PM Lee Hsien Loong at Official Opening of Duke-NUS Graduate Medical School

I am happy to be here this evening for the opening of Duke-NUS Graduate Medical School.

The medical school is a strategic collaboration between Duke University in the United States and the National University of Singapore. It has been doing well since its establishment in 2005. The school took in its first batch of students in August 2007, and its third class of 56 students just began lessons last month. The inaugural class is expected to graduate in 2011.

I am also happy to inaugurate the Khoo Teck Puat Building, which houses the Duke-NUS Graduate Medical School. The building is cleverly designed to make full use of the land available. It houses a well-equipped, vertical campus, with over 26,000 square metres of space for wet-lab research, classrooms and teaching labs.

Supporting the Expansion of our Healthcare System

Duke-NUS is an important piece in our long term plan to develop Singa pore’s healthcare system. We are investing heavily to meet the needs of our population, building new hospitals like the Khoo Teck Puat Hospital and Jurong General Hospital, as well as new specialty centres, including a second national Heart Centre and second national Cancer Centre. These facilities will enable us to continue delivering affordable, accessible and good quality care to Singaporeans.

Putting this physical infrastructure in place is the basic step. More critical is our investment in software. We will need more doctors, as well as nurses and allied health professionals, to operate the new systems and deliver the quality healthcare that we are aiming for.

Training More Doctors

Currently, the NUS Yong Loo Lin School of Medicine trains 250 doctors each year. Its facilities will be expanded to train another 50 doctors. The Duke-NUS Graduate Medical School will produce about 50 doctors annually. Altogether, these efforts will expand our pipeline to a total of 350 doctors a year.

But this will still not be enough. We will need even more doctors to cope with a growing and ageing population. While we can hire a good number of doctors and specialists from overseas, we will still need a substantial core of locally-trained doctors. Hence we are continuing to study options to expand the supply of local doctors.

Training Doctors Differently

As we enlarge the training pipeline, we should also take the opportunity to bring in good practices from different systems. Modern medical practice has become more complex. Doctors have to be equipped to tackle modern ailments, meet heightened expectations of patients and the public, and deliver “whole medicine”.

In the past, doctors usually encountered and treated communicable infections like cholera, typhoid and smallpox. Today, with rising affluence, “lifestyle” and chronic illnesses like heart diseases and diabetes are taking an increasing toll. There is no vaccine for obesity and heart disease, unlike for cholera, typhoid or smallpox. Doctors cannot simply treat and cure these chronic conditions with a prescription or operation. They also have to educate and cajole patients to watch their diets, stop smoking and exercise regularly, before complications set in.

The nature of healthcare provision is changing as well. We are progressively linking up our healthcare facilities to deliver “integrated care”. Doctors need to be part of multi-disciplinary teams, in order to deliver “whole medicine” to patients. Their roles extend beyond episodic care. They must cooperate with other medical practitioners on preventive care and aftercare, and help patients navigate the increasingly sophisticated healthcare landscape.

To best serve patients, doctors need good communications skills. This is all the more critical as patients today are more knowledgeable and have higher expectations. Doctors must be able to establish rapport with patients and their families, explain clearly different treatment options and risks, and help them to make informed decisions for themselves.

Our medical schools regularly update their curriculum to train doctors better. Duke-NUS has its own unique methods. Its students are organised and taught in small teams, and inter-personal skills and communications are emphasised. Students are also exposed to clinical training early. They are embedded in the wards and are responsible for the care of a number of patients. Some students take to this very well. At KK Women’s and Children’s Hospital, a Duke-NUS student made such a deep impression on a patient’s family with his professionalism and warmth that the family wrote in to thank him as a "doctor". They had no inkling that he was a second-year student!

Duke-NUS is not the main model for medical education in Singapore. The school takes in students who have already earned a bachelor’s degree, unlike the NUS Yong Loo Lin School of Medicine which takes in undergraduate students. However, Duke-NUS has stimulated new thinking about how to approach clinical training and postgraduate medical education. Some friendly rivalry between our two medical schools is to be expected, and even encouraged. It is through such constructive competition and mutual learning that we can raise our overall standards of medical education.

Supporting the Biomedical Sciences

The approach taken by Duke-NUS also supports our efforts to establish the biomedical sector as another key pillar of our economy. We have set up the Biopolis, and are actively encouraging research initiatives in our hospitals and universities. To complement these efforts, we need to train a pool of doctors who are both astute clinicians as well as skilful scientists, i.e. clinician-scientists. These doctors need the right mindset and training, as well as strong capabilities in translational and clinical research. They have to understand the needs and problems faced by patients, plus possess the knowledge and skills to pursue complex scientific enquiry. This combination of talents equips them to pursue better treatments for illnesses, develop new drugs and technologies, and create more effective medical devices, all to improve the quality of our medical care.

Duke-NUS students receive intensive training in both medicine and research. One of the four years in the curriculum is fully devoted to research and independent scholarship. Students can tailor their research experience according to their own long-term goals and interests. They also have the opportunity to work alongside world-class clinician-scientists.

However, whether these students can follow-through after their training to become clinician-scientists themselves also depends on us creating the right healthcare and research ecosystem. Over time, we must develop the right support structures and culture to enable a good balance of research, teaching and patient care. Academic medical centres like the Outram campus, which Duke-NUS is a part of, and the National University Health System (NUHS) are key components of the overall healthcare system. They need to develop a “triple bottom line” of delivering good medical care, educating the next generation of doctors well, and enhancing our medical capabilities through research.

Early Success due to Strong Support to Duke-NUS

Although Duke-NUS is still in its early years, it has done well. The school has met or surpassed all its mid-term targets, several of them well ahead of schedule. The school’s distinctive curriculum and good branding has attracted top quality students and faculty, and garnered significant international attention.

This early success is due to the efforts of many parties. I wish especially to recognise Duke University, which has been deeply committed to this project. Duke has given its name to the school, and sent a top-notch faculty team to teach here. I also thank NUS which has put in dedicated efforts, even though it is in effect setting up a rival to its own Yong Loo Lin School of Medicine. The school has also received active support from the hospitals, A*STAR and Ministries of Education and Health.

I also want to thank donors who have contributed generously to Duke-NUS. The Estate of Tan Sri Khoo Teck Puat donated $80 million to the school to further its biomedical research initiatives. In addition, Goh Foundation, Lee Foundation, Lien Foundation, Shaw Foundation and Tanoto Foundation and others made important contributions to various research programmes and scholarships for talented students. With your strong support, I am confident that the Duke-NUS Graduate Medical School will continue to progress and strengthen into the future.

Conclusion

Finally, let us never forget that for all the excitement over new facilities and medical research, at its core doctoring is a human enterprise. The medical profession is about people. Doctors must want to help their patients, and try their utmost to make them better; researchers must want to find better drugs and more effective treatments to save lives. Both must uphold the highest ethical standards, whether in medical practice or research. Therefore, medical schools cannot focus solely on teaching medicine and research. They must also provide the right environment and mentorship, so that their students might acquire the humanity, compassion and right values to undertake their chosen calling. Only then will we continue to nurture caring and selfless doctors, who are committed to doing the best for their patients.

Thank you.

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