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Issue 6 . October 2011 . Page One

The PRiME Update keeps our physicians posted with the latest happenings in the area of education and research in SHP.

PRiME Time News 3rd SHP Clinical Update Symposium A record 220 staff and GPs attended the 3rd SHP Clinical Update Symposium organised by PRiME on 9th July 2011 held at the Grand Hyatt PRiME Training Singapore - 30% more than last year! Specialists Update highlights from other institutions including SGH, CGH, the happenings NNI, TTSH spoke and shared on various clinical around SHP topics like Diabetes Mellitus, stroke, managing common childhood behavourial problems, liver conditions, lower back pain, etc. Feedback has been very positive -100% of the participants found the symposium useful.

1st Live Telecast of CME The regular clinic CME sessions have taken a new twist amidst proliferating technology in this new era. 23 August 2011 marks the first day when CME takes on the Simulcast platform, a collaboration between PRiME and SingHealth Academy, featuring the topic on Obesity – Medical Management by Dr Joan Khoo, Consultant from CGH Dept of Endocrinology. Simulcast taps on technology to allow 1 or more sites to view the teaching session simultaneously from another location in real time. It allows viewers to view both the speaker’s face together with the synchronized set of slides without the need to be physically at the delivering site. Gaining positive feedback from its first session, PRiME is intending to roll this out to all 9 polyclinics in the near future.

SingHealth Family Medicine Clinician Leadership Programme The last batch of Fujian training was concluded during 18 to 29 July 2011. 22 China delegates sat in the various training in the area of management and chronic disease management including Human Resource Management, Principles of Family Medicine & Preventive Care etc. The training was conducted through various activities such as didactic teachings, interactive sessions and workshops. On the last day of the training, all participants shared with what they have learnt during the 2-week attachment, and how they would be able to apply it onto their work in a different culture setting.

MSP + Dermatology Workshop This popular workshop has once again been rolled out to our current batch of new Medical Officers. Many procedures were taught during the 2 sessions held on 25 June and 30 July 2011, including Elbow Injection, Shoulder Injection, etc. Participants are presented both theoretical and hands-on experience during this 4-hour session. 100% of the participants feedback that the training was effective and they have gained new knowledge from the workshop. They also agreed that the contents covered are relevant to their work and the useful knowledge translated to managing their patients better. Brought to you by SHP Education & Research

For Internal Circulation Only



Issue 6 . October 2011 . Page Two

The PRiME Update keeps our physicians posted with the latest happenings in the area of education and research in SHP.

Clinical Tips : Treatment of viral warts and callosities PRiME Training Update highlights the happenings around SHP

For treatment of viral warts and callosities, one option is the use of concentrated salicylic acid (as in Duofilm). While this is appropriate for most patients, it should not be used in patients with Diabetes Mellitus, and those with Peripheral Vascular Disease of any aetiologies. Concentrated Salicylate can aggravate the problem of impaired circulation, and cause gangrene of the tissue.


Studies have confirmed the effectiveness of this treatment modality (66% treatment group vs 18% placebo group). To optimize treatment, patient should be given proper instructions. The lesion should be soaked for 5-10 min in warm water, and dried. This is followed by rubbing the lesion with pumice stone or emery board to remove the softened surface tissues. Apply the medication, allow to dry and cover the lesion with a plaster. While cure may take 6 to 12 weeks, there should be a review 2-3 weeks to assess response.

Medical Student Attachment (24 Oct – 3 Nov 11)

MMED Mock Exam (8 Oct 11) New MO Posting (31 Oct 11)

CME Simulcast (28 Oct 11)

CME Simulcast (7 Dec 11)

Heartsaver Course (20 Dec 11) Dec’11

CME Report Target: Clinics should target to conduct at least 2 CMEs per month Target of 6 CME in 3 months

18 16 14 12 10 8 6 4 2 0

PRiME Reports

Clinics CME per posting (Aug - Oct 11)


12 10








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Accumulated Clinic CMEs over 6 months (For posting period from May 11 to October 11) Target of 12 CME in 6 months

33 30 27 24 21 18 15 12 9 6 3 0

Clinics CME per posting (May - Oct 11)





21 17



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Brought to you by SHP Education & Research

Medical Student Attachment Sep 2011 25 medical students completed the Feedback on the last day of their 2 weeks attachment at SHP. The top 3 activities ranked most useful by the students include Case Clerking & Presentation, Sit-in and Observation of cases & Discussion of Observation of cases. The students are asked if they have a preferred choice in medicine before coming to this polyclinic posting, a high 56% indicated that they are inclined towards becoming a hospital specialist, compared to a low 8% whose inclination is towards Family Medicine. Interestingly, after going through the polyclinic posting, 68% feedback that they would consider becoming a Family Physician! “…never ever have I truly appreciated the beauty of polyclinics and family medicine till we came under your wings…” Medical Student, CG28 For Internal Circulation Only



Issue 6 . October 2011. Page Three

The PRiME Update keeps our physicians posted with the latest happenings in the area of education and research in SHP.

PRiME Research Highlights Research Workshop Participants from various departments, including medical, nursing and pharmacy, attended the 2-day workshop conducted by Dr Tan Ngiap Chuan on 14 July and 2 August. Various research techniques were taught, and the participants also have first-hand experience in conducting a focus group discussion on their selected topic and transcribing the contents thereafter. After the end of the 2-day session, the participants will continue to meet up periodically to continue on with their research project, which they would be embarking on for the following one year.

New Publications S/N


Name of Journal

Year of Publication

Volume Number

Page Number




Health-related Quality of Life is Associated with Diabetic Complications, but not with Short-term Diabetic Control in Primary Care

Ann Acad Med Singapore




Dr Joanne Quah

Nan Luo, Wai Yee Ng, Choon How How, Ee Guan Tay

New Research Projects S/N 1





Start Date

How do primary care physicians manage their health & disease?

Dr Christopher Chang Ngai Kin


Oct 11

A/Prof Serena Koh Siew Lin



Registered nurses' knowledge on risk factors, prevention, screening and treatment for osteoporosis

Family Medicine Residency Program MOH Primary Care Work Plan Seminar 2011 Residents and faculty attended the MOH Primary Care Work Plan Seminar on 8 Oct 2011 to learn about Singapore’s health care system and the role of primary care, an important aspect of the competency of systems-based practice. It was an opportunity hard to come by to hear from MOH and the Minister for Health on the direction forward for care integration with Regional Health Systems, Community Health Centres and Family Medicine Centres. RHS, CHC, FMC, PCPS, CDMP were some of the new concepts and acronyms that were rolling off their tongues by the end of the session which concluded with a wrap up of the learning objectives and review of pre-session MCQs, facilitated by Drs Adrian Ee, Derek Tse and Sally Ho.

Accreditation Timeline


PIF Submitted: 12 Sep Internal Dry run: 30 Sep Accreditation Site Visit: 20 Oct

Abstract Highlight A Qualitative Study of Parental Use of the Written Asthma Action Plan for Their Children in Primary Care in Singapore Ngiap Chuan Tan, Wern Fern Soo and Agnes SH Ngoh A symptom-based written asthma action plan (WAAP) was introduced to both adult and pediatric patients as part of the evidence-based local clinical practice guidelines to educate patients in asthma self-management in Singapore in 1998. This article aimed to explore the issues pertaining to the parental use of the WAAP for their children with asthma. A qualitative method using focus group discussions was used to gather qualitative data from parents of children with asthma who are on review at primary care clinics in Singapore. Qualitative data analysis based on grounded theory was carried out to identify emergent themes. Parents expressed difficulty in differentiating asthma-related symptoms from early symptoms of an upper respiratory tract infection. Because of the failure to recognize cough as an asthma-related symptom, they focused more on symptomatic treatment of cough. They often relied on their own assessment of their children’s asthma status and sought medical consultation soon after onset of the children’s symptoms, rather than adjusting their inhaled medication. This deviated from the WAAP given by their physician. Their threshold to consult a doctor was thus variable, reflecting their confidence in self-management of their children’s asthma condition. Factors that hinder the implementation of the WAAP for children included difficulty in symptom recognition, parental focus on symptomatic treatment, and confidence issues in using the tool. Journal of Asthma & Allergy Educators 2(4):185–188

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The PRiME Update October 2011