My journey in anaesthesiology has taught me to effect change and face uncomfortable situations with calm and control.

By Dr Adeline Leong
Anaesthesiology Senior Resident, SingHealth Residency
Chief Resident, Singapore Chief Residency Programme

As one of a handful of direct entrants from medical school who went into a Residency Programme, anaesthesiology was a foreign field to me. The learning curve for anaesthesia was steep and stressful, but unforgettable.

I’m currently part of the Singapore Chief Residency Programme (SCRP)*, where I have opportunities to meet peers from other institutions and discuss similar challenges. We have become a close bunch and our rapport is a highlight of my residency – it’s refreshing to know we have friends in people from different healthcare environments and specialities.

Having spoken to healthcare administrators including the former Permanent Secretary (Health) Ms Tan Ching Yee and former Second Permanent Secretary MG Ng Chee Khern during SCRP dialogue sessions, I see that we should be the proactive change we want to see in the future.

Dr Adeline Leong

As part of the programme, I am currently developing a set of indicators to improve the efficacy of the Emergency Operating Theatre system so that we can reduce waiting and fasting times for patients. I have learnt a lot from trying to make this happen.

Having to modify a system that affects others is not easy – there has to be sufficient buy-in as well as a belief in the change, otherwise it is difficult to implement and to sustain. There are many factors, not just systemic but also human and monetary, that influence healthcare systems planning and implementation.

Healthcare is complex: It’s clear that any solutions implemented can take years to take effect. But changes are only necessary to serve our future patients better, and we shouldn’t be afraid to open the can of worms so we may improve the system we are in.

As an anaesthesiologist, ensuring that patients have a quality end-of-life is an issue close to my heart, as we often review those who need ICU care. In my personal capacity, l broach the topic on end-of-life planning with families and patients.

“We shouldn’t be afraid to open the can of worms so we may improve the system we are in.”

I believe that the quality of life is much more important than the quantity of life, and I wouldn’t want to miss the boat of catching a patient when he is lucid. Making an informed decision is important, though it’s never easy to discuss options, because you are actually telling a patient that life is going to end soon.

Most of the patients and family are willing to explore the subject, but there are some that refuse to consider such an option or even talk about it. Discussion about end-of-life is usually most difficult with families of patients that are suddenly diagnosed with a life-threatening condition.

Some people ask me where I find the courage to start the conversation – I just think that it is the right thing to do. Many patients don’t want to have a prolonged life on tube feeding or the ventilator, once you explain to them clearly the possibilities and the options.

My career has taught me many important lessons and gives me intimate perspectives of how a medical profession can be more than the sum of its parts. This journey is rich with returns, and I hope to pass the torch on by getting involved in the education of new clinicians.

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*The Singapore Chief Residency Programme is a year-long national programme under MOH Holdings that was designed to develop the nation’s future generation of medical leaders.