SingHealth Anaesthesiology Residency Program (SHARP) - A New Era

We hear from A/Prof Darren Koh, Program Director from 2014 - August 2021, Dr May Mok, who took over as Program Director with effect from 1 Sept 2021 and Dr Angela Tan, who will be Associate Program Director (APD), KKH with effect from 1 Jan 2022.

We asked A/Prof Darren Koh for his thoughts on stepping into new roles, challenges faced in Education and stepping down as the Anaesthesia Residency Program Director after seven years at the helm.

ACP: Congratulations on your promotion to Clinical Educator Lead at SGH, Prof Koh. Can you give us an idea of what your new role entails?

DK: Thank you! The clinical educator lead (CEL) is responsible for the clinical training of all medical students in SGH. As the associate dean, I liaise closely with the NUS-Yong Loo Lin School of Medicine, Duke-NUS Medical School and Lee Kong Chian School of Medicine to ensure that the curriculum of the medical students is met. I need to be attuned with the SingHealth Duke-NUS academic medical centre’s mission for the undergraduate education. The areas of focus include the optimisation of resources and facilities and ensuring the fulfilment of learning outcomes for the medical students. Faculty development and advancing the educator appointments of doctors are priorities to me too. In addition, I work closely with our SGH education council, program leads (who are doctor representatives) and administrative staff to streamline and coordinate the provision of teaching by all our specialty programs.

ACP: Is there a difference between post-graduate and under-graduate training?

DK: In post-graduate training, the residents are akin to my own children. I ensure their growth, well-being, and administer discipline like their parent. As the saying goes, a country has its laws and a family its rules ‘国有国法，家有家规’. For undergraduate training, the students are like other people’s children. Now, I feel as if I am running a childcare centre where parents drop off their kids every morning and come pick them up in the evening. It is really a different ball game, needing to focus on their safety, classroom learning, discipline and entertain them like a school teacher. 

ACP: What are your thoughts on stepping into new leadership roles?

DK: Starting a new leadership role is like a sculptor setting out on a new work of art. He needs time to assess his materials and tools to carve out something fine. He needs to adapt, grasp new concepts and apply his knowledge and skills carefully. It’s an exciting time and often with lots of vigour and inspiration. With trials and errors, it takes the first three years to come up with the idea and formation of his work. The next three years, he should see his sculpture in its true splendour.

ACP: What is the main challenge faced in medical education today?

DK: I feel that we are approaching the boiling point of the demand and stress in our clinical work environment. Factors like COVID-19 pandemic, demand from patients and their family add fire to these. The presence of medical students and untrained personnel would accelerate it. However, we do know that it is imperative to educate our young. I am glad that our faculty are aware of this and putting in lots of commitment and dedication. With this challenge, educators must trust that our learners will learn and contribute immensely one day. Patience and kindness will go a long way. As for the learners, they should be respectful and listen to the faculty intently. Hopefully this creates a peaceful and conducive learning environment.

ACP: How would you describe the residency program if it is akin to flying?

DK: Helming our SHARP is indeed like flying a huge aircraft full of passengers to get to their destination safely. Some analogies:

Education leaders – For example, DIO, MOHH, ACGME, JCST. They provide us the location of the destination. The pilot needs to know their visions and work with them (if possible), so that he can factor in the flight path.

Administrators – The engine of this whole residency aircraft. Without it, the plane will just stall and plunge into the sea.

Faculty - The hull of this mighty carrier to house and protect the passengers

Residents – The passengers. “Apologies there will be no flight service crew to serve them”, DK laughed. There must be buy-ins, ownership and housekeeping of the aircraft. In reality, they have to help look after themselves on this plane (this is a 5-year voyage!) and to play a part in making this journey pleasant and safe.

Program Director - The pilot who is at the controls. He/she is assisted by capable co-pilots (we have a superb team of APDs).

CCC & PEC Committees – Air traffic controllers who provide advisory for alteration of flight plans in response to weather conditions and situations on the ground.

ACP: As you step down as a residency Program Director after seven years at the helm, what advice would you like to give?

DK: I feel it is time to focus on professionalism, soft skills and resilience of the trainees. I do not see the terrain ahead being smoother and less stressful. There are much societal changes, demands of patients, complexity of diseases, exponential growth in knowledge and disruptive technological innovations. Amidst all these stressful conditions, soft skills like how to communicate effectively, being compassionate and showing empathy are important.

In terms of mental and emotional resilience, knowing how to cope with obstacles and handling problems is vital. When a resident faces any challenge, it is akin to dropping into the sea. We need to teach our residents how to “swim” instead of throwing life-buoys all the time. Lastly, as educators/seniors, we must strive to see the potential hidden in each resident and use customised means for these to surface and grow. Just like what Michelangelo says, “I saw the angel in the marble and carved until I set it free”.

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Dr May Mok took over as Anaesthesia Residency Program Director on 1 September 2021. We asked her for her thoughts on her new role.

What are your thoughts on stepping into new roles and challenges faced in Education? I have many thoughts but mainly worry about not being able to do the job well enough and disappointing the residents and the faculties.

Vision for residency A big happy family where the residents are helping each other and their departments to develop, thrive and grow. I see our MOs and residents as our future friends and colleagues whom we will be working and socialising with.

What are the upcoming exciting opportunities for residency growth / innovation?

We have some exciting education research projects coming up and we are trying to strengthen our residents' research capabilities.

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Dr Angela Tan takes on the role of Associate Program Director, KKH with effect from 1 Jan 2022. She shares her thoughts on education.

The face of education has evolved over the years. Whilst the apprentice style of “See one, do one, teach one” was widely accepted previously, it is less referred to nowadays. Would it be reasonable to draw parallels to those days when lessons were taught using OHPs (overhead projectors)?

On the other hand, there was a time when simulation was seen as novel and experimental, but has now become an integral aspect of training. These are but the tip of the iceberg on how the realm of education has made headway and will continue to do so particularly with the integration of technology.

Therefore, it is crucial that we keep up to date and stay abreast of developments. I must admit this is no easy task and is an arduous undertaking on top of the clinical and administrative duties as well as personal obligations. Commitment, sacrifice and a good dose of humility are all in the mix as educators, past and present. I hope to mirror qualities of educators who have inspired me and also continue inspiring future generations.

The role of technology in education has been pivotal and will continue expanding. Hopefully, there will come a day when the AI can track a resident’s clinical exposure and robotically roster them to appropriate lists! How awesome that would be!