“A journey of a thousand miles begins with a single step.”

It starts from the heart: having the interest and passion and willingness to step out of your comfort zone is the key to future success in research or any other endeavour. There are many who had the experience and are more than willing to share and work with a young enthusiastic budding researcher to help to facilitate your journey in discovery.

Sometimes, opportunity comes knocking at your door; don’t hesitate, take the first step and enjoy the adventure of discovery.

- Professor Chay Oh Moh, Master Academic Clinician, Duke-NUS, and Emeritus Consultant, Respiratory Medicine Service, KK Women’s and Children’s Hospital

In many career choices, it is unlikely that someone will have any experience before applying to that course of study. However, if you are considering studying medicine, because the course of study is so specific and options for a career switch out of medicine after graduation are difficult, it is especially important to have some ‘experience’.

This ‘experience’ can cover several areas and pertain to the relevant attributes one would expect to see in a doctor. For many doctors like myself, medicine is more a calling than a career. As our lives revolve around our patients, it comes with some degree of sacrifice. Volunteering in any capacity will help you understand if medicine is something you can do for the rest of your life.

Another important ‘experience’ to have, comes in the form of observerships or internships where you shadow doctors in their daily work to give you some idea of the life to expect and how the system works. As the working hours can be long and irregular, this will also help you understand your suitability.

When we consider an applicant’s suitability to enrol at Duke-NUS, one important consideration is their maturity. Life experiences of any sort that enrich the person will always make for a more empathetic and resilient doctor. Sometimes, the experience of failure and how you overcome this can be very valuable. One of the ways we nurture such experiences in our students is through our conditional admissions pathways, which allow them to grow and develop while having a somewhat ‘guaranteed’ admission to study medicine, dependent on their undergraduate studies.

Medicine is about people and life—whatever experiences you have in life that enrich and strengthen you will better prepare you for a calling in medicine.

- Professor London Lucien Ooi Peng Jin, Associate Dean, Admissions, Recruitment and Financial Aid, author of Getting into Medical School: A Guide for Students & Parents

Simply put, variants evolved from the original COVID-19. During virus replication, mutations are introduced into the genome. This results in a population of viruses with diverse mutations, also known as quasispecies. These mutations can be beneficial or deleterious. When the host environment changes, some mutations may have an advantage and can outgrow the ancestral strain, thus resulting in the emergence of new variants. There are multiple hypotheses on the emergence of the Omicron variant: (i) the virus evolved in an immunocompromised patient with chronic SARS-CoV-2 infection; (ii) the virus evolved in an animal host after reverse zoonosis—where the virus jumped from a human into an animal—and spilled-back into the human population; and (iii) the virus evolved due to selective pressure after a change in the population immunity landscape.

The major difference between the ancestral SARS-CoV-2 and the Omicron variant is the mutations in the spike protein, the area where neutralising antibodies bind to the virus to prevent it from entering cells. With its many mutations, omicron is more immune evasive—in terms of neutralising antibodies—than other variants.

- Dr Tan Chee Wah, Senior Research Fellow, Emerging Infectious Diseases Programme

Diabetes as a disease has been known since the time of the ancient Greeks. With our modern lifestyle, diabetes has become an increasingly important health problem throughout the world. Singapore is not spared and the Singapore Government has been leading a “War on Diabetes” as a way to improve the health of its citizens.

Despite the long history of intensive research into the causes and potential treatments for diabetes, we have not yet been able to solve this problem. We have, however, made notable advances over the last ten years with the introduction of several new classes of drugs for treating patients with diabetes in the clinic.

Patients with diabetes are at risk for serious complications including heart attacks, stroke, blindness, foot amputations and kidney disease. At Duke-NUS, our main focus has been on trying to understand the kidney disease that occurs in up to one third of patients with diabetes. Unfortunately, Singapore has one of the highest rates of kidney disease caused by diabetes.

Thomas Coffman, Dean of Duke-NUS, is a prominent kidney disease researcher and he is leading a consortium of Singapore research institutions to tackle this problem. In this effort, Duke-NUS is joined by Singapore General Hospital, Khoo Teck Puat Hospital, the Singapore National Eye Centre, Singapore Eye Research Institute and Yong Loo Lin Medical School. Called DYNAMO (Diabetes studY in Nephropathy And other Microvascular Complications), this large project uses a multi-faceted approach to better understand the causes and potential treatments for diabetic kidney disease. The project involves basic science studies, measuring genes and chemicals in the blood of patients with diabetes and performing a clinical trial to see if different medications can help patients with diabetic kidney disease. The goal is to find ways to reduce the incidence and severity of kidney complications in patients with diabetes in Singapore. I am a part of the DYNAMO study team. I perform basic science studies, analyse blood samples from patients with diabetic kidney disease and help to coordinate the human clinical trial.

- Assistant Professor Jean-Paul Kovalik from the Cardiovascular and Metabolic Disorders Programme

As you have put it, we are in a war against diabetes, and this war is by no means a short nor easy one. Researchers have been studying diabetes for many years, but we are still grappling with it. In a war, we have the generals (aka principal investigators) who plan and execute the war plans, we have the logistics personnel (non-research staff including administrators) who help supply the tools for fighting the war and we have the soldiers who are on the front line. Everybody plays a part in the fight. For me and my team, I would consider ourselves front-line soldiers who are handling patient samples, analysing them to find chemicals unique to them and, from there, understanding how these chemicals arise during the disease. If we eventually understand how the disease arises and progresses, we might be able to find a good intervention.

Duke-NUS has done much unique work on diabetes for Singaporeans, such as trying to find out the susceptibility of Singapore’s different races to diabetes, using a combination of genetic, proteomic and metabolomic studies. Most recently, our team and colleagues at the National Heart Centre Singapore (NHCS) also discovered a group of compounds called acyl-carnitines, which are associated with cardiovascular ageing in diabetic patients. Such information helps us to detect heath issues earlier, so we can effectively treat or prevent deterioration from disease. Without the help of researchers like Dr Angela Koh and Dr Gao Fei from the NHCS team who were critical to the study, these findings might not have been possible.

It is, however, important to understand that researchers are not the only warriors in the war. Most importantly, it is everyone’s responsibility to keep healthy, so that diabetes does not have a chance to attack.