Speakers
Prof. Fun-Gee CHEN
Co-Chair
Joint Committee of Specialist Training
Director
NUS Division of Graduate Medical Studies
Singapore
Dr Chen Fun Gee is a graduate of the National University of Singapore. He completed his postgraduate training in Anaesthesia in Singapore and in Australia in 1987 and 1990 respectively. He underwent subspecialty training in Critical Care Medicine at St Vincent’s Hospital Sydney in 1990. With an interest in medical education, Dr Chen underwent a 2-year Masters Health Professions Education course at Maastricht University Holland and graduated in 2016.
Dr Chen has been involved in anaesthesia training and examinations since 2006. He is an examiner in the Singapore anaesthesia training system, the Malaysian anaesthesia program and has been invited many times as an examiner in the Hong Kong College of Anaesthesia finals examination.
As the Co-Chair of the Joint Committee of Specialist Training (JCST) and Director of the NUS Division of Graduate Medical Studies (DGMS), Dr Chen was directly involved in the formulation of training requirements in all 36 specialist training programs and licensing processes during the COVID-19 pandemic. These experiences have been published in medical education literature.
Dr Chen’s research has been focused on critical care outcomes, medical simulation and currently medical education.
The 2019 novel coronavirus (SARS-CoV-2) was first identified by the Chinese Centre for Disease Control and Prevention from a throat swab of a patient in Wuhan, Hubei province of China on 7 January 2020. 2020. This infection began to spread to many countries, and by 11 March 2020, the World Health Organization (World Health Organization 2020a) declared it a pandemic.
The first case of COVID-19 in Singapore, a tourist from Wuhan was confirmed by the Ministry of Health (MOH) on 23 January 2020. The number of cases very quickly increased. In response to this, Singapore health ministry elevated its risk assessment from disease outbreak response system condition (DORSCON) orange with the stepping up of use of personal protection equipment in high risk healthcare areas such as in emergency medicine departments, operating rooms and isolation/ intensive care rooms for suspected cases. There was nationwide restriction of healthcare movement between healthcare institutions, as well as compulsory quarantine for travellers entering Singapore. Non-urgent elective surgeries were postponed, and the focus was on the care of COVID patients. This was to have a severe impact of provision of medical care and training. In anaesthesia residencies, the volume and variety of cases was curtailed. Rotations from one hospital to another was not allowed. Examinations, necessary for progression had to be postponed or modified.
Singapore had survived the effects of severe acute respiratory syndrome (SARS) as well as middle eastern respiratory syndrome (MERS) in the past with relatively minimal disruption in medical training because it was short-lived. The COVID 19 on the other hand continues to rage on with new variants, despite development of vaccines and herd immunity of the population.
The Joint Committee of Specialist Training (JCST) and the Ministry of Health (MOH) Singapore developed guidelines regarding the conduct of training examinations in various possible scenarios in the pandemic, including a situation of high virulence and transmissibility (DORSCON RED). These guidelines were adopted by all education and healthcare institutions, and covered the areas of training, assessments and licensing.
In developing the guidelines, the focus was on competency based medical education. Whilst the duration of training could be flexible, the competency of the graduate from the residency is to be a non-negotiable criteria for licensing. This required adjustments to the training, to enable the residents to have similar experience, and a change in the conduct assessments to one which poses the least risk to transmission of COVID 19 transmission.
The presentation will cover how medical training, residency and licensing will proceed with different pandemic scenarios, whilst minimizing the risk of transmission of the disease. In Singapore, the current situation is now in an endemic state. Medical training and examinations have returned to normalcy, with modifications to minimize transmission should the virus mutates to a more virulent and transmissible variant yet achieving the goals of graduating competent specialists.
Reference:
1. Ashokka, B., Ong, S. Y., Tay, K. H., Loh, N. H. W., Gee, C. F., & Samarasekera, D. D. (2020). Coordinated responses of academic medical centres to pandemics: sustaining medical education during COVID-19. Medical teacher, 42(7), 762-771.
2. Pan, T. L., & Chen, F. G. (2021). Opportunity within a crisis—A push towards programmatic assessment in the COVID‐19 pandemic situation. Medical Education, 55(5), 637.
3. Foong, T. W., Tan, J. K. H., Ashokka, B., Agrawal, R., Lieske, B., Bose, S., ... & Chen, F. G. (2020). How do we turn surgical residents into safe intensive care unit clinicians? An Entrustable Professional Activities guided framework. Journal of British Surgery, 107(11), e491-e493.
