It's been almost 3 weeks since Mel and I started working at Tan Tock Seng Hospital and I have to say we're having a blast. We've both met a lot of very cool people and we're really enjoying working in a system that is ridiculously clean and efficient. Over the last 3 weeks a number of things strike me about working in Singapore:

1) Things happen crazy fast.

Sometimes we will request a CT scan on our morning ward round and before we have finished the patient has been downstairs, through the radioactive donut, returned glowing to the ward and the images and report are in our hands. Back in the UK we would still be trying to persuade the radiology dungeon master to squeeze the scan in before the end of next week, then when next week comes the porters would undoubtably be on strike. Once we'd have carried the patient down 3 flights of stairs (the lift is out of order) to the CT scanner it would have turned 5:01pm and the radiologist would be well on his way home and we'd have to wait until the next morning to find out what the scan actually means.

2) Food is central.

The hospital has it's own food court downstairs with a huge selection of malay, chinese, hokkien and indian food. Plus westernish food (pork chops and chips). Not a sandwich in sight. On our operating days there is a little canteen in the operating theatre. Our morning ward rounds end with makan (malay for food) and our meetings and tutorials are usually bountifully supplied. Back in blighty I was used to ending the day feeling hungry thirsty and needing to pee all at the same time. Now I just need to pee.

On the downside, the majority of disease seen in Singapore appears to be caused by roti prata.

3) Good English is hard to come by

I am strongly resisting asking collegues to "Off the catheter" or "on the light" (remove the catheter, turn on the light). The health system is also littered with abbreviations that everyone understands but no one can actually remember what the letters stand for. 'Please' and 'thank you' are generally regarded as superfluous and inefficient words that unnecessarily lengthen the sentance and therefore are not commonly used in Singlish . On the background of this, the English accent has an absolutely devastating effect on all within ear shot. Nurses listen carefully, Patients quit smoking, Consultants carefully consider your opinion (ok, so the last one isn't really true...) unfortunately English doesn't get you very far with all the old Hokkien/Mandarin Aunties and Uncles.