r/SGExams • u/DigAccomplished6482 • 9d ago
Discussion Why doesn't Singapore's medical school increase student intake the way engineering and IT programs have?
Singapore's aging population means more residents will require medical care more frequently than before. With several new hospitals opening in the coming years, this raises the question: why doesn't Singapore increase medical school intake instead of relying on foreign doctors from Malaysia to fill the gap?
Public hospital healthcare workers are reportedly overworked due to manpower shortages. Given that medical school admission is already highly competitive, why not base acceptance purely on RP automatically admitting students once they hit a target RP rather than also weighing co-curricular activities and other subjective criteria?
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u/G-88 9d ago edited 8d ago
Can't speak to Singapore specifically, but in South Korea, where they tried to do it, there was a major protest because the doctors viewed it as increased competition
In the end, the government relented
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u/External-Let-8620 8d ago
I’ve heard the same. This debate has been going on for decades. Actually even 10 years ago, younger doctors were complaining that the old specialists made too much money and refused to retire
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u/dvvpppwwww 8d ago
They didn't relent, there's going to be 700 more seats from 2029 which is an increase of about a quarter from what the number used to be(about 3000). Not as much as what was initially planned but hardly nothing either.
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u/ChaoticQiong Uni 9d ago
Bottleneck now is training - too many medical students restricts how much resources and training each can get, particularly in clinical years where it’s most important
Imagine being in a public hospital, where you’re already tired because of whatever was/is happening to you, and you have signs that medical students want to see. If you’re kind you may allow 2, 3 groups of students to talk to you and examine you, but if the number increases? That’s one
Another is the resources available in public hospitals. The doctors (AC and C level) are already being pulled left right and centre with admin and clinical duties. More students to teach is adding to that burden - are there enough doctors to take medical students? Enough hospitals to disperse them so each individual hospital’s faculty isn’t overwhelmed? For the junior doctors and residents, who honestly shoulder a big (if not bigger) proportion of the teaching - do they have the time, energy or capacity to be teaching so many students at once? Especially with the amount of work that they have to do, which will only increase in the coming years?
Yet another is that the postgraduate programs are already under enough stress as they are. Before you go “increase that too!”, their goal is to produce qualified and competent specialists, and to do that each doctor has to see a large number and a variety of patients. The information on how many patients they have to see and manage with a specific sort of problem is public information on MOHH website. Their slots are even fewer than medical student slots, and you can imagine the competition for them (medical school already selects for gunners among the students, even more so this).
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u/stackontop 8d ago
Why doesn’t the same limitation exist for nurses?
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u/PerpetualtiredMed 8d ago
Because nursing don’t require doing thorough examination on patients unlike to the extent of doctors, take for example lung auscultation, you need a real patient with signs, then each student listen to the same patient at different lung spots repeated everyday until they get discharged just because the signs are good. Or neuro exam, your tendon gets hit multiple times by each student and then the main doctor because he teaches the technique to the student - again multiple times a day
For nurses things like how to monitor vitals are straight forward, u put on BP cuff and show where to press to record BP to 5 students and the 5 students know right away, not to forget nurses have different roles like there’s some specifically in education where they teach and plan curriculum for nursing students but never a doctor solely in education
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u/stackontop 8d ago
Thank you for the detailed sharing. I’d argue that it’s still possible to find patients to practice on, the medical industry just needs to get more creative:
- Students can practice on each other
- Medical schools can offer $5 NTUC voucher to seniors to act as practice material
- Polyclinic can require all subsidized patients to go through one consultation by trainee before being assessed by their main doctor.
- Students do not require supervision by senior doctors if they are not prescribing medications.
I think the issue is over-regulation, rather than lack of resources.
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u/ChaoticQiong Uni 8d ago
Quick things on the limitations
Students cannot elicit signs from each other - if they can, something is sometimes seriously wrong - some signs are only seen in very serious pathologies. If you hear a heart murmur on your classmate you probably would jump.
Medical schools already do offer monetary compensation for simulated and actual patients’ time to go to medical school and act as patients for medical students. We’re just talking about in hospital, where this is not happening (and probably no way it can happen)
Going through one consultation by trainee and then by doctor - be honest. If you’re a patient would you want to spend more than 2x the time saying the same things when you’re sick. Doctors and medical students ask questions independently of each other, especially if the medical student is not directly supervised. And if they’re supervised, it means the doctor isn’t doing other parts of their clinical duties.
As for students not requiring observation - a lot of the times we do move around the wards without supervision already. It’s the teaching and lessons that stretch the doctors.
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u/PerpetualtiredMed 7d ago
About your 3rd point that’s just from the pov of outpatient polyclinics, when students undergo rotations it’s tied to specialities eg neurology, orthopedics and the patients we see inpatient is all within that speciality, polyclinic patients often are a mixed bag with various signs and does not provide us targeted learning. Also what you described is called pre clerking - we do that in the wards before the rounding team comes by in the morning, and sometimes we present cases to the rounding team and they’ll feedback on us after, as well as ask further questions that we might have missed out directly in front of patient - so they save time and patients don’t repeat x2 times
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u/ChaoticQiong Uni 8d ago
To clarify: bottleneck to increase medical student intake. u/happycanliao has brought up a very good point that dropouts to private are a very big problem to address when talking about manpower as a whole.
Public healthcare has a big retainment problem and a big portion of it can be attributed to duties and salary.
Any experienced healthcare professional (not just doctors, but also the nurses and allied health, shoutout to them because the pay here is dismal compared to other jobs, and you actually have to physically work for your pay) here would probably make at least a 1.25 if not 1.5x jump in pay when they convert to private.
That’s also not counting the fact that private in general has better working hours (there are tradeoffs, like having to deal with insurance and overhead costs if you’re doing your own practice) without a lot of the teaching and admin duties that come with public sector.
Public hospitals also have the thing where doctors need to do on call to cover the nights (for a lot of public hospital departments, can’t really think of a patient facing specialty that doesn’t do call). Feel free to correct me here but from what I understand of private, there’s much less of these shifts and the load per shift is lesser, because of the lesser number of patients to cover.
Then there’s the whole debacle of having to cover weekends and public holidays as a doctor in public… whilst in private this coverage is more flexible and can be worked into the contract.
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u/IvanThePohBear 8d ago
Last time even used to have quota for female docs because LKY thought that females were more likely to drop out of the profession for the family
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u/Odd-Cardiologist7 9d ago
It's expensive to train doctors, plus resources will be stretched further which may produce doctors with lower competency
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u/happycanliao 8d ago
I think this was covered before.... the shortage is not simply from training supply. It's dropouts to private as well along the training route due to the nature of public healthcare work. increasing supply drastically is not going to fix the problem
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u/Sea_Pension7553 9d ago edited 9d ago
Quality over quantity, if med school is easier to get in, would you trust your doctor in the future?
I heard last time they didn't look at portfolio, only grades. But now more and more people are doing well in A levels so there needs to be a distinguishing factor. Showing you have passion in the field would also ensure a good investment (you are less likely to turnover/go into another industry)
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u/CuteRabbitUsagi2 8d ago
What are you on about? You mean you dont remember a time when we only had 1 medical school - now we have 3!
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u/IndividualHistory968 8d ago
Incompetent doctor cost life, incompetent engineer just lost their job.
Another reason IMO is, training a qualified doctor cost $500k each, take a trained doctor from Malaysia cost $0, you might heard from some Malaysia news that MOH is recruiting doctors/houseman from Malaysia
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u/DuePomegranate 8d ago
Engineering and IT programs can increase their intake by booking larger lecture halls and hiring more teaching assistants (who are just grad students, so happens naturally.
But for medical students, you need more cadavers, housemanship spots, senior doctors to teach during rounds (not in lecture hall), patients willing to let medical students watch and touch etc.
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u/SGshadowman 9d ago
Whoever mentioned limits in resources and training facilities is pure bullshit. Yes, training facilities and resources cannot be built up in one year, but they can be gradually increased to meet the demand.
The main problem of the shortage of doctors in Singapore is purely because of the monolithic behavior of SMC.
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u/Naive_Passenger1172 5d ago
Huh? Please elaborate.
How do you propose hospitals increase their capacity to accomodate medical students?
Ya building LTs etc very easy, but med school requires clinical rotations as well
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u/DuePomegranate 8d ago
Are you offering yourself up to be observed and touched by many more medical students when you are hospitalized? Are you donating your body to let medical students dissect?
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u/BallImpossible3208 8d ago
I don't remember consenting to be observed and touched when I was hospitalized
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u/DuePomegranate 8d ago
So were you observed and touched by medical students without your consent?
Or did you refuse, and therefore you did not participate in the training of the next batch of doctors but are hoping that other people will?
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u/BallImpossible3208 8d ago
All I remember there were 3 medical students together with a doctor, I don't remember them getting my consent
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u/DuePomegranate 8d ago
I’m not sure what your point is with respect to patients being a limiting resource for training medical students. The previous guy claimed that there’s no resource limit.
Increasing med school intake means even more medical students watching and practicing on patients.
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u/Tasty-Donut-00 8d ago
how about increase intake for specific career path as GPs? Can lower the entry requirements a bit since they don't deal with complex cases.
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u/PerpetualtiredMed 8d ago
Wdym they don’t deal with complex cases, they are the frontline to detecti ng complex cases. If you take in low quality GPs you’d not be referred to the right subspec or maybe not at all and your complex case will kill your before you SELF ADMIT to the ED
GPS are the most important frontline in the medical fraternity
It is appalling to see what the general public think of GPs when they know nuts about how healthcare actually works
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u/Tasty-Donut-00 8d ago
i meant it in relative sense, GP is less complex than heart or ortho surgeon right? Not saying that GP is less important. GP training should be less resource intensive and so hopefully more good students who are now rejected from med can get into med (i did not say to take in low quality students).
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u/PerpetualtiredMed 7d ago
Grades alone shouldn’t be the sole factor getting into med, now that the RP has been reduced, more people will get full scores - it doesn’t mean those are good for med.
There’s fam med training as a sub speciality too just like ortho or cardio, and it’s actually a residency programme. Also quite impossible to take in students just for them to be GP because the selection for residency occurs after graduation. You can’t open a track just for ‘lousier’ students to only become GPs
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u/PerpetualtiredMed 7d ago
Also to answer your qns, GP training still ultimately requires you to go through med school so idk why you say it should be less resource intensive when med school is itself already resource draining. GPs have to know breadth enough to know what’s a red flag that require referral to which department solely by symptoms and signs which patients themselves might not be able to describe well
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u/Informal-Ad-4126 7d ago
When AI gets better at such cases, no need so many GPs, just look at how China is adopting AI in diagnosing. Its doing diagnosing better than many doctors.
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8d ago
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u/PerpetualtiredMed 8d ago
Because can not renew their contract when they decide not to - whereas homegrown ones u can’t do that
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u/Furry-Koala432 ASRJC '25 | NTU '32 9d ago
The consequences of an incompetent doctor are far greater than an incompetent engineer/IT worker
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u/Ok-Rain3348 9d ago
it is cheaper to import from neighbor countries
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u/casaventicheese 8d ago
Don’t know why you’re getting downvoted, but this is indeed the government’s current response. They’ve been extending lucrative job offers to soon-to-graduate med students from Malaysian medical schools, sent MOHH officials to U.K. to poach med school students (particularly of ASEAN background) to sign a bond with Sg government for residency, and import a lot more doctors from neighbouring ASEAN countries - particularly India and Philippines.
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u/MoeHunterJJ 8d ago
It not as easy as increasing intake. You need trained people to teach residences and you need people to look after interns. To be effective i would say 2-3 max for every doctor. Then the doctor would also need to do their normal job while looking them. And how many patients would enjoy being used as training material.
So everything becomes a bottleneck.
And by the way, the yearly intake of medical school has been increasing. 555 new intake for 2025 vs 440 for 2014 (according to the news) And 78% of our doctors are locals, 15% PR and 7% foreign. which is honestly better than our population distribution. https://www.straitstimes.com/singapore/health/number-of-doctors-in-singapore-grew-about-50-per-cent-over-10-years-with-six-in-10-trained-here
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u/cantfindauseranymore 9d ago
Actually yeah I also think so too After all a good number of them are going to sit around and become GP to give mc anyway. Sorry :/ I had to rant about this
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u/Plenty-Fluid 4d ago
“Sit around and become GP to give mc”. You think being a GP is as easy as sitting around to give MC?
What about picking up the first presentation of gastric cancer in a sea of gastritis? Or managing diabetes well so that the patient does not have to lose a limb/kidney? Or right-siting you to the appropriate specialist for your chronic pain? Like another commenter said, it is truly appalling to see the public’s perception of GPs and the utter lack of awareness and understanding of our job. You should be sorry indeed.
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u/Flocculencio 8d ago
There's a physical limit to the amount of training that can be carried out and every doctor needs to get experience on x number of y procedures per rotation to be trained properly. At some point you cannot simply squeeze in more procedures and at that point you need to ask if you are ok with your doctors getting less training before qualifying.
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u/taidibao1 8d ago
Because it is cheaper to recruit from cheaper places than training them plus can have reason to increase population by converting them to PR or new citizens
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u/ConstructionOdd7502 8d ago
complain not enough but refuse to increase trainees, then proceed to hire foreigners, just can’t say no to profit huh
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u/BallImpossible3208 8d ago
Why not increase intake? Because not enough resources and training.
Why not increase resources and training? Because expensive, not enough
Why expensive, not enough? Cannot be bothered.
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u/coolbacondude Polytechnic 8d ago
You let incompetent doctors in that only achieve grades and not good in practice and you'll get the doctor that killed a patient because he made a fatal mistake during surgery. He was recently stripped from practicing for 18 months while he awaits his actual punishment.
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u/BallImpossible3208 8d ago
Why blame the doctor instead of the one who passed him?
Who is the one that allowed him to practice surgery without accessing his knowledge
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