Cerebrovascular diseases are one of the leading causes of death in Singapore and worldwide. Post-stroke neuropsychiatric disorders such as depression and anxiety disorders are common and there have been primary care articles highlighting the need for general practitioners to actively monitor patients for neuropsychiatric sequelae such as post-stroke depression. There is however a scarcity of primary care articles on post-stroke delusional disorder. Though post-stroke delusional disorders are uncommon, primary care physicians should be equipped to not only be able to manage common diseases well but also uncommon presentations of common diseases, as they can cause significant morbidity and mortality. We present a pilot case report on a middle-aged Chinese gentleman with a rare occurrence of post-stroke delusional disorder that presented and was managed in the community setting in Singapore.

This review provides an update of education and training in family medicine in Singapore and worldwide. Family medicine has progressed much since 1969 when it was recognised as the 20th medical discipline in the United States. Three salient changes in the local healthcare landscape have been noted over time, which are of defining relevance to family medicine in Singapore, namely the rise of noncommunicable chronic diseases, the care needs of an expanding elderly population, and the care of a larger projected population in 2030. The change in the vision of family medicine into the future refers to a new paradigm of one discipline in many settings, and not limited to the community. Family medicine needs to provide a patient-centred medical home, and the discipline's education and training need to be realigned. The near-term training objectives are to address the service, training and research needs of a changing and challenging healthcare landscape.
Aged ; Family Practice ; education ; methods ; organization & administration ; Geriatrics ; methods ; Health Services Needs and Demand ; Humans ; Patient-Centered Care ; Program Development ; Singapore ; Societies, Medical