AODA Country Information— Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

National dietetic association address, contact name for credentialing verification

Singapore Nutrition and Dietetics Association (SNDA) http://www.snda.org.sg For Inquiries: [email protected]

Mailing Address: Singapore Nutrition & Dietetics Association c/o Nutrition & Dietetics Department Khoo Teck Puat Hospital 90 Yishun Central Singapore 768828

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Training of national dietitians, professional role and regard There are currently no academic and professional courses for the training of dietitians in Singapore. All practicing dietitians were trained overseas, mainly in the United Kingdom, Australia, New Zealand, Canada, United States and . However, there are food and nutrition-related degree and diploma programmes in Singapore. These programmes have created more opportunities for dietitians who wish to consider teaching in the academia.

 The Singapore – Newcastle University UK offers a 2-year Honours degree programme in Bachelor of Science with Honours in Food & Human Nutrition (http://www.singaporetech.edu.sg/food-and-human-nutrition/bachelor-of-science-with-honours- in-food-human-nutrition-2).

 The Culinary Institute of America – Singapore offers a culinary-related degree program in Bachelor of Professional Studies (BPS) in Culinary Arts Management (http://www2.ciachef.edu/singapore/program.html).

 The offers a 3-year diploma course in Applied Food Science and Nutrition and in , a diploma in Food Science and Nutrition (http://www- as.tp.edu.sg/asc_home/asc_courses/asc_ft_courses/asc_courses_afsn.htm, http://www.nyp.edu.sg/scl/courses/diploma-in-food-science-n-nutrition).

 A Polytechnic is similar to community colleges in the USA. Students wishing to become a Registered Dietitian could use this degree as a bridge for obtaining admission into a foreign university offering a dietetics and internship program, eg, for obtaining admission into Australian universities where students complete of their 4th year of education and dietetic internship.

 There are also health and wellness-related programmes, for example, the Specialist Diploma in Health Promotion by the Nanyang Polytechnic School of Health Sciences, Diploma in Sports & Exercise Science, Diploma in Health Management and Promotion by the Republic Polytechnic School of Sports, Health and Leisure and Diploma in Nutrition, Health & Wellness by the . Correspondence studies /long distance courses on nutrition & dietetics are popular, but most are for short duration and/or are not accredited.

Page 1 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

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Brief description of national healthcare system and private practice In Singapore, there is a dual system of healthcare delivery. The public system is managed by the Government, while the private system is provided by the private hospitals and general practitioners. The healthcare delivery system comprises primary health care provision at private medical practitioners' clinics and outpatient polyclinics, as well as secondary and tertiary specialist care in the private and public hospitals.

The practitioners from some 2000 private medical clinics provide 80% of the primary healthcare services while the 18 government polyclinics provide the remaining 20%. For the more costly hospital care, it is the reverse situation with 80% of the hospital care being provided by the public sector and the remaining 20% by the private sector. The 9 public hospitals comprise 7 general hospitals (Singapore General Hospital, National University Hospital, Changi General Hospital, Tan Tock Seng Hospital, Alexandra Hospital, Ng Teng Fong General Hospital (under construction), Khoo Teck Puat Hospital), the KK Women's and Children's Hospital and a psychiatry hospital (Institute of Mental Health).

The philosophy of healthcare here emphasizes the building of a healthy population by the promotion of healthy living and through preventive healthcare programmes. Singaporeans are encouraged to adopt a healthy lifestye and be actively responsible for their own health. Patients are also expected to co-pay part of their medical expenses and to pay more when they demand a higher level of service. However, the Government also ensures that good and affordable basic medical services are made available to all Singaporeans by providing heavily subsidized medical services at the public hospitals and government clinics. Information of hospital bill size is available for public access. To help Singaporeans to pay for their medical expenses, the Government has put in place a financing framework, which consists of Medisave, Medishield, Eldershield and Medifund. Healthcare and health-related services are under the purview of the following ministries: Ministry of Health (MOH) is responsible for providing preventive, curative and rehabilitative health services in Singapore. MOH formulates national health policies, co-ordinates the development and planning of the private and public health sectors, as well as regulates health standards. For more information about the healthcare system in Singapore, visit website www.moh.gov.sg Agri-Food & Veterinary Authority of Singapore (AVA) Its mission is to ensure a resilient supply of safe food, to safeguard the health of animals and plants and facilitate agri-trade for the well-being of Singapore. It is also the national authority on food safety for both primary and processed food. For more information, visit website www.ava.gov.sg.

Ministry of the Environment and Water Resources (MEWR) Its mission is to deliver and sustain a clean and healthy environment and water resources for all in Singapore. The National Environment Agency (NEA), a statutory board formed under MEWR is responsible for environmental protection and public health services such as sewage, drainage and waste disposal systems, control of air and water pollution and of toxic chemicals and poisons, the control of outbreak of infectious diseases, vector or insect control and the safety of the food prepared and sold in Singapore. For more information, visit websites www.mewr.gov.sg and www.nea.gov.sg.

Page 2 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

Ministry of Manpower (MOM) is responsible for the industrial and occupational health of the workers. Together with the Ministry of Community Development, Youth and Sport, they also promote work life effectiveness and work life harmony in the workplaces. For more information, visit website www.mom.gov.sg & www.mcys.gov.sg.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employment opportunities profile Dietitians in Singapore work in hospitals, polyclinics, government and community agencies, food industry, food service establishments, educational institutions, and in private practice. Examples of employment opportunities for dietitians are the Health Promotion Board; Singapore Airport Terminal Services (SATS); Temasek Polytechnic; Singapore Polytechnic, Republic Polytechnic, , the Singapore Institute of Technology, food & catering companies, public & private hospitals and government polyclinics in Singapore. Research opportunities are available through A*STAR and the National University of Singapore.

Some job openings come as emails from the SNDA secretary to SNDA members, as employers sometimes send job recruitment advertisements to SNDA. Many dietitians and nutritionists in Singapore are SNDA members; so attending their meetings is a good way to start networking.

A dietitian seeking employment in Singapore needs to be mindful of this country’s unique ethnic composition. Although English is commonplace, each ethnic group has its own language, religion, food customs and beliefs. The total population is about 5.18 millions, with a resident population of 3.78 millions in 2011. In 2011, the population is comprised of about 74.1% Chinese, 13.4% Malay, 9.2% Indian and 3.3% other ethnic group. Like many developed countries, Singapore faces key challenges such as low fertility rate and ageing population. In 2011, 9.3% of the population is above 65 years of age.

Singapore’s modern healthcare system and progressive government influence provide expanding prospects for dietitians seeking employment there. With a proven track record of adopting good ideas from outside its borders and a forward thinking society, Singapore provides an appealing opportunity for dietitians to make a difference.

The future likely holds more job opportunities for dietitians in Singapore. The Ministry of Health is concerned about future challenges including a shortage of dietitians and nutritionists, and has acted to improve the situation. Other concerns and challenges facing Singapore will also help generate job opportunities for dietitians in the future, such as:

. The-increasing cost of providing healthcare as a result of advances in medical knowledge and technology, leading to increased specialization and sub-specialization. . The rising expectations and demand for better and more sophisticated health services by an increasingly well-informed and more affluent public. . The rapid ageing of the population where the proportion of those 65 years and above is estimated to increase from 8.7% in 2008 to 19% in year 2030. By then, one in five residents will be a senior.

Most doctors are aware of the benefits of nutrition therapy. Certain specialties such as cardiology, endocrinology, gastroenterology, neurology, geriatrics, cancer, renal, GI surgery and critical care will utilize the services more than others, mainly because patients seen by these specialists tend to be at

Page 3 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

higher risk. Doctors in hospitals and polyclinics typically will make a referral to a dietitian when necessary. Those in private practice may not do so as often. Unfortunately, there are no national statistics on doctor awareness or utilization of nutrition therapy.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ How to obtain work permit (also known as “Employment Pass”) Singapore boasts an open immigration policy and fast-processing employment pass system. Singapore’s Ministry of Manpower has a very extensive website outlining everything needed to obtain an Employment Pass. For more information, visit website http://www.mom.gov.sg.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Educational Opportunities (reciprocity, acceptance of credential) There are no opportunities in Singapore to obtain further education in nutrition. There are however, many opportunities for dietitians wishing to pursue other degrees (e.g. MBA, MPH, food science, healthcare management, diploma in other field, etc).

At present, there are no policies governing the practice of nutritionists and dietitians in Singapore. SNDA is in contact with the Ministry of Health to develop a common framework for statutory registration of all allied health professionals including physiotherapist, occupational therapist, speech therapist, etc in Singapore. Statutory registration of dietitians in Singapore will be expected in the next few years. For more information, visit the Allied Health Profession Councils website.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Internship Opportunities for Dietetic Students The National Healthcare Group of hospitals have signed an agreement with Flinders University in Australia to provide up to 6 clinical placements (10-12 wks), food and catering (about 6 wks) and independent studies (8-10 weeks- thereabout) every year for Singaporean dietetic students only.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Local Food Customs and Culture Food is a hot topic in Singapore. Typical Singapore food is a blend of many elements brought by the different ethnic groups who have settled here. There are three dominant cultures in Singapore: Chinese, Malay, and Indian each having their own distinct customs, foods and eating styles (hands, chopsticks or a fork and spoon). The intermingling of theses cultures has produced new cuisines distinct to Singapore. There are many hybrid dishes to be found in hawker stalls at the local food centers or in fine restraints where the ever-popular “Fusion” dinners blend Western and Asian influences to create new and exciting flavors.

Singapore imports most of its food. The only type of farm you’ll find here is the indoor hydroponics variety. Being only 1 degree North of the equator, Singapore enjoys seasonal foods from both hemispheres. You’ll find that money can buy you just about any kind of food you’re looking for in Singapore. Singapore’s central location makes it a melting pot of cultures and cuisines.

Chinese Chinese food is the most prominent cuisine in Singapore. Food from every region in China is found here. There is elegant Shanghainese and Beijing cooking, spicy Sichuan and Hunanese food, Southern Cantonese cuisine, homely Hokkien food and seafood-based Teochew dishes.

Page 4 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

You can find Cantonese Dim Sum, (yellow wheat noodles), and Teochew fishballs (contain pork) in every corner of Singapore. The melding of cultures and cuisines in Singapore began when Chinese men married Malay girls to form the first of the Straits or Peranakan Chinese culture. They developed a cuisine combining the Chinese affection for pork (prohibited by Muslim Malays) and Malay ingredients such as coconut milk, fragrant roots and herbs, chillies and dried spices.

Malay Straits Chinese cuisine is Chinese food with strong Malay overtones. Yet, Malay food has incorporated Chinese ingredients such as noodles, bean sprouts, bean curd and soy sauce to produce Singaporean Malay dishes such as Mee (yellow noodles with chicken in a spicy broth) and Tauhu Goreng (deep fried bean curd with spicy sauce). Malay Belacan, a spicy condiment of dried and chilies, is so well accepted that it is found on most tables in Singapore.

Typical is a blend of Indonesian and Thai foods. Distinctive Malay ingredients include: galangal, ginger, fresh turmeric, shallots, garlic, fresh and dried chilies, lemongrass, dried shrimp paste (belacan), and coconut milk. Malay curries are different from those found in Indian cuisine. Malay is quite popular in Singapore. Chinese versions of satay are Satay Celup, Nonya Pork Satay, and Satay Bee Hoon.

Many restaurants in Singapore are boast halal cuisine meaning they conform to Muslim dietary laws by serving no pork or pork derivatives.

Indian Most of the Indians living in Singapore are from Southern India. Distinctive Southern Indian ingredients include coriander, cardamom, cumin, fennel, cloves, dried beans and lentils. Southern Indians eat a rice-based diet and liquid curries rich in coconut milk. Roti prata (a fluffy bread rich in ghee) and thosai (tangy pancakes) are popular dietary mainstays.

Fish-head curry is a favorite Singapore-Indian dish. Another local favorite is the Singapore-Indian (fried wheat noodles with chilies, potato, bean sprouts and curry sauce). Another hybrid dish is Indian : tempeh goreng from Java and Chinese fried tauhu and fishcakes served with boiled potatoes, hard-boiled eggs in batter and fritters all dipped in either a sweet starchy sauce or chili sauce.

Mutton has Chinese accents such as copious amounts of cilantro and spices. Popular dishes among the Muslim Indians are , stuffed fried pancakes, and Briyani, fragrant saffron-colored rice with onions, spices, raisins, and nuts cooked with mutton or chicken.

Indians do not eat beef because of religious restrictions imposed by Hinduism. Indian Muslims do not eat pork.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Continuing Education opportunities The Singapore Nutrition and Dietetics Association advocates Continuing Education (CE) and organises CE meetings regularly. These CE sessions are free of charge to members; non-members are required to pay for a nominal fee by per session basis. The SNDA’s Continuing Education Scheme is a voluntary

Page 5 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

program that gives recognition to dietitians and nutritionists who actively seek professional development. Through the scheme, SNDA full members can qualify for the Certificate of Continuing Education (CCED), which is awarded by the Singapore Nutrition and Dietetics Association (SNDA). Members who are awarded the CCED will be entitled to use the designations Accredited Dietitian of Singapore (ADS) or Accredited Nutritionist of Singapore (ANS), respectively. The list of ADS and ANS is updated every year. Visit the SNDA website http://www.snda.org.sg for more details on the accreditation information and continuing education (CE) events.

For US Registered RDs and DTRs, the following are examples of CEU opportunities:  ADA (website; JADA; CE articles by DPGs)  Local and international conferences  Self-study courses  Local seminars organized by SNDA

AODA volunteer opportunities Opportunities to assist AODA with your time are probably endless. Learn as much as you can about the AODA and where your skills and interest would be of most benefit both to you and to the AODA. For example, you could:  Be a member on the AODA board; Assist in organizing conferences; Submit articles to the AODA newsletter!  Become a Country Representative for a country that you know a lot about and that is not represented in order to help to educate others about what your country is really like related to nutrition and health.

Singapore has a National Volunteer and Philantrophy Centre (www.nvpc.org.sg). The Centre’s web site features Volunteer eMatch, which is a volunteer-referral service for both volunteers and volunteer host organizations. The website is very helpful in locating an opportunity on the volunteer’s location, interests and time restraints. At times, some voluntary organizations may request for assistance (on food & nutrition related matters) from the SNDA, who will then channel the information to its members.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Websites of Interest Health Promotion Board (www.hpb.gov.sg) Information on nutrition programmes such as Health Eating in School and Childcare Centres, Nutrition Labelling and Healthier Choice Symbol Programme, Restaurant and Hawker’s Programme, Healthier Catering, health programmes such as Workplace Health Promotion, Youth Health Promotion are available at this site. You can also do “Food Info Search” on nutrient & energy values of more than 6,000 foods commonly eaten in Singapore, analyse recipes and your diet. Information on the National Nutrition Survey and Health Survey are available.

Asian Food Information Centre (AFIC) (www.afic.org) A site providing science-based information on health, nutrition and food safety, primarily to educators, health professionals, scientists and the media.

International Life Science Institute, Southeast Asia (http://southeastasia.ilsi.org/about/index.cfm?pubentityid=24) ILSI is a global network of scientists devoted to enhancing scientific basis for public health decision-making. This site provides information on scientific research, programmes and events undertaken by ILSI.

Page 6 of 6 AODA Country Information—Singapore Updated by Natalie Goh, Country Representative for Singapore June 2012 (For more information, contact [email protected])

Allied Health Profession Councils (http://www.healthprofessionals.gov.sg/content/hprof/ahpc/en.html). Established by the Allied Health Professions Act 2011 to regulate the allied health professions in Singapore.

Health Professionals Portal A one-stop portal for the healthcare professionals to access multiple secure e-services and information using a common password entry and interface. http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/allhealthcareprofessionals.html). e-Citizen (http://he.ecitizen.gov.sg/). A gateway to all information about Singapore government services including health and environment resources, employment pass, and setting up of businesses.

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