Education

The SGH Department of Rheumatology & Immunology (RHI) manages the broadest spectrum of Rheumatological diseases, the common and mild as well as the rare and severe. 

As an academic medical centre, specialist clinicians and scientists in our Department team up with the hospital’s comprehensive medical and surgical specialties to deliver state-of-the-art and sustainable patient care. The department’s dynamic teaching faculty coupled with tertiary hospital services serve as our foundation to comprehensively educate students in Rheumatology, Internal Medicine, Nursing and Allied Health. 

The Department’s educational programmes synergise with its clinical and research focuses to offer experiential learning at undergraduate and graduate level, including doctorate positions. Teaching methods include multimedia cloud-based learning such as SGH RHI produced videos and podcasts, didactic lectures and tutorials. Clinical learning involves rigorous bedside teaching, case-based discussions, inpatient rounds and outpatient clinics.

1. Postgraduate training programmes in the Department includes advanced training for doctors specialising in Rheumatology for which the Department is fully accredited.
   
2. The Department has achieved accreditation from the US Accreditation Council for Graduate Medical Education International (ACGME-I) for Rheumatology Senior Residency. This accreditation is testimony of our dedication towards medical education and training of the next generation of Rheumatologists  
   
3. Research in medical education is part of our endeavour to further improve our delivery of teaching in order to produce the necessary and best possible skillsets for doctors and healthcare professionals in training to ultimately benefit patients.

SGH RHI’s outreach in graduate education also involves teaching and the sharing of knowledge with clinicians and healthcare staff such as Family Medicine physicians and Advanced Nursing Programmes.

“I have truly enjoyed myself tremendously during the Rheumatology elective posting at SGH. My original aim for this posting was to obtain a greater exposure to the field of Rheumatology, to learn how to pick up clinical signs, to learn how to do a proper rheumatology hand examination and to talk to patients to find out about more about the clinical manifestations of rheumatology conditions. This posting has far exceeded my expectations, as I was immersed in the team during ward rounds, engaged in clinics, and learnt a lot from bedside tutorials with our supervisors. 

Being attached to the ward rounds has allowed me to learn more about how to manage day to day clinical issues that the patients present with, that goes beyond their underlying conditions, as well as catch a glimpse of the clinical reasoning that goes behind certain aspects of management. I am extremely thankful to the ward consultants such as Prof Thumboo, residents, as well as the medical officers in the team whom I have had the honour to learn alongside with. They were extremely patient with us, answering all of our questions and tried to teach us as much as they could. I am grateful to the medical officers and residents who have spent their precious lunch time teaching us about the basic knowledge we should have as medical students, giving us chances to present cases that we have clerked, and gave us tutorials on the areas that we were weaker at.

Clinics were also extremely useful as we got to see a multitude of signs from stable long-term patients as well as learn more about Rheumatological conditions that we did not see from the inpatients. Of these, I found the Systemic Sclerosis clinic under A/Prof Andrea Low extremely interesting as I got to see multiple patients of the same condition coming in with a wide variety of clinical presentations, with different disease subtypes, and a range of complications. It allowed me to better appreciate the concept of personalized medicine, as I discovered the intricacies of management of the condition as it differs from patient to patient.

I am also thankful to Dr Yoong, Dr Hong, Dr Poh, and Dr Law for taking my friends and I through bedside tutorials which have really helped us better interpret clinical signs of patients and to discuss the conditions that they came in with in greater detail.  This posting has showed me the breadth and depth of Rheumatology and has piqued my interest in this area which medical students are not well-exposed to during clinical years.

Rheumatology has also showed me that conditions can affect a patient’s function and life in many different ways, and it is important to be empathetic to understand what they are going through and help them to return to their normal function as much as possible. Most of the time, autoimmune conditions are multi-systemic and can be very debilitating to the patients’ life. It is important to consider how the condition is affecting their work, their relationships, in order to improve compliance and better manage the patient.

All in all, I will strongly recommend this elective posting to my friends and my juniors, as I have learnt so much in this short 2 weeks of elective. Besides feeling more confident in my approach to joint pain and discussions on Rheumatological conditions, I am also inspired by the capable and empathetic doctors whom I have met during my posting. I am determined to improve my clinical reasoning and clinical acumen and strive to become a more competent and holistic medical practitioner in the future.”

“These two weeks have been deeply fulfilling. I had initially signed up for this elective because I didn’t know much about Rheumatology at all and wanted to fill this gaping hole in my clinical knowledge. Having known about the Department’s review course, which I had signed up for last year before COVID struck, I was keen to join the Department at SGH.

Fast forward to the elective – I was amazed at all the signs which I had read about and seen in pictures but never in real life. I saw so many Systemic Sclerosis (Scleroderma) patients in the clinic that the physical examination was easily imprinted in my memory. In the wards, I was constantly being challenged by the systemic manifestations of Rheumatological diseases – it required knowledge from almost every other specialty in IM. I am glad that I did Rheumatology with a firm foundation in the other systems, as it was a good revision for medicine and even orthopaedics (we saw a patient with disc herniation today who had sensory loss over the entire lower limb and strongly positive straight leg raise test – I hadn’t even seen this during my ortho posting!). Listening to the patients about the various presentations of their disease was also a great learning experience – every Lupus patient presents differently and even after clerking a few, there was always something more to learn.

I am also very grateful to the Medical Officers (especially Dr Zheng Cong, Dr Chloe, Dr Zheng Wei, Dr Fadhli), Senior Residents (Dr Andrew and Dr Charmaine) and ward and clinic Consultants who were mostly very welcoming and invested time teaching us. My supervisors, Drs Annie and Jon Yoong, allowed me to clerk new cases in the next room, which was most helpful for my learning. I hope to pay it forward in future, just like they have done for me.

Overall, it has been a fantastic posting. I have no regrets coming to SGH Rheumatology and will recommend the posting to my juniors in future. Thank you for organizing this for us!”

 

“These 2 weeks of electives with SGH Rheumatology have been extremely fulfilling for me, in more ways that I can list.

In terms of content, I have become exponentially more confident and comfortable with Rheumatological topics. Prior to this posting, Rheumatology has been something that, if it came out for long/short cases, would strike considerable apprehension in me. However, with the wide variety of cases I was exposed to – both in the wards and clinics – I have become much more comfortable with facing Rheumatological cases, whether for the exams, or for the future, when I become a practicing physician.

Aside from becoming more confident/comfortable, I’ve become to appreciate the beauty of the field of Rheumatology even more. Rheumatology is such a multi-organ and multi-faceted field; literally any organ of the body can be affected in our body’s folly of autoimmunity, presenting with a bizarre range of manifestations. While obviously it is not a good thing for the patients themselves with the autoimmune conditions, I think it’s an interesting field to consider in the future, with a very broad and holistic approach to every patient. 

All in all, this posting has been nothing short of great, with good cases, good doctors and a great learning environment. Thank you for organizing this for us!”