Carrying on the Legacy

“In the end, working in Trauma turned out to be very meaningful because I got to help many poor and underprivileged patients – many of whom work in industrial plants and factories where serious accidents can happen.”

In addition to his clinical work as a senior consultant at the Singapore General Hospital’s Department of Orthopaedic Surgery, Prof Howe is also actively involved in research. Among his achievements include being one of the first few to discover and publish about the link between bisphosphonate use and atypical femur fractures.

Prof Howe explains: “Around the turn of the century, we began to see patients come in with thigh fractures and very little trauma. We just couldn’t figure it out. After some time, however, our team started to recognise a correlation between the medicine that patients were taking for osteoporosis and thigh fractures. Turns out that while the medicine was helping to make their bones harder, it was also making it more brittle.

Back then, we didn’t even call what we did research. It was really just us trying to find answers to our clinical problems.”

Even though Prof Howe continues to be actively involved in various research projects ranging from the use of robotics in biomechanical research to stem cell research, he shares that his focus over the past couple of years has started to shift more towards mentoring the next generation.

“Today, we are so much better off in terms of research facilities and funding. Research has really grown so big that now it’s beyond the expertise of just any one person or discipline. So, I feel that I can use my experience to help guide juniors along their research path."

Besides getting them to have a clear view of what is the problem that they are trying to solve, I’m also helping them to identify where their strengths lie. For example, someone good at physics might be well-suited to doing research on biomechanics, while someone good at stats can probably contribute more to epidemiology.”

Yet another way that Prof Howe is helping to shape the next generation is with his work as an educator at
Duke-NUS.

“I believe there are two things that make a great doctor. The first is technical proficiency. We’ve pretty much got this covered as the people that come into medicine and orthopaedics are already the cream of the crop.

The other part that we need to work on is to help our students develop the soft skills that will make them a more complete doctor. Beyond our physical body, we also have a soul. As our population continues to age, it is important that we train the next generation of surgeons to not just be technicians, but to have empathy for the elderly.”

In recognition of his contributions to academic medicine and research, and to support his ongoing endeavours to improve patient care, Prof Howe was awarded the Balachandran-Kajima Professorship in Academic Medicine in October 2022.

Prof Balachandran’s firm belief in transferring skills and knowledge to younger surgeons inspired me to do the same with my juniors. To quote him: ‘The next generation has to be better than us. If not, we’ve failed in our job.’