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Family Medicine Residency Programme

The Family Medicine Residency Programme which started its first intake of residents in Year 2011, has a 3-year duration similar to the previous MMed (FM) Programme.

The programme aims to equip the resident with educational and clinical experiences in accordance with ACGME-I standards, which focuses on structured training and close supervision. The resident will undergo clinical rotations in the hospitals and polyclinics, call-back sessions and teaching sessions that combine foundation teaching, continuity clinics, skills workshops/attachments and community medicine etc. Regular formative assessments will also be introduced to enhance the training progress of the resident

For more details, you may refer to the Singhealth Residency webpage, the NHG-AHPL Residency webpage, and the NUHS Residency webpage.

Singapore Country Addendum

The Singapore Country Addendum to the ACGME-I Advance Specialty Requirements document prescribes specialty-specific programme requirements applicable to residency programmes in Singapore as discussed with the ACGME-I and the Singapore Residency Advisory Committees (RAC).

Read together with the ACGME-I Advanced Specialty Requirements, they represent the requirements of graduate medical education in the specialties listed

Please refer to the table for more detailed information

Section ACGME-I Specialty-Specific Program Requirements for Graduate Medical Education Addition/Change Clarification
II.E.1 The facility must be clearly and significantly identified as a Family Medicine Center and must be for the exclusive use of the residency program.

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 The Family Medcine Centers are largely for the use of patient care, but we have developed dedicated facilities within FMCs for use by family medicine residency programmes.  Please refer to Annex A .
II.H.10 The three-year FMC experience for each resident must include a documented total of at least 1650 patient visits, with at least 150 visits occurring in the first year. Residents workload should be graduated to not more than:
  • 1-4 patients per hour in FM Year 1; 
  • 5 patients per hour inFM Year 2; 
  • 6 patients per hour in FM Year 3
 We recognise that the workload at our FMCs is high compared to that in the US.
The FM RAC has noted this and as an interim solution made a recommendation to cap the number of patients seen per hour.
II.C. 1 The residency must define and monitor the most common medical problems cared for by family physicians in the hospital where inpatient experience takes place.

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 Family Medicine training and practice in Singapore was built along the lines of the UK system. In our system, Family Physicians are based in the community while acute hospital inpatients are looked after by specialists, be they Internal medicine specialists, Paediatricians or Obstetricians.
To enable inpatient continuity of care in our family medicine programmes, the Sponsoring Institutions have made provisions in their IT systems to alert the residents when their patients are admitted into an acute care hospital.  The resident together with the supervising faculty will then arrange to visit their patients and discuss the management with the inpatient care team.
II.H.14.b All programs training residents in labor and delivery competency must identify at least one family physician delivering and teaching maternity care. All programs training residents in labor and delivery competency must identify at least one obstetrician to assist the family physician in delivering and teaching maternity care.

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II.I.9.c Maternity Care
The program should have at least one family physician faculty who is engaged in providing these services and who can participate in supervising the residents and serving as a role model for them.		 The program should have at least one family physician faculty who is engaged in providing outpatient antenatal and postnatal services and who can participate in supervising the residents and serving as a role model for them.

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II.H.18.b Inpatient Experiences
This inpatient experience should occur primarily on a family medicine or an internal medicine service, and must involve teaching and role-modeling by family physician faculty.

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Annex A – The Family Medicine Center
  1.             In Singapore, primary care services are provided through a network of public polyclinics and private medical clinics. In general, the public polyclinics provide 22% while the private medical clinics provide 78% of primary care in Singapore.
  2.             The existing public polyclinics facilities are administered by 3 clusters namely, the Singapore Health Services, National Healthcare Group, and National University Health System while the private medical clinics operate in group practice or stand alone clinics.
  3.             Some of these clinics, which are identified as FMCs, will provide the primary setting for education in the knowledge, skills and attitudes of family medicine
  4.             Singapore is a small and densely populated country with limited resources and the public polyclinics have been built with the primary intention of providing affordable and comprehensive healthcare to the public. The designated FMC, therefore, cannot be used exclusively for the Family Medicine Residency program. However there will be dedicated clinic facilities and resources for the Family Medicine Residency program within the designated FMC
  5.             The FMC should uphold the concept of a family physician directed healthcare team providing patient-centric comprehensive and preventive care within the family and community context that encourages continuous healing relationships and whole person orientation. Patient care should be coordinated and integrated
  6.             The FMC’s case-mix must reflect the practice of family medicine in Singapore.