​Assoc Prof Chua receiving the National Outstanding Clinician Award 2019 from Minister for Health, Mr Gan Kim Yong in the 2019 award ceremony.

It all began in the 80s, when Assoc Prof Chua Yeow Leng, Senior Consultant from the Department of Cardiothoracic Surgery (CTS), graduated from medical school and began training as a general surgeon. Initially, Assoc Prof Chua was interested in the trauma specialty, “I liked the excitement from working in trauma cases, and always found the abdomen quite familiar but did not know much about what is above it!”

As part of his training, he was first exposed to CTS and quickly found it to be exciting, with unlimited possibilities. Witnessing patients who went from extremely sick to having their lives turned around after a heart surgery, Assoc Prof Chua said, “No doubt it takes plenty of intense commitment and that the long hours take a toll on family life but when I realised how CTS can change a patient's life through our surgical team's efforts, I knew it was the vocation for me."

Specialising in the care for patients

Being a recognised leader and expert for heart valve repair surgery in Singapore and the region was just one of the many reasons why Assoc Prof Chua was recently awarded the National Outstanding Clinician Award 2019, held at the National Medical Excellence Awards earlier this month.

Sharing why he chose to specialise in atrial fibrillation (AF) and valve surgery, Assoc Prof Chua explained that out of all abnormal heart rhythms, AF is the most common arrhythmia which is typically detected in patients with heart valve problems.

“When one has AF, the risk of stroke goes up many times – sometimes up to 30 times. The aim of a valve repair surgery is to normalise the heart rhythm, effectively  reducing the risk of stroke for these patients.”

Highlighting the importance of teamwork with cardiologists for valve repair cases, Assoc Prof Chua shared, “Repairing a valve involves much more work as compared to changing one. It requires intensive pre-surgery preparation work – a surgeon has to know exactly what is wrong, how to classify and describe the valve problem, on top of many more details.”

He is particularly thankful to Assoc Prof Ding Zee Pin and other NHCS Echocardiography cardiologists for their help with visualising patients’ valves before a surgery, “Different specialties need to come together to look at valve repair cases, speak the same language and work together, only then can our treatment be administered well.”

Citing the ability to gain patient’s confidence as one the most important qualities for a clinician, Assoc Prof Chua expressed, “Gaining the trust from my patients is very important. As a surgeon, I have to be forthcoming and truthful in explaining their health condition, and establishing good rapport is key, even before the actual surgery.”

The Birth of NHCS

Working at the Singapore General Hospital (SGH) and thereafter NHCS, Assoc Prof Chua has met many exceptional doctors whose dedication greatly inspired him. Heart surgery in the 70-80s was then in its developing stage in Singapore, and he had witnessed how his seniors and mentors improved on novel techniques and placed tremendous effort to ensure that surgeries went smoothly, “I was very fortunate to work with many brilliant doctors,” Assoc Prof Chua recounted jovially.

He was also one of many who were involved in establishing NHCS, “Our hard work finally paid off when in 1994, Singapore Heart Centre finally opened at Mistri Wing on SGH campus. My employee number then was ‘02’ – meaning I was the second staff in the organisation!”

In our first heart transplant case performed in Singapore, Assoc Prof Chua was responsible for many behind-the-scenes preparation work, "I was very excited for our first heart transplant surgery but had to go​ on a two-year HMDP Fellowship at​ Mayo Clinic in the United States and had to miss the actual surgery!"

Later, he played a key contributing role in several new initiatives and services such as the introduction of Mechanical Heart Assist Devices, Extra-Corporeal Membrane Oxygenator (ECMO) and the robotics surgery programme to NHCS.

Steering the surgical ship

At the young age of 35, Assoc Prof Chua became the Head of CTS. It was a huge challenge then as he was the main surgeon at NHCS. He juggled the (almost) daily on-calls and interrupted sleeps with phone calls coming from the hospital in the middle of the night updating him on the conditions of critical patients. It was not until new blood joined the department over the years that the workload became more manageable, allowing the whole CTS team to further strengthen their skills and capabilities.

While he stayed focused on his intensive and extensive surgical work, Assoc Prof Chua also made a commitment to train his junior surgeons. A firm believer in imparting his knowledge and skills to younger generations of doctors and other medical staff, he also believes in succession planning for leadership for the institution, “You need to have two or three staff trained in every discipline, this is why training and learning is so important.”

He believes that each individual has their unique strengths and is dedicated to grooming and developing these doctors to their fullest potential in all aspects – from clinical care, research to personal development.

Going beyond local borders

Besides treating patients in Singapore, Assoc Prof Chua also leads medical and mission teams to China, Myanmar, Vietnam and more, for surgeries and case discussions. He believes that one of the ways to achieve beyond what a clinician can do is to look at improving healthcare in global health perspective. For examples, important causes such as bringing healthcare aid to the rest of the world like healthcare provision to places with malaria and emerging disease.

In 2014, Assoc Prof Chua was appointed the Group Director for the International Collaboration Office for SingHealth. He has since led teams of healthcare professionals in outreach and humanitarian mission efforts to regions such as China, Papua New Guinea, Nepal, Cambodia and Vietnam.

Assoc Prof Chua went on multiple medical mission trips to Kayin Chiang Station Hospital, Myanmar where he and his team are on a 10-year project to assist with patient consultations.

With these humanitarian efforts, Assoc Prof Chua said that resources such as medical equipment and supplies were often needed, “Some may think I’m a beggar or a karang guni (rag-and-bone) man. Those whom I meet often are asked to give money (for funding of humanitarian trips) or medical equipment!” He added that unwanted hospital equipment such as ECMO machines or hospital beds were often sent to countries on his mission trips, where they were given a new lease of life.

Closer to home, Assoc Prof Chua had helped to garner funding for the prestigious International Council of Nurses Congress 2019, held for the first time in Singapore.

His mentor

When asked who was his biggest influencer or mentor, Assoc Prof Chua was almost hard-pressed for an answer, recalling how there were too many ‘teachers’ in his life, “A great mentor I really cherish was Professor Abu Rauff whom I had learnt so much from and was a very important figure during my surgical training days.

He told of how he had initially failed one of his medical exams, “Prof Rauff was a positive force. He told me not to worry about failures and said that I may feel like it’s the end of the world now but in future, I would surely look back at this as a defining moment in making me a stronger person. He then paid for me to retake the exams.”

Assoc Prof Chua (middle) with fellow supportive colleagues.

When asked if he had any advice for younger, aspiring cardiothoracic surgeons, Assoc Prof Chua had this to share, “You need the fire in your belly in whatever you do in life. Do your best and learn to enjoy things that come your way.”

Our outstanding clinician certainly has lots that we can learn from, and we are immensely proud for all that he had achieved for NHCS and beyond!