Annual Report

2005

SingApoReMedicAlcouncil

Singapore Medical council annual report 2005

contentS Page

2 president’s Foreword

6 Members of Singapore Medical council

10 Medical Registration / Specialist Registration

14 complaints lodged with the council

16 disciplinary inquiries

1

President ’s Foreword

T h e b e g i n n i n g o f t h e y e a r

saw a change in leadership of the

Council. Dr.LeeSuanYew stepped

down asPresident and subsequently

retired from Council in August. As a

respected senior medical practitioner

and a former President of the College

ofFamilyPhysicianshehad awealth

ofexperienceandwisdom. Heserved

the Councilwithgreat distinction as

President for 4 years and as a council

member for 12years. TheCouncil is

indebtedtohimforhisableleadership

andguidance.

Drs ClarenceTan andLimLean

Huat steppeddownafter serving the

Council forover10years. DrAdrian

Leong and Prof Low Cheng Hock

also completed their terms and left

the Council. They have sacrificed

manydaysandhoursoftheirfreetime

in the interest of the profession and

the council ismost grateful for their

dedicatedservices.

The Counc i l was p leased to

welcome back Drs Tan Kok Soo, Tan

ChiChiuandRichardGuanwhowere

re-elected and Prof RNambiar and

LowPohSimwhowere reappointed.

TheCouncilalsowelcomedtwonewly

elected members, Prof NgHanSeong

andDrThirumoorthy and twonewly

appointedmembers,A/ProfHoLai

YunandDrLimCheokPeng.

All are well respected senior

membersof theprofession and their

contributions will add much value to

theCouncil.

House officer training

The house o f f i c e r yea r i s a

crucialpartofthetrainingofadoctor.

2

Therefore we who are involved in

training should ensure that these new

doctorsreceivewellsupervisedquality

training not only to achieve good

clinical knowledge and skills but also

develop good communication skills,

rightattitudeandprofessionalbehavior

in preparation for full registration.

T h e M e d i c a l C o u n c i l h a s b e e n

responsibleforapprovinghospitalsfor

the training of house officers. SMC

defined the standards, goals and made

recommendations for credentialing of

houseofficer training in the training

departments. Three site visits in the

last 5 years to training hospitals and

interviews withdoctors and feedback

fromhouseofficerswereconductedas

part of regular reviewand assessment

oftraining.

temporary Registered doctors

S ince 2001 there has been a

steady increase in the number of

fo re ign t ra ined doc to rs seek ing

temporary registration inSingapore.

Since temporary doctors are under

training,theymustbesupervised.The

SMChas imposed stricter supervisory

requirements and regular assessment

reports in order to maintain high

standards of practice. The Council

would like to see those recruited for

service needs to have a fewyears of

experience and relevant postgraduate

qualification.

c o m p l a i n t s a n d d i s c i p l i n a r y

Hearings

Thecouncilreceivedatotalof83

complaints against 101doctors during

the year.Honesty, integrity andgood

practice are essential qualities in our

interaction and communication with

patients.Seriouspersonalmisconduct

cases when reported in the media

reflectpoorlyon themoralandethical

standingofourpractitioners.

A l t h o u g h t h e n u m b e r o f

complaints at 12.3 per 1000 doctors

hasnot increasedfrompreviousyears,

3

the number of cases of excessive or

inappropriate prescriptionof drugs is

a cause for concern. Inappropriate

prescription of opiates hypnotics

and other addictive drugs must be

dealt with punitively. Therefore,

doc to r s who t r ea t pa t i en t s wi th

chronic dependency on hypnotics

andother drugsmust exercise special

care. Failure to assess the medical

indication is not in line with good

medical practice. Suchdrugsused

inappropriatelycanresultinaddiction.

continuing Medical education

CompulsoryCMEwasintroduced

in2003andallfullyandconditionally

registered doctors holding 2-year

practising certificateswere required to

obtain aminimum of 50points over

a periodof twoyears.Doctorswho

have notmet theCME requirement

are not a l lowed to pract ise once

their practising certificates expire.

They will have to accumulate the

shortfall ofCME points before they

can renew their practising certificates.

Out of a total of 1218 doctors whose

CME qualifying period ended on31

December2005,1207or(99%)doctors

fully met the CME requirement. The

majority of the11doctors whodid

notmeet the requirement were either

not practising, had left Singapore or

hadinformedtheCouncilthattheydid

not intend to renew their practising

certificates.

Revalidation and Maintenance of

competency

I t i s o f in te res t to no te tha t

following a series of apparent failures

of professional regulation inU.Kand

U.S.A, the issueof revalidationor the

evaluation of medical doctors’ fitness

to practicehasbeenmuchdebated.

Revalidation is to assure thepatients

and thepublic that doctors continue

to perform effectively and also to

identifypoorperformingdoctorsearly.

CME in its current form may result

in some increase in knowledge but

4

cannot show onwhat a doctor cando

or has actually done. The standards

andassessmentmethodsarestillbeing

workedout.

A s t h e e m p h a s i s i s o n

performance in pract ice, doctors

will be expected to maintain clear

records of a l l c l in ica l work and

educational experiences.Recordsof

CMEandprofessional development,

information onprescribing practices,

audits of clinical practice, feedback

from patients and peers and even

mandatory tests of knowledge and

skills are considered as potential tools

to screen for acceptable performance

andpractice. TheCMECommittee of

themedical councilwill be studying

the issues and developments in other

countries carefully before we take our

nextstep.

conclusion

Medical Practice is becoming

m o r e c o m p l e x w i t h i n c r e a s i n g

globalization. There are numerous

factors that increase the temptation to

engageinunethicalpractices.Doctors,

more than anyother professionals are

alwaysunderpublicscrutinyregarding

selfregulationofprofessionalpractice.

Serious problems may arise from

poor awareness, communication and

behaviorthanfromlackofknowledge.

“In this competitive environment,

while we have to constantly strive

to raise our standardof care to our

patients we also need to pay equal

attention to our conduct and ethical

standardsinourdailypractice.”

RajM.Nambiar

5

Members Of Singapore Medical Council 2005

President ClinicalProfRNambiar

Registrar ProfKSatku

NUSNominees ProfJohnWongEuLi ProfRobertPhoWanHeng

ElectedMembers ClinicalAssocProfChanYewWeng ClinicalAssocProfGilbertChiangShihChuin DrHoNaiKiong DrRichardGuan DrTanChiChiu ClinicalAssocProfTayBoonKeng ProfNgHanSeong DrTanKokSoo DrTThirumoorthy

AppointedMembers ClinicalAssociateProfHoLaiYun (from1Sep2005)

ProfLeeEngHin DrLeeSuanYew (until31Aug2005)

DrLimCheokPeng (from1Sep2005)

ProfLowPohSim ClinicalProfLowChengHock (until31Aug2005)

AdjunctProfWalterTanTiangLee DrYapLipKee

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Other Members Of Singapore Medical Council 2005

A/Prof Chan Yew Weng

Prof Robert Pho

A/Prof Ho Lai Yun

Prof Lee Eng Hin

Dr Yap Lip Kee

Prof Low Poh Sim

Dr Richard Guan

Dr Lim Cheok Peng

Dr Tan Chi Chiu

Dr T Thirumoorthy

8

9

Medical Registration / Specialist Registration

Medical Registration

As a t 31 Dec 2005, a tota l of6748 medical practitioners were fullyor conditionally registered inSingapore,resulting in a doctor to population ratioof1:640.

In2005,theCredentialsCommitteecons ide red 1142 app l i ca t ions fo rregistration. 1033 medical practitionerswere reg is te red of which 96 werepreviously on conditional registrationand15on temporary registration.Thebreakdown of the registration granted isgiveninTable1.

O f t h e 2 6 5 o n p r o v i s i o n a lregistration, 210 were NUS medicalgraduates and55weregraduates fromforeign universities granted medicalregistration to dohousemanship trainingin restructured hospitals and institutionsforoneyear.

Among the 342 foreign-trained,medical practitionersgranted temporaryregistration, 95were employed toworkunder supervision on short-term basisin restructured hospitals or institutions.Another 152were foreignpractitionersaccepted for postgraduate training inSingapore. 951 visiting experts wereinvited by the hospitals and medicalorganisations to provide short-termtrainingandconsultancy.

T h e r e w e r e 7 4 m e d i c a lpractitioners not in active practice dueto various reasons such as retirement,working or studying overseas. Thesea re doc to r s who had no t r enewedtheir practising certificates in 2005. 7medical practitioners were restored totheMedicalRegisterwhentheyreturnedtoresumepracticeinSingapore.

As compared to 2004, the totalnumber of doctors as at 31 Dec 2005registeredanetincreaseof256doctors.

Specialist Registration

As at 31 Dec 2005, there were2511doctors registered as specialists onthe Register ofSpecialists.The numberof specialists had increased by 144(6.08%)ascomparedto2004.Theyalsorepresented 37.2% of the 6748 medicalpractitioners registered inSingapore.The numbers of registered specialists inthevarious specialities are inTable 4.Table 5 shows the trends for specialist’sregistration.ThenumbersfromYear2000toYear 2005 were the cumulative totalasat31Decemberoftheyear.

1 Including 48 doctors who were registered previously.

10

Registration types total

Medical practitioners Registered from:

Medical practitioners from:

new Applications

provisional Registration

temporary Registration

conditional Registration

Full - 203 - 96 299

Conditional 86 26 15 - 127

Provisional 265 - - - 265

Temporary 294 - 48 - 342

total 645 229 63 96 1033

Registration types Singaporean

nuS trained Foreign trained

non-Singaporean

Full 177 18 8+10* 86* 195 104 299

Conditional - 1 16 95+15* 16 111 127

Provisional 188 22 14 41 202 63 265

Temporary - - - 294+48* - 342 342

total 365 41 48 579 413 620 1033

Singaporean non-Singaporean Singaporean non-

Singaporean

Sub-totaltotal

*doctors converted from conditional registration (for fully registered doctors) or temporary registration (for conditionally registered doctors)

Registration types 2000 2001 2002 2003 2004 2005

Full Registration 170 215 156 182 201 203

NUSDegree 146 153 146 175 193 195

ForeignDegree 24 62 10 7 8 8

conditional Registration 114 146 121 128 114 112

NUSDegree - 1 - 1 - 1

ForeignDegree 114 145 121 127 114 111

provisional Registration 173 173 187 213 239 265

NUSDegree 156 144 175 195 197 210

ForeignDegree 17 29 12 18 42 55

temporary Registration 252 193 334 256 345 342

ForeignDegree 252 193 334 256 345 342

Note: This table does not include conversion cases.

table 1: new Medical Registration by Registration type in 2005

table 2: new Medical Registrations by citizenship and training in 2005

table 3: Medical Registration by Year and place of Medical training

11

1. Anaesthesiology 124 100 224 55 452. Cardiology 52 46 98 53 473. CardiothoracicSurgery 15 12 27 56 444. Dermatology 30 30 60 50 505. DiagnosticRadiology 91(1) 44 135(1) 67 336. EmergencyMedicine 48 4 52 92 87. Endocrinology 32(1) 15 47 68 328. Gastroenterology 35 23 58 60 409. GeneralSurgery 82 83 165 49 5110. GeriatricMedicine 32 6 38 84 1611. Haematology 22 8 30 73 2712. HandSurgery 11 1 12 92 813. InfectiousDisease 21 4 25 84 1614. InternalMedicine 24(1) 36 60(1) 40 6015. MedicalOncology 32 15 47 68 3216. Neurology 38 12 50 76 2417. Neurosurgery 14 12 26 54 4618. NuclearMedicine 8 6 14 57 4319. Obstetrics&Gynaecology 74 191 265 28 7220. OccupationalMedicine 9 23 32 28 7221. Ophthalmology 81 44 125 65 3522. OrthopaedicSurgery 76 43 119 64 3623. Otorhinolaryngology/ 35 33 68 51 49 ENTSurgery24. PaediatricMedicine 92 115 207 44 5625. PaediatricSurgery 9 4 13 69 3126. Pathology 74 19 93 80 2027. PlasticSurgery 12 20 32 38 6228. Psychiatry 65 43 108 60 4029. PublicHealthMedicine 52 22 74 70 3030. RehabilitationMedicine 14 2 16 88 1231. RenalMedicine 21 13 34 62 3832. RespiratoryMedicine 45 18 63 71 2933. Rheumatology 19 6 25(1) 76 2434. TherapeuticRadiology/ 17 4 21 81 19 RadiationOncology

35. Urology 29 19 48 60 40 total 1435 1076 2511 57 43

()denotesnumberofdoctorswithdualspecialties.

no. Specialities public Sector

private Sector total

Ratio in %public private

table 4: Specialist Registration as at 31 dec 2005

12

1. Anaesthesiology 166 173 196 203 211 224 34.9

2. Cardiology 68 72 77 83 89 98 44.13. CardiothoracicSurgery 21 23 25 26 29 27 28.64. Dermatology 44 47 48 48 55 60 36.45. DiagnosticRadiology 88 97 111 118 128 135 53.46. EmergencyMedicine 21 24 30 34 41 52 147.67. Endocrinology 33 34 37 41 46 47 42.48. Gastroenterology 43 46 52 54 58 58 34.99. GeneralSurgery 126 128 133 150 156 165 3110. GeriatricMedicine 17 22 23 32 35 38 123.511. Haematology 21 24 25 30 30 30 42.912. HandSurgery 7 7 8 9 10 12 71.413. InfectiousDisease 11 13 14 16 18 25 127.314. InternalMedicine 45 46 52 55 58 60 33.315. MedicalOncology 23 27 31 37 43 47 104.316. Neurology 36 37 45 47 47 50 38.917. Neurosurgery 21 23 23 23 25 26 23.818. NuclearMedicine 6 6 9 10 10 14 133.319. Obstetrics&Gynaecology 225 233 241 253 262 265 17.820. OccupationalMedicine 28 29 29 30 32 32 14.321. Ophthalmology 86 90 96 108 117 125 45.322. OrthopaedicSurgery 86 92 98 103 111 119 38.423. Otorhinolaryngology/ 55 58 63 65 66 68 23.6 ENTSurgery24. PaediatricMedicine 156 169 181 184 193 207 32.725. PaediatricSurgery 11 11 12 13 13 13 18.226. Pathology 72 69 74 84 88 93 29.227. PlasticSurgery 24 26 30 30 31 32 33.328. Psychiatry 86 92 95 97 105 108 25.629. PublicHealthMedicine 60 67 67 67 71 74 23.330. RehabilitationMedicine 11 11 12 13 15 16 45.531. RenalMedicine 25 24 29 33 34 34 3632. RespiratoryMedicine 42 46 49 53 58 63 5033. Rheumatology 15 14 19 19 22 25 66.734. TherapeuticRadiology/ 11 17 17 18 20 21 90.9 RadiationOncology

35. Urology 29 33 37 38 43 48 65.5

total no. of Registered Specialists 1819 1930 2088 2224 2367 2511 38.0 as at 31 december each year:

no. Specialty / Year

table 5: total number of Specialists as at 31 december in Year 2000 to 2005

2000 2001 2002 2003 2004 2005 increase(in %)

13

Complaints Lodged With The Council

Year total no. of total no. of doctors complaints per complaints Received on Register 1000 doctors

complaints Received

TheCouncilreceivedatotalof83complaints against 101 doctors duringthe year compared to 84 complaintsin 2004 and66 complaints in 2003(seeTable6).Therewasnosignificantincrease in complaints for the past 5years.

Out of the132 cases consideredduring the year, including the 49complaints carried forward from2004, 1waswithdrawnand46were

dismissed. 27medical practitionerswere issued letters of advice and10 were issued letters of warning.15 cases were referred for ei thera Disciplinary inquiry or a HealthCommittee hearing. 33 cases wereadjournedto2006.

The main complaints concernprofessional negligence/ incompetence(38%) , i nappropr i a t e t r ea tmen t(16%), and excessive/inappropriateprescriptionofdrugs(13%).

table 6 : complaints Received by the Singapore Medical council1995 - 2005

1995 36 4495 8.0 1996 66 4661 14.2 1997 57 4912 11.6 1998 55 5148 10.7 1999 45 5325 8.5 2000 60 5577 10.7 2001 84 5922 14.2 2002 69 6029 11.4 2003 66 6292 10.5 2004 84 6492 12.9 2005 83 6748 12.3

14

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6

Professional Negligence/ 20 23 1 19 6 2 15Incompetence

Misdiagnosis 4 4

Over/Unnecessary/ 6 10 6 7 2 1Inappropriate treatment

Excessive/ Inappropriate 5 15 1 3 2 12 2prescription of drugs

No informed consent 7 3 2 1 1

Improper delegation of 1 1duties

Failure to perform 1 1appropriate tests

False / Misleading 3 3 2 1 1 2certification

Refusal to provide 2 2 3 1emergency attention

Providing false information 1 3 1 1 2

Delay in treatment 1 1

Fitness to practice 1 1 1 1

Breach of SMC Code of 2 4 1 1 4Ethics

Abusive behaviour 1 1

Conviction in court 1 1

Other Complaints 5 10 5 5 1 4

Total 49 83 1 46 27 10 14 1 33

15

There were 7 disciplinary inquiries completed in 2005 under the Medical Registration Act (Cap 174). A brief account of each case is given below:

E x c e s s i v e / I n a p p r o p r i a t e Prescription of Drugs

Case 1:

A m e d i c a l p r a c t i t i o n e r w a s convicted of 6 charges of inappropriate prescript ion of benzodiazepines, hypnotic medication and amphetamine-type slimming pills to her patients without clear documentation of her patients’ diagnoses, symptoms and/or conditions in her clinical notes over the period of treatment.

T h e p r a c t i t i o n e r w a s u n d e r treatment for chronic endogenous depression and was not present or legally represented at the inquiry. In the psychiatrist’s opinion however, the practitioner was fully aware of what she was doing when she prescribed the benzodiazepines and other medications to her patients.

The practit ioner was censured and suspended for 12 months. She was also ordered to pay the costs of

the proceedings. Once suspension is completed, her application to the Medical Council for a practising certificate must be supported by a psychiatric report certifying fitness to continue practice as a doctor.

Case 2:

A m e d i c a l p r a c t i t i o n e r w a s c o n v i c t e d o f 1 5 c h a r g e s o f i n a p p r o p r i a t e p r e s c r i p t i o n o f D h a s e d y l a n d / o r S u n s e d y l t o h i s p a t i e n t s w i t h o u t a n y c l e a r d o c u m e n t a t i o n o f t h e p a t i e n t ’sdiagnosis or indications for treatment.

The practitioner claimed that the medical records were tampered with and that many of the entries in the medical records of repeat sales of cough mixtures were made without his knowledge and consent. However, the Disciplinary Committee (DC) found that all the disputed entries in the medical records had been initialed and the practitioner had accepted the initials as his. The disputed entries were also interspersed with his own accepted entries and consultation notes. Hence, the DC held that when the pract i t ioner ini t ialed against the accepted entries or wrote his consultation notes, he could not have

Disciplinary Inquiries Held In 2005

16

failed to notice the disputed entries. The notes in the clinical records were deemed to be accurate.

The practitioner was censured and suspended for a period of 15 months. He was also fined $10,000, ordered to give an undertaking to abstain from the conduct complained of and to pay the costs of the proceedings.

Improper Delegation of Duties

Case 3:

A medical practitioner pleaded g u i l t y t o 2 o u t o f 3 c h a rg e s o f professional misconduct. These 2 charges related to improper delegation to her nurse for a procedure involving a Class 4 medical laser on 2 separate occasions. This was in contravention of the licence issued to her by the Centre for Radiation Protection (CRP), Health Sciences Authority (HSA).

The DC held that the practitioner’s breaches of Regulations 9(4) and 15 of the Radiation Protection (Non Ionising Radiation) Act 1991 by the improper delegation of the use of the laser to her nurse were serious offences. The practitioner claimed trial on the 3rd charge that related to her failure to properly manage the treatment of her patient by recommending non-

ablative laser therapy based on the patient’s clinical presentation. The DC held that this error of judgement on the part of the practitioner did not amount to professional misconduct. Hence, she was acquitted of this charge.

The DC also highlighted to the practitioner that she should correct h e r p o o r r e c o r d k e e p i n g o f h e r patients’ case notes including sloppy notations (ambiguous terms, incorrect t e r m i n o l o g y ) a n d t h e o m i s s i o n of important parameters for laser treatment in the operative notes.

The practitioner was censured and suspended for a period of 3 months. She was also fined $10,000, ordered to give an undertaking to abstain from the conduct complained of and to pay the costs of the proceedings.

Conviction In Court

Case 4:

A medical practitioner pleaded g u i l t y t o a c h a rg e t h a t s h e w a s convicted of an offence punishable under section 324 of the Penal Code in year 2003. The conviction related to the practitioner voluntarily causing hurt to her 19-year-old domestic maid by scalding her with a hot iron on her right forearm. The practitioner had been sentenced to 4 months’

17

imprisonment under section 324 of the Penal Code.

The practit ioner admitted that what she did was wrong and that it was done impulsively under trying conditions. She had regretted her action and was extremely remorseful. S h e a p o l o g i s e d t o t h e M e d i c a l Council for the trouble her action had caused and for disgracing the medical profession.

The practitioner was censured and suspended for 6 months. She was also ordered to undertake to abstain from the conduct complained of and to pay the costs of the proceedings.

Professional Negligence

Case 5:

A m e d i c a l p r a c t i t i o n e r w a s convicted of 2 charges of professional misconduct. The 1st charge alleged that he was in willful neglect of his duties and grossly mismanaged the treatment of his patient. The 1st charge alleged that he was in willful neglect of his duties and grossly mismanaged the treatment of his patient. He failed to adequately assess the medical condition of his patient and to refer him to hospital for further management of a serious medical condition. i.e. appendicitis. The 2nd charge alleged that

he failed to keep proper medical records of the consultation with his patient.

The DC held that the practitioner’sabdomina l examina t ion was no tadequately conducted or documented. He had failed to take an adequate medical history and examine the patient properly. The fact that the patient’s condition had not improved despite earlier treatment by another general pract i t ioner should have alerted him that there could be a serious underlying condition that merited a referral to the hospital. His professional conduct was deemed to be dishonourable.

The DC also found the practitioner’smedical record-keeping inadequate. The clinical records of his consultation would not have enabled another doctor to take over the management of this case. The DC held that this was important since the practitioner was working as a locum at the clinic.

The practitioner was censured and ordered to give an undertaking to take a full medical history of his patients and keep adequate clinical records. He was fined $10,000 and ordered to pay the costs of the proceedings.

Case 6:

A medical practitioner faced 2 charges of professional misconduct.

18

The f i r s t charge a l leged tha t he failed to deliver a standard of care a p p r o p r i a t e t o h i s s p e c i a l t y b y neglecting to perform an ultrasound scan on his patient to determine the size of her fibroids before performing laparoscopic surgery. The 2nd charge alleged that he failed to properly inform his pat ient the resul ts of laparoscopic surgery, hence giving his patient a false impression that the 2 fibroids he removed were the 2 fibroids that were identified in the patient’s ultrasound scan report.

A t t h e c o n c l u s i o n o f t h e Prosecut ion’s case , the Defence Counsel informed the DC that the medical practitioner would not testify and would not call any witnesses. The DC was disappointed that as a senior member of the profession, the practitioner did not show the degree of co-operation with the DC as would be expected. His failure to testify gave rise to questions whether he had something to conceal.

The DC held that although the practitioner’s failure to perform an ultrasound scan on his patient fell short of good clinical practice and this omission may be construed as negligence on his part, negligence m u s t b e o f a n a t u r e t h a t w o u l d reasonably be regarded as disgraceful or dishonorable by his professional b r e t h r e n o f g o o d r e p u t e a n d

competency to amount to professional misconduct.

The DC found no evidence on which it could infer an intent that the practitioner ’s omission on the information on the fibroids was a willful attempt to mislead the patient. Hence, the practitioner was acquitted of both charges.

Breach of Ethical Code

Case 7:

A medical practitioner pleaded guilty to 5 charges of professional misconduct. These charges were in respect of the statements that she made in a Business Times article dated 2 July 2004 entitled “Flatter your Skin”. The following statements made were in breach of Regulation 17 of the Medical Registration Regulations read with Sections 4.3.1, 4.3.2, 4.3.3, 4.4.2 and 4.4.3.1 of the SMC’s Ethical Code and Ethical Guidelines

The practi t ioner did not make any public withdrawal or apology for the offending remarks. The DC held that remarks made about fellow practitioners especially in public, should not inter alia, undermine the trust in a professional colleague’sknowledge of skills and deprecate other practitioners.

19

The practitioner was censured, f ined $5000, o rdered to g ive an under tak ing to abs ta in f rom the conduct complained of and to pay the costs of the proceedings.

Health Inquiry held in 2005

T h e r e w a s o n e H e a l t h i n q u i r y completed in 2005 under the Medical Registration Act (Cap 174). A brief account of the case is given below:

Case 1:

A medical practitioner suffered from schizophrenia characterized by paranoid delusions and hallucinations which caused his fitness to practise to be impaired. He had responded previously to psychiatric treatment and his symptoms improved. However, he suffered from 3 relapses in Feb 2001, Mar 2002 and May 2005 and was admitted to the Institute of Mental Health (IMH) after his third relapse.

The practitioner admitted to the Health Committee that he will not be able to cope mentally with the stresses of clinical practice and he had no immediate plans to return to clinical practice. In the light of the practitioner ’s own admission, the Health Committee recommended to the Medical Council that in the public and the doctor’s interest that:

(i) h is name be removed from t h e R e g i s t e r o f M e d i c a l Practitioners; and

(ii) s h o u l d h e a p p l y f o r t h e restoration of his name to the Register in the future, that his application for restoration be accompanied by a psychiatric report on his fitness to practice medicine.

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E-mail:moh_smc@moh.gov.sg

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