The development of postgraduate training programmes in Singapore.

Singapore is a small country compared to Pakistan. Being an urban modern developed nation with a high population density, adequate doctors (& specialists), and good infrastructure, it has one medical school enrolling 200 students annually, one Graduate School of Medical Studies (GSMS) responsible for entry postgraduate examinations (the M Med) and one Academy of Medicine (AM) responsible (jointly with the Graduate School) for exit certification/examinations (FAMS) into 35 specialties. There is also one College of Family Physicians with a significant role in the training of Family Physicians jointly with the Graduate School. The Aga Khan University runs 14 residency (3 to 4 years) and 2 fellowship programmes. It has the College of Physicians and Surgeons of Pakistan, which awards fellowships to trained postgraduate doctors. Formal postgraduate education in Singapore began in the 1960s with the help of the Australasian Royal Colleges. The Graduate School of Medical Studies was born in 1969 to conduct Master of Medicine courses and examinations, either alone or jointly with overseas colleges. Over the years up till 1996, the M Med covered 11 disciplines. Programmes are set up based on local needs for a specialty, subspecialty, skill or expertise. Both the GSMS and AM have heavy responsibilities under the Specialists Accreditation Board (SAB) of the Ministry of Health, to administrate the 35 Specialist Training Committees. Syllabus, log books, registers, supervisors, mentors, interviews and exit certification/examinations are essential components of the specialist training programmes which last 6 to 7 years. As new specialties and subspecialties develop internationally, they will be introduced locally at the appropriate time. Through the local training programmes, doctors become specialists in their early thirties. The challenge is to develop systems to ensure that for the next 30 years of their practice, they remain up-to-date, competent and effective doctors.