Duke-NUS Graduate Medical School Singapore Groundbreaking Dinner

01 Sep 2006

By Mr Khaw Boon Wan, Minister for Health

Venue: College of Medicine Building

"A Worthy Piece To Our Healthcare Jigsaw"

A few hours ago, we witnessed the groundbreaking of the Duke-NUS Graduate Medical School Singapore, or "GMS". This is historic as it is not often that new Medical Schools are set up.   For Singapore, GMS will only be our second medical school.

An Old Tradition

I know many of you will view this development with mixed feelings. We all welcome the setting up of the GMS.  But at the same time, we will miss the old KE Hall which unfortunately has to go.  Many generations of medical students have stayed in these humble quarters.  These KE Hall alumni, or KEVIIans as they are affectionately known, would remember how they burnt the midnight oil studying in these rooms.  They would also remember their many pleasant moments here.  Many of them, including several past Masters of KE Hall, are here with us tonight.

How nice if we can allow development without knocking down old buildings?  We tried and sometimes we succeeded.  For example the preservation of this College of Medicine Building as the Ministry HQ is an excellent example.  But sometimes, we could not. 

While we are sad to see KE Hall go, we are determined that GMS will continue the proud tradition of excellent medical education at the Outram campus.  On this very site at Outram, medical education began a century ago and stayed for 81 years until its move to the Kent Ridge campus in 1986. With GMS, medical education will return once again to Outram.  For the stakeholders in Outram, they have much to cheer about.

A New Medical School

How did this project come about?

The Medical Faculty at the Kent Ridge campus has just increased its intake from 230 to 250.  This is in response to rising demand.  Our population will continue to grow and age.  We are confident of attracting many more foreign patients.  If the number of doctors and specialists do not go up in tandem with rising demand, patient care will suffer, not to mention rising healthcare cost. 

A medical specialist takes years to train.  The increased intake in the NUS Medical Faculty this year will only benefit the patients in 2015 or beyond. We cannot wait.  So we must top up with foreign recruitment.  Every year, we recruit about 130 doctors who graduated overseas.  Singaporeans have benefited from these foreign doctors.  Let me just quote three examples who were recruited in the last 10 years or so and who went on to head our clinical departments.  SGH recruited Dr Colin Song from South Africa.  He is now the Head of SGH's Plastic and Reconstruction Surgery, doing an excellent job treating burns and cancer patients and mentoring younger plastic surgeons.  NUH recruited Prof Peter Manning from UK.  He was until recently the head of NUH's Emergency Medicine Department, and has also become a Singapore citizen.  NUH also recruited Prof Wang Shih Chang from Australia.  He now heads its Diagnostic Imaging Department.  There are many more such examples who are doing excellent work serving our patients.  And more are welcome.  We are expanding the schedule of recognised medical degrees.  We will step up foreign recruitment.

But at the same time, we should also expand local training of doctors.  We are proud of our standard of medical education and training.  We can do more.  NUS has set an immediate target to increase the intake by 50 per year, but we know that a larger expansion will be needed in due course.

There are two options.  Expand the Medical Faculty at the Kent Ridge campus, or start a second Medical School.  At 250 student intake per year, the Kent Ridge campus is already among the largest medical schools in the world.  In comparison, Duke University takes in only 100; Johns-Hopkins, 120 and Harvard Medical School, 165 per year.

We decided that a second Medical School will serve our long term interest better.

First, it allows for further expansion.  At 300 student intake per year, the Kent Ridge campus may be able to cope.  But beyond 300, we are really pushing the limits and it will not do justice to the faculty and the students.

Second, it gives us an opportunity to experience a different model of medical education.  The Kent Ridge campus originated from the British model of medical education. Over the years, we have evolved and tried to adapt the best practices from around the world.  We are proud of it and its graduates. 

But there will be pleasant surprises when one goes beyond familiar territory.  See how the SMU has contributed to our local university scene.  It has added to the diversity and brought new dynamism.

We know that the US medical education is quite different from the UK model.  Let me just highlight two major differences.

First, it is a graduate programme, unlike an undergraduate programme like ours.  It takes in graduates who have already completed a basic university degree in say science, or engineering. The students are mature and for them to decide to invest in a medical education, their motivation is clearly strong.

Second, in many American medical schools, clinical research has a significant emphasis.  For example, in Duke University, its medical programme is for 4 years, but one of the 4 years is fully devoted to clinical research.  The graduates of such a model of medical education are more likely to devote their career to be clinician-scientists, combining medical practices and clinical research.

This decision to set up a second Medical School is not an isolated decision.  It is part of a larger strategy launched 6 years ago to develop the life sciences as an engine of our economy.  Through A*STAR Chairman Mr Philip Yeo's indefatigable drive, brilliant leadership and considerable charm, Biopolis and the recruitment of many world-class scientists are the early results.

While we will continue to recruit foreign scientists, we are actively training our own.  We must have outstanding Singapore scientists, clinician-scientists and their global counterparts working side by side, advancing the knowledge of science and medicine, bringing benefits to our patients and the global community.  We must be active players in this search for a better solution to the many medical problems of the world.

It is against this backdrop that we decided to build a second Medical School, in partnership with a top medical school, using an American model of graduate medical education.  It was a decision taken jointly by the MOE, MOH and MTI, the three stakeholders in this venture.

Picking Our Partner

After a thorough search, we decided on Duke University as our partner.  Duke Medical School is among the top ten medical schools in the US. It was number six in U.S. News and World Report's 2006 rankings. Duke has contributed many clinical discoveries and is one of the largest recipients of funding from the US' National Institutes of Health.

Duke's research-intensive curriculum will allow the GMS to develop a new breed of doctors who can be further trained as clinician-scientists with strong research capabilities in translational medicine. In line with Duke University's tradition, GMS students will devote a full year to independent study and research projects of a basic science or clinical nature under close faculty mentorship.

Joint Responsibilities

Given the diverse interests in the success of the GMS, it is not the sole responsibility of one Ministry.  Three Ministries have strong but separate interests in the GMS: MOE, MOH and MTI.  MOE is a natural stakeholder and the key driver, but MOH and MTI too are keen that the graduates of the GMS add suitable value to our hospitals, the research laboratories and the industry. 

Dr Tony Tan, then DPM in charge of life sciences promotion and the universities, persuaded the 3 Ministries to jointly fund the GMS so as to register their stakes in this venture.  If and when GMS becomes a resounding success in the future, Singaporeans will look back on Dr Tony Tan's contribution in championing the cause of the GMS and his larger vision that through GMS, we help raise Singapore's standards of medical education, clinical services and clinical research to new heights.

Our Aspirations

But what will constitute a resounding success?  Different stakeholders will define success differently.

Let me share with you MOH's aspirations for the GMS.  I will highlight three criteria.

First, that GMS will become a top medical school in the world, sought after by top students from around the world.  To measure this success, international rankings of medical schools is one, but this will take time to be achieved.  For the short term, one proxy indicator of success is when the Duke University agrees to grant degrees to the GMS graduates in its name jointly with NUS.  This is in fact a declared aim of the joint venture and we look forward to its early realisation. 

Second, that GMS will help transform the Outram campus into a major centre for academic medicine in the region, attracting doctors, nurses, students, trainees and patients from afar to participate in medical education, research, and service delivery. In particular, the GMS will help boost the culture and results of clinical research, creating new knowledge and technologies, leading to new treatments and diagnostic tools.  The ultimate aim is to enhance Singapore's reputation as a biomedical research hub. 

Third, that GMS will help Singaporeans live a long and healthy life. This is the mission of the MOH but we need all our healthcare partners to jointly realise this mission.  For GMS, this means working closely with all the healthcare partners in Singapore to translate the benefits of medical education and clinical research into better care for our patients.  This in turn will boost Singapore's reputation as a regional medical hub, serving patients from near and afar.

Clinical Research Mandate

Singapore is small but we have the potential to be a serious contributor in biomedical science.  Much has already been achieved under the capable leadership of Dr Tony Tan and Mr Philip Yeo.  We have attracted many renowned and talented researchers at the Biopolis and our many institutions.

The new GMS is the next big piece of jigsaw that we are putting in place.  It will draw on and contribute to the increasing pool of clinician-scientists in Singapore.  They will help bridge the gap between research laboratories and hospital beds, translating the findings in the basic sciences into practical solutions to help our patients recover and stay healthy.

This year, MOH has updated its portfolio and formally incorporated clinical research as part of its mandate.  It is a significant step forward for the Ministry.  We will continue to emphasise clinical services, but we will begin to devote new resources to supporting clinical research.  The big money for clinical research will still come from MTI and A*STAR, but we will also put in some funds to register our new emphasis.  Our focus remains our patients, and clinical research must help enhance our care for our patients.

Our patients are beginning to appreciate this shift.  Last month, I received a thoughtful email from one cancer patient.  He is under the care of the National Cancer Centre.  Let me quote what he wrote:

"Recently I went over to National Cancer Centre readily resign myself for one or two hours wait.  But I must say I was totally wrong.  After 20 minutes wait I entered the room to see Dr Wong Nan Soon -Medical Oncology.  I expected to see him only 5 minutes but instead Dr Wong spent close to 20 minutes to tell me about my conditions and how we can work together as Patient and Doctor Team.  I even had a chance to ask him if he is thinking of leaving public hospital to join private hospital.  He said that the direction of MOH has changed.  Right now there are more researches in public hospital with good facilities and funding.   

I left the room smiling, knowing that I will receive good care from the Doctors who love their job."

In 10 years' time, I hope to see many more clinician-scientists like Dr Wong Nan Soon.  And many more such appreciative patients who see and benefit from the efforts we are putting in to make our healthcare system the best in this region.

A Worthy Addition

The NUS Faculty of Medicine has done us proud.  It is an outstanding faculty.  Our doctors are of high standard, with sound character and strong values and public ethos.  That is why Singaporeans hold doctors in high regard.  They trust our doctors and our healthcare system. 

GMS will in due course find its worthy place in the healthcare community in Singapore. As a stakeholder, MOH will do its best to help contribute to its success.  The decision by Duke University to appoint its own Medical School Dean, Prof Sandy Williams as the concurrent Dean of the GMS gives me much comfort, that Duke appreciates the high expectation that Singaporeans have set for this second medical school.  You know that you must succeed.  We will all do our part to help you succeed.

Meanwhile, I look forward to meeting your full Medical Faculty and your pioneering batch of students next year and seeing the new GMS campus completed in 2009.  I am confident it will be a worthy addition to the Outram campus and our healthcare system.