A moment with Dr Danny Tng (Class of 2019)| MEDICUS 2024 Issue 2

Engineering the future of medicine

By Dr Danny Tng (Class of 2019), Clinician-Innovator and Clinical Instructor, Medicine Academic Clinical Programme, Emerging Infectious Diseases Research Programme, Duke-NUS; Resident Physician, Department of Infectious Diseases, Singapore General Hospital

I have always aspired to be an innovator. During my university years, I majored in electrical and electronic engineering with the dream of creating new medical devices to solve clinical problems and enhance patient care. A stint at Beijing Hospital in the final year of my PhD convinced me of the need for clinical knowledge to interact with patients and understand clinical pain points. And so, I enrolled with Duke-NUS Medical School.

At Duke-NUS, I sought collaboration opportunities with scientists, though differences in approach between engineers and scientists initially made this challenging. Perhaps because, as engineers often joke, scientists always ask why, but engineers are more focused on how. This difference in perspective and priorities made it hard for me to find any collaborators who were interested in working together. I even asked myself: what’s the point of staying on?

I was contemplating withdrawing from medical school until a conversation with Dr Mara McAdams, the then Dean of Student Affairs, led me to meet Professor Soo Khee Chee, a prominent figure in Singapore's medical scene.

“Why not?” I thought, I was going nowhere on my own anyway.

That was how I met Professor Soo, founding director of the National Cancer Centre Singapore and the former Vice-Dean for Clinical and Faculty Affairs at Duke-NUS.

Prof Soo, recognising the potential of engineering in healthcare, encouraged me to persevere. He took me under his wing and said: “You’ll see, let’s develop something together.”

Under his mentorship, I learnt how engineering and science could be combined to solve healthcare problems. We managed to collaborate with other clinician-scientists and even managed to raise a modest sum of $30,000 to develop a less invasive method to diagnose thyroid cancer.

Absorbed in working on the thyroid project and the rigours of medical school, thoughts of my school withdrawal lay forgotten. Eventually, in June 2019, I graduated from medical school.

Danny Tng at his graduation ceremony

Together with my mentor, Prof Soo Khee Chee // Credit: Courtesy of Danny Tng

Shortly after my graduation, the COVID-19 pandemic struck. With it, came the need for frontline workers to test regularly for the virus using a Polymerase Chain Reaction or PCR test because that was the gold standard at that time. But it was labour-intensive, uncomfortable and expensive.

Towards the end of my housemanship, I received a call from Prof Soo. He told me that a group of clinician-scientists from the Singapore General Hospital, the National Cancer Centre Singapore and the National University of Singapore wanted to create a new tool to screen for COVID-19 better and they could use a clinician-engineer.

Needless to say, I jumped at the opportunity and that was how the idea for a saliva-based test was born. Combining our clinical, scientific and engineering skills, we developed an amplification technique for Antigen Rapid Tests (ARTs) which could produce results from a saliva sample in minutes regardless of when the patient’s last meal was.

The team assembled by Prof Soo Khee Chee (centre), included Prof Melvin Chua from the National Cancer Centre Singapore (left), Prof Jenny Low from Singapore General Hospital (second left) and Prof Ooi Eng Eong from Duke-NUS’ Emerging Infectious Diseases Programme (right). We were just missing Prof Zhang Yong from the National University of Singapore that day. // Credit: Duke-NUS

The product we developed was a saliva-based SARS-CoV-2 ART called the Parallel Amplified Saliva rapid Point-of-CaRe Test (PASPORT). We chose this acronym because we hoped that an accurate and easy-to-administer test would be a passport for users to venture out and continue about their daily activities with peace of mind.

PASPORT showed promise in early clinical testing, nearly matching the sensitivity to the PCR tests. It was eventually patented and licenced to Singapore-based company, Digital Life Line for further development, beyond just SARS-CoV-2 testing.

This was a milestone for me as an aspiring clinician-innovator and it taught me how engineering and science could come together to solve clinical problems. It was the cumulation of a long journey trying to invent things that benefit healthcare.

Pasport components

The components of the prototype PASPORT saliva test kit // Credit: National Cancer Centre Singapore

Me with a prototype of PASPORT // Credit: National Cancer Centre Singapore

The first step of that journey had its roots in my childhood.

As a kid, I was always taking things apart to find out how they worked. I put these experiences to good use when I was in Secondary 2.

I built my first gadget—a sensor for people with visual impairments. It was part of my interdisciplinary project work module.

I got inspiration from sensors that could detect if a door was closed, like the ones used in home alarm systems. I thought, why not superpower one of these sensors so that it can identify obstacles over a longer distance?

question-mark

Have a question? Send it in and it may be answered in the next issue of MEDICUS!

ASK MEDICUS

So I went to Sim Lim Tower, Singapore’s go-to mall for IT gadgets, and bought the most powerful door sensor I could find. I fitted the device to a hat and made some modifications so that the ultrasound waves that the sensor used to detect objects were translated into vibrations when they bounced back.

So if there were obstacles in front of the wearer, the waves would be reflected back as vibrations, alerting the wearer to be cautious.

ACS magazine cover

Drug screening microfluidics chip featured on cover of ACS Biomaterials Science & Engineering // Credit: Courtesy of Danny Tng

Microscope high-res made by Danny Tng

Self-made fluorescence microscope using an old digital camera and 3D-printed parts // Credit: Courtesy of Danny Tng

From then on, I went on to create lots of “weird stuff”.

As an engineering student in university, I made my own fluorescent microscopes, speakers and projectors using 3D-printed parts.

One of my proudest inventions was a cancer drug screening chip which was featured on the cover of the first edition of the Journal of ACS Biomaterials Science & Engineering.

I would have never thought that years later, this experience would enable me to collaborate with scientists to develop novel medical technologies that could directly impact healthcare.

Although I am now working on other innovations, PASPORT is still my most memorable project.

From raising funds, pitching to potential investors, to making a proof-of-concept prototype and my involvement in the clinical trial — I got a taste of the entire journey of innovation and entrepreneurship through my involvement in PASPORT.

At the same time, I am honoured to have played a role in Singapore’s fight against the pandemic.

I am thankful for all the guidance my mentors have given me during my journey and will keep their teachings close to my heart as I embark on my next journey in innovation.

I will be setting up my own startup focusing on sensors and actuators and I hope to continue collaborating with my scientific peers. Together, we can leverage both engineering and scientific concepts to achieve new clinical innovations.

As told to Alice Chia, Senior media and content specialist.