Speech by Director of Medical Services, Professor K Satku at the Physician's Pledge Affirmation Ceremony on 3rd November 2012

Our new doctors who are here to take the physician’s pledge, let me welcome you first,

Professor Tan Ser Kiat

President of the Singapore Medical Council;

Members of the Singapore Medical Council;

Distinguished guests, Ladies and gentlemen, Good afternoon.

INTRODUCTION

1. The physician’s pledge affirmation ceremony is a significant milestone in the career of our doctors.

Let me congratulate you, for having come this far, as you join our ranks and embark on this new phase of your lives. You are now at the threshold of obtaining full registration.

With full registration will come many responsibilities and accountabilities, including self-regulation and appropriate ethical conduct. Society expects these responsibilities of all professions, but perhaps they have higher expectations of ours.

The medical profession has for centuries been a noble calling.  As every day, people, rich and poor, important and ordinary, commit their own lives and the lives of those near and dear to them into our hands.

I hope you will each take some time to reflect on what full registration means to you personally – the fulfilment of your aspirations to become a doctor, the beginnings of your life’s work. 

2.      More than a century ago US Supreme Court Justice, Louis Brandeis, a learned man who had a great influence on his own profession, defined the characteristics of a profession, as opposed to other occupations.

Let me tell you what he said in my own words :

First, a profession is an occupation which is pursued primarily for the benefit of others, and not merely for oneself. 

Second, a profession is an occupation for which the necessary training is intellectual in character, involving knowledge, and learning, as distinguished from mere skill. It involves mastering a body of knowledge.

Third, it is an occupation in which the amount of financial return is NOT the accepted measure of success.

Allow me to briefly expand on these points.

PATIENT CENTREDNESS

3.      We are in this profession primarily for the benefit of others. I am sure this is why you started medical school. This is what we came into the profession for. This means that not only must we work for the benefit of our patients, but also that we cannot take advantage of our patients.

Rich or poor, our patients are always in a vulnerable position. We should not feed unnecessary fear, nor should we advise doing procedures which may not be necessary. We should not be neglectful of our duties and we should never hesitate to look up the literature or consult our colleagues in order to do a good job.

Because our patients are in a vulnerable position, even if you have your patient’s consent you will be deemed to be taking unfair advantage of your patient if our colleagues do not agree that your actions are reasonable.

It is good, as a working doctor, that you reflect often on why you took up medicine in those post A-level days. You were inspired to do good and to help your fellow man.

If you can adhere to this purpose and remind yourselves sometimes of the pledge taken here today, I think you will also fulfil the first requirement of a profession.

 SOCIAL RESPONSIBILITY

4.      However, while recognizing that responsibility to your patient is of primary importance it must be said that you also have another responsibility- to society and to the system set up, in good faith, by society, to care for the sick. 

In the context of a healthcare system, resources are finite. You will need to consider the opportunities and limitations of the system, and the needs of other patients, while looking after your own.

5.      The SMC physician’s pledge contains the various elements to cover all these aspects. Take it seriously, put it up on your wall, and let it guide your medical practice.

CONTINUED LEARNING AND EXPANSION OF KNOWLEDGE. FURTHER TRAINING

6.  In our progressive world, the body of knowledge for medicine continues to evolve. Rapid changes in science and technology dictate not only adoption of new treatments, but also rejection of some of those previously recognised as good.

7.      Indeed, medical knowledge has become so complex nowadays that it is increasingly being recognized worldwide, that a basic degree, an MBBS or a MD, may soon be inadequate training for the practice of medicine. 

8       I earnestly encourage all of you to apply for a residency programme. You personality, your personal preferences and choice of lifestyle will determine which specialty you choose or whether it be family medicine. But whatever you choose to do, take pride in it.

9.      Most of you will be serving your bonds for the next five years, so this is your opportunity to make a quantum leap in your career, to put in an investment with no loss.  The ministry aims to expand our capacity to train everybody, be it in family medicine or the specialties.

BUILDING THE PROFESSION       

10. There is another responsibility I would like to address: shaping the profession. Each of you, whether you realise it now or not, has a role to play in formulating our medical landscape. If each of you only looks out for your own interests, our healthcare system will disintegrate.

11.    We need you to get involved to help build up and sustain the profession. It can be done in many ways- you can start by mentoring medical students or housemen.  But eventually, to play a role you will need to get actively involved in a professional organisation.

12.    If you have a heart for sharing, teaching, or even just a passion for your particular area of interest, take an active role in the society or specialist chapter that has been set up for its advancement.

Don’t let someone take a role in the society who has no interest in sharing but is there to further his own self-interest. Or someone who leads the society down the wrong route- he will misguide and misrepresent the profession.

If all of us say, “let the other doctor do it”, we will let those who have self-interest run our societies and associations.

13.    You should, as many say, ask what you can do for the organisation and not what the organisation can do for you.

Let me leave you with this quote from Edmund Burke, a statesman from the eighteenth century in England, a quote that has meant a great deal to many great men and women over the years: he said, “The only thing necessary for the triumph of evil is for good men to do nothing.” 

And so my colleagues, if you have a chance to do something, take the challenge and make your presence felt in the profession.

16.    On this note, I would just like to remind you once again to take the Physician’s Pledge to heart and continue to uphold the ethical code and the values of the profession.

If you practise medicine with a conscience and with dignity, it will always be to the benefit of your patients, our profession and society. Then, I am sure, you will have a fulfilling life’s work, and a good life. Thank you.