How To Prepare For Singapore Medical Schools’ Interviews

With interviews for NUS and NTU medicine right around the corner, you must be wondering, what should you be doing to prepare?

It goes without saying that you should get ready for predictable questions such as your motivations for pursuing medicine and your insights from medical experiences such as volunteering and shadowing. However, since Multiple Mini Interviews involve several stations, you should anticipate a wide range of question styles.

For instance, some of the stations may test you on knowledge of Singapore’s healthcare landscape and public health issues. Try to prepare for questions such as ‘How do you envision the healthcare landscape to change in the next 20 years’? Or ‘What is the most pressing problem facing Singapore’s healthcare system today, besides Covid-19?’

In this article, we hope to equip you with the basics of Singapore’s healthcare system.

1. Singapore Healthcare In Numbers

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• The Global Burden of Disease 2017 Study published in The Lancet ranked Singapore favourably as the country with the highest life expectancy (84.8 years on average now)
• The percentage of the population aged 65 and above is expected to double to 20% by 2030.
• According to the World Bank, Singapore’s Total Fertility Rate in 2014 is 1.25, making it 196 out of the 200 countries ranked
• Singapore’s acute hospital beds-to-population ratio is 2.6 per 1,000 total population
• 2.5 doctors per 1000
• Singapore has 19 acute care hospitals, 1 psychiatric hospital and 9 community hospitals. 

2. How is healthcare in Singapore financed?

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Singapore has a multi payer health care financing framework, where a patient’s treatment might be covered by multiple schemes and payers. Three popular schemes, also known as the 3M system, include:

Medisave

The idea that Singaporeans should be largely responsible for our own health and healthcare needs has been advocated by the People’s Action Party Government hence, Medisave, a national medical savings scheme, was introduced in the early 1980s. Medisave helps individuals put aside part of their income into their Medisave Accounts to meet their future personal or immediate family’s hospitalization, day surgery and certain outpatient expenses. Under the scheme, every employee contributes 8% – 10.5% (depending on age group) (CPF) of his monthly salary to a personal Medisave account. The savings can be withdrawn to pay the hospital bills of the account holder and his immediate family members.

Medishield Life

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It is basic because it is sized for subsidised treatment in the public hospitals. MediShield Life premiums will be affordable, and may be fully paid from Medisave

Medifund

MediFund is a government endowment fund that provides a safety net for patients who face financial difficulties. This kicks in after individuals have received government subsidies and are drawing on other means of payment including MediShield Life, MediSave and cash. It is administered at the discretion of hospital boards. Medifund, unlike the schemes that promote personal responsibility, was designed to ensure a certain degree of social equity.

For a full list of healthcare schemes and subsidies, please refer to the MOH website. 

3. What are some pressing healthcare issues in Singapore?

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Ageing population 

Singapore is one of the fastest ageing populations in the world. Incidence of dementia and other age-related conditions is on the rise, leading to issues with long term care. Elderly face a unique set of issues such as social exclusion, and caregivers experience extended stress as well. There is increasing demand for geriatric care physicians, various community hospitals which provide tertiary care, and other centres for physiotherapy, occupational, speech and language therapy.  

Rise in Diabetes

An estimated 400,000 Singaporeans have diabetes and National University of Singapore’s Saw Swee Hock School of Public Health has projected that there may be potentially one million Singaporean diabetics by the year 2050. If left untreated or uncontrolled, diabetes can lead to several health complications such as blindness, kidney disease, and heart disease. The War on Diabetes was declared in 2016 and several initiatives targeting education and awareness and healthy living incentives have been launched. 

Mental Health Challenges

Suicide continues to be the leading cause of death for youths, and one in seven in Singapore has experienced a mental disorder in their lifetime, of which more than three-quarters did not seek any professional help.  Barriers to seeking help include stigma, lack of awareness, financial concerns, long waiting times among others. There is a shortage of mental health professionals with an average of 4.4 psychiatrists and 8.3 psychologists for every 100,000 people in Singapore. Moreover, there is only one psychiatric hospital, The Institute of Mental Health. 

Migrant Worker Issues 

Brought to the spotlight during Covid-19, the substandard living environments and poor working conditions of migrant workers led to increased spread of the virus, and continues to remain a risk for future infectious diseases. In April 2020, Singapore’s daily case count hit the hundreds – a trend that continued into August. Unsurprisingly, migrant workers face higher rates of mental illness as well, arising from a variety of stress factors. They are also at higher risk of various occupational diseases, several of which can be life-threatening. Comprising a fifth of the population, this is simply a segment of the population Singapore cannot overlook. 

4. Future trends

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The Ministry of Health’s (MOH) solution to keep quality healthcare affordable into the future includes “3 Beyonds“:

Beyond healthcare to health 

Preventing healthcare conditions to ease burden on the healthcare system is a top priority. Focus needs to be shifted to improving overall well-being, disease prevention, and empowering individuals to choose healthier lifestyles. Several initiatives such as HPB’s Healthier Dining Programme, The National Steps Challenge etc are already in place to promote healthy living. 

Beyond hospital to community 

The transition from a traditional hospital-centric model to a broader community-based one is necessary to avoid frequent hospital admissions and to receive long-term care.Not only is this model better for the patient in terms of health and convenience, it also saves cost for the healthcare system. This will require building stronger links between tertiary institutions and the primary, intermediate, long-term and home care sectors, and to better integrate social and healthcare services.

Beyond quality to value

Given the growing ageing population, the rise in chronic conditions and the shrinking workforce – the healthcare budget has more than doubled in the span of five years. With increasing costs of healthcare treatments falling onto patients’ shoulders, additional efforts need to be made to ensure affordability. The Agency for Care Effectiveness (ACE) was set up in 2015 to research treatments that provide the best value for money. Moreover, fee benchmarks for certain procedures have also been introduced to place a quota on healthcare costs.