Clinical care, medical research, education and administration - Professor Fong Kok Yong has covered them all at the highest levels during his 39 years in healthcare. In recognition of his stellar leadership and contributions, the Deputy Group CEO (Medical & Clinical Services), SingHealth, Chairman of Medical Board, Singapore General Hospital (SGH) and Senior Consultant Rheumatologist has been conferred the SingHealth Duke-NUS Seah Cheng Siang Professorship in Medicine. Prof Fong remembers the master clinician and shares how he plans to use the Professorship to build on Prof Seah’s medical education legacy.

What impact did Professor Seah Cheng Siang have on your career?

I was fortunate to join Medical Unit III at SGH in the 1980s, when it was led by Prof Seah. He set high standards for patient care and expected everyone to work hard to achieve them. His meticulous eye for detail could be rather intimidating, but I learnt much from him. Prof Seah cared deeply for all his patients, regardless of their wealth or social status. He was an expert in diagnosis and encouraged his doctors to conduct research. He was particularly passionate about medical education, mentoring the doctors in his team, passing on his clinical skills and knowledge and also championing specialist training in Singapore. Building on his legacy, I want to use this Professorship to do more to ensure our doctors have the right skills they need to practise Medicine in the 21st century. 

How have training needs changed since Prof Seah’s time? 

Technological advances over the past 30 years have transformed the way we diagnose illnesses. For example, generations of doctors have used their hands to check for and assess an enlarged liver, and palpation is still taught to medical students. However, a scan can now give a more definite, detailed result and with accurate measurements. Therefore, I plan to use the Professorship to define the clinical skills today’s doctors need. Are there traditional skills that can be de-emphasised and new techniques that need to be developed? How can we develop a framework to ensure that doctors are equipped with the right mix of skills to deliver the best care they can? This will have an impact on the curricula and the way in which we train doctors.  

For example, with so much data now available, our doctors need to develop capabilities in informatics and data analytics to enhance clinical reasoning. Similarly, as we delve deeper into genomics and cellular therapies, more emphasis must be placed on medical ethics, so that doctors can anticipate potential issues and understand the importance of following guidelines to safeguard the patients’ safety and privacy. 

Despite the rapid developments in science and technology, Medicine remains deeply human in nature. Today’s junior doctors have grown up with smart phones and in this increasingly digital age, they are so much more connected, active on social media and adept at communicating via their phones, sometimes to the detriment of face-to-face conversations. Now, more than ever, the communication skills that Prof Seah instilled in his doctors, such as the art of listening to patients, expressing concern and knowing how to talk to family members, need to be emphasised and reiterated.  These skills help build trust in the patient-doctor relationship and can teach doctors lessons that last a lifetime. 
Please share an example of a lesson that a patient taught you.

I was fortunate to receive such a lesson early in my career. In the 1980s, when I was a Medical Officer running an outpatient clinic at SGH, I remember an old woman who waited several hours for me to finish the clinic. It was Chinese New Year and she had walked to SGH from Chinatown to give me two mandarin oranges to thank me for looking after her. That simple gesture encapsulated the meaning of all we do. It has carried me through my career, keeping me rooted during the ‘ups,’ picking me up during the ‘downs’ and constantly reminding me of the difference healthcare professionals make to our patients’ lives. 

Why are you choosing to focus on education rather than research?

I’ve been interested in both medical research and education throughout my career. When I specialised in rheumatology in the 1980s, the field was relatively new in Singapore. I was particularly interested in Systemic Lupus Erythematosus (SLE) because this relatively rare autoimmune disease mainly affects young women. At that time, it was often fatal, but thankfully now there are drugs to manage it, although there is still no cure. In SLE, the body’s immune system attacks major organs such as the kidneys, brain, skin, heart and the joints. This can have a huge impact on a patient’s quality of life.  

My initial research focused on the epidemiology and mortality of SLE so as to get a better understanding of the situation here. Over the years, my research narrowed in on immunological markers and I became particularly interested in neuropsychiatric lupus, where antibodies attack the brain. This results in symptoms ranging from headaches to memory loss, seizures and strokes. Differential diagnosis is challenging but important to ensure medication is adjusted correctly and it becomes a balancing act when a combination of these factors are involved.

Training juniors has always been an expectation of doctors because much of the learning happens after medical students graduate and start treating patients. However, early in my career I was fortunate to work for some of Singapore’s great medical teachers such as Prof Seah, Prof Feng Pao Hsii, the father of rheumatology in Singapore and Prof Wong Hock Boon, the renowned paediatrician. Benefiting from their teaching expertise highlighted to me the importance of medical education and the impact it can have on patient care. I also enjoy teaching clinical skills and providing a listening ear and guidance when staff face challenging situations at work and watching them progress in their careers. 

When I became Chairman Medical Board at SGH in 2012, I decided to stop doing active clinical research, but I have continued as a collaborator, and actively support and encourage research initiatives. I have also continued my interest in medical education, chairing the Residency Advisory Committee in Rheumatology. Going forward, I feel that using the Professorship to focus on the training needs of today’s doctors will have a significant long-term impact on healthcare in Singapore and be a fitting way to continue Prof Seah’s legacy of clinical excellence and medical education.

What does it mean to you to be conferred the Seah Cheng Siang Professorship in Medicine?

It is an honour to be conferred a Professorship named after one of my mentors and one of Singapore’s great physicians. When the Seah family made a generous gift to the SingHealth Duke-NUS Medicine Academic Clinical Programme (ACP) to honour Prof Seah’s contributions to Medicine, the ACP decided to put it towards establishing a Professorship in his name. Prof Seah taught and shaped the careers of nearly two generations of doctors who are now teaching and practising in universities, hospitals and clinics in Singapore, and many of them willingly contributed to the Seah Cheng Siang Professorship in Medicine. Prof Seah died in 1990, yet nearly three decades later, his former doctors and students continue to recognise the impact he had on their careers, a testament to his reputation as a truly outstanding clinician and teacher.