees with this idea.

"Who is going to run the clinic when you are on holiday or conference? You have to seek for locums whose fees are rising. At Raffles, we are able to take leave or arrange for flexible work hours. There are always colleagues who can stand in for you so that the next time he needs to go on leave, you are around to run the clinic," he added.

Emphasis on career progression and development

Large groups like Raffles have a wide range of career opportunities, allowing doctors to take on different challenges ranging from Physician Leadership to Healthcare administration, management and also teaching. These options can be lacking for smaller groups and solo practitioners.

“Career progression is a form of retaining employees. We have annual reviews where doctors are presented with many options — clinical, operational, management, corporate services etc. — and whichever chosen, will be accommodated within limits,” said Dr Lim.

He added, “Raffles willingly invests money to training good doctors. Doctors are actively encouraged to take up further education or opportunities such as an MBA or be involved in procuring. At Raffles, monthly CMEs are mostly compulsory for every doctor to ensure we continually stay up-to-date with clinical practices."

For those pursuing the clinical option, Dr Tan said that ultimately, the company will allocate a teaching position. A variety of diplomas can be taken to open up career options such as in aviation medicine, workplace health, family medicine.

Two family physicians from Raffles Medical Group share their career journeys with MIMS.
Two family physicians from Raffles Medical Group share their career journeys with MIMS.

Growing into bigger shoes

Dr Lim shared how he went from a conditional doctor to be trained as a family physician, a move fully supported by Raffles. And when he was getting comfortable, he was challenged once again by the senior management to consider handling a cluster as a deputy physician leader. All these happen in the span of just five years.

“We were presented with opportunities as RMG is a dynamic and growing organisation that is constantly looking to develop its doctors. There were of course many lessons to be learnt, but with senior doctors within the group, you can easily get guidance and advice," he said.

The progression from being a clinically based family physician to handling a cluster was a rather adaptable one, Dr Lim explained. "It is not difficult per se. And every year, you can discuss with the higher-ups if you wish to continue or choose a different path," he added.

Operational work comes with its own set of challenges that differ from being a clinician, such as manpower issues and patient complaints, but Dr Lim said that it opened his eyes to the operational demands of running a clinic.

"It is similar to working or owning a clinic," said Dr Lim, "But in big groups, you are slowly eased into it depending on your calibre and interests. And if you do well and enjoy it, you progress. Otherwise, you can always return to seeing patients."

In large groups, a structured, yet flexible career advancement path is present as options are always available and progress is made at a comfortable pace.

U-turn always possible

It is understandable that some doctors might change their minds after two years of working with a large group and want to explore other options — that does not entail opening a clinic themselves. A common concern is that they would hit a dead end and struggle to find a job elsewhere.

However, Dr Tan is confident that the experience gained from working with big companies is always valuable.

"It is not difficult to find a job, but finding what you really want might be difficult as smaller groups or clinics will not provide the same flexibility or pay," he said.

Groups like Raffles have an established incentive schemes for good performance. When the clinic does well, the staff get performance bonuses. And as Raffles is on the stock exchange, doctors also receive employee stock options on an annual basis.

Strong support enhance medical practice

No man is an island, and no doctor can provide good quality care by himself alone.

And for Dr Lim, this is critical. “As a practitioner, having a strong team to support my medical practice is important. I am always able to turn to my colleagues, be they senior doctors in the medical clinics, or specialists in the hospital, for sound advice and assistance.”

Added Dr Tan, “Our team of professional support staff makes our practice easier and smoother. Be they experienced clinic managers, fresh-faced nurses or highly qualified allied health staff, they have to undergo systematic training to ensure they are able to support the clinic operations fully. The support provided by clinic managers and healthcare support staff allows me to focus on patient care.”

"There are many options out there. Having a large group means more established systems and protocols which insulates you from risks and hopefully, allows for better medical practice,” concludes Dr Tan. MIMS

Interested in joining Dr Tan and Dr Lim as a part of Raffles Medical Group? Find out more about the career opportunities at Raffles Medical Group on the MIMS Career portal. 

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