Graduate Education

The Duke-NUS Graduate Medical School Singapore offers an innovative and rigorous four-year graduate-entry medical education programme with a distinctive focus on medical education, research and patient care. Duke-NUS offers the world-renowned Duke University School of Medicine’s 4-year doctor of Medicine (M.D.) curriculum, with a full year devoted to independent research. The programme provides students with early clinical exposure, world-class research opportunities, and the flexibility to tailor their educational experiences. It is the optimal springboard to becoming an outstanding clinician and academic physician in the biomedical industry.

3.1        Degrees Offered

Joint Doctor of Medicine (M.D.) degree from Duke University and the National University of Singapore.
Students receive one diploma (degree scroll) signed and sealed by both universities.

3.2        Degree Requirements

Candidates for the Duke-NUS M.D. or M.D./ Ph.D. programmes must apply to and be admitted directly by Duke-NUS. At selected times during their 1st, 2nd or 3rd year, admitted M.D. students also will be given the opportunity to apply to the Duke-NUS M.D./Ph.D. programme.

While dates are subject to change, the application deadline for the Duke-NUS M.D. programme is 1 December annually. Academically outstanding candidates are encouraged to apply for Early Acceptance by submitting all their required admission documents, including their MCAT scores, by 1 September. All applications are reviewed on a rolling basis.

Academic Requirements for the M.D. and Ph.D. programme

Candidates must submit official transcripts of the following:

• Attainment of at least a Bachelor’s degree before the start of the academic year for which you are applying.  Applicants who are completing their degrees may apply during their final year of study. Candidates with higher post-graduate qualifications such as M.Sc., Ph.D. are strongly encouraged to apply.
• MCAT results (Medical College Admission Test)
• Results of TOEFL or IELTS only if English was not the language of instruction during undergraduate studies.

Other Requirements for the M.D. and M.D./Ph.D. programme

• Completion and submission of the online application, all the above required documents, and test results before the application deadline for the year.
• Submission of three to five recommendation letters from mentors who can testify to the varied exemplary conduct and performance of the candidate (All letters received by Duke-NUS will be kept confidential).
• Attend two or more interviews and complete the on-the-spot essay during the interview process, if short-listed.
• Proof that health requirements are met, including negative Hepatitis B surface antigen and positive Hepatitis B immunity. Applicants are strongly encouraged to be screened for Hepatitis B virus to determine their immunity status before applying to Duke-NUS. The current policy from the Singapore Ministry of Health does not allow Hepatitis B carriers (as shown by a positive Hepatitis Surface Antigen) to enter medical school. Candidates selected for admission are required to submit a HBV status report to verify that they meet the HBV requirements before they can register as Duke-NUS students.

Other Requirements for the M.D./Ph.D. Programme

• Applicants to the Duke-NUS M.D./Ph.D. programme may apply directly to the programme or apply once enrolled in the M.D. programme.
• An enrolled M.D. student applying to the M.D/Ph.D. programme will need to complete a short application for review by the Ph.D. Admissions Committee during their 1st, 2nd or 3rd year of the M.D. programme.
• Candidates will also sign a waiver allowing the Ph.D. committee to review their initial M.D. application, grades and any other documents from their academic record.

Service Agreement

According to the Singapore Ministry of Health (MoH) guidelines, all medical students training in Singapore are required to serve a service agreement with the MoH upon successful completion of the M.D. course. They are also required to serve the first year (internship) of their residencies for registration in Singapore.

For students graduating from Duke-NUS, the service agreement period is as follows:

• Four years for Singapore Citizens
• Five years for Singapore Permanent Residents and International students  

Candidature

The normal candidature period for the degree of Doctor of Medicine is 4 years and the maximum candidature period is 7 years.

An M.D. student accepted into the Duke-NUS M.D/Ph.D. programme will start in the Doctor of Medicine programme and complete the first 2 years of the curriculum.  In lieu of the 3rd year, the student will begin the Ph.D. component of the programme, and will continue to complete the Ph.D. in 4 years.  The student will then return to the M.D. programme to complete the 4th year and graduate at the end of that year with M.D. and Ph.D. degrees. 

3.3        LEAD Curriculum

The core values of the Duke-NUS programme are reflected by the LEAD Curriculum. LEAD stands for Learners who are Engaged in their team and individual learning; Advocates for their patients, society and own education; and Developing critical and creative thinking skills. To achieve these we emphasize an active, team-based learning environment that we call TeamLEAD — Learn, Engage, Apply and Develop. Our first year curriculum in particular uses this TeamLEAD strategy to deliver core materials. Students spend their first-year in the same group studying and working on assignments, learning the key aspects of teamwork, communication, feedback, and working together effectively. Core basic science content is accessed and learned independently through recorded lectures from Duke University in Durham, North Carolina, USA, readings (articles, book chapters, websites), and teamwork activities. Clarification, enhancement and application of this content are achieved through active engagement of students and Duke-NUS faculty through TeamLEAD and practicums (hands-on lab work).

The Foundations Course: The first two-and-a-half weeks of the first year are dedicated to the Foundations Course, during which the first year students are introduced to the core values, principles and foundations of Duke-NUS. Workshops and presentations during the Foundations Course cover topics such as teamwork, leadership, ethics and professionalism,doctor-patient relationship, medical research and patient care.

At the end of the Foundations Course, the White Coat Ceremony is held to mark the transition of the students into the profession of medicine, and the beginning of their journey to become future physician-scientists.

First Year: Basic Sciences and Clinical Skills

Duke-NUS students concentrate on the basic sciences in their first year, covering four interdisciplinary basic science courses. 

The four courses include:

• Molecules and Cells (integration of Biochemistry, Genetics and Cell Biology)
• Normal Body (integration of Gross Anatomy, Micro-anatomy and Physiology)
• Brain and Behaviour  (integration of Neurobiology, Neuro Anatomy and Human Behaviour)
• Body and Disease (integration of Microbiology, Immunology, Pathology and Pharmacology)

Each course is conducted by teams of expert clinicians from respective medical fields in Singapore and basic scientists working at Duke-NUS.  This gives the students an opportunity to gain first hand, up-to-date information. In addition, faculty members from Duke University visit Duke-NUS to conduct some of the courses, sharing their knowledge and research experiences.

Students also attend two longitudinal courses which are core components in the first year.

• Practice Course 1
• Investigative Methods & Tools

Practice Course 1 is a half-day session conducted weekly throughout the first year. In this course, students learn and practice their communications skills and physical examination techniques. These include history taking, interviewing patients, and conducting physical exams at the Clinical Performance Centre. The centre has a simulated clinical environment that involves standardised patients and simulation devices.

A key component of the Practice Course 1 is the “Standardized Patient Program” conducted at the Clinical Performance Centre. Standardised Patients (SPs) are individuals who are carefully trained to portray patient roles. The similarity of these portrayals to real patient situations allows the students to conduct an actual clinic consultation. These simulated doctor-patient encounters are closely monitored under the guidance of Duke-NUS faculty members and are recorded/ video-taped for the purpose of learning and assessment. During the initial months, students learn how to take patient histories, conduct a physical exam, and establish good doctor-patient relationships, among other clinical skills.

The Practice course 1 dovetails with the first-year basic science curriculum, giving students a holistic view of their studies, and helping them translate knowledge learned in the classroom into real life situations.

Investigative Methods & Tools is conducted on a monthly basis where students begin to understand the basic principles of research and data management, review journal articles as a means of being critical readers, and begin learning how journals can be tools in the practice of medicine, through evidence based medicine.

Second Year: Clinical Rotations and Professionalism

Duke-NUS students begin their clinical rotations full-time during their second year, a year earlier than their peers in other typical US based medical schools. Essential basic science components they learnt during the first year, and their clinical skills from the Practice Course become valuable when seeing patients from hospitals such as Singapore General Hospital, National Neuroscience Institute, KK Women’s and Children’s Hospital and the Institute of Mental Health.  

The year, which begins with an orientation, focuses on a series of core clerkship rotations designed to develop students’ clinical problem-solving skills and their ability to appropriately use resources to diagnose and treat patients. The duration of each rotation is eight weeks and each week is preceded by a one-week Clinical Core.

Core rotations include:

• Medicine
• Surgery
• Paediatrics
• Obstetrics and Gynaecology
• Neurology & Psychiatry

Upon completion of clerkships, students can explore subspecialties that were not covered during clerkships by taking Electives during a period of four weeks.

There is one week of orientation to the clinical year, four clinical cores and one research core during the second year. Students return to discuss more integrative topics such as Patient Safety, Radiology, Geriatrics/Palliative Care, Critical Care Medicine and Alternative  Medicine, to name a few. Also, approximately three times per month, students also return for Practice Course 2. This course is devoted to the themes of professionalism, ethics, Singapore healthcare system, legal system and health law, end of life issues, and advanced clinical skills and communication dealing with difficult patient encounters. At the end of Practice Course 2, students are also expected to submit a paper, which may be published, regarding the ethical and professional issues and topics of their interest.

Third Year: Independent Research and Scholarship

Duke-NUS’ unique third year provides students an unparalleled opportunity to study an area of particular interest in depth. Third year students gain scholarly experience in using their critical thinking skills and creativity to develop a research project, in a programme designed to prepare students for leadership roles in medical care and research - resources such as Medical Statistics Seminars are made available for students to attend to make sense of the numbers in the Medical literature they encounter in the course of their research.

They also further explore their interests in shaping up their long term career goals in medicine. At the end of their third year, students are expected to submit a thesis and give a formal presentation of their research.  

Third-year students are also expected to complete their Family Medicine Clerkship, unless precluded by their scholarly experience requirements. The Family Medicine Clerkship is made up of three modules. The Knowledge Foundation Module serves as a foundation for the students. After two-weeks of the Knowledge Foundation Module, our students are given the opportunity to have their clinical experiences in the community and at the patients’ home via the Continuity Clinic Module and Patient-Centred Care Module. If not met during the third year, students must complete the Family Medicine Clerkship in their fourth year.

Fourth Year: Advanced Clinical Skills and Career Planning

The fourth year at Duke-NUS enhances students’ preparation for their internships and residencies through clinical rotations.

All final year Duke-NUS students are required to complete a rigorous year composed of 5 core rotations and electives of their choice. The 5 mandatory rotations include a Medicine Sub-Internship, a Surgery Sub-Internship, a Musculoskeletal Core Rotation, a Critical Care Core Rotation and an Emergency Medicine Core Rotation. In addition, students are to complete Practice Course 4, and Capstone Course.  
Students must also complete their Family Medicine Clerkship, if it has not been completed in the third year.

Grading

Duke-NUS adopts the grading scheme of the Duke University School of Medicine, as follows:

• Pass/ Fail
• Pass/ Honours/ Fail
• Pass/ High Pass/ Honours/ Fail

Certification by the faculty shall constitute grounds for Pass (P); High Pass (HP) and/or Honours (H).

Pass is given to those students who have achieved a high level of competency and we feel are prepared to move to the next phase of becoming a quality clinician.

Honours are reserved for students who have achieved the criteria, representing outstanding performance, set by the faculty. 

Incomplete (I) grades are reserved for students who have not met the course requirements due to illness, other extenuating circumstances, or inability to attain sufficient understanding of course materials without additional study. Incompletes which are not satisfied within the timeframe specified by the Student Promotions Committee shall automatically become grades of Fail (F). 

Grades of Fail (F) cannot be erased from the permanent record.

3.4        Financial Assistance and Awards

To ensure that financial difficulties or economic circumstances do not hinder students from applying to Duke-NUS, we provide financial aid to our students in the form of merit scholarships, need-based scholarships (bursaries) and loans. 

Merit scholarships are generally awarded based on academic achievement. Besides academic excellence, involvement in co-curricular activities and community service are sometimes considered in the award of certain scholarships. Students need not apply for merit scholarships and are automatically considered by the school prior to admission. The school will notify students who are successful in securing a scholarship.

Need-based scholarships (bursaries) are awarded  based solely on financial need. Students have to apply for need-based scholarships each year and submit financial documents as required in the application process. The Scholarships Selection Committee (SSC) will decide on the amount to award each needy student.

Certain merit scholarships may have a service bond requirement. There is no service obligation or bond attached to bursary awards. Prior to formal acceptance, students will be provided with the terms and conditions of each scholarship or bursary they are awarded.  

Loans are available for the purchase of laptops and to finance tuition fees. The Tuition Fee Loan (TFL), available to all students, covers up to 90 percent of tuition fees payable by Singapore Citizens. Details on the TFL are available at the NUS Registrar’s Office website at
http://admissions.nus.edu.sg/financial-loans-tutionfee.html
Students admitted to the Duke-NUS M.D. / Ph.D. programme will be offered a full scholarship for the Ph.D. component of the programme. This includes tuition fees and a stipend to help with living expenses. If the student completes his/ her Ph.D. at Duke-NUS, the programme will also pay for the final year of M.D. tuition fees upon successful completion of the Ph.D. component. Full details on this scholarship will be provided to accepted applicants.

Application for Financial Aid

Students who are in need of financial assistance may submit an online application for financial aid by the stipulated deadline.

External Financial Aid

Duke-NUS considers financial aid received by students from external sources when making financial aid awards. It is the responsibility of students to promptly keep Duke-NUS Financial Aid office informed of any external financial aid they may be receiving, or of any changes they may have in their financial situation. The School reserves the right to reconsider its offer of financial assistance in the event of an external award to a recipient.