Posted on Monday, January 15, 2018
I am very privileged in coming to Singapore and especially East Coast Podiatry Centre to do my placement. This is a highly advanced, patient orientated clinic that specialises in both general treatment and musculoskeletal injuries by focusing on lower limb biomechanics which I am very interested in pursuing following my graduation.
‘discussion on different types of footwear and in consideration of human biomechanics and patients’ lifestyle choices’
In my first two weeks of my placement, I have learned a lot that I would not have learned in Australia. Firstly, the way private clinics here operates is very different from Australia. In Australia, the majority of patients have private insurance; however, in Singapore, podiatry is not usually covered by insurance. Furthermore, based on the limited time and high work demands of Singapore residents, patients visiting private clinics have higher expectations. Hence, a more effective therapy as first line treatment is used here in Singapore instead of a more conservative treatment such as padding and strapping.
‘being coached on general treatment methods. no pressure at all…!’
Secondly, the environmental factor is important when implementing treatment plans. Due to the humid environment in Singapore, certain treatment such salicylic acid may cause additional maceration of the skin even though salicylic acid is considered the gold standard treatment for Verruca Pedis in Australia. Due to such conditions, salicylic acid may be less effective in Singapore. Therefore, for wart treatments, salicylic acid is often avoided and instead, warts are treated with combinations of cryotherapy, silver nitrate and more up to date medications to improve the efficacy of VP treatment in Singapore.
Through my 4 weeks of internship, every week there is a day dedicated to train the podiatrists. Every Wednesday, all podiatrists come together for a mini-conference, everyone presents their cases or talks about a topic of interest as well as to train in practical techniques such as soft casting for diabetics, shockwave therapy, as well as diagnostic ultrasound reading. In my opinion, this is a very good opportunity for the podiatrist to learn and practice certain techniques that have become quite rusty for them and also to observe other podiatrists’ techniques and learn from each other.
During the course of my internship, I was also asked to present several case presentations to fellow podiatrists and senior podiatrists. This was a very good opportunity for me to learn and explore the current literature on the topic and discuss the case with other podiatrists on different diagnoses and treatment approaches. This also helps me in the long term when I get back to university to prepare myself for more case presentations.
Furthermore, in those training sessions, I was exposed to shockwave therapy and diagnostic ultrasound to gain hands-on practical experience. Back in Australia, it is very hard to get such opportunity to use shockwave and diagnostic ultrasound so these training sessions have been very beneficial to me. I was also tutored by senior podiatrists from different countries and gained a lot of knowledge.
Lastly, through my 4 weeks of internship at East Coast Podiatry, I was given the opportunity to assess and treat pro-bono patients with different foot conditions ranging from corns and callus to fungal infections and foot pain under the supervision of seniors. Especially with scalpel techniques, where I was exposed to another form of scalpel technique which I was not familiar with in Australia.
These 4 weeks of internship at ECP has been a fantastic experience for me to learn new treatment modalities and observe the success and the fast cure rate it has on many patients. It is also great to be together with a podiatrist team that came from different backgrounds, different countries of study, to observe each of their unique way of approaching different situations.
‘observing and assisting Senior Podiatrists at The Singapore Diabetic Foot Centre, a high risk diabetic foot unit of East Coast Podiatry’
I was also very lucky to spectate patient care and treatment at the Singapore Diabetic Foot Centre, a new specialised clinical service unit by East Coast Podiatry for diabetic foot conditions. The equipment and the quality of care provided are extraordinary. From consultation to taking an assessment, and from assessment to treatment, a high level of professionalism is maintained throughout. Patient history was taken very thoroughly. This has made me reflect on my own communication skills and in hope to improve in the future.
Moreover, in the procedure room for the scalpel debridement and dressing application, all procedures were completed in sterile conditions from surgical lights with a built-in HD camera to zoom in and record the wound care process. This is really an eye-opening scene to observe that high-risk care is taken so seriously here in ECP that is rare in other clinics I’ve been to.
‘East Coast Podiatrists with placement students Grace Wan of UWA on far left and Jason Chu of QUT on far right’
Overall, this is truly a one-of-a-kind experience for me. The way this clinic operates is very unique and established as a premium quality healthcare. Initially I did not have such an overly high expectation as I thought this would be very similar to the private practice in Australia; However, after this 1 month internship, it really did exceed my expectations of private practice, and I believe this world standard is uniquely only East Coast Podiatry in Singapore.
4th year Podiatry student at Queensland University of Technology
15 January 2018