Career Overview     

Are you looking for variety, unpredictability and excitement? Then emergency medicine may be just for you

If you are thinking of a career in emergency medicine, you are probably attracted by the challenging, high-pressure environment of the emergency department.

As an emergency medicine specialist, you will be an expert in establishing an accurate diagnosis for undifferentiated symptoms with minimal history and time constraints. You must be able to identify the critically ill and injured, provide safe and effective immediate care and plan for definitive care. You will be looking after patients with a wide range of pathologies, in all age groups. The work is unpredictable and sometimes stressful, but it will never be dull.

You will have practical skills and expertise in resuscitation and be able to place patients on the correct care pathways that lead to appropriate discharge with follow-up, admission to an emergency department-based observation unit or admission to hospital.

Working in the emergency department, it is important to be a team player. You will develop important communication and interpersonal skills.

Aim of Program    

We will train you to be resuscitation leaders and acute care specialists, proficient in a wide range of resuscitative skills and managing problems across a wide age range. The NHG-AHPL Emergency Medicine (EM) Residency Program is a 5-year apprenticeship that covers the essential topics of emergency medicine as well as other aspects including pre-hospital and disaster medicine, observational medicine, communication and teaching skills, department management, simulation and ultrasound.

You will rotate through various clinical specialties, such as medicine, cardiology, geriatrics, surgery, trauma, orthopaedics, anaesthesia, and more. Built into our program are preparatory courses to guide you through the various examinations and you will also benefit from the integrated inter-department and inter-hospital teaching.

Tan Tock Seng Hospital has the largest Emergency Department in Singapore and has the highest trauma and SCDF ambulance volume amongst all the hospitals, presenting you with an opportunity to work with rich clinical material. Through graduated responsibility, close supervision and mentoring by an established and much sought-after faculty, supported by approachable and helpful nurses, a graduate of the Program will be a highly skilled, competent emergency physician, confident of holding his own in any situation.

Example of Rotation for R1 Residents     

R1 rotations

The R1's objectives will be to learn the art of targeted history and physical examination in an Emergency Department (ED) setting, the types of investigations to order and their interpretation. You will be given graded responsibility and paired with a senior resident or consultant. The ED’s focus is somewhat different from the wards, hence the necessity for immersion right from R1.

Typical sequence of rotations for subsequent years (each block is 1 month)

Faculty Members

Name	Designation and Department
Program Director:
Dr Kenneth Heng	Consultant, Emergency Department, TTSH
Dr Kenneth Heng is currently a consultant emergency physician at the Emergency Department, TTSH. He is the Program Director of the NHG Emergency Medicine residency program. He graduated from the National University of Singapore in 1994 and obtained Fellowship of the Royal College of Surgeons of Edinburgh (A&E) in 2001. His main interest is in trauma epidemiology and injury control and he has done fellowships at The Alfred Emergency and Trauma Centre, Melbourne Australia in 2002 and Injury Research Centre, Medical College of Wisconsin in 2005. He is actively involved in training and has held posts as Chairman of the Emergency Medicine Training Workgroup, Institute of Medical Education & Training (IMET), Chairman of TTSH Life Support Training Committee and is a member of the Specialist Training Committee in Emergency Medicine. He was given the Best Teacher Award in TTSH (senior category, surgical division) in 2006.
Faculty:
Dr Tay Seow Yian	Head and Senior Consultant, Emergency Department, TTSH
Dr Gregory Cham	Senior Consultant, Emergency Department, TTSH
Dr Lim Ghee Hian	Senior Consultant, Emergency Department, TTSH
Dr Chan Kim Chai	Senior Consultant, Emergency Department, TTSH
Dr Foo Chik Loon	Consultant, Emergency Department, TTSH
Dr Goh Hsin Kai	Consultant, Emergency Department, TTSH
Dr Loh Seow Siang	Consultant, Emergency Department, TTSH
Dr Ang Hou	Associate Consultant, Emergency Department, TTSH
Dr Vivian Siu	Associate Consultant, Emergency Department, TTSH
Dr Ooi Chee Kheong	Associate Consultant, Emergency Department, TTSH
Dr Lee Ching Ching	Associate Consultant, Emergency Department, TTSH
Dr Chan Wui Ling	Associate Consultant, Emergency Department, TTSH
Dr Wong Ming Hai Eric	Associate Consultant, Emergency Department, TTSH
Dr Madeline Puah	Associate Consultant, Emergency Department, TTSH
Dr Ng Kee-Chong	Senior Consultant and Head, Children’s Emergency (CE), KKWCH
Dr Darryl Lim	Associate Consultant, Children’s Emergency (CE), KKWCH

For further information, please contact:

Program Director: 

Dr Kenneth Heng            

Email: Kenneth_heng@ttsh.com.sg

Core Faculty:

A/Prof Tham Kum Ying

Email: kum_ying_tham@ttsh.com.sg   

Program Coordinator:

Ms Jocelyn Kwan

Email: Jocelyn_yk_kwan@nhg.com.sg

Frequently Asked Questions:  

Why is the NHG Emergency Medicine Residency Program the choice for me?  

Tan Tock Seng emergency department (ED) is the largest and one of the busiest EDs in Singapore. We have the largest short-stay ward, the Emergency Diagnosis and Treatment Centre (EDTC) and fever screening area. We are also the only ED with a purpose-built decontamination structure for HAZMAT incidents. This provides an excellent opportunity for you to hone your capabilities as an emergency physician with ample training material. Our proximity to Communicable Disease Centre also means that we will be the first to be called into action in the event of any infectious disease outbreak. You will have valuable infectious disease and emergency response experience that few EDs can provide.

Being part of a busy ED is hard work. While we value tenacity and perseverance in our residents, we are cognizant that residents must not become bogged down with service, and the faculty on shift will ensure that teaching and learning is optimized. We work together as a team to deal with emergencies and you will receive help and support not only from faculty members and doctors, but also from our nurses.

We are also involved in many regional outreach projects, such as teaching programs and humanitarian missions. This will enrich and enhance your training to be an emergency physician.

What are the exams that I have to take? 

The Membership of the College of Emergency Medicine of UK (MCEM) Part A should be completed between year 1 and 3, and Part B and C by the beginning of year 4. Promotion through the residency years does not depend on the outcome of the MCEM exams but is contingent on passing the end-of-posting and end-of-year competency tests. At the end of the fifth year of residency, you will sit for an exit examination comprising clinical, administration, teaching and critical appraisal components. We will prepare you to tackle these hurdles and we are committed to help you clear these exams on the first try.

Will there be a consultant job for me?   

Upon successful completion of the Residency Program, you will exit as an associate consultant. There is a great need for more consultant emergency physicians both in TTSH and nationally as the patient attendances continue to climb yearly and with the opening of two new hospitals. There is an emerging trend of older, sicker, unstable patients presenting to the ED. New evidence-based practices such as early-goal directed therapy for patients with sepsis has brought ICU-care to the ED and consultant emergency physicians are needed to manage this. The long-term plan is for a consultant-led service to ensure better, more expedient care for the patients.

What sub-specialization opportunities are available?  

At the end of residency, you will choose to do a fellowship in one of the following:

• Trama
• Toxicology
• Emergency Geriatrics
• Pre-hospital Emergency Medicine
• Disaster Medicine
• Observation Medicine
• Emergency Cardiology and Critical Care  

This will typically involve in an overseas or local stint under the HMDP scheme.

Are there opportunities for research?