When a close friend sank into severe depression a few years ago, all Dr Gerard Heng could do was grasp at straws. This harrowing incident made Heng determined not to remain clueless about mental health.

While this was the tipping point, it was not Heng’s first encounter with mental health issues. As a teenager, he saw family members struggling with dementia. As an undergraduate, he witnessed the challenges that people with mental illnesses face from a wide range of social and cultural sources. But it was seeing his friend suffer while he felt so helpless that Heng decided to make an impact by dedicating himself to mental health awareness advocacy.

“Looking back, I wish that I was more educated on various mental health problems so that I could recognise the red flags when my friend slowly slid into her crippling depression,” Heng reflected, with a frown.

Now a newly minted graduate, he hopes to specialise in psychiatry after completing his basic medical training.

Part of the Class of 2021, Heng is only one of the many talented individuals who finished their studies at Duke-NUS this year. Among the 62 graduates, 54 received their MD degrees, six earned PhDs and two left with combined MD-PhD degrees.

Addressing the graduates during the virtual ceremony on 29 May, Professor Thomas Coffman, Dean of Duke-NUS, offered his congratulations to this group who had persevered in the face of unprecedented disruption in their training as medical doctors due to the pandemic.

“I am really proud of the Class of 2021. They have shown true grit and resilience in the face of the great uncertainty brought about by the global pandemic. I have no doubt that these qualities combined with their curiosity, compassion and pursuit of excellence will allow them to flourish as they forge their own careers, becoming outstanding clinicians who will make substantive contributions to the healthcare and biomedical ecosystems.” 

Thomas Coffman, Dean, Duke-NUS

Forging forward despite the COVID-19 pandemic

While COVID-19 had a very direct impact on the MD students by stopping them from going into the wards, the PhD students, too, were challenged in unprecedented ways. They were not only barred from going into the labs at times during the Circuit Breaker period but also had to defend their theses over Zoom. For some, this was not how they had imagined the final stretch of their PhD.

Keenly attuned to the early signs of depression, Khoo—who is a neuroscientist and a psychologist herself—reached out to a medical social worker and her psychiatrist to help her get through these difficult times by better understanding what she was experiencing so that she could keep pushing herself to complete her thesis.

Khoo said, “I learnt that it’s okay—maybe even normal—to fail sometimes, as long as you keep trying. As someone who seeks to meet others’ expectations, this lesson has really taught me to change my mindset to something more realistic and attainable.”

“Especially in the current pandemic era, learning to live with uncertainties makes me uneasy every now and then,” said Dr Sonia Chothani, another PhD graduate from the Class of 2021. Although Chothani had planned to start work at the Wellcome Sanger Institute in the UK upon graduation, her plans have remained uncertain to this day because of the ongoing travel restrictions.

Undeterred, Chothani added, “But what I have learnt is to be okay with the fact that things may not always go as planned, one needs to reframe timelines and set new roadmaps while managing personal and professional goals. Through my PhD at Duke-NUS, with the help of extremely supportive mentors and environment, I have begun to learn to deal with these uncertainties and bounce back quickly.”
 

Paving their own ways through a world-class curriculum

As an MD-PhD graduate, Dr Geraldine Goh has trekked along both Heng’s and Khoo’s paths. She recounted how much she enjoyed her first year as a medical student, delving into the curriculum and getting to know her new classmates.

“At Duke-NUS, we use a team-based learning format that lets us learn how to solve clinical questions in groups while understanding the topic but also getting to know our classmates’ strengths and backgrounds,” said Goh. “And I think that was what was really fun for me during my first year. It’s very good exposure before getting our first taste of the clinical world in our second year.”

But even then, Goh described how the toughest experience through her studies—much like many other PhD students’—were the endless days of negative results that she got from her experiments, knowing that she was only using more precious samples as time went by.

“There were many, many times when I just questioned my sanity,” she said. “There were multiple challenges that I was thrown into and had to learn how to function at a certain level of independence by being responsible for my own experiments. I also needed to learn when to reach out for help and to be really resilient to re-evaluate what I was doing.”

With just four years, the MD programme is an intense experience. “We also have to deal with research here, so we have less exposure to the clinical environment compared to our peers in other medical schools,” said Dr Wong Xiang Yi, a Ngee Ann Kongsi Scholar and a recent MD graduate. “But we learn to be very independent and to handle the rigorous demands of studying, which I think prepares us better as doctors.”

This independence and ability to manage a rigorous schedule puts these graduates in a strong position to handle the busy schedule of junior doctors while keeping an eye out on their own health.

“A critical, longitudinal takeaway was appreciating the importance of self-care while caring for the needs of others,” Heng added, “Ultimately, a healthy and well-rested doctor is better protected from any kind of burnout and, thus, better positioned to extend quality and safe care to his charges.”

Dr Wong Xiang Yi

Continuing to chase their dreams

Despite the challenges that the students have faced and conquered, they were raring to go on their next adventures.

Wong is posted to the Department of General Medicine at Changi General Hospital, while Heng is currently doing his first posting at the National University Hospital’s Paediatrics department.

“I have been looking forward to being a safe and proficient doctor during my time here and learning from the best practices of my faculty, colleagues and patients. Now that I’m here, I’m excited and ready to practice medicine and do my best for my patients and my team,” said Heng.

As for the PhD graduates, they both took up positions as Research Fellows at Duke-NUS. While Khoo is delving into the world of regenerative cell therapy to try to find ways to treat Parkinson’s disease at the Laboratory of Human Neural Models in Neuroscience and Behavioural Disorders, Chothani is developing an atlas of RNA translation in human cell types and tissues at the Data-Driven Network Biology lab.

Now that Goh has completed the PhD part of her MD-PhD studies, she is setting off to start her Postgraduate Year 1 clinical rotations, alongside Heng and his fellow MD graduates, in the General Medicine department at Sengkang Hospital.

Joining the fight against the pandemic as newly-minted doctors, the skills that they have learnt through the research-intensive MD curriculum at Duke-NUS only serves to better healthcare for the general population.

“COVID has made [the ability to translate studies] quite an essential skill,” Goh said, “because as healthcare professionals, we need to interpret studies and data and then translate it in understandable forms in relationship to the general population and patients to better serve them.”