Psychiatry has a critical place in medical education, given the increasing prevalence of various mental disorders and their increasing comorbidity with various medical conditions. In Singapore, psychiatry is part of the undergraduate and postgraduate curriculum at all three medical schools – the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine (NUSMedicine), Nanyang Technological University’s Lee Kong Chian School of Medicine (LKCMedicine) and Duke-NUS Medical School. In this article, we will exemplify the unique characteristics of the psychiatry curriculum that is delivered at the undergraduate and postgraduate level.
The aim of psychiatry education in the medical training curriculum is to ensure that medical students are equipped with the necessary history taking, mental state examination and communication skills that they could deploy in their future practice to assess patients with suspected mental health pathologies.
LKCMedicine
Psychiatry in LKCMedicine is taught in Year 4. At this stage, students will have had 2 years of classroom-based teaching in pathophysiology and pharmacology, and a year of clinical rotations in specialties including internal medicine and surgery, which form a foundation for learning psychiatric concepts. The posting lasts for 5 weeks, consisting of a week of campus-based teaching, followed by 4 weeks of clinical rotations.
Campus-based teaching
For the campus-based teaching, students are given pre-session training materials and recommended reading. The lessons cover the basics of psychiatric history taking and mental state examination, with role-playing scenarios for students to practise the psychiatric assessment. The campus-based teaching also provides basic knowledge of a wide range of topics, including general psychiatry, child and adolescent psychiatry, psychogeriatrics and addiction medicine. Lessons adopt a team-based learning (TBL) pedagogy, as with other areas of medical teaching in LKCMedicine’s curriculum (Rajalingam Reference Rajalingam, Rotgans and Zary2018). The effectiveness of TBL has been widely studied, with the literature showing that it increases student engagement and improves learning outcomes such as test scores (Reimschisel Reference Reimschisel, Herring and Huang2017).
Clinical rotations
The second part of the posting involves clinical rotations. Students typically spend 2 weeks at the Institute of Mental Health (IMH), a large tertiary psychiatric institution that is currently the only hospital designated for the involuntary admission of mentally disordered persons under Singapore’s Mental Health (Care and Treatment) Act 2008 (MHCTA), as revised in 2020. They also spend 2 weeks in a general hospital offering with other medical services. This allows for students to be exposed to a wide range of patients, including those from consultation liaison psychiatry and others requiring the enactment of the MHCTA.
The clinical postings also involve tutorials given by clinical tutors and clerkships (clinical rotations) to learn the application of psychiatric knowledge in a clinical setting under supervision. Students also shadow allied health professionals to understand their respective roles in a multidisciplinary team.
Assessment
Students are required to complete mini clinical evaluation exercises (Mini-CEX) to consolidate their learning. Besides knowledge and clinical skills, there is a focus in the learning outcomes on learning the right attitudes, which involve delivering care with empathy and respecting ethical, religious and cultural sensitivities. At the end of the academic year, psychiatry is formally tested through multiple choice questions (MCQs) and observed structured clinical examination (OSCE) stations, as part of a summative examination testing the entire academic year’s content. Only with a pass in the exam are students able to progress.
NUSMedicine
The undergraduate psychiatry curriculum at NUSMedicine follows a similar teaching and assessment approach to that described above. The psychiatry module constitutes 6 weeks of the Year 4 medical curriculum, where students undergo didactic teaching and clerkship in hospital.
NUSMedicine has also recently incorporated the use of technology to teach psychiatry, where students are tasked to manage violent patients in a virtual reality (VR) program during their psychiatry rotation (Bharade Reference Bharade2022; Tay Reference Tay, Tong and Yap2025). Such immersive learning helps to improve confidence in handling agitated patients, improves mental health literacy and reduces stigma (Tay Reference Tay, Tong and Yap2025).
Duke-NUS Medical School
The structure of psychiatry education at Duke-NUS Medical School, a postgraduate medical school, is slightly different. The medical training programme is a 4-year programme, and students undertake a 4-week psychiatry clerkship in Phase II of their medical training (typically in Year 2). Similar to their undergraduate counterparts, Duke-NUS students would have completed pre-clinical modules in basic sciences and pathophysiology. The method of instruction also includes team-based learning.
Psychiatry clerkship
The psychiatry clerkship at Duke-NUS is made up of 2 weeks at IMH and another 2 weeks in a restructured hospital (a government hospital run as a private company), where they shadow clinicians and participate in direct patient care to gain skills in history taking, evaluation and management of patients with psychiatric disorders. Clinical rotations in different psychiatric settings serve to expose students to the breadth of mental health services in Singapore and their respective challenges.
What is unique for these postgraduate students compared with their undergraduate counterparts is that during their IMH posting, students are also attached to addiction groups on several evenings, giving them the opportunity to appreciate the role of self-help groups in the recovery process first hand. Students who are attached to Singapore General Hospital, the main training hospital of Duke-NUS, will also get unique exposure to Singapore’s only specialised eating disorders programme.
Classroom-based teaching
Classroom-based teaching is weaved into the clinical rotation, where students gather once a week to learn about topics such as psychiatric assessment, management of common psychiatric conditions and psychotherapies. This teaching serves to provide the necessary psychiatric knowledge and skills for a general medical practitioner, including screening for drug and alcohol addiction, recognising the addictive potential of certain prescription medications, and understanding the legal and ethical framework behind psychiatric care in Singapore. In addition, there is a focus on health promotion, where students are required to gain competencies in advising patients on sleep hygiene and progressive muscle relaxation techniques.
Assessment
Similar to their undergraduate counterparts, Duke-NUS students will have assessments, including mini-CEX and case-based discussions, during their postings.
Challenges
Despite the rigorous psychiatry curriculum in all three medical schools, good delivery of psychiatry education remains challenging. First, although there is a focus on not just acquisition of knowledge but also communication skills and attitudes, practically these are less tangible and are more difficult to consistently instil in all students. It is also impractical to expect that such attitudes and communication skills can be developed adequately in just a few weeks. Therefore, schools like LKCMedicine focus on early exposure to patient contact, with a ‘long-term patient project’ in pre-clinical years that involves following up a particular patient beyond the clinical encounters and helps students understand how culture affects illness behaviour. There is also use of simulated patients in both the undergraduate and postgraduate medical schools to improve clinical communication skills – a key part of medical education in general, but particularly important in psychiatry (Freeman Reference Freeman, Xin and Canning2021; Han Reference Han2024).
Second, there is often a competing demand for time and resources with other medical specialties, while psychiatry is a specialty with much breadth and depth. It is hence a tough undertaking for psychiatry educators (who typically are specialists in the field) to consider what is practically needed to function at the level of a general practitioner as opposed to a specialist.
Conclusion
Psychiatry education forms a small yet integral part of the medical curriculum in Singapore’s medical schools. There is an awareness that patients in all medical care settings can present with psychiatric complaints or have psychiatric comorbidities, and medical schools recognise the importance of educating their students in the basic approaches to psychiatric evaluation and implications of psychiatric comorbidities to medical care. Thus, while there are some differences in terms of the curriculum between the different medical schools, the core objective remains similar. The three medical schools also ensure that students are exposed to the two distinct settings where public psychiatric care is practised, whether in a psychiatric hospital where patients can be involuntarily admitted, or a general hospital where there is the interface between general medicine and psychiatry. The psychiatry clerkships in the respective medical schools all aim to provide the necessary psychiatric knowledge, skills and attitudes for students to fulfil their future roles as doctors.
Author contributions
M.W.Z. conceptualised the idea for this article. J.H. wrote the initial draft of the manuscript, which was further revised by M.W.Z.
Funding
This work received no specific grant from any funding agency, commercial or not-for-profit sectors.
Declaration of interest
None.
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