Your Role as an Observer

As a clinical observer at NUH/NCIS, you are there to learn through observation, not to provide direct patient care. This distinction is important for medicolegal and professional reasons.

What you CAN do:

• Observe ward rounds, MDT meetings, clinics, and procedures
• Discuss cases with the clinical team
• Ask questions (at appropriate times)
• Take notes for your own learning
• Participate in teaching sessions and tutorials
• Present cases if invited by the supervising consultant

What you should NOT do:

• Write in medical records or prescribe medications
• Perform physical examinations without supervision and patient consent
• Make independent clinical decisions
• Access patient records without authorization

Hierarchy and Communication

Singapore's medical hierarchy follows the British model:

• Consultant / Senior Consultant — Most senior, leads the team
• Associate Consultant — Junior consultant level
• Registrar / Senior Registrar — Experienced trainee, runs day-to-day ward work
• Medical Officer (MO) — Junior doctor
• House Officer (HO) — Most junior doctor (intern)

Communication etiquette:

• Address seniors as Dr. [Surname] until invited to use first names
• In ward rounds, listen first, ask questions later — wait for an appropriate pause
• When presenting a case, use the SBAR framework (Situation, Background, Assessment, Recommendation)
• Email communication should be formal and concise

Dress Code

• Clinical areas: Scrubs (provided) or smart casual with white coat. Closed-toe shoes required. No jewelry on hands/wrists.
• Non-clinical areas: Smart casual (no shorts, no slippers)
• ID badge: Must be worn visibly at all times within the hospital

Daily Schedule (Typical)

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07:30 - 08:00 Morning handover / pre-round preparation

08:00 - 10:00 Ward round (Ward 56 — palliative care)

10:00 - 12:00 Outpatient clinic or follow-up tasks

12:00 - 14:00 MDT meeting or lunch teaching session

14:00 - 16:00 Afternoon clinical activities

16:00 - 16:30 Evening handover

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Assessment: Mini-CEX and 360-degree Feedback

Mini-CEX (Mini Clinical Evaluation Exercise)

A structured clinical assessment where a consultant observes you during a patient encounter and provides immediate feedback.

What is assessed:

• Medical interviewing skills
• Physical examination skills
• Clinical judgment
• Counseling / communication skills
• Professionalism
• Organization and efficiency

Tips:

• Treat it as a learning opportunity, not an exam
• Demonstrate structured thinking (e.g., differential diagnoses)
• Communicate clearly with the patient and the assessor
• Ask for specific feedback: "What could I improve?"

360-degree Feedback

Multi-source feedback collected from consultants, nurses, allied health professionals, and sometimes patients.

How to maximize positive feedback:

• Be punctual and reliable
• Show initiative in learning
• Be respectful to ALL team members (nurses, cleaners, pharmacists)
• Thank people who teach you
• Participate actively in discussions

Cultural Tips for Working at NUH

• Punctuality matters — Being on time is expected and respected
• Face — Avoid publicly criticizing or correcting others (especially seniors)
• Lunch etiquette — Junior doctors often eat together. Accept lunch invitations to build relationships.
• Tea breaks — Short breaks are normal. The ward pantry usually has hot water for drinks.
• Gift-giving — A small souvenir from your home country for the team at the end is appreciated but not expected.
• Feedback culture — Singaporeans may give indirect feedback. "Not bad" often means "quite good." Silence may mean disagreement.

Useful Contacts and Resources

• NUH main line: +65 6779 5555
• NCIS (National Cancer Centre): +65 6436 8000
• NUH Palliative Care Centre: Located at NUHS Tower Block, Level 5
• Staff canteen: Located at Kent Ridge Wing, Level 1
• Nearest MRT: Kent Ridge (Circle Line, CC24)