MEDICAL STUDENTS IN NATIONAL UNIVERSITY OF SINGAPORE (Cost of training)

Dr Lily Neo asked the Minister for Education if he could provide a breakdown of the cost of training a medical student at the National University of Singapore.

The Minister of State for Education (Dr Ng Eng Hen) (for the Minister for Education): Mr Speaker, Sir, the Medical Faculty of the National University of Singapore currently incurs a cost of $80,000 a year for every medical student. Each student pays $16,000. The Ministry of Education subsidises, per capita, to the tune of about $64,000. This cost includes operating expenditure and manpower. It does not include developmental costs, neither does it include specific research grants given to the institutions to do their research.

Dr Lily Neo: May I ask the Minister of State did he mean per year's cost of $80,000? How much would it add up to in the end?

Dr Ng Eng Hen: Yes, if it is per capita per year, the total cost would be around $400,000.

Dr Lily Neo: May I ask the Minister of State why is there such a big difference in the fees charged for medical education in Singapore as compared to those in Sydney, Cambridge and Oxford? The total unsubsidised tuition fees for the full course in Sydney, Oxford and Cambridge are between $170,000 and $250,000, as compared to about almost double here.

Dr Ng Eng Hen: Sir, I am no expert on the way the other schools account, and I am not sure whether what the Member says is completely true, in the sense that it is unsubsidised. We have just come back from a tour of a number of medical schools in the United States. I have asked the same questions to the deans of those faculties. In Cornell, the full course is US$400,000. So, dollar for dollar, it is equivalent. And they said that even then, they think that the cost is higher, that they are not fully funding all their teachers. The same is true in UPenn (University of Pennsylvania). Lord Oxburg, the Chairman of our IAP report did state that there were differences in accounting with different schools.

But the point is this: it is very expensive to train medical students. I am not quite sure that the Member's point is true that it is more expensive to train medical students here, as I understand that most medical faculties do subsidise even foreign students.

Dr Warren Lee: Sir, may I ask the Minister of State whether, in the computation of the $80,000 per annum, the salary component of the teachers concerned includes the amount computed for direct service to patients or whether it is actually just computed as the teaching component.

Dr Ng Eng Hen: Sir, the breakdown of the $80,000 is roughly 6:3:1, 60% in terms of academic teaching; 30% in terms of research; and 10% in terms of clinical practice.

Dr Lily Neo: May I ask the Minister of State how different is our method of costing compared to other world-leading medical schools?

Dr Ng Eng Hen: Sir, I am no accountant. The high cost of medical education is of equal concern to the Ministry as it is to Members, and indeed the public. This is taxpayers' money and we want to make sure that what we are paying, we are getting our money's worth. We do ask the same question to academics when we visit other universities and the first retort is yes, it is really expensive business. Two, the accounting is complex. Why? Because your teachers are also practitioners. They practise, they do research. Whatever it is, we have to ask ourselves: one, are we getting value for our money? Do we produce good doctors? Secondly, is it money well-spent? MOE subsidises NUS, as I said, to a tune of $64,000 a year per student. My own sense is that this is justified because we have good schools, we have good doctors and we have a reputation.

Dr Lily Neo: The Minister of State said earlier about getting good money for our medical education. Am I right to say that the medical faculty is the only one that requires its graduates to fulfill a five-year bond? Therefore, are we not already ensuring taxpayers' money is well-spent?

Dr Ng Eng Hen: The answer would be yes.

Dr Lily Neo: May I ask the Minister of State whether he concurs with the Minister for Health when he said recently that the five-year medical bond could become a non-issue if medical students pay the full tuition fee?

Dr Ng Eng Hen: In an economic sense, it is completely sensible. If you have paid for it, you have no moral obligation. On a social point of view, one can argue whether despite that, you could say that this does not cover developmental cost. The amount I quoted was $80,000 a year. It does not quite include developmental cost.

Dr Lily Neo: On that note, could I then ask the Minister of State whether would it not be too much a burden for medical students to bear a huge sum of $400,000 for the medical education? Would it be right to commercialise medical studies in this way? Would it not lead to high medical cost in the future as young doctors aim to clear their huge loans? Would it be right to set a precedent for unsubsidised tertiary education in the future?

Dr Ng Eng Hen: Sir, the Member has asked a number of questions and I would try to understand the gist of it. Her main point was, if we move on to a completely unsubsidised track, would it create a burden for the undergraduate? The answer must be yes. A large proportion of US students - as we know, a lot of US students going to universities, and at the end of their education, they have huge loans. We have a peculiar system. In fact, in Asian countries the culture is such that the State bears the cost, the parents bear the cost. And I hope that our younger generation understands this.