Back

Donning the White Coat

Marking the start of an exciting new journey, the fourth batch of medical students were inaugurated to the Duke-NUS Graduate Medical School at the symbolic White Coat Ceremony, held on 13 August 2010.

Ms Yong Ying-I, Permanent Secretary of the Ministry of Health graced the event as Guest of Honour. Over 250 guests were present, including fellow students and faculty members from both Duke and Duke-NUS.

The Class of 2014 comprises 56 students from 15 countries and 24 academic institutions around the world, their varied backgrounds adding richness and diversity to the vibrancy of Duke-NUS. The joy of each medical student was palpable amid beaming mentors and elated parents, some of whom flew into Singapore specially to participate in what must be one of their child’s proudest moments in life.

The SMA News takes the opportunity to connect with Ms Ong Shi Wei and Mr Wong Zi Yang, medical students from the Class of 2014, both of whom are equipped with sterling nursing backgrounds.

SMA: Congratulations, Shi Wei and Zi Yang! Both of you have backgrounds in Nursing – Why didn't you pursue Medicine in the first place, and what made you decide to take it up?

Shi Wei: My entry into Nursing was fortuitous – I had actually always wanted to be a doctor, but was unable to gain entry into the NUS School of Medicine when I applied after my ‘A’ levels. To sum up simply, I joined nursing when I realised that I wanted to be in an industry where I could make a difference, and where what I did mattered in a person’s life. And so, if I couldn’t be a doctor, then maybe I could be a nurse. I completed my B.Nursing (Hons) specialising in psychiatric mental health nursing at the University of Manchester, UK, and worked as a nurse at the Institute of Mental Health for 10 years from 2000. I revisited my dream of becoming a doctor when I realised that even though I had gathered much experience as a nurse, there was still a lot that I did not know. I became dissatisfied with how my care for patients was limited by my lack of knowledge. I want to be able to do more for my patients; and if I have been a good nurse to my patients, I can be even better as a doctor with my nursing background.

Zi Yang: I have always been interested in Medicine since young and seek to have a holistic view of healthcare. With the advent of both Duke-NUS and the Nursing degree course from NUS, I realised that I had the choice of pursuing an undergraduate degree in Nursing to broaden my perception of healthcare and undertaking Medicine after I obtained my basic degree. I believe that entering Medicine with a good knowledge of the practicalities of caring for my patients will help me in my day-to-day clinical decisions in the future.

SMA: What would you say is the biggest difference between Nursing and Medicine?

Shi Wei: Both Nursing and Medicine share the same goal for optimal patient care and management of their health and disease conditions. But the way the two disciplines go about achieving this goal differs – Nursing strives for a broad-based education across the disciplines that govern or affect health, including the biological and social sciences, as well as the softer aspects of caring. A nurse is a little like a “jack of all trades”: knowing the basics of anatomy, physiology, pharmacology, psychology, sociology, and so forth, but not in any great depth. Its place within the healthcare system and structure (frontline, 24/7 point of contact for patients, families/caregivers and other health professionals) require that they have this basic knowledge. Conversely, Medicine delves deep into the one critical aspect of health and disease – its scientific and biological basis. Drawing an analogy, from the daily interactions and monitoring of patients and their conditions, Nursing picks up various pieces of the puzzle, while Medicine’s contribution is in seeing how these pieces fit or click together in the bigger framework of the physiological mechanisms of life and disease.

Zi Yang: Nursing as epitomised by Florence Nightingale is about the art and science of caring for patients, while Medicine is the brain and cognitive process behind the treatment of patients. Nursing is involved with the art of delivering care such as administering intravenous drugs efficiently and correctly while in Medicine, it is about deciding if the intravenous drug is right for the condition ofthe patient. It is apparent that both Nursing and Medicine deals withpatient care at different levels.However I felt that there is more similarity between Nursing andMedicine than difference, in that both strive for the best clinical outcome in patients. This is to mean that both Nursing and Medicine put patient care and outcome above all other considerations. Personally I feel that itis only with such an understanding between the two fraternities that wecan deliver the best possible outcome for the patients.

SMA: One of the fundamentals in Medicine is patient care – given your experiences in Nursing, are there any advantages ordisadvantages anticipated in your academic and clinical roles?

Shi Wei: A clear advantage is that nursing patients on a 24/7 basis has provided me with the opportunity to observe and understand how their illnesses (and prescribed treatments) affect daily functioning, as opposed to just hearing their descriptions of symptoms and troubles. I have visited patients in their homes, and have observed first-hand the living and social circumstances that impact patients’ coping and adherence to treatment; experiences which cannot be gleaned from interviewing patients in a consultation room. Thus in my future physician’s role, I can relate better to the patient experience, and speak with more than just academic knowledge of disease and pathology.

Zi Yang: From an academic point of view, studying about the conditions or even molecular basis of the conditions was easier because I was able to draw relation from the clinical knowledge obtained from my Nursing degree. For example, learning the molecular basis of diabetes in retrospect helps me to understand why we give certain anti-diabetic drugs to different patients.

Clinically, I realise that I have entered Medicine from the perspective of a nursing clinician; this primes me to seek relations of the knowledge obtained during studies to patient care. I have also found that the drive to study more does not lie in the anticipation of having to regurgitate information during class tests but more often than not, I know that any extra information obtained will aid me in patient care in the future as a physician.

SMA: Would you say that a nursing background has endowed you with crucial soft skills such as communication, which wouldstand you in good stead as a clinician?

Shi Wei: Definitely. A clinician not only requires hardcore knowledge and skills, he/she also needs to be able to relate and communicate with patients, families, as well as co-workers in the healthcare team. Nursing has given me ample opportunities to hone my skills in this area, as frontline workers who deal with people on a daily basis, including challenging interpersonal situations.

Zi Yang: Learning about therapeutic communication is part of being in Nursing and I feel that soft skills such as empathy will aid me in connecting with my patients. I hope that with the communication skills I have obtained and am continuously developing myself with in Duke- NUS, I will be a bridge between my patients and the rest of the medical professionals so as to coordinate and advocate the best care for them. In addition, I hope that I will be able to have a balanced view on clinical problems based on the perspective of Medicine, Nursing and the patients themselves.

SMA: Shi Wei – How do you juggle a hectic school life with family?

Shi Wei: With clear priorities, discipline, necessary sacrifices, and tremendous understanding/support from my family. There are only 24 hours in a day, so some things have to give. Weekday evenings are dedicated to my 4-year-old daughter when I get home from school, so studying starts only from her bedtime. On weekends, I split the days between family and study time.

I am fortunate to have built up a strong relationship with my girl, so that she is ok with me needing to carve out time to study. That’s because I make sure that when I am with her, I am present, not just there. In fact, she actually prompts me to “go study” when she goes to bed, and even on weekends after I have spent time with her.

Nonetheless, I still struggle with keeping up with the frenetic pace. To this end, Duke-NUS’s innovative TeamLEAD paradigm of learning has allowed me to learn in a much more efficient way than I ever could within the limited amount of time I have.

SMA: Zi Yang – Having obtained B.Sc Nursing from NUS, and moving on to Duke-NUS with its varied student pool, do you think there are any differences between both institutions? For example, are local students more exam-oriented?

Zi Yang: Having been in both NUS and Duke-NUS has definitely been an eye-opener. This is the first time that my class is made up of many international students, all of whom are highly intelligent. At first I was quite apprehensive whether there would be communication difficulties between the local and the international students. However after spending time together these past two months, I am glad that this potent mix of local and international students has proven to yield fantastic results in terms of generating ideas and helping one another to develop critical thinking skills.

A perennial symbol of physicians, the white coat also embodies the compassion to be afforded to patients, and the donning of which represents a student’s entry into the calling of Medicine.

Extracted from SMA News September 2012