Dear Fellows,
This month’s message is a bit more detailed and data-heavy, but I believe it is an important topic for us to explore. Before diving into the core focus of this message – Medical Manpower – I would like to take a moment to share an important announcement with all fellows and members of AMS.
Before the end of this year, AMS will be conducting a comprehensive engagement survey. The last survey was conducted in 2021, and it is time for us to gather fresh insights into how we can better serve you. I strongly encourage each of you to take a few minutes to participate in this online survey. Your feedback will help us refine our efforts, ensuring AMS can be more responsive, relevant, and valuable professional body for all our members.
Thank you for your continued support, and now, let us delve into the topic of Medical Manpower.
Recently, I have received some anecdotal observations from a few specialist colleagues that our public healthcare sector may be somewhat now “top-heavy” in terms of medical manpower.
The latest SMC Annual Report (2024) has been released just earlier this month. It has been my habit for many years to read the Report almost cover to cover.
The Numbers at a Glance
- As of 2025, 18,316 medical practitioners are registered in Singapore, resulting in a doctor-patient ratio of 1:343.
- Over the past five years, the number of medical practitioners has grown by 600 to 800 annually. In 2024, this growth reached 850, but there were only 734 provisional registrations (i.e., house officers). This suggests that the difference between 850 and 734 likely reflects an increase in conditional and temporary registrations.
- The growth rate has accelerated in the last two years, especially when compared to the Covid-19 period (2020–2022).
About 12,155 doctors (two-thirds) serve in the public sector while the remainder work in the private sector.
The Specialist Workforce
Let us now focus on the specialists.
We currently have 7,200. About 2,325 (one-third or 32.3%) work in the private sector and 4,875 (two-thirds or 67.7%) work in the public sector.
The profession continues to train approximately 40% of each cohort of doctors to become specialists. In 2024, 279 locally trained specialists were added to the Specialist Register. This is augmented by 32 foreign-trained specialists that came to our shores last year, bringing the total to 311 new specialists.
A Closer Look : Public Sector Composition
Here is where it gets interesting.
There were 4,756 fully-registered specialists versus 4,764 fully-registered non-specialists. That is a ratio of 1:1 for specialists to non-specialists for those who are fully registered.
In addition to those that are fully-registered, we can also take into account other registration classes. In 2024, there were 7,280 non-specialists in the public sector for all classes of SMC registrations, of which there were 734 house officers and 830 family physicians. After deducting these groups from 7,280, we are left with 5,716; which is a good estimate of the number of medical officers working in the public sector hospitals, (including the smattering of resident physicians and hospital clinicians).
While a fraction of these medical officers are employed in non-MOH institutions (eg. MINDEF, Ministry of Manpower [MOM], Ministry of Home Affairs [MHA]) their numbers are unlikely to alter the broader picture significantly. Likewise, for the specialists, the 4,875 working in the public sector also includes a small number of specialists who work in MINDEF, MHA, MOM etc.
Therefore, the specialist to medical officer ratio working in the MOH family and Public Healthcare Institutions (PHIs), but excluding family physicians mainly working in polyclinics, can be estimated to be around 1: 1:17 (5,716/4,875).
In other words, for every specialist, there were only about 1.2 medical officers, give or take a few. I do not think the exact ratio is far off from this approximation.
A Top-heavy Specialist Manpower Distribution
Though we lack complete public data on grade distribution, I am told that in some of our more established hospitals, the number of Senior Consultants roughly equal the total of Associate Consultants + Consultants. This suggests a manpower distribution that is top-heavy.
Of course, there are pockets of need for specialist manpower in the less popular specialties and newer hospitals, but I think the trend from the national numbers are unambiguous. For every specialist, there is about 1 to 1.2 medical officers (excluding family physicians who can also be medical officers), with about half of the specialists working in the clusters being senior consultants.
The Road Ahead: Questions We Must Ask
As we speak, two new general hospitals are being built and the capacities of several older hospitals (AH, TTSH etc) are being expanded. Against the backdrop of an ageing (if not already aged) population, demand for doctors, both specialists and non-specialists, will be high in the short to medium term. But if we are to take the longer view of things, we need to be asking ourselves a few tough questions:
- Is it sustainable to continue to offer residency positions to about 40% of each cohort of new doctors (excluding family medicine)?
- Is the current distribution of specialists vs medical officers in the public sector sustainable and optimal?
- Is it sustainable or optimal to have senior consultants account for about half of the specialist workforce in the public sector?
- With a doctor-patient ratio of 1:343 now, how long should we continue increasing the number of doctors by 600 to 800 annually?
- Is the distribution of having one-third of specialists working in the private sector ideal?
- Can we offer better long-term career prospects in the public sector for those that do not become specialists or family physicians?
Admittedly, these are complex questions. Moreover, the serious consequences of getting these questions wrong will not be apparent for some time. But if we are to continue to provide good healthcare to future generations of Singaporeans, these questions need to be considered in depth and breadth now, when we still have the luxury of time and resources to do so.
Rethinking, Strategically
The best time to overcome inertia and try new and bold approaches to solving complex problems is when you have adequate capacity to innovate and try out new approaches.
It is therefore noteworthy that in a press release by MOH on 20 Sep 25 titled “Transforming hospital care teams to meet care needs of an ageing population”1, it was announced that henceforth, there will be three main career tracks for doctors in. the public sector. They are namely,
- Family Physicians and Family Medicine Specialists
- Specialists
- Hospital Clinicians
Many of us may not be familiar with the Hospital Clinician track. In the aforesaid press release, it is stated,
“Instead of having multiple primarily specialist-led care teams looking after a patient with multiple conditions, the same patient can now receive care from a unified care team led by a Principal Doctor who will coordinate and integrate care according to his needs. Principal Doctors may be specialists who have retained broad-based competencies, or Hospital Clinicians with broader-based hospital training”.
On the same day, the Minister for Health, Mr Ong Ye Kung gave more details of the Hospital Clinician scheme in a speech given at the SMC Physician’s Pledge Affirmation Ceremony2. He said, “Earlier this year, we introduced a new care team model across selected disciplines in all our public hospitals – general surgery, orthopaedics, paediatric surgery and so on”. This new care team model he referred to involved the deployment of Hospital Clinicians.
He said there were already about 150 Hospital Clinicians in the public healthcare system, and this Hospital Clinician Scheme has “a huge potential for growth”. There are already three levels of Hospital Clinicians now: Hospital Clinician, Senior Hospital Clinician and Principal Hospital Clinician. An apex fourth level will be added – Senior Principal Hospital Clinician.
What is AMS’ role in all this? For a start and as revealed by the Health Minister, AMS already runs and awards the Graduate Diploma in Hospital Practice. Hospital Clinicians who obtain this Graduate Diploma will qualify to be promoted to the Senior Hospital Clinician level.
Going forward, AMS is also well-positioned to conduct courses so that Senior Hospital Clinicians receive appropriate training before they can qualify to progress to the Principal Hospital Clinician level.
These are exciting times for AMS as it plays an important role in the professional development and training of Hospital Clinicians.
Warm Regards,
Wong Chiang Yin
Master
Academy of Medicine, Singapore
References:
Master's Message 
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