I will stand by what I say with regards to specialisation. If you have been following the news, the head-honchos (A*STAR of Singapore) tasked with building up Singapore as a biomedical hub has identified translational clinical research as one of its focus. In line with GMS and the head honchos' goals, I am not surprised at the current perception is that GMS wants to produce clinician-scientists. Even professors in the know of happenings within GMS seemed to be telling me that in informal conversations at the very least. One advised me that if I want to be a physician per se, forget about Duke-NUS. (not heaping scorn on Duke-NUS, but rather the issue is the difference between applicant's and Duke-NUS focus)
In Singapore at least, specialty training is by no means a short process. Unlike regular MBBS graduates, the Duke-NUS applicants would be behind by 5 years at the very least (if they do their four year bachelors). The perception is that GMS graduates will be more or less involved in clinical research as opposed to patient care (which will be handled by the MBBS graduates). I am not sure myself if conducting research is part and parcel of specialty training, but my friends in regular MBBS program aren't that enthusiastic about research.
With regards to the nature of the Duke and NUS collaboration, I would rather choose not to comment as there is not much information on that.
It is no doubt that GMS hopes to produce doctors who can boost Singapore's efforts in translational research, leading to cutting-edge therapies. As far as I can see, the area that doctors can contribute is to identify relevant and the most important problems in the clinic that should be researched upon. In collaboration with the PhD scientists (biochemist, molecular biologist etc), we also need doctors who can co-ordinate with these scientists and conduct clinical trials on patients with the techniques developed in the laboratory by the scientist. In other words, these doctors have to be involved in patient care to fulfill the above roles. The only scenario for doctors not to be practising as a physician is for the doctor to take on a scientist role in a laboratory and forgo clinical practice completely. I seriously do not think that MOH will force a doctor to go into full-time laboratory research straight after graduation during the bond period. Don't you think it is a waste of resources to spend so much time and money to train a person in medicine and then to force him or her to forgo medical practice altogether? Besides, GMS graduates without a PhD are not the best qualified people to do laboratory research. A life science PhD holder would be better suited. Also MOH are currently planning residency programs for the GMS graduates and I would expect that they would lead to specialisation. If the residency programs do not lead to specialisation and instead lead to 100% research with 0% patient care, this GMS will become like a medical PhD program. It would not be a medical school any more.
So I think the clinician-scientists that GMS are mainly trying to produce would be doctors who has a research perspective while seeing their patients so that they are able to identify problems in the clinics and communicate to the PhD researchers in the laboratories. Also, these doctors would be important in conducting clinical trials on their patients and to track their progress. And the Singapore government is changing their focus in hospitals. Previously, the strategy is to keep costs low by focusing on patient care and to let other people spend the money on research and then to tap on any successful proven therapies. That is why the MBBS curriculum has not been designed with any emphasis on research. And due to the focus on patient care in hospitals, it is natural that traditionally in Singapore, MBBS graduates are not enthusiastic about research. But there has been a shift in focus in recent years. I think even in the MBBS curriculum, there has been more emphasis on research. And if you have read some of the BST and AST specialist training requirements, there are also research components.
And looking at the direction that Singapore is going, I think to be a leader in public hospitals, research expertise would be highly valued. I would think that only if one is adverse to even doing a little bit of research and simply hates research to the core, then probably GMS will be a pain because it has a research year (in fact this is one of the special features of the Duke curriculum).
The only clear-cut case would be if one is aspiring to become a private GP after the bond and to have your own clinic, then GMS will not be suitable. Or if you want to have absolute nothing to do with research after you become a consultant and you aspire to go into private practice in private hospitals. But I think while undergoing specialisation training, it would be hard to avoid research totally, whether you are a MBBS or MD graduate.
I do not think that just because the GMS graduates are older, they would be discouraged from specialising. At the admission seminar, it was mentioned that the hope is for the graduates to go into residency programs and become experts in their preferred specialty areas. It was also mentioned that for those who are keen on a 100% research career in the laboratory after graduation, GMS still wants the person to do 1 year of internship in the hospital so that he can be licensed to practice medicine before he goes into the laboratory. Singapore need more specialist doctors and there are on-going plans to shorten the specialisation process. Also, the age cap on specialisation application has been lifted recently, meaning that doctors of any age can apply to specialise now. As I mentioned, the only way for your feared scenario of GMS graduates being forced to do research and forgoing patient care altogether and not being allowed to train to become a specialist is for MOH to post graduates into the laboratories straight after the internship year. Do you foresee this really happening? How sustainable is such an arrangement? If that happens, GMS would not be a medical school any more. It would be more of a medical PhD program. But other PhD programs in Singapore comes with stipends and scholarships. Who will then enroll in GMS?
Any comment or discussion is welcomed from anyone on the forum.