Imperial Connection: Imperial College London Clinical Research and Innovation (CRI) Project: an insight into Singaporean life, health and culture

By Hanya Irfan, Year 2 student, Imperial College London

Stepping off the plane into the warm hazy evening air was such an alien experience; some of us wondered whether we would struggle to breathe such heavy humid air during our three-week long trip. However, we discovered that we would all soon grow accustomed to not only the weather, but the spiced food, the Singlish (Singaporean colloquial English) and the rich vibrant multiculturalism Singapore has to offer. 

Indeed, the very first thing we did after checking into our hotel was head to one of the local hawker centres: a culinary experience we all miss now in England. 

The next day, in between welcome lectures and LKCMedicine tours, saw us taking the bus down to Little India where the majestic skyscrapers of the Singaporean skyline gave way to colourful streets, stunning street artwork and bustling bazaars. 

Similar scenes greeted us at the Geylang Serai Ramadan Bazaar, but on a much larger scale. This was a fascinating dip into a rich cultural background that makes a sizable percentage of the Singaporean community. 

We visited these streets again on Hari Raya, looking to mingle with the locals on this public holiday especially as it was the first Eid al-Fitr away from home for a few of us.  

Chinatown's maze of busy roads and lively stalls was yet another dive into the rich cultural heritage of Singapore. Despite the excitement of the hustle and bustle, some of us preferred the tranquility of the Chinese Gardens where we found a 252-year-old sacred fig tree amongst pagodas and traditional Chinese gardening art. 

This relaxing trip was after an eye-opening Team Based Learning (TBL) session on Professionalism, Ethics, Law, Leadership & Safety (PELLS) where we contemplated the different cultural background of the patients and families our Year 1 colleagues would engage with compared to those in the NHS and the impact of this on our medical practice. 

The TBL facilities were state of the art and it is clear that Imperial and LKCMedicine share a drive to further enhance medical education through technological means. LKCMedicine's Anatomage table was particularly useful as it reconstructed systems accurately and provided an unprecedented insight into physiology compared to cadavers through its similarities to radiological imaging. 

We were confronted with these realisations again when we visited Yishun Community Hospital and Khoo Teck Puat Hospital. We had the opportunity to engage with patients and staff in a variety of settings from visiting patients in their own homes with the home care team to hospice care and sub-acute wards. Understanding your patients' background and preferences is an important factor that guides patient management and can significantly improve outcomes. 

We were all amazed how much the family dynamic plays into disease management and affects communication and we will be more mindful of this aspect in our own care for patients. For some of us on the End of Life Care project, approaching patients on their deathbed was a particularly difficult experience, but it has helped us grow tremendously as medical students.

One of the most impressive technological advancements was the use of telecommunication by physicians to speak to patients and nurses in the nursing homes. By using video-call appointments, it gave the nurses the reins to manage the overall care, but this came with its own challenges. While efficient, it was sometimes difficult to notice signs such as pallor and so the physicians used the nurses' complexion on the same screen as a comparison. 

There are countless other examples of logistical ingenuity that have allowed Singapore's healthcare system to be so multi-faceted and yet so integrated. I particularly liked the idea of polyclinics and medical campuses such as HealthCity Novena which incorporate medical education, research, health services and community hubs in one sustainable urban development to promote a holistic outlook on leading a healthy life. 

One of our most memorable experiences was visiting the surrounding islands of St John, Lazarus, Kusu, Seringat and Ubin. Each island had something different to offer, from the sunny beaches of Lazarus and religious temples of Kusu to the disused quarries, quaint kampongs (villages) and lush Chek Jawa wetlands of Pulau Ubin.  

Immersing ourselves in this natural beauty both offshore and on mainland, we even trekked the MacRitchie Nature Trail to cross the TreeTop Walk on one of our last days in Singapore. 

The Year 2 students we had met previously during their Imperial Exchange in March took note of our affinity to nature and were kind enough to take us to Gardens by the Bay where we visited the Flower Dome and Cloud Forest. 

Here, the refreshing mist from the former world's tallest indoor waterfall provided respite from the glaring sun outside and the abundance of sweet floral fragrances soothed our senses. We were so awe-inspired that we made sure we visited Singapore's newest attraction – Jewel Changi Airport and the newly unveiled world's tallest indoor waterfall, the Rain Vortex – on our last day. 

Later we were also joined by the Year 1 students when we visited the Night Safari where we were lucky enough to see exotic animals such as African white lions, Asian elephants and even the world's smallest deer species, the púdu. 

No trip to Singapore is complete without visiting Sentosa Island, a remarkable feat of engineering as a man-made island featuring the massive Resorts World, soft sandy beaches, and Universal Studios theme park. Here, we braved a 450m-long zip line over the jungle canopy of Imbiah Hill and marvelled at the sunset from the southernmost point of continental Asia.

Throughout the trip, we were incredibly grateful for the administrative work by Imperial and LKCMedicine that allowed us this experience of a lifetime to immerse ourselves in Singaporean life, health and culture. 

The faculty was very helpful in all aspects of our research project and my supervisor Vice-Dean for Clinical Affairs Professor Pang Weng Sun was invaluable in showing us important sights such as columbariums, memorials and the undeniable impact of culture on healthcare preferences and management. We would have been lost without Assistant Manager, Admissions, Projects and Electives, Ms Andrea Liew's organisation skills. 

Finally, we were all amazed by Vice-Dean for Education Professor Naomi Low-Beer's vision of an innovative medical curriculum that has made LKCMedicine the thriving establishment it is today. Undoubtedly, we at Imperial will continue to learn from and with LKCMedicine to improve medical education, of which the CRI project is a fantastic example.