National Medical Excellence Awards 2019

• Senior Consultant, Department of Hand & Reconstructive Microsurgery Centre, National University Hospital

• Professor, Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore

• Physician-In-Chief and Group Chief Human Resource Officer, National University Health System

A hand and reconstructive microsurgeon with nearly 30 years of experience, Professor Aymeric Lim is internationally recognised as an expert in neuromuscular anatomy and surgery. He is also well respected among his peers for his dynamic leadership and passion for nurturing the next generation of healthcare leaders. As one of the pioneer nerve surgeons in Singapore, Prof Lim’s clinical expertise includes flaps, peripheral nerve reconstruction and tendon transfers, techniques which have successfully restored hand functionality to forearm and hand trauma patients. He is highly regarded for his skills in restoring the nerve functions of brachial plexus patients, as well as restoring quality of life for stroke, brain injury and tetraplegic patients.

Prof Lim is dedicated to the advancement of clinical care and continues to raise the bar in his area of expertise for the benefit of his patients. He is credited with developing novel split muscle transfers, restoring hand function in complex trauma patients who otherwise would not have enough donor muscles for transfer. Even more signficant is his discovery of a design in upper limb innervation that allows surgeons to pin point the location and number of nerve branches available in each muscle and plan for free-style nerve transfers. This has led to the development of a treatment for patients with stroke and brain injury, relieving them from uncontrollable, painful spasms and random movements that limit their social interactions. In addition, Prof Lim pushed the limits with reverse flow flaps, applying the surgical techniques for the hand to the foot, and also widened the scope of the specialty by getting microsurgeons to be involved in liver transplants.

During his two-term tenure as Chairman, Medical Board at the National University Hospital (NUH) from 2008 to 2016, Prof Lim demonstrated exceptional leadership and fortitude, spearheading the implementation of several critical initiatives to enhance safety and clinical outcomes for patients. One of these was the introduction of 100% procedural audits, which was subsequently adopted by the Ministry of Health (MOH) and rolled out to all public healthcare institutions.

Under Prof Lim’s leadership, NUH adopted the Republic of Singapore Air Force’s safety strategy with the intent of achieving zero preventable errors and building a just workplace culture, where departments are accountable for the safety of patients and staff in their units. From 2012 to 2015, the MRSA Bacteremia rates showed a consistent decrease and exceeded the national target set by MOH. The core value of excellence he instilled during his term has become embedded and runs strongly in the hospital’s day-to-day activities. Prof Lim also established the thoracic outlet syndrome service at the hospital, providing relief for patients who had previously sought multiple unsuccessful treatments elsewhere.

Beyond his clinical and teaching responsibilities, Prof Lim is heavily involved in policy planning and administration duties. As Physician-in-Chief and Group Chief Human Resource Officer with the National University Health System, he manages the planning and development of the integrated, seamless and comprehensive clinical care programme across the cluster. Prof Lim also oversees leadership and organisational development, policy perspectives, health system design and innovation within the public healthcare system in his capacity as Dean of the Healthcare Leadership College, MOH Holdings.

Over the course of his illustrious career, Prof Lim has served in various leadership roles at both institutional and national levels. He was Chairman of the MOH Specialist Training Committee from 2009 to 2010 and the President of the Singapore Society for Hand Surgery from 2007 to 2009.

In 2018, Prof Lim was conferred the Public Administration Medal (Silver) at the National Day Awards for his contributions to the nation’s healthcare sector. On the international front, he was also nominated to the prestigious French National Academy of Surgery and French Society for Hand Surgery in recognition of his expertise and surgical skills.

For his outstanding achievements in the advancement of hand and reconstructive microsurgery, peripheral nerve surgery, and his contributions to shaping the safety culture of healthcare services in Singapore and beyond, Prof Lim is awarded the 2019 National Outstanding Clinician Award.

• Senior Consultant, Department of Cardiothoracic Surgery, National Heart Centre Singapore

• Group Director, International Collaboration Office, SingHealth

Dedicating his life to raising the standards of cardiothoracic surgery in Singapore, Associate Professor Chua Yeow Leng has been a strong advocate for the role of surgery in atrial fibrillation and valve diseases.

Since 1996, A/Prof Chua has championed the use of mitral valve repair surgery in Singapore and is the recognised leader and expert in this subspecialty, thereby contributing greatly to reputation of the National Heart Centre Singapore (NHCS) for heart valve repairs in the region. He is also one of the key opinion leaders in the surgical radiofrequency ablation technique for the treatment of atrial fibrillation. A/Prof Chua is also regularly invited as an expert speaker at many scientific meetings in Asia and the region. Beyond providing care to local patients, A/Prof Chua also assists with overseas surgical cases and offers specialised guidance for these surgeries.

When A/Prof Chua was the Head of Department of Cardiothoracic Surgery in NHCS from 1995 to 2007, new initiatives and services, such as the life-saving Mechanical Heart Assist Device Programme for patients with end-stage heart disease who could not find a suitable heart for transplantation, as well as the Extra-Corporeal Membrane Oxygenator (ECMO) that greatly reduced mortality and morbidity rates, were introduced, which established the reputation of NHCS as the leading national and regional referral centre for heart related problems.

A/Prof Chua was appointed the Group Director for the International Collaboration Office for SingHealth in March 2014, where he led teams of healthcare professionals in outreach and humanitarian mission efforts worldwide, such as in China, Papua New Guinea and Vietnam. He has actively participated in and led numerous mission projects partnering with organisations, such as Temasek Foundation and SingHealth Duke-NUS Global Health Institute, to help develop cardiac and other types of surgeries in the Asia-Pacific region.

A/Prof Chua is a firm believer in imparting his knowledge and skills to younger generations of doctors, as well as nursing staff and overseas fellows. He believes that each individual has their unique strengths and is committed to grooming and developing these doctors to their fullest potential in all aspects – from clinical care, research to personal development. His commitment has led to generations of cardiothoracic surgeons being trained in NHCS, with succession planning for leadership in this challenging specialty.

As an advocate for cardiovascular research, A/Prof Chua believes in advancing clinical capabilities through research work, and is highly involved in clinical trials and driving research in his department. He has obtained two A*STAR Biomedical Research Council grants of more than $900,000, of which he is the Co-Investigator.

For his exemplary contributions to the role of surgery for atrial fibrillation and valve disease, and the advancement of cardiothoracic surgery standards in Singapore, A/Prof Chua is awarded the National Outstanding Clinician Award 2019.

• Deputy Director (Research) & Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore

• Adjunct Professor, Department of Pharmacology & Medicine, Yong Loo Lin School of Medicine, National University of Singapore

• Group Chief Physician Leadership & Organisational Development Officer, National University Health System

• Director, Investigational Medicine Unit, National University Health System

• Deputy Director, Cancer Science Institute of Singapore, National University of Singapore

Adjunct Professor Goh Boon Cher is an internationally renowned and experienced cancer pharmacologist and Phase I clinical trial expert who is highly regarded in the field of drug development. He regularly provides consultancy to early drug pipeline research teams from the pharmaceutical industry and is a key opinion leader in the development of these drugs.

Following a successful research fellowship in Clinical Pharmacology and Phase I clinical trials at the University of Chicago, Adj Prof Goh saw the value of establishing a clinical trial unit at the National University Hospital (NUH). Upon his return to Singapore in 1999, he started a clinical trial unit in the Department of Haematology-Oncology at the National University Cancer Institute, Singapore (NCIS). Through his dedication and efforts, the facility has established itself as a world-class clinical trial unit that offers state-of-the-art molecular profiling to select the most suitable patients for clinical trials. This infrastructure has enabled the National University Health System to cultivate many productive collaborations with international pharmaceutical companies and numerous therapeutic trials. Some of the trials led by Adj Prof Goh are the first in the world, for instance, the first-in-man development of Singapore’s first cancer drug, SB939, a histone deacetylase inhibitor.

Adj Prof Goh is well recognised as an expert in head and neck cancer, particularly for nasopharyngeal carcinoma (NPC), one of the most prevalent head and neck cancers in Singapore. He is currently leading efforts at NCIS to translate laboratory discoveries to clinical trials in nasopharyngeal cancer, a type of cancer which is endemic and difficult to treat, and is in urgent need of new treatment options.

Adj Prof Goh has been studying anti-VEGF therapy and immunotherapy in NPC, and has presented some of this work as well as a published study investigating nivolumab. These have led to promising leads in evolving the way that NPC is being treated, with the potential to revolutionise the care of this disease. He has also pioneered the application of anti-angiogenic drugs in modifying the NPC tumour micro-environment, enhancing drug permeability and the trafficking of immune cells into the core of the tumour. This work was the result of a completed four-arm clinical trial that has since been twice presented at the Annual Meeting of the American Society of Clinical Oncology (ASCO). The presentation will be transcribed into a manuscript this year, and will serve to guide future research in this promising area of study.

In the field of molecular diagnostics, Adj Prof Goh has spearheaded work in the development of a panel of proteins from plasma particles called exosomes that is being evaluated for early diagnosis of lung cancer. This work is currently filed for patent as intellectual property.

As a prominent clinician scientist, Adj Prof Goh has also been dedicated to the mentoring and nurturing of the next generation of basic and clinician scientists through the years, both in formal structures initiated by the Ministry of Health as well as within his own personal capacity, providing invaluable research opportunities, supervision and career guidance to many currently successful researchers.

With his wealth of research achievements, Adj Prof Goh has published 190 peer-review articles to date and is a regular keynote speaker at national and international conferences and workshops. He is also frequently invited to contribute on the editorial boards of prestigious journals of oncology and clinical pharmacology. He is currently serving on the editorial board of Annals of Oncology, the official journal of the European Society of Medical Oncology. He has also written a book chapter on “Pharmacogenomics” in “De Vita, Hellman and Rosenber (editors) Principles and Practice of Oncology 7th Edition, 2005”, a highly regarded reference publication in the field of oncology.

For his outstanding and pioneering contributions in cancer pharmacology and drug development, bringing hope to cancer patients through promising experimental treatments, Adj Prof Goh is awarded the National Outstanding Clinician Scientist Award 2019.

• Senior Consultant, Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital

• Professor, Surgery Academic Clinical Programme, SingHealth Duke-NUS Academic Clinical Programme

• Associate Dean (Recruitment, Admissions, Financial Aid) & Professor, Duke-NUS Medical School

• Professor, Yong Loo Lin School of Medicine, National University of Singapore

In his illustrious career of more than three decades, Professor London Lucien Ooi Peng Jin has worn many hats. Currently Senior Consultant at both the Department of Hepato-pancreato-biliary and Transplant Surgery at Singapore General Hospital (SGH), and the Division of Surgical Oncology at the National Cancer Centre Singapore, Prof Ooi has excelled in varied roles. He is a surgeon, researcher, administrator and teacher, and importantly, a mentor to successive generations of surgeons and clinicians, many of whom bear witness to his generous and inspiring leadership.

He has been imparting knowledge and skills, as well as strong values of generosity and collegiality to young clinicians and other healthcare professionals throughout his career. During his term as the Chairman of SGH’s Division of Surgery between 2006 and 2015, Prof Ooi was actively involved the mentorship of potential leaders for the 16 clinical departments in his division. Most of his leadership mentees went on to head departments and divisions – who have, in turn, gone on to mentor others.

During that time, he was also instrumental in bringing together the several surgical departments and services to function as a family. Prof Ooi’s strong and inspiring leadership allowed him to successfully galvanise the surgeons, nurses, technicians and administrative staff to give their best to improve patient care and train the next generation of surgeons in the best tradition.

Prof Ooi saw the growing importance of technology and the use of high-tech imaging, robotics-assisted devices to enhance operating procedures. Prof Ooi also saw the possibilities of technology in teaching, and took an important role in designing and building the skills simulation laboratories at the Academia. He engaged industry players to provide top-of-the-line, state-of-the-art instruments and operating theatre systems to enable training the next generation of clinicians and healthcare professionals.

Prof Ooi was also instrumental in establishing entities like SingHealth Transplant, which incorporated nine transplant programmes and served as a platform for developing and mentoring clinicians in leadership roles in transplantation; and the SingHealth Tissue Repository which provided a powerful resource for clinician researchers.

More recently, as Chairman of Surgery Academic Clinical Programme, he established new roles and appointments in academic medicine to allow clinicians to embrace academic leadership in research and training. He continues to mentor clinician leaders in higher leadership appointments.

Prof Ooi holds several appointments that allow him to shape the evolution of surgical training and assessments for generations of general surgeons in Singapore. These include Chairman of the Joint Committee on Specialist Training General Surgery Exit Examinations Committee (since 2016), Chief Examiner of the American Board of Surgeons Singapore Board MCQ Examinations (since 2014), Chief Examiner of the Joint Specialties Fellowship Conjoint Exit Examination in GS with the College of Surgeons of Hong Kong and the Royal College of Surgeons of Edinburgh (since 2007).

Prof Ooi continues to be highly sought after by trainees for pre-examination tutoring, and with his characteristic collegial manner, patience and kindness, Prof Ooi never fails to oblige these trainees when they need his guidance. Prof Ooi is a true academic surgeon – someone who excels in clinical expertise, research, teaching and administration, and combines all in order to be a mentor extraordinaire in all these areas.

For his inspiring leadership in grooming successive generations of surgeons who became leaders in their own right, and passing on strong mentoring values of generosity, collegiality and patience, Prof London Ooi is awarded the 2019 National Outstanding Clinician Mentor Award.

• Chief Executive Officer and Senior Consultant Physician, St Luke’s Hospital

• Associate Programme Director, National University Health System Family Medicine Residency Programme

A passionate and indefatigable clinician educator and administrator, Associate Professor Tan Boon Yeow is a trained Family Physician and is currently the Chief Executive Officer and Senior Consultant at St Luke’s Hospital. A/Prof Tan has been heavily involved in undergraduate and postgraduate residency and fellowship educational work since 2003. He is an inspirational role model who has trained many doctors, clinician leaders and clinicians in the public, private and people (non-profit) sectors, thus nurturing future generations of clinicians in Singapore.

When Singapore introduced the Accreditation Council for Graduate Medical Education – International (ACGMEI) residency programme in 2010, A/Prof Tan seized the opportunity and helped establish the first Family Medicine Residency Programme in National University Health System (NUHS). He took over as Programme Director from 2012 to 2019 and led the programme to successful accreditation. As NUHS then did not own any public primary care assets, he innovatively collaborated with private and the voluntary sectors to establish the programme, paving the way for fruitful public-private-people sector cooperation for the national good.

A/Prof Tan was instrumental in developing a robust training curriculum with core faculty and motivating residents in actively creating a conducive learning environment to achieve core competencies and values in Family Medicine. To ensure high educational standards of residents and continual training for faculty development, he is present for most of the Friday night training sessions and personally does most of the home visit teaching sessions with residents usually conducted on Saturday afternoons.

A/Prof Tan is also a visionary leader. A rigorous Fellowship programme for the College of Family Physicians Singapore (CFPS) was established when he was the Censor in Chief of CFPS. Working together with the other college and academy leaders, he was also instrumental in helping to establish the Chapter of Family Medicine in the Academy of Medicine. One of the main aims of the Chapter is to promote the recognition and development of Family Medicine as a specialty in Singapore. He was inaugural Chairperson of the Chapter of Family Medicine (2015-2016) and currently Vice Chairperson (since 2016).

As one of the longest-serving Censor in Chief of CFPS, A/Prof Tan managed to significantly increase the number of doctors trained in the various programmes that CFPS oversees, such as the Graduate Diploma in Family Medicine (GDFM), the College Programme for the Masters of Medicine course and the Fellowship Programme. The high standing of Family Medicine and the popularity of the discipline today has its roots in these well-run and well-subscribed programmes.

A/Prof Tan also contributed to the establishment of the Family Medicine and Continuing Care Department of Singapore General Hospital as a Visiting Consultant, where he conducted weekly grand rounds and teaching from 2007 to 2013.

A/Prof Tan continues to teach and train medical students in his role as adjunct Associate Professor in Family Medicine Academic Clinical Programme, Duke-NUS Medical School, as well as Yong Loo Lin School of Medicine, National University of Singapore. He also continues to support the NUHS Family Medicine Residency Programme as Associate Programme Director and Site Director for St Luke’s Hospital.

In recognition of his passion and contribution in clinician education, A/Prof Tan has received teaching awards such as the NUHS Postgraduate Teaching Excellence Award in 2013, NUHS Teaching Excellence Award 2015, Singapore Chief Residency Programme Mentoring Excellence Award 2016 and Trailblazer Programme Director Award 2019. The latest award was for outstanding leadership and driving postgraduate education in NUHS Residency.

For his extraordinary dedication and visionary contributions to education in Family Medicine, A/Prof Tan is awarded the National Outstanding Clinician Educator Award 2019.

Diabetic retinopathy (DR) is a significant complication of diabetes and a leading cause of vision impairment in Singapore. About 10% or 400,000 of Singaporeans aged between 18 and 69 years have diabetes mellitus. Of these, approximately 30% (120,000) have DR and 10% (40,000) have vision-threatening DR. Vision loss from DR is preventable if diagnosed early and treated appropriately.

The team, led by Assistant Professor Gavin Tan and Clinical Associate Professor Wong Hon Tym, with members from National Healthcare Group Eye Institute and Singapore National Eye Centre, established a new Singapore Integrated Diabetic Retinopathy Programme (SIDRP), which is a comprehensive screening model based on “real time” assessment of DR from photographs. This is a major improvement from the old DRP model as the assessment can now be done centrally by a team of trained and accredited non-physician readers, supported by a robust tele-ophthalmology IT infrastructure. Patients’ photographs are graded within one business day and if necessary, they will be referred to tertiary eye care, based on a standardised protocol.

SIDRP started in 2010 and is one of the first successful joint cluster programmes between National Healthcare Group and SingHealth. With SIDRP, the programme has initiated improvements when compared to the traditional model, such as:

1. Faster – Shorter turnaround time for reports
   99.8% of the reports are generated within one business day, with about 50% reported within an hour, in comparison to two to four weeks previously. The short turnaround time allows for early detection of eye diseases and prevents delay in diagnosis and treatment.

2. Better – Higher accuracy, standardised protocol with recommended timeframe
   With online training and audit monitoring features available, readers are trained, tested and consistently monitored to ensure strict compliance to the new harmonised grading protocol to detect eye diseases. Patients with Mild DR are monitored closely in the primary care centres instead of referral to tertiary care.

3. Cheaper – Cost-savings by upskilling non-physician readers to perform image assessment
   SIDRP has upskilled the allied health workforce by equipping them with new skill sets of assessing and reporting DRP images. Results have shown that the present value of future cost savings associated with the SIDRP model is estimated to be S$29.4 million over a lifetime horizon.

To date, SIDRP has screened more than 267,000 patients in the polyclinics, and expanded its scope to the endocrinology clinics and the community by including community healthcare centres, optometry practices and primary care networks. The SIDRP system is a major paradigm shift in the management of DR with direct benefit to patients, improved productivity and cost savings to the healthcare system.

For their outstanding contributions and achievements in the establishing a national diabetic retinopathy screening programme for the benefit of patients with diabetes in Singapore, the SIDRP team is awarded the 2019 National Clinical Excellence Team Award.