Living Better, Longer: How Research Is Giving New Life to Ageing - National University Health System
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ISSUE 39
AUG 2021
DOSSIER
Goh Keng Swee Foundation Gifts S$1.2m
Living Better, In support of medical education for financially
disadvantaged NUS medical students.
P. 10
Longer: COVID-19 SPECIAL
COVID-19 Vaccination Phases or Passports:
How Research Is Giving Special Rules in Special Times?
New Life to Ageing
Thinking through policy measures in this new normal.
P. 22
Contents
DOSSIER 18 Little Known: Raising Awareness of
02 Walking in Their Shoes Lymphedema
04 NUS Medicine Clinches Grand Gold in the 20 All the Buzz and Bites of Malaria
CASE 2021 Circle of Excellence Awards
05 First in Singapore: WSQ Professional Biorisk COVID-19 SPECIAL
Management Training Course at NUS Medicine 22 COVID-19 Vaccination Passes or Passports:
Special Rules in Special Times?
06 INSIGHTS
Medical Education, Technology 24 Don't Slip Up on Sleep
26 Knocking on Wood – Superstitions, Taboos
and Enterprise (METE) and Meaning-making in Medicine
30 Conversations Worth Having
32
Medical Technologies
Open Doors to New
Possibilities
10 Goh Keng Swee Foundation Gifts S$1.2m in
Support of Medical Education
48 NIC Art for Kids – Disrupting Cancer,
Restoring Lives
IN VIVO
12 Ah Leng’s Canteen
SCIENCE OF LIFE
34 Found – A Key Protein Essential for Building
the Brain’s Neuronal Network
A L L I N T H E F A M I LY
38 Musings of a Family Medicine Residency
Programme Director
14 E T H I C A L LY S P E A K I N G
Living Better, 41 Compassion – An Ethical Imperative
Longer: How
Research Is Giving PEOPLE OF NUS MEDICINE
New Life to Ageing 44 The Eye Surgeon’s Art – A Matter of Heart,
Hands and Ears
DEAN’S MESSAGE
Dean’s 1962 by the University of Singapore and was
appointed Founder Director of the School
Message
of Postgraduate Medical Studies (now the
Division of Graduate Medical Studies) in
1965. His devotion to the daily ward round
with the Paediatrics department was
legendary. Starting promptly at 7.30am every
Dear Reader, day, a gruelling 365 days a year, Prof Wong
I
led a long train of paediatricians, trainees,
t is August 2021, and we are a year and and students through the wards, solving
a half into the pandemic. Much has clinical problems for all patients, regardless
changed, and much more change will of social class. Each day, immediately
come our way in the coming months after the ward rounds, Prof Wong would
as we learn to deal with the impact of the jot down on a small piece of paper the
virus and adjust to new ways of living. upended their clinical postings, killed off difficult problems he had encountered on
overseas attachments and programmes the ward rounds. He would then make his
Amidst these unprecedented times, we and plans, forced them into online learning way to the medical library to research the
welcome the Class of 2026. Medical and sessions, and minimised social interaction. latest advances on these clinical problems
nursing studies for our newest students The Class of 2020 did not even have the and write down his findings. This lifelong
will be an experience unlike that of their opportunity to participate in the time- habit of continuous learning and teaching
predecessors’. But thanks to careful honoured tradition of receiving their degree culminated in 52 volumes of the Paediatric
planning, blended learning, innovative scrolls on Commencement Day, so urgent Clinical Conference notes, wrote two of
pedagogies and creative technologies, we was the need for their services. Along his former students turned colleagues,
are able to make the learning journeys of with the Class of 2021, the shared spirit of Dr William Yip and Prof Quak Seng Hock
our new students as enriching and fulfilling tenacity and compassionate devotion to in a tribute to their teacher and mentor
as that experienced by their seniors. duty in the face of uncertainty and highly in March 2009. Besides his academic
stressful times is laudatory. Let me share approach to the practice of paediatrics,
But what will the world be like by the time the example of Dr Megan Loy, from this Prof Wong campaigned vigorously to tackle
they graduate? While it is highly possible year’s graduating class. childhood malnutrition and infantile
that COVID-19 may have been suppressed, diarrhoeal diseases, through the promotion
or at least controlled, thoroughly by then In her Phase III Paediatrics posting, Megan of breastfeeding, aiming to improve the
with the arrival of next-generation vaccines met a woman whose daughter had been health status of children in the region. He
and therapeutic treatments, what other warded for treatment. The mother’s distress pioneered the use of rice-water for oral
pandemics are waiting to jump out of over her daughter’s condition prompted rehydration in the management of acute
Pandora’s Box? How do we ensure that Megan to reach out to the woman to gastroenteritis, and this enabled a new and
tomorrow’s doctors and nurses are equipped reassure her that her daughter was being highly cost-effective approach to diarrhoeal
to meet the challenges that will surely be well looked-after. It was a small gesture that diseases in the developing world. His
waiting for them? In this sense, nothing has touched the woman profoundly. A few years pioneering work on glucose 6 phosphate
changed. The study and practice of Medicine later, in her final year of medical school, dehydrogenase (G6PD) deficiency in
has evolved and developed in response to one of the House Officers on Megan’s team newborns resulted in a significant reduction
new needs, whether these take the form turned out to be a relative of this woman. in the incidence of kernicterus in Singapore
and shape of novel viruses or diseases that The House Officer recounted that the and in the region. Prof Wong passed away in
are a consequence of globalisation and our woman still spoke fondly of the kindness December 2008.
21st century lifestyles, as well as the ever- that Megan showed her. A comforting word
widening effects of global climate change. and a listening ear—clear testimony of the Two alumni of the School, generations
impact that genuine compassion can have apart, but linked by an enduring common
The Class of 2026, like those before and on the lives of patients and their loved ones. compassion to provide the best of care for
after them, will need courage, vision, others. This is the DNA of the School that
compassion and drive to successfully The same spirit of compassion drove another has energised every generation of NUS
handle the stresses and challenges that will alumnus, the late Professor Wong Hock Boon Medicine students.
be waiting for them. I see these qualities in to devote his life to caring for people. Prof
this year’s graduating classes of 2020 and Wong graduated from the then University
Yours sincerely,
Yap Seng
2021. They have come through a particularly of Malaya in Singapore in 1952. He was
trying 18 months, in which the pandemic offered the Founder Chair of Paediatrics in
NUS Yong Loo Lin Follow us on
School of Medicine
1E Kent Ridge Road @NUSMedicine
NUHS Tower Block, Level 11
Singapore 119228
MediCine is published quarterly Tel 6772 3737 @NUS Medicine
by the communications office of Fax 6778 5743
the NUS Yong Loo Lin School of Email medmedia@nus.edu.sg NUS Yong Loo Lin
Medicine. Web medicine.nus.edu.sg School of Medicine
ISSUE 39 / AUGUST 2021 1
DOSSIER
Walking in Their Shoes
BY KOH YE KAI, NICHOLAS, PHASE II MEDICAL STUDENT
In light of the COVID-19 pandemic as
well as circuit breaker measures imposed
throughout Singapore from April to June
2020, the healthcare and social needs of
marginalised communities were brought
even more to the fore. People were
urged to stay at home and only leave
their residences for “essential activities”.
The chatter and buzz on the streets of
Singapore faded into an eerie quiet. For
some communities living on the fringe,
adjusting to the “new normal” became a
new reality they had to face and tackle.
I
t was in this context that experience as a former drug playing through the boom box,
we—Phase 1 NUS Medicine abuser, which resulted in her Mel danced on as we followed
students—embarked on serving two terms in prison. her energetic moves.
a five-day “Medicine for She founded the dance group
the Marginalised” experiential to provide teens with a sense While Mel’s dance routine
learning journey (MMEJ) from of belonging, and to keep them highlighted the ways in which
14 to 18 December 2020. This away from a life of drugs and art intersects and transcends
experiential programme was unhealthy habits. social troubles, the night walk
crafted and helmed by Associate around Jalan Kukoh gave us
Professor Tan Lai Yong for Joined by two other dancers, an opportunity to experience
students to learn about the Mel led the students on a how social architecture can
social determinants of health socially distanced dance shape community bonding. As
among vulnerable groups such routine. It felt poignant to 26 an old public housing estate,
as the homeless, elderly and be part of the routine once I medical students Jalan Kukoh houses many
former convicts. understood Mel’s perspective. took part in rental flats—usually heavily
the five-day
For Mel, dancing is her way of "Medicine for the subsidised—for individuals
Twenty-six medical students coping with stress and to keep Marginalised" and families with no other
settled in at the Kampung from straying back into her experiential housing options. We began the
learning journey
Siglap Life Skills Training and previous lifestyle. For me, Mel’s from 14 to 18 nights’ activities with a sharing
Retreat Centre on our first day story illuminated the mental December 2020 session. Under whirling ceiling
of MMEJ. The centre engages and emotional turmoil of an fans at Jalan Kukoh Food
with displaced individuals unstable family and social Centre, Mr Irza, a volunteer
and families to promote their environment which led to football coach, shares with
well-being, by providing unhealthy coping mechanisms, us his experience coaching
them with skills necessary such as stealing, fighting teenagers from lower income
for independent living. At and drug abuse—a story that families at a street soccer court
the centre, Mel, founder of resonated with many of her on the rooftop space above
community dance group—Plus dancers at Plus Point. Stepping the Jalan Kukoh multi-storey
Point, candidly shared her life to the beat of hip-hop music carpark.
2
DOSSIER
Much like Plus Point, football The next day, we were treated chat with the fisherman as well
training is a way to engage to another morning of walking as the retired doctor, I discovered
teenagers from at-risk at East Coast Park. “Observe how green spaces can serve to
backgrounds—by nurturing your surroundings carefully… deliver positive social, mental and
a sense of belonging and what you see as well as what physical health for all. As a respite
encouraging meaningful you do not see… the people who away from dense urban centres,
time outdoors. We learnt that exercise and the people who eat green areas provide restorative and
through Mr Irza’s guidance and at the food centre”, advised Assoc serene spaces for reducing stress,
motivation, the teenagers are Prof Tan, before dismissing us, carrying out lifestyle activities, and
empowered to explore their in groups of five, to explore the improving social interaction and
passions and develop self- area. To the sounds of Chinese community bonding.
discipline through the sport. music played through speakers by
After the session, Assoc Prof Tan elderly people practising qigong We ended our walk at East Coast
guided us through the corridors underneath ketapang trees, and Park with lunch at Marine Parade
and stairwells of Jalan Kukoh as the chatter of senior citizens Food Centre. Between food,
well as the adjacent Chin Swee heading home after a morning exercise and lifestyle activities,
Estate, observing the sights and swim, we set off. My group struck health and medicine, we learnt
sounds of the neighbourhood, up a conversation with a retiree to appreciate the intricacies that
particularly the rooftop street seated on a stone bench at the edge define individuals’ well-being—the
soccer court at Jalan Kukoh. of the parkland. Coincidentally, social determinants of health that
Towards evening, we interacted he shared with us how he used to relate to what we medical students
with the estate residents, had serve as a general practitioner in will experience clinically. Indeed,
dinner at a food centre where the past when he lived in India, where food is concerned, we were
residents commonly visit, and and how he now enjoyed mornings given an opportunity to get our
spoke to an artist who usually seated along the coastline as a hands greasy in an interactive
paints in Chinatown. Known retired doctor. We appreciated his session making roti prata back at
for his paintings of famous advice for us as medical students Kampung Siglap Centre. Choosing
Singapore landmarks, this and parted ways. healthier oil to make the roti
artist sat outside OG Chinatown prata, we appreciated the chance
to paint the landscape there. Another interaction which stood to learn how diet and nutrition are
We spoke about our shared out to me was, getting to know a important factors in health and
interest, photography, and he fisherman who had just returned healthcare. At a point where health
shared more about himself. We with his fishing boat. Sharing takes centre stage in an individual’s
left Chinatown for Read Bridge how much the fishing scene has well-being, to what extent can
soon after, as I thought to myself changed since the redevelopment healthcare alleviate and mitigate
that I would soon see him of East Coast Park, the fisherman these risks?
again, seated in another spot in also recounted fond memories
downtown Singapore, focusing from the past as well as his love MMEJ ended with a case-study
on his artpiece. for being out at sea. Between our discussion conducted by Dr Paul
Ang, and other lecturers from
Family Medicine. Students were
invited to role-play as family
members of a drug abuser to
discover how our social circle
and immediate environment
can determine our habits and
coping mechanisms. This session
summarised what we went
through during the entire five-day
programme—mindfully putting
ourselves in the shoes of people
from disadvantaged backgrounds,
and coming to understand more
intricately and sensitively, the ways
Prata making in which our living environment
session and habits shape health.
ISSUE 39 / AUGUST 2021 3
DOSSIER
NUS Medicine Clinches
The School’s winning entry
Going Viral: An Academic Year in
the Time of COVID-19 provides
Grand Gold in the an account of the year in which
a novel coronavirus upended
CASE 2021 Circle of
life and business as we knew it.
Classroom lectures and tutorials
went virtual, as previously
Excellence Awards bustling campus facilities
emptied and fell silent when
Singapore went into a seven-week
long circuit breaker to flatten the
trajectory of the pandemic.
The 2020 edition Going Viral: An Academic Year in the Time of
NUS Medicine had to review and
COVID-19 is an annual publication which provides a snapshot of
revalidate the strategic game
the School's work in education, as well as research and innovation plan. The School revised and
efforts amidst the pandemic. reconstituted its approach to
medical education and research,
reorientated and then pivoted
to a different pace and rhythm
of work. Emerging from the
enforced countrywide curfew,
it was apparent that technology
had enabled much continuity
of the School's work, with staff
working relatively easily from
home. This yearbook tells of
how the School weathered the
storm, and is a testimony to
the grit, resilience and creative
resourcefulness of the staff,
students and alumni of the NUS
medical school.
The judges commented on
the entry, “While this report
is dense, the information is
presented in an organised
N
fashion that highlights main
US Medicine was the efforts of talented staff points and makes the content
one of 39 Grand members from hundreds of Going Viral: An digestible. The cohesive layout
Gold recipients institutions who advance their Academic Year
also facilitates this strong
chosen worldwide, institutions through inspiring in the Time of
COVID-19 bagged presentation of the content.
beating many organisations and and creative ideas. Winners are the top Grand The overall design is creative,
universities to clinch the Council selected based on several criteria: Gold Award.
with excellent use of colour
for Advancement and Support overall quality, innovation, use and creative implementation of
of Education (CASE) Circle of of resources and the impact on strong photography.”
Excellence Awards under the the institution or its external
“Publications”, “Institutional and internal communities, such
Relations Publications” and as alumni, parents, students,
“Presidents Reports & Annual faculty and staff. In 2021, CASE
Reports” categories. received almost 3,000 entries
from 27 countries. Those entries
Each year, the CASE Circle of came from 530 institutions across Scan to read
Excellence Awards recognises 100 categories. “Going Viral” here:
4
DOSSIER
First in Singapore:
WSQ Professional Biorisk Management
Training Course at NUS Medicine
BY DR TESSY JOSEPH, ASSISTANT DIRECTOR, BSL-3 CORE FACILITY, NUS MEDICINE
F
or the past two and skills acquired from these
decades, our world has modules enable participants
been hit by numerous to develop and implement
infectious diseases, a comprehensive biosafety
such as SARS in 2003, followed and biosecurity management
by Swine Flu, MERS, Zika, programme in biomedical
Ebola, and now, COVID-19. laboratories of various industries
As today’s world is facing a such as education, healthcare,
myriad of emerging pathogens, pharmaceutical, biomedical
the launch of the “Professional sciences and technology. It is
Biorisk Management Training” highly imperative that laboratory
course by the NUS Medicine personnel are trained in this
Biosafety Level 3 (BSL-3) core area as they play a critical role Many participants found the
facility on 4 January 2021 in reducing or eliminating Prof Chong Yap course highly relevant as it
could not be more timely. This the risk of potential exposure Seng, Dean, Yong covered a wide range of biorisk
Loo Lin School of management topics which can
inaugural Workforce Skills to biological hazards and Medicine, awarding
Qualifications (WSQ) biorisk also in preventing the loss, the certificate to be applied to their workplace
management course lays the theft or misuse of biological a participant (Ms settings. Impressed with the way
Wong Wai Kwan, the course was conducted, one
foundation for aligning the best agents, materials and sensitive Deputy Director
biorisk practices in Singapore information. of National Parks participant mentioned: “Scenario-
and aims to prepare biorisk Board, Animal based group discussions, practical
& Veterinary sessions and the learning visit
professionals adequately in This course saw its first batch Service, Singapore)
tackling future pandemics and of 19 participants successfully who completed the to the mechanical plant room
the emergence of dangerous completing four core and two Professional Biorisk of the BSL-3 core facility helped
Management us to better understand the
pathogens. elective modules. Associate Training course.
Professor Justin Chu, Director various points covered.” There
In the opening address of the NUS Medicine BSL‑3 Core was also a call from the first
delivered at the launch by Dr Su Facility, delivered the opening cohort—encouraging biosafety
Yun Se Thoe, Deputy Director address at the certificate award coordinators, BSL-3 laboratory
of Biosafety branch, Ministry of ceremony which took place on users and even top management
Health, she highlighted that this 31 March 2021. In his speech, he to attend the course.
course will prepare Singapore’s emphasised the importance and
workforce with the appropriate usefulness of this course and
biorisk management also commended the dedication About Professional Biorisk
knowledge, skills and of the BSL-3 Core Facility team Management Training
capabilities to better respond who organised this course: “It is
This course was developed under the WSQ framework,
to future infectious disease very timely we have started this funded and quality-assured by SkillsFuture Singapore.
outbreaks and pandemics in a training to enhance biosafety It is recognised by the Ministry of Health as a qualification for
safer and more secure manner. and biosecurity awareness, the Biosafety Coordinator role in Singapore. Curriculum was
developed and classes were conducted by in-house trainers
training more professionals in including Assistant Director, Dr Tessy Joseph and Senior
The comprehensive modules the field to support the national Manager, Ms Sindhu Ravindran who are both from the BSL-3
covered in this course provide need for safely managing Facility at NUS Medicine. The mode of training is interactive
with hands-on training. Biosafety professionals, laboratory
laboratory personnel with laboratories in Singapore, as well managers, researchers or anyone keen to learn more biorisk
a foundation in biorisk as protecting the personnel and management are all welcome to enrol.
management. The knowledge the environment.”
ISSUE 39 / AUGUST 2021 5
DOSSIER
Medical Education, METE aims to enhance the adoption
Technology and of digital transformation in medical
education, and serves to:
Enterprise (METE)
BY ASSOCIATE PROFESSOR ALFRED KOW WEI CHIEH, ASSISTANT DEAN
(EDUCATION), CHAIRPERSON, MEDICAL EDUCATION TECHNOLOGY
ENTERPRISE (METE) COMMITTEE, NUS MEDICINE
Regulate and encourage the adoption of
technology-related teaching pedagogy
Formed in 2019, the Medical Education Technology
Enterprise (METE) Committee anchors NUS Medicine’s
strategic goal of promoting innovation in technology for
teaching and learning in medical education. Review proposals for technology-related
educational pedagogy
Link with the Undergraduate
Curriculum Committee (UGCC) at NUS
Medicine to recommend suitability for
curriculum implementation
Review funding support for innovative
technology-enabled pedagogy
Collaborate with industry partners to
co-develop innovative teaching pedagogies
Explore potential enterprising
opportunities for unique pedagogical tools
created in NUS Medicine
6
DOSSIER
T
he members of the in the market to be reviewed we have identified various
METE committee and assessed for suitability technologies which may
comprise faculty for implementation in our be helpful in enhancing
members from the medical school curriculum. medical training. These are
clinical departments, medical For example, METE reviewed summarised in the chart
science cluster, nursing, the recommendations for below. Faculty members are
enterprise office, legal office AMBOSS, Acquifer, Body encouraged—through various
and administrative team from Interact and other software for platforms—to think, explore,
the Deanery. implementation at the school. play, create and innovate
The usage and outcomes of the using these technologies in
Regulate technology- online tools are also carried out medical education. By sharing
related teaching pedagogy periodically to evaluate their success stories and showcasing
and encourage technology suitability in the curriculum. projects at events such as
adoption in medical NUHS Educator’s Day, we
education In order to encourage hope to raise awareness of the
METE is the entry point for the adoption of digital importance of digital adoption
technology-enabled tools transformation at the school, in medical education.
Technology-enabled Learning at NUS Medicine
Learning Online Learning Extended Reality
E-books Gamification
Management System Resource Projects
Mixed Reality
Med2Lab (Clinical CVS Physiology
COMPASS 2.0 PASSED Virtual Reality (Project HORIZON
Reasoning) (Prof Hooi SC)
using Hololens 2.0)
Procedural Skills Psych Med E Book Project Polaris
VIP (AI Chatbot) HEALING PASS-IT
Logbook (Prof Roger Ho) (Procedural Skills)
RESCUE (CE, Project Delphinus
Integrated Care
Pathweb PRESCRIBE SDE, Med, (Communication
Chronic Disease Paramedic) Skills)
Management
O&G
Project MIRA
Anat Surgical Web
VIHA (Surgical & Clinical
(Future)
Anatomy)
Acquifer VISE
Orthopaedic
AMBOSS
VR
Complete Anatomy O&G VR –
(Subscription-based) Delivery Suite
Singular Pilot
ISSUE 39 / AUGUST 2021 7
DOSSIER
Body to review proposals
for technology-related
educational pedagogy
METE is able to review the
interesting proposals submitted
by faculty members to provide
appropriate suggestions and
support for the projects.
Through METE’s effort, we have
been able to provide invaluable
input for applicants to enhance
their projects, and continue
monitoring the progress of
the projects. One example is
the PAtient Safety aS Inter-
Professional Training (PASS-IT
2) project. With the successful
implementation of the PASS-
IT programme, the PASS-IT
team has received approval to
develop further modules using
virtual reality (VR) technology
in teaching the niche topic of
patient safety in surgery. PASS-
IT 2 is currently at the initiation
phase and METE is guiding the recommendations is essential and curriculum for critical
progress and implementation of to ensure robust evaluation of reasoning through an online
the project along the way. innovative teaching pedagogies cloud- and case-based
before they are implemented platform. Their teaching
Linking with UGCC at into our curriculum. Often, a model combines coursework
NUS Medicine to short pilot study is conducted to and technology to address the
recommend suitability gather feedback before formal reasoning training needed
for curriculum implementation. for doctors of the future. This
implementation universally applicable model
An appropriate review process Review funding support teaches critical reasoning
has been put in place for for innovative technology- by using a simulated virtual
identifying suitable online tools. enabled pedagogy patient model. Students learnt
We will conduct a trial period METE is able to provide through feedback, tailored
with free subscriptions from the some funding support for to their own decision and
software company in order to faculty members to develop reasoning patterns.
gather valuable feedback from innovative teaching pedagogies
the faculty members. Following at the medical school. We have Working closely with
that, suitable programs will be provided financial support for developers based in San
recommended for discussion the Virtual Integrated Patient Francisco, the NUS-Med2Lab
at the UGCC. Where relevant, (VIP) program to facilitate team has successfully created
UGCC will explore with the its content development and a few modules to teach clinical
stakeholders, including scale-up to the implementation reasoning at the school. More
the educators at clinical phase. In addition, we funded modules are currently being
departments and the medical the development of NUS- developed and continuous
science cluster, to explore the Med2Lab project, which is funding support has been
placement of these tools, either led by Dr Chen Zhi Xiong and secured through the regular
as self-directed learning or Dr Soh Jian Yi. The NUS- review process at METE.
mandatory guided teaching Med2Lab was developed with
tools. The bi-directional the purpose of cultivating a Funding for innovative
flow of information and medical learning approach projects does not only come
8DOSSIER
create innovative tools in medical Conclusion
education. One of our biggest At METE, we hope to encourage
partnerships currently is with the faculty members in the
Microsoft Corporation to develop school to think about technology
medical training tools using the as a potential solution to fill
Hololens 2.0 device, based on curriculum gaps where relevant.
the Mixed Reality technology. In medical training, nothing
Project Polaris, one of our first will be able to replace the
explorations done in close sacred relationship between
partnership with Microsoft, the doctor and the patient,
will explore using Hololens 2.0 and the fundamentals of
platform to develop procedural medical training will continue
skills training. to be on patient and real
clinical experience. However,
Explore potential technology can enhance the
enterprising opportunities training through standardisation
for unique pedagogical of experience, reducing
tools created in NUS opportunistic encounters,
Medicine increase interactivity and
With the appropriate personnel making medical training fun. In
in the committee, we are able addition, we can better prepare
to harness the expertise within our students through simulation
the school to direct enterprising of these experiences, and also
opportunities at the medical raise awareness of patient safety,
school. One such example is the before they enter the clinical
solely from the medical school. VIP project. The VIP platform training environment. The wave
METE has faculty members An NUS Medicine
was developed to provide of the 4th Industrial Revolution is
with vast experience in grant student learning a limitless array of virtual already here. We must actively
applications for technology- in a virtual patients. Medical students, embrace the technology and
environment
enabled educational tools. When with the use of
early career medical graduates digital transformation with open
information regarding suitable VR headsets and general practitioners have arms in medical education.
grant calls are made available, and handheld limited access to patients due to
controllers.
METE will strive to share these patients’ reluctance to be used Educators, students and
notices and information with as subjects, rarity of certain administrators are encouraged
the teaching communities. diseases, etc. Such limitations to submit their project proposal
Interested faculty members compromise the development for funding support from the
can seek guidance to apply for of clinical reasoning skills METE Committee—whereupon
these funds and appropriate and diagnostic skills. VIP can the value proposition of the
advice is provided to shape and randomly generate clinically project enriches the learning
enhance the proposals before realistic patients to supplement experience of students. The
submission. the gap in medical training METE secretariat has digitalised
and allow true conversation the application and submission
Collaborate with engagement with the virtual of proposal to make the process
industry partners to patient via a chatbot. VIP seamless, convenient and easy.
co-develop innovative also plans to launch speech
teaching pedagogies recognition and voice output
Using METE as the base, many on the platform in the future.
discussions have taken place Created in-house by Prof
to explore partnerships with Edmund Lee, Dr Judy Sng and
industry partners in this field. their team, this project has
Technology-enhanced innovative achieved significant success,
teaching tools are widely and the team is in the process
available in the market. Many of of commercialising this tool
Scan to see more
these companies have explored for wider use in the medical information about
partnering NUS Medicine to education community. METE here:
ISSUE 39 / AUGUST 2021 9DOSSIER
Goh Keng Swee Foundation
Gifts S$1.2m in Support of
Medical Education
The gift was announced on founding Prime Minister
The Goh Keng Swee Foundation, established by the 11th death anniversary Lee Kuan Yew, holding
Dr Phua Swee Liang in 2008 to perpetuate her of Dr Goh, who passed away Cabinet appointments as
on 14 May 2010 at the age of Deputy Prime Minister,
late husband's values, announced on 14 May 2021
91 after years of ill health, as well as helming the
a gift of S$1.2 million to the NUS Yong Loo Lin during which he was nursed finance and defence
School of Medicine (NUS Medicine) in support of by Dr Phua. The late Dr Goh portfolios at key stages of
financially disadvantaged medical students. served alongside Singapore’s Singapore’s development.
10DOSSIER
He is widely regarded for his initiated the establishment of NUS President Professor
role in the development of the Economic Development Tan Eng Chye said, “We are
Singapore into a prosperous Board (EDB) in August 1961. deeply appreciative of this
nation. As early as 1981, generous gift from Dr Phua.
1 in 6 Dr Goh set up the Government The Foundation has been a It will go a long way towards
NUS medical of Singapore Investment longstanding donor to the NUS nurturing the next generation
undergraduates Corporation (GIC) with Medical Society – Christine of medical leaders, helping
needs financial Chong Hui Xian Bursary,
the foresight to protect train the compassionate
assistance
Singapore’s reserves from set up in 2011. The bursary and competent doctors that
unforeseen economic commemorates the late Singapore needs, as well
crisis. In the year before his Christine Chong, from the as advancing the science
retirement from political Class of 2012, who succumbed and practice of medicine in
office, he sowed the seeds of to cancer during the course of Singapore.”
biotechnology in Singapore, her studies. In memory of her
with his involvement in passing, the 62nd NUS Medical Professor Chong Yap Seng,
Close to
the introduction of Nobel Society formed a committee Dean of NUS Medicine,
laureate Dr Sydney Brenner to raise funds for an endowed expressed the School’s
70 to Singapore, and the bursary. They approached gratitude for the Foundation’s
medical students
benefitted from
establishment of the Institute the Foundation and Dr Phua gift, “We are deeply
Goh Keng Swee for Cell and Molecular Biology was so impressed by the honoured and grateful for
Foundation's (IMCB). knowledge that the students this gift from Dr Phua and
donation to the
themselves contributed funds the Foundation. One in six of
NUS Medical
Society – Christine “I am very pleased that Dr to initiate the bursary, that our medical undergraduates
Chong Hui Xian Goh’s life and memory will she instantly made a sizeable needs financial assistance
Bursary
be honoured by this gift contribution. Since then, the and this gift from the
to NUS Medicine. In his Goh Keng Swee Foundation Foundation will be invaluable
dealings with people, Dr Goh has frequently made donations in alleviating their financial
was genuine and made no to add to the fund. Since its worries, allowing them to
distinction between race, inception, the bursary has fully experience the benefits
religion, gender, wealth or helped close to 70 medical of a comprehensive medical
power. His compassion and students to significantly education and contribute to
thoughtfulness towards people alleviate the financial burden the greater community as
has always moved me and it is of their medical education. students.”
my hope that recipients of this
bursary will embody the same
attitude towards their patients
and those around them,” said
“Dr Goh’s life and memory will be
Dr Phua. honoured by this gift to NUS Medicine.
In his dealings with people, Dr Goh
The Foundation was set up by
Dr Phua two years before the
was genuine and made no distinction
passing of Dr Goh, who was between race, religion, gender,
also Minister for Education wealth or power. His compassion and
as well as Chairman of
the Monetary Authority of
thoughtfulness towards people has
Singapore (MAS), and headed always moved me and it is my hope
various government-led that recipients of this bursary will
companies. As Singapore’s
first Minister for Finance in
embody the same attitude towards
1959, he introduced a massive their patients and those around them.”
industrialisation programme
Dr Phua Swee Liang
and transformed the swampy
Jurong into Singapore’s first
industrial estate. Dr Goh also
ISSUE 39 / AUGUST 2021 11IN VIVO
Ah Leng’s
Canteen
Ah Leng, the legendary owner and
operator of the eponymous canteen
at Sepoy Lines so beloved by earlier
generations of medical students,
passed away on 31 May 2021.
We reproduce the article below in
memory of the man whose beverages
and simple canteen menu fed
generations of medical students.
12IN VIVO
C
ounsellor, banker, Later, we started serving kway My wife and I lived at the back
provider of food teow, chicken rice, bee hoon and of the canteen with our four
and drink—Wong eventually even hamburgers for children until we bought our
Ngiap Leng operated lunch and dinner. I remember flat at Tiong Poh Road in 1966.
Ah Leng’s canteen on the Dr Mahathir (former Malaysian We could walk across the road
University’s former campus. He Prime Minister Tun Dr Mahathir from the canteen. There was no
is remembered fondly by several Mohamad, Class of 1947) liked my expressway (AYE) then and we
generations of students for the bee hoon soup. walked through the field using a
kindness he showed to many of torch because it was so dark.
them who could not pay for their After I closed my canteen at 7pm, I
meals. Mr Wong reminisced ran a small stall on the roof of KE It is true some of the students
about the time when he operated Hall, serving snacks and hot drinks borrowed money from me to
the canteen for seven days a to the hostelites until midnight. pay their fees or for food. Some
week, from 1947 to 1983. Then I would go home. It was like of them also gambled. I kept
that seven days a week. records of what people owed
The funny part about Ah Leng’s me in the tiga lima buku (555
Canteen is that it wasn’t a name I don’t know why the students liked books). Most of them paid me
picked by my father, who started my canteen. It was a cosy corner back once they started working.
the canteen in the 1920s, or where they all sat and chatted. But Some forgot, but it is okay. The
me. At that time, the hospital I can still recall the smell of the names are still in some of the
was called Sepoy Lines by the chemicals wafting into the canteen 555 books which are in a locked
British and my father just ran from the anatomy department box. I won’t let anyone see them.
the canteen… and it never had a (now a carpark near Harrower
name. Ah Leng’s Canteen was just Hall). Or was it the smell of the I collect all the newspaper
the way all the medical students dead bodies? I was not sure. articles about the canteen. I
of that time referred to it and I also received a copy of a special
guess it just stuck. And, in a way, Some of the students were book (the Centenary of Tertiary
it is apt since I was born there! hiding from lecturers, others Education by the Medical
were waiting for boyfriends or Alumni) where the doctors
I took over the canteen in 1947 girlfriends. I don’t want to say Ah Leng and
printed my name on the cover.
when my father went back to who they are but most of them his wife at Dr Ngiam Tong Lan also wrote
China—he had to shut it during are successful doctors now. And their canteen a poem about me. In 2005,
for the last
the war (World War II). I was because we were near the sports time before
Professor Tan Ser Kiat asked
19 years old and had just got field, students would pop in after it was shut me to make tea at the opening
married, so my wife helped me at playing football, cricket or hockey. down on of Duke-NUS Graduate Medical
2 June 1983.
the canteen. There were a few fights after the School at the Singapore General
games, but not at my canteen. Hospital (SGH) grounds. I was
Many of our customers were so happy to go back to SGH to
students who returned to make the same tea I made for
medical school after the war. all of them when they were
At the time, there was no students.
Singapore or Malaysia, so there
was no difference. It was just I am 86 years old now. I still
hostelites at King Edward VII remember everything; I
College of Medicine and non- remember everyone. They are
hostelites. And because we lived always in my head and in my
on the premises, we opened the heart.
canteen at 6am and closed only
around 7pm. At that time, we
served toast with half-boiled
eggs, coffee, tea, Milo, Horlicks, This story first appeared in the MOHH
curry puffs and ham and cheese book “Caring for our people” and was
reproduced in the February 2020 issue of
sandwiches. One piece of toast at the School’s newsletter, MediCine, with the
the time cost 10 cents. kind permission of the publisher.
ISSUE 39 / AUGUST 2021 13IN VIVO 14
IN VIVO
Living Better,
Longer:
How Research Is
Giving New Life
to Ageing
BY DR KHOR ING WEI
When I was younger, I thought the term “ageing gracefully”
had a nice ring to it. I rather liked the idea of someone
describing the 70-year-old me this way as I sipped
chamomile tea and knitted a scarf.
F
ast forward to body ages and, ultimately, find
the 2020s and ways to improve the health
aspiring just to age and vitality of people as they
gracefully smacks grow older.
of low ambition in the face
of research that aims to slow The work could not come 12.4%
of Singaporeans
or even reverse the ageing at a better time, what with
were older than
process. the rapid ageing of the 65 years old
Singaporean population. In in 2019
Some of this exciting 2019, 12.4% of Singaporeans
work, especially resonant were older than 65 years.
in Singapore with its By 2050, this proportion is
33%
of Singaporeans
rapidly ageing population, projected to almost triple to would be older
is taking place in the 33%.1,2 than 65 years old
NUS Medicine Healthy by 2050
Longevity Translational
Research Programme.
The programme brings Just after age 30, our bodies begin to
together scientists from a
broad range of disciplines deteriorate and our functioning declines in a
to investigate the many systemic ageing process called senescence.
aspects of ageing. The However, the most important part of ageing
researchers aim to achieve
a more comprehensive is not the actual age, but rather maintaining
understanding of how the a high quality of life for as long as possible.
ISSUE 39 / AUGUST 2021 15IN VIVO
The Healthy Longevity and clinical scientists from the Singaporean population
programme includes 39 different disciplines to address aged 40 years and older. These
members of faculty who an important disease need or biomarkers include classical
specialise in one of four focus research question. indicators like pulse rate
About the
areas: systemic ageing, brain velocity, DEXA scans, VO2max,
ageing, vascular ageing, Healthy The lifelong process of and grip strength, new
and female reproductive Longevity growing old AI‑based markers including
ageing. The programme lead, programme In the area of systemic ageing, the epigenetic clock, integrated
Professor Brian Kennedy, is a researchers are working to complete blood count data
professor in the departments understand the mechanisms and metabolomics, as well as
of Biochemistry and Physiology 39 governing how the body ages as an assessment of age based
at NUS Medicine, and the faculty members a whole and find interventions on 3D facial reconstruction
specialising in one
former President and CEO of of 4 focus areas: that slow or reverse the process. analysis. The idea is to identify
the Buck Institute for Research systemic ageing, Prof Kennedy will be working people earlier (say, around 40
on Aging in Novato, California. brain ageing, with Professor Andrea Maier, years old) who have markers
vascular ageing,
The programme is one of and female a new faculty member in the that indicate a propensity
nine Translational Research reproductive Department of Medicine who for unhealthy ageing. These
Programmes that were ageing specialises in human ageing people can then be targeted for
established at NUS Medicine in studies. One study involves interventions to prolong their
2020; bringing together basic measuring 10 biomarkers in years of healthy life.
16IN VIVO
Another exciting study in
the field is being headed by
Professor Koh Woon Puay and
involves deep characterisation “The healthcare challenge of an ageing population
of the ageing process in is one of the biggest issues facing Singapore in this
individuals during their 60s
century. By understanding the ageing process,
and 70s. This is an important
period in a person’s life, during the Healthy Longevity Translational Research
which some people remain Programme seeks to develop strategies to keep
highly functional and disease-
people healthy, happy and active as they age.”
free while others experience
significant functional decline Prof Brian Kennedy, Lead, Healthy Longevity Programme
and multiple morbidities.
Understanding what keeps
people healthy in this age researchers made modifications and Equality, was recently set up
range will help to inform the to the FINGER interventions to study ways to extend the period
development of strategies for that may be even more effective of reproductive fitness for women.
ageing populations. in the local population. The This is an exciting new direction
next step is to conduct a clinical of research, as the relationship
“The healthcare challenge of study to compare outcomes between reproductive ageing and
an ageing population is one between a group that receives the systemic ageing remains poorly
of the biggest issues facing interventions and another group understood. This institute, which
Singapore in this century. that does not. involves researchers from the
By understanding the ageing Healthy Longevity programme,
process, the Healthy Longevity Ageing in the cells that make was funded by a donation from
Translational Research up our blood vessels also has Ms Nicole Shanahan, President
Programme seeks to develop wide-ranging impacts, potentially of the Bia-Echo Foundation. The
strategies to keep people causing vascular diseases such foundation supports research in
healthy, happy and active as as heart disease and stroke. healthy longevity and equality,
they age," said Prof Kennedy. Biomarkers such as cholesterol among other causes.
and triglyceride concentrations
In Singapore, brain ageing are predictors of vascular ageing Just after age 30, our bodies begin
conditions such as dementia and the risk of morbidity and to deteriorate and our functioning
are increasing in prevalence mortality. Associate Professor declines in a systemic ageing
with the rapid ageing of Raymond Seet, Deputy Director process called senescence.
the population. Associate of the programme, is overseeing However, the most important part
Professor Christopher Chen, the development of research in of ageing is not the actual age, but
a researcher in the Healthy this area, with ongoing clinical rather maintaining a high quality
Longevity Translational cohorts and molecular studies. of life for as long as possible.
Research Programme, is Instead of our bodies slowing down
leading the SINgapore GERiatric As more women around the world as we age, the researchers in the
intervention study to reduce are deciding to have children Healthy Longevity Translational
physical frailty and cognitive in their 30s and 40s, ageing and Research programme are working
decline (SINGER).2 This study fertility has become an important to slow down the ageing of our
showed that interventions research focus internationally. bodies which is good news for all of
that prevented the onset of Professor Rong Li from the us. Perhaps I can put my knitting
dementia in Finland (in a Mechanobiology Institute at NUS needles away for a bit longer.
Finnish study called FINGER) and Dr Huang Zhong Wei from the
are likely to be effective in the Healthy Longevity Translational
Singaporean population. These Research Programme, are
interventions included diet, developing candidate therapeutics 1. Chen C, Xu X, Chew E, Henry CJ, Koo EH. Singapore
exercise, cognitive training for female reproductive ageing, intervention study to prevent cognitive impairment and
disability (singer) initiative. Alzheimers Dement. 2017;13(7).
and monitoring of vascular risk which they plan to test in clinical
2. United Nations, Department of Economic and Social Affairs,
factors such as blood pressure. trials. A new initiative, the Asia Population Division. New York: United Nations: World
In addition, the SINGER Centre for Reproductive Longevity Population Ageing; 2019.
ISSUE 39 / AUGUST 2021 17IN VIVO
Little Known:
Raising
Awareness of
Lymphedema
BY LEIGHTON TEO, CHANEL LEE, NIGEL SIM AND LEE ZHI YAN,
PHASE IV NUS MEDICINE STUDENTS
Lymphedema is one of the diseases that have low
public awareness. Currently, lymphedema patients in
Singapore can only find out more about their conditions
by retrieving bits and pieces of information from various
websites, making it highly confusing for the patients.
Motivation for patients and the general
As a group, we wanted to public. This included the
consolidate and organise definition of lymphedema,
information about this disease pathophysiology, causes,
in a way that the general clinical features, staging,
public could easily access and current treatment options as
understand. Presenting such well as the complications of
information on a website would lymphedema. This information,
not only benefit patients, which can be easily accessed
but also benefit healthcare and found on our website,
professionals. Research provides a convenient platform
regarding lymphedema and for patients to learn more about
its treatment options are the condition and encourages
continually being done and future research into the
they can be updated quickly treatment of lymphedema.
online.
We also wanted patients to
What did we do? be able to understand the
We started off by creating treatment and subsequent
various content for the website management of the disease
to provide adequate resources better. As such, we created
18IN VIVO
videos so that patients would
be able to refer to them in
the comfort of their homes
in the event that they cannot
remember how to put on
the various compression
garments. We hope that
through educational resources
found on the website as well
as videos provided, patients
would be able to better care for
themselves and prevent further
deterioration.
We also helped in the
formulation and brainstorming
of the logo for Lymphedema
Society Singapore. As these transitions were very
(From top left new, we had to adapt ourselves
Learning experiences clockwise) to the limitations of these
As medical students, Medical students meetings. Zoom did not allow
Leighton Teo,
learning should go above Nigel Sim, Chanel multiple people to speak so we
and beyond that of our Lee, and Lee Zhi decided that one person should
classroom curriculum. This Yan discussing talk at a time to ensure effective
the types of
venture has provided an content that communication among the
opportunity for us to learn should go on the team members. Zoom also had
more about lymphedema as new Lymphedema a 30-minute time limit for each
Society of
well as understand the possible Singapore website meeting and as such, we kept
treatment options available. over a Zoom creating new Zoom meeting
meeting during sessions after every 30 minutes.
the circuit breaker
As we embarked on this in 2020.
project during the circuit Thirdly, we had to learn how to
breaker period, we faced many work as a team effectively and
challenges while attempting to efficiently. Initially, we edited a
complete it. single video together which took
us more time than expected as
Firstly, this project is demanding there was no virtual platform to
as it requires us to learn and edit videos concurrently. After the
master new skills in a limited first video was done, we decided
amount of time. Unlike other to delegate the various roles to
Associate Professor Tan Bien Keem
projects, we are required to know each member such as voice-overs,
(top) from Singapore General
skill sets which were beyond our video splicing, background music Hospital and Associate Professor
curriculum: these were video sourcing, music splicing, which Veronique Angeli (bottom) from
the Department of Immunology at
editing, video-taking and website helped us to cut down on the
NUS Medicine mentored the four
creation. All of us had no prior amount of time spent on each students throughout the duration
experience in these areas. video. Hence, we were able to of this project.
meet the tight deadlines quickly,
Secondly, as face-to-face and also produce quality videos.
meetings were not possible,
meetings via Zoom were Even though this project took a
conducted. These virtual lot of time and effort, we are very
meetings were not as grateful for this opportunity as
productive as physical meetings we were able to learn more about
and it was not easy to find lymphedema as well as improve
suitable time slots for all of us our skills and work effectively as Scan to view
to meet. a team. website here:
ISSUE 39 / AUGUST 2021 19IN VIVO
All the Buzz and Bites of
Malaria
In April 2021, the Department of Microbiology
and Immunology at NUS Medicine was abuzz with “Malaria is an
anticipation and activity, as researchers, staff and
infectious disease
students came together to mark World Malaria Day.
that is still
endemic in many
T
he idea of having a a senior lecturer from the countries today,
department-organised department, led a team in
organising an on-site event
and we believe that
initiative to highlight
the complex issues which comprised a series commemorating
surrounding malaria was of short, live seminars World Malaria
first put forward by Dr Ch’ng by researchers from NUS
Junhong, a lecturer from the Medicine, pre-recorded talks by
Day offers us an
department. He explained, international guest speakers, Did you know?
opportunity to look
“Malaria is an infectious games and activities, as well as World Malaria
Day is on
beyond the biology
disease that is still endemic in a showcase of malaria-related
many countries today, and we exhibits and photographs.
25 April of the disease, which
believe that commemorating is typically what
World Malaria Day offers us Discussing the history is emphasised in
an opportunity to look beyond of malaria in Singapore,
the biology of the disease, the situation in countries
the School, to the
which is typically what is plagued by the disease, interdisciplinary
emphasised in the School, to elimination efforts and vaccine issues that underpin
the interdisciplinary issues that development across the world,
underpin real world progress.” the outreach shed light on
real world progress.”
current research surrounding Dr Ch'ng Junhong
As part of the initiative, malaria, and why the disease is
Dr Rajesh Chandramohanadas, still relevant to Singapore.
20IN VIVO
Dr Rajesh
Chandramohanadas
observing malaria-
infected blood
cells under a
microscope.
In circle:
Microscopic view
of malaria-infected
blood cells (visible
as blue dots) among
human red blood
cells (stained light
purple).
“Although Singapore was declared malaria-free by the World
Health Organization in 1982, the nation remains surrounded
by countries vulnerable to the disease. We play an important
role in the global fight against the debilitating disease, and
it is my hope that our outreach can help explain how we are
contributing towards that.”
Dr Rajesh Chandramohanadas
“Although Singapore was context of the disease through
declared malaria-free by the bite-sized information and
World Health Organization interesting trivia on malaria
in 1982, the nation remains and the global research work. Find out more here:
surrounded by countries
vulnerable to the disease. Associate Professor Kevin Tan, https://www.
We play an important role in who heads the department, straitstimes.com/
singapore/health/
the global fight against the added, “It is important to singapore-a-hub-in-
debilitating disease, and it is recognise that the war against region-for-malaria-
my hope that our outreach malaria is not yet over. We research.
can help explain how we hope that through our team’s
are contributing towards outreach efforts, we have
https://www.
that,” shared Dr Rajesh helped the larger audience straitstimes.com/
Chandramohanadas. see the need for continued singapore/can-malaria-
outbreaks-bite-spore-
investment and commitment
again.
To inspire conversations on for malaria prevention. We
malaria, the department also believe the initiative has also
carried out a virtual walkathon offered our students insight on
to raise awareness of malaria what education entails—that
relief efforts across the globe, beyond achieving good grades, https://www.
and put together an extensive there is very significant and againstmalaria.com/.
series of malaria-related real impact on what is taking
content on social media. Led place globally, in terms of the Or follow us:
by Dr Ch’ng, the department’s political, geographical and
@uictok @uictok
social media team introduced demographical aspects of
the biology and on-the-ground infectious diseases.”
ISSUE 39 / AUGUST 2021 21You can also read
