Monday, November 1, 2010

The NTU-Imperial College Medical School

So it's out in the open now, as NTU and Imperial College London signed an agreement to form Singapore's 3rd Medical School. Target is 150 students, which is quite substantial compared to the current 250-300 at the NUS Medical School.

Prof Stephen Smith is the Founding Dean designate for the new school. A gynaecologist, Prof Smith was the Principal of the ICL in 2004, and subsequently also became the Chief Executive of the Imperial College Healthcare NHS Trust.

The formation of the 3rd Medical School is being watched with considerable interests from those who have been involved with medical education in Singapore. How will it differ from the approach NUS had taken? So far the leadership have been saying all the right things. Exploiting existing strengths in engineering and business, the new Imperial College London-Nanyang Technological University Medical School (ICNMS), will focus on training good doctors "equipped for tomorrow's challenges".

All nice words.

Many are hoping it will not fall into the same trap that the other medical school did by over-investing in the clinician-scientist mission. No doubt we need clinician-scientists to fuel the biomedical industry, but this should not be the main mission of a medical school. Singapore needs good caring doctors who can look after patients - not doctors whose primary mission is to serve the biomedical industry. Many have felt that the NUS Medical School had so over-reached itself to pursue the research agenda that the medical mission had been severely compromised.

If the new ICNMS remain true to the educational mission, the worrying outcome may be that many committed medical educators may decide to jump ship for a school environment that is much more aligned to medical education and the training of good doctors.


angry doc said...

I don't think it really matters what the medical school chooses as its mission or vision: people will go to medical schools because they want to be doctors, and they will be the kind of doctors they want to be.

Even when there are 500 places in the various medical schools each year, there will still be more applicants than places; and only a few can afford to pick which school they wish to go to - the rest will just grab any place they can.

If they are smart enough to make it to the interview, they are smart enough to say the right things to get accepted (I got accepted, didn't I?). Having a mission and vision does not prevent a determined student from bluffing his way through the interview, or medical school itself - surely you have met a few Duke students who aren't really planing to do research and really, really just want to look after patients, haven't you?

I don't believe the ratio of clinicians vs clinician-scientists being trained will affect the actual numbers of practising clinicians and clinician scientists - if you make clinical practice rewarding, people will gravitate towards it. If you make research hell, people will turn to clinical practice (or other careers), and we both know the public and private sectors are (at least for now) both fighting each other to hire clinicians.

The old NUS medical school didn't train us to be drug peddlars, yet some of our classmates are selling sleeping pills; it didn't teach us to be businessmen, yet some of our seniors own chains of clinics; it didn't school us in the art of salesmanship, yet some of our juniors are selling beauty products will little evidence behind them.

When you come right down to it, medical school is but a fraction of the entire lifespan of a doctor. Much of what you learn will become obsolete by the time your graduate, and much of what you do daily you won't learn until you start working as a doctor. You cannot know what the market will be like in 10 years, and so you cannot know with certainty whether the kind of doctor you think you want to be will fit with the kind of lifestyle you expect yourself to have then.

Medical school is small stuff.

Don't sweat the small stuff.

gigamole said...

Not sure I agree with you re the small stuff bit. I am a firm believer in the value of the medical school in shaping doctor's value system.

I think what you have in mind has been coloured largely by the failed systems we have, where students are more concerned with grades/passing exams and staff are more interested in academic research/consultancies.

No one really seem to care.

Can we do better? I believe so. Can the medical schools play a more important role in shaping doctor attitudes, values and practices?

Yep. Most definitely.