By Professor Wong Tien Yin
Group Director of Research, SingHealth
Senior Consultant and Deputy Medical Director, Research, Singapore National Eye Centre
Vice-Dean, Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore

When we talk about embarking on a journey to become an Academic Medical Centre (AMC), we are aware there are significant challenges to tackle, structures to build, partnerships to forge and people to engage.

I was privileged to be selected as an Eisenhower Fellow* to visit the top academic medical and research institutions in the US for two months, with an aim to broaden my horizons on our vision to build up Singapore’s largest Academic Healthcare Cluster. I realise that while we have a long way to go, in many aspects, we are off to a great start.

*Eisenhower Fellowship is a pogramme where outstanding leaders worldwide visit and consult with key players in the US to further their contributions to society.   Notable past recipients from Singapore include several current and former Permanent Secretaries and Ministers.

Several observations in particular struck me and are worth emulating.

First, successful institutions are led by clear nd visionary leaders who embrace and onsciously nurture a culture of innovation and excellence.   Leaders encourage and ave a high tolerance for changes; some eaders even say, “change is expected” as art of the culture.   Furthermore, there is an xpectation that “failure leads to success” ith no stigma of failing.

Second, there is a strong tradition of celebration and sharing successes. In Stanford and Harvard, decorated hallways celebrate successes and outcomes from their Academic Medicine journey, reinforcing the core vision and creating a culture that makes the institutions a great place to work for top talents. I   even observed these at the train stations in Pittsburgh and in the airport in St Louis.   Universities and hospitals showcase their innovation in science and medicine and there is a commitment for Academic Medicine to reach out to the community. 

Third, a committed partnership between the medical school and the hospital brings transformation to the entire healthcare system as well as the community at large.  

An example of this is the role of University of Pittsburgh Medical Centre (UPMC) in the transformation of what was a “coal and steel economy” in the 1970s to now being a global giant in Academic Medicine and centre for innovation. 

While the promise of a better tomorrow might steer us in the right direction, there are still several hurdles we have to clear in order to make our mark in the world of Academic Medicine. 

First, we have to clearly ration the emphasis we place on our tripartite missions.   Patient care, research and education must each stand on equally important grounds and support one another in achieving a level of growth that is both organic and impactful. 

In research, bridging the gap between physician and scientist remains one of our biggest challenges, as it is even in traditional powerhouses such as Harvard, Mount Sinai Hospital and University of California, San Francisco.   It is vital that we establish a culture of understanding and a successful “marriage” of the two will result in the nurturing of more clinician scientists and translational outcomes that benefit our patients directly. 

Singapore has the disadvantage of a small size with a small patient base.   Thus, we need to make “every patient a research participant”, focusing on medical intersections where the need for a cure meets the availability of local expertise.   We have to develop our key strategic areas. We can then dedicate the limited resources to achieving long-term outcomes without the stresses of immediate returns on investment.  

These are not uncommon issues, but no journey is started without an end in mind. 

If one takes a closer look, our SingHealth Duke-NUS partnership is actually already well on its way to improving the lives of our patients through high quality clinical care, innovative education, and breakthrough research. We can do this by establishing a culture of medical excellence that exemplifies every successful AMC.