Burnout drives Singapore’s junior doctors to private sector

Dr Faith Choo criticised the call system at public hospitals as being dangerous for patient safety, as sleep deprivation reduces the quality of care doctors could provide. (Freepik pic)

PETALING JAYA: Junior doctors in Singapore’s public service are facing high rates of burnout, leading many to consider breaking their medical service bond – repaying around S$100,000 (RM347,826) for every unfulfilled year of service – to enter the private sector.

The bond they sign with MOH Holdings (MOHH), the holding company for the nation’s public healthcare institutions, requires them to work in the sector for five years upon graduation, not including a year of housemanship.

In a report by Singaporean online daily Today, Dr Faith Choo, 27, who works as a locum doctor in the private sector, said she broke her bond in 2022 after suffering from burnout.

Her experience in the public sector saw her under constant scrutiny at work, facing sleep deprivation and ill health.

The report also quoted a user of online forum Reddit, identifying as a Singapore doctor, as bemoaning the traditional “call system” at public hospitals, which may see doctors work up to 30 hours straight.

Choo criticised this call system, saying it has repercussions for patients.

“It’s quite dangerous for patient safety, because (the sleep deprivation) really reduces the quality of care I could provide to them,” the report quoted her as saying.

The report said data on the proportion or number of junior doctors in Singapore who break their bonds is not publicly available, but doctors who spoke to the news outlet said they believe more junior practitioners are planning to do so.

It quoted another 27-year-old interviewee, who took out a loan to break her MOHH bond and work as a private sector locum, as saying she now earns S$14,000 to S$18,000 a month by taking on more locum assignments.

The report said some private clinics also offer public doctors jobs as locum doctors effective immediately, offering to pay off their bonds for them.

Burnout in the public healthcare sector is not unique to Singapore. Malaysia has also faced this issue for some time.

Azrul Khalib, CEO of the Galen Centre for Health and Social Policy, spoke in a previous FMT report of a manpower shortage in health facilities and widespread disappointment among public health sector professionals.

“As patients pour into hospitals and clinics, workers are forced to choose between caring for themselves and their patients, which is incredibly unfair,” he told FMT.

He said many doctors and nurses are leaving for the private sector, deciding to work in another country or start a new career altogether.

A survey by the Malaysian Medical Association shows that 95% of public health facilities are short-staffed, and according to health ministry data, 3,046 contract doctors have resigned over the past three years.

Azrul said some doctors here also work 30-hour shifts, leaving many junior doctors, housemen or medical officers physically and mentally exhausted.