Addressing Manpower and Throughput Issues in Restructured Hospitals

Assoc Prof Fatimah Lateef asked the Minister for Health what are the Ministry's plans and strategies to handle manpower and throughput issues in restructured hospitals in order to meet the criteria and guidelines specified by the Accreditation Council for Graduate Medical Education-International (ACGME-I).

The Residency postgraduate training system is a collaboration between the Ministry of Health (MOH) and the Accreditation Council for Graduate Medical Education-International (ACGME-I) in developing

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and implementing a structured training system that ensures that each doctor trainee consistently receives quality specialist training. To date, all residency training programmes offered in the three main training institutions (referred to as "Sponsoring Institutions"), namely the National Healthcare Group, the National University Health Systems and SingHealth, are accredited by ACGME-I.

Training throughput had risen two-fold from 257 trainees in 2009 to 475 in 2012. Such an expansion entails the Sponsoring Institutions to ramp up their educational capabilities in terms of qualified clinical teachers and educational facilities in accordance with standards set by MOH and ACGME-I. For instance, Sponsoring Institutions must provide, among other things, a requisite number of dedicated teaching faculty who will devote 20% of their work week for educational activities. There are 219 doctors who are directly involved in teaching, representing 4% of the total number of doctors in the three Sponsoring Institutions.

To help Sponsoring Institutions meet their teaching workload, MOH supports the Sponsoring Institutions in three ways. First, MOH provides funding for the employment of additional manpower commensurate with the number of work hours devoted by doctors to teaching. This service backfill arrangement is intended to assume the service obligations of these doctors so that they can devote some of their time to teaching. MOH has provided approximately $10 million to Sponsoring Institutions to fund this arrangement since the residency programmes started in 2010. Collectively, the three Sponsoring Institutions were able to provide backfill for 90% of the appointed teaching faculty. However, the situation may be uneven across institutions and specialties. MOH will continue to work with the Sponsoring Institutions to improve on this.

Second, the Ministry also provides other resources to Sponsoring Institutions to support the residency programmes, including funding for key administrative staff. An additional 62 staff have been made available to Sponsoring Institutions so far.

Third, MOH makes available funds for the acquisition of teaching aids, such as simulators and infrastructural improvement to existing educational facilities. Faculty development programmes and workshops are also offered, enabling teaching staff to be more efficient in their work.

MOH will continue to work closely with the Sponsoring Institutions in the transition to the new system of specialist training, which will allow Singapore

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to benefit from better trained specialists.