Government determined to increase population to 7 mil in 2030.

[safetyfirst]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

[Temperament]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

i hearsay, an orthopedic surgeon in popular private practice in Singapore can earn easily 800k p/a. How about cancer specialist? In millions? No money never mind, still can survive to find money. Poor health or sick sure die one.

[Thiock]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

Another point is that you need current doctors to train trainee doctors. Put yourself in the position of a current doctor working in public hospital. Besides day to day treating patients in hospital, you are tasked to teach and supervise a group of medical students (who wants the additional load?). So it may not be that easy to ramp up the number of new doctors (or even the number of vacancies in Medicine faculty) at a moment of notice. Besides, patients may not be comfortable/willing to let the medical students treat them as case studies.

[safetyfirst]

huh, if you set your mind to ramp up the number of doctors, many problems can be overcome. There will sure be doctors who have earned enough, and dont mind just focus on teaching the new generation.

As for treating them as case studies, this is equally funny. All doctors training to be specialist will have to learn from case studies. I have not heard or seen an existing patient complaining of medical students treating them as case studies. Come on!

For you, you sound like a doctor and are so worried that your income will be affected if the market is flooded with doctors

[Bibi]

I have not heard or seen an existing patient complaining of medical students treating them as case studies. Come on!

Patients who chose subsidized treatment should be expected to be operated by trainee doc or treated by medical students. They cant pay peanuts and expect to get top surgeons operating on them. I heard of some rare cases where the patient is in serious stage cancer then experienced doc might handle their case. My colleague mother is one of them. Maybe its pure luck I dunno know.

[Thiock]

huh, if you set your mind to ramp up the number of doctors, many problems can be overcome. There will sure be doctors who have earned enough, and dont mind just focus on teaching the new generation.

As for treating them as case studies, this is equally funny. All doctors training to be specialist will have to learn from case studies. I have not heard or seen an existing patient complaining of medical students treating them as case studies. Come on!

For you, you sound like a doctor and are so worried that your income will be affected if the market is flooded with doctors

No, I am not a doctor. I am just sharing what my friends in MOH explaining to me what are some of the challenges in training more doctors.

[investor101]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

In schools, students who are in the best classes are geared towards engineering. Best classes basically are students who are primarily good in Maths and Science.

While some of these students go on to be lawyers (usually those good in English and Literature and Humanities) or doctors (Biology, Science), vast majority of these students go on to study Engineering in university because of the prestige given to top classes in school.

Every modern society needs a lot of engineers and technicians to be modern, simply because this group of people have the technical expertise to make technology progress possible. However, there are simply too many engineers and the economic pie has to be shared. So, each engineer gets only a small piece of a pie.

It is pretty different for medicine. The university intake for medical students is probably less than 300 a year in Singapore, as compared to thousands of engineering students. Everybody at some point, needs to see a doctor. So, fewer doctors, each of them get a much bigger slice of the pie. Most people are also less likely to bargain about the price of their medical treatment, as compared to firing Singaporean engineers and replacing them with a cheaper foreigner.

[Temperament]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

In schools, students who are in the best classes are geared towards engineering. Best classes basically are students who are primarily good in Maths and Science.

While some of these students go on to be lawyers (usually those good in English and Literature and Humanities) or doctors (Biology, Science), vast majority of these students go on to study Engineering in university because of the prestige given to top classes in school.

Every modern society needs a lot of engineers and technicians to be modern, simply because this group of people have the technical expertise to make technology progress possible. However, there are simply too many engineers and the economic pie has to be shared. So, each engineer gets only a small piece of a pie.

It is pretty different for medicine. The university intake for medical students is probably less than 300 a year in Singapore, as compared to thousands of engineering students. Everybody at some point, needs to see a doctor. So, fewer doctors, each of them get a much bigger slice of the pie. Most people are also less likely to bargain about the price of their medical treatment, as compared to firing Singaporean engineers and replacing them with a cheaper foreigner.

Hey!
i think hiring FT Doctors are cheaper too as they may be paid relatively lower in their own countries. Just like so many FTs replacing locals.

[Riderr2000]

Hi Rider2000, your comments are plain shallow and ignorant. Doctors' number has been kept artificially low to keep this field limited to a small group of mainly rich and powerful people. There is definitely no shortage of doctors globally. In fact, western and developed countries, such as Australia, are having an oversupply problem. It is frustrating that many Singaporeans do not agree or understand that a medicine degree is no more difficult nor easier than other degrees like engineering, accounting or science. The main obstacle to become a doctor in Singapore is money, half a million or more, peanuts to the rich. Another fact that the top doctors, usually specialists in western countries, are earning in the range of $150k to $200k annually, much less than what a HDB GP is making, is laughable. How about the case of charging $24 million for several months of treatment? If our current hospital beds shortage problem is not poor planning, then what is? Our healthcare system leaves a lot more to be desired. The only consolation is the comparison with our regional countries but that is another story.

http://www.theaustralian.com.au/national...6809011455#

http://sg.news.yahoo.com/surgeon-susan-l...22896.html

I guess its good that this is generating quite a bit of interest and discussion, in an area where I feel somewhat more competent in adding value to the discussion, as opposed to the valuation of stocks, where I am happily sponging off the knowledge of others...

First off, on the point of doctor and bed shortage (which also supports the point another buddy made on if there is a need for docs to be trained so long)
- World Health Organization says "We need more doctors" http://www.slate.com/articles/health_and...ation.html
- Health Workforce Shortage: A Global Crisis
- World is short 7.2mil healthcare workers
- Too few doctors in the US

If you search a bit more, outside of the developed nations, the developing world is fairing much worse in doctor and infrastructure shortage.

I think its illogical to conclude that there is "definitely no shortage of doctors globally" just from looking at data from a few countries - especially when you pick an example from a small country like Australia. I would in fact add on to your argument - there could be a huge oversupply of nurses, estimated at potentially 300,000 in the Philippines. Nurse unemployment in the Philippines. It is so bad there, that new nurse graduates are willing to work for free just to get 1-2 years of experience, so they can get a full time job in a local hospital. Yet UK, US, Europe, etc., are seeing shortages of nurses
- Europe Nursing Shortage
- Shortage of 20,000 nurses in NHS
- Nursing shortage in the US

So two issues here: (i) while there is a global shortage (asides from the links I provided, there are numerous WHO and US, UK, and Europe studies that support this), (ii) there is also oversupply in some countries. We can definitely reallocate resources, but many barriers are in place, due partly to protectionism, partly to need to ensure quality (i.e. a doctor from certain countries are not as well trained as a doctor from other countries), language etc.

Technology has helped this somewhat - see telemedicine, where your xray can be sent to either a cheaper doctor in India or a more specialized doctor in the US to get your diagnosis. Medical tourism is another way to reallocate resources, but moving patients instead of doctors. (I can see this as another point for public debate in SG). Numerous other examples of changes to the patient care pathways also helps somewhat.

But I circumvent back to my original point of looking at the issue as a healthcare issue, rather than a treatment issue, which some other buddies have also touched on. One of the solutions has to be to reduce the burden on health by preventive health.

Again, I am in total agreement that we need to improve on our healthcare system - we are short of beds, short of doctors, healthcare costs are rising too much etc. Regardless if this is a global issue, it is ultimately a Singapore issue and it needs to be solved.

But I disagree that our healthcare system is only better than our neighbours'. The US healthcare costs is currently 17% of their GDP, and is expected to hit 20% by 2020 US Healthcare costs. I assure you, this is a huge concern to the policy makers there, and they are looking for various models to contain this. This is not restricted to the US. Impact of rising healthcare costs.

Anecdotally, in Australia, if you need a knee implant surgery, you may need to wait up to 18 months if you are in the public system. Imagine the pain you feel when you are hobbling around for 1.5 years. To be fair, its free treatment though. We probably all heard of the long waits and expensive healthcare treatments in the developed world, which drives them to seek medical treatment in other countries. The point is, there isnt an ideal healthcare system in the world, and Singapore has a system that is comparable with the better ones globally. Still needs improvements though.

While I agree that the extreme and increasing income inequality (again, a global issue) has led to a hugely unlevel playing ground, with rich having access to much more treatment options, I think its far fetched to conclude that "doctors' numbers have been kept artificially low... limited to small group of mainly rich and powerful". I have not seen any evidence to that, and fail to understand the rationale why a policy maker would plan for that. To protect his turf and income? A little too much conspiracy theory for me.

I also disagree with some of the foundations of your arguments.
- "The main obstacle to become a doctor in Singapore is money, half a million or more". From what I watch on TV I have this impression that newly trained doctors in the US are saddled with huge amounts of debt. So I did a quick search. NTU med school SGD180k (30k*6 yrs). US med student debt more than US$150k. Seems comparable to me
- "Another fact that the top doctors, usually specialists in western countries, are earning in the range of $150k to $200k annually, much less than what a HDB GP is making"US annual salary GP: US$150k salary, Specialists over US$400k.

So if your argument is that the reason for doctor shortage is due to (i) high costs of medical education in SG, (ii) protectionism of our doctors' high incomes, then I have to say its not a convincing argument. I cant disagree with your point that the planning "leaves a lot more to be desired" though

[Freenasi]

I always find it interesting that our local universities have so many vacancies for engineers, yet from personal experience, many of my engineering peers do not graduate to become an engineer.

However, i dont have a single friend who's trained as a doctor and is not working as a doctor now. oh and all of them have good incomes.

Having not enough beds is a problem, refusal to train more doctors is also another problem. If so many people graduate with an engineering degree but dont practise engineering, is it time to cut down the engineering numbers in uni and allocate the resources to train more doctors?... Or is it more important to restrict the number of doctor vacancies so that they can maintain a high salary when they graduate?

In schools, students who are in the best classes are geared towards engineering. Best classes basically are students who are primarily good in Maths and Science.

While some of these students go on to be lawyers (usually those good in English and Literature and Humanities) or doctors (Biology, Science), vast majority of these students go on to study Engineering in university because of the prestige given to top classes in school.

Every modern society needs a lot of engineers and technicians to be modern, simply because this group of people have the technical expertise to make technology progress possible. However, there are simply too many engineers and the economic pie has to be shared. So, each engineer gets only a small piece of a pie.

It is pretty different for medicine. The university intake for medical students is probably less than 300 a year in Singapore, as compared to thousands of engineering students. Everybody at some point, needs to see a doctor. So, fewer doctors, each of them get a much bigger slice of the pie. Most people are also less likely to bargain about the price of their medical treatment, as compared to firing Singaporean engineers and replacing them with a cheaper foreigner.

The population of undergrad trainees for doctors is quite small and apparently not enough to support the current population growth. Basic economic theory, low supply also have caused the salary to be high. I am sure the minister is looking at this issue, not sure ramping up supply is one of their plan though. Having observed the cut-points of tertiary schools here, the engineering faculties cut-off is usually highest, meaning not many people want to go into engineering. Maybe future resources can be diverted to medicine schools to increase the intake, focus on medicine and also this will reaffirm the goal of a medical hub.