(a)    To examine early clinical exposure and to carefully structure and integrate it with the system-based medical science education.

(b)    To include, where appropriate, simulated patients, videos and clinical skills laboratories to complement hospital visits that will allow the early clinical contact to be valuable and instructive rather than merely voyeuristic.

To allow students to experience medical practice outside the hospital environment at an early stage in their training to avoid the increasingly misleading impression that medicine is all about what goes on in hospitals

(a)    To design assessments which incorporate some of the integrated problem-based approach to help students understand clearly how the problems are integrated with the lecture and practical programme.

(b)    To cover material which is complementary to but additional to that covered in the concurrent lecture programme via PBL so that it is regarded as an essential component of the course. 

To develop a greater appreciation by all the students of the necessity for medical research and the opportunities for a career involving medical research either basic or clinical.

To give prominence to research and evidence-based medicine within the medical curriculum.

To develop an active strategy for multidisciplinary teaching to expose medical students to other health professionals during their course as medical care is increasingly being delivered by multidisciplinary teams.

To re-examine the relationship between NUS and the major hospitals in Singapore with a view, where appropriate, to locating academic departments or sub-departments within them, and to harnessing for research the immense resource of their patient bases.

To consider the possibility of changing the organisational structure of the Medical Faculty organised by academic departments along subject disciplines to one that reflects the multi-disciplinary nature of medical education.

To increase the number of clinical graduates in Singapore to around 350 per year over the next ten to fifteen years, this number to include around 50 for R&D in industry and the public sector:

Short-term Strategy

(a)    To set up a second, graduate-only intake, or stream within NUS and based on SGH with an intake of 40 – 50 per year (assuming an intake of 200 for the existing NUS course). If necessary, the undergraduate entry to NUS could be slightly reduced to give the graduate entry school sufficient numbers.

5.11

7.9.2

Long-term Strategy

(b)    To start planning now for a second medical school at NTU based on Jurong Hospital, to be fully functional within ten years with an intake of 100 per year.

5.12

7.9.1

(a)    To establish around 200 full-time equivalent research posts, mainly physician/scientists where 75% of the time is protected for research, within the University, the Research Institutes, and the Hospital system for meeting the needs of Singapore to undertake clinical research.

(b)    Of these about 12 should be research lectureships within the medical faculty to act an immediate stimulus to university research.

(c)    To consider training at least 50 graduate clinicians per year in research to meet the needs of healthcare and the developing biomedical sciences industry.

(d)    To identify future clinical scientists early in their training for, if possible, two groups of scientists; those who go on to PhD training in the sciences after their medical training and those who go on to medical training after their PhD training in the sciences.

4.7

7.9.5

6.5

6.3

(a)    To create a career structure for researchers in biomedical sciences that extend from postdoctoral training into junior independent investigator positions and to senior scientist positions, for both PhD scientists and MD PhDs.

(b)    To put in place a career structure with independent secure posts funded on a competitive 5-year rolling basis. Remuneration for researchers should be competitive with that of those on the clinical track.

6.4-5

To establish an individual Fellowship programme similar to that supported by the Howard Hughes Foundation or the Wellcome Trust, for bio-medical and physician-scientists with 75% of their time protected for research. The scheme would cover both career grade and training positions and both would be reviewed on a five-year rolling basis.  Such posts would be expected to be held jointly between University, Institute and/or Hospital.  Funding and management of such a programme might appropriately fall to the BMRC.

To review the salary arrangements for clinical academics at NUS and the current disincentives for research removed.

To establish funding machinery (or modify the present machinery) to provide substantial funding on a competitive basis for a mix of programmatic- and individual-initiated research projects (i.e. top-down and bottom-up). Physician-scientists or biomedical scientists (PhDs and/or MD/PhDs), could be funded competitively with five to ten year programmes at an average annual programme cost of S$500,000.  This will require a new recurrent expenditure of S$100 million per year to sustain.

7.9.6

(a)    To set up a programme-centred initiative under which substantial funding is associated with a limited number of strategically chosen programmes, say four or so, at any one time. 

(b)    To focus future funding on the development of programmatic research activities around specific disease related programmes. The funding would cover both recurrent costs and some salaries.  The programmes would probably, but not necessarily, exclusively be located in universities.

6.11

To externally recruit the best programme directors as leadership is crucial for the success of these programmes. It is strongly recommended that all members of biomedical research institutes and programmes have some University affiliation and the graduate students will necessarily be enrolled through departments.

To ensure funding is merit-based by utilising internationally supported peer-review as Singapore is too small a research community to ensure that funding decisions will be truly independent and, hence, a strong cadre of international scientists need to be involved in determining the allocation of funds.

To encourage and develop critical mass in integrated projects that run between many disciplines, the funding of science needs to reflect a strategic balance between large top-down funded strategic projects and smaller investigator-led projects that are based around individual grant support with up to 70% of funding be allocated to large strategic projects.  [The ratio of funding between large top-down projects and smaller projects is subject to change and needs to be kept under continual review.]

(a)    To foster close relationships between the medical school and the existing clinical facilities at SGH and NUH so as to integrate basic biomedical science with clinical science for the successful development of research activity.

(b)    To place Biopolis very close to the NUH to encourage interactions, and if this is not possible, to set up simple and rapid communications between the two.

(a)    To foster constructive competition as an important element of the new arrangements where there could be competition between the two and ultimately three streams of medical students; competition for research positions and competition for research funding.

(b)     To recognise that there are areas where considerations of scale mean that competition has to be external rather than internal.

7.9.7

To make regular and informed use of the Science Citation Index by MOE and MOH to evaluate research progress in biomedical sciences internationally.