Singapore Medical Council

Introduction

The Singapore Medical Council (SMC) has a duty to ensure that patients’ safety is always safeguarded, and this is achieved through its implementation of a Supervisory Framework, which is a tool used by SMC to monitor foreign-trained doctors who are on Conditional and Temporary registration.

Objective

The objective of the SMC’s Supervisory Framework is to ensure there is direct and timely supervision for foreign trained doctors while they are at work, so that patient’s safety is not compromised.

Structure

A medical practitioner who is conditionally or temporarily registered will be subjected to monitoring under SMC’s Supervisory Framework throughout the period of his medical registration, which may range from 1 to 4 years or more. 

In order to ensure that there is optimum supervision, the supervisor must first meet the criteria and adhere to the supervisory ratio stipulated by SMC.

The supervisor’s assessment reports are required at periodic intervals, and multi-rater assessment reports from the supervisee’s colleagues e.g. doctors, nurses and other healthcare professionals, may also be requested to get a more holistic assessment of the doctor’s performance.

SMC will systematically review the doctor’s performance based on such regular assessment reports.

Details of the framework, based on each institutional setting, can be found in the “Guidelines” section below.

Guidelines

The supervisory framework guidelines are broadly categorised into:

(a) Orientation
(b) Supervision
(c) Monitoring & Feedback
(d) Supervisor’s Assessment Reports
(e) Multi-Rater’s Assessment Reports
(f)  Identification of Poor Performers

Guidelines that are applicable to different types of institutions:

1. Public Sector Hospitals/Specialty Centres
2. Polyclinics
3. Health Sciences Authority/Health Promotion Board
4. Private hospitals
5. Community hospitals/Hospices
6. Medical Centres/General Practices

Assessment Forms Reference Table

Letter of Undertaking by Prospective Supervisor

SMC reserves the right to subject the doctor on conditional/temporary registration to review(s) by registered medical practitioners and/or other healthcare professionals when it deems necessary.

Accreditation as Learning Institution

Currently new International Medical Graduates (IMGs) from schools on the Schedule in the Medical Registration Act may apply for Conditional registration (C-reg) to practise only in approved healthcare establishments, under the supervision of fully registered medical practitioners.

Healthcare providers who wish to recruit new IMGs to work at their institutions are welcome to apply to SMC to be accredited as Learning Institutions. Healthcare providers may wish to note that certain structures and processes, as listed below, should be in place, for their applications to be considered. This allows healthcare providers to fulfil their medical manpower needs while enabling new IMGs to adapt to our healthcare system and continue their professional development through peer interaction and practice-based learning. This framework ensures the safety and well-being of our patients.

The pre-requisites are as follows:

1. The institution has been accredited by JCST and/or ACGME-I for the training of residents or trainees; OR
2. There is a “departmental” structure in place within the institution where doctors are given the opportunity to work as a team in the management of patients.
3. The institution has in place a structured training programme or programmes for its doctors, for peer interaction and practice-based learning.
4. The institution must make available structured Continuing Medical Education (CME) programmes to their doctors.
5. There must be sufficient supervisors who meet the criteria for supervising new C-reg doctors under SMC's supervisory framework.
6. The institution must ensure there is a proper system of assessment, monitoring and feedback regarding the performance of both doctors and their supervisors, as follows:
   
   

   a) There should be proper documentation of the assessments done and feedback given to new IMGs, which may be audited.

   b) In the event of any weakness identified with the new doctor, remedial measures must be implemented and they must be documented.

7. The institution must observe and maintain the supervisor-supervisee ratio, the intensity of supervision as stipulated, and comply with the guidelines issued by the SMC.
8. The institution must have in place a quality assurance framework.
   
   

The details of the supervisory framework, which is reviewed from time to time, can be found above. For more information, please contact Secretariat at enquiries@smc.gov.sg