INTRODUCTIONIt is important that medical students possess the correct attitude towards the elderly and not have an ageist attitude. This is because they will be caring for an increasing proportion of elderly patients. We thus sought to assess the attitudes of our medical students towards the elderly.

MATERIALS AND METHODSWe conducted a cross-sectional study assessing the attitudes towards the elderly of 225 fi rst-year and 135 third-year students using a self-administered questionnaire that incorporated the Kogan's Attitudes Toward Old People Scale (KAOP). Elderly people were defined as those aged 65 years and above for this study.

RESULTSThe majority of fi rst- (98.2%) and third-year (99.2%) medical students had positive attitudes towards elderly people (KAOP score above 102). KAOP scores were not significantly different regardless of seniority (medical student year), gender, race, household income, or having a doctor-parent. Although the mean KAOP score of third-year students was higher than that of fi rst-year students, this was not significantly different (P = 0.062).

CONCLUSIONSMedical students in Singapore have a positive attitude towards the elderly. It is important that their medical curriculum continues to have an increasing geriatric component in view of the increasing numbers of older persons that they will be caring for due to the ageing population.

Age Factors ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Pilot Projects ; Prejudice ; Psychometrics ; Self-Assessment ; Singapore ; Social Perception ; Students, Medical ; psychology ; Surveys and Questionnaires ; Young Adult

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.
Credentialing ; history ; Education, Medical, Continuing ; history ; Education, Medical, Graduate ; history ; Family Practice ; education ; history ; History, 20th Century ; History, 21st Century ; Humans ; Singapore

INTRODUCTIONPrevious studies on patient acceptance of medical student teaching were from Western populations and in one setting only. However, there has been no prospective study comparing patient acceptability before and after an actual experience. We studied patient acceptability of medical student teaching in private and public family practices and public hospital specialist outpatient clinics in Singapore, and before and after an actual medical student teaching consultation.

MATERIALS AND METHODSWe conducted an anonymous cross-sectional survey from March through October 2007 of Singaporean or permanent resident patients attending 76 teaching private family practices, 9 teaching public family practices and 8 specialty clinics in a teaching public hospital. We used pre-consultation cross-sectional patient surveys in all three settings. For private family practice setting only, post-consultation patient survey was conducted after an actual experience with medical student presence.

RESULTSOut of 5123 patients, 4142 participated in the cross-sectional survey (80.9%) and 1235 of 1519 patients in the prospective cohort study (81.3%). Eighty percent were comfortable with medical students present, 79% being interviewed and 60% being examined. Regarding being examined by medical students, parents of children were least comfortable while patients between 41 to 60 years were most comfortable (adjusted OR = 1.99 [1.55-2.57]). Females were less comfortable with medical student teaching than males. Chinese patients were the least comfortable about being interviewed or examined by medical students among the ethnic groups. Indians were most comfortable with being interviewed by medical students (adjusted OR = 1.38 [1.02-1.86]) but Malays were the most comfortable being examined by them (adjusted OR = 1.32 [1.07-1.62]). Family practice patients were more receptive to medical student teaching than the hospital's specialist outpatients. Common barriers to patient acceptance were lack of assurance of patient privacy, dignity and confidentiality. Actual exposure to medical student teaching did not change levels of patient acceptance.

CONCLUSIONSCompared to similar studies from Western countries, Asian patients appear to be less receptive to medical student teaching than Western patients. Family practice settings offer medical students a more receptive learning environment.

Adult ; Cross-Sectional Studies ; Education, Medical, Undergraduate ; Family Practice ; Female ; Health Care Surveys ; Humans ; Male ; Middle Aged ; Odds Ratio ; Outpatient Clinics, Hospital ; Patient Satisfaction ; Physician-Patient Relations ; Private Practice ; Students, Medical ; Young Adult

In many countries, family medicine (FM) training has been conducted mainly by senior family physicians alone. However, FM training in Singapore in the last 30 years has involved specialists working in close collaboration with family physicians. The areas in which specialists are currently involved include the training of FM trainees in tertiary hospitals, the Master of Medicine in Family Medicine [MMed (FM)] and Graduate Diploma in Family Medicine (GDFM) programmes. This close relationship has been crucial in the continuing vocational and professional development of family physicians and in fostering closer collaboration between family physicians and specialists, thus ultimately benefiting patient care.
Education, Medical, Graduate ; Humans ; Interdisciplinary Communication ; Medicine ; Physicians, Family ; education ; Singapore ; Specialization

INTRODUCTIONWith the potential threat of an avian influenza (AI) pandemic, healthcare workers (HCWs) are expected to play important roles, and they encounter significant stress levels from an expected increase in workload. We compared the concerns, perceived impact and preparedness for an AI pandemic between HCWs working in public primary care clinics and a tertiary healthcare setting.

MATERIALS AND METHODSAn anonymous, self-administered questionnaire was given to 2459 HCWs working at 18 public polyclinics (PCs) and a tertiary hospital (TH) in Singapore from March to June 2006. The questionnaire assessed work-related and non-work-related concerns, perceived impact on personal life and work as well as workplace preparedness.

RESULTSWe obtained responses from 986 PC and 873 TH HCWs (response rate: 74.6% and 76.7%). The majority in both groups were concerned about the high AI risk from their occupation (82.7%) and falling ill with AI (75.9%). 71.9% accepted the risk but 25.5% felt that they should not be looking after AI patients with 15.0% consider resigning. HCWs also felt that people would avoid them (63.5%) and their families (54.1%) during a pandemic. The majority expected an increased workload and to feel more stressed at work. For preparedness, 74.2% felt personally prepared and 83.7% felt that their workplaces were prepared for an outbreak. TH HCWs were more likely to be involved in infection-control activities but the perception of infection-control preparedness in both groups was high (>80.0%).

CONCLUSIONSHCWs in both public primary and tertiary healthcare settings felt prepared, personally and in their workplaces, for a pandemic. Their main concerns were risks of falling ill from exposure and the possibility of social ostracism of themselves and their families. Preparedness levels appeared high in the majority of HCWs. However, concerns of HCWs could affect their overall effectiveness in a pandemic and should be addressed by incorporating strategies to manage them in pandemic planning.

Adolescent ; Adult ; Aged ; Animals ; Attitude of Health Personnel ; Birds ; Disaster Planning ; Disease Outbreaks ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Influenza A Virus, H5N1 Subtype ; pathogenicity ; Influenza in Birds ; transmission ; Influenza, Human ; epidemiology ; prevention & control ; transmission ; virology ; Male ; Middle Aged ; Primary Health Care ; Singapore

INTRODUCTIONDuring an avian influenza (AI) pandemic, primary-care physicians (PCPs) are expected to play key roles in the prevention and control of the disease. Different groups of PCPs could have different concerns and preparedness level. We assessed the concerns, perceived impact and preparedness for an outbreak among PCPs in Singapore.

MATERIALS AND METHODSA cross-sectional survey of PCPs working in private practice (n=200) and public clinics (n=205) from March to June 2006 with an anonymous self-administered questionnaire on concerns (12- items), perceived impact (10 items) and preparedness (10 items) for an outbreak.

RESULTSTwo hundred and eighty-five PCPs responded - 149 (response rate: 72.7%) public and 136 (response rate: 67.3%) private. The majority were concerned about risk to their health from their occupation (95.0%) and falling ill with AI (89.7%). Most (82.5%) accepted the risk and only 33 (11.8%) would consider stopping work. For perceived impact, most felt that people would avoid them (69.6%) and their families (54.1%). The majority (81.3%) expected an increased workload and feeling more stressed at work (86.9%). For preparedness, 78.7% felt personally prepared for an outbreak. Public PCPs were more likely to be involved in infection-control activities and felt that their workplaces were prepared.

CONCLUSIONSMost PCPs felt personally prepared for an outbreak but were concerned about their exposure to AI and falling ill. Other concerns included social ostracism for themselves and their families. Public PCPs appeared to have a higher level of preparation. Addressing concerns and improving level of preparedness are crucial to strengthen the primary-care response for any AI outbreak.

Adult ; Animals ; Birds ; Communicable Disease Control ; methods ; Cross-Sectional Studies ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Female ; Health Care Surveys ; Humans ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza in Birds ; epidemiology ; Male ; Middle Aged ; Odds Ratio ; Physicians, Family ; statistics & numerical data ; Risk Factors ; Singapore ; epidemiology ; Surveys and Questionnaires