NHG Residency Handbook With Annexes 20131218

NHG-AHPL Resi denc y Handbook
NHG-AHPL RESIDENCY HANDBOOK - Table of Contents

TABLE OF CONTENTS

Content Page
I About this Handbook 1

II About NHG-AHPL Residency 2
Commitment to Graduate Medical Education 4
NHG Graduate Medical Education Committee (GMEC) 5
GMEC Membership 7
Institutional Agreements 7

III Appointment to NHG-AHPL Residency Programs 9
Eligibility of Appointment 9
Application 10
Selection 10
Appointment 11
Transfers/Switches 11
Resident Responsibilities 12
Conditions for Reappointment and Promotion 13
Program Closure/Reduction 14
Conditions for Separation 14
Certification Requirements 16
Academic Records 16

IV Resident Supervision and Duty Hours 17

V Resident Impairment and Substance Abuse 18

VI Other Provisions for Residents 20
Access to Confidential Counseling, Medical, and
Psychological Services
20
Complaints and Concerns 20
NHG Disciplinary Policy and Procedure 21
Residents with Disabilities 21

VII Employment and Related Benefits 22
Salary and Services 22
Access to Food Services 24
Reasonable Accommodation 24
E-mail Access 24
Overseas Conference Sponsorship 25

VIII The Resident Council 26

IX Other Important Policies, Procedures and Guidelines 27
Moonlighting 27
Disaster Preparedness Policy and Procedure 27
Vendor Policy 27
Non-Discrimination and Harassment 28
Release of Information 28
Confidentiality 28
Corporate Communications and Social Media Guidelines 29
Other Important Policies 30

NHG-AHPL RESIDENCY HANDBOOK - Table of Contents

ANNEXES

Annex A GME PP3-1 NHG GME Grievance Policy and Procedure
Annex B GME PP11-1 NHG GME Policy on Resident Transfer-Switches-Resignation
Annex C GME PP8-4 NHG GME Policy on Resident Evaluation and Disciplinary Guidelines
Annex D GME PP4-0 NHG GME Policy on Program Closure & Reduction
Annex E GME PP5a-0 NHG GME Policy on Supervision of Residents
Annex F GME PP5b-1 NHG GME Policy on Duty Hours in Learning and Working Environment
Annex G GME PP13-1 NHG GME Policy on Addressing Complaints and Concerns
Annex H NHG GME Leave Application Procedures
Annex I GME PP1-0 NHG Institutional Disaster Preparedness Policy and Procedure
Annex J GME PP17-0 NHG GME Policy on Overseas Conference Sponsorship
NHG-AHPL RESIDENCY HANDBOOK 18 DEC 2013

1 of 30
I ABOUT THIS HANDBOOK

1. This handbook has been developed as a guide and resource to all NHG-AHPL
residents. It outlines what a resident needs to know about graduate medical
education in NHG-AHPL and in particular, policies and procedures as established by
the NHG Graduate Medical Education Committee (GMEC).

2. These policies and procedures pertain to training matters under all NHG-AHPL
residency programs. They are not intended to replace non-training related policies
and procedures of individual participating sites, clinical departments and MOH
Holdings Pte Ltd (MOHH). If areas of conflict develop, such conflicts are to be
evaluated by the GMEC for a resolution.

3. This handbook will be amended and updated as necessary with the latest version
posted on the NHG Residency website (www.nhgresidencyprogram.com.sg). When
additions, changes or revisions are made to this handbook, notice will be sent to
Program Directors (PD), Program Coordinators (PC), Core Faculty and residents.
Updated policies will become effective upon posting. Residents are expected to be
familiar with and comply with all policies set forth in this handbook.


2 of 30
II ABOUT NHG-AHPL RESIDENCY

1. In 2009, the Ministry of Health, Singapore (MOH) identified National Healthcare
Group (NHG) as one of the 3 Sponsoring Institutions (SIs) for residency programs in
Singapore. MOH has also agreed that NHG may partner one of its major
participating sites, the Khoo Teck Puat Hospital (KTPH) under the Alexandra Health
Pte Ltd (AHPL), to offer residency programs. NHG and AHPL thus agreed to adopt
the co-branding of NHG-AHPL Residency and this name will be used in this
document and publicity material.

2. With the mission to develop medical professionals who are competent,
compassionate, team-focused and committed to life-long learning, NHG-AHPL is
committed to providing excellent graduate medical education for Singapores future
generations of doctors.

3. NHG as a Sponsoring Institution (SI) sponsors the following programs under the
umbrella of NHG-AHPL Residency:
i) Advanced Internal Medicine
ii) Anaesthesiology
iii) Cardiology
iv) Dermatology
v) Diagnostic Radiology
vi) Emergency Medicine
vii) Endocrinology
viii) Family Medicine
ix) Gastroenterology
x) General Surgery
xi) Geriatric Medicine
xii) Hand Surgery
xiii) Infectious Disease
xiv) Internal Medicine
xv) Medical Oncology
xvi) Ophthalmology
xvii) Orthopaedic Surgery
xviii) Otorhinolaryngology
xix) Pathology
xx) Plastic Surgery
xxi) Psychiatry (National Program)
xxii) Rehabilitation Medicine
xxiii) Renal Medicine
xxiv) Respiratory Medicine
xxv) Rheumatology
xxvi) Surgery-In-General
xxvii) Transitional Year
xxviii) Transitional Year at KTPH
xxix) Urology

4. NHG-AHPL Residency will also take part in the national Preventive Medicine
Residency Program sponsored by NUHS.


3 of 30
5. Other participating sites for NHG-AHPL residency programs include but not limited
to:
i) Alexandra Hospital (AH)
ii) Changi General Hospital (CGH)
iii) Dover Park Hospice (DPH)
iv) Health Promotion Board (HPB)
v) Health Science Authority (HSA)
vi) Institute of Mental Health (IMH)
vii) KK Women's & Children's Hospital (KKH)
viii) National Cancer Centre (NCC)
ix) National Healthcare Group Polyclinics (NHGP)
x) National Neuroscience Institute (NNI)
xi) National Skin Centre (NSC)
xii) National University Hospital (NUH)
xiii) Renci Community Hospital
xiv) Singapore Armed Forces (SAF)
xv) Singapore General Hospital (SGH)


4 of 30
NHGs Statement of Commitment to Graduate Medical Education

As a Sponsoring Institution for graduate medical education, NHG is committed to support
graduate medical education, and to provide the necessary educational, financial, and human
resources, to ensure compliance to the prevailing training and educational standards
stipulated by the Ministry of Health, Singapore (e.g. the ACGME-I Institutional, Foundational
and Specialty/Subspecialty Specific Requirements). NHG will provide continued support
towards quality graduate medical training, in an environment that is conducive, encouraging
and safe, while committed to quality care for our patients.

NHG-AHPL RESIDENCY HANDBOOK 8 NOV 2013

5 of 30
NHG Graduate Medical Education Committee (GMEC)

1. All NHG-AHPL residency programs are overseen by the NHG GMEC. The functions
of the NHG GMEC include:

a. Complying with existing NHG GME policies and procedures that ensure quality
education and conducive work environment for residents and fellows in all
programs; and where such policies and procedures are absent, establish and
implement them to ensure quality education and conducive work environment for
the residents and fellows in all programs, including:

i) Perform annual review and make recommendations to relevant Assistant
Chairman of Medical Board (Clinical Manpower) or equivalent in
participating NHG, AHPL institutions, Human Resource Director, MOHH
and other relevant departments/services regarding resident and fellow
stipends, benefits, and funding for resident positions.
ii) Establish and maintain effective communication mechanisms between
GMEC and all PDs within NHG-AHPL.
iii) Ensure that PDs:
Maintain effective communication mechanisms with Site Directors at
each participating site for their respective programs;
Maintain proper oversight at all clinical sites.
iv) Develop and implement written policies and procedures regarding resident
duty hours to ensure compliance with the Institutional, Foundational, and
Specialty/Subspecialty Specific Program Requirements.
v) Consider for approval requests from PDs prior to submission to a
Residency Review Committee (RRC) for exceptions in the weekly limit on
duty hours in compliance with ACGME-I Policies and Procedures for duty
hour exceptions applicable to Singapore.
vi) Monitor programs supervision of residents and fellows and ensure that
supervision is consistent with:
Provision of safe and effective patient care;
Educational needs of residents and fellows;
Progressive responsibility appropriate to residents and fellows level of
education, competence, and experience; and
Other applicable Foundational and Specialty/Subspecialty Specific
Program Requirements.
vii) Communicate between leadership of the medical staff regarding the safety
and quality of patient care that includes:
The NHG GMEC Annual Report (see para c below);
Description of residents and fellows participation in patient safety and
quality of care education;
Accreditation status of programs and any citations regarding patient
care issues.
viii) Ensure that each program provides a curriculum and an evaluation system
that enables residents and fellows to demonstrate achievement of the
ACGME-I general competencies as defined in the Foundational and
Specialty/Subspecialty Specific Program Requirements.
ix) Select, evaluate, promote, transfer, discipline and/or dismiss residents and
fellows in compliance with the Institutional and Foundational Program
Requirements.
x) Review all ACGME-I program accreditation letters of notification and
monitor action plans for correction of citations and areas of non-
compliance.

6 of 30
xi) Review NHG ACGME-I letter of notification from the Institutional Review
Committee (IRC) and monitor of action plans for correction of citations and
areas of non-compliance.
xii) Review the following for approval prior to submission by PDs to ACGME-I:
All applications for ACGME-I accreditation of new programs;
Changes in resident complement;
Major changes in program structure or length of training;
Additions and deletions of participating sites;
Appointments of new PDs and re-appointments of PDs;
Progress reports requested by any Review Committee;
Responses to all proposed adverse actions;
Requests for an appeal of an adverse action;
Appeal presentations to a Board of Appeal or the ACGME-I;
Requests for exceptions of resident duty hours;
Voluntary withdrawal of program accreditation.
xiii) Oversee all phases of educational experiments and innovations that may
deviate from Institutional, Foundational, and Specialty/Subspecialty
Specific Program Requirements including:
Granting approval prior to submission to the ACGME-I and/or
respective Review Committee;
Ensuring adherence to Procedures for Approving Proposals for
Experimentation or Innovation Projects in ACGME-I Policies and
Procedures; and
Monitor the quality of education provided to residents for the duration of
such a project.
xiv) Oversee all processes related to reductions and/or closures of:
Individual programs;
Major participating sites; and
National Healthcare Group.
xv) Provide a statement or institutional policy that addresses interactions
between vendor representative / corporations and residents and
fellows/GME programs.

b. Exercising authority and responsibility for the oversight and administration of NHG-
AHPL residency programs and responsibility for assuring compliance with
ACGME-I Foundational, Specialty/Subspecialty Specific Program Requirements.

c. Preparing an annual report henceforth known as NHG GMEC Annual Report to the
NHG CMB Committee and relevant Medical Board of NHG institutions, AHPL and
participating institutions, and

i) Present the annual report which describes activities of the GMEC during
the past year with attention to:
resident and fellow supervision;
resident and fellow responsibilities;
resident and fellow evaluation;
compliance with duty-hour standards;
resident participation in patient safety and quality of care education.
ii) Deliver the NHG GMEC Annual Report to the Medical Board or equivalent
Organized Medical Staff of major participating sites that do not sponsor
GME programs.


7 of 30
d. Developing, implementing, and overseeing an internal review process by:
i) Appointing an Education Review Committee for each program that:
must include at least one faculty member from NHG-AHPL but not from
within the program being reviewed;
must include at least one resident from NHG-AHPL but not from within
the program being reviewed;
If necessary, include additional internal or external reviewers;
If necessary, include administrators from outside the program.

ii) Establishing the policy NHG Education Review Protocol that incorporates
the items detailed in the ACGME-I Institutional Requirements and ensuring
compliance by the programs.
iii) Documenting in GMEC minutes of meeting, the internal review process at
the approximate midpoint of the accreditation cycle for each program.
iv) Demonstrating continued oversight of program(s) with no resident, through
a modified internal review to ensure maintenance of adequate Faculty and
staff resources, clinical volume, and other necessary curricular elements
required to be in substantial compliance with the Institutional, Foundational,
and Specialty/Subspecialty Specific Program Requirements prior to the
program(s) enrolling a resident.
v) Monitoring the response by the program to actions recommended by the
GMEC and internal review process.
vi) Submitting the most recent internal review report for each training program
as part of the Institutional Review Document (IRD). If the institutional site
visitor simultaneously conducts individual program reviews at the same
time as the institutional review, the internal review report(s) for the/those
program(s) must not be shared with the site visitor.

e. Meeting at least quarterly and maintaining written minutes.

GMEC Membership

2. The NHG GMEC is chaired by Designated Institutional Official (DIO), A/Prof Nicholas
Chew. Full list of members can be found on the NHG-AHPL Residency website
(http://www.nhgresidencyprogram.com.sg).

Institutional Agreements

3. To ensure quality and consistency of graduate medical education for NHG-AHPL
residents provided at all participating sites, all NHG-AHPL residency programs sign
Program Letter of Agreement (PLA) with each agreement outlining the
responsibilities of the Sponsoring Institution (NHG) and of the participating site
towards ensuring the quality of graduate medical education for NHG-AHPL residents
at that site.

4. The DIO reviews all program letters of agreement when a participating site is added.
By this, the DIO ensures that all PLAs for new participating sites contain the four key
components as outlined in the ACGME-I Foundational Program Requirements of:
a. identification of the faculty who will assume both educational and supervisory
responsibilities for residents;

8 of 30
b. specification of facultys responsibilities for teaching, supervision, and formal
evaluation of residents, as specified later in this document;
c. specification of the duration and content of the educational experience; and,
d. statement of the policies and procedures that will govern resident education
during the assignment.

5. Each of these agreements is signed by the PD/DIO, as well as, by the Site Director
(SD) and his DIO/Chairman of Medical Board (CMB) or his/her designee for the
participating site in order to ensure that both parties agree to the content of the
agreement.


9 of 31
III APPOINTMENT TO NHG-AHPL RESIDENCY PROGRAMS

Eligibility of Appointment

1. All programs sponsored by NHG-AHPL:
a. will select residents from among eligible applicants on the basis of preparedness,
ability, aptitude, academic credentials, communication skills and personal
qualities such as motivation and integrity;
b. will not discriminate with regards to sex, race, age, religion, ancestry, color,
national origin, disability or any other applicable legally protected status;
c. will participate in and abide by the rules and regulations established by the
national resident matching program administered by MOHH.

2. Applicants must meet the following criteria to be eligible for appointment as a
resident:
a. Possess appropriate qualifications:
i) Possess a MBBS degree from the National University of Singapore; OR
ii) Possess a basic medical degree awarded by an overseas medical school
listed in the Schedule of the Medical Registration Act (MRA) of Singapore
(for complete list, please refer to
(http://www.healthprofessionals.gov.sg/content/hprof/smc/en/leftnav/beco
ming_a_registereddoctor/international_medical_graduates.html)

Those from recognised medical schools listed in the Schedule must
pass the relevant national licensing examinations in the listed country
e.g. in the USA medical graduates must pass the USMLE and in
Canada, they must pass the MCCQE to be registered to practise in
Singapore. For any country that imposes such national licensing
conditions on its own medical graduates, the corresponding conditions
will also be required for registration to practise in Singapore.
The medical school conferring the qualification must also be
registered in the International Medical Education Directory (IMED)
(http://www.faimer.org/resources/imed.html)

b. Eligible for medical registration with the Singapore Medical Council (for complete
list, refer to
http://www.healthprofessionals.gov.sg/content/hprof/smc/en/leftnav/becoming_a_
registereddoctor/registration.html)

c. Fulfill the applicable Residency Advisory Committee (RAC) specialty and
subspecialty entry requirements.

d. Must have discharged any outstanding obligations and must forego any pending
claims against NHG, Tan Tock Seng Hospital (TTSH), Institute of Mental Health,
NHG Polyclinics or any of the participating institutions within the NHG-AHPL.

3. Other than the above criteria,
a. A criminal background check and drug screening may be conducted on
prospective residents and fellows. If an individual is found to be convicted of
serious criminal offences such as assault, criminal sexual conduct, etc. that
disqualify the individual from positions with direct patient contact, the individual

10 of 31
becomes ineligible for appointment or continuation of appointment in NHG-AHPL
residency programs.
b. A pre-admission health review and current immunization record are required prior
to commencement of graduate medical education in keeping with NHG HR staff
policy.
c. Non-Singaporean or a non-Singapore permanent resident must be eligible to be
issued with a Work Pass by the Ministry of Manpower to be employed.

Application

4. Application for residency programs in Singapore is coordinated by the MOHH.

5. Calls for applicants to apply for residency programs will be announced on the
MOHHs Physician website (http://www.physician.mohh.com.sg/) and all SIs sites
every year.

6. Applicants are encouraged to apply early to the programs that interest them and
travel for interviews (for overseas graduates) if invited. New graduates who are
unsuccessful with their applications with Residency will have to apply for their
preferred postings in the national House Officer Posting Exercise/ Medical Officer
Posting Exercise (HOPEX/MOPEX), also administered by MOHH.

7. Applicants must submit a completed application with supporting documents as
prescribed by MOHH.

Selection

8. NHG-AHPL Residency follows the selection process defined by MOH and MOHH.

9. A two tier system is used to determine the eligibility of applicants:
a. a specialty-specific National Selection Panel comprising the PD from each SI or
their representatives and a representative from the Residency Advisory
Committee (RAC) of the specialty determines the eligibility of applicants. This
panel determines the eligibility of an applicant to enter training in the specified
specialty and to provide a national ranking of all applicants for the same
specialty.
b. the NHG-AHPL Residency Program Selection Panel comprising the PD,
Associate Program Director (APD), Core Faculty/Designated Faculty will also
internally rank the applicants and participate in the national matching exercise,
administered by MOHH.

10. NHG-AHPL Residency then takes part in the national matching exercise
administered by MOHH.

11. The rules of the matching exercise are devised to be impartial to both
hospitals/healthcare institutions and the applicants. Applicants rank the residency
programs that they are interested in, and the SIs rank the candidates of their choice
separately. Candidates and SIs are blind to each others ranking.

12. Candidates are then offered based on their preference within the training capacity of
the SI during the matching exercise.


11 of 31

Appointment

13. Upon successful match through the national matching exercise and fulfilling the
criteria for appointment, successful applicants will be issued with a Residency Offer
Letter co-signed by the DIO and Director (Manpower Standards and
Development)/MOH, a Residency Agreement, together with the offer of employment
letter from MOHH, where applicable.

14. All residents will be appointed for the duration of the residency program they are
offered, subject to yearly renewal.

15. Training duration may be extended by long leave and absence from training beyond
the allowed number of days, below par performance during the residency, failure in
examinations and where competency to progress to the next level is not evident.

Transfers/Switches

16. The following guideline on transfers is based on the MOH Residency Terms and
Conditions 2013.

17. Residents who withdraw from one residency program and wish to enter into another
residency program or BST/AST/Seamless programme in:
a. the same specialty offered by a different SI; or
b. a different specialty offered by the same SI; or
c. a different specialty offered by a different SI

will be required to re-apply. However they cannot reapply in the subsequent year but
can only reapply the year after next (one year penalty) unless the change is due to
strong reasons
1
, and recommended by the PD and approved. This is to ensure
responsible decisions when you enter into training and accountability of funded
training programs.

18. Residents are to note that they may not get the program of their choice if they are not
selected. They will not be able to return back to their previous program once they
have withdrawn from it.

19. Program Withdrawn From The PD of the program from which the resident
withdrew is required to provide a written or electronic verification of the transferring/
switching residents
a. training and educational experiences;
b. performance evaluation including assessment of competence in:
i) Patient care
ii) Medical Knowledge
iii) Practice-based learning and improvement
iv) Interpersonal and communication skills
v) Professionalism
vi) Systems-based practice
c. any other information relevant in program transfer (e.g. reason for withdrawal).

1
Eg health reasons that render a resident unsuitable for a particular specialty

12 of 31
20. The information should be provided at the point of withdrawal for the residents
personal records. The program from which the resident withdrew should also keep a
record for their own use.

21. The NHG GME Institutional Policy on Resident Transfer/Switches/Resignation shall
apply. The policy is attached as Annex B for reference.

22. Program Receiving The PD of the receiving program should obtain the information
in Para 19 before accepting a resident transfer/ switch into his or her program.

23. Resident transfers/switches, if successfully matched and accepted, are to commence
residency at R1 and must be placed on close monitoring/supervision for assessment
of competencies and the appropriate remediation required if needed, to determine
placement at R2 under the current rules.

Resident Responsibilities

24. Residents shall:
a. Provide patient care, under appropriate supervision, as assigned by the
Residency PD or his/her designee, consistent with the educational goals of the
program and high standards of patient care. ("Patient care" includes
responsibility for associated documentation in the medical record, which should
be completed in a timely fashion, and attendance at patient care rounds as
assigned);
b. Make appropriate use of the available supervisory and support systems, seeking
advice and input from faculty when and as appropriate, and in accordance with
the NHG GME Policy on Resident Supervision;
c. Participate fully in the educational and scholarly activities of the Residency
Program as specified by the PD, including attendance at didactic teachings, and
other responsibilities which may include research projects, the completion of
examinations, the maintenance of procedure logs, or other items;
d. Develop a personal learning program to foster continued professional growth,
with guidance from the teaching staff;
e. Assume responsibility, as called upon, to teach more junior trainees and medical
students, within the scope of the Residency Program;
f. Participate in improving the quality of education provided by the Residency
Program, in part by submitting any confidential evaluations of the faculty, the
program and the overall educational experience requested by the PD;
g. Adhere to the established practices, procedures and policies of the SI, the SI's
Medical/Professional Staff, the Department and affiliated training sites;
h. Participate in institutional programs, councils or committees and other medical
staff activities, as appropriate;
i. Abide by the institutional and program-specific Resident duty hours policies and,
as scheduled by the PD, accurately report his/her duty hours;
j. Comply with MOHH and institutional requirements for health and safety training,
vaccinations and health screening;
k. Comply with MOH's Residency terms and conditions.
25. The SI is responsible for overseeing the residents training and rotations throughout
the period of residency. Residents should check with their respective PC prior to
beginning rotations at an affiliated site to obtain the necessary procedures for
reporting to the rotation site. Upon arrival for a rotation in an affiliated hospital,
residents must report to the appropriate office to complete necessary paperwork.

13 of 31
Residents are responsible for adhering to the policies and procedures established by
the GMEC, the institutions in which they function, and their individual programs.

26. While on rotations, residents shall also be:
a. accountable to the PD to whom they have been assigned for all matters
pertaining to the professional care of patients. They are accountable to the Site
Director and Chairperson of the Medical Board at each facility to which they are
assigned for matters of administrative policy and procedure;
b. responsible for checking with the PD regarding any response time requirements
while taking call from home.

Conditions for Reappointment and Promotion

27. Evaluation Each residency program will develop educational goals and objectives
for its residents, which are consistent with the ACGME-I criteria for the particular
specialty. Evaluations shall use criteria and procedures appropriate to the particular
program and shall include, but are not limited to, the core competencies of Patient
Care, Medical Knowledge, Communication and Interpersonal Skills, Practice-Based
Learning and Improvement, Professionalism, and Systems-Based Practice, as
defined by the ACGME-I.

28. A written evaluation of each resident addressing medical knowledge, competence in
patient care, professionalism, system-based practice, interpersonal and
communication skills, and practicebased learning and improvement will be
completed at the end of each major rotation. The PD or faculty designee will share
the evaluation(s) with the Resident and provide feedback in accordance with
ACGME-I requirements for that specialty. This evaluation sharing will occur at least
semi-annually, includes a written review of performance, and a discussion of areas of
strengths and deficiency and plans for improvement.

29. The written evaluation and any documentation regarding the meeting will be
maintained in the Program file by the PC.

30. If an evaluation indicates unsatisfactory performance, the resident will be provided
with a remedial plan for correcting any deficiencies, in accordance with the NHG
GME Policy on Resident Evaluation and Disciplinary Guidelines. If remediation is not
satisfactory, it may be cause for probation or termination from the Residency
Program.

31. The Residents advancement to a position of higher responsibility will be made only
on the basis of an evaluation of his/her readiness for advancement.

32. Reappointment The term of appointment expires at the end of the period defined in
the Resident Appointment Agreement signed by the resident, unless sooner
terminated in accordance with applicable policies. Re-appointment of Post-Graduate
Year 1 residents will take place upon their successful completion of the first (1
st
) year,
according to the level of competencies defined in each program, their ability to
continue with the program, and upon fulfilling licensing requirements defined by the
SMC.

33. For residents who have already obtained full practicing license from the SMC, re-
appointment will take place annually with the successful completion of each
residency year, according to the level of competencies defined by each program and

14 of 31
as determined by the PD. In making this determination, the PD will take inputs from
the Clinical Competency Committee and may consider inputs from supervising
attending physicians, Chief Residents and others who have worked closely with the
resident during the period of this engagement. The PD may also consider the results
of an in-training examination, where applicable. Residents must, at a minimum, have
completed responsibilities as appropriately assigned within the scope of the
Residency Program and attained the knowledge and skill necessary to progress to
the next level of post-graduate training.

34. Non-promotion The PD, with inputs from the Clinical Competency Committee
and other faculty members, with ample reasons, may decide on a non-promotion of a
resident in his residency program. The resident will be notified in writing of the non-
promotion at least four (4) months before the expiry of the term of appointment. The
resident may appeal against the decision following the NHG GME Grievance Policy
and Procedure (Annex A). MOHH will also be duly informed.

35. Final Evaluation The PD or his/her designee will provide a written final
evaluation for each resident who satisfactorily completes the program. The
evaluation will be based on performance during the final period of training and will
verify that the resident has demonstrated sufficient professional ability to practice
competently and independently. The PD is responsible for providing verification of
residency education for any resident who may leave the program prior to completion
of his/her training.

36. Completion of Residency Program A Resident will be certified to have completed
the Residency program if he has fulfilled all the requirements stated in the program
requirements and completed the mandatory courses set out by the Specialists
Accreditation Board (SAB) including the prescribed Medical Ethics, Professionalism
and Health Law Course. All Residents are required to register for the course and
make payment directly to the provider. For more information on the course, please
visit the Specialists Accreditation Boards website at:
http://www.healthprofessionals.gov.sg/content/hprof/sab/en/topnav/specialist_training
/general_overview/medical_ethics_law_professionalism.html.

37. Successful completion of the Residency program and the prescribed exit exam does
not equate to automatic entry into the Specialist Register or Family Physician
Register. Residents are required to personally apply to the Specialists Accreditation
Board (SAB) or the Family Physicians Accreditation Board and the SMC before they
are statutorily eligible to practice as a Specialist or Family Physician.

38. Non-Renewal of Appointment Non-renewal of appointment will be based on
the programs evaluation of a residents performance and progress, decided by the
PD, with inputs from the Clinical Competency Committee, and in consultation with the
DIO. The resident will be notified of the non-renewal of the appointment in writing at
least four (4) months before the expiry of the term of appointment. MOHH will also
be informed to prepare for the subsequent rotations of the resident.

39. The NHG GME Policy on Resident Evaluation and Disciplinary Guidelines is attached
as Annex C.


15 of 31
Program Closure/Reduction

40. If, in its sole discretion, NHG-AHPL decides to either reduce the size of, or close a
program or certain parts of a program, residents will be notified as soon as
practicable.

41. Residents already in the program at that time will be allowed to either complete the
program or be assisted in identifying another ACGME-I-accredited program in which
to continue their education.

42. The NHG GME Policy on Reduction in Size or Closure of a Residency Program is
attached as Annex D.

Conditions for Separation

43. Resignation The Resident may resign from the Residency Program he/she is
appointed to with one (1) month written notice of his/her intent to resign in
accordance to the NHG GME Institutional Policy on Resident Transfer, Switches or
Resignation from Program. The Residents resignation must be submitted to the PD.
All conditions of appointment will terminate on the effective date of the resignation.

44. Separation Separation may occur at the end of an appointment term under any
circumstances in which reappointment does not occur, including a residents
successful completion of the Residency Program.

45. Termination A residents appointment may be terminated at any time by the NHG
Residency upon notice to the resident due to the following conditions:
a. Without the consent of the SI, abandons the Residency Program or is disqualified
from the Residency Program owing to unsatisfactory attendance at the Residency
Program or without good reason in any way fails or renders himself unable or
unsuitable to pursue the Residency Program before the completion thereof; or
b. Fails in any of the prescribed tests and/or examinations; or
c. Is convicted by a Court of law in any country of any offence involving dishonesty
or moral turpitude or of such nature, which offence, in the absolute opinion of the
SI renders the Resident unsuitable for an appointment for service with the SIs; or
d. Willfully and persistently disobeys or fails to conform with the lawful and
reasonable orders or directions of the SIs supervisors, tutors or instructors
associated with the Residency Program or the prescribed institutions; or
e. Refuses or in the opinion of, the SI willfully renders himself unable to serve in
accordance with the provisions of this Terms and Conditions; or
f. Is found to have committed any act of dishonesty or misconduct which, in the
absolute opinion of the SI, is likely to bring the SI or any officials of the SI into
disrepute, whether or not such dishonesty or misconduct or act is directly related
to the affairs of the SI; or
g. With or without the consent of the SI, resigns from or leaves the service of the SI
and fails to serve or complete the term of the appointment Period; or
h. Before the expiry of the appointment Period, is dismissed from the service of the SI
for misconduct, negligence, incompetence, poor work performance not meeting the
SI's standard or breach of discipline or for any reason whatsoever, has his service
terminated; or
i. Is terminated by his/her employer.


16 of 31

Certification Requirements

46. ALL NHG-AHPL residents are to ensure that he/she holds a valid:
a. SMC practicing certificate;
b. Medical Malpractice Insurance (MMI) or alternative professional indemnity
coverage;
c. BCLS certificate;
d. ACLS certificate; and
e. Certificate to Administer Moderate Sedation in SI and affiliated training sites (if
applicable)

for himself/herself throughout the entire period of appointment with the
SI/participating training sites during which the resident is providing patient care and
clinical services at the SI/participating training sites.

47. The MMI coverage provides legal defense and protection against awards from claims
for which the resident may be liable even when reported or filed after completion of
the training period if the alleged acts or omissions had occurred within the scope of
the education program.

48. Should the resident fail to maintain such insurance coverage at any particular time
during his/ her appointment with the SI, the SI shall have the rights to terminate the
agreement of appointment with immediate effect.

49. In the event of financial difficulties being encountered by the residents medical
defense insurance organizations or indemnity providers, the above clause shall
apply.

Academic Records

50. The NHG-AHPL Residency upholds the highest standards regarding the
management of resident academic records and confidentiality. Faculty and
administrative staff may have access to resident records on a need-to-know basis in
the course of training, performance improvement, research, or education/training.
Misuse of medical data and/or inappropriate release or disclosure of information may
result in penalties for violation of medical privacy.

51. Disclosure of resident information and requests from outside parties shall require an
appropriate signed release from the resident specifying what information NHG-AHPL
shall disclose. Exceptions to this policy may apply for requests from Governmental
agencies where NHG-AHPL is required to respond to requests for information,
inspections, or investigations.

17 of 31
IV RESIDENT AND DUTY HOURS

1. NHG-AHPL and all residency programs it sponsors are committed to and responsible
for:
a. promoting patient safety and resident well-being and to providing a supportive
educational environment;
b. ensuring that the learning objectives of the programs are not compromised by
excessive reliance on residents to fulfill service obligations;
c. ensuring that residents education and clinical training have priority in the
allotment of residents time and energy;
d. ensuring that duty hour assignments recognize that faculty and residents
collectively have responsibility for the safety and welfare of patients.

2. The NHG GME Policy on Resident Supervision and Duty Hours is attached as Annex
E and F respectively for reference. Residents are also to refer to program specific
policies on resident supervision and duty hours, where applicable.


18 of 31
V RESIDENT IMPAIRMENT AND SUBSTANCE ABUSE

1. NHG GMEC recognises the need to help residents who may suffer from impairment,
to maximise their potentials in training and to maintain clinical quality and safety.

2. Parties who bring to the attention of the NHG GMEC possible impaired residents will
be protected with anonymity and from any forms of reprisal. This policy is in keeping
with Ethical Code published by the SMC.

3. Resident Impairment is defined as a resident who is unable to perform his duties in a
safe and competent manner by reason of physical, psychological, substance misuse
or social factors.

4. Substance misuse is defined as inappropriate, excessive or recurrent use of
substances or drugs that result in adverse consequences.

5. All residents and training faculty will attend and document participation in a training
session on the following:
a. How to identify Impaired clinicians
b. Fatigue and sleep deprivation
c. Psychological factors
d. Substance use disorder

6. It is the responsibility of any resident to disclose to the APD or PD in charge of the
training rotation if he is suffering from any medical, psychological or substance
misuse conditions that might render him/her unable to practice safely and
competently.

7. It is also responsibility of any resident or faculty to inform the APD/PD if they suspect
that a resident is suffering from impairment or exposing patients to unnecessary
risks.

8. In the event that a potentially impaired resident is reported to the APD/PD, the
APD/PD will conduct an investigation to determine the validity of the report. If the
report is valid, the APD/PD will notify the NHG GMEC. During this time, the APD/PD
may decide to temporarily suspend the resident from training and clinical work if
there are any potential patient safety issues.

9. The APD/PD will offer assistance in obtaining the necessary medical, psychological
and social assistance for the resident and monitor the residents progress in
treatment.

10. An ad-hoc meeting of NHG GMEC will review the report and decide on the severity of
the impairment. This meeting should consist of at least 4 APDs/PDs and the DIO or
Acting DIO.

11. Where there are concerns regarding severe impairments leading to patient safety
concerns, the NHG GMEC will raise the matter to the CMB of the respective
hospitals.

12. After reviewing the facts, the NHG GMEC will recommend to the CMB the following
outcomes:
a. Specialist assessment and treatment where necessary.
b. Full reinstatement of training privileges may be recommended

19 of 31
i) On obtaining adequate treatment and assistance, and
ii) Assessed by the NHG GMEC to be able to return to full time training.
iii) This may result in an increase in duration of residency programme.
c. Partial reinstatement may be recommended,
i) On obtaining adequate treatment and assistance, and
ii) Assessed by the NHG GMEC to be able to return to training but requiring
limited caseload; and/or
closer supervision; and/or
remediation.
iii) This may result in an increase in duration of residency programme.
d. Termination from training maybe recommended in the event that
i) full or partial reinstatement is persistently deemed to be unsuitable up to 1
year following adequate treatment; or
ii) if the resident should refuse evaluation by appropriate specialist or comply
with recommended treatment.

27. The final outcome decision will be made by the CMB of the hospital in which the
resident is rotated to and communicated to the NHG GMEC. The NHG GMEC will
inform the resident, the Site HR, and MOH Holdings Pte Ltd (employer of resident) of
the decisions taken in writing.


20 of 31
VI OTHER PROVISIONS FOR RESIDENTS

Access to Confi dential Counseling, Medical, and Psychological
Services

1. All NHG-AHPL residents in distress or in need for confidential counseling, medical
and psychological services are encouraged to tap on the NHGs 3S Program.

2. The 3S Program is a TTSH wide staff support network that trains and utilizes the
peer as a resource person to provide emotional support. The program has identified
and trained registrars and consultants in both medical and surgically related
departments to help identify doctors in need and provide emotional assistance to
them.

3. All doctors working in TTSH have easy access to staff support and mental health
services if required. Doctors who feel the need to talk to someone confidentially can
activate help by contacting:
a. Hotline: 97208515
b. Email: Staff_Support_Staff@TTSH.com.sg

4. NHG Residents training in any participating sites may also utilize this service.

Complaints and Concerns

5. Residents could raise complaints and concerns that they might have with fellow
residents, other members in the healthcare team, faculty members, including PDs,
and administrators from the GME Executive Office including the DIO, following the
NHG GME Policy on Addressing Complaints and Concerns. The policy is attached
as Annex G of this handbook.

6. NHG Residency assures residents who raise any complaints or concerns that they
will be accorded protection against retaliatory acts from their supervisors or any other
staff. If the resident suspects that he/she is a subject of retaliatory action, he/she is
to report directly to the PD or DIO. Faculty members, supervisors or staff who are
found to have taken reprisal actions or victimized the resident will face disciplinary
actions, including possibility of dismissal from NHG Residency, and will be referred to
the CMB, of the respective institution for disciplinary hearing.

7. Residents may also report any misconduct, negligent or improper activities following
the guidelines and procedure set out in the NHG Whistle-Blowing Policy. The policy
is available for all residents reference through the NHG Intranet.


21 of 31
NHG Disciplinary Policy and Procedure

8. NHG Human Resources Disciplinary Policy and Procedure provides for
staff/residents to raise and resolve concerns about other matters not related to
training, e.g. harassment (including sexual) and other forms of misconduct in a
confidential and protected manner without fear of intimidation or retaliation. If any
resident raises such a concern directly to the DIO, the DIO will guide him/her to the
proper channel. The NHG Human Resources Disciplinary Policy and Procedure is
available to all residents through the NHG Intranet.

Residents with Disabilities

9. NHG and NHG Residency do not discriminate against any staff/resident with physical
disabilities as long as the staff/resident is able to fulfill his/her roles and
responsibilities as required. Access and facilities for disabled residents are available
at common areas of the various participating sites.

10. All call rooms have lifts and wheelchair access. Wheelchair assistance is available
twenty-four (24) hours a day by contacting the appropriate Security Office.

22 of 31
VII EMPLOYMENT AND RELATED BENEFITS

Salary and Services

1. MOHH
2
administers the residents employment contracts and other relevant Human
Resources matters including leave, medical benefits, salary, insurance coverage, etc.
Residents shall abide and receive salary, annual leave, medical benefits, insurance
coverage and other benefits set out in the MOHH employment contract.

2. Annual Leave and Training Leave All residents should note that:
a. For PGY1, the following conditions apply:
i) Residents are entitled to 21 working days per calendar year and the
annual leave is allocated according to their PGY1 posting period as follows:
Posting Period (Months) No. of Annual Leave Days
2 3.5
4 7
6 10.5

ii) The annual leave will be pro-rated according to completed calendar days
where the residents period of service with MOHH is less than a calendar
year.
iii) Such leave is to be taken at times convenient to MOHH and not be
accumulated without the prior written permission of MOHH. Any
unconsumed leave will be forfeited upon completion of each posting period.
iv) PGY1 residents are also entitled to 14 days of medical leave in a year.
There is no additional training leave (as defined below) for PGY1 residents.
v) Training leave is defined as leave taken for activities relevant to the specific
residency program and approved by the PD. Activities include but not
limited to conferences/symposiums, seminars, workshops, lectures and
courses. PDs should exercise due discretion. The total number of days
allowed for training is 12 per year. Training leave should not be taken to
study for examinations.
vi) Should PGY1 residents be required to participate in activities like
conferences/symposiums, seminars, workshops, lectures, courses,
examinations relevant to the program, PDs are to plan them as part of the
residents Protected Training Time, capped at a maximum of 12 days per
year. As a guide, for
3-month rotations, up to 3 days could be planned;
4-month rotations, up to 4 days could be planned;
6-month rotations, up to 6 days could be planned.
vii) For longer period of absence possibly due to overseas travel, PD are to pre-
plan with residents at least 6 months ahead to facilitate manpower planning.
viii) The total number of days of absence
1
in PGY1 should not exceed 35 days
in a year with the allowable days for each period of posting shown in Table
1.

2
Or the SAF for SAF Scholars
1
Days of Absence is defined as the total number of days a resident is absent from training whether
from official leave entitlements or any other reasons (e.g maternity leave, no pay leave, etc.)

23 of 31
Table 1
Period of Posting (Months) Allowable Days of Absence
2 6
3 9
4 12
6 18

b. For PGY2 and beyond who have completed their licensing year in PGY1
successfully, the following conditions apply:
i) Residents are entitled to 24 working days
3
per calendar year.
ii) The annual leave will be pro-rated according to the completed months of
service where the residents period of service with MOHH
2
is less than a
calendar year.
iii) Such leave is to be taken at times convenient to MOHH
2
and not be
accumulated without the prior written permission of MOHH
2
. Residents may
only carry forward a maximum of five (5) days of annual leave entitlement to
the next calendar year (the second calendar year). Leave carried forward
must be consumed by 31 December of the second calendar year, failing
which such leave will be automatically forfeited without any compensation
or notification.
iv) PGY2s and beyond are also entitled to 14 days of medical leave
3
in a year
and a maximum of 12 days of training leave
3
is allowed in a year.
v) Training leave is defined as leave taken for activities relevant to the specific
Residency program (including but not limited to conferences/symposiums,
seminars, workshops, lectures, courses, examinations) and hence will not be
considered as leave of absence. Training leave cannot be cumulated and
carried forward to the following year.
vi) Examinations may be considered under activities relevant to the specific
residency program. For approved training activities requiring travel
overseas, up to a maximum of 2 days before and 2 days after of training
leave may be approved for travel. PDs should exercise discretion when
approving the number of days for travel.
vii) Residents who apply for training leave must obtain approval from the PD. The
PD will decide whether the training leave is considered appropriate and
relevant to the program. Should there be misinformation or misuse of training
leave, action will be taken to recover funding for training days and the leave
days will be forfeited from the annual leave.
viii) The allowable days of absence for each period of posting for PGY2 and
beyond are as shown in Table 2.

Table 2
Period of Posting (Months) Allowable Days of Absence
1 3
2 6
3 10
4 13
6 19

3
SAF Scholars are to refer to the SAF employment contract for the leave entitlement.

24 of 31
ix) In the event that a resident is required to exceed the total number of allowable
days of absence from a posting, the resident must inform his/her PD in
advance.
c. The leave application procedure for NHG Residency Programs is attached as
Annex H for reference and compliance.

3. Leave for Volunteer Work
a. Residents who wish to apply for leave for volunteer work must abide by the
policies set out by MOHH
2
.
b. For volunteer trips organized by the institution, the residents should follow the
institutions policy.
c. For self-initiated trips, residents may apply for a maximum of 5 days per year.
i) Residents must seek the approval of the Head of Department and PD;
ii) The email approval from the HOD must be forwarded to MOHH HR for
processing. .

Access to Food Services

4. Residents on duty have access to adequate and appropriate food services 24 hours
a day in all institutions. Each site has its own policies regarding the provision of food
for residents. Residents should check with the relevant site information regarding
meal benefit and charging policies.

5. Policy on meal subsidies for Residents whose normal working hours span through
late evening or the night is as stipulated in the MOHH
2
Employment Terms and
Benefits.

Reasonable Accommodation

6. Residents will be responsible for securing his/her living quarters and transportation. If
the resident is taking in-house calls, then clean, adequately-lit call rooms will be
provided by the applicable hospitals and made available to the resident on call for
sleep.

7. Assistance for transport for individual residents with disability will be provided through
NHG GMEC on a case-by-case basis.

8. All call rooms have lifts and wheelchair access. Wheelchair assistance is available
twenty-four (24) hours a day by contacting the Security Office.

E-mail Access

9. All residents are assigned a MOHH e-mail account. Communication to residents will
be done via this e-mail. Residents are expected to check their MOHH email accounts
on a regular basis.


25 of 31
Overseas Conference Sponsorship

10. To promote an environment of inquiry and scholarship with an active research
component, NHG Residency put in place the NHG Residency Overseas Conference
Sponsorship for residents whose research findings are to be presented at regional or
international conferences.

11. It is a form of financial assistance which seeks to reimburse the cost of expenses
incurred for participation in regional or International conferences.

12. The sponsorship is open to all NHG residents who are unable to apply for the MOHH
Sponsorship for Overseas Conferences, and is limited to one sponsorship per resident per
year.

13. Please refer to the NHG GME policy on Overseas Conference Sponsorship
4
for more
details.

4
Annex J : GME PP17-0 NHG Overseas Conference Sponsorship doc

26 of 31
VII THE RESIDENT COUNCIL

The Resident Council is established as a sub-committee of the GMEC as an advisory input
on matters affecting graduate medical education from the residents perspective.
Membership includes resident representatives from each training program. Members of the
Resident Council are in a unique position to share information with their peers and bring
questions/concerns to the attention of relevant parties. As part of their Resident Council
assignment, they are encouraged to disseminate information to and bring forth issues from
their colleagues.

Full list of Resident Council members can be found on the NHG-AHPL Residency website
(http://www.nhgresidencyprogram.com.sg).


27 of 31
IX OTHER IMPORTANT POLICIES, PROCEDURES AND
GUIDELINES

Moonlighting

1. Moonlighting is defined as "engaging in professional activities outside the educational
program" while internal moonlighting is defined as engaging in professional activities
outside the educational program but for the any major participating sites within NHG
and AHPL; and external moonlighting is defined as engaging in professional
activities outside the educational program and for an institution outside the major
participating sites of the NHG-AHPL Residency.

2. The NHG GMEC requires all residents not to engage in moonlighting. When internal
moonlighting is to be carried out, the resident must submit a prospective, written
request to his/her PD detailing the proposed moonlighting activities. The request
must be approved by the PD and is made part of the residents file. The program may
revoke approval or initiate corrective action in the event outside professional activity
interferes with the ability of the resident to fulfill satisfactorily the obligations of the
program.

3. Any hours that a resident clocks through internal moonlighting must be considered
part of the 80-hour weekly limit on duty hours.

Disaster Preparedness Policy and Procedure

4. Guidelines are provided for administrative continuity and maintenance of the teaching
missions of the NHG-AHPL residency programs in the event of a disaster or
significant interruption in patient care. This includes reconstitution and restructure of
GME educational experiences a disaster, or the transfer or closure in the event of
being unable to reconstitute normal program activity.

5. Please refer to Annex I for the NHG GME Disaster Preparedness Policy and
Procedure.

Vendor Policy

6. The NHG GMEC has adopted the NHG Cluster Human Resource Policy on gifts,
sponsorships and entertainment (received from external parties). This policy is
located in the NHG Cluster HR Policies on the NHG Intranet

http://nhgweb.nhg/NHGIntranet/Human%20Resource/Cluster%20HR%20Policies/S%20-
%20Rules%20&%20Regulations/Gifts%20&%20Entertainment%20&%20Sponsorships.pdf


28 of 31
Non-Discrimination and Harassment

7. Non-Discrimination Harassment and other forms of discrimination are prohibited.
No residents of the NHG-AHPL Residency will be discriminated against because of
race, ethnic origin, religion, marital status, national origin, ancestry, sex, sexual
orientation, physical, or mental handicap.

8. Harassment NHG-AHPL Residency is committed to creating and maintaining a
community in which all persons who participate in residency programs and activities
can work together in an atmosphere free of all forms of harassment, exploitation, or
intimidation, including sexual. Each resident should be aware that the SIs strongly
opposed to sexual harassment and that such behavior is prohibited by law and by
NHG-AHPL Residency.

9. The Disruptive Resident The PD may restrict the duties of a resident exhibiting
disruptive behavior in the work/learning environment. Disruptive behavior may
include but is not limited to conduct, performance level or competence, or significant
physical or emotional disability that appears to require that immediate action be taken
to protect the life or well-being of a patient(s) or to reduce a substantial and imminent
likelihood of significant impairment of the life, health, or safety or any patient,
prospective patient, or adversely influence the welfare of any NHG-AHPL residency
program and/or parts including the affiliated hospitals and staff.

Written notice of the imposed restriction must be given to the involved individual as
soon as possible. This notice must include the reason for the restriction and the
requirements (if applicable) for the reinstatement of duties.

Release of Information

10. All residents are to note that should another institution, organization or individual to
which the resident has applied for a position request a reference from the SIs,
affiliated training sites, such SIs/affiliated training sites may share any and all
appropriate information that it possesses concerning the resident, including
information relating to any disciplinary proceedings, suspension or termination from
the program or the SIs/affiliated training sites, or perceived inability to practice within
commonly accepted standards of care. The resident acknowledges that the
SIs/affiliated training sites will release such information under these circumstances at
any time, provided such information is given in good faith and without any malice
whatsoever.

Confidentiality

11. NHG GMEC requires all residents to observe the Code of Confidentiality as detailed
in the NHG Human Resource Policy on Confidentiality. This policy is located in the
NHG Cluster HR Policies on the NHG Intranet

https://mynhg.nhg.com.sg/sites/HR/Shared%20Library/b)%20HR%20Policies/Group%20HR%
20Policies/S%20-%20Rules%20and%20Regulations/S04%20-%20Confidentiality.pdf


29 of 31
12. The policy was developed with the guiding principles that In the course of their work
and based on authorized access granted by NHG/institution, staff will have access to
and will be given custody of NHGs corporate information and/or information relating
to NHGs customers/patients. Corporate information is deemed as assets of NHG,
hence staff must safeguard the integrity of corporate information and handle such
information with responsibility. As for information relating to customers/patients, the
code of ethics expected of healthcare professionals requires that such information be
treated with the highest degree of confidentiality..

13. The scope of the policy covers all types of information that staff receive in the course
of work, which includes:

a. corporate information defined as any information relating to the operations of
NHG/institutions;
b. information relating to NHGs customers/patients.

The information may come in any form or format (whether oral, written, computer
readable or otherwise).

Corporate Communications and Social Media Guidelines

14. Residents, staff and faculty are free to respond to requests from the media regarding
their research, scholarship, teaching or professional expertise. In such cases, the
GME Executive Office must be notified before he/she responds to the media.

15. Issues that should not be discussed with the media are 1) legal issues, 2) personnel
issues, 3) questions that involve institution integrity, such as ethics or issues that may
result in harm to others, or 4) a major crisis or emergency. Please refer all such
inquiries to the GME Executive Office immediately.

16. These guidelines apply to all residents, faculty and staff who identify themselves with
NHG Residency or affiliated institutions in social medial platforms such as
professional society blogs, personal blogs, LinkedIn, Facebook, Twitter, etc.

17. These guidelines apply to private and password protected social media platforms as
well as open social platforms.

18. The Internet has created the ability for physicians and medical students to
communicate and share information quickly, and the use of social media websites is
increasingly common for residents, faculty and staff. Social networks, blogs, and
other forms of communication online also have a significant impact on organizational
and professional reputations. Residents, staff and faculty should weigh a number of
considerations when maintaining a presence online:
a. Residents, staff and faculty must respect copyrights and disclosures, and not
reveal proprietary financial, intellectual property, patient care or similar
sensitive or private content.
b. Residents, staff and faculty must be cognizant of standards of patient
confidentiality and privacy that must be maintained in all environments,
including online, and must refrain from posting identifiable patient information
online.
c. When using the Internet for social networking, residents, staff and faculty
should use privacy settings to safeguard personal information and content as
much as possible, but should realize that privacy settings are not absolute

30 of 31
and that once on the Internet, content is likely stored permanently. Thus, they
should routinely monitor their own Internet presence to ensure that the
personal and professional information on their own sites is accurate and
appropriate.

20. When residents, staff and faculty see content posted by colleagues that appears
unprofessional, they have a responsibility to bring that content to the attention of the
individual, so that he/she can remove it and/or take other appropriate actions. If the
behavior significantly violates professional norms and the individual does not take
appropriate action to resolve the situation, the resident, staff or faculty member
should report the matter to the GME Executive Office.

Other Important Policies

21. Residents are to note that NHG GMEC requires all NHG-AHPL residents to comply
with the following policies as well. Relevant AHPL policies will apply when residents
rotate to KTPH.

NHG Policies
a. General Conduct

NHG Intranet: Home >Group Human Resource >HR Policies >Group HR Policies >S - RULES
& REGULATIONS

b. Dress Code

& REGULATIONS

c. Attendance and Punctuality

& REGULATIONS

d. External Communication and Publication

& REGULATIONS

e. Secondary Employment

& REGULATIONS

f. Breach of EMR Usage

NHG Intranet: Home >Group Human Resource >HR Policies >Group HR Policies >T
DISPLINARY AND GRIEVANCE PROCEDURES


31 of 31

g. Disciplinary Policies and Procedures


h. Staff Grievance


TTSH Policy
a. Dress Code For Clinical Staff

TTSH Intranet >All Work Is Part Of A Process >Clinical Guidelines, Guidelines & Procedures,
Directives, Circulars and Policies >Guidelines, Directives and Circulars >CMB >POLICY ON
DRESS CODE FOR CLINICAL STAFF (MED-04-07)

SMC Policy
a. Ethical Code & Ethical Guidelines

www.smc.gov.sg >
http://www.healthprofessionals.gov.sg/content/hprof/smc/en/topnav/guidelines/ethical_code_and_ethical_guidelines.html

MOH Policy
a. A Guide for Hospital Medical Staff

TTSH Intranet >All Work Is Part Of A Process >Clinical Guidelines, Guidelines & Procedures,
Directives, Circulars and Policies > Guidelines, Directives and Circulars > MOH > MOH-GP-
HOSPITAL MEDICAL STAFF- 01 A Guide for Hospital Medical Staff
http://intranet/MOH_Guidelines/MOH-GP-HOSPITAL_MEDICAL_STAFF-01.pdf

National Healthcare Group
Graduate Medical Education

GME PP3-1 NHG GME Grievance Policy and Procedure Page 1 of 5
NHG-GME INSTITUTIONAL POLICY & PROCEDURE

TITLE:

NATIONAL HEALTHCARE
GROUP GRADUATE MEDICAL
EDUCATION GRIEVANCE
POLICY AND PROCEDURE

DOCUMENT NO:
GME PP3-1

REVISION NO:
Policy Revision 1

ORIGINAL DATE:
12/05/2010

EFFECTIVE DATE:
20/09/2011

REVISION DATE:
19/09/2011

PAGES: 03

PROCESS OWNER:

NHG-GME Executive Office

APPROVAL:

GMEC

Objective

1. This policy aims to set out a framework and procedure to address NHG residents
grievances over training matters in a systematic, fair and expeditious manner.

Scope

2. This policy applies to all NHG residents.

Principles

3. The NHG Graduate Medical Education Committee (NHG GMEC) recognises the
importance of the residents rights of appeal against any training management and
training decisions affecting them. For non-training matters, residents should follow
existing grievance procedure provided by MOHH/NHG HR policies.

4. A resident who surfaces a grievance or appeal is required to use the NHG GME
Grievance Procedure to ensure systematic, fair and expeditious resolution of grievances.

5. Any resident who surfaces a grievance or appeal and follows the NHG GME Grievance
Procedure will be protected against any form of reprisal.

Operating Guidelines

6. A resident may surface grievance or appeal against training management decisions or
training situations that directly affects him/her.

Annex A

7. The grievance or appeal should be made in writing using the Resident Grievance and
Appeal Form (Annex A), and submitted to the Programme Director (PD) or Site
Director/Associate Programme Director (APD) in charge of the training rotation.

8. In the event that the grievance or appeal is done verbally or via email, the staff/faculty
receiving the feedback or appeal is to follow-up with the completion of the Resident
Grievance and Appeal Form.

9. Where the grievance or appeal is made against the PD, the resident may direct the
grievance or appeal to the DIO. Similarly, a grievance or appeal against the DIO may be
raised directly to the Deputy Group CEO (Education) of NHG.

10. On receipt of the grievance or appeal, the PD/APD
1
or appointed NHG-GMEC member
will perform the necessary investigations and address the issues within 14 days of
receiving the grievance or appeal.

11. In the event that the APD/PD is unable to resolve the grievance, the matter should be
raised to the PD/DIO. If the matter remains unresolved, the PD/DIO will raise the issue
to the NHG-GMEC.

12. Within 21 days of receiving the grievance or appeal, the NHG-GMEC will appoint an ad-
hoc sub-committee Appeals Panel comprising:
a. A Consultant grade (or higher) doctor, who participates intimately in the resident's
training, to be appointed by the Chairman Medical Board; and
b. A Consultant grade (or higher) doctor, who participates intimately in the resident's
training, to be appointed by the resident; and
c. NHG-GMEC member appointed by the PD/DIO or NHG-GMEC.

13. During the meeting of the Appeals Panel, the PD will provide an outline of the issues to
the Panel. The resident will be provided an opportunity to present his grievances or
appeal. The decision of the sub-committee will be reached by means of a single
compulsory vote by each member of the panel. In the event that the appeal is made
against a decision by the PD, the DIO will provide the brief outline of the issues to the
Panel instead.

14. The resident will be informed of the decision of the Appeals Panel within 7 days of the
meeting.

15. The resident may raise a final appeal against the decisions of the Appeals Panel to the
Chairman Medical Board of the hospital in which the appeal was raised or to Assistant
CEO (Education)-NHG, who oversees all education and training matters in NHG.

1
or DIO if appeal is made against the PD

16. During the period of the investigation, the resident who raised the grievance or appeal is
to be apprised of the progress of the investigation at least on a weekly basis.

Reviewed by GMEC on:

19 Sep 2011

Approved by GMEC on:

19 Sep 2011

Dr Nicholas Chew
Name and Signature of Chair of GMEC


ANNEX A
RESIDENT GRIEVANCE / APPEAL FORM
(At end of each stage, form must be completed and submitted to the GME Executive Office for tracking purposes.)

Name : NRIC No. :
Program : MRC No. :
Residency Year : Date J oined :

Nature of grievance brought up on __________________ to _____________________________
(state date) (state name of officer attending to grievance)
Summary of Grievance:

Name of Resident

Signature

Date
Actions Taken:


Outcome:
[ ] Grievance is resolved on ________________ (state date)
[ ] Resident requested to further appeal to ___________________________ (state name of officer)
[ ] Resident does not wish to proceed further from here.
[ ] Grievance remains unresolved on __________________ (state date) due to:
(Please provide reasons below)

Name of Resident

Signature

Date

Name & Designation of Attending Officer

Signature

Date
For GME Executive Office Use Only

STAGE OF APPEAL ____________________________________ ( 1st / 2nd / 3rd / 4th / 5th etc)
Remarks:

Name of Officer

Signature

Date


GME PP11-1 NHG GME Policy on Resident Transfer, Switches or Resignation Page 1 of 4

TITLE:

INSTITUTIONAL POLICY ON
RESIDENT TRANSFER,
SWITCHES OR RESIGNATION
FROM PROGRAM

DOCUMENT NO:
GME PP11-1

REVISION NO:
Policy Revision 1

ORIGINAL DATE:
12/05/2010

EFFECTIVE DATE:
20/04/2012

REVISION DATE:
16/04/2012

PAGES: 04

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This policy aims to establish an institutional policy on resident transfer, switches and
resignation. It is established in accordance with the MOH Training Circular Minutes.
11/2011 dated 23 August 2010.

2. This policy takes reference from the MOH Residency Terms and Conditions dated April
2011, National Healthcare Group Residency Agreement and NHG-AHPL Residency
Handbook.

3. It will be updated in accordance to guidelines from MOH.

Definitions

4. Resident transfers/switches are defined as residents who withdraw from one residency
program and wish to enter another residency program or BST/AST/Seamless program
in:
a. The same specialty offered by a different Sponsoring Institution; or
b. A different specialty offered by the same Sponsoring Institution; or
c. A different specialty offered by another Sponsoring Institution.

5. Resident resignation is defined when residents express the intention to voluntarily
terminate his/her training from the residency program prior to the end date of the
Residency Agreement.

Policy

6. One Year Penalty Residents described in Clause 4a-4c will be required to re-apply to
their desired programs on a competitive basis during the annual resident applications.
However, they cannot reapply in the subsequent year but can only reapply the year after
Annex B

next (one year penalty
1
) unless the change is due to strong reasons
2
, and recommended
by the Program Director (PD) and approved. This is to ensure responsible decisions
when the resident enters into training and accountability of funded training programs.
They may also not get their program of their choice if they are not selected. They will not
be able to return back to their previous program once they have withdrawn from it.

7. Procedures
I. Resident who wishes to transfer/switch/resign from the current residency
program must inform the PD on his/her intention. The PD will speak with the
resident to find out the problems and issues faced by the resident and provide
counsel.

II. PD will escalate to Designated Institutional Official (DIO) should the resident
insists on transfer/switch/resignation.

III. DIO will meet the resident to understand the problems and issues faced by the
resident and to provide remedy plans.

IV. Resident will submit a written notice of his/her intention to transfer/switch/resign
from the residency program to the PD with one (1) month notice period. A copy of
the written notice must also be sent to the DIO and MOH Holdings (MOHH).

V. PD of the program from which the resident withdrew is required to provide a
written or electronic verification of the transferring/switching/resigning residents
a. training and education experiences;
b. summative competency-based performance evaluation in:
i) Patient care
ii) Medical Knowledge
iii) Practice-based learning and improvement
iv) Interpersonal and communication skills
v) Professionalism
vi) Systems-based practice
c. any other information relevant in program transfer (e,g. reasons for
withdrawal)

VI. The information should be provided at the point of withdrawal for the residents
personal records. The program from which the resident withdrew should also
keep a record for their own use.

8. Program Receiving The PD of the receiving program should obtain the information in
Clauses 7.V and 7.VI before accepting a resident transfer/switch into his/her program.

9. Resident transfers/switches, if successfully matched and accepted, are to commence
residency at R1 and must be placed on close monitoring/supervision for assessment of
competencies and the appropriate remediation required if needed, to determine
placement at R2 under the current rules.

1
For example, residents who withdraw from their program on 1 May 2011 would only become eligible to
re-apply for residency on 1 May 2012.
2
For example, health reasons that render a resident unsuitable for a particular specialty

10. Resident resigning from the residency program will have to undergo postings to other
institutions as a Medical Officer (MO) at the discretion of MOHH.

11. The workflow depicting the process for resident transfer, switch or resignation from any
residency program is attached as Annex A for reference.


16 April 2012


20 April 2012

A/Prof Nicholas Chew



ANNEX A
Resident expresses intention to
transfer/switch/resign from
residency program to PD
PD will find out problems/ issues
from resident and provide timely
counsel
Resident still insist on
transfer/switch/resign from
residency?
PD will escalate to DIO
DIO will find out problems/ issues
from resident and provide timely
remedy plans
Resident still insist on transfer/
switch/resign from residency?
Continue with
residency program
Resident will submit withdrawal
notice with 1 month notice period
to PD (copied to DIO, MOHH and
J CST)
PD will provide verification of
residents performance,
evaluation, assessments and
other relevant information
Resident opting for
transfer/switch?
Program Coordinator will file the
withdrawal notice and verification
documents by PD into the
residents personal folder.
Resident** who is
successfully matched and
accepted in new program /
SI will commence residency
at R1
Resident to undergo
postings to other
institutions as MO at the
discretion of MOHH
** Resident who withdraw from the program will only be eligible to reapply for residency after a one-year penalty.
NO
NO
YES
NO
YES
YES


GME PP8-4 NHG GME Policy on Resident Evaluation and Disciplinary Guidelines Page 1 of 13

TITLE:

INSTITUTIONAL POLICY AND
PROCEDURES FOR RESIDENT
EVALUATION AND
DISCIPLINARY GUIDELINES

DOCUMENT NO:
GME PP8-4

REVISION NO:
Policy Revision 4

ORIGINAL DATE:
14/07/2010

EFFECTIVE DATE:
12/09/2013

REVISION DATE:
20/10/2010
16/04/2012
10/09/2012
12/09/2013

PAGES: 07

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This policy aims to provide a system for resident academic performance evaluation and
management.

Guiding Principles

2. All NHG residents are employed by MOH Holdings Pte Ltd (MOHH) / Singapore Armed
Forces (SAF) but seconded to NHG for residency training. As such, all employment related
evaluation will be in accordance to principles and guidelines set out by MOHH / SAF.

3. The policy and procedures set out in this document mainly pertains to training related
evaluations and academic performance. For non-training performance evaluation and
management, NHG
1
policies apply. For unsatisfactory conduct and/or gross misconduct,
the policy and procedures set out in this document and the NHG Disciplinary Policy and
Procedures (or that of the Institution that the resident is posted to) can apply concurrently.

4. NHG Residency believes that a proper evaluation and disciplinary framework serves the
following important objectives for all NHG residency programs:

a. accord fair treatment to all NHG residents;
b. discourage and manage errant resident behaviour pertaining to learning and training
c. promote desired resident behaviour by guiding/enforcing faculty to take corrective
actions.

1
and/or AHPL
Annex C

5. The primary intent of this policy is to be supportive and corrective, rather than punitive.
Wherever possible, the resident is put through a progressive system of feedback to give the
resident an opportunity to take corrective action and make improvement to achieve the
desired standard of academic performance.

Appointment

6. Upon successful match through the national matching exercise administered by MOHH,
and fulfilling the criteria for appointment, successful applicants for NHG Residency will be
issued with a Residency Offer Letter co-signed by the DIO and Director (Manpower
Standards and Development)/MOH, together with the offer of employment letter from
MOHH / SAF.

7. All residents will be appointed for a period of one (1) year, unless sooner terminated in
accordance with applicable policies, with annual re-appointment, subject to successful
completion of each residency year and satisfactory performance as required by the
program.

8. Re-appointment of Post-Graduate Year 1 Residents will take place upon their successful
completion of the first (1
st
) year, according to the level of competencies defined in each
program, their ability to continue with the program, and upon fulfilling licensing
requirements defined by the Singapore Medical Council.

9. For Residents who have already obtained full practicing license from the Singapore Medical
Council, re-appointment will take place annually with the successful completion of each
residency year, according to the level of competencies defined by each program and as
determined by the Program Director. In making this determination, the Program Director
will take inputs from the Clinical Competency Committee and may consider inputs from
supervising attending physicians, Chief Residents and others who have worked closely with
the Resident during the period of this engagement. The Program Director may also
consider the results of an in-training examination, where applicable. The Resident must, at
a minimum, have completed responsibilities as appropriately assigned within the scope of
the Residency Program and attained the knowledge and skill necessary to progress to the
next level of post-graduate training.

Evaluation

10. Evaluations shall use criteria and procedures appropriate to the particular program and
shall include, but are not limited to the core competencies of Patient Care, Medical
Knowledge, Communication and Interpersonal Skills, Practice-Based Learning and
Improvement, Professionalism, and Systems-Based Practice, as defined by ACGME-I.

11. A written evaluation of a resident addressing medical knowledge, competence in patient
care, professionalism, system based practice, interpersonal and communication skills, and
practicebased learning and improvement will be completed at the end of each major
rotation. The Program Director or faculty designee will share the evaluation(s) with the
resident and provide feedback in accordance with ACGME-I requirements for that specialty.
This evaluation sharing must occur at the end of major rotation blocks as defined by the
Program Director, and at least semi-annually, will include a written review of performance,
and should also include a discussion of areas of deficiency and plans for improvement.


12. The written evaluation and any documentation regarding the meeting should be
permanently maintained in the program file by the Program Coordinator.

13. The evaluations, evaluation summaries and/or other non-privileged documents provided by
the GME Executive Office and/or department to the Clinical Competency Committee, as
determined by each program, may be reviewed by the resident with the Program Director,
the Head of Department, the Designated Institutional Official (DIO), or an individual
designated by the DIO upon request.

Feedback and Counselling

14. In addition to evaluations, Program Directors, Associate Program Directors, and faculty are
to provide and document timely feedback on an ongoing basis, which includes positive
feedback as well as minor performance or conduct concerns as they occur and are
documented as such.

15. For minor performance or conduct concerns, verbal counselling with documentation is
required. The Program Director or designee signs off the documentation at the end of the
counselling for record purposes
2
. DIO sign-off will also be required for his oversight of all
residents under NHG Residency.

16. If the minor performance or conduct concerns persist, the Program Director or designee
may initiate a performance improvement plan where the Program Director/designee and
the resident agree on expected performance targets to be achieved within an agreed
timeframe. The Program Director/designee and the resident co-sign the agreed
performance improvement plan
2
.

Corrective Action

17. Corrective action is to be taken to address any concern about the residents performance or
conduct which is too serious to be resolved by feedback and counselling or was not
corrected by feedback and counselling. Performance or conduct issues subject to
corrective action include, but are not limited to, the following examples:

a. Any deficiency or conduct which adversely bears on the individual's performance, such
as poor attitude, conduct, interpersonal or communication skills, or other misconduct
3
;
b. Failure to progress or perform at the expected level of training;
c. Violations of professional responsibility, NHG policies and procedures, or any other
applicable rules and regulations.
d. Insufficient or poor medical knowledge;
e. Poor effort in acquiring and applying medical knowledge.

2
Please use Training Performance Feedback Record Form which is attached as Annex A for reference.
3
For misconduct, NHG or relevant institutions Disciplinary Policy and Procedure can be applied
concurrently.

18. Initiation of Corrective Action

a. There may be concerns regarding the performance or conduct of a resident which have
not been remedied or should not be addressed with feedback or counselling.
b. In those situations, one of the actions listed below (Warning(s), Probation, Summary
Suspension, Termination or Non-renewal) is to be taken, depending on the nature
and/or severity of the deficiency, actions, or conduct. In determining which level of
intervention is appropriate, the Program Director should take into account the residents
overall performance, including previous evaluations, feedback and counselling done,
Warnings, and Probationary Periods.
c. Warning
i. A Warning is appropriate if concerns arise or continue regarding the performance or
conduct of a resident which are too serious to be dealt with by feedback and
counselling but which do not impact the health or safety of patients or others.
(Actions that may adversely impact on health or safety of patients or others are
addressed by Probation, Summary Suspension and/or Immediate Termination from
the Residency Program.)
ii. A Warning will be given to the resident explaining why the conduct or performance
is unacceptable. Examples of such unacceptable conduct/performance include,
but are not limited to, failure to respond to feedback and counselling, unprofessional
conduct, and poor formative assessment scores.
iii. A Warning may be given verbally or in writing, but will be documented in the
residents file, with a copy to the DIO. For written Warnings, MOHH / SAF, being
the employer of the Resident, will be notified.
iv. The resident will be advised by the Program Director or designee about
expectations for improvement of the deficiency or conduct and be given a time
frame in which to meet these expectations.
v. During or at the end of the Warning Period the resident will meet with the Program
Director or designee to advise the resident whether the deficiency or conduct has
been corrected or whether further corrective action will be taken. If the resident
does not correct or improve the conduct or deficiency within the Warning Period, or
if the same or additional conduct or deficiency occurs within that period, then the
Program Director may immediately place the resident on Probation, recommend
non-renewal, or recommend immediate termination from the residency program. At
any time, whether before or after the Warning Period has passed, the Program
Director may recommend further action.
d. Probation
i. If a residents academic performance, performance of duties, attitude, deportment,
or interpersonal or communication skills falls below acceptable standards or other
deficiencies exist which are not corrected by feedback and counselling or a
Warning, or are of a serious nature such that feedback or counselling or a Warning
are not appropriate, the resident is placed on Probation by the Head of
Department
4
, Program Director, or DIO.
ii. The resident will be informed in writing by the Head of Department, Program
Director, or DIO that he/she is being placed on Probation. The notification should
include an explanation of the deficiencies, performance or conduct giving rise to
Probation, and the time period of the Probation. The length and conditions of the
Probationary Period are determined by the Head of Department and/or Program
Director, after consultation with the DIO. A copy of the written notification of

4
Refers to the Head of the Department that the resident is rotated to.

Probation shall be sent to the DIO and the resident. The effective date of the
Probationary Period will be the date of the written notification. MOHH / SAF, being
the employer of the Resident, and Site HR, will also be notified.
iii. Expectations for improvement of the residents performance, deficiency or conduct
are conveyed to the resident by the Head of Department and/or Program Director,
together with a copy of these guidelines. During the Probationary Period, efforts are
made to advise and assist the resident to address the performance issues and/or
correct deficiencies or conduct with the goal of the resident successfully completing
the program.
iv. If at any time during the Probationary Period additional performance or conduct
issues arise, or if the issues which resulted in the Probation continue, the Program
Director may extend the Probation, recommend Non-renewal, Summary
Suspension or Immediate Termination from the Residency Program.
v. At the end of the Probationary Period, the Head of Department and/or Program
Director determines which of the following actions will be taken and notifies the
resident:
(a) Remove the resident from probationary status;
(b) Extend the probationary period;
(c) Notify the resident of non renewal of his/her appointment;
(d) Notify the resident of his/her immediate termination.

The DIO, MOHH / SAF and Site HR are to be notified of the actions in (a) through (d)
above.
e. Summary Suspension
i. If at any time a residents conduct requires that immediate action be taken to protect
the health or safety of patients or others, or to reduce the substantial likelihood of
immediate injury or damage to the heath or safety of patients or other persons, any
member of the Medical Staff, the Hospital Administrator on Call, or the DIO shall
have the authority to summarily suspend the resident.
ii. If a resident exhibits performance or conduct that is too serious to warrant a
Warning or Probation, the resident may also be summarily suspended by the Head
of Department, Program Director, or DIO.
iii. The Summary Suspension will be reported immediately in writing to the DIO and the
residents Program Director and Head of Department, with a copy to the resident.
MOHH / SAF, being the employer of the Resident, and Site HR, will be notified but
the resident will remain in paid status while on Summary Suspension.
iv. The DIO, after review of the circumstances giving rise to the Summary Suspension
and after consultation with the Head of Department and Program Director,
determines a course of action which includes one or more of the following:

(a) Lifting, modifying or extending the Summary Suspension;
(b) Probation;
(c) Notification of Non-renewal;
(d) Immediate Termination from Residency Program.

v. The resident is to be notified in writing, with copies to the residents Program
Director and Head of Department, of the action taken, and that he/she may not be
present in the clinical areas or otherwise participate in on-campus GME activities
unless specifically instructed.
vi. In the event of Summary Suspension or Immediate Termination from the Residency
Program, if the resident wishes a review, he/she should notify the DIO in writing

(C/O GME Executive Office) within 14 working days of the time written notification of
the action was provided to the resident or sent to the residents home address.
f. Non-renewal or Non-promotion
i. Non-renewal of a residents contract or non-promotion of a resident may be
appropriate for a number of reasons, including but not limited to, poor acquisition
and/or application of medical knowledge, incompetence in patient care, lack of
professionalism, inability to effectively use resources, poor interpersonal and
communication skills, and inability to participate in practice-based learning, based
on the programs evaluation of the residents performance and progress. The
resident will be notified in writing of the intent not to renew his/her appointment or
non-promotion no later than four (4) months prior to the end of the residents current
agreement.
ii. If the primary reason(s) for the non-renewal or non-promotion occur(s) within the
four (4) months prior to the end of the current agreement or the academic year, the
program will provide the resident with as much written notice of the intent not to
renew or not to promote as circumstances will reasonably allow prior to the end of
the agreement or academic year. The resident will be allowed to implement the
grievance procedures if the resident has received a written notice of intent not to
renew the agreement of appointment or of intent to renew the agreement but not to
promote the resident to the next level of training.
iii. If a resident receives notice of Non-renewal and chooses to initiate a review, he/she
must notify the DIO within fourteen days and request the initiation of NHG Graduate
Medical Education Grievance Policy and Procedure.
iv. If, in the event that within the fourteen day period, the Program Director and the
resident have resolved the matter to their mutual satisfaction (and the Program
Director notifies the DIO in writing), an Appeals Panel of the NHG-GMEC need not
be convened and the request for review will be considered withdrawn. In either
case, the DIO is to be advised of the outcome.
v. For non-renewal cases, MOHH / SAF will be notified so that they may prepare
subsequent rotations for the resident.
g. Termination from the Residency Program
i. Performance issues or conduct not resolved by a Warning or Probation, or other
serious actions or behaviour may result in Immediate Termination from the
Residency Program. If at any time, including during or at the end of a probationary
period, the Program Director determines that Immediate Termination from the
Residency Program is warranted, he/she, makes the recommendation to the Head
of Department/Division (that the Resident is rotated to) and the DIO for concurrence
and approval. Once approved by the DIO and Head of Department/Division, the
resident will be notified. The resident is relieved of all clinical duties upon
notification that the termination is warranted. The Program Director will consult with
the DIO and Head of Department/Division to determine the effective date of
Termination from the Residency Program.
ii. The resident will be notified in writing of the action taken, and that he/she may not
be present in the clinical areas or otherwise participate in on-campus Graduate
Medical Education. MOHH / SAF will be notified in writing of the action taken by the
GME Executive Office.
iii. Any equipment including, but not limited to, mobile phones, ID badges, keys,
parking labels, laptops, email privileges, is revoked upon Termination from the
Residency Program. In addition, all access to the hospital and NHGs computers will
be terminated.

iv. MOHH / SAF, being the employer of the Resident, and Site HR, will be notified of
the residents Termination from Residency Program and will be advised to dismiss
the resident from employment if the situation warrants.
h. Response of Resident
i. The resident has fourteen (14) working days from the time written notification of the
Termination from the Residency Program is provided to the resident or sent to the
residents home address to choose one of two alternatives:

(a) Accept the Termination from the Residency Program without requesting a
review;
(b) Request a review of the Termination from the Residency Program.

ii. The response of the resident must be submitted in writing to the DIO and received
by the GME Executive Office by 5:30 p.m. on the fourteenth working day after
notification of Termination from the Residency Program. Failure to notify GME
Executive Office within this time frame is considered acceptance of the Termination
from the Residency Program.
i. Review Procedure for Summary Suspension or Termination from the Residency
Program

i. Residents can request a review of a Summary Suspension or Termination from the
Residency Program following the NHG Graduate Medical Education Grievance
Policy and Procedure.
5


10 Sep 2013


12 Sep 2013


5
GME PP3-1 NHG GME Grievance Policy and Procedure

RESIDENT TRAINING EVALUATION FEEDBACK FORM
(Form must be completed and filed in the Residents Personal File. DIO & IC to be informed.)

Name of Resident : NRIC No. :
Program : MCR No. :
Residency Year : Date Joined :

Which Core Competency Does This Feedback Relate to? (more than one (1) may be selected)
Patient Care Professionalism Practice-Based Learning & Improvement
Medical Knowledge System-Based Practice Interpersonal & Communication Skills

Nature of Action: Feedback & Counselling Non-renewal or Non-promotion
Warning Summary Suspension
Probation Termination from the Residency Program

Section A Summary of Feedback
(Note: If this is an incident, summary suspension or termination, supporting documentation of correspondences, reports
and previous evaluation feedback forms, if applicable, are to be attached)


Section B Summary of Residents Account/Feedback


Section C Summary of Follow-Up Action/Remediation
1) Follow-Up Action By Resident/Remediation actions recommended by CCC

2) Duration of monitoring / warning / probation (delete the nature of action that is not applicable)

3) Targets Set for Improvement (Additional pages made by attached if necessary)

Target Set Assessment Timeframe for Assessment


Section C Summary of Follow-Up Action/Remediation
4) Possible consequences if targets are not met within given timeframe.

5) Any other remarks/information

------------------------------------------------------------------------------------------------------------------------
Meeting conducted and recorded by:

______________________________ _________________________ _____________
Name & Designation of Attending Officer Signature Date

Acknowledgement by Program Director: (if Program Director was not the Attending Officer)

______________________________ _________________________ _____________
Name of Program Director Signature Date

Acknowledgement by DIO:

______________________________ _________________________ _____________
Name of DIO Signature Date

Acknowledgement by Resident:

I understand and agree with the feedback given, the remediation and targets set. I have
also been informed and understand the possible consequences if I do not meet the targets
set within the agreed timeframe.

I do not agree with the feedback given, the remediation and targets set. I have been
informed of the NHG GME Grievance Policy and Procedure.

______________________________ _________________________ _____________
Name of Resident Signature Date


FORM FOR FOLLOW-UP MEETING WITH RESIDENT

Name of Resident : NRIC No. :
Program : MCR No. :
Residency Year : Date Joined :

This meeting is based on previous discussion held with resident and documented on:

Resident Training Evaluation Feedback Form completed and signed on <<Date>>

Present: Name Designation

1. Did resident meet the targets set within the given timeframe? (A separate
attachment may be used if this space is insufficient)

Target Set Assessment Timeframe for
Assessment
Met Target?
(Yes/No)
Remarks

2. Summary of Feedback to Resident

3. Summary of Residents Feedback


4. Outcome at the End of Review Period
Nature of Action: End of Review Non-renewal or Non-promotion
Warning Summary Suspension
Probation Termination from the Residency Program

------------------------------------------------------------------------------------------------------------------------
Meeting conducted and recorded by:

______________________________ _________________________ _____________
Name & Designation of Attending Officer Signature Date

Acknowledgement by Program Director: (if Program Director was not the Attending Officer)

______________________________ _________________________ _____________
Name of Program Director Signature Date

Acknowledgement by DIO:

______________________________ _________________________ _____________
Name of DIO Signature Date

Acknowledgement by Resident:

I understand and agree with the outcome decided.

I do not agree with the outcome decided. I have been informed of the NHG GME
Grievance Policy and Procedure.

______________________________ _________________________ _____________
Name of Resident Signature Date


Annex D GME PP4-0 NHG GME Policy on Program Closure & Reduction Page 1 of 2

TITLE:

NATIONAL HEALTHCARE
GROUP GRADUATE MEDICAL
EDUCATION POLICY ON
PROGRAM CLOSURE &
REDUCTION

DOCUMENT NO:
GME PP4-0

REVISION NO:
Policy Revision 0

ORIGINAL DATE:
12/05/2010

EFFECTIVE DATE:
12/05/2010

REVISION DATE:
NA

PAGES: 02

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This policy aims to describe the circumstances and procedures for reducing the size of or
closing a residency (including fellowship) program or closure of the Institution.

Policy

2. The National Healthcare Group (NHG) recognizes the need and benefits of graduate
medical education and sponsors residency programs which emphasize personal, clinical
and professional development. NHG ensures, through the GMEC Education Review
process, that its residency programs are in substantial compliance with the institutional,
foundational and specialty-specific requirements of the Accreditation Council for Graduate
Medical Education-International (ACGME-I) and its individual Residency Advisory
Committees.

3. Circumstances that may lead to reduction in the size of or closing a program may include:
a. Failure of the program to correct concerns and/or comply with recommendations of the
NHG GMEC based on the Education Review of the program;
b. Failure of the program to correct citations of the ACGME-I;
c. Decreased financial or educational resources to support the program.

4. Circumstances that may lead to closure of the Institution include:
a. Failure to demonstrate substantial compliance with the requirements;
b. Delinquency in payment of fees according to the ACGME-I policies and procedures;
c. Failure to undergo a site-visit and Sponsoring Institution review;
d. Failure to follow directives associated with an accreditation action;
e. Failure to supply the Institutional Review Committee with requested information (e.g.,
Progress Report, operative data, resident survey);
f. Failure to maintain current data through web ADS.
Annex D

Annex D GME PP4-0 NHG GME Policy on Program Closure & Reduction Page 2 of 2
Procedure

5. The following procedure will be followed in the event that the NHG GMEC and/or a Program
Director decide to reduce the number of positions in or close a program or close the
Institution:
a. The residents currently in the program will be notified immediately;
b. If possible the number of positions will be reduced over a period of time so residents in
the program can complete their education;
c. If this is not possible, the Program Director will assist the residents to the extent possible
to find a new AGCME-I accredited program in which they can continue their education;
d. The Program Director must receive approval and documented support from the NHG
GMEC prior to submitting the request for reduction in size or closure of a training
program to the ACGME-I.


12 May 2010


12 May 2010

Cl A/Prof Lim Tock Han


Annex E GME PP5a-0 NHG GME Policy on Resident Supervision Page 1 of 2

TITLE:

SUPERVISION OF RESIDENTS

DOCUMENT NO:
GME PP5a-0

REVISION NO:
Policy Revision 0

ORIGINAL DATE:
14/07/2010

EFFECTIVE DATE:
14/07/2010

REVISION DATE:
NA

PAGES: 02

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This policy aims to:
a. establish an institutional policy that ensures appropriate supervision for all residents
of the National Healthcare Group Residency;
b. assist Program Directors in the development of program specific policies governing
resident supervision.

Principles

2. The National Healthcare Group and all residency programs it sponsors are committed to
and responsible for promoting patient safety and resident well-being and to providing a
supportive educational environment.

Policy

3. Each residency program must have written policies governing supervision of residents.

4. Program policies on supervision must be approved by the NHG Graduate Medical
Education Committee (GMEC), distributed and clearly communicated to residents and
faculty.

5. Program Directors shall be responsible for the quality of resident supervision and
adherence to supervision guidelines and policies shall be monitored through review of
the Residents evaluation of their faculty, rotations and annual program review. For any
significant concerns regarding resident supervision, the respective program director shall
submit a plan for its remediation to the GMEC for approval and the program director may
Annex E

Annex E GME PP5a-0 NHG GME Policy on Resident Supervision Page 2 of 2
be required to submit progress notes to the GMEC until the issue is resolved. Serious
concerns should be brought to the attention of the Designated Institutional Official (DIO)
immediately.

6. All patient care must be supervised by qualified faculty in such a manner that permits a
resident to assume graded, increasing responsibility for patient care according to their
level of training, ability, and experience, while ensuring the availability and accessibility
of direct supervision by an attending physician.

7. The Program Director must ensure, direct, and plan adequate supervision of residents at
all times. Although senior residents require less direction than junior residents, even the
most senior residents must be supervised by teaching faculty.

8. Residents must be provided with a rapid, reliable system of communication with, and
appropriate involvement of, supervisory physicians in a manner appropriate for quality
patient care while at the same time gaining the knowledge and skills necessary for their
educational experience.

9. Faculty schedules must be structured to provide residents with easily accessible
supervision and consultation on/off site, and backup plan must be available should the
faculty be on leaves of absence (urgent, medical, annual, conference, etc).

10. The level of responsibility accorded to each resident must be determined by the Program
Director with inputs from members of the teaching staff via a structured evaluation
process and approved by the programs Clinical Competency Committee.


14 July 2010


14 July 2010



GME PP5b-1 NHG GME Policy on Duty Hours Page 1 of 5

TITLE:

RESIDENT DUTY HOURS IN
THE LEARNING AND WORKING
ENVIRONMENT

DOCUMENT NO:
GME PP5b-1

REVISION NO:
Policy Revision 1

ORIGINAL DATE:
12/08/2010

EFFECTIVE DATE:
20/09/2011

REVISION DATE:
19/09/2011

PAGES: 04

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This policy aims to:
a. establish an institutional policy that ensures appropriate work environment for all
residents of the National Healthcare Group Residency;
b. assist Program Directors in the development of program specific policies on resident
duty hours in the learning and working environment.

Principles

2. The National Healthcare Group (NHG) and all residency programs it sponsors are
committed to and responsible for:
a. promoting patient safety and resident well-being and to providing a supportive
educational environment;
b. ensuring that the learning objectives of the programs are not compromised by
excessive reliance on residents to fulfil service obligations;
c. ensuring that residents education and clinical training have priority in the allotment of
residents time and energy;
d. ensuring that duty hour assignments recognize that faculty and residents collectively
have responsibility for the safety and well-being of patients.

3. Duty hours logging must thus be timely and accurate so as to allow the NHG GMEC to
take necessary actions to address any issues that inhibits residents from complying with
the duty hour standards set forth in this policy.

Annex F

Policy

4. Each residency program must have written policies governing resident duty hours in the
learning and working environment that are optimal for both resident education and the
care of patients.

5. Program policies on resident duty hours must be approved by the NHG Graduate
Medical Education Committee (GMEC), distributed and clearly communicated to
residents and faculty.

6. Program Director (PD) shall be responsible for monitoring of duty hours with frequency
sufficient to ensure an appropriate balance between education and service. In dire
patient need, service must be rendered. However, the program must have a clear chain
of command for the PD to be alerted and for alternative arrangements to be made, if
necessary. Serious infringement should be brought to the attention of the Designated
Institutional Official (DIO) immediately for rectification.

7. Program policies must apply to all participating sites used by the programs.

8. Duty Hours are defined as all clinical and academic activities related to the program; i.e.,
patient care (both inpatient and outpatient), administrative duties relative to patient care,
the provision for transfer of patient care, time spent in-house during call activities, and
scheduled activities, such as conferences. Duty hours do not include reading and
preparation time.
a. Duty hours must be limited to 80 hours per week, averaged over a four-week period,
inclusive of all in-house call activities.
b. Residents must be provided with one day in seven free from all educational and
clinical responsibilities, averaged over a four-week period, inclusive of in-house call.
c. Adequate time for rest and personal activities must be provided. This should consist
of a 10-hour time period provided between all daily duty periods and after in-house
call.

9. On-call Activities
a. In-house call must occur no more frequently than every third night, averaged over a
four-week period, and not more than 6 calls per month for postgraduate year 1.
b. Continuous on-site duty, including in-house call, must not exceed 24 consecutive
hours. Residents may remain on duty for up to six additional hours to participate in
didactic activities, transfer care of patients, conduct outpatient clinics, and maintain
continuity of medical and surgical care.
c. No new patients may be accepted after 24 hours of continuous duty.
d. At-home call (or pager call)
i) The frequency of at-home call is not subject to the every-third-night, or 24+6
limitation. However at-home call must not be so frequent as to preclude rest
and reasonable personal time for each resident.
ii) Residents taking at-home call must be provided with one day in seven
completely free from all educational and clinical responsibilities, averaged
over a four-week period.
iii) When residents are called into the hospital from home, the hours residents
spend in-house are counted toward the 80-hour limit.


10. For programs where program requirements are more rigorous than institutional
requirements, the more restrictive limits will apply.

Oversight

11. The responsibility for ensuring that the working environment and duty hours are
appropriate and in compliance with institutional and program requirements is determined
by the GMEC through:
a. review of programs' policies on duty hours and resident working environment;
b. monitoring of duty hours and call schedules for all programs;
c. the NHG GMEC education review done annually.

12. For monitoring of duty hours and call activities for all programs, the NHG GMEC
requires:
a. the Program Coordinator (PC) of each program to maintain the weekly timetable and
call schedule of the residents for each rotation. Duty hours are clocked by the
residents and submitted to the PC at least bi-weekly. Infringements, defined as more
than 100% of duty hours allowed per week, are to be reported immediately to the PD
and DIO. It is the responsibility of the PD to provide alternative rest period for the
resident once infringement occurs.
b. Heads of Departments (HODs) receiving NHG residents to be briefed either through
formal HOD meetings or through letters of notification at the beginning of each
residency intake. The rationale of duty hour compliance is to be presented to the
HOD.
c. All residents to be briefed regarding duty hours limit, logging and tracking during
Institution/Program Orientation.
d. All faculty members to be similarly briefed by the PD.
e. PDs to report at each GMEC meeting the programs compliance rate to duty hour
standards.
f. For programs with non-compliance, PDs must report how any non-compliance have
been remedied, and if the non-compliance is not sufficiently and adequately
addressed, an action plan for compliance with timeline must be included.
g. The DIO to inform HODs
1
receiving NHG residents of the compliance rate to duty
hour standards of residents rotated to their department on a monthly basis.

13. The flowchart depicting the process for duty hour logging and monitoring is attached as
Annex A for reference.

14. The DIO may call upon duty hour records at any time for any program. It is the duty of
the PC to make available timely data at all times.

15. The DIO will also call for audits of the duty hour logs at regular intervals.

16. Any issues of non-compliance that are due to excessive service demands and have not
been successfully addressed by the program will be referred to the GMEC for resolution.

1
For departments not within NHGs governance, this will be done through the respective PDs and Site
Directors.


17. NHG Residency takes duty hour monitoring seriously. Any report of lack of effort of duty
hour logging or wilful infringement will result in disciplinary actions, as decided by the
NHG GMEC.


19 Sep 2011


19 Sep 2011

Dr Nicholas Chew


Annex A

GME PP13-1 NHG GME Policy on Addressing Complaints and Concerns Page 1 of 7

TITLE:

ADDRESSING COMPLAINTS
AND CONCERNS

DOCUMENT NO:
GME PP13-1

REVISION NO:
Policy Revision 1

ORIGINAL DATE:
30/09/2010

EFFECTIVE DATE:
20/04/2012

REVISION DATE:
16/04/2012

PAGES: 07

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This document aims to establish an institutional procedure on how residents could raise
complaints and concerns that they might have with fellow residents, other members in
the healthcare team, faculty members, including Program Directors, and administrators
from the GME Executive Office including the Designated Institutional Official.

Scope

2. This document covers how different types of complaints and concerns of varying severity
and confidentiality required may be addressed.

Policy

3. Minor Training and/or Service Related Concerns
a. Minor training and/or service related concerns will include matters NOT listed in
Annex A which are categorised broadly into:
Breach of Duty
Breach of Discipline
Moral Delinquency
Disgrace or Disrepute

b. Minor training and/or service related concerns can be brought to the attention of the
faculty/supervisor, and where necessary, further discussed with the Program Director
(on training matters) or Head of Department (on service-related matters).

Annex G
4. Major Complaints and Concerns Regarding Faculty
a. Major complaints and concerns regarding faculty will include but not limited to
matters listed in Annex A.

b. If there are major complaints or concerns regarding faculty, particularly when the
information to be shared is highly sensitive, the following channels for reporting are
available:
i) Verbally to Program Director
1
The DIO and all NHG Program Directors
maintain an open door policy for residents to highlight concerns to them in
confidence.
ii) In writing to Program Director
1
Residents may email the Program Director
1
,
or for those who prefer to write in, he/she may mail the letter to the GME
Executive Office addressed to the Program Director
1
. The letter is to be
marked Private and Confidential. The mailing address of the GME Executive
Office is:

Tan Tock Seng Hospital
11 J alan Tan Tock Seng, Singapore 308433
Annex Building, Level 5, Graduate Medical Education Executive Office

c. Anonymity Residents are encouraged to disclose their names when raising a
complaint or concern to facilitate appropriate follow-up. Anonymous disclosure of
issues and concerns is acceptable and concerns expressed anonymously will be
investigated but due consideration will be given to:
the seriousness of the issue raised;
the credibility of the concern;
the likelihood of confirming the allegation from other sources.

d. Malicious allegations may result in disciplinary actions.

e. All major complaints and concerns will be acknowledged in writing to the discloser
within 7 days after the complaint is received, if the identity of the discloser is known.
The response will include:
Who is handling the matter;
How the discloser can contact him/her;
Whether the disclosers further assistance may be needed.

f. Within 21 days of receiving a complaint or concern, an investigation will be
conducted and NHG Residency undertakes to keep the discloser informed of the
progress and outcome of the investigations. The Program Director
1
or his designee
and 1 other GMEC member appointed by the DIO will form the investigation team. If
the Program Director is involved in the complaint, DIO will appoint 2 GMEC members
to form the investigation team. The Program Director or his designee, by default, is
the Chief Investigator, unless otherwise appointed by the DIO.

g. At the end of the investigation, the Chief Investigator is to provide a report on:
Who raised the complaint or concern;
When was the complaint or concern raised;

1
If issue concerns the Program Director, then report to the DIO. If it concerns the DIO, report to Assistant
CEO(Education and Research)/NHG.
Complaint or concern raised;
Investigation done;
Actions taken;
Resolution achieved, and if otherwise, whether further actions will be taken;
Insights/comments (from the staff attending to the complaint or concern).

The template for the report can be found in Annex B.

h. The report is to be completed and submitted to the DIO within 30 days upon receipt
of the complaint or concern. The Chief Investigator/DIO will also decide on
additional recipients of the confidential report, if necessary.

i. NHG Residency assures residents who raise any complaints or concerns that they
to report directly to the Program Director
1
or DIO. Faculty members, supervisors or
staff who are found to have taken reprisal actions or victimized the resident will face
disciplinary actions, including possibility of dismissal from NHG Residency, and will
be referred to the Chairman, Medical Board (CMB), of the respective institution for
disciplinary hearing.

j. If the discloser had been personally involved in the same act, NHG Residency may
also consider according him/her immunity from the disciplinary process. The accord
of immunity status shall however be at the managements discretion, based on the
merits of the case, including the gravity of the residents role in the act and mitigating
circumstances, etc.

5. Whistle-Blowing Residents may also use the NHG Whistle-Blowing Policy to report
any misconduct, negligence or improper activity.

6. Assessment Outcome For matters pertaining to assessment outcome, residents
may initiate the grievance process outlined in the NHG GME Grievance Policy and
Procedure. The policy is described in the NHG Residency Handbook as well as posted
on the NHG Residency website.


16 Apr 2012


20 Apr 2012

ANNEX A
EXAMPLES OF MISCONDUCT
The list is only illustrative and shall not be taken as exhaustive.

Category Examples of Misconduct

Breach of Duty

1. Non-performance of Job Duties
Failure to perform duty
Failure to report on work matters
Failure to follow orders/instructions
Failure to exercise due care (Negligence)
Failure to deliver results, poor work performance
(Incompetence)
2. Performance of Non-permitted Activities
Performing non-job related tasks or personal activities
during company time


1. Absence without Leave
Failure to report to work
Absence from workplace
Late coming
2. Subversion of Duty
Refusal to obey orders/instructions (Insubordination)
Obstruction to others in carrying out work
Creation of disturbance
3. Defiance of Authority
Disrespect to superiors (abusive language, insolence, etc)
Defamation or personal attacks or threats
4. Disruptive Conduct towards superiors/co-
workers/customers
Assault, fighting, violence, physical abuse
Quarrelling, rudeness
Non-cooperation with superiors/co-workers
Horse-play at the workplace
5. Offensive Behaviour
Physical acts that are offensive in nature
Verbal or Written statements that are offensive nature,
made in all types of media (in print or electronic medium).
Offensive includes, but is not limited to racist, sexual,
harassing, indecent, intimidating, hateful, etc.
6. Participation in Collective Actions
Riot, picketing
Concerted disobedience (eg. taking medical leave en-
masse, boycott of overtime work, etc)
ANNEX A
(continued)


Moral Delinquency

1. Falsehood
Lying or misrepresentation
Non-disclosure of material information
Falsification of records
Fraudulent claims of money/reimbursements
Forgery
2. Theft
Misappropriation of funds
Stealing, pilfering from company or customers
3. Corruption
Bribery
Extortion or solicitation of money from customers for personal
gain
Embezzlement of money / assets belonging to the company or
customers or patients.
4. Disloyalty
Sabotage
Divulge of confidential information or trade secrets of
company
Wilful destruction of company property
Wilful damage of companys reputation or goodwill

Disgrace or
Disrepute

1. Disgrace or disrepute of oneself outside work
Violation of government laws (criminal offences)
Drug abuse, drunkenness
Loss of credibility

ANNEX B

CONFIDENTIAL

NATIONAL HEALTHCARE GROUP (NHG) RESIDENCY

REPORT ON COMPLAINT OR CONCERN RECEIVED

I. COMPLAINT/CONCERN RECEIVED
Complaint or Concern Raised By:
(if available)

(Complainant)
Date Received:
Details of Complaint or Concern:

Date acknowledgement sent to Complainant:
II. INVESTIGATION
Name of Staff Attending to Complaint or
Concern:

(Chief Investigator)

(GMEC Member)
Date Investigation Initiated:
Details of Investigation Done:

III. ACTIONS TAKEN
Details of Actions Taken:


CONFIDENTIAL



IV. RESOLUTIONS ACHIEVED

[ ] Resolution is achieved on ________________________________________ (state date)
[ ] Complaint or concern remains unresolved on _________________ (state date) due to
(state reasons below)

V. CONCLUDING COMMENTS (Insights, comments by Chief Investigator, including
whether there will be additional recipients of this confidential report. If yes, to indicate
who.)

VI. SIGN-OFF BY INVESTIGATION TEAM
Name: (Chief Investigator)
Designation:
NRIC No.:
Employee No.:
Signature and Date:

Name:
Designation:
NRIC No.:
Employee No.:
Signature and Date:


TITLE:

ADDRESSING COMPLAINTS
AND CONCERNS

DOCUMENT NO:
GME PP13-1

REVISION NO:
Policy Revision 1

ORIGINAL DATE:
30/09/2010

EFFECTIVE DATE:
20/04/2012

REVISION DATE:
16/04/2012

PAGES: 07

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. This document aims to establish an institutional procedure on how residents could raise
complaints and concerns that they might have with fellow residents, other members in
the healthcare team, faculty members, including Program Directors, and administrators
from the GME Executive Office including the Designated Institutional Official.

Scope

2. This document covers how different types of complaints and concerns of varying severity
and confidentiality required may be addressed.

Policy

3. Minor Training and/or Service Related Concerns
a. Minor training and/or service related concerns will include matters NOT listed in
Annex A which are categorised broadly into:
Breach of Duty
Moral Delinquency
Disgrace or Disrepute

b. Minor training and/or service related concerns can be brought to the attention of the
faculty/supervisor, and where necessary, further discussed with the Program Director
(on training matters) or Head of Department (on service-related matters).

Annex G
4. Major Complaints and Concerns Regarding Faculty
a. Major complaints and concerns regarding faculty will include but not limited to
matters listed in Annex A.

b. If there are major complaints or concerns regarding faculty, particularly when the
information to be shared is highly sensitive, the following channels for reporting are
available:
i) Verbally to Program Director
1
The DIO and all NHG Program Directors
maintain an open door policy for residents to highlight concerns to them in
confidence.
ii) In writing to Program Director
1
Residents may email the Program Director
1
,
or for those who prefer to write in, he/she may mail the letter to the GME
Executive Office addressed to the Program Director
1
. The letter is to be
marked Private and Confidential. The mailing address of the GME Executive
Office is:

Tan Tock Seng Hospital
11 J alan Tan Tock Seng, Singapore 308433
Annex Building, Level 5, Graduate Medical Education Executive Office

c. Anonymity Residents are encouraged to disclose their names when raising a
complaint or concern to facilitate appropriate follow-up. Anonymous disclosure of
issues and concerns is acceptable and concerns expressed anonymously will be
investigated but due consideration will be given to:
the seriousness of the issue raised;
the credibility of the concern;
the likelihood of confirming the allegation from other sources.

d. Malicious allegations may result in disciplinary actions.

e. All major complaints and concerns will be acknowledged in writing to the discloser
within 7 days after the complaint is received, if the identity of the discloser is known.
The response will include:
Who is handling the matter;
How the discloser can contact him/her;
Whether the disclosers further assistance may be needed.

f. Within 21 days of receiving a complaint or concern, an investigation will be
conducted and NHG Residency undertakes to keep the discloser informed of the
progress and outcome of the investigations. The Program Director
1
or his designee
and 1 other GMEC member appointed by the DIO will form the investigation team. If
the Program Director is involved in the complaint, DIO will appoint 2 GMEC members
to form the investigation team. The Program Director or his designee, by default, is
the Chief Investigator, unless otherwise appointed by the DIO.

g. At the end of the investigation, the Chief Investigator is to provide a report on:
Who raised the complaint or concern;
When was the complaint or concern raised;

1
If issue concerns the Program Director, then report to the DIO. If it concerns the DIO, report to Assistant
CEO(Education and Research)/NHG.
Complaint or concern raised;
Investigation done;
Actions taken;
Resolution achieved, and if otherwise, whether further actions will be taken;
Insights/comments (from the staff attending to the complaint or concern).

The template for the report can be found in Annex B.

h. The report is to be completed and submitted to the DIO within 30 days upon receipt
of the complaint or concern. The Chief Investigator/DIO will also decide on
additional recipients of the confidential report, if necessary.

i. NHG Residency assures residents who raise any complaints or concerns that they
to report directly to the Program Director
1
or DIO. Faculty members, supervisors or
staff who are found to have taken reprisal actions or victimized the resident will face
disciplinary actions, including possibility of dismissal from NHG Residency, and will
be referred to the Chairman, Medical Board (CMB), of the respective institution for
disciplinary hearing.

j. If the discloser had been personally involved in the same act, NHG Residency may
also consider according him/her immunity from the disciplinary process. The accord
of immunity status shall however be at the managements discretion, based on the
merits of the case, including the gravity of the residents role in the act and mitigating
circumstances, etc.

5. Whistle-Blowing Residents may also use the NHG Whistle-Blowing Policy to report
any misconduct, negligence or improper activity.

6. Assessment Outcome For matters pertaining to assessment outcome, residents
may initiate the grievance process outlined in the NHG GME Grievance Policy and
Procedure. The policy is described in the NHG Residency Handbook as well as posted
on the NHG Residency website.


16 Apr 2012


20 Apr 2012

ANNEX A
EXAMPLES OF MISCONDUCT
The list is only illustrative and shall not be taken as exhaustive.


Breach of Duty

1. Non-performance of Job Duties
Failure to perform duty
Failure to report on work matters
Failure to follow orders/instructions
Failure to exercise due care (Negligence)
Failure to deliver results, poor work performance
(Incompetence)
2. Performance of Non-permitted Activities
Performing non-job related tasks or personal activities
during company time


1. Absence without Leave
Failure to report to work
Absence from workplace
Late coming
2. Subversion of Duty
Refusal to obey orders/instructions (Insubordination)
Obstruction to others in carrying out work
Creation of disturbance
3. Defiance of Authority
Disrespect to superiors (abusive language, insolence, etc)
Defamation or personal attacks or threats
4. Disruptive Conduct towards superiors/co-
workers/customers
Assault, fighting, violence, physical abuse
Quarrelling, rudeness
Non-cooperation with superiors/co-workers
Horse-play at the workplace
5. Offensive Behaviour
Physical acts that are offensive in nature
Verbal or Written statements that are offensive nature,
made in all types of media (in print or electronic medium).
Offensive includes, but is not limited to racist, sexual,
harassing, indecent, intimidating, hateful, etc.
6. Participation in Collective Actions
Riot, picketing
Concerted disobedience (eg. taking medical leave en-
masse, boycott of overtime work, etc)
ANNEX A
(continued)


Moral Delinquency

1. Falsehood
Lying or misrepresentation
Non-disclosure of material information
Falsification of records
Fraudulent claims of money/reimbursements
Forgery
2. Theft
Misappropriation of funds
Stealing, pilfering from company or customers
3. Corruption
Bribery
Extortion or solicitation of money from customers for personal
gain
Embezzlement of money / assets belonging to the company or
customers or patients.
4. Disloyalty
Sabotage
Divulge of confidential information or trade secrets of
company
Wilful destruction of company property
Wilful damage of companys reputation or goodwill

Disgrace or
Disrepute

1. Disgrace or disrepute of oneself outside work
Violation of government laws (criminal offences)
Drug abuse, drunkenness
Loss of credibility

ANNEX B

CONFIDENTIAL



I. COMPLAINT/CONCERN RECEIVED
Complaint or Concern Raised By:
(if available)

(Complainant)
Date Received:
Details of Complaint or Concern:

Date acknowledgement sent to Complainant:
II. INVESTIGATION
Name of Staff Attending to Complaint or
Concern:

(Chief Investigator)

(GMEC Member)
Date Investigation Initiated:
Details of Investigation Done:

III. ACTIONS TAKEN
Details of Actions Taken:


CONFIDENTIAL



IV. RESOLUTIONS ACHIEVED

[ ] Resolution is achieved on ________________________________________ (state date)
[ ] Complaint or concern remains unresolved on _________________ (state date) due to
(state reasons below)

V. CONCLUDING COMMENTS (Insights, comments by Chief Investigator, including
whether there will be additional recipients of this confidential report. If yes, to indicate
who.)

VI. SIGN-OFF BY INVESTIGATION TEAM
Name: (Chief Investigator)
Designation:
NRIC No.:
Employee No.:
Signature and Date:

Name:
Designation:
NRIC No.:
Employee No.:
Signature and Date:

PC to inform
resident within 1
week
Resident may
need to repeat
posting
Annual Leave Application
Resident to submit leave
application to HOD and/or
roster planner
Resident to submit to PC
leave projection
Has resident exceeded
max allowable number of
days of absence?
No
Resident to submit HOD
approval to PD and PC
application to PD (cc PC)
through Prosoft for approval
PC to record residents leave
application
Page 1
Annual Leave Application
Resident to submit application
during next posting
Residents to obtain
approval from PD.
PD approves?
Yes
No
Yes
HOD and/or roster
planner approves leave
application?
Yes
Resident to submit
application for another
period
No
PD approves leave
application?
Yes
No
Updated on 15 April 2012
Note: SAF employees must refer to the Program Coordinator for leave application.
Annex H
Page 1
Conference / Training / Exam Leave application (for PGY1s only)
Conference / Training /
Examination Leave application
Resident to submit to PC for
courses / training application
Has resident
utilized training leave
allocated?
during next posting/ next
academic year
roster planner
Resident to submit HoD
No
application to PD through
Residency website portal
(email sent to PD & PC)
PC to process PTF
application and record
residents application
Resident to submit course /
conference / exam application
and supporting documents to PD
through PC
PD agrees that training
activity is relevant?
Resident to cancel application No
Yes
HOD and/or roster
planner approves of leave
application?
Resident to inform PD
Yes
No
Yes
PD approves and Resident to
submit PTF application (if
applicable) to PC
PD to determine the need
of training and discuss with
HOD on case-by-case basis
HOD
approves
No
Resident to submit
application for another
period
Conference/ Training Leave
application
Resident to submit to PC for
courses/ training application
Has resident utilized
training leave allocated?
during next posting/ next
academic year
roster planner
Resident to submit HOD
No
application to PD (cc PC)
through Prosoft for approval
PC to process PTF
application and record
residents application
Resident to submit course/
conference application and
supporting documents to PD
PD agrees that training
activity is relevant?
Resident to cancel application
No
Yes
Page 1
Conference / Training Leave application (for PGY2s and above)
HOD and/or roster
planner approves of leave
application?
Resident to inform PD
Yes
No
Yes
PD to determine
the need of training and
discuss with HOD on
case-by-case basis.
HOD
approves
No
for another period
Resident may
need to repeat
posting
As this is urgent leave, it will be
provisionally approved at this juncture;
resident may proceed with leave.
Urgent Leave (medical leave,
compassionate leave, etc)
Application
Resident to inform HOD, roster
planner and PC
Resident to formally submit leave
application to PD (cc PC) through
Prosoft for approval
PC to record residents leave
application
Page 1
Urgent Leave Application
(medical leave, compassionate leave, etc)
PD approves leave application
No
Has resident exceeded
max allowable number of days of
absence?
PC to inform PD
PD to decide on disposition
of resident (with input from
CCC or GMEC, if indicated)
Yes

Annex I GME PP1-0 NHG Institutional Disaster Preparedness Policy and Procedure Page 1 of 7

TITLE:

INSTITUTIONAL DISASTER
PREPAREDNESS POLICY AND
PROCEDURE

DOCUMENT NO:
GME PP1-0

REVISION NO:
Policy Revision 0

ORIGINAL DATE:
12/05/2010

EFFECTIVE DATE:
12/05/2010

REVISION DATE:
NA

PAGES: 07

PROCESS OWNER:


APPROVAL:

GMEC

Objectives

1. The policy and procedure serves to provide guidelines for:
a. administrative continuity and maintenance of the teaching mission of NHG residency
programs in the event of a disaster or significant interruption in patient care. This will
include reconstituting and restructuring GME educational experiences as quickly as
possible after a disaster, or determining need for transfer or closure in the event of
being unable to reconstitute normal program activity;
b. communication with and assignment/allocation of resident/fellow manpower in the
event of a disaster

Definitions

2. A disaster is defined as an event or set of events causing significant alteration to the
residency educational experience at one or more residency programs.

3. This policy and procedure document acknowledges that there are multiple strata or
types of disaster: ranging from acute disaster with little or no warning (e.g., bombing), to
those with some lead-time and warning (e.g., infectious strain of flu). This document will
address disaster and disruption in the broadest terms.

Policy

4. NHG GMECs Responsibilities
a. The NHG GMEC is responsible for maintaining the currency of this document by
yearly review, for making this document available to all stake holders at the onset of
Annex I

disaster, and for assuring that all graduate medical education programs and directors
are aware of and comply with this policy.
b. The NHG GMEC is also responsible for the annual review, provision and monitoring
of the program-specific contingency plans. An example is shown in Annex 1 and 2.

5. NHG Affiliated Institutions Responsibilities
a. All NHG affiliated institutions sponsored graduate medical education Directors are
responsible for implementing this policy and to communication with residents and
clinical fellows regarding temporary and/or permanent transfers.

6. DIO /ADIOs Responsibilities
a. The Designated Institutional Official (DIO) / Associate DIO (ADIO) is responsible for
working with disaster affected program group(s) to reconstitute or reconfigure the
educational experience for residents and clinical fellows. Wherever possible,
DIO/ADIO should be a member of the institutions Disasters Ops Group.
b. The DIO/ADIO presents the educational needs and safety concerns of the residents
and fellows under his charge.
c. It is the responsibility of the DIO/ADIO to inform, discuss with, and seek approval
from MOH/ACGME-I of the residents and fellows involvement with disaster
response, restructuring, reconfiguration and/or re-constitution of the curriculum,
including temporary or permanent resident transfer. In the case of the latter, it is the
responsibility of the DIO/ADIO to obtain, to the best of his ability, placement of the
affected resident or fellow, in another program.

7. Program Director (PD/APD)s Responsibilities
a. Each PD/APD will conduct internal manpower management with head of department
(HOD), including designation of medical staff to response teams, consistent with the
prevailing policy and procedure for disaster response of the hospital and the
department. Wherever possible, the PD/APD should be a member of the
departments Disaster Ops Group.
b. The PD and APD present the education need of the residents and fellows, while the
HOD is responsible for the disaster response plan.
c. It is the responsibility of the PD/APD to inform his DIO and ADIO of substantial
deviation from curriculum plan and potential non-compliance to program
requirement, and his recommendation in the re-structuring, re-constitution or re-
configuration of the curriculum. (Restructuring of rotation blocks, reconstitution of
existing block, reconfiguration of curriculum)
d. It is the responsibility of the PD/APD to keep his residents and fellows informed of
the development of the disaster, the overall disaster response plan, the changes in
the educational schedule, and possible temporary or permanent resident transfer.

8. Overview of Other Stake-holders
a. All medical staff (faculty, residents, fellows) are ultimately responsible to the Medical
Board of their institution under the leadership of the respective Chairperson, Medical
Board (CMB), through the respective HOD.
b. As determined to be necessary by the CMB, medical staff reassignment or
redistribution to other areas of need will be made, superseding departmental team
plans for manpower management.



Procedures

9. Safety Immediately after a disaster or interruption in patient care occurs, each
GME program affected by the disaster or interruption, under the direction of its PD, HOD
and appropriate institutional leadership (Chairman of the Medical Board, CMB), and in
collaboration with the DIO, will undertake all reasonable measures to ascertain the
whereabouts of its residents and ensure their safety. If residents are in immediate
danger, the PD, in consultation with the DIO / GMEC, will coordinate all reasonable
measures available to the relevant institutions to remove residents from harm and return
them to safety.

10. Communication As soon as possible after the disaster or interruption in patient
care occurs, the DIO will notify MOH/ACGME-I of the nature and details of the disaster
or the interruption. The DIO will monitor this information and maintain ongoing
communications with the MOH/ACGME-I. The DIO will also be the primary institutional
contact with the MOH and MOHH, and for disaster plan implementation and
communication regarding specific graduate medical education needs within NHG.

11. Check-list for Each Program Group At the announcement of the disaster, each
PD/APD, together with his program group, will take responsibility for reviewing
contingency plans and procedures to address continuation of program leadership,
evacuation planning, relocation, program recovery, maintenance of communication and
working with affiliates in the event of a disaster or interruption in patient care.

12. Reconfigure Following declaration of a disaster or an interruption in patient care, the
DIO, HOD, PD and CMB or designee will work to restructure, reconfigure or reconstitute
the educational experience for residents enrolled in the graduate medical education
programs affected by the disaster or interruption, as quickly as possible.

13. Submission After a declaration of disaster is issued, the DIO or his/her designee will
contact the MOH/ACGME-I to:
a. submit proposed program reconfigurations for review by the ACGME-I;
b. inform each resident/clinical fellow of a transfer decision.

The due dates for submission shall be no later than 30 days after the disaster unless
otherwise approved by MOH/ACGME-I.

14. Monitor The DIO/ADIO will monitor progress of both healthcare delivery and
functional status of the residency programs for their educational mission during and
following a disaster. They (or their designees) will work with the MOH/ACGME-I to
determine the appropriate timing and action of the options for disaster impacted
institution and/or programs:
a. maintain functionality and integrity of program(s);
b. temporary resident transfer until program(s) reinstated, or
c. permanent resident transfer, as necessitated by program or institution closure.

Information and decision communications will be maintained with PDs, residents and
fellows, as appropriate to circumstances of the individual disaster event


15. Transfer
a. If the DIO determines that the Institutions sponsored residency program(s) affected
by the disaster or interruption in patient care cannot be restructured or reconstituted
to provide an adequate educational experience for resident or clinical fellows, or if
the program cannot be restructured or reconstituted within an appropriate time frame
to allow residents or fellows to complete their training program requirements within
the standard time required for certification within their specialty, then the DIO working
in collaboration with the PD/APD, HOD, CMB, through GMEC, will:
i) arrange temporary transfers to other programs/institutions until such time
as the residency/fellowship program can provide an adequate educational
experience for each of its residents/fellows;
ii) cooperate in and facilitate permanent transfers to other
programs/institutions. Programs/institutions will make the keep/transfer
decision expeditiously so as to maximize the likelihood that each resident
will timely complete the resident year
b. DIO, through the GME Executive Office, informs each transferred resident of the
minimum duration of his/her temporary transfer, and continue to keep each resident
informed of the minimum duration. If and when a program decides that a temporary
transfer will continue to and/or through the end of a residency year, it must so inform
each such transferred resident.
c. During the period of time that NHG residents spend in temporary transfer at the
host program, MOHH and NHG, if necessary will continue to provide salary, travel,
and benefits to the trainee, consistent with applicable law.

16. Data Protection The GMEC will, to the extent permitted by available resources and
program personnel, protect the academic and training files of residents or clinical fellows
from loss or destruction by disaster.

17. Maintaining the Recall Roster It is the responsibility of the GME Executive Office
to update and maintain contact information (Recall Roster) for all residents and fellows,
and to provide these information to the CMB or his designated authority, for the purpose
of manpower recall. The Recall Roster information will contain, at a minimum, the
address, mobile number, and home numbers, and all available email addresses, and
emergency contact individual(s) and their contact information. This information will be
updated at least annually before J uly 31, and as appropriate to maintain optimal
accuracy and completeness. The programs will maintain this information with internal
backup and maintenance as determined appropriate. As backup, this information will be
shared with the medical Human Resource Department (or its equivalent), and saved in
the resident information folder lodged with the Human Resource Dept.


18. Finance During and/or immediately after a disaster, residents will be allowed and
encouraged to continue their roles where/as possible, and to participate in disaster
recovery efforts. Residents will continue to receive their salary and benefits during any
(disaster) event recovery period, and/or accumulate salary and benefits until such time
as utility restoration allows for fund transfer.


12 May 2010


12 May 2010



ANNEX 1

CONTINGENCY FRAMEWORK FOR INTERNAL MEDICINE RESIDENCY PROGRAM IN
CRISIS

TIME RESIDENTS INSTITUTION
First 3 months 1. 3
rd
year residents going for
summative assessment
2. 3
rd
year residents who have not
fulfilled core posting requirements

KTPH for GM and GRM
NUH for the other
subspecialties
Second 3
months
1. Remaining 3
rd
year residents
2. 2
nd
year residents who have
completed <4 core postings

KTPH for GM and GRM
NUH for the other
subspecialties
Third 3 months Remaining 2
nd
year residents KTPH for GM and GRM
NUH for the other
subspecialties

Fourth 3 months 1
st
year residents KTPH for GM and GRM
NUH for the other
subspecialties


ANNEX 2

CONTINGENCY FRAMEWORK FOR PATHOLOGY RESIDENCY PROGRAM IN CRISIS

TIME RESIDENTS INSTITUTION
First 3 months Residents who have not had rotations
in these units will have priority.
Dept of Pathology, NUHS
Laboratory Services, KKWCH
Center for Forensic Medicine,
Health Sciences Authority

Second 3
months and
beyond
Temporary transfer to Pathology
Residency Program, NUHS, subjected
to confirmation by PD, Pathology,
NUHS, and approval by DIO, NUHS.

Residents nearer their completion of
residency program will have priority

Dept of Pathology, NUHS


Annex J GME PP17-0 NHG GME Overseas Conference Sponsorship Page 1 of 7

TITLE:

NHG OVERSEAS CONFERENCE
SPONSORSHIP

DOCUMENT NO:
GME PP17-0

REVISION NO:
Policy Revision 0

ORIGINAL DATE:
26/07/2011

EFFECTIVE DATE:
26/07/2011

REVISION DATE:
NA

PAGES: 07

PROCESS OWNER:


APPROVAL:

GMEC

Objective

1. This policy sets to establish the NHG Residency Overseas Conference Sponsorship for
residents whose research findings are to be presented at regional or international
conferences. The term conference refers to similar events that may be known as
congress, symposium, and seminars.

2. The sponsorship is directed as an encouragement to residents for scholarly activities and
research. It is a form of financial assistance which seeks to reimburse the cost of
expenses incurred for participation in regional or International conferences.

Criteria for Eligibility

1. The sponsorship is open to all NHG residents who are unable to apply for the MOHH
Sponsorship for Overseas Conferences, and is limited to one sponsorship per resident per
year.

2. Applicants applying for more than one sponsorship per year may be granted approval on a
case-by-case basis.

3. The presentation that the resident intends to present should meet the following criteria:

i. Applicant must be the first or second author of the paper or poster presented;
ii. Approval from Program Director;
iii. Acceptance for presentation in an international or regional conference pre-
approved by the Program Director. Other conferences and journals can be
considered on a case-by-case basis.

4. The closing date for applications will be 1 August, 1 November, 1 February and 1 May,
and must be at least 2 months before the planned travel date for the conference.
Annex J

Terms and Conditions

1. There are 10 sponsorship awards available for application on a yearly basis. Sponsorship
will be capped at S$2,500.

2. If a paper has already been presented at a conference (local or international), the
applicant is not eligible to apply for sponsorship for the same paper in other conferences.

3. Where several residents or staff jointly authored a paper, the sponsorship will be provided
to only one applicant.

4. Awardees will not be eligible to apply for funding from the Departments for attending the
same conference. The sponsorship also cannot be used in conjunction with any other
funding. All other forms of sponsorship by external parties or other sources MUST be
declared in the application form.

5. Sponsorship provided by NHG is intended as a form of financial assistance to the resident.
It may not cover all expenses that arise and the resident may expect to incur some
expenses on his/her own.

6. In the event of cancellation or failure to attend, the applicant would not be entitled to any
reimbursement.

7. The sponsorship is strictly non-transferrable. If the applicant is unable to attend
conference for any reason, his/her replacement must submit a separate sponsorship
application.

Application Process

1. In order to be eligible for sponsorship, applicants are required to submit the following
documents to the Program Coordinator:

i. Original copy of the application form (Annex A);
ii. Copy of abstract of the intended presentation (Annex B);
iii. Proof of acceptance for the presentation stating the day of presentation; and
iv. Flyer or brochure of the conference.

2. Applicants must obtain approval of sponsorship before leaving for the conference.

3. The applications will be reviewed by the Selection Committee and approved based on the
selection criteria as follows:

i. Originality of ideas
ii. Quality of research
iii. Quality of draft publication
iv. Only 1 sponsorship for each research title

4. Notification on the outcome of the application will be sent via email by the NHG GME
Executive Office.


Claimable Expenses

1. Airfare

i. The applicant is entitled to the most direct, economical route to the conference
destination;
ii. Stopovers due to personal cause have to be borne by the applicant.

2. Subsistence Allowance

i. The applicant shall be provided with a daily Subsistence Allowance (SA) as a
reimbursement for out-of-pocket expenses incurred throughout the duration of
the conference.
ii. The SA rates are dependent on the country of visit and are given based on
estimated hours spent in the foreign country. Please refer to the Rates of
Subsistence Allowance list
1
available on the NHG Intranet.
iii. The computation of SA starts one day before at the place of conference and
ends at the time of departure from that place. On the day of departure, for any
period less than 24 hours (1 day), SA reimbursable will be as follows:

SA reimbursable (applicable on day of departure)
12 hours and less day
More than 12 hours 1 day

iv. Conference program or other appropriate documentation will be used as a
reference for the duration of the conference. Reference for times of arrival and
departure will be taken from a copy of the itinerary from the travel agency or the
air ticket. Time spent traveling by air and sea is to be excluded from the
computation.
v. Applicant is allowed to arrive at the destination 1 day before the start of the
conference.
vi. For one-day conferences i.e. depart and return on the same day, subsistence
rate will be 30% of the full day rate for that country.
vii. For those days that free meals and lodging are provided, an allowance
equivalent to 10% of the eligible subsistence allowance will be paid, but not less
than $10.00 per day to cover incidental expenses.

3. Registration Fee

i. Personal Training Fund should be used to pay for registration fees.
ii. Purchase of conference materials will not be considered as part of this
sponsorship.
iii. Where the activity is social and non-academic, the applicant is expected to bear
the cost, if he/she intends to attend the activity.

1
Refer to NHG Intranet (http://nhgweb.nhg/NHGIntranet/app_scripts/default.asp), Cluster Finance
Policies, 02 Rates of Subsistence Allowance for the list of countries and rates.

4. Travel Insurance

i. Travel insurance is granted only for coverage for the actual duration of the
conference, including one day before and after the conference.
ii. Cost will be covered for standard/basic travel insurance plans only.
iii. Applicant will bear the travel insurance premium (if any) for extended trips that
are not related to the purpose of the overseas conference.

5. Poster Charges

Reimbursement

1. Reimbursement claims must be submitted to the Program Coordinator within 1 month from
the return from the conference. Awardees must include original receipts and/or invoices for
processing of claims.

2. Reimbursement will be made on actual expenditure incurred. The foreign exchange rates
used in the computation of reimbursement will be based on that shown in credit card or
phone bills, or money changer receipts or exchange rate of that day when the expense
was incurred. For the latter, please attach supporting document for source of exchange
rate.

3. Payment will be made by cheque to the awardee only.


Annex A
NHG Residency Overseas Conference Sponsorship Application Form

SECTION I: PERSONAL PARTICULARS
Name of Appli cant (as in NRIC. Please underline surname)

Program Resident Year: ____ Postgraduate Year: _____
Contact Number MCR Number
E-mail Address (MOHH)

SECTION II: CONFERENCE INFORMATION (Please attach conference details or brochure)
Conference Name

Conference Address

Date of Conference
Start Date (dd/mm/yyyy)

End Date (dd/mm/yyyy)

Duration:
Days
Regional (less than 6 hours of direct flight) International (more than 6 hours of direct flight)
Estimated Conference Expenses:
Registration Fee (claim from PTF):
Poster Charges (if applicable):
Estimated Travel Expenses:
Airfare:
Travel Insurance:
Capacity in which you are attending the conference:
Oral Presentation Poster Presentation
Presentation Abstract (Please complete and attach Annex B)
Title:
Author(s):
Additional Information
Have you applied for any other sponsorship?
No Yes (If yes, please specify: )
Have you obtained funding from other agencies for the above conference?
No Yes (If yes, please specify: )

SECTION III: DECLARATION

I declare that:
the above paper has not been presented at any local/international conference before;
the above paper has not been presented by other co-authors at any local/international conference
before; and
to the best of my knowledge the information I have provided on this form is true, accurate and
complete. Any breach of regulations or inaccurate information in the application will result in liability
for severe punishment.

Signature of Applicant Date

SECTION IV: APPROVAL BY PROGRAM DIRECTOR (PD)

I recommend and approve this application.
(Please specify relevance/benefits of conference to applicants job functions and development
needs.)

I DO NOT recommend and approve this application.
(Please provide reasons.)

Name of Program Director Signature & Date

SECTION V: FOR OFFICIAL USE ONLY

I/We approve this application.

I/We DO NOT approve this application.
(Please provide reasons.)

Chairperson, Selection Committee
Signature and Date

FOR APPROVAL BY CHAIRMAN, MEDICAL BOARD
(INSTITUTION)

__________________________________________
Signature and Date
Designated Institutional Official
Signature and Date


Annex B

PRESENTATION ABSTRACT

Oral Presentation Poster Presentation
Title:

Abstract:

NHG Residency Handbook With Annexes 20131218

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

NHG Residency Handbook With Annexes 20131218

Uploaded by

Copyright:

Available Formats

NHG-AHPL Resi denc y Handbook

NHG-AHPL RESIDENCY HANDBOOK - Table of Contents

You might also like