International Elective: National Neuroscience Institute, Singapore

elective placement, Singapore, National Neurology Institute, Austin Tan

By Austin Tan

I was humbly granted the opportunity to undertake a neurology/neurosurgery elective at the National Neuroscience Institute of Singapore in January 2023 for 4 weeks. Despite Singapore being my home country, this particular elective had been a very insightful exposure for me. It allowed me to recognise the differences in both the medical system and working cultures between Singapore and Australia. The demographics of Singapore are multi-cultural, most of the patients are often of Chinese, Malay or Tamil ethnic groups. While the Singapore medical system operates under the English language, the community converses in their own mother tongues and dialects. Although language barriers may seem like an issue, Singapore does have doctors from various ethnic backgrounds to cope with such problems and make the healthcare system all the more effective.

I have always been interested in the deep intricacies of the brain and its related topics; hence my decision to apply for the National Neuroscience Institute of Singapore. I also had the chance to sit in to weekly ‘skull base’ meetings where interesting cases and important decisions were made. During the elective, I also learnt to appreciate the process of patient flow, from the clinic/polyclinics to specialists to community discharge. I was also proactive in seeking out the latest research advances with regards to Parkinson’s ongoing management, and how the latest AI technology could improve patient outcomes.

For someone who prefers the adrenaline rush, I would definitely recommend taking an elective in Singapore. Singapore’s medical system is considerably fast paced compared to the Australian system. As for potential language barrier concerns, I personally wouldn’t sweat on it, as despite Malay being Singapore’s national language, most of its population communicates in English on a daily basis.

Some of the more memorable experiences are the ones spent in clinics or when taking a history or examining a patient. I was not only able to observe how my supervisor talks to patients with affection and clarity, but I was able to appreciate how he was able to talk to patients in a patient-centred language whilst avoiding jargons and laying out a clear management plan for their conditions. During some of my time spent alone with the patient on the wards, I was also able to comprehend how taking a collateral history is equally important, and how support services like physiotherapy and rehabilitation can provide crucial care to the journey of recovery. I also had the experience trying to communicate in my mother tongue, Mandarin, to aged patients who could only understand the language, and it is truly a revelation when you really start to be more observant about the verbal and non-verbal cues; it is when you have finally placed yourself in the patient’s shoes that you begin to truly understand them. It is when you understand them that you can provide the best care they deserve.

All medical things aside, Singapore itself is a bustling city with plenty of options for affordable food (average meal costs about $5) and cultural learning. You can visit the famous tourist attraction sites like Orchard or Bugis, or even its resort island of Sentosa. It will always be helpful to do prior research before choosing a country for your elective, and will be even more so if you have friends there!

Overall, my electives have taught me to appreciate that each country has its variations in the operations of the healthcare system, and is ultimately suited to the societal needs.