UPCM InSPIRE
The Official Magazine of the UP College of Medicine Community

Volume 32 Issue 2 (2022)
Christmas in Polaroid

By Joana Marie Cruz, UPCM Class 2024“Ho ho ho ho, Merry Christmas!” The most wonderful time of the year is here. All Christmas lights have been hung. All gifts have been wrapped. Christmas trees have been set up. And Christmas cheers are now the ones that wake us up. Christmas, without a doubt, is a season we all look forward to, filled with joy, hope, and love. A season for togetherness, sharing, and giving.The Christmas spirit can be seen and felt everywhere, even in places we least expect it - from corridors that seem dark and quiet, to the streets that are filled with cars, street lights and jeepneys, the houses that look so dull and boring, and even the hospitals where grief and hardship surround.Despite these difficult times, Christmas gives us hope, quite like magic. Gloomy places light up, which brings joy to the people as well. As a prelude to this year’s Christmas celebration, here are some daily reminders of how beautiful the Christmas season is.Celebrating a birthdaySimbang gabi is part of our Filipino Christmas culture where we attend a nine-day series of masses in anticipation of the birth of Jesus Christ. We express our gratitude and reflect on the year that has passed and pray for the new year that is coming. Wishing to the starsChristmas trees are symbols of an everlasting hope that people will continue giving and sharing. Each branch may hold gifts and decorations, with the highest one holding the star, reminding us that even at the darkest of times, giving and sharing is the one that will give us pure joy and happiness. Turning on the lights Christmas parols give us light and hope during the Christmas season. Wrapping it up with a ribbon The joy of preparing and receiving gifts for our monitos and monitas is what makes giving gifts during Christmas special. Singing a Merry Christmas “We wish you a Merry Christmas. We wish you a Merry Christmas. We wish you a Merry Christmas and A Happy New Year.” Christmas is when we feel most alive with people extending words of cheer, knocking door-to-door and singing the happiest songs of Christmas.From setting up our Christmas trees to singing Christmas carols, Christmas never fails to give light in the darkest places, to give hope to the ones that needed company, and to bring peace in times of chaos and suffering. Indeed, it is always a Merry Christmas!

Kindness in a World of Toxicity: Breaking the Fourth Wall

By: Charlene Divine Catral“What we remember in the great times of struggle or when overcoming adversity, aren’t the days that were hardest to get through but rather the people who were kindest, when we needed it most.”— Kirsten CorleyMost of us tend to keep ourselves busy each day, taking up more tasks along the way. Even after accomplishing one task, there is a tendency to take up more — regardless if the original pile of work did not significantly change. Having a long list of to-dos has become the norm. Instead of feeling a sense of relief when we try to take small breaks, anxiety looms deep within ourselves, making us wonder whether moments of respite could truly help us reach optimal productivity. These commitments are accompanied by daily adversaries — personal, financial, emotional problems and mere expectations as the breadwinner, or a child in the household. In reality, a short pause cannot always be found in the momentum of speeding through each day. That is, until it overwhelming overflows, leading to feelings of incompetence, loneliness, and depression — the result: a fruition of the idea that the world is against us. This culture is quite common in Asian environments, most especially in the Philippines, where success is measured by the amount of work one does; where poverty is coined as a result of laziness rather than that of systemic circumstances; and where failure is dubbed to be caused by one’s neglect.Unfortunately, many still fail to see that the world is already harsh enough. Cultural beliefs of “not doing enough”, “being lazy”, or even “failure defines you” rarely actually serve as encouragement; rather, these push one further away. Everyone faces their own demons and struggles to climb the top of their own mountains, so why is there a lack of empathy for those who are in search of their own happiness and self? A small act of kindness could go a long way, especially knowing that each of our demons do not just magically disappear at a specific time in the day or a particular moment of our lives. Challenges and struggles persist for they are partly what shape a person’s actualization. However, this does not mean we should be hindrances that contribute to the hardships of others. Instead we could provide the necessary support others need by being kind, lending a helping hand, or extending a listening ear. We need to be kind, even if the world is not kind to us.Smile, say “hello”. This can be to break the ice in the room or even as you pass by someone you know in the halls of Calderon. This small gesture may be the push one needs to move forward and take courage in facing what looms ahead. Studies have shown that different smiles display a variety of emotions that you are able to communicate through one simple gesture. A genuine smile, coined as the “Duchenne smile”, is formed through the movement of the zygomaticus major and orbicularis oculi muscles presenting positive emotion towards others and to one’s self (Jaffe, 2011). This suggests that expressing positive emotion through your smiles not only helps others feel a fleet of happiness, but you benefit as well as it stimulates positive feelings to flow within you.Give compliments and help those in need. Notice something you like about another person, or simply just want to make their day? Do not hesitate or second guess! Not only can this strengthen your bonds, but it also can build up their confidence and self-esteem. And do not underestimate the tangible form of help either. If you find someone literally carrying numerous things all at once, offer an extra hand. You never know just how much more intangible weight they are carrying at the same time.Swap ill feelings for compassion. Have you ever encountered someone who is having a bad day and seems to be very expressive about their current emotions? Yes, it is understandable to be irritated when on the receiving end of someone’s anger and aggression, but fire with fire is not the solution. Be as respectful and mindful as possible. Watch your own words, mind your tone and language, and try to understand where they are coming from. You can ask them if they need advice, someone to talk to, or if there is anything you could do to help. Should they have offended you in any way, you may gently explain it to them when they have already simmered and cooled down so that they will be more receptive, too.Always say “thank you”. Expressing one’s gratitude to another does not only help others feel good, but helps in validating their efforts—knowing that they are recognized so that at the end of the day, they could look back and think, “my effort was all worth it”. Saying thank you when someone goes out of their way to help you, even through the smallest of things could be a real game changer to many who are struggling and wondering of their worth in this world.These are only a few examples of how you can show kindness to others. The situation of another may be unbeknownst to us; there are realities in this world that are not kind. Although a lack of kindness exists at times, we can take on the responsibility to fill the gap. One need not share the entire burden of another; others only hope to attain a warm, sincere smile or even a simple “hello”. Resilience has its limits, too. What keeps people going through each day is not the material things, nor fame and glory. The little “why’s” are what motivate people everyday, how one’s purpose has grown from dreams to realities, or how friends and family ceaselessly support these aspirations. We must never forget to be kind even if the world is not kind to us; for only in kindness can people remain strong and move forward.

Health Beyond Measure is Man’s Greatest Treasure: On Promoting Joy in the Health Workplace

By: Karl Gerard R. Crisostomo, UPCM Class 2023The World Health Organization, in the year 1948, famously defined the concept of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Such a statement implies that health deals not only with the biological aspect of well-being, but also that of the psychosocial. While steps have been undertaken to better understand the unseen facets of health, these are not as well-documented and presented as biological conditions are.Invaluable to the healthcare scene are healthcare workers; they are human, too. Inasmuch as their pursuit is to provide holistic health to their patients, they are just as vulnerable to the loss of physical, mental and social well-being. Hence, further discussion and discourse must be initiated for us to determine ways to ensure better health for our healthcare workers. Beyond the physical needs, we must also ascertain their needs that are not seen, but rather felt. Conversation on this important issue was trailblazed by Prof. Nina T. Castillo-Carandang, MA, MSc, PhD through her talk, “Promoting Joy in the Health Workplace”.Prof. Carandang started her forum with a poll asking the attendees if they considered themselves a “joyful” person, defining such as a fulfilled person who is constantly growing and evolving into the best version of themselves. A majority (68%) of the attendees answered in the affirmative, a small portion (11%) were unsure, and the rest (21%) answered in the negative. Prof. Carandang then proceeded to ask the participants to remember their response as she continued with her talk.She noted that it had been 894 days since the start of the COVID-19 lockdown. Prof. Carandang made an active point to express her gratitude towards the frontline workers, both those in healthcare and those who constantly worked in economic and security sectors throughout the most difficult days of the pandemic. She also proceeded to offer her prayers to those who were sick and in need of blessing, as well as the souls who have passed on.Prof. Carandang then highlighted the fact that the Philippines was in the middle of the longest lockdown in the world. Most countries had already relaxed their respective measures at the time, whereas our country was still in the middle of stringent measures imposed by the government. But despite this difference, there remain experiences that are universal to the COVID-19 pandemic. Two primary emotions were felt throughout the course of the lockdowns: Hunger — not only for food — but also for clear policies and assistance through these trying times. Confusion, during the many policy changes enacted as COVID numbers fluctuated in response to new rules. Many opportunities were lost, from spending time outdoors with our families, interacting in a face-to-face environment, to saying goodbye to our loved ones who had gone ahead. These feelings are further exacerbated by various factors, such as undiagnosed diseases prevalent in the country, delay in treatment that led to poorer prognosis — all results of the lack of an adequate and timely response to this pandemic.She goes on to cite Nick Routley’s study titled “The Relationship Between Wealth & Happiness”, highlighting how the pursuit of happiness has long been a preoccupation of humankind. In our modern day, happiness is not only measured relative to our own life experiences, but also in relation to the people around us — not only in our immediate vicinity, but also cognizant of people around the world. Prof. Carandang then defines the way in which the World Happiness 2022 report, of which 146 countries participated, measures the concept of Happiness, focusing on three key indicators. The first is Life Assessments, which is measured through the use of the Cantril Ladder. This defines each country’s happiness as a function of six factors: per capita GDP, social assistance, healthy life expectancy at birth, freedom to make life decisions, generosity, as well as views of corruption. Next comes Positive Emotions, which were measured as the average of “yes” or “no” answers about emotions experienced in the previous day, these being laughter, enjoyment, as well as learning or doing something interesting. Lastly, Negative Emotions were measured similarly as the previous indicator, with the emotions highlighted being worry, sadness, and anger. With the results of the Happiness Report, it was reported that the Philippines ranked 60th among 146 countries, with an average life evaluation score of 5.904. Among Southeast Asians, the Philippines ranked 2nd among all Southeast Asian countries, trailing behind Singapore. A point highlighted by Prof. Carandang was how starkly different both of these countries achieved happiness: while Singaporeans mainly derive their happiness from their high GDP as a nation, Filipinos’ happiness is often rooted in high social support.While the aforementioned factors were key in ranking happiness, Prof. Carandang highlighted another point by Routley: that the factors that contribute to happiness, at their core, are as varied, specific, and subjective as the people in the world that they surely influence. However, some factors span the test of time, resonating with respondents from different years regardless of current events. These factors are Family, Love, Purpose, and Wealth. While the first three are subjectively felt, the fourth can be objectively measured. Upon exploring this concept further, Prof. Carandang noted that the data, while measurable, did not tell the whole story, as some middle-low income countries like the Philippines were noted to have a relatively high happiness index score, whereas high income countries had a relatively low happiness score. Prof. Carandang left the audience to ponder on this, as these differences were left unsaid in the study.Prof. Carandang then proceeded to posit the question: Why is JOY important in the health workplace? Joy surrounds one of the most important assets of healthcare, the PEOPLE, that are so vital in ensuring that adequate care is dispensed to those in need. Effective workforce policy, or the health service provides for the needs of its workers such as training, pay, and support, is of utmost relevance in designing an effective healthcare system. Upon asking the audience regarding the status of such an important factor in the Philippine healthcare system, she then highlighted how the workforce is often considered an afterthought, a footnote, as most healthcare systems focus on clinical, operational, as well as financial factors in designing and implementing their respective plans. Currently, the country prioritizes the utilization of both contractual and financial incentives as a means to encourage productivity, but is noted to lack staff engagement, a balance between the stress and morale of their healthcare workers. To combat this, it is crucial to work on the intrinsic personal and professional motivation of the staff to deliver effective and more sustainable change.An infographic presented by Prof. Carandang from the Women In Global Health emphasizes the call for a better workplace. This showed the need to end violence and harassment in the health and care sectors. There must be assurance that health workers, most especially women, are protected from workplace violence through the implementation of policies. Workplace violence is associated with lower staff retention; deterioration of not only physical, but also mental health of staff; increased healthcare costs; and a reduction in the quality of care provided. Enhancing the discussion, she also highlighted how, in a post-COVID healthcare setting, 5 key pillars were instrumental in improving the healthcare setting as it was: these were improving population health, enhancing the care experience, focusing on the well being of the care team, advancing health equity, and reducing costs. Aside from this, Prof. Carandang also cited a study by McGaffigan et al. (2020) highlighting how workforce safety is key to patient safety. A workforce that is physically and psychologically safe, joyful, and thriving can better provide adequate care to its patients.Prof. Carandang then cites Perlo et al. (2017) in defining joy in the workplace. Joy in this context is not merely the absence of burnout or individual wellness. Rather, as stated by Berwick (2017) in the report “The gifts of hope, confidence, and safety that health care should offer patients & families can only come from a workforce that feels HOPEFUL, CONFIDENT, & SAFE”, it is an essential resource for the enterprise of healing. The lack of this joy — burnout — is a threat towards achieving true happiness in the workplace. It is classified not as a medical condition, but as an occupational phenomenon brought about by chronic workplace stress that has not been successfully managed. Individuals experiencing burnout would often feel energy depletion and exhaustion, mental distance from one’s job and cynicism, as well as reduced professional efficacy.Prof. Carandang then provided a response unique to the context of our country, pulling inspiration from her own work on the concept of Kagalingan. Good Social Relations, Material Sufficiency, and Food Security are essential to a Filipino’s sense of well-being. The Institute for Healthcare Improvement also shared various points that would assist in creating a joyful workplace. The well-being of healthcare workers is at the forefront of this pursuit. The approach includes constantly checking on the staff and asking how they are doing, then identifying impediments to joy in the workplace, committing to a systems approach to ensuring joy is a shared responsibility, and testing approaches to improving joy in the respective organizations. For more concrete steps towards developing adequate mental health and well-being, Prof. Carandang suggested allowing a day off, facilitating opportunities for gratitude, reclaiming agency through reframing negative experiences as positive ones, limiting time on-site, designating clear roles and leadership, and making peer support services available to staff.Prof. Carandang then ended her discussion by bringing forth ideas from her own esteemed mother, Dr. Gelia Tagumpay Castillo. She shares a mindset that would help one to grow “Gracefully, not Grudgingly” as she put it, putting an emphasis towards having a purpose, reframing bad experiences, appreciating the counting blessings, sharing these, and overall, practicing a life that takes into consideration the needs and well being of others as well as oneself. While further steps are still needed for our healthcare workers to feel true joy, Prof. Carandang’s forum has provided us with a blueprint that gives us hope that Joy, as well as a deluge of other positive emotions, can be felt in the workplace, even in our most trying times.

POV: On-site Learning Across the Learning Units

By Nathaniel Bernard Macatangay, UPCM 2026Emerging from the desolate grip of the pandemic, the UP Manila campus is slowly regaining life with the return of students to on-campus learning.Beginning this Academic Year 2022–2023, all learning units in the UP College of Medicine are offered opportunities to hold in-person activities. Here's a glimpse on the experiences of the various learning units in their face-to-face classes.LU I and II: Education in the Basic SciencesConrad Raymond Arreola, Learning Unit I &David Dizon, Learning Unit IIMost of the subjects taken up by Learning Units I and II are of the basic sciences including Biology, Physics, Chemistry, Mathematics among others. They also have their Introduction to Patient Care (IPC) courses and other courses in Arts, History, and Physical Education.Conrad Raymond Arreola, a Learning Unit I student, is currently taking his Physical Education classes in Pilates at the Sports Science and Wellness Center (SSWC). He recounts that certain courses such as PE really benefit from having on-site classes.“For PE, nakikita talaga namin kung paano siya ginagawa unlike kapag online. Usually kasi, pinapanood lang kami ng videos online showcasing how to do the actions [in Pilates] Mas okay sana na dinedemo siya para if ever meron kaming immediate questions, or may mali pala sa ginagawa namin at least mapapansin ng prof agad-agad.”David Dizon, a Learning Unit II student, agrees with this view. “There are a lot of things the [face-to-face] classes have that makes it a more authentic learning environment. First of all, with the teacher and the students being there, it is often easier to foster interaction … as compared to an online setup wherein people are restricted by their internet,” he states. David is currently taking his PE in Social Dance at the SSWC as well.For both Conrad and David, some of their courses conduct face-to-face exams in the College of Arts and Sciences. For Bio 110: Integrated Principles of Biology, Conrad takes his exams in-person and admits he is a bit on the fence when it comes to face-to-face exams.“For the exams, I think it’s 50-50. You can’t really say na majority ng tao motivated kapag face-to-face. I think majority of us still prefer na online [exams] since hassle pumunta ng school for literally one exam. But overall okay naman ang experience namin,” Conrad explains.Aside from these subjects, the other courses being taken by the LU I and II students are being delivered online with some planning to implement more face-to-face classes and blended learning in the coming weeks.More than the classroom activities, there are many other things to look forward to with the return to in-campus life, as David weighs in.“Aside from the academic, the social aspect of [returning to campus], being able to meet with my classmates and my friends that I made in my first year feels nice… Overall, the shift from online to face-to-face is something that is a positive for me, and something I generally look forward to as it continues happening. It helps me form easier relationships with other people, at the same time, it helps me learn because of the authentic learning environment,” he comments.LU III: Beginning Med School in Hybrid Set-upsA lateral entrant perspectiveCyril Francis Wakit, Learning Unit IIIStudents of Learning Unit III are faced with the challenge of taking up essential foundation subjects. These include their first interdisciplinary courses, human health and wellness courses, and the anatomy and physiology subjects of the various organ systems.Cyril Francis Wakit, member of the Class of 2027, expresses his excitement in beginning his transition from finishing his undergraduate degree to studying in the UP College of Medicine. He is a graduate of BS Biology Major in Medical Biology from the University of Santo Tomas.As a lateral entrant beginning his medical education, he feels overwhelmed with doing multiple adjustments all at once. “I’m from UST. It’s been overwhelming… Aside from adjusting in terms of [changing] universities, there’s also the adjustment from college to med school. Puro adjustment talaga ang naramdaman ko… But also exciting since I get to be more flexible.”Along with the rest of Class 2027, Cy is taking up his courses mostly online. Lectures, small group discussions, laboratory simulations and the like are mostly delivered online, however, he has been able to participate in hybrid on-site small group discussions in their OS 204: Head and Neck Module.In their on-site sessions, he was also able to use the Anatomy Laboratory which houses cadavers, plastinated specimens, and other 3D anatomy models.“[Face-to-face sessions] really maximized the hands-on learning that we’ve been missing during the online set-up,” Cy comments. He adds that having in-person learning activities is more conducive to learning especially with the subjects that they are taking such as anatomy and physiology.“Mas conducive mag-aral sa school compared to when you’re studying at home where there are a lot of distractions. Your home kasi, syempre, is your resting place. Ang hirap mag-concentrate when you’re supposedly in your resting place but you have to study,” he explains.For Cy and the Class of 2027, in-person activities have been limited to a few students who are physically able to attend since many are still in their respective provinces and are confined to participate online. Weighing in further on having to go to on-site classes, Cy notes that he has to wake up earlier and sacrifice some personal conveniences to do so.“Unlike when you’re in an online setup, kung late ka nagising, you just open your laptop then nasa class ka na. Pero pag face-to-face, you really have to wake up early and prepare early in order to attend classes.”LU IV: Welcoming the Return of Learning Opportunities Nicole Marie Biglete, Learning Unit IVPrior to the current academic year, the Class of 2026 was already given the opportunity to have the Learning Enhancement in Anatomy Program (LEAP) for one week on-campus last June 2022. This allowed the class to supplement their online learnings with the specimens and models available in the anatomy laboratory.Beginning this semester, however, the now Learning Unit IV students frequent the halls of the College of Medicine and College of Public Health for subjects such as HS 202: Biopsychosocial Dimension of Illness, Ther 201: Pharmacologic Basis of Therapeutics, and OS 216 Hematology and Immunology Modules.Nicole Marie Biglete, along with her batchmates from the Class of 2026, attend lectures, small group discussions, laboratory sessions and examinations on-site for said subjects.She also shares her optimism with the return of patient interactions in the wards. “Start na ibalik yung patient interactions for our OS subjects and along with it yung skills improvement,” she comments after being able to interview and assess a patient for the OS 216 Hematology Module.She adds that small group discussions held face-to-face in the same module, enhanced her communication skills.Despite these developments in the mode of instruction for the students, Nicole points out possible improvements for the current setup such as the fine-tuning of scheduling woes and added expenses for the students.“Hassle for other people na hindi pa nag rerent [near UPM]. Tumaas rin ang living expenses ng [students] from the provinces. Hindi rin super sulit if hindi consistent yung face-to-face.” She explains that many students travel from afar to attend face-to-face classes while those who rent for lodging near UPM battle with high costs of living while the majority of classes are still delivered online.LU V: Taking that Leap, Going to the ClinicsJose Raphael Delos Santos, Learning Unit VBy the time students become Integrated Clinical Clerks (ICC), they are already exposed to both in-patient and out-patient settings. This, as well as migrating to in-person training in the clinics, is the great transition that Jose Raphael Delos Santos and the Class of 2025 are currently embarking on.The Class of 2025 have just begun their clinical exposures this semester. Prior to this, their lectures are still mainly delivered online, and only the small group discussions and exams have been delivered through in-person means.Among the subjects that Raph and the rest of his batchmates took this semester so far, their interdisciplinary course in anesthesiology allowed them to have clinical activities where they had turns learning how to use an ultrasound, operate a patient-controlled analgesia machine, and how to administer central and peripheral analgesics. Aside from that, in their IDC 221/222 courses, they had activities in different departments to observe and even conduct patient interviews.Raph recounts that learning clinical skills was very difficult for him in an online setup in the past two years and sees in-person learning as a great motivator for him.“Clinical activities are more visualized by the students and in turn making it easier to learn. [There are] interactions with professors and mentors which just positively impacts learning overall. Also [by] slowly starting to have patient interactions, we get to work with our batchmates in real life,” Raph narrates.In the coming block modules that they have to take, there will be more time dedicated to patient interaction and training in the clinics. With this, Raph recognizes that the risk of COVID is still present and even just one COVID-positive case among their batchmates would affect all the planned sessions. Hence, Raph hopes that face-to-face sessions will be optimized despite these risks, and more opportunities for face-to-face learning could still be provided for them.LU VI: From Computer Screens to the ClinicsVince Justin Tiu, Learning Unit VIEntering their clerkship year, the majority of the Learning Unit VI students’ learning experiences come from duty posts and patient interaction supplemented by small group discussions after shifts.Vince Justine Tiu, Learning Unit VI, shares his experiences from their duty posts. “The number of clerks per duty post can range from 1-18 at a time. Shifts are implemented but the hours vary from 4-hour and 30-minute shifts up to 12-hour shifts. The implementation of [face-to-face] activities may vary from one block to another as the departments receive feedback from the rotation.”When asked of the impact of this shift to in-person learning, Vince has this to say: “In my case, I would say that it supplemented what I’ve learned during online classes. I was able to relate real life experiences with theoreticals. It also provided a new environment from computer/tablet screens.”As they venture into this new environment, he notes that as clerks they also follow protocols when it comes to their safety and well-being.“Symptom tracing, self-monitoring, and wearing of PPEs (N95 mask or better) are strictly implemented as preventive COVID-19 protocols. Clerks are also refrained from doing procedures that produce aspirates to lessen the risk of contracting the infection,” he emphasizes.Vince anticipates more patient interaction and hands-on guidance from his senior colleagues as they get to see and manage cases in real-life rather than just reading them in websites or books.LU VII: Preparing for the Post-pandemic World Outside Medical SchoolApryll Raedine Saavedra, Learning Unit VIIAmong the different learning units, in-hospital training is a non-negotiable for the Learning Unit VII students who are taking up their internship at the Philippine General Hospital. LU VII students, even during more stringent pandemic restrictions, were already given opportunities to have clinical rotations and patient interactions, SGDs, ward endorsements, clinical rounds, and case presentations.The courses that the interns rotate in depend on their internship track. All of which have face-to-face clinical rotations generally in departments such as internal medicine, pediatrics, surgery, obstetrics and gynecology, and family and community medicine among others.Apryll Raedine Saavedra from the Class of 2023 cites specific challenges in adjusting her study habits during her internship while juggling more hours in clinical rotations.“Having more hours of clinical rotation compared to my experience in clerkship, wherein some rotations were done online due to COVID surges, [I] definitely needed some huge adjustment in allotting time for studying.” Raedine recounts. She also adds that she understands that this is how it’s going to be when she becomes a licensed physician.“It will only become more challenging. So, I understand that this shift in learning and the demands are only preparing me for the future…” she explains.As her time in the College of Medicine draws to a close, Raedine still anticipates much more learning.“I look forward to further improving my skills in history taking and physical examination, as well as arriving at a diagnosis and differentials, and formulating a plan for my assigned patients. Also, I would like to improve my skills on performing procedures and to have better flexibility and time management with all the tasks. Most importantly, I am looking forward to learning firsthand from the patients and residents, fellows, and consultants because having F2F clinical rotations make these more motivating and engaging rather than having online activities.” she narrates.As many are still grappling with living out this pandemic, the UP College of Medicine is now at a crossroads in medical education where previous learning modalities have been challenged and innovative strategies are now the requirement. Despite these monumental changes, there have been constants along the way. Among which are our patients, our peers, and our mentors. As we tread on ever so cautiously as a medical community, our steadfastness and conviction to excellence in medical education shall not waver.

Anesthesiology 250 Enhanced Learning Activity: An Innovative Approach to Teaching

By Mitchell Jared De SilvaLast October 28, 2022, the UP College of Medicine Class of 2025 attended the Enhanced Learning Activity spearheaded by the Division of Pain Medicine of the Department of Anesthesiology at Buenafe Hall. It was an eventful day as two batches of the class came in the morning and afternoon. To formally start the program, the course coordinators, Dr. Dominic Villa and Dr. Evangeline Villa, along with their Department Chair, Dr. Grace Anne Herbosa, warmly welcomed and oriented the participants. Afterwards, the students were grouped and assigned to take turns in visiting five prepared stations. Equipped with visual aids, machines, and other complementary materials, each station uniquely presented a series of topics essential in the field of anesthesiology and pain medicine. As a review, questionnaires were also administered before and after each session. It was an appropriate medium to assess the accomplishment of the set primary objectives.For the first station, the department prepared a section on the concepts behind sonoanatomy, better known as ultrasound imaging, as well as its proper use. Ultrasound machines were readily available in the station for appropriate demonstration. After a brief introduction, students were oriented on the different parts of the equipment and were soon provided the opportunity to use the device. Under the guidance of the attending lecturers, Dr. Joniday Nieva and Dr. Rommel Manderico, participants learned how to handle and differentiate the types of ultrasound probes and were taught the basics on reading a sonogram. The exposure to the station was a fitting preface for the rest of the stations, as it complemented the other relevant procedures to be discussed, such as in the case of peripheral nerve blocks.The peripheral nerve block station featured a comprehensive presentation by Dr. Karmi Margaret Marcial and Dr. Dwight Siazon, which encapsulated the key concepts of the procedure. As an introduction, there was a volunteer who acted as a patient with a chief complaint of knee pain, paving the way for the rest of the discussion. Several video demonstrations were shown to instruct the students on the necessary steps in preparation for the peripheral nerve block. From the use of nerve stimulators as well as the selection of local anesthetics, the station was able to showcase the process behind the aformentioned procedure.Patient-controlled analgesia (PCA) through intravenous and epidural routes was the main topic for the third station. The session with Dr. Kim Epino and Dr. Ulrica Forbes began with the discussion of the PCA machines, the specific medications used, and the significant doses needed. It was then followed by a thorough step-by-step video guide on how to access the devices. With the assistance of the station instructors, the students were given the time to explore and use the intravenous and epidural PCA machines. It was a notable experience shared by all the attendees mainly because it is one of the first rare instances wherein the students were given the opportunity to handle such refined equipment for the first time.The fourth station directed the learning course on the topic of neuraxial analgesia. Similar to the setup of the previous stations, the session began with the introduction of the subject by Dr. Emmanuell Villano and Dr. Angelo Realina. The different analgesic techniques, primarily the spinal and epidural blocks, were extensively taken up. Relevant anatomic landmarks were also reviewed using the Department of Anatomy’s Virtual Human Dissector, greatly aiding in visualizing the insertion process. Moreover, the specifics of the equipment needed, from the type of needles to the catheters, were also highlighted. To complement the lecture, some of the items used for the procedure were passed around the group for closer evaluation and appreciation.For the last station, the department, headed by Dr. Dominic Villa and Dr. Evangeline Villa, arranged different activities to cover the topic of acupuncture and complementary medicine. Unlike the other stations, it took on a more holistic approach towards presenting the intended lesson. Upon entering the aromatherapy-perfused room, students were greeted with brewed coffee or tea, and several food treats, significantly setting the tone for the rest of the session. Acupuncture, herbal remedies, and even virtual reality were discussed. Some students were even able to try acupuncture themselves towards the end of the session. The participants were then acquainted with the Department’s newly launched e-book, Compaindium, an assembled collection of work featuring the creative outputs of the UPCM LU 5 students for the past two-and-a-half years of the COVID-19 pandemic. Presentations ranged from musical performances, written poetries, and artworks, to the varying personal hobbies and specialties of the students. While the videos were being shown, electric massage devices and even a personal service from a licensed massage therapist were made available for students to enjoy. The station undoubtedly managed to demonstrate the other ways to address pain that are often overlooked. Through such efforts, the attendees were able to experience firsthand the relief provided by these methods.The enhanced learning activity served as the culminating program for the Anesthesiology 250 module. Catering to over 170 students, it was a successful and prolific way to supplement learning. Whether it involved the format of demonstrating procedures, allowing for the use of the equipment, or setting up interactive platforms, the organizers had evidently shown tremendous effort in guaranteeing a worthwhile experience for all participants.In the midst of a transitional period from an online to a hybrid or even a complete face-to-face setup, the department boldly takes on the challenge of developing a new approach to education. Despite the limited timeframe and existing limitations, the activity was able to make the most out of the opportunity by maximizing the use of all available resources.It may still take a while before the resumption of the same format of pre-pandemic learning. However, as we adapt to the new normal, it is crucial that new means of instruction are continuously discovered and integrated into the system. The Enhanced Learning Activity by the Department of Anesthesiology definitely offered a fresh take on a possible mode of teaching — one that can hopefully serve as a prime standard or an inspiration for others to develop a way of their own.

We hope we have been changed for good

Editorial By Angela G. Sison-Aguilar, MD, MBA, MSC, Editor-in-ChiefAs we return to our campus from the long hiatus forced upon us by the pandemic, we are met with the welcome sight of a brand-new structure, the Medical Sciences Building. It is a metaphor of what we should return to after this long break.We don’t just return to settings as we had known them but we should get back to better situations.Better education. We hope we had taken advantage of this break to reassess our methods of teaching, the content of our courses and the way we evaluate our work. Indeed, the events have transformed the way we teach, accelerating the adoption of technology, long available even before the crisis, but embraced almost desperately during those long lockdowns. The integration of remote learning even as we go back to in-person classes is underway and has enhanced our pedagogical instruction and interactions.Better social support. Even before this world-changing event, mental health issues were slowly being brought out in the open. During the pandemic, however, the struggles became more prominent, leading us to pay greater attention to caring for this aspect in our communities. We checked in on our colleagues, our students, our family. There was no shame in admitting our battles, there was no reluctance in inquiring how well or poorly each of us was doing, there was only concern and empathy.Better equity. We all grappled with the challenges to survive, but we have seen how disproportionate the impact of the crisis had on the marginalised. We hope that such a spectacle will not desensitise us, rather, it should mobilise us into action. We have to work against inequity not just in opportunities for upward mobility but also in access to basic services.Better discernment. In this digital world where information flies fast and facts and truth are fuzzy, we became more critical. We vetted sources, scrutinised provenance, demanded credibility and clamoured for accountabilityBetter quality of life? This is the ultimate task as we get back to this transformed world, we hope our existence has become more meaningful, our work-life balance better, our wellness within reach. Let us not allow this cataclysm go to waste. It has, after all, touched all of us. We fervently hope that—to paraphrase the words of the witches in the musical “Wicked” written by Stephen Schwartz—we have been changed for good.

A Novel Perspective on Medicine: Holistic Health for All

Editorial By Karl Gerard R. Crisostomo, UPCM Class 2023, Chief EditorThe practice of medicine has long existed since before written history. In 1865, Paul Broca, known for being the eponymous namesake of the area in the brain we associate with speech production (Broca’s area), received a curious specimen from one Ephraim George Squier, a renowned American archaeologist and ethnologist. This was an ancient skull discovered in Peru, with its most defining feature being a square cut around half an inch in size. What baffled experts such as Broca was not the fact that such a large cut existed in the first place, but rather, that there was evidence of healing along the periphery of the hole in question, indicating that the person who received such a primitive operation survived in the first place. Even with the most primitive means, our Peruvian forebearers realized that there was a pressing concern that needed such a drastic operation, before the advent of antiseptic techniques, anesthesia, and techniques developed by modern surgery. Indeed, the most recent advancements in medicine were brought about by an immediate pressing concern that served as impetus for innovations that would define their respective fields in the coming decades.Today, new strides have been made towards further innovations in health. In the past century, we have made important discoveries such as antibiotics, eradicated conditions like smallpox, and facilitated an unprecedented vaccine rollout in response to the COVID-19 pandemic.These advancements helped save billions of lives over the course of our existence in the world. However, we should not rest on our laurels just yet. In 1948, the World Health Organization famously defined the concept of “health”, a notion which has remained persistent and relevant even to this day:“A state of complete physical, mental and social. well-being and not merely the absence of. disease or infirmity”-WHO ConstitutionThe definition specifically mentions not only the physical aspect of health, but also aspects which are not as tangible. Why were these highlighted all those years ago? It follows that ensuring the physical well being of an individual may lead to both a positive mental and social well being as well, but this statement is much more nuanced than that. Health exists not merely in the vacuum of the physical and the tangible, it exists as a function of the unseen, yet equally important aspect of our daily lives: our psychosocial well being.While the world was mostly focused on finding ways to deal with the virus that attacked its victims systemically, manifesting symptoms and signs that would prompt admission, even intubation in the worst of cases, another silent, yet equally potent force also took hold on the general populace. In 2022, the World Health Organization, released a report on early evidence of the pandemic’s impact on Mental Health. According to data collected, there was a 27.6% increase in cases of major depressive disorder (MDD) and a 25.6% increase in cases of anxiety disorders (AD) worldwide since the onset of COVID-19. Alarming numbers, but not one to be surprised about. In the span of a month or so that year, we were thrust into a situation the likes of which the world had not experienced, a pandemic rivaling that of the 1918 Pandemic in scale and size. The pandemic affected all of us, one way or another. For some, their lungs ravaged by the respiratory ailment with a wide array of systemic symptoms. For others, having their lives upended with the snap of a finger, many experienced a deluge of psychological symptoms of varying severity. Languishing became a common experience throughout the course of the pandemic, a so-called middle child between depression and flourishing, a state wherein one felt empty, aimless, as well as joyless, probably due to the loss of many opportunities for physical, mental, and social stimulation due to isolation. Social support systems, once taken for granted, were now relegated to words on a screen, or pixels lit up on a screen to approximate the image of a human being. The concept of mental health, a science so comparatively young to that of medicine, was foreign to many until they started experiencing it themselves, realizing that their symptoms were not from the virus but rather, from the situation brought about by its spread to the world as we knew it. Many lives were snuffed not by the suffocating grasp of COVID, but by the silent whispers of depression, loneliness, bereavement, even hopelessness.As the world heals from the pandemic, it is our responsibility, not only as physicians, but as human beings, to do our part in ensuring the good health of those around us. We are given the opportunity to make an active and palpable difference in the good health of those around us without having to resort to life threatening procedures like the aforementioned trepanation example. As physicians we have long exuded a particular role in our society, not only as authority figures, but as figures of hope, who can give a person in their last hours a chance at experiencing another sunrise.Inasmuch as we should care for the mental health of our patients, friends, and colleagues, we must also focus on our own health. With a profession known for constantly exposing its workers to less than ideal circumstances, as well as stressful situations that would buckle even its most stalwart figures, being mindful of one’s experiences and being open to finding ways to care about oneself is just as important. As a doctor, it is our duty first and foremost to save lives, and oftentimes, we forget to include ourselves in these efforts.We have every opportunity from here on out to advance better health in our own unique ways. When history looks upon our efforts with bridging the post pandemic era towards a better status quo, I hope we will not merely be remembered only for fighting the pandemic through medical means, but beyond this, through our individual efforts to make the postpandemic world a better place.REFERENCES:Randall, T., Sam, C., Tartar, A., Murray, P., Cannon, C., Armstrong, D., Qiu, Y., Pollak, A., Wallbank, D., Carroll, J., Dube, E., Lee, J., Shah, J., Lin, L., & Lee, S. (2020, December 4). More than 12.7 billion shots given: Covid-19 vaccine tracker. Bloomberg.com. Retrieved December 11, 2022, from https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ World Health Organization. (1948). Constitution of the World Health Organization. World Health Organization. Retrieved December 11, 2022, from https://www.who.int/about/governance/constitution World Health Organization. (‎2022)‎. Mental health and COVID-19: early evidence of the pandemic’s impact: scientific brief, 2 March 2022. World Health Organization. https://apps.who.int/iris/handle/10665/352189. License: CC BY-NC-SA 3.0 IGO

Volume 32 Issue 1 (2022)
Finding our Way Back to the Clinics: A Third-Year Medical Student Perspective

By Joana Marie Cruz, UPCM 2024From “What Zoom link are we using today?” to “What do we need to bring to the OPD for today’s duty?,” change has been constant in the second semester for UPCM LU5 students as face-to-face classes resumed. This shift has brought about unimaginable emotions of worry, nervousness, excitement, and happiness all together. Waking up early thinking, “We will be in the OPD today,” “We will be learning new sets of clinical skills with the entire block,” or “We will be presenting clinical cases in front of the residents and coordinators,” truly adds a dose of motivation and inspiration, especially after mornings filled with synchronous Zoom sessions and physical examinations on stuffed toys. Our daily routine would have probably been more familiar, maybe even less anticipated, if COVID-19 did not happen. Change is a lot to take in, but one thing’s for sure, it’s good to be back.A core memory from our first year days, the facade of Calderon Hall always welcomes us with open arms.zoom in “A medical student sitting in front of her desk studyingDoes not capture what it’s like doing medical school online.From having to set up an area conducive for learning to fighting Zoom fatigue,There’s so much that’s happening behind-the-scenes.”Having to learn medicine online was never easy. There were a lot of silent battles behind Zoom lectures and SGDs. The voices and images reflected in our audio and cameras could only capture so much of what was there at the moment—students who set an alarm minutes before the lecture or SGD so they could log in just in time for the session, students who patiently wait to unmute their microphones to ask questions, and students who had to drink coffee or do short exercises to maintain their attention for the entire day. Behind these were moments of reflection if what we were learning was enough. During the online med school setup, we missed several OSCEs, OPD duties, and many more clinical experiences, but as assured by many coordinators and residents, we were doing the best at the moment. Brushing up on our theoretical knowledge, we sought to read our books, watch comprehensive videos, and practice our history-taking and physical examination skills. Indeed, any step forward was a significant one amidst a global pandemic.Before the pandemic happened, over 180 students spent their LU3 days here: chatting, studying, eating, and even napping. This was the setting of many milestones in medicine.passion“Nothing can beat the passion of studentsWho for two years have been waiting for the perfect opportunityTo learn and experience firsthandThe medical skills they have only been hearing about.”However hard we tried each day, most students would say that some things can never be learned online. Key lessons are found by being in the moment and experiencing new things on our own. This was what was missing during the past two years of online medical school. While the components of a complete patient history and physical examination were familiar to us, it is only by experiencing it firsthand that we realize that we cannot always follow the sequence and that we should know how to adapt to different patient scenarios. For example, we can understand the method of properly examining the nose of the patient using a nasal speculum through reading books, but we will only realize that keeping the thumb at the fulcrum while supporting the nose with our index finger and holding the rest of the speculum steady would take more practice than we expected. We were also taught palpation and auscultation through watching videos and listening to abnormal lung and heart sounds, only to realize that abnormal findings are harder to discern for someone who has not heard it in person before. Indeed, there is still much to learn. Being back in the clinics after two years, however, is somehow our saving grace: opening avenues for us to discover more.With the advent of limited face-to-face classes, students maximize each opportunity to learn as many skills and apply learnings that they have gained during online classes. In Photo: Block 5 (UPCM 2024) Students during the Blood Extraction Workshop offered by the Department of Medicine.balance“Studying medicine is already an uphill battle from the startCovid-19 did not make the road less toughBut it may have led us to find and understandThe balance we ought to find in this career pathAnd learn how in the hardest of times, we remain resilient.”Studying medicine has never been never easy, but the struggles, pains, and hardships that come with it are alleviated by the study breaks with friends who share the same experiences and patient encounters that remind us of our purpose. When the pandemic began, there were no invitations of “tara kain” after an exam, no shoulder taps and hugs of comfort when feeling down, no clinical experiences to remind us of our why’s. Sources of comfort of med life suddenly disappeared in the past two years. On the other hand, the pandemic actually gave us time to slow down, be on our own, and take hold of our time. We were able to spend meaningful moments with our families and learn new things outside medicine. Our online medicine experience was unyielding at times, but it opened doors to some things that were unexpectedly beautiful.Looking back at our first moments in UPCM from when we passed our requirements in the admission’s office, sat for hours to wait for our interview, waited for the list of accepted students, first met our classmates, first wore our white uniforms, took our first medical exam, to when we had to bid goodbye when classes were suspended because of the COVID-19 pandemic, a lot has happened since the day we decided to pursue medicine. Who would have thought that UPCM Class 2024 will be one of the batches to experience medical school during a pandemic? It was hard for everyone, but the growing passion to learn and become the medical doctors we envision ourselves to be never left us. Akin to our class cheer, every medical student will keep “forging legacies” no matter what happens—to keep learning, to be better doctors, and to serve the underserved.Eager medical students return to the halls of Buenafe for their ORL skills building with Dr. Jeannette Matsuo and ORL residents. In Photo: Block 2 (UPCM 2024) students with Dr. Jeannette Matsuo and ORL residents.

A Man’s Legacy through Others: Remembering Dr. Noel R. Juban

By Joseph Rem Dela Cruz, UPCM 2024Kindness without condition. Support unbounded by distance and time. Dr. Noel R. Juban, lovingly known as Boss No to his colleagues and friends, exemplified this unconditional regard for everyone he met — and naturally, this was reciprocated by even the most respected scholars and leaders of today. So much so, that no less than the Director General of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, lamented Dr. Juban’s sudden loss . A large void was left by Dr. Juban in our community since his passing last January 21, 2022. Even today, we still find his jokes and nuggets of wisdom faintly ringing in our minds — all of which he would have loved to share with more people. Perhaps, simply recounting these would not do justice to the memory of Dr Juban. Instead, let us relive Boss No’s life through anecdotes and stories that he loved to share the most.Narratives from short yet meaningful encounters with Doc Noel stand testament to his legacy in advocating for youth participation in epidemiology and social innovation, paving the way for generations to come.Dr. Juban had a penchant for conversing with anyone about anything under the sun, from their families to their shared vision for a healthy Philippines. In fact, one would have to schedule an entire afternoon or evening to speak with him. For every laugh he shared with a mentee or newfound acquaintance, he imparted sound advice on career prospects and proper networking. Such was the experience of Leonard Lim, a UPCM student from Class 2024 — one of his many mentees: “Doc Juban introduced me to the field of public health, and it was because of him that I decided that this is what I want to do for the rest of my life. Even when I wasn’t interning anymore, he would always invite me to help out with his projects… serve as facilitators and note takers at his events, or … encourage to publish manuscripts, join contests, and present abstracts.”The pivotal role of epidemiology in public health continues to spark several minds. At the 36th Philippine Council for Research and Development, Boss No poses with his mentees in research.Dr. Juban was also known to have been a beloved adviser to the UP Medical Students for Social Responsibility (UP MSSR) organization. In almost a decade of his tenure, he had nurtured countless ideas to blossom into fruition. Leonard, being one of his mentees, warmly recalls: “Doc Juban is the type of mentor who’d be more proud of you for your achievements than yourself and maybe even your parents. He’s the type of mentor who’d be so excited when your plans turn to reality. Talagang ipagkakalat niya [yung successes mo] to all his colleagues.”Health Hacks: Synapse, an event by UP MSSR, gathered people from various backgrounds to ideate feasible solutions to community problems. Boss No was in attendance with his students from UP MSSR.Such was the unwavering support of Doc Juban who — even at the most ungodly hours — stood guard like a doctor on call, ready to answer questions or meet with national and international bodies. These same organizations rallied behind him in his quest to establish the Social Innovations in Health Initiative (SIHI) Philippines Hub within UP Manila — an institutional leader in bringing together stakeholders for research, capacity building, and influence. Dr. Jana Deborah Mier-Alpaño, the current Hub Manager of SIHI-Philippines, fondly reminisces, “Sir Noel has been described to be very friendly and humble. Even colleagues who we only met for a short time in events or conferences, have sent messages saying that this was what stuck with them — that Sir Noel was excellent but friendly and humble. And even for us, while he was our boss, we were not afraid of him; we could discuss freely, and he always listened to our ideas, our thoughts.” More than a boss, he was a friend: “Whenever we have work trips, there would surely be some side trips, because as he would always say, we should be able to enjoy our work, and enjoy the fruits of our labor… We also have funny memories or bloopers with Sir. Especially recently, when all meetings have been online. There was one time in a Zoom meeting, he probably forgot, and turned on his camera, and behold! He was wearing only a sando. Similarly another time, he forgot that his camera and audio were on, and later we heard some funny sounds. Apparently, he was cutting his nails. But these things, we could genuinely laugh about, because of how down to earth Sir Noel was; he laughed at things like these as well.”SIHI Partners’ Meeting in 2019. Boss No spearheaded the establishment of the SIHI Hub within UP Manila to promote the collaboration of stakeholders for research, capacity building, and influence.Of all the fond memories one can recall about him, we can certainly distill Dr. Juban’s life into one simple yet profound word: “social”. More than anyone, he knew how to meet people where they are, make them smile, and share their story. Even as a man working with numbers day and night, he never reduced people into mere statistics, always keeping his eye on the social impact of his research. He never counted the minutes he would spend lost in conversation with his mentees and colleagues, as he knew — like a sage — what was truly relevant: the people right before his eyes.Beyond dealing with research in epidemiology, Doc Juban also served as an advisor to the UP Medical Students for Social Responsibility (UP MSSR). Here he poses with active members and officers.His legacy stands testament to the indelible impact our relationships and interactions bring. It was through his innate charm in advocating for the importance of youth participation in epidemiology, community involvement in social innovation, and giving back to the nation that continues to steer many into research and advocacy in the Philippines — the two oft-forgotten stars outshined by the glamor of being a clinician and living abroad. It was through this skill in referring incipient leaders to old wisdom that started many of his mentees’ careers in public health. By leveraging this talent in building and fortifying bridges with various organizations, he was able to start the Philippine hub for SIHI and collaborated with many more advocates the world over. Simply put, Pam Pasco, one of his mentees from UPCM 2023, explains: “I am sure he would have wanted us to pursue our passions — to work hard while balancing the different aspects of our lives... He would want us to work while making meaningful friendships and enjoying what we were doing, … [relish] our breakfasts (just like his almusal series) and the conversations we have with each other.”Surely, the hearts he has touched still mourn to this day. Yet, the shared vision of health equity he has helped build will stand strong like the hallowed yet timeless halls of Rome. If the price of love was grief everlasting, then our community is glad to have paid it in full — and even more — just to have met and served with Boss No in this lifetime. Long may he be remembered.

Venturing Into the Unknown: The Heights and Plights of Medical School in Hybrid Learning

By: Charlene Divine M. Catral, UPCM 2027An unexpected turn of events has led us to a crossroad. What happens next? The adventitious arrival of the pandemic brought about uncertainty as people tried to salvage bits and pieces of normalcy. Time seemed to have stopped these past two years, yet everyone knew that life must go on to prevent the worst of things. In education, continuing the mission to cultivate young minds for tomorrow was at a standstill—lockdowns prompted suspension of classes and learning. In the pursuit of a new normal that included social distancing, wearing personal protective equipment, and following numerous precautions against COVID-19, the shift to a digital platform for the everyday began.Access to numerous digital resources allowed for easy transition to an alternate mode of learning for most students and teachers. However, one cannot turn a blind eye to those without access to the internet or the resources (i.e., laptops, smartphones) required to accomplish online tasks. Both public and private institutions attempted to bridge that gap by providing such resources to those who require them; however, there was still one out of five students who faced difficulty in acquiring a computer [1]. Similar statistics were found for those utilizing prepaid mobile data services to access the internet. Furthermore, this new learning environment involves tasks different from the previous mode of learning. Household chores, school works, and other responsibilities combine in an online setup, requiring a student to balance multiple aspects all at once. It takes extra effort to conduct activities designed for online learning since adequate preparation is needed. There is an increase in the academic papers required of students, video recording of reports of students or lectures by professors also take a lot of time, and many find it difficult to grasp concepts using a purely online setup, consequently requiring double effort to understand their lessons. Luckily, most have adjusted, yet some anxiety persists on the quality of learning one has acquired.Students who learned clinical concepts and principles at patients’ bedsides had to grow accustomed to the virtual setting, far from human touch.The online set-up had its respective advantages and disadvantages amongst medical students; those who entered during the pandemic have yet to experience face-to-face lectures and patient encounters.Despite advances in controlling the pandemic, there is still a lot of work to be done. Existing drugs are said to be effective against the virus; however, some are not yet FDA approved, solely reserved for emergency situations. Numerous hospitals continue to cater to patients experiencing severe complications brought by COVID-19. Many are yet to be vaccinated, however, the growing numbers towards herd immunity has helped decrease the alert level in the country. Thankfully, people are now roaming freely in the streets, within the walls of malls and supermarkets, as well as working and studying in the office and universities. Cases have started to decrease, with more and more hospital staff catching a glimpse of rest after a grueling two years. While this is not a complete reversion to pre-pandemic times, it is a good compromise, showing the potential for technology to enmesh in our daily lives.As of March 2022, the Commision on Higher Education reported approximately 313 colleges and universities already engaging in the minimum face-to-face classes, with about 1000+ degree programs in participation [2]. Of course, proper health precautions and protocols remain in place to prevent a surge in COVID-19 cases, which is why some universities have adopted a hybrid mode of learning to maximize the students' learning experience. Forty four UPCM students participated in a survey released by UPCM InSPIRE last March 27 to May 12, 2022 regarding the ongoing shift from a completely online mode of learning to a hybrid form.Mornings in the OPD are usually bustling with patients and new students navigating their way with patient interactions and consultations.Of the respondents 79.5% found the possible shift from online learning to a hybrid setup to be agreeable. On the other hand, 13.6% remained undecided while 6.8% did not agree. Reservations stemmed from issues affecting their preparedness to shift back to face-to-face classes, such as financial constraints which may hinder finding housing, as well as logistic considerations such as travel time from the provinces to Manila. Others were also hesitant due to the increased risk of contracting COVID-19. When asked what emotions surfaced when considering the shift to hybrid learning, the majority were excited (70.5%) and happy (68.2%). Despite this, about half were scared (47.7%) and others reluctant (36.4%) because of some fear in not knowing what the clinics are like. Eight individuals (18.2%) were also stressed, while one respondent had mixed and unsure emotions.When asked if they believed that the current online learning setup has been effective, 43.2% answered “maybe” while another 43.2% stated it was ineffective. Only 13.6% found the online setup effective, brought by their experiences of having more time to read primary source materials and allowing them to exercise their independence and time management skills. Many have cited that certain household responsibilities limited their time and ability to concentrate on their studies, and others had difficulties due to the increased workload. One of the students expressed that the online learning setup exposed technological disadvantages, pertaining to the difficulties in internet connectivity and lack of adequate resources. In hindsight, some believed that over time, people were able to get used to the online set-up and learned to manage their academic and extracurricular affairs. However, there are certain classes that require skills honed through hands-on training such as laboratory courses in chemistry and biology, dissections in anatomy, clinical practice, hospital rotations, and fieldworks, thereby putting the online setup at a disadvantage. Insights were also gathered from students who have recently experienced face-to-face classes alongside online classes. They discussed that some difficulties experienced were due to overlaps between online and face-to-face requirements. While they were juggling previous workloads required of them from the online set-up such as Zoom classes, academic papers, and online exams, they were also actively conducting laboratory experiments on-site. Although it was a fun and exhilarating experience to finally get some hands-on learning done, juggling two different kinds of work proved to be a challenge they hope can be improved in the future. To adjust to this transition, they actively communicated with their professors, especially in cases of schedule adjustments. Furthermore, comfort from their peers has helped in making hybrid classes more meaningful. For future plans, they suggest a more fleshed out scheduling of online and face-to-face classes, where both are done in separate days or periods of the semester to prevent any overlaps in the schedules.Students were anxious but eager to return to the face-to-face setting after 2 years of learning on the online setting.Students have their patients to thank for the hands-on learnings and experiences that weren’t accessible with the online set-up.Other students also shared suggestions on what can help them in the transition from an online to a hybrid set-up. From some in the provinces and those requiring financial assistance, provision of assistance for accommodation (i.e., housing, transportation), consideration for travel time to Manila and time to canvas for houses, and relaying updates on the concrete plans to be implemented during the semester are of utmost importance. These measures would reassure and strengthen their excitement to rejoin the college in Manila.As we venture to discover the best educational approach to address both the limitations of the pandemic and the standards for quality education, the health of all remains a priority. Regardless of the current circumstances, the University considers the safest options for its students, faculty, and staff. Although it is unknown how long the virus will be here to stay, the growing pool of scientific knowledge and medical breakthroughs will soon find a way to ease us out of our four walls.The students of the UP College of Medicine are part of the community of learners⁠—young minds that will be the hope of the future. Hand in hand, the bustling streets of Manila will be greeted by the energy of students. The buildings will come alive again with the thriving minds of future doctors, cultivated beyond the screens and through the lenses of their eyes. Until that day, we must continue paving the road towards our envisioned future. The collision of the digital and physical worlds will maximize the discovered benefits of online learning and the provision of a new perspective on practicing medicine. Partnered with hands-on classes for laboratory work and clinical rotations, we will be able to harness the best of our potential to learn the skills a six-star physician must have.References:[1] Baticulon RE, Sy JJ, Alberto NR, Baron MB, Mabulay RE, Rizada LG, et al. Barriers to online learning in the time of COVID-19: A national survey of medical students in the Philippines. Medical Science Educator. 2021;31(2):615–26.[2] Cruz K. 300 colleges, universities resume in-person classes. The Manila Times. 2022 Mar 14. Retrieved 2022 Apr 24 from www.manilatimes.net/2022/03/14/news/300-colleges-universities-resume-in-person-classes.

Finding Ways to Unwind During the COVID-19 Pandemic: Online Hobbies

By Patricia Therese de Claro, UPCM Class 2024The COVID-19 pandemic has brought about countless changes in the way UPCM students currently live, such as abiding to safety protocols when going out and taking the majority of their classes online. One of the aspects of life affected by the pandemic is the way we relax and unwind. Events like Palarong Medisina and Tao Rin Pala, both most revered and awaited by UPCM students, were moved to an online setting.However, in light of these changes, UPCM students are now, more than ever, in tune with their passions. They have found creative ways to cope and channel their energy into extracurricular activities that excite their hearts and minds. These hobbies include immersing in online games—now the focus of Palarong Medisina, pursuing content creation, and managing an online business. Here, students share their journey and insights on the hobbies they have developed during the pandemic.Online GamingMany of the college’s online gamers actually started playing before the pandemic. For Gabrielle Rose “Gwen” Pimentel of UPCM Class 2024, popular video games like PlayerUnknown's Battlegrounds, Call of Duty Mobile, and Rules of Survival were introduced to her in Learning Unit I. Similarly, for Mohammad Sarifola “Jayr” Alonto, Jr from UPCM Class 2024, Mobile Legends, amongst other online games, has been in his radar since grade school; he has been playing regularly since 2017. Both students cite gaming as a means to cope with the pandemic: using games as a way to wake up during study breaks by entertaining themselves, socializing with friends, and meeting new people with shared interests.Gwen is an LU5 student who recently returned to the wards after 2 years online.Jayr is a BS Public Health graduate hailing from Marawi City, currently in LU5 and back in Manila for face-to-face classes.Though gaming has become a respite for plenty, it also comes with its challenges. It can be hard to set boundaries between time for classes and time for playing online games, mainly because tools for this hobby are so readily accessible. Given the dynamic nature of our online classes, it can be hard to balance doing well in academics and setting aside time to level up your game character.During and before the pandemic, Jayr grew to master the tactics and strategies of his favorite game, Mobile Legends, where he consistently wins and gains the MVP mantle.Nevertheless, our online gamers have a few words of advice to those interested in pursuing the sport. Firstly, it is important to set your expectations when you start. You will not be a pro right away, but practice always makes perfect. Next, it is integral to find a balance between playing online games and studying. You can block off a specific time in the day specifically for games, while using the rest of the time for other tasks, especially those relating to academics. Lastly, playing with friends makes online gaming more fun. You can set up Discord channels with your gaming buddies, so that you can feel their presence in the game, as well as through audio and video.Gwen spends her free time playing Call of Duty mobile, one of her favorite quarantine hobbies.Content CreationAnother interesting hobby that some students of the college engage in is content creation. From creating studygrams to vlogging on online platforms like YouTube and TikTok, UPCM students have a real knack for making imaginative and inventive posts on social media.One of the college’s most popular content creators is Isabela Andrea “Bela” Legaspi from UPCM Class 2025. She started creating online content in April 2021—her first video being a blooper reel of her Neuro OSCE with her father, PGH Director Dr. Gap Legaspi. The video went viral, and TikTok users began to ask questions on her life as a medical student. She then decided to create videos to answer them. One year later, she still posts her content on TikTok, usually focusing on day-in-my-life vlogs, where Bela captures her daily routine as a medical student. Whenever her days feel monotonous and life feels like a never-ending loop, vlogging helps Bela find the good in every day. Furthermore, with her frequent posting on social media, she has been able to create a support system with other medical student content creators and a community with those who watch her videos.Bela Legaspi is an LU4 student from Class 2025 who has grown a following on TikTok – you can find her viral videos on her profile (@beli.button)!One of the struggles that she faced with her hobby is the hate comments that people leave under her videos, which made her anxious during the start of her content creation journey. Although vlogging has helped Bela cope with the pandemic creatively, it has also made her feel burned out, especially when balancing content creation with academics. But through months of persevering, Bela now takes breaks from TikTok when she feels the need to, prioritizing medical school over content creation. Moreover, Bela chooses to ignore online bashers and to remember that her family and friends beyond the screen are there to support her.Bela shares her tips for budding content creators: brainstorm for your niche that you want to post, and focus on these ideas instead of creating content that you think others would want to see. Post consistently, but keep in mind the topics that you want to share. It is also important to set expectations with views or likes, and to not be discouraged when these numbers are low when you first start out.Bela likes to document her workouts, hobbies, and daily life as a med student by making TikToks, a lot of which have reached social media users widely.Online BusinessFrom selling food products to arts and crafts, managing an online business is another hobby that is growing in popularity among students. One student entrepreneur who has made a business out of her craft is Camille Joyce Tan from UPCM Class 2026, who sells made-to-order and customized amigurumi (knotted or crocheted plushies) and keychains.Camille Tan is a student from Class 2025 who has found both passion and business in crocheting.Her hobby-turned-business was inspired by the fact that she has always been an admirer of all things kawaii. She started creating amigurumi in the summer of 2020, when her twin brother gave her a crochet keychain. Inspired by this gift, she started watching YouTube tutorials and decided to open her own online business in December 2020 after mastering her craft. Camille noted that learning the Japanese art amigurumi became something she looked forward to, especially during the lockdown. During her days spent at home, she would research techniques online, as well as look through social media for inspiration from other creators.Though maintaining this online business and hobby became difficult when her academic workload started piling up, blocking off time each day to spend time doing her craft helped Camille relieve her stress. She was also able to balance her academics with the management of her business by setting realistic goals for herself with regards to the number of custom orders she could take monthly. Another hardship Camille faced is that she tends to compare herself with other creators. However, she reminds herself that everyone has a different journey and that there is space in the crochet community for all creators to thrive in.You can find her handmade creations on her Instagram online store, Crafted by Camille (@craftedby.camille)!Some tips for aspiring entrepreneurs from Camille include focusing on your strengths and noting what makes your business unique. It is also important to be consistent when posting on social media, if this is your means of marketing your business, and to maintain frequent engagement with your followers. In the pursuit of staying consistent, Camille also stresses the importance of bettering your craft, especially with many online resources at one’s disposal. It would be best to learn how to adapt, in that sales may vary per month, as this will help you get through even the worst of slumps. These times pose an opportunity of experimentation to reassess your marketing plan, try different strategies to promote your products, or do something different with your business. Lastly, don’t underestimate the power of word of mouth.There are definitely a myriad of interesting online hobbies that one can start exploring during the pandemic. Although in-person activities are slowly becoming more accessible, our two years online have created many opportunities for fun and enrichment. But beyond these activities where productivity abounds, hobbies that offer a respite from being a busy medical student are what matter most. It is these passions that inspire us that we must seek out to fully enjoy our medical school days.

An Ordinary Journal

By Joaquin Arriola, UPCM Class of 2026The following was originally posted on Facebook by Joaquin Arriola over the course of his first year of medical school, December 2021-June 2022. UPCM InSPIRE has been given permission to publish these.Seatwork #1: Draw Your Future SelfMaybe one of the most important decisions we’d ever make is how we’d want to spend the rest of our lives. As a young adult, I find it frightening to simply entertain the idea. Luckily (or to my demise?), my 6-year-old self was confident and ambitious enough to answer for me.It was 2006. I was still in Claret, class number 7 of my section, Prep-Maagap. Young, naive, and without an inkling of how the world worked, I decided, without a shadow of doubt, that I wanted to become a doctor.It remains a mystery to me why I looked so sure of myself so early in life. What did I know of the fire and brimstone of the medical profession? Maybe it was that if I couldn’t shoot webs out of my wrists like my idol Spiderman, then the next best superheroes I could emulate would be my parents, clad in white coats, armed with stethoscopes. However, later on, Science would never become my strongest subject; I didn’t pass the Science High School admission exams nor make the cut for the INTARMED program. In college, my failed Bio exams, lack of higher Chem and Physics units, mocked my hopes of getting a good NMAT score.Fifteen years since I made that drawing, I’ve somehow managed to survive my first 4 months in medical school. While I bet my 6-year-old self would be over the moon to see his drawing still on track to fulfill its prophecy, the question lingers.How do we decide how we spend a journey that lasts a lifetime? I don’t know. I think that life is too unstable and unpredictable to map out a definite destination at the moment. But at the very least, all journeys have to start somewhere, and mine is no exception. “Always go back to your whys,” they say. Even then, I don’t have all my reasons fully laid out yet, and that’s okay.We don’t have all the answers now, but perhaps the whole point of this journey is self-discovery and learning more and more about ourselves every day. And maybe as we go along, things will finally start to make sense.First Exam, FailedI waited my entire life for this – my first (virtual) step into the perilous path for the white coat. Eager, prideful, ambitious, I felt unstoppable. “The sky’s the limit for these next 5 months”…. or so I thought.In just my first month into medical school, I failed my first exam (Biochemistry, of course). And before my first med school tear could even fall off my cheek, I was begrudgingly logging into my next class for the another set of lectures. With watery eyes, I took a shaky but determined breath as I rolled my sleeves up.In my second month, I was helpless as we whisked through an entire dictionary of Latin words just to name skeletal muscles. One time, our lecturer called me on-the-spot to interpret MRI scans of the femur. Still mentally stuck on last week’s lecture, I wished the earth swallowed me whole then and there. But after a few hits and misses in my haphazard responses, I made it through. That night, I made the firm resolve to start waking up before dawn to carve extra hours into my study.Three months in, I was dangerously calm. Our Head-and-Neck final exam was fast approaching and I wasn’t fully prepared, but I wasn’t fully afraid either. My laptop can attest to how much screen time I’ve devoted to reviewing. I knew my limits, and I was way beyond them already. If I fail, then I’ll sleep soundly knowing I fought until my last breath. Here, I learned to appreciate the value of the effort behind the outcome, more than the outcome itself.Fourth and fifth. I learned from our neuroscience module that I knew nothing at all. Even as I share this story with you now, I’m still neck-deep in backlogs of brain lectures I’m excited to learn. “One day at a time,” ika nga. From this, I realized there’s beauty in accepting that I don’t know everything. For this is perhaps the admission through the gates of a plethora of knowledge and a lifetime of learning.Med school hits you hard, and it hits you fast. Soon, I realized the most important thing for me this semester was not to get good grades. It was to develop a mindset that could endure “bad” ones.After I failed my first Biochem exam, everyone in the batch submitted anonymous code names to go alongside our exam scores for all to see. When the list was released, beside my subpar score was the codename “Wax babawi next exam.” Not even a name. Hardly anonymous. It was a challenge.By the grace of the stars above, I later passed the next 3 exams. Honestly, in the grander scheme of med school, this doesn’t mean much. But I celebrate the little victories as they come.After all this, I still believe that sky’s the limit. So, tara, climb with me.Lessons from Inside the ThoraxI thought it would take just 5 years to go through med school. I’m nearly through my freshman year, but why does it feel like I’ve aged 50?Everything feels so cyclical. Every day is a new series of lectures we have to swallow. Every week, there’s a more sinister storm of small group discussions we have to brave. Every new module is a deeper, more treacherous ocean we have to cross. Is this the daily commute all med students take to arrive at that MD?The most laborious travels of them all were, for me, pulmonology and cardiology. The experience was marred by grappling with arterial blood gases, cardiac electrophysiology, and hemodynamics, all inhaled in one go. I still have to run my fingers across my patient’s entire forearm to palpate the brachial pulse for a routine BP reading. I can’t auscultate the simplest heart sounds if I don’t first shut my eyes, furrow my eyebrows, and channel all the energy of the universe into the stethoscope. It frustrated me.Madalas, nahihirapan ako. Nagagalit, nalulungkot, nawawalan ng gana, nagdadabog, sumasama ang loob, ginugustong sumigaw sa kawalan.On days when my chest feels heaviest, I look back on one of our doctor’s parting words after her radiology lecture, “Will you understand all of this? Yes, but it will take time.” Other lecturers follow a similar tune, “Hang in there. This will all make sense when you go to the clinics.” My personal favorite: “Follow your heart. It will never fail you.”My professors’ end-of-lecture wisdom guide me toward an attitude to stay unbowed in the face of adversity. In part, this means slowing down and seeing the bigger picture. There’s a reason it takes 5 years to go through medicine. As freshmen, still at the bottom rungs, we’re supposed to be works in progress. The clinical eyes and ears will follow; the patient skills are on their way. If right now, 1 year in school feels like 50, then we’ll proudly boast 250 years' worth of learning later on.When I’m out of breath from the regular tolls of an online med school, these consoling words fill my lungs like a cool ocean breeze. From these, I learned to embrace faith and patience that, in the wake of tempests, calm seas emerge. A lot of things in life are unknown but there remain a few that are certain. For one, I believe in the certainty that the sun rises after every dark. And, with a faith of equal measure, I believe that my difficult days, too, shall pass.To “inspire” means 2 separate things: (1) to motivate an action or belief, or (2) to breathe in air. But when slowing down, taking deep breaths is what pumps strength for us to keep moving forward, I learned that sometimes maybe to inspire means to do both at once.

Towards the Digital Age of News: Students and Faculty on Keeping Aware of Information

By Mitchell Jared De Silva, UPCM 2025From global matters such as the pandemic to the recent national and local elections, the past few years have truly been a series of historic events. With pressing issues surrounding daily life, information awareness and its dissemination have never been more crucial. News distribution experienced a faster spread and a wider reach with the emergence of online platforms. However, its integration also introduced the prevalence of unchecked data. The once-presumed easy access to accurate information has now become an active pursuit.Media plays a crucial role in raising awareness for social, political, and economic events around the world; its influence on daily life is one we must understand. Current events are not limited to politics and the immediate persons involved. Instead, it consequently affects different domains, such as education and medicine. In the digital age of communication, an individual’s proper discernment of available data has become an apparent duty. The UP College of Medicine students and faculty are no exception here.Accounts from students of different Learning Units and the current faculty of UPCM reveal varying approaches in selecting trustworthy sources. Here, they share their insights on the significance of information awareness.Romina Francesca Letaba from UPCM Class 2028 uses different social media platforms, physical copies of daily newspapers, and news video reports to learn about current events. To ensure information is verified, she turns to certified news sources and observes the habit of cross-checking. She shared that being updated is of utmost importance as a medical student. Recognizing that health is multifactorial, she explained, “Health is tied to all sectors in our society in one way or another, and it is our responsibility that we stay aware of our current events because these may or may not have drastic changes or effects on the healthcare field.”Romina Francesca Letaba from UPCM Class 2028Viewing social media as a double edged sword, Romina noted that it does not only offer a more efficient means of broadcast but also the spread of unchecked information. Despite the promotion of fact-checking and critiquing references, misinformation is still rampant. She believes that it does not help that politicians and officials can take advantage of the situation for personal gain. Security must also be updated to protect the sites and its users from possible online hacking.Romina encourages vigilance in reminding the public of the importance of fact-checking and also advocates that it be integrated into the academic curriculum. Most importantly, she stressed that one should take the initiative to correct misinformation to prevent its further spread.On the importance of information awareness, Maria Katrina Joaquin from UPCM Class 2027 alluded to the UPCM teaching that health is multifaceted, where each facet is affected by the current events. She argued that one cannot serve the people properly if there is a lack of knowledge on current affairs. She is kept informed mainly by browsing through social media platforms and by counterchecking facts through reputable media outlets.Maria Katrina Joaquin from UPCM Class 2027She described news dissemination in the country as either dire or reassuring. Both the lack of verification and the fast flow from source to the common person give rise to the quick spread of misinformation. She asserted that the government should address such issues by enacting laws that regulate information being posted without crossing the line of censorship. Most importantly, many of the problems faced could be solved through an improved educational system that would promote the discernment of sources and the habit of fact-checking. She believes that social media is currently being weaponized and everyone must take part in halting its misuse.“To put it simply, fake news, especially when made with the intention to deceive, manipulate, and misguide people, is no different than a lie,” said Christine Nicole Therese Nicanor from UPCM Class 2025 when asked about the current situation of information dissemination in the country. With the prevalence of false information, she pointed out that the situation is truly heartbreaking because the ones who hold the intention to deceive are the those who have vowed to protect and serve the people. This malpractice has perpetuated a culture of mistrust, lack of accountability, and abuse.Christine Nicole Therese Nicanor from UPCM Class 2025Nicole remains critical of information by verifying its source and then comparing reports from different reputable references. She highlighted the significance of reviewing the character, intention, reputation, and the track record of news sources. In cases of publication materials in the form of images, she recommends the use of Google reverse image search to check its validity.Hoping to improve the information propagation system, she mentioned that the primary sources of news should be determined. Demanding accountability by setting repercussions for people who perpetuate misinformation should also be done. In addition, she hopes that an independent Fact Check Committee be established to monitor circulating information online. Lastly, attributing the prevalence of misinformation today to how the people can easily forget about the past, she emphasized the importance of improving the country’s education system. This improvement may prevent the lack of awareness that ultimately led to people easily changing the narrative and twist the truth.Hannah Joyce Abella from UPCM Class 2024 is able to keep herself updated on current affairs using her social media and by fact-checking with credible websites. Acknowledging the impact of current affairs to the lives of students, physicians, and their patients; she expressed how important it is to be aware as it will aid in rightfully knowing how to ultimately serve the underserved.Hannah Joyce Abella from UPCM Class 2024On the topic of information dissemination, Hannah expressed, “Depending on the stance of the person, social media tends to adjust and show the person what they want to see — for those who believe in fake news, this is a dangerous thing.” She believes that the system can still be improved, most especially concerning fact verification. Furthermore, such a challenge can be answered through seminars on media literacy or by prohibiting sources of false information.Simoune Raphaella Licuanan from UPCM Class 2023 mentioned that dissemination of fake news has been made easier nowadays. She added that it was disheartening that even so-called professionals or experts contribute to the spread of false information, instead of educating audiences.Simoune Raphaella Licuanan from UPCM Class 2023Personally, Simoune keeps herself in the loop by scouring through articles on social media and by engaging in conversations with her friends. In verifying information, she examines if the source is reputable and free of biases. She also tries to explore different perspectives on the matter at hand. As a medical student, she believes that it is essential to be informed. “As we always say, #HealthIsPolitical. I think keeping abreast of current events teaches you to stay grounded and lends good insight into patients' and colleagues' circumstances,” said Simoune. In dealing with misinformation, she believes it stems largely from poor leadership, citing powerful entities that resort to hiring “trolls” that generate fake news to serve their clients’ interests. Improvement can be achieved through honest governance and media coverage. Government agencies should be proactive in publishing correct and evidence-based information so the public will not rely on mere hearsay.The UPCM faculty members also present varying ways in obtaining information and bear insights on its proper dissemination. Their awareness and take on current affairs can influence their approach in teaching, as well as how they engage with the students.Dr. Gene Nisperos, an assistant professor from the Department of Family and Community Medicine, primarily refers to Facebook, Twitter, and the television news as his source of current affairs. To ensure access to accurate information, he cross-checks with other credible sources.Dr. Gene Nisperos, Assistant Professor from the Department of Family and Community MedicineAs an educator, he believes that awareness of current events is essential in teaching and engaging with students. On describing how it affects the way he teaches, Dr. Nisperos expressed, “It is how we converse with our students, how we set the dominant discourse in the perspectives (that we set), and how we correct misleading narratives.” He also highlighted the importance of informed opinions, as it will allow educators to participate in discussions in the proper frame.He described the information dissemination in the country as doing poorly on two essential fronts, namely promoting correct information and combating false information. To improve this, he cited a change in government leadership as an immediate measure, as he believes that tue current dispensation itself is the biggest culprit in disinformation and malinformation. In the long run, this change will provide an environment fostering empowered people to herald a better education system, better mass media, and better protection of human rights.“A lot of misinformation arises from miscommunication, misquoting the primary source, or misinterpreting the facts,” explained by Dr. Leonard Pascual, a professor from the Department of Anatomy and Neurosciences, on the importance of being aware of current news. Relating it to his field, he shared how clinical thinking is upheld by going straight to the source informant, verifying findings of his colleagues by performing the examination himself, and viewing the results. He mentioned that these actions are the essence of being data-driven and evidence-based, and not merely relying on reports and depending on what someone else analyzed.Dr. Leonard Pascual, Professor from the Department of Anatomy and NeurosciencesDr. Pascual keeps himself updated by reading the whole article presented by online newspapers and accessing their social media handles on Twitter. When teaching, he uses current events as a tool to make lectures more relatable to students.Agreeing on the current efforts to fact check and verify information, he emphasized critical thinking as a means to immunize the vulnerable against disinformation. He explained further that, “The strength of evidence is strongest with what can be shown in plain sight, while unverified facts as well as unvetted claims from anonymous sources must be scrutinized with healthy skepticism, and this can easily be learned by layfolk.”The predominance of and shift to online platforms have undeniably paved the way for wider and more accessible sources of information. Along with its advantages also came the rampancy of misinformation. Addressing misinformation is not merely limited to individual efforts of following trusted sources and careful content verification, as it extends significantly to established systems and authorities. The promotion of trusted organizations and online pages to verify content like Vera Files and Fact Check Philippines will greatly help in achieving such a goal. When done successfully, it will lead to an environment that fosters correct information and its rightful dissemination. As an institution that heavily values honor and belongs to a field that hinges on verifiable evidence, the UPCM — represented by its students and faculty — is surely to benefit from being informed of the truth.Despite the benefits of the media, misinformation is rampant. Social media’s duality and the growing consumption of humans of information on these platforms raise the importance of news literacy.

Policy Pivoting Practice: Government Decisions, Medical Consequences

By Harold de Guzman, UPCM Class 2023Healthcare delivery is directed by a country’s constitutional laws and policies. Since the government is responsible for creating, interpreting, and enacting these laws; it must be the government that directs the context by which healthcare is delivered to the people. These health policies and their enactments are dependent on the administration’s perceptions and perspectives — regardless of the accuracy of these views — to direct which issues to prioritize and how to address them. Often, a change of people in power comes with a change in emphasis on which issues the government will tackle. With the advent of a new administration in June 2022, a new series of changes in the delivery of health should be expected.As policy has an immense impact on our practice, government must look to science in the creation of new laws for the betterment of Philippine healthcare. Photo by: Joaquin ArriolaIn almost all cases in the Philippines, doctors hold the highest positions in the healthcare system. Doctors have the responsibility of evaluating health-relevant bills and laws for their appropriateness. Through their feedback, doctors advise and help the government make better decisions regarding the direction of the country’s healthcare. Along with the different medical societies and groups, the Department of Health (DOH) can and should be expected to be the main bearers of this responsibility as the government’s healthcare arm. Policy then appears to be one of the primary junction points where doctors and the administration meet. A notable example is the Sin Tax Law wherein doctors such as Dr. Antonio Dans, a faculty of the UP College of Medicine, have played an important role in the passing of this law.However, the relationship between healthcare professionals and policy-makers has not always been favorable. There were cases when the DOH and other medical groups attempted to defend public health by opposing policies with negative and uncertain health-related consequences, such as the recent Senate Bill No. 2239, more widely known as the “Vape Bill.” This bill, if passed into law, would bring down the age restriction on vaping from 21 to 18, allow for various advertising strategies of vape products, e.g., online, and would allocate regulatory responsibility and power to the Department of Trade and Industry instead of the Food and Drug Administration. These provisions along with others in the bill indicate a clear attempt to circumvent the Sin Tax Law.Examples of implemented laws that have affected Philippine healthcare include the Local Government Code of 1991 (in which the devolution of healthcare was codified), the Cheaper Medicines Act of 2008, and the more recent Universal Health Care Law of 2019. Some of these laws drew criticism and protestation from medical and activist groups — but it seems that these qualms did not carry much weight in the eyes of the government. On the surface, these policies appear to be beneficial for the public. However, the mechanisms by which these policies intend to reach their goals are ineffective. For example, the Cheaper Medicines Law promised to make medicines more affordable by facilitating competition between drug companies to lower prices as its primary mechanism. However this mechanism failed, thus prompting then President Gloria Macapagal-Arroyo to release the Maximum Drug Retail Price list, followed by the Government Mediated Access Price list, and later amendments to directly control the price of selected medicines. Had the law controlled the prices from the start, the coverage of medicines would have been complete and there wouldn’t have been a need to make these later modifications. Even then, it did not address other pressing issues such as unavailability and inaccessibility.The most recent examples of government directives that have affected healthcare include President Rodrigo Duterte’s war on drugs and his pandemic response. Duterte’s rhetoric indicated that he chooses to view the illegal drug use epidemic as a criminal issue rather than a public health issue. His view has exacted a heavy toll. Despite the official Oplan Tokhang guidelines that prescribed precautions to avoid unnecessary violence and death, the Philippine News Agency reported that 6,229 individuals have died during drug-related operations while the International Criminal Court’s Office of the Prosecutor estimated that as many as 12,000 to 30,000 individuals may have been killed. Muddling these figures further is the issue of falsified death certificates of alleged drug war victims. Many certificates claimed that alleged victims have died of natural causes, such as heart disease or complications of diabetes. However, the country's foremost forensic pathologist Dr. Raquel Fortun's recent investigation into the matter has uncovered evidence of violent causes of death such as gunshot wounds in skulls and other bone fractures. These findings clearly show that these deaths are other than natural. Unfortunately, the effects of this operation does not end once the suspected users are dead. The effects extend into affected families and the community by shaping attitudes towards suspects and their relatives. Duterte’s pandemic response likewise takes a military approach by appointing military personnel in key positions, calling the disease “kalaban” or enemy, and describing how the response must be a war on COVID-19. This emboldened the use of draconian measures in one of the world’s longest and restrictive lockdowns. Such was the case of Darren Manaog Peñaredondo who died after he was forced to perform squat-like “pumping exercises,” after he was seen outside curfew hours attempting to buy water for his family. In another case, five youths were forced to be locked in a dog cage for likewise violating curfew. With these terribly ineffective strategies, many have died and many more have suffered through hunger and unemployment especially during the height of the pandemic. According to the Philippine Statistics Authority (PSA), the combined total of deaths due to COVID-19 from 2020 to 2021 amounts to about 135,863. Unemployment rose during the pandemic reaching a record high of 17.6% in April 2020, slowly settling to 8.7% in April 2021, and 6.2% in November 2021. While the PSA announced that the country’s self-sufficiency improved and that import dependency declined during the pandemic, a Social Weather Stations survey showed that hunger still rose to a record high of 21.2% in 2020, remaining high ranging from 10% to 16% during 2021 to the first quarter of 2022. According to Jun Neri, Bank of the Philippine Islands economist, this could be interpreted to mean that while there were more goods available for purchase, there were fewer buyers due to loss of income from unemployment.When policies are poorly made, the consequences compound. But Filipinos embody the quality of being “matiisin” or long-suffering. They often choose to bear hardship rather than speak out or complain, and only doing so when they can bear the weight no longer. Dr. Gene Nisperos, Faculty of the Department of Community and Family Medicine of the UP College of Medicine, observes this to be a trait prevalent in doctors. “Hindi naman usually nagrereklamo ang doktor,” he said. For example, as long as the doctors’ ability to provide healthcare services are not too severely hindered, they tend to accept any change that comes along their way without much fuss. Medical associations, societies, and colleges did not speak out nor publish any statements. This silence was still brought about despite the poor handling of the pandemic response and individual doctors voicing out their thoughts in several platforms. “Saka na lang nagsalita noong nananawagan na ng time-out yoong mga healthcare workers dahil sa overload ng mga pasyente,” Dr. Nisperos said. It seems that for many, doctors are viewed to be primarily involved in the delivery of healthcare more than in the development of policies that influence this delivery.This is the other side of the relationship between doctors and the government. From one side, the government releases its instructions to its healthcare arm, and the healthcare arm accepts it. However, to simply accept an instruction knowing that it may do more harm than good is a grave error especially since these instructions have consequences of life and death. During the height of the pandemic, health professionals have called for mass testing and community empowerment. But the highest office in the land and its allies responded with an attitude that a vaccine drive alone would be enough to rescue the country. The administration even went so far as to red-tag some personnel who attempted to contribute in some way to ease the burden of the pandemic, such as in the case of the community pantries.There are many laws with ill-conceived provisions based on unsound premises. Expertise should have been lent to the making of these policies. Even if they were lent, they were not listened to. The perspectives and opinions of policy authors must not be the sole or primary factor in determining national directives, but rather it must be the truth arising from data and evidence which is often in the stewardship of respected experts.Politicians who refuse to keep an ear to the ground have caused more harm than good. We as a nation have chosen the people who will occupy the highest posts in the country last May 9, 2022. These people will determine the direction of healthcare in our country. For there to be any point to delivery of healthcare, the elected government officials must heed the words of the doctors, nurses, pharmacists, therapists, scientists, researchers, and all other professionals who have been urging for improvements, proposing sound plans, and fighting for true health for all. Otherwise, the Filipino people will have to endure another six years of needless suffering, perhaps longer.

An Unprecedented Road to Victory: Reactions of UPCM Students to the 2022 Philippine Elections

By Jose Carlos Bognot, UPCM Class 2024After months of intense campaigning by the candidates of the 2022 Philippine National Elections, the dust has finally settled and the next six years of leadership have been decided — Ferdinand “Bongbong” Marcos Jr. is to become the next president of the Philippines. To his supporters, this means the Philippines shall be made great again through unity. To his detractors, this means misinformation and fake news have triumphed and democracy is once again at risk. Whatever it is we believe in, it is clear that the political environment in our country will not recede into normalcy before the elections made headlines.We fervently watched everything unfold, be it through online, traditional media, or on the ground. We engaged with our family, friends, patients, colleagues, and even strangers, and discussed various aspects of life that are influenced by politics. We eagerly awaited the conclusion of this chapter in Philippine history, and now, we are finally here. As medical students from the University of the Philippines, we are encouraged一even expected一to engage in the progress of our nation. What, then, do the students of the UP College of Medicine feel and think about the recently concluded elections? And what do we expect from our newly elected leaders from here on out?Health is political. It is crucial for the incoming administration to put health at the center of its plans as we emerge from this pandemic.Three students* agreed to share their insights regarding the national elections. Andrew , a Learning Unit 3 student; Bernard, a Learning Unit 5 student and Carol, also a Learning Unit 5 student, share their insights about the recently-transpired elections and the impact of the outcomes on medical students and Filipinos at large.For all three, the election results were not really surprising. Bernard said that he is a believer of the pre-election polls. He also made a constant effort to follow multiple presidential candidates online so that he could gain perspective from different sides. He often noticed that the social media page of Bongbong Marcos would receive the most engagement. For Andrew, he heard from his mom who monitored the voting precincts on election day that in their area, the voters supporting Marcos greatly outnumbered the voters of his closest rival, Leni Robredo. Although the results were what Carol expected after her interactions with people of various backgrounds before the elections, she still had some hope that it would turn out differently.When probed further on their thoughts regarding the results, many of their musings involved trying to understand how Marcos was able to achieve such a massive amount of votes to win the elections. Bernard brought up the notion that it might have had more to do with the way the candidates talked to the masses. He believed that candidates like Isko Moreno and Bongbong Marcos were able to talk and relate to the masses well. Andrew, meanwhile, pointed to the idea of “alternative facts” on social media, and claimed that it must have taken years of persistent effort to instill these alternative facts onto a larger number of people. On the other hand, Carol felt confused and disappointed about where arguments against certain candidates came from. She brought up an example of an Angkas driver she encountered who claimed that he would not vote for Robredo, “kasi babae siya”. Carol believes that a multitude of factors, not just a single campaign season, that created enduring beliefs such as this.When it came to their personal feelings regarding the elections, the sentiments were mostly of disheartenment and frustration. Carol immediately brought up the notion that health is political, and she felt that other candidates might have been better suited to look after the health needs of people, especially the patients we encounter daily at the Philippine General Hospital. Andrew, on the other hand, mostly disagreed with the people online who blamed the masses for allowing the elections to lead to this result. He reflected on how we should instead acknowledge that there are systems in place that led to the victimization of the masses via misinformation. It is important, Andrew says, to change this mindset. Instead of blaming the masses, we should reach out to them and engage in productive discourse. Despite the discouragement, though, the three students still felt hopeful for some positive changes to arrive in the future. Bernard gained hope as the campaign by Robredo turned into a movement that inspired many. He feels that despite her defeat, it is worth celebrating the fact that many have woken up to the call that there is still much more to fight for, for the benefit of the Filipino people.When Bongbong Marcos eventually takes the helm of the presidency, he will not only be inheriting the seat to be vacated by the incumbent president, Rodrigo Duterte. Marcos will also fall heir to the many issues that plague the country to this day. Most notably, we are still facing the effects of the COVID-19 pandemic. Marcos would have to commandeer the country’s return to normalcy, and according to Bernard, the primary consideration in this regard should be the country’s economy. Many jobs were lost and still have not been recovered, many industries were disrupted, and it begs the question of how well will Marcos rise up to this challenge. Andrew also agreed that financially, the country is in a difficult spot, and the Filipinos most affected by this will be those from the masses — everyone from the urban poor to our Lumad brothers and sisters. When the investments go away, so will the jobs, and so will the ability to fulfill basic needs. Carol also recognized that human rights violations, an issue which has surrounded President Duterte since the beginning of his term, should be acknowledged as well. She believes that we should also acknowledge that Duterte’s approach to the war on drugs has had an effect on the mindset of many Filipinos, who now believe that authoritarian power and violence are the only solutions to the problem of drugs in the country.Despite these issues that Marcos will have to tackle, the three respondents also hope that other problems will not be left behind. They agreed that our educational system needs to be improved. Andrew believes that the necessary first step is the return of face-to-face classes, made more challenging within the context of the ongoing pandemic. To Carol, focusing on the educational system means decreasing the risk of misinformation and improving the attitudes of citizens towards the state of affairs in the Philippines. Bernard concurred, saying that creating an educational system fit for a democratic country is important, as democracy values transparency, criticism, and openness. Carol also reiterated that basic needs and empowering those who supply these (i.e., fishermen and farmers) should not be forgotten by the incoming administration. With education and empowerment will also come employment and further opportunities for Filipinos. Carol expressed that, ultimately, to solve any problem within a community, seeking their needs and building a connection are foundations to real change.One cannot deny that many people wished for a different outcome for these elections. A great number of students of the UP College of Medicine fought for a candidate who they felt would bring love in a radical way into the highest position of service in our country. In the end, this candidate may not have won the elections, but for Andrew, Bernard, and Carol, and many other UPCM students, this candidate triumphed, still, by sparking a movement. For them, the fervor and desire to serve the people must be maintained. The people must also continue to be critical of the government, especially now at a time where there remains some level of distrust between the administration and some sectors in the country.As medical students, there are also many things we can do to contribute to the welfare of our countrymen. One of the best ways to give back is to work hard now and eventually return the service to our fellow Filipinos here in the country. Good doctors are needed to ensure that the people, whose taxes subsidize our medical education, receive the level of care they deserve. We can also continue participating in service projects that aim to address needs in various communities. Whenever we are not bogged down by clinical work or papers, we may also continue to participate in volunteer efforts, or join our fellow countrymen on the streets who are simply calling for a better treatment of and future for the Filipino people. To quote the late Kobe Bryant, “The job’s not finished.” There are battles that will still need to be fought. The difference now is that we remember not to fight for a particular candidate; we fight for the Filipino people.Medical students fulfill their national duty by casting their vote last May 9, 2022 in their respective precincts.-------------------------------------------------------------------------------------------------------------------------------* - The names of the three students were changed for anonymity.

LIWAYWAY: PGH Internship Class of 2022

By Jose Marcel Magno, UPCM Class 2022In the blink of an eye, five years have passed and UPCM Class 2022 awaits graduation. The class had just completed the 12-month gauntlet of internship filled with work, learning, and service on the floors of the Philippine General Hospital. Regarded by some as a rite of passage for physicians, this year was the same as traditional internships with its hardships and triumphs. However, as much as things remain the same, everything still changes. As the dawn rises on Class 2022, let us look back on their penultimate hurdle before becoming full-fledged physicians.PGH Internship in 2021–2022 followed the traditional format of having interns rotate in different departments around the hospital. They would spend roughly two months in the big four major departments, around a month in community deployment, and a few weeks in other departments. Albeit the same in spirit, some concessions had to be made to account for the ever-changing climate of public health in the country in recent years.Internship officially began in July 2021, though the interns had not yet been officially cleared for face-to-face hospital duty due to COVID-19. Unable to physically attend to their posts, the administration set a crash-course on board-relevant subjects to tide them over. This was a series of reviews dubbed the Board Reviews Series. Lectures and tests on Anatomy, Physiology, Biochemistry, Pharmacology, Pathology, Legal Medicine, and Microbiology and Parasitology were prepared. An allotment of one subject per day meant an onslaught of information coming in waves for the interns. The students were overloaded with information and an understanding of the weight of future studies to come afterwards. Though this series was an appreciated stopgap, the interns preferred to be in the hospital, learning from the patients.Fortunately, the interns would eventually be cleared to return to the hospital for August onward. Hence, in preparation for eventual deployment, Skills Training and BLS-ACLS sessions were scheduled weeks prior to the resumption of in-hospital duty. Procedures such as venipuncture, IV lining, NGT insertion, and ABG extraction were taught to bridge the skill gap brought about by the extended time away from the hospital. Equipped with skills and techniques for the long road ahead, the interns set foot on the floors of PGH.As face-to-face internship began, the hospital implemented new policies to adhere to guidelines set by its own HICU and other pertinent governing bodies. The first innovation is the UPM Bayanihan Na! Employee Symptoms Tracking System, wherein UP accounts were used to track COVID symptoms and exposure through daily logs. This monitoring system came particularly handy in contact tracing and immediate testing of symptomatic cases. This led to prompt intervention and schedule adjustments whenever a positive case was detected.Another adjustment was the removal of the “true post.” Shifts were shortened to a maximum of 12 hours per shift. This reduction of duty duration led to the PGH community moving away from the “pre-duty-post” scheduling system in favor of an “AM-PM-GY-Off” or “AM-PM-Off” pattern. Pre-duty tasks were then accomplished by PM duty or off-duty interns. These tasks included scheduled OR assists and OPD duty. This pattern did not affect the infamous routine rounds such as OBGYN’s daily Summary Rounds and IM’s Guazon Endorsements, held initially via Zoom and slowly transitioned back to face-to-face.Lastly, the year was divided into two phases, with a reblocking of interns from 27 blocks down to 20 after six months. This effectively halved the durations of several rotations. However, the interns were offered the option to shift out to different departments during a rotation, provided that they have completed all competencies of their supposed rotation, and that both the departments are amenable to the transfer. This allowed interns with limited exposure or deeper interests to explore these departments.There were many adjustments that everyone in the PGH community had to get used to. In fact, scheduling troubles plagued the entire hospital at the beginning of the year, as new concerns and developments would often arise. But if the PGH community is anything, it is adaptable. Soon these problems were resolved, schedules normalized, and the hospital continued on as usual until the new PGH ER opened.Perhaps the biggest change this year was the grand opening of the brand-new PGH Emergency Department and OB Admitting Section. Shortly after these posts were opened, the interns were assigned to these locations. Departments were once again working to adjust guidelines and protocols for the COVID-undetermined ER and OBAS posts. This was no cause for concern as interns were safely decked to these posts throughout the year, despite the fact that at some point this year, it filled to almost thrice its full capacity. PGH was back to operating beyond capacity.In no time at all, it was already the end of June. Internship flew by and the end was in sight. Each block would contribute their own social media posts counting down the days remaining. Then the counter hit zero. The end of internship was celebrated the only way PGH Interns do, with the Sunog-Puri. This hallmark event had been in the back of the minds of each person in PGH throughout the year, wondering who the most outstanding members of the PGH community were, and more interestingly, who drew the most ire from the interns. With the intention of leaving with a bang, the PGH Interns 2022 dropped their list with cheers and merriment as they bid farewell to the hospital they called home for the past year.Internship has always been a professional learning experience that offered meaningful work in the field of medicine in each department the interns rotated in. This year-long trial of attrition wore down the students and challenged their mettle. Many tears were shed and stress meals ordered, yet work had to be continued. Emotional and physical exhaustion were common themes all throughout the year. Time returning home to family, friends, and loved ones was limited by the risk and fear of bringing home infections from the hospital. Decompressing or relieving stress with meals or drinks out with the block was limited by the risk of causing a COVID outbreak in the wards. Despite these usual coping mechanisms being unavailable, the interns pressed on.Now, these interns stand at the break of dawn. The eternal night of internship has passed, and they face a bright tomorrow. They may have many more sleepless nights ahead of them, more loss, stress, and pain to endure in the future. Countless other seemingly insurmountable challenges await. Soon, many will face the Physician Licensure Exam, and shortly after, they will follow their individual career paths. But with each challenge they face, Class 2022 will do as they always do. Twenty twenty two, Breaking Through!

The Pursuit for Knowledge Starts and Ends With A Question: Life in the MD-PhD Program

By: Charlene Divine M. Catral, UPCM 2027“If we knew what we were doing, it wouldn’t be called research.” Such were the words of Albert Einstein that unexpectedly hit home. One usually envisions research as a process of venturing out in search of new knowledge; at times, however, more questions are uncovered than answers. Alongside the unquenchable thirst for knowledge, creativity is challenged as research demands one’s ability to construct a question and paint a picture of their findings through scientific papers, posters, and presentations in scientific fora.The University of the Philippines Manila is recognized as the breeding ground for six-star physicians in service of the Filipino people. Starting in 2010, the premiere university’s medical school opened its doors to students aspiring to enter their pioneering program: the MD-PhD (Molecular Medicine). The eight-year program trains aspiring physician-scientists in the art of medicine, while also gearing them up to contribute to the advancement of health at the individual and global scales through basic and applied biomedical research. It is composed of one year of PhD subjects (e.g. advancements in biochemistry, physical biochemistry, genetics, microbiology, etc.) that tackle health and medicine at the molecular level, five years of medical school, and two years of dissertation. During their years of study, the Department of Science and Technology-Philippine Council for Health Research and Development grants these students full scholarships to support their studies. As of 2022, the program’s students and graduates have produced 176 scientific research works published in peer-reviewed journals worldwide.“Things you’d need in the program include wit, determination, resilience, and lots of prayers,” said students from Batch 12 of the program as they recounted their starting days in Grant Year 1 this AY 2021–2022. Admittedly, there would be days with no breaks in between classes and laboratory work, as well as hours of sleep lost as one strives to accomplish deliverables. Nevertheless, these challenges train the MD-PhD students for something greater. Researchers know better than most that failure is part of the learning process — for failed experiments not only generate new findings, but also help you learn ways to troubleshoot your methodology. Research is a process of trial and error through which one must persevere as they work towards their goal of acquiring answers to scientific questions.MD-PhD Batch 12 attends face-to-face laboratory classes where they were trained with the necessary laboratory skills in the diagnostics of parasitological specimens. Photo by: Charlene CatralThe MD-PhD program is a community built on its students, professors, and key stakeholders. Everyone in the program is like family, helping each other in times of need, crying together in times of sadness, and laughing together in moments of joy. Regardless of stressful events and the mountain of tasks that surround the program, it is a place one can call home. Post exam lunch-outs turn into extensions of scientific discussions and immersive humor. When one hits a slump, others would be there to offer their insights and experiences. There are days when research becomes a far away dream due to the countless failures and challenges, but there are systems within the program that assure its students they have people to lean on and ask for help. Per batch of MD-PhD students, a batch adviser is assigned to guide and assist them in their struggles. Alongside this, their professors are also willing to lend an ear and helping hand should they need it. A buddy system is also in place where students and alumni alike help each other in times of need, giving advice on how to survive the program."It was a delicate experience," Rafael Manalo said as he recounts his anxiety and exhiliration in witnessing the birth of a new life in an operating room of the Philippine General Hospital. Photo by: Rafael ManaloRafael Vincent Manalo is an MD-PhD student currently taking his dissertation at the Children's National Medical Center in Washington DC through the Research Enrichment Program (REP) offered by the Department of Science and Technology. The REP is a research track offered to MD-PhD students who are impassioned to take their dissertation in between clerkship and internship in the regular MD program; it is usually conducted abroad. He discusses the great difference between the first year of the program — where students tackle graduate courses — versus the medical subjects they take in the years thereafter. He describes the transition between PhD courses to medical courses as “a complete turnaround.” He expounds that while a PhD requires one’s creativity while pursuing answers to scientific questions, medical courses utilize one’s ability to familiarize concepts and utilize this knowledge in diagnosing and treating their patients. “Balancing both gigantic fields in the MD-PhD program requires a balance between knowledge and creativity, learning to discipline scientific ideas so as not to become too radical, and acknowledging current limitations in patient management to allow possible improvements through research,” he further explained.Metamorphosis: After years of grueling hard work, Dr. Joanne Tan is now graduating with a dual degree of MD-PhD in Molecular Medicine at the University of the Philippines Manila, College of Medicine. Photo from: Dr. Joanne TanWhile other students are still taking their medical courses and conducting their dissertations, one of the MD-PhD students who will be graduating this 2022 is Dr. Joanne Jennifer Tan, who conducted her dissertation — titled “Effects of peptides derived from the alpha-2 domain of apolipoprotein B-100 on low-density lipoprotein aggregation” — in The City University of New York. Dr. Tan is no stranger to the tedious adventures of a researcher for she also faced many obstacles in her path to graduation, including schedules pushed back due to the COVID-19 pandemic. Yet, through her creativity and wonder, she was able to incorporate her interests in cardiology when an opportunity was presented to her to work on amyloid fibril formations. She described her ten months abroad as “one of the best times of my life” filled with memorable experiences and knowledge gained. “Aside from the fleeting euphoria of achieving something ‘great’, I actually felt a sense of loss of direction.” The euphoria came from her surprised transformation through the years, becoming somebody she never imagined she could have become as she dedicated herself to the program for the past eight years. Although the big question of ‘What comes next?’ lingers, Dr. Tan noted that, “I take comfort in the reality that I am finishing on a good note, scarred, yet made it through.”Immersive application of science in research during Dr. Tan's 10-month stay in New York to complete her dissertation. Photo by: Dr. Joanne TanAn MD-PhD in Molecular Medicine is one among the roads less traveled. Realistically, it is a difficult path with daily challenges, but it aims to transform students into the national scientists they are meant to become. The journey traveled thus far has brought the program’s students and graduates to continue pursuing greater heights of discovery through research and clinical practice, all with the aim to achieve knowledge in service to those in need. Like butterflies after a long period of transformation in their cocoons, they hope to someday take flight and become what the country and the world needs the most. Like flowers budding anew as the seasons change, it is once again time for a new batch of MD-PhD scholars to be welcomed. The pursuit for knowledge is no easy feat, and yet, here they are continuously seeking it.

Teaching and Learning Innovations in Obstetrics and Gynecology in The Time of The Pandemic

AUGUSTO M. MANALO PROFESSORIAL CHAIR LECTUREBy Maria Julieta V. Germar, MD,FPOGS, FSGOP, FPSCPCProfessor 4, University of The Philippines College of MedicinePhilippine General HospitalExcerpts from the Professorial Lecture delivered on June 22, 2022Dr. Maria Julieta V. Germar, fondly known as Dr. Jayjay, shares her experiences in teaching during the pandemic.I feel very privileged to be given this honor and opportunity as the mentor who holds this professorial chair is more than just a mentor to me. He has been our source of inspiration through the years and our source of wisdom and strength long after he’s gone.He taught us not just to be the best gynecologic oncologists, not just to be astute researchers or excellent teachers, but to be good people as well. He played a loving part in our lives, and he will always be our Papang.In memory of Papang who taught us how, let me share with you what we did in this pandemic to teach our students while learning to be better teachers. We all have a lot of stories to tell, our struggles, our triumphs and how we found our hearts in this pandemic.My story is the story of a teacher. My very first idol outside the home was my kindergarten teacher. I think I speak for most of you when I say ang unang idol natin ay si ma’am o si sir. Our teachers are like superheroes as we were growing up. They have superpowers, they’re all-knowing, they’re always present, and so we follow everything they say.When I entered medical school, in my heart, I still wanted to be a teacher. The rockstars for me then were our professors who taught us well whether in the classroom or in the clinics, just like Dr Augusto Manalo. I wanted to be like them.Dr. Jayjay Germar with her co-interns who faced the full PGH experience togetherMy first job when I became faculty at the UP College of Medicine, was the OB GYN Academic Coordinator of the Integrated Clinical Clerks and I've held that position for 18 years now. I've always asked to keep the position no matter how toxic, because I like that part of my work.I am happiest when I teach.One of the best decisions I’ve ever made was enrolling in NTTC in 2017, I wanted to be a better teacher. As a teacher, I find joy and fulfillment in seeing the students eagerness in learning something new, and the awe they feel in performing a skill for the very first time.Then, COVID 19 happened. It disrupted our lives in an unprecedented manner we could never have been prepared for. This however became the catalyst for this transformation in health professions education. We need to continue to teach and transform. The pandemic brought clarity and critical urgency to this purpose. It pushed us to find ways. In the clinical sciences, we were hit hard. The pandemic removed our students from the opportunity to talk, examine and interact with a patient. We had to keep our students away from the very place where they would experience learning best.Let me tell you our story.When the pandemic hit, it was the second week of my students, and I had to think of teaching learning activities they can do from home. I made them work on infographics on COVID-19 and pregnancy. We met virtually and I gave them whatever guidelines were available. We found refuge in the work we were doing.We posted their work on Facebook, Twitter, and all Viber groups. They were the FIRST ever infographics on COVID-19 and pregnancy, and in one day, these were shared 331 times in social media platforms. Clinicians from Palawan, Zamboanga and Ilocos asked to create tarpaulins as guidance for their trainees and patients. The Philippine Obstetrical and Gynecological Society President and Vice President acknowledged their work.A day later, on March 17,2020, I got a call from Dr Pura Rayco-Solon of the World Health Organization. She was calling from Geneva. She asked about the infographic on COVID-19 and breastfeeding and how our students can add the just posted WHO recommendations. She then posted the updated infographic on her social media page. The post was shared 132 times. My students went international.On January 2021, it was decided that our third year medical students still could not have face to face classes. Third year is when they have their first clinical exposure. In this year level, everything is amazing, everything is wow. How do we now teach them these clinical skills virtually?We needed to look at each teaching and learning strategies and modify, adapt, and modify again. We had to check our resources, our personal capabilities and we had to inform and prepare our faculty–our greatest resource, a constant resource that COVID cannot change. My greatest weapons through the years are my residents who share the passion and commitment to teach. We were prepared.We had to learn about our students, our learners. We must create an environment where learners feel supported and psychologically safe especially in this pandemic. I set aside every first Monday of the rotation to get to know them. This pandemic disrupted our social relationships. We all longed for social interaction. The virtual platform actually allowed more intimate interactions. I ask them to introduce themselves and mention a fun fact no one knows. They become excited and creative. I asked what they did in the pandemic—some baked, some have pets, some have art, plants. We had show and tell. It breaks the ice. Then I ask their expectations, their learning needs, their connectivity issues. I got to know each student more now than pre pandemic. We developed friendships.Access and communication became critical. I had a telegram chat group with them. All 6 blocks, 30 students per block. They have direct access to me, and I have access to them. Access provided us so much comfort during these uncertain times.I learned to be mindful of their circumstances. I had students who could not join because of internet limitations. One had a brownout at home and tried to join using a streetlight. One had to be in a bus to come to Manila due to an emergency. One had to take care of family with COVID, and one had to work after 5 pm and so had to leave. We have weekly feedback also by Telegram, either in the group chat or direct message. Sometimes I send a summary post session to reinforce key messages, and/or a reflective exercise to help consolidate their learning.The next step is facilitating active learning. Visual learners prefer material that is delivered through visual media. Auditory learners prefer the spoken word to visual material. We have AVPs prepared for these aspects of learning. Kinesthetic learners learn best when the learning involves them in physical activity. The tactile aspect of learning must be achieved. I had to engage them in these 3 aspects. So we needed to find a way to do this virtually.This is the conceptual framework of the OB GYN 250 Virtual Learning Simulation Kit. First, I sent them the AVPs for all the clinical skills—Physical Examination in OB GYN. I gave them performance checklists for each skill. Then I sourced the cheapest materials I can find, made a cervix out of clay, found low-cost disposable specula and tested prototypes. I assembled each one and included instructions.This is the first ever OB GYN 250 Virtual Learning Simulation Kit. For the pelvic exam and pap smear, the kit has a disposable speculum, gloves, spatula, swab and glass slide and the clay cervix to be mounted in a toilet paper core. For episiorrhaphy, the kit contains a needle holder, scissors, tissue forceps, suture, gloves, syringe, and a yellow sponge simulator. I asked the students to prepare toilet paper cores to be vaginal canals, find their old stuffed toys and use their imagination.I sent them one by one to those in Metro Manila and the regions. Thirty students at a time every 3 weeks, for all 181 students. The Foundation and donors helped augment the cost of the kit. It was a test of patience, but I wanted to make this work.OB GYN 250 Simulation Kits are assembled by Dr. Jayjay Germar, which are then delivere dto each student’s homes for their best learning during the pandemicSkills acquisition in clinical teaching involves learning how to perform the skill, the rationale for doing each step, and the interpretation of the findings. Without these three components, the skills merely become a mechanical performance with limited clinical applications. It’s not just knowledge, it’s not just muscle memory, there’s a fourth aspect. How to humanize the learning experience so that it makes a student perform the skill in a gentle manner while interacting with a patient and making sure she is not in pain she is comfortable, and she understands the procedure being done. When we teach our health professionals the skills necessary to make them competent physicians the most important aspect is, how to make sure each step is understood not just in the cognitive aspect, not just in perfect motor synchrony but with empathy as well.I do a live demonstration for each skill every Thursday of their 3-week rotation. I annotate, explain the rationale for each step. I encourage questions and promote interaction. We must engage the learner; we must compensate for what can’t be done face to face. Particular attention is given to making sure each step is done with care with the patient’s comfort and safety in mind. I asked them to use stuffed toys and regard them as patients as they inform her of every step. I encourage the students to ask questions and clarify what is not clear in the steps. Redirection, refocusing, and increasing critical awareness are important.For Normal Labor and Delivery, we do the live demo on the cardinal movements of labor and delivery using a pelvic model and a baby. I use three cameras for better views. For the episiorrhaphy workshop using a yellow sponge simulator, I do a live demo again, using all possible angles. I then ask them to mark the muscles in their sponges, so they review the anatomy of the perineum. I sometimes do the demo 2-3x per block before the breakout to make sure they learned. Sometimes some cannot follow so I schedule a separate one on one with that student. Individualized learning and feedback are necessary for some students.We divide them into breakout groups and do the return demo using the checklist. The tactile component of learning became evident. They annotate as they perform the steps. We then debrief each one. What has been achieved may be conscious competence. We may then aim for unconscious competence by constant practice at home which makes the kits handy.Scenes from Dr. Jayjay Germar’s session teaching episiorrhaphy to Integrated Clinical ClerksThis Kolb’s Experiential learning cycle is applied. We start with the concrete experience, then reflective observation in the breakout rooms, conclusions drawn during the debrief and active experimentation starts with skills enhancement before the actual patient encounter.Motivation is key. The kit was something they appreciated and something they own. It sparked interest as they assembled and found other items from the house to help with their learning. The learning became individualized participative and interesting.Student’s learning is affected by their motivation. Controlled motivation is brought about by external pressures (other people’s expectations; rewards and punishments) or what they think is expected. This leads to rote-learning with little integration of the material into the student’s long term values. In contrast, autonomous motivation occurs when individuals see the material to be learned as intrinsically interesting or important. This leads to greater understanding, better performance, and greater feelings of competence. This is what we continuously aim for.Motivation is for both the students and the teacher so we must ourselves be motivated. Like oxygen needed at a time of an emergency, we need to fit our own oxygen masks first before we help others.Next is the lack of patient exposure. This would have been their first exposure to patients in the ambulatory setting. I can’t make them do telemedicine as a tag along with residents because most patients don’t have gadgets nor access so it’s usually a simple call, no videos. So, we must find ways. We found low-cost gadgets and made telemedicine hubs at the OPD.They interview and interact with the patient via Zoom. They discuss their findings with preceptor who in turn examines the patient and discusses the findings with the student. They arrive at a diagnosis and plan. The student then discusses the diagnosis and plan with the patient. All competencies except for the actual physical exam were fulfilled. Patients appreciate the attention of the students, and the students get the chance to have a patient encounter even if virtually. There are many skills that cannot be taught even in a face-to-face classroom. The humanistic aspect of medicine requires the presence of a patient, real or simulated.The next step would be assessments both to assess the students and the course and the teacher. Rubrics are essential. We had to balance accurate evaluations with compassion. We need to grade them, but we need to prioritize learning over grades. I give them personal feedback on their quizzes. I find it therapeutic as I get to know them more and it motivates them to do better.The last step would be to calibrate the responses based on feedback. We needed to complete the last two steps to complete the experiential learning cycle. So we designed the skills enhancement program. This was formative with feedback and debriefing. We focused on basic physical examination skills. This was our bridging module to close the learning gaps, face to face.We started hybrid sessions in March 2022. What we continue to provide: a safe learning environment, formative assessments, personalized feedback, and a calibrated response. We’ve resumed doing the lectures that precede the workshops as face to face. We did birth simulation using a high-fidelity simulator, keeping in mind the mindfulness and one on one teaching we learned when it was online. The face to face encounters we do now are much more appreciated. This is something we will never take for granted ever again.As face to face classes are slowly resuming, skills enhancement sessions are conducted to ensure adequate knowledge and skill of incoming clerks.The pandemic is not yet over. We must prepare our students to be compassionate, to be brave and to remember the very reason they want to be in this profession. We need to arm them as they play multiple roles in Society. The roles we play go beyond just being educators.Ang pandemya ang nagturo sa atin na ang mahalaga ay hindi lamang ang utak o galing kundi ang malasakit at ang puso.Dr. Augusto M. Manalo said the following in a speech he delivered in 1997 addressing his students now educators and he said:“Kung sa tinagal-tagal ng iyong pagdadalubhasa ay natutunan mong tumangis sa kahirapan at kalungkutan ng iyong mga kababayan,kung natagpuan mo sa iyong puso na maglingkod sa kanila nang kahit paminsan-minsan ay walang inisip na katumbas na kabayaran,ikaw na marahil ang isa sa maitatanghal na tunay na bayani ng ating pangkasalukuyang lipunan...Maybe you are the reason why many of us have spent the best years of our lives being involved with teaching and residency training programs.Maybe you are the reason why we never stopped to improve these programs…Maybe you are the reason why we can walk with joy in the twilight of our careers......because we know that there will be you to take good care of our people.”We can only hope our students become the individuals we envisioned them to be, the individuals they themselves aimed to be and the individuals the society, this country deserves to have.

What Lies Ahead

By: Karl Gerard CrisostomoIn the three years since the pandemic came, many changes have come and gone throughout the country and the world as we know it. In the interim, seasons have changed, lives have made their full circles, and everyone is settling towards a new normal, a new beginning, a new chance to make things right. After three years of struggling against the coronavirus, we have reached a point where there is a settling status quo; a new way of experiencing life in the post-pandemic world. Schools around the country have been told to prepare for face-to-face classes starting this academic year [1], finally providing students who have spent months in Zoom classrooms the opportunity to meet their peers and faculty and experience education as it was before all the commotion [1]. Independent research from the OCTA Research Group has even indicated the possibility of mask mandates in the country being made optional once COVID-19 reaches endemicity [2].The improvement of the pandemic situation and loosening of restrictions provided opportunities for medical students to catch up on clinical skills which were deprived during the online set-up. Featured are some UPCM 2024 Block 5 students during their surgery skills training. Photo by: Beatrice QuerolAs modern civilization finds its footing, we must never forget the contributions of those in our profession — as well as the medical field at large — towards ensuring the progress towards protecting our communities. Despite the difficulties from the changes brought about by this unprecedented situation, we were able to mobilize ourselves in the national scene. Healthcare workers of all ages and stages in their medical careers opted to volunteer in various capacities. Some volunteered in the various vaccination drives set up by organizations such as the Philippine Red Cross [3] and offices such as the Office of the Vice President, as well as vaccination drives by local government units [4]. Some took part in voluntary teleconsults such as the Bayanihan E-Konsulta, an initiative set forth by former vice president Leni Robredo near the onset of the COVID-19 pandemic. The efforts of those in our profession have not gone unnoticed, as the former president Rodrigo Duterte conferred the Presidential Merit Awards to various healthcare professionals who contributed towards the country’s pandemic response [5].The unique cases encountered in the clinics is evidence that medicine is best learned by the bedside. Featured is an SVD case attended by ICCs, OB residents, and interns. Photo by: Deirdre PuñoWith all these in mind, what now? As the country is slowly settling towards a new normal, we must then remember that the fight is not over yet. While the dust is settling and we are slowly getting accustomed to a life where COVID-19 looms ever-present, our contributions should not go unnoticed. As we in the health sector have been tasked with holding the line against this invisible enemy, we have made many sacrifices. We have lost colleagues, friends, and family in service of the country and its people. In our efforts to make this world a better place, we have given up so much. The main thrust that galvanizes those in our field, other than to heal the infirm and ensure that everyone is of good mind, health, and body, is that we dispense hope to those in need during their darkest, lowest points. Our profession is one of sacrifice, yet also one of service. We are regularly tasked with giving up precious time and exposing ourselves to the newest variants of the coronavirus, all while actively combating exhaustion, burnout, and the deepest darkest recesses of our mind that call for an end to all the suffering and difficulties that we experience on a day-to-day basis. Yet, we must do what we can to trust in ourselves and our colleagues, that we will support each other through all these moments and ensure that we render the best care possible to those in need.Beyond the cases encountered by medical students at the busy halls of the OPD, are the patients’ stories which humanizes every clinical encounter. Photo by: Steffi FranciscoAs the world that we live in has changed, for better or worse, so has our responsibility. It lies not only in healing those who are sick, or ensuring that the world moves on from the pandemic, but also in mobilizing ourselves in differing capacities towards our various advocacies, all working towards a common goal. Over the course of this past year alone, we have seen a massive shift in the perception of doctors. This was seen throughout the recent elections, where doctors from all over the country mobilized for their own political candidates, volunteering their time, talents, and services to ensure that their beliefs and their actions were heard and understood by many. This best exemplifies one of the core tenets of what Dean Charlotte M. Chiong terms the Six Star Physician: one where we are Scientists with Nationalist Fervor. The call to serve not only lies in the service of the people, or the country, it also lies with how we are empowered on a national level to let our voices be heard.Throughout the years, the medical profession has often been associated with the idea of hope. Indeed, one of the more recent interpretations of the abbreviation PGH no longer refers to the hospital or institution, but rather, the people who kept working tirelessly to ensure that the institution maintained its status as a beacon of hope in one of the most trying times of our country's history. PGH: People Giving Hope, as they say. Thus, we must use this platform to the best of our ability, as the fight is not over yet. Our duty as social mobilizers has just begun.What lies ahead then, is not a return to the status quo. We doctors are now at the forefront of shaping the country in many ways. We are where we are today due to the tireless efforts of our cohort in offering themselves to the best of their capacity to meet the needs of the Philippine nation. Hence, moving forward, we must find it in ourselves to move towards this brighter future, for we have finally been given the opportunity not only to heal individuals from their medical conditions, but also to make a palpable difference in the national stage through our advocacies, as well as our actions in the coming years.We are relevant.We continue to make a difference.[1] Galvez D. DepEd orders all schools to shift to face-to-face classes by November 2 [Internet]. INQUIRER.net. 2022 [cited 2022Aug2]. Available from: https://newsinfo.inquirer.net/1626494/deped-orders-all-schools-to-shift-to-face-to-face-classes-by-november-2[2] Staff CNNP. OCTA: Optional face mask use possible once covid-19 reaches endemicity [Internet]. cnn. 2022 [cited 2022Aug2]. Available from: https://www.cnnphilippines.com/news/2022/7/11/OCTA--Optional-face-mask-use-possible-once-COVID-19-reaches-endemicity-.html[3] Pagkalinawan AJ. Philippine Red Cross Bakuna Centers Open to walk-in clients who are qualified to get the second COVID-19 Booster Shot [Internet]. Philippine Red Cross. 2022 [cited 2022Aug2]. Available from: https://redcross.org.ph/2022/05/20/philippine-red-cross-bakuna-centers-open-to-walk-in-clients-who-are-qualified-to-get-the-second-covid-19-booster-shot/[4] Community vaccinations help overcome stigma and practical barriers [Internet]. World Health Organization. World Health Organization; 2022 [cited 2022Aug2]. Available from: https://www.who.int/philippines/news/feature-stories/detail/philippines-community-vaccinations-help-overcome-stigma-and-practical-barriers[5] Geducos AC. Duterte honors IATF members, health experts for pandemic response contribution [Internet]. Manila Bulletin. 2022 [cited 2022Aug2]. Available from: https://mb.com.ph/2022/06/17/duterte-honors-iatf-members-health-experts-for-contribution-to-pandemic-response/

A Vote for Health

By Dr. Angela Sison-Aguilar, Faculty Editor-in-Chief of INSPIRE“The first task of the doctor is ... political: the struggle against disease must begin with a war against bad government." Man will be totally and definitively cured only if he is first liberated...” (Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception)Physicians like ourselves would often steer clear of this statement and focus on what we believe we do best, that is, to practice good medicine. However, throughout history, and especially with current national and even local developments, we in the medical profession are challenged to go beyond this comfort zone of traditional professionalism and engage in the very public arena of politics. Why this predicament?GOVERNMENTS INFLUENCE HEALTH RESOURCE ALLOCATION and SOCIAL DETERMINANTS OF HEALTHSocial determinants affect health outcomes at many levels– individual, national and global. Indeed, many groups in the health professions not only recognize this but incorporate these strategies as well to augment traditional medical interventions [i]. The commitment to public health has never been as important as it is today with the advent of the COVID pandemic [ii]. Without community and national action aided by global support, treating individual patients on one’s lonesome will be an exercise in futility. The health professional striving to achieve a cure for a patient should pay attention to these determinants. The physician should be aware that health disparities produce disappointing outcomes regardless of individual efforts. Lastly, the physician should understand that power structures that influence health and economic policies decide whether the patient lives or dies due to variable access to care. National government policies also influence health outcomes by controlling the health risk exposure of the populace. For example, the intent of Increasing the costs, by imposing higher taxes, on goods such as cigarettes, alcohol, and sugar-containing products–is to limit access to a particular demographic [iii]. In addition, the revenue from these tax measures finances health services targeted to benefit the same demographic [iv]. What brought about these changes in public policy? What influenced the government to craft favorable laws despite the powerful industry lobby? This is the result of collective sectoral action [v]! The cooperation of civil society groups and the leadership of enlightened health advocates provided the effective push to enact this piece of legislation. The impact is not only on individual health but also on societal health as well. The physician participating in this effort not only saved a life but also, collectively, improved national health outcomes.HEALTH ADVOCACY INFLUENCES PEOPLE TO VOTE FOR GOOD GOVERNANCEWhat are we to do with such realizations? How can lessons from such successful campaigns be replicated? Upstream care, as described in the paper by Meili, features the involvement of physicians beyond the active management of the clinical aspects of patient care. Upstream care engages physicians to lift barriers to health improvement. This was previously considered part of the domain of public health. Recently, however, the “traditional” public health approach was criticized as lacking attention towards the “upstream” issues [vi], too preoccupied with “downstream” micro and individual concerns.More physicians now espouse “upstream” medicine, going beyond the confines of traditional practice, turning their gaze to view the bigger picture. By engaging in health advocacy, they seek to influence not just national policy directly by acting as technical consultants, they also drive the populace to vote for health-responsive politicians. These politicians will in turn form a “good” government, promoting human development. Success in health advocacy will install governments that will enact laws favorable to health, for example, those which will mitigate climate change. Failure in this arena allows the passage of detrimental laws such as the bill known as the Vaporized Nicotine and Non-Nicotine Products Regulation Act, which lowers the minimum age at which individuals can access vape products from 21 years old to 18 [vii].POLITICAL ENGAGEMENT NECESSARY TO ACHIEVE A HEALTHY SOCIETYIndeed, there is much to be done in this arena, beyond the traditional scope of our profession as physicians. A recent position paper by the American College of Physicians aims to sway the discourse to promote upstream medicine to further improve health outcomes [viii]. Our national medical societies have since become actively engaged, forming broad coalitions such as the Health Professionals Alliance Against COVID19 (HPAAC) to direct public policy to fight the pandemic [ix]. Another example of collaborative action is the united opposition of the Philippine College of Physicians and other medical societies against the Vape Act. In this day and age, therefore, physicians should be able to redefine their engagement as professionals. Many a treatise on how to incorporate health advocacy in the undergraduate medical curriculum have been published. A redefinition of medical professionalism already includes this new role of promoting societal health and well-being through advocacy [x]. Social accountability and advocacy to ensure equitable health systems are now considered among the required competencies of a medical graduate in progressive medical schools.Those of us in the academe should support this initiative. Moreover, those of us in the clinics should model this role. In doing so, we uphold the words of Virchow: “Politics is medicine on a larger scale.” It is time to embody this kind of medicine.[i] Meili, R., & Hewett, N. (2016). Turning Virchow upside down: medicine is politics on a smaller scale. Journal of the Royal Society of Medicine, 109(7), 256-258.[ii] Peretz, P. J., Islam, N., & Matiz, L. A. (2020). Community health workers and Covid-19—addressing social determinants of health in times of crisis and beyond. New England Journal of Medicine, 383(19), e108.[iii] Javadinasab, H., Masoudi Asl, I., Vosoogh‐Moghaddam, A., & Najafi, B. (2020). Comparing selected countries using sin tax policy in sustainable health financing: Implications for developing countries. The International journal of health planning and management, 35(1), 68-78.[iv] Javadinasab, H., Masoudi Asl, I., Vosoogh‐Moghaddam, A., & Najafi, B. (2020). Comparing selected countries using sin tax policy in sustainable health financing: Implications for developing countries. The International journal of health planning and management, 35(1), 68-78.[v] Hoe, C., Weiger, C., & Cohen, J. E. (2022). Understanding why collective action resulted in greater advances for tobacco control as compared to alcohol control during the Philippines’ Sin Tax Reform: a qualitative study. BMJ open, 12(5), e054060.[vi] Lantz, P. M. (2019). The medicalization of population health: who will stay upstream?. The Milbank Quarterly, 97(1), 36.[vii] https://newsinfo.inquirer.net/1635286/bill-allowing-younger-vapers-lapses-into-law[viii] Daniel, H., Bornstein, S. S., Kane, G. C., & Health and Public Policy Committee of the American College of Physicians*. (2018). Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Annals of internal medicine, 168(8), 577-578.[ix] http://hpaac.org.ph/[x] Howell, B. A., Kristal, R. B., Whitmire, L. R., Gentry, M., Rabin, T. L., & Rosenbaum, J. (2019). A systematic review of advocacy curricula in graduate medical education. Journal of general internal medicine, 34(11), 2592-2601.

Volume 31 Issue 2 (2021)
Finding Strength in Research: The Dr. Evangeline Olivar Santos Memorial Award

By Patricia Therese de Claro, UPCM 2024Research has become increasingly important in our society today. From COVID-19 vaccine development to point-of-care tests before prescribing antibiotics, research provides evidence for medical practitioners to make judicious clinical decisions and provide quality healthcare. Medicine is indeed advancing so quickly, heightening the challenge to stay updated with guidelines and procedures, among many other aspects in this field.Back in a time when research was still starting out with modern advancements, Dr. Evangeline Olivar Santos already found her passion in research. She filled her life with this purpose, from holding positions in various organizations, to spearheading national programs in ophthalmology. With her unfortunate passing last year, her classmates in the UP College of Medicine Class of 1965 set out to keep her legacy alive through the creation of a namesake award for pioneering individuals in research.Even after retirement, Dr. Santos continued to play an active role in the field of medical research. With over 50 years of research experience to her name, she became a mentor to students, residents, and fellows in community ophthalmology. Photo from UPManilaChannel [https://www.youtube.com/watch?v=EbxexofGyPg&t=17s].Dr. Santos’ Early Life and EducationDr. Santos was the eldest of 9 children of a government employee and a teacher. At the age of 3, she contracted tuberculosis of the spine which progressed to a back deformity that other children teased her about. Nevertheless, she persevered to excel in school to pursue a medical degree. Despite her family’s financial status, her parents were adamant to send her to medical school. However, the young Dr. Santos promised to help send her brothers and sisters to school when she finished her medical degree.When she graduated from the UP College of Medicine, Dr. Santos was accepted as a research fellow, and later, as a resident in the Department of Ophthalmology of the Philippine General Hospital – an unpopular field at the time. She joined the Philippine Eye Research Institute (PERI) when she was forced to stop her residency training due to a recurrence of her illness. Despite not finishing formal residency training, Dr. Santos practiced ophthalmology through various provincial missions and out-of-hospital teach-ins. Through her perseverance, she was certified by the Philippine Board of Ophthalmology and even became a board examiner later on in her career.In her simple and humble ways, Dr. Santos was spiritual, compassionate, and trustworthy. Former UPCM Dean Cecil Tomas, a colleague of Dr. Santos, shares that she was also selfless, caring, responsible, and “generous to a fault” – always concerned for the well-being of her family, friends, and classmates. Dr. Santos possessed many hobbies as well, such as gardening, watercolor painting, and singing.Dr. Santos was a lifelong learner, finishing her Masters in Hospital Administration at the UP College of Public Health in 1981 and receiving a Diploma in Community Ophthalmology at the University of London International Center for Eye Health in 1984. She also received a UP-Fogarty scholarship for a Diploma in Bioethics in 2003. Dr. Santos was also very nationalistic, service-oriented, and committed to democracy. She took a stand for the principles and ideas she believed in that became issues of her time, most especially academic freedom.Dr. Santos in Research and Medical ServiceAs a researcher, Dr. Santos was competent and committed to serve. She was a PERI University Researcher from 1966-2007, Assistant Director from 1986-1988, and Clinical Associate Professor of the Department of Ophthalmology until her retirement in 2006. Even after, she regularly attended conferences and mentored students, residents, and fellows in community ophthalmology. She served as Chair of the UPCM Ethics Review Board from 2005-2011 and remained a member until 2020. Dr. Santos was in two committees of the Philippine Health Research Board (PHREB) and was Founding Chair of the National Committee for Sight Preservation and Eye Care Program Consultant for Helen Keller International and Christoffel-Blindenmission (Christian Blind Mission).Few ophthalmologists practiced in the provinces during the 1970s; patients usually had to travel to Manila for treatment. Dr. Santos saw the need for an ophthalmologist in Batac City where there was a high incidence of blindness. Selfless and generous as she was, Dr. Santos bought instruments with her own funds and visited Ilocos Norte regularly to see patients. In 1982, Dr. Santos proposed a modified residency training program that would train ophthalmologists in provinces, who would then serve for six years. As Former UPCM Dean Cecil Tomas shares, “This was probably the greatest service she did – the training of selected ophthalmologists in various regions.” In 1990, DOH appointed Dr. Santos as its Technical Consultant for the Prevention of Blindness Program where she conducted the National Blindness Survey with a community approach. In 2004, she was awarded the “Dangal ng Bayan'' by the Philippine Civil Service Commission and the “Outstanding Alumna in Community Service” in 2005 by the UP Medical Alumni Society.With the recently approved “Dr. Evangeline Olivar Santos Memorial Award,” the legacy of Dr. Santos shall remain forever etched in the stones of time. Photo from UPManilaChannel [https://www.youtube.com/watch?v=EbxexofGyPg&t=17s].Research in the UPCM SettingDr. Santos was one of the few medical students interested in research during her time. Slowly, however, as research evolved, UPCM students also became more interested in the field. However, Dr. Jacinto Blas Mantaring shares that currently, there are few research opportunities available to students save for the IDC 211 projects with limited funding. Research grants for the faculty are provided by the University, College, and NIH depending on the availability of funds.Research is introduced formally in the UPCM curriculum as IDC courses from Learning Unit 3 to Learning Unit 6, as well as in select courses like Pharmacology. Dr. Mantaring also mentioned that when students start to rotate in the clinical departments, application of the principles of evidence-based medicine are integrated into journal clubs.Dr. Mantaring suggested improvements in students’ interest in research by endorsing dual degree programs in the college such as the MD-PhD and MD-MCE (Masters in Clinical Epidemiology) degrees, the latter currently being finalized. Another strategy that Dr. Mantaring suggested is to increase available funding for student-initiated research or provide incentives for students’ research to be published or presented internationally. UPCM students would also benefit from more role models among the faculty, so they can be encouraged to join faculty research as assistants or observers; role models like Dr. Evangeline Olivar Santos who relentlessly fought to integrate research into her life as a student, as well as in her medical practice.The Dr. Evangeline Olivar Santos Memorial AwardThe award was recently approved this 2021 with funding coming from the UPCM Class 1965 Trust Fund. When asked about the inspiration behind this award, Former UPCM Dean Cecil Tomas mentioned, “The entire life of Dr. Evangeline Olivar Santos was a commitment to the betterment of her countrymen by reducing blindness in the underserved areas and by helping provide trained ophthalmologists in these areas.” This commitment to her goals was paralleled by her professionalism; she did not let her physical deformity hinder her from becoming a competent researcher and ophthalmologist. As Former Dean Tomas said, “She stood as tall as or taller than the other delegates and speakers and she was very much respected and admired by her colleagues.” Despite limited resources, her perseverance in preventing blindness and the success of her programs showed that much can be done with the purest intentions.The UPCM Class of 1965 was greatly saddened by Dr. Santos’ sudden death on November 13, 2020. She was well loved and greatly admired by her classmates. They wished to honor her memory with a research award in the UPCM in her name. Her classmates, along with other alumni and friends, donated to the award fund deposited in the UPMASA Perpetual Endowment Fund, and thus, this accolade was born.Guidelines for the AwardsThere are two awards available, one for the students and one for the faculty of UPCM. The award for Best Student Research Paper motivates students to pursue high-impact research work for publishing in peer-reviewed international and local journals, while the award for Meritorious Publications in Peer-Reviewed Journals encourages the faculty to publish their work in indexed peer-reviewed journals that adhere to high standards of scholarship.The UPCM Research Implementation and Development Office (RIDO), under the Associate Dean for Research, shall evaluate award applications. The following criteria will be considered for Best Student Research Paper entries: significance of the research, methodologic rigor, and plans for dissemination and publication. Similarly, the Award for Meritorious Publications in Peer-Reviewed Journals will be judged based on its publication in a PubMed-indexed or Scopus-indexed journal, publication in a Web of Science indexed journal, and its impact factor. The research paper must also be registered in the UPCM RIDO, technically and ethically approved by UPM Research Ethics Board, and registered in UPM Research Grants Administration Office.The Best Student Research Paper Award shall be granted to one student per year, and the grantee will receive $500.00. On the other hand, the Award for Meritorious Publications shall be granted to two clinical faculty members per year, the awardees each receiving $550.00.A call to actionDr. Evangeline Olivar Santos was definitely no stranger to research, and her many accomplishments in ophthalmology serve as an important reminder to UPCM students that anything can be achieved despite obstacles and perceived difficulties.Evidence-based medicine can be used for clinical practice, developing guidelines and policies, and writing research proposals. We must find ways to entice UPCM students to pursue research in medical school and in their professional careers. Without researchers, there would be no innovations and improvements to the medical field. Thus, we must add focus to research, as it is a necessary skill and discipline that makes a UPCM graduate a holistic, six-star physician. Hopefully, with improvements in the curriculum and an increase of funding towards research, UPCM can produce more research-oriented students and faculty, and reach its fullest potential in contributing to the development of medicine, especially in the national setting.

Sowing Seeds of Innovation: The ECE 197/ChE 297 Experience

By Jonathan Chan, UPCM 2022In an unprecedented partnership, the College of Medicine in UP Manila and the College of Engineering in UP Diliman launched their first ever joint course offering in AY 2020-2021. Titled “ECE 197: Introduction to Systems Design for Healthcare” for undergraduates and “ChE 297: Process Systems Design for Healthcare” for graduate students, the course was offered to students with either engineering or medical backgrounds.“Identify, Invent, and Implement”. ECE 197 and ChE 297 was attended by students from the UP College of Engineering and the UP College of Medicine.It was an interdisciplinary classroom handled by Engr. Roxanne De Leon, Dr. Richard Hizon, and Dr. Bryan Alamani from the UP College of Engineering. They were joined by Dr. Lourdes Tejero of the UPM Technology Transfer and Business Development Office (TTBDO) and Dr. Edward Wang who is affiliated with both the Department of Orthopedics in the Philippine General Hospital (PGH) and the UP Surgical Innovations and Biotechnology Laboratory (SIBOL).The course was conceived after conversations between engineers and medical doctors within UP SIBOL. UP SIBOL is a partnership that started two years ago in 2019 between the UP College of Medicine and the UP College of Engineering. Under this partnership, there are several teams working on different projects. They realized that in order to encourage a deeper collaboration between Engineering and Medicine, the interdisciplinary thinking required to work at the interface of both fields must be nurtured early on. Preparations were well on their way with how the logistics of a combined course will be handled; that was until the pandemic threw a wrench into their plans.In the chaos of the ensuing months, the UP SIBOL team remained resolute in their mission to bridge the two fields together. Indeed, the collaboration was fruitful as the team accelerated the design of several different projects such as Sanipod, a self-contained disinfecting cubicle, whose prototype is already in use in PGH. The rapid adoption of remote learning also gave them an avenue to push through with the course despite the pandemic. The collaboration is even more urgent now since fresh solutions to address our problem at hand in an effective, interdisciplinary manner are of paramount importance.ECE 197/ChE 297 was attended by undergraduate & graduate students from the UP College of Engineering as well as medical students from the UP College of Medicine. It follows the Stanford Biodesign process that outlines 3 phases –Identify, Invent, and Implement— with two specific stages performed during each phase. The course focused on the first phase of the process that consists of Needs Finding and Needs Screening.COVID Task Force Research Projects of UP SIBOL which were made possible through the support of the Philippine Council for Health Research and Development.Essentially, the purpose of this phase is to identify a problem whose resolution will yield the greatest value to all stakeholders. The course aimed to help students along this journey in two stages. The first part consisted of a case series where different speakers talked about the translational medicine process. In this part of the course, there were also discussions on bioethics, Intellectual Property (IP) law, and technology transfer.The second part was where the students put it all together— a capstone design project where groups of three students focused on a subfield of medicine to identify an unmet need. The students were divided according to interest and combined together to form groups consisting of a medical student, an engineering major, and a graduate student.At the outset, it may seem like a daunting experience to work with people from different fields. However, Engr. De Leon said in an interview that each individual brought with them a unique perspective and their own way of tackling problems. This sentiment was echoed by Nick Cumigad, a student from Class 2023 who took the elective: “It has been fun to work with engineers for the whole semester of ECE 197. The most important insight from this course that I have learned was [that] no idea is too farfetched to be realized."“No Idea is too farfetched to be realized,” The UP SIBOL challenges minds for the innovation of surgical devices adapted to the health needs of Filipinos.The success of all groups in the elective was because of, not in spite, of the interdisciplinary nature of the discussions. The medical students brought with them biological knowledge and field experience, while the engineers provided the technical skills to design novel solutions.In a virtual interview, Dr. Wang was delighted with how the groups were learning and collaborating since, according to him, that is how we should be tackling problems in the real world—through a holistic perspective. Engr. De Leon was also surprised at how one group was able to identify a problem one UP SIBOL team was currently working on. It was a testament to how effective the program was in imparting interdisciplinary thinking to students.One limitation of the course, however, was the purely virtual setting. The elective may have been more fruitful had the students met in person and seen the current innovations that the UP SIBOL team have been working on. Engr. De Leon and Dr. Wang expressed their desire to hold future classes onsite, and tackle the next stages of the Biodesign process.In the meantime, the UP SIBOL team has launched the Biomedical Immersion in Health-Related Industries (BINHI) as a pilot immersion program for students. This was offered to students who want a more in-depth experience in the biodesign process. Students chosen to be part of BINHI will have the opportunity to learn theoretical knowledge and practical skills in health research, and take part in UP SIBOL and its ongoing flagship projects.It is the hope of UP SIBOL that all these initiatives will spark in students a deeper interest in research at the interface of Engineering and Medicine. This close cooperation is envisioned to foster better collaboration between the two fields and translate to innovative medical products by our homegrown engineers and doctors. One can envision a local tech startup arising from this partnership, which can then manufacture state-of-the art biomedical devices for our patients that are truly for Filipinos, by Filipinos.

A Small Step for Med Students, A Big LEAP for Juan

By Joseph Romeo Paner, UPCM 2026Last July 16, the Learning Enhancement in Anatomy Program (LEAP) took off as 151 Class 2025 students finally set foot in the halls of the UP College of Medicine for the first time since the pandemic started. This optional bridging program offered the students a chance to demonstrate and reinforce what they had learned about human anatomy throughout the online academic year. To circumvent the limitations presented by the pandemic, the UPCM administration and faculty devised LEAP and implemented the program during the midyear.Scalpel please! UPCM Class of 2025 underwent the face-to-face Learning Enhancement in Anatomy Program (LEAP), last July 14-30, 2021. This opportunity was implemented by the UPCM Administration and the faculty and staff of the Department of Anatomy.Preparing for the Big LEAPA hands-on anatomy course provides an invaluable learning experience that is absent in a digital dissection. For example, the actual human body exhibits anatomical variations that are not accounted for in on-screen learning. To bridge this gap with LEAP, UPCM wasted no time getting approval for holding limited face-to-face classes from the Commission on Higher Education as mandated in the CHED-DOH Joint Memorandum Circular 2021-001.Several students were filled with excitement upon hearing the news of the program’s approval. Apart from learning anatomy with actual cadavers, it was also an opportunity to finally engage with their professors and fellow students in person. Led by Ms. Arlyn Adlawan as their president, the Class of 2025 pitched the idea of a bridging program to the Dean and the Dean’s Management Team during the College Town Hall Meeting last November 2020. The class then took part in the planning of LEAP by giving their insights, feedback, and concerns regarding the proposed program. The efforts of the Class 2025 Council Officers were critical for information gathering and dissemination as part of the administrative work and decision-making process.The preparation for the LEAP program was quite a logistical undertaking. First and foremost, participating students had to be fully vaccinated before the start of the program. Coordinating with the Dean and College Secretary, students residing in or near the National Capital Region were given the opportunity to be vaccinated in the Philippine General Hospital or the Sta. Ana Hospital, Manila. For those who were unable to avail of this, the UPCM admin provided a letter of request addressed to concerned LGUs for the vaccination of the endorsed medical students. The National COVID-19 Vaccination Operation Center Advisory No. 29 released last April 12 states that medical students rotating in approved hospitals shall be vaccinated as part of Priority A1.The shared learnings from #LEAP2025 were insurmountable and effective. This program shows that despite the current conditions of medical education, the desire to learn and to serve has not wavered and will continue to thrive.Some students also had to straighten out their travel back to NCR as well as living arrangements. Coming from Puerto Princesa, Ms. Jeanine Bianca Lastino had to set her flight schedule and accommodations for the entire program’s duration herself. She also braced herself mentally for the reality in NCR. "I had to condition myself to be mindful of the different risks being in an area with a drastically different COVID profile to where I had been staying at for [the] majority of the pandemic," she said.Aside from these, Class 2025 also coordinated with the Office of Student Affairs regarding students who needed dormitory accommodations. They even arranged their own daily meals wherein they opened a call to their batchmates who knew food suppliers. After choosing suppliers based on menu and quotation, their class made an order for their preferred weekly food set. Lastly, Class 2025 conducted an internal solicitation drive to raise funds for their classmates who were most affected by the schedule changes. These students included those who needed to rebook their flights and accommodations.Over and Under the CrossbarTo ensure everyone's safety, the faculty followed safety precautions approved by both CHED and DOH. In partnership with the Department of Anatomy, the PGH Hospital Infection Control Unit conducted a safety protocol orientation and provided copies of the guidelines to the class. Ms. Sheila Ozaeta, the UPM COVID-19 Coordinator, arranged the students' pre- and post-dissection COVID-19 RT-PCR swabs. In compliance with the preexisting safety regulations in Calderon Hall, everyone entering was required to fill out a health declaration form which is conveniently available on the UPCM website.With LU4 becoming imminent, the journey of this new batch of doctors-in-training continues. Surely, 2025 will storm on, and they will relentlessly #DareToBeXXV.The faculty also thoroughly planned the physical layout of the program. Stations were divided among all the available rooms of Calderon and access to sanitizing stations was ensured in each room. Every student received their schedules and room assignments beforehand to streamline the workflow. They also acquired COVID-19 kits containing additional face masks and shields.For the program, which lasted from July 16 to July 30, the faculty split the class into two batches―one for each week. Each batch was further divided into subgroups of five students to control traffic in the stations. The faculty placed the stations in various rooms of Calderon Hall, including those in the second floor up to the third floor.In stark contrast to the typical dissection experience, the students arrived to cadavers already prosected by the Department of Anatomy. Set-ups were provided for students to practice their clinical skills in doing procedures such as thoracentesis, ophthalmoscopy, and endoscopy. The UPCM faculty unveiled its prowess in medical education technology through Anatomage Table, a table with a touch screen that reconstructs individual structures in accurate 3D, allowing visualization of the human body as they would in a fresh cadaver. Dr. Jose V. Tecson III, an associate professor of the Department of Anatomy, even lent his virtual reality headset to the entire batch for an immersive, three-dimensional dissection. All these set-ups truly enriched the class' understanding of human anatomy.Class 2025 likewise faced unexpected challenges participating in the program. Considering the welfare of the students, the faculty had to postpone the start of the program due to inclement weather, and students exposed to floodwaters were given prophylaxis for leptospirosis. Most notably, they had to end the program early due to the increasing threat of the new COVID-19 Delta variant which eventually raised the NCR's restriction level to ECQ just a few days after the program ended. Dr. Tecson reported that no faculty, staff, and students developed COVID-19 symptoms during or after the program.UPCM 2025 pursued all opportunities to get #VaccToSchool! Last July 2021, students of the UPCM Class of 2025 received their COVID-19 vaccine doses at the Sta. Ana Hospital and PGH in Manila.Looking back at LEAPDissection is a memorable milestone in a medical student's journey. Flaunting their newly-bought scrubs and greaseless scalpels, students looked forward to getting a hands-on, deep dive into the human body. However, with the pandemic, the national education system had to make use of whatever’s available and resorted to alternative learning platforms.LEAP 2025 proves that with proactive planning with health experts and by strictly enforcing guidelines and protocols, it is possible to transition, albeit slowly, from the alternative virtual learning to an ideal face-to-face set-up. It goes without saying that learning through actual, face-to-face encounters is integral for professions dealing with actual people such as medicine. To be a competent physician, one must have a real-world experience in both basic and clinical aspects of medicine. With this, we all can build on the experience of LEAP 2025 as we prepare and hope for the future of medical education.

Innovations Against The Information Epidemic: Medical Professionals on Social Media

By Carl Bognot, UPCM 2024“Dok, nabasa ko sa Facebook…” These are words that many doctors hear from patients, family, and friends during consultations or conversations outside of the clinic. These are words that may sound shallow upon first hearing them but signal to us that people do not want to remain ignorant about health. In fact, they seek to know more about it and are taking the initiative to read about it where it is most accessible to them -- on social media. Given the highly accessible nature of the information online, are they correct or appropriate? Are people beneficiaries or victims of information on social media?This is one of the issues that doctors like Dr. Iris Thiele Isip-Tan aim to address by being on social media. Dr. Isip-Tan is known by many for her online persona “The Endocrine Witch” or “Dok Bru,” and she shared with her insights regarding the use of social media as a medical professional in an interview with InSPIRE Magazine.Dr. Isip-Tan realized how rampant misconceptions about health are on social media and she wants to help correct them with her social media pages. She advocates for health literacy, the ability to keep, obtain, and understand basic health information and services that are needed to make appropriate health decisions. She believes that if there is correct and appropriate health information accessible online, then people can make the right decisions regarding their health.The current ravages brought about by the pandemic constrains a whole-of-society approach to developing and implementing eHealth interventions. The intersection of social media and telemedicine has catapulted Health information education campaigns into the mainstream media.Bringing People TogetherMany medical professionals have already taken advantage of social media to reach more people and share basic information regarding health and medicine. Some have chosen to write Facebook posts regarding various health topics like COVID-19 vaccines. Other medical professionals have chosen to ride the trends found on TikTok and inject basic information about topics like nutrition and remaining healthy during the pandemic in short videos. This allows them to deliver information in an attention-grabbing way and to reach more younger audiences online. Dr. Isip-Tan herself has been posting about common endocrine diseases like diabetes and hyperthyroidism for many years now, and she is often told by her patients that they feel like they have already met even before seeing her in person because they have seen her speak in her videos online. Truly, the opportunities for medical professionals on social media are endless.Revolutionizing the healthcare landscape in the time of COVID-19 has inspired many social medical professionals “Social MDs” to promote healthy discussions in addressing misconceptions and educating the masses on the SARS-COV2 virus and the COVID-19 Vaccines. The investigators, Dr. Iris Thiele Isip Tan, Dr. Geoffrey Solano and Dr. Jerome Cleofas, intended to study COVID-19-related misinformation circulating on Facebook and Twitter from January 1, 2020 to March 23, 2020 (when the Bayanihan to Heal as One Act was enacted). This study is a recipient of the 2020 University of the Philippines National Institutes of Health Faculty Research Grant.Pulling People ApartThis openness and freedom to express is undoubtedly welcome, but it has also invited new challenges to arise. As “The Endocrine Witch” Facebook page grew, one glaring issue that Dr. Isip-Tan has had to contend with is the vitriol in the comments sections of her posts. If some of Dr. Isip-Tan’s followers disagree with her opinions, they would leave nasty comments on her posts. There are also many who advocate for unproven alternative treatments and exploit others just to sell their products, and this is not exclusive to people in the comments. Dr. Isip-Tan has observed the rise of “physician influencers” who accept offers to promote products on their social media pages. She says that the issue is conflict of interest as sometimes the posts are not declared to be paid endorsements. These “influencers” end up contributing to the information epidemic, or “infodemic,” that continues to plague social media with its propensity for false and inaccurate information. This could lead to potentially dangerous consequences for people who don’t know any better. One could wonder why some medical professionals have become contributors to the infodemic. With the endless possibilities of social media and with how easy it is to go viral, medical professionals must remember to practice care and responsibility with their content. After all, primum non nocere.UPCM Social Media GuidelinesOne of the ways to minimize and avoid the misuse of social media is by crafting social media policies. The University of the Philippines College of Medicine (UPCM) has its own social media guidelines, outlining topics such as posting on personal and institutional accounts, protecting patient privacy and confidentiality, and maintaining professionalism online. Dr. Isip-Tan headed drafting the guidelines, and it involved a lengthy process of examining the school culture, learning from other social media policies from other institutions, consulting students, administration, and even seeking legal opinion.Dr. Isip-Tan believes that academics everywhere should have a presence online as they could play a vital role in disseminating information as well as in aiding the branding and outreach of their respective institutions. To concur with a similar point made by Dr. Daniel Cabrera as mentioned by Dr. Isip-Tan, clinician educators have the responsibility to make knowledge accessible and impactful in their respective communities. While the UPCM guidelines are not full-fledged policies yet, it still can serve as a guide to encourage productive and responsible use of social media without hindering freedom of expression.A Braver, Newer World OnlineThe climate on sites such as Facebook and Twitter has grown into one that is much different from how it started out. Social media has evolved into a bigger biosphere teeming with more activity than ever before; with information campaigns, discussion threads, and many more kinds of online engagement previously unheard of. This evolution of social media also displays the immense power that it now holds. With the influence that medical professionals hold through the opportunities available to them on their social media platforms, they should also remember the oft-quoted movie cliche, “with great power comes great responsibility.”Dr. Isip-Tan hopes that healthcare professionals on social media can help fight against the infodemic and at the same time further the practice of evidence-based medicine by giving more attention to online research. She also hopes that instead of being “physician influencers,” more physicians can instead practice health marketing which, as defined by the CDC, involves creating and delivering health information and practices using customer-centered and science-based strategies to promote health. Health literacy is an area that deserves greater attention, and with more doctors like Dr. Isip-Tan around on social media, millions of people could gain much insight about their health.Medical practitioners, and even medical students too, have the golden opportunity to help solve the problems caused by the infodemic by fulfilling this newfound duty to use social media responsibly. Amidst all the noise that one can come across online, medical professionals should remember that they have the power to make a difference in the lives of many - even with just a single click.

Doctors to The Barrios, Masters of Public Health

By: Harold Joshua De Guzman, UPCM 2023This year, the Doctors to the Barrios-Masters in Public Health (DTTB-MPH) program will be sending forth their first graduates. Since its beginnings, the DTTB program has not only augmented communities’ health workforce, but it has also trained and equipped participating doctors with relevant knowledge and skills in public health through continuing medical education (CME). The DTTB-MPH is the latest iteration of the DTTB program, and it is designed to prepare doctors for the unique challenges they will face as clinicians and health administrators in their assigned municipalities. This is overseen by the UP College of Public Health, with some courses handled by the College of Medicine and the College of Arts and Sciences. Upon completion of this program, participants will earn a master’s degree in public health in addition to being a DTTB graduate.The original DTTB program established in 1993 was intended to supply doctors to the estimated 200 doctorless municipalities at the time; however, only 50 applicants per year could be accepted. Around 2009, the program had evolved with the needs and policies of the times, requiring a minimum of two years of service to assigned municipalities. Moreover, the government had expanded the program coverage to include more than just doctorless municipalities. Following an increased demand, the number of people taking the program likewise increased with the introduction of two government scholarships: one offered by the DOH and the other being the Bagong Doktor Para sa Bayan offered by the First Gentleman Foundation. By then, around 100 DTTBs were being accepted per batch.Dr. Jasmine Arcilla (leftmost), together with municipal officials, conduct a 4-day capacity development training for Barangay Health Workers on basic first aid and initial medical assessment and referrals. With initiatives like this, DTTB-MPH program aims to empower communities to cultivate their own local health systems. Photo from Dr. Jasmine Arcilla. To equip doctors with the proper skills and knowledge required of a DTTB, they are to undergo a CME course. This consists of a two-week-long saga of seminars, with one week dedicated to clinical topics and another covering public health topics. At first, this was conducted by the DOH Health Human Resource Development Bureau. By around 2009, the CME course was upgraded to a proper academic track by a dedicated academic institution, the Development Academy of the Philippines, to handle new logistical challenges. With this arrangement, the DTTBs could earn a master’s degree in public management, major in health systems and development upon completion of their contract.In 2017, however, the DOH opted to transfer the responsibility of delivering the CME to UP Manila. With the combined efforts of university executives and staff, the institution was able to quickly set up the MPH program. The course consists of nine core subjects which cover topics such as biostatistics, epidemiology, and principles of effective health system administration.[1] Through this program, UP was further capacitated to help doctors become invaluable assets to improving Philippine healthcare.Dr. Jasmine Arcilla (front row; center) caps off the Annual Individual Performance Assessment with her DOH-deployed Human Resources for Health staff. DTTBs are meant to reinforce, not replace, the municipal healthcare workforce such that DTTBs would no longer be needed. Photo from Dr. Jasmine Arcilla. The program, however, calls for a certain drive in those filling in the shoes of a DTTB. Doctors are to juggle their responsibilities in the municipalities while fulfilling the MPH track requirements. Dr. Jasmine Arcilla, a graduate of UP College of Medicine (UPCM) Class of 2018 and the DTTB-MPH program who was assigned to Dumaran, Palawan, says, “When I got into UPCM and noong nag-clerkship and internship, namulat ang aking mga mata sa actual situation ng patients.” To be a DTTB, “you really have to understand the needs of the community, and you have to be ready to go all in. You have to be willing to serve in a community despite knowing it will be very frustrating.”Currently, Philippine healthcare functions as a two-tiered parallel system of public and private healthcare. On one hand, the government-run public system aims to provide free or discounted health care for all citizens. On the other hand, the private system mostly caters to those who are able to pay; thus, they are able to access any level of care if they so desire, and they can even choose to forgo seeing a general practitioner and instead visit a specialist right away. It is no secret that many, if not most, of our countrymen only have access to the public healthcare system. Unfortunately, the public healthcare system is neither funded nor developed enough to meet the needs of those who require it.To help this ailing system, DTTB was specifically implemented to work as an augmentation program meant to temporarily increase the healthcare human resources in areas where primary healthcare is lacking. The program is to run indefinitely—as long as is necessary to reach as many municipalities as possible. As the program is primarily intended to reinforce rather than replace the municipality’s healthcare force, the ultimate goal is to help the area develop enough such that DTTBs will no longer be needed.The success of DTTB is measured in different ways. From the perspective of the national government, the first measure of success is achieved when the DOH is able to assign a doctor to a municipality in need of one. However, a more meaningful success is achieved when the doctor assigned to that municipality is able to improve the healthcare system of that area. While this is difficult to quantify, the DOH does employ the Local Government Unit scorecard system which classifies LGU performance into Red, Yellow, and Green. This measurement system helps assess whether LGUs have achieved set target health indices such as those for health sector spending, health facilities enhancements, and health governance. It is the goal of the assigned DTTB to assist the community in achieving these targets through community empowerment.Achieving the latter measure of success is where the additional training from the CPH comes to use. By training in public health administration, doctors would be more able to design better health programs that are much needed by their communities. “The six building blocks of health systems can be seen in action in the community,“ says Dr. Jasmine. Discussing the most impactful subjects for her service, she says epidemiology and the principles of data-driven decision-making were very helpful in determining the best types of programs to design for the community. The applied field practice[1] in public health was also very helpful in planning and coming up with a program relevant to the community.Municipal Health staff and administrators, Red Cross Palawan Chapter, together with Dr. Jasmine Arcilla (first row; 3rd from the left) conclude a Blood Drive for community members. Photo from Dr. Jasmine Arcilla. While the doctors are known and expected to provide both clinical and community services, it is less known that they must also provide administrative services. Apart from diagnosing and treating diseases and organizing health-promoting events at the community level, the assigned doctors are also the respective administrators of their local offices. Through this, it becomes necessary that they be socially adept. DTTBs have to contend with the personal beliefs and affairs of both the citizens and local officials just as much as, if not more than, the diseases and health problems of the area. “When the pandemic hit, it was difficult to get people to follow the health protocols [such as] washing hands frequently, wearing masks in public, etc. kasi hindi naman nila nakasanayan yoon. We had to contend with many kinds of misconceptions; some didn’t even believe in the pandemic. It is also very difficult to balance their different needs, [and] to convince someone to isolate when ‘yung kabuhayan nila on a day-to-day basis depends on them going out.” Dr. Jasmine relays that they had to go barangay-to-barangay to teach the different officials the importance of health protocols. The municipality even decided to set up policies and fines for violations.Dr. Jasmine Arcilla (2nd from the right) and her entire DTTB Batch 36 assigned to the MIMAROPA region finalize their preparations before they are sent off to their own areas to where healthcare is needed most. Photo from Dr. Jasmine Arcilla. One natural critique of the DTTB program is that municipalities might take advantage of it by relying on the consistent supply of doctors. Why would they need to invest in local healthcare systems if the DOH is going to assign doctors to them anyway? However, it may also be the case that municipalities may simply be struggling to set up their own local systems. Whatever the reason may be for each municipality, the reality is that some areas remain doctorless despite having received a succession of DTTBs throughout the years. Such is the case of Dumaran which, during Dr. Jasmine’s time there, was yet to have its first permanent municipal health officer. “Willing naman magsupport ang LGU ng whatever hilingin ng DTTB,” says Dr. Jasmine, but she also acknowledges that “depende rin sa LGU kung paano sila mag-alaga ng doktor. Kung alam nila na hindi ok, e di, walang mags-stay. LGUs need to have a better understanding of what health is and how it is multifactorial and multisectoral. Kapag iniisip nila na pagdating sa health, health ‘lang yung gumagalaw, nakakapagod ‘pag ganoon, and it’s not really going to work. Kung itatambak lang nila lahat ng responsibility onto the rural health unit, superficial lang ‘yung support nila.”Health systems are inextricably tied to the governments that run them, and no matter how many DTTBs are sent to a municipality, it is up to the local government and the community to decide what their course will be. The ultimate goal of a well-functioning and sufficient healthcare system can therefore only be achieved if local leaders and communities work toward such a goal on their own accord. That being said, with the approaching elections, we must remember that it is our duty to elect just and competent leaders who will help us reach this goal. Hopefully, in the future, instead of doctors to the barrios, we may have doctors from and for the barrios.Reference:College of Public Health. Master of Public Health [Curriculum]. University of the Philippines Manila; 2019 [cited 2021]. Available from https://cph.upm.edu.ph/sites/default/files/MPH_2019.pdf

Budding Research Projects at Phil-DIAMOND

By: Isabella Orteza, UPCM 2025A stimulating three-year program funded by the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD) was recently started in January 2021 but is already quickly executing innovative studies to keep an eye on.Thanks to a recent interview with the program leader Dr. Marissa Marcelo Alejandria and her co-investigators Dr. Christian Francisco and Dr. Ana Joy Padua, further information on the program’s creation, current progress, and future plans are detailed in this article.The Phil-DIAMOND or the Philippine Program for Diagnostic Biomarkers, Disease Modeling and Nutraceutical Product Development: Initial Focus on HIV-related Neurocognitive and Metabolic Complications was born out of UP’s ongoing collaboration with the Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii in Manoa, and University of St. Louis in Missouri. With the funding of the DOST-PCHRD, the program was able to send Dr. Alejandria’s research mentees and current co-investigators Dr. Francisco and Dr. Padua abroad to bring their knowledge back home and establish research projects that have relevance in our society.The main goal of this program is to address the growing needs of fellow Filipino people living with HIV (PLHIV). As Filipinos have been receiving effective antiretroviral therapy (ART) through different treatment hubs, the program’s researchers anticipate that Filipino PLHIV will eventually manifest different sets of HIV-related complications called serious non-AIDS defining events (SNAEs), especially since the pathogenesis of the disease evolves with highly effective treatment regimens. These SNAEs include non-AIDS malignancies, HIV-associated neurocognitive disorder, cardiovascular events, renal and hepatic disease, bone disorders, and other metabolic disorders. Through this program, the researchers aim to identify possible immune biomarkers for the early diagnosis of SNAEs and to discover therapeutic targets for adjunct interventions to ART.The Phil-DIAMOND’s objectives from its three component projects are to identify inflammatory traits (biomarkers) associated with HIV in relation to the virus’ neurocognitive and metabolic complications among Filipino patients, to study critical molecular processes involving these biomarkers through disease models, and to develop probiotic-based nutraceutical products which can serve as adjunct therapy for HIV-related complications.Project 1, led by Dr. Alejandria with Dr. Christian Francisco and MD-PhD graduate Dr. Ana Joy Padua, will characterize immune cells for HIV-related biomarkers and perform clinical assessments of Filipino HIV patients. Project 2, led by Dr. Ahmad Mazahery of the UPD Institute of Biology with Dr. Mylah Villacorte-Tabelin and MD-PhD graduate Dr. Sheriah Laine de Paz-Silava, will generate biological models that mimic symptoms of HIV complications to provide pre-clinical molecular data that cannot be obtained from patient-level studies. Lastly, Project 3, led by Dr. Marilen Balolong of the UPM College of Arts and Sciences with Dr. Francisco Elegado and MD-PhD Program Coordinator Dr. Leslie Dalmacio, will screen novel probiotic strains for the development of functional food products that can be used as adjunct therapy for HIV-related complications.[In the photo: Dr. Ana Joy Padua] The UP Manila Flow Cytometry Core opens up groundbreaking avenues for local research in understanding the dynamics of HIV and the immune system among Filipino patients. Photo from Dr. Marissa Marcelo Alejandria. Discussing the implications and relevance of Project 1, Dr. Alejandria and her co-investigators explained, “HIV infection is now a chronic disease thanks to the wide use of ART. However, HIV is not fully eradicated in the body and stays in various reservoir sites like the brain, bone marrow, and lymph nodes to name a few. This viral persistence causes the continuous immune activation that will later lead to immune senescence and exhaustion. These processes are associated with various HIV-related chronic complications like dementia and cardiometabolic complications. The characterization of immune cells will be done by measuring the expression of various immune receptor markers and ligands using flow cytometry in a process that is called immunophenotyping. “With this program, we received support from the DOST-PCHRD to establish here in our university the UP Manila Flow Cytometry Core composed of a 19-color cell analyzer and a 15-color cell sorter. Now that we locally have a flow cytometry facility, we will be able to characterize these immune markers that will help us understand the dynamics of HIV and the immune system among Filipino patients. There is also a chance to look for markers (receptors and ligands on immune cells) that can be used as a potential target for therapy to prevent, attenuate, and possibly treat chronic complications from HIV infection.”Dr. Christian Francisco, along with his co-investigators, fly to Hawaii Center for AIDS at the University of Hawaii to learn new ways to revamp our local HIV research scene. Photo from Dr. Marissa Marcelo AlejandriaAlong with the program’s aim to identify biomarkers and potential targets for therapy, the program also aims to find therapeutic agents in the form of probiotics. “The use of probiotics as adjunct therapy for HIV-associated gut dysbiosis and gut microbial translocation is still in the early or investigative stage. However, since ART alone cannot effectively control these events, we think that a possible adjunct therapy targeting the gut microbiota to curb gastrointestinal inflammation is necessary. Probiotics and prebiotics could help support and grow the microbiota. Through this project, we aim to develop locally-sourced probiotic strains that will provide possible preclinical data on adjunctive therapy for HIV.”Besides the exciting research that all students and faculty will now be looking forward to, the program also led to the establishment of a local flow cytometry core and a virology laboratory. Dr. Alejandria added that, “the virology laboratory is currently hosted at the UP College of Public Health and is most definitely open to all researchers interested in virology research, whether on HIV or other viral infections. It is equipped with two biosafety level 2 cabinets and various equipment for cell culture studies (CO2 incubator, liquid nitrogen tanks, -80°C freezer, refrigerated centrifuges, cell counters, microscopes, etc.). Anyone who is interested in performing virology study techniques, from beginners to veterans, are all welcome to collaborate in our lab.”The Phil-DIAMOND project headed by program leader Dr. Marissa Marcelo Alejandria (4th from the right, wearing purple in 2nd picture)​​, with their international collaborators, hopes to usher in a new age of medical research to address the growing needs of Filipino people living with HIV. Photo from Dr. Marissa Marcelo Alejandria. Lastly, in relation to the program’s plans for the future, the researchers shared with excitement that, “we most definitely plan to continue what we have started in Phil-DIAMOND. Once we have characterized the immune response among our Filipino PLHIV, we plan to further improve these candidate biomarkers to develop an immune marker panel for the diagnosis of HIV-related complications. For the in vitro disease modeling of HIV, we plan to test other candidate drugs for high-throughput testing. We plan to test the locally isolated probiotics in vivo in animal models and in humans. Also, we already have at least two other projects from UP Manila and UP Diliman who will use our UPM flow cytometry core facility.”As can be seen through the compelling projects of the Phil-DIAMOND, the program is leading our society towards a progressive future in terms of facilitating early diagnoses and discovering innovative adjuvant therapies for Filipino PLHIV. Along with the aforementioned projects, the program brings in new equipment for research such as flow cytometers and a virology laboratory to the UP College of Public Health. With the advent of new research, equipment, and laboratories, the College is now set to usher in a whole new era for medical research and collaborations for all students and faculty to look forward to.

Tell-A-Med: The Trials and Triumphs of Going Online in Medicine

By: Charlene Divine M. Catral, UPCM 2027Despite all efforts, the COVID-19 pandemic remains a dire crisis. Countless lives continue to be lost as the mutating coronavirus ravages our country. Of the many problems the Philippines faces, the lack of reach in areas where help is most needed has become even more pervasive. Indeed, the pandemic took the Philippines by storm — silent but rabid — and called for the nation’s utmost fortitude and creativity to simply make ends meet.Promotion of use of telemedicine has been an ongoing effort by physicians and public health advocates since the early 2000s — an avenue to reach more Filipinos, especially those in remote and isolated areas. Strengthening telemedicine in the country would prove useful, especially for geographically isolated and disadvantaged areas (GIDA) where health interventions are heavily needed yet are difficult to access.In the Philippines, developing our telemedicine is a continuing effort of physicians and public health advocates to expand the reach of our healthcare system, especially for fellow Filipinos from geographically isolated and disadvantaged areas. Photo by Joaquin Arriola, UPCM 2026.Republic Act No. 11223, better known as the Universal Health Care Act (UHC), is among the current thrusts in healthcare equity, emphasizing that health is a right, not a privilege. This indicates that all Filipinos have a right to quality healthcare goods and services that are affordable and accessible to all. However, a long road lies ahead for stakeholders to fully enjoy the benefits of the UHC. The UHC Law stipulated the organization of technology-enabled healthcare provider networks throughout the Philippines; and telehealth plays a major role in this envisioned system.To gain a better perspective of these obstacles and opportunities, we interviewed Dr. Portia Marcelo, Professor of Community Medicine, UP College of Medicine (UPCM) and former Director of UP Manila’s National Telehealth Center (NTHC, in 2011 to 2017). She led projects to expand UP Manila’s Telehealth efforts to up to 600 rural municipalities nationwide. She built on the work of other professors of the UPCM who pioneered telehealth in the country. The NTHC is the research unit with focus on the use of information and communications technology (ICT) for health (alternative names include eHealth and digital health).Telehealth as an instrument to strengthen the Philippine healthcare delivery system spans nearly two decades of advocacy. NTHC’s initiatives were a response to poor healthcare access. It began in 2004, led by Dr. Herman Tolentino, Director of the NTHC and concurrent Clinical Associate Professor at UPCM Medical Informatics Unit (MIU) and Department of Anesthesiology. With funding from the government’s Commission on ICT, they implemented the first nationwide telehealth project Buddyworks implemented in 10 sites. In 2007, Dr. Alvin Marcelo, Professor of Medical Informatics (UPCM MIU) and Surgery, took over the NTHC, initiated the National Telehealth Service Program (NTSP) funded by the Department of Science and Technology Philippine Council for Health Research and Development (DOST PCHRD). The NTSP provided support to the Doctors-to-the-Barrios (DTTB) serving GIDA by linking them with the medical faculty of the UPCM-PGH. When the primary care DTTB encounter clinical dilemmas, they pose their queries to the UP-PGH medical faculty. The NTSP shifted the web-based Buddyworks telehealth platform to an SMS-based one, more useful in the GIDA. It incorporated and developed the first version of the RxBox telemedicine appliance. Developed with Dr. Luis Sison, Professor of Engineering in UP Diliman, the RxBox would have its second version in 2012. Dr Portia Marcelo and Dr Sison designed RxBox-2 to be interoperable with Community Health Information Tracking System (CHITS) — electronic medical records system (also developed by UPCM and the NTHC) and seamlessly linked with the NTS telehealth platform. Other pioneering telehealth projects supported or co-developed by the NTHC include the Medical Teleparasitology Project led by Dr. Vicente Belizario (current Dean of the UP College of Public Health, and Professor of Parasitology) implemented in the Cordillera Administrative Region and Davao Region. Telepsychiatry efforts were led by UPCM Professor Emeritus Dr. Lourdes Ignacio, with the UPCM-PGH Department of Psychiatry providing support to Infanta, Quezon in the aftermath of Typhoon Reming. The teledermatology Dermlink project led by Dr. Belen Dofitas, Associate Professor of Dermatology, was intended for neglected tropical diseases and other dermatology conditions in remote communities of Mindanao; the same NTS platform was used. The Mag-Ina Telereferral System (MINTS), seamlessly linked with CHITS, allows the referral of parturient mothers found to have complicated birthing processes from the primary care lying-in clinic to the nearest hospital, better equipped to manage complex cases. The MINTS allows exchange of patient clinical data between health facilities organized into a healthcare provider network in Quezon City, the first of its kind in the Philippines. The Hearing for Life Project led by UPCM Dean Dr. Charlotte Chiong, and Dr. Philip Fullante, Clinical Associate Professor of Otolaryngology, also saw use of telehealth for newborn hearing screening healthcare provider networks in Iloilo, Bacolod and Romblon.The need for telemedicine has been thrust into the limelight ever since the COVID-19 pandemic struck. This avenue has facilitated providing health services while minimizing physical contact between patient and healthcare providers. Photo by Joaquin Arriola, UPCM 2026. Through their efforts, telemedicine has moved beyond proof-of-concept, supporting physicians and primary care health professionals who attend to patients in rural, remote areas, delivering better quality care. UP’s telehealth efforts introduced concepts and actual use of telemedicine/ telehealth modalities to these communities. These were, unfortunately, time-bound projects: they existed while the research was ongoing. While the health sector eagerly collaborated, there was no enabling policy to support telehealth expansion and sustain its implementation specially for GIDA.Dr. Portia Marcelo describes telehealth’s boost in use amidst the COVID-19 pandemic in the Philippines. First, as a means to triage non-COVID cases from probable and COVID cases, then as a means to follow up on patients while also minimizing physical contact. The DOH provided hotlines for Filipinos to access for their medical queries and engaged with private companies to provide telemedicine services in the country. Dr. Marcelo narrates how despite these achievements, there remains many concerns, including that of poor internet connectivity and even basic electrical power that characterize many of the GIDA and rural municipalities in the country. “It (telemedicine) definitely reached a lot of people amidst this COVID pandemic. But these are the same people who do have access to care even in non-pandemic times.” The question remains, “what about those in GIDA?” Thus, telehealth advocacy is anchored not only on the overall health sector strengthening, but is also built on the call for more urgent social development of rural communities.Dr. Marcelo also discussed how despite the lack of legislation that governs telemedicine, the local government units of Navotas, Marikina, and Taguig have already carried out efforts in telemedicine for their constituents amidst the pandemic. The Department of Health released the first set of guidelines during the pandemic, namely the DOH-National Privacy Commission Joint Memorandum Circular 2020-0001 “Guidelines on the Use of Telemedicine in COVID Response” and the DOH-UPM Joint Memorandum Circular No. 2020-0001 “Telemedicine Practice Guidelines”. These are large strides towards the common goal, but there must be proper infrastructure and equipment for more Filipinos to have access to these digitized health services such as online consultations.To further improve telemedicine in the country, the understanding of digitized healthcare must be reframed: it is another form of medical practice but not less. Thus, Filipinos should not only be made aware of the benefits of telemedicine, they should actually have access to telemedicine and basic health and social services. And, it goes to say, that the Government should properly allocate resources for all these.We also interviewed a patient who has engaged in telemedicine services. She acknowledges telemedicine as a new and cost-efficient approach to address the imposed barriers of lockdown. It has provided her with the comfort she needed from a professional as well as relief knowing she was safe within the four walls of her home. She expresses how telemedicine is beneficial for she “ Feels at peace and able to fully express herself in front of the camera”. Teleconsults allow her to avoid inconveniences like traffic; all one has to do is open a laptop or phone and call the doctor. However, she worries that others may not be as fortunate to experience this service due to lack of internet access, electricity, or availability of a device — all of which are considered “basic needs” to some Filipinos but luxuries to most.The patient further recounts other limitations such as limited assessment to see the patient’s real-time habits and behavior which may influence her diagnosis. To address this, doctors have adapted by employing different strategies. Among those employed by the patient’s physician, she noted the use of daily journals to capture her lifestyle habits for the doctor to understand her current condition.Familial support and cooperation are necessary to assist in the treatment of the patient and maintain a safe and healthy environment for optimal health.With the numerous headways made for telemedicine, there are still no regulating policies to govern telemedicine in the country. The future of a developed Philippine healthcare system remains grim for as long the government refuses to prioritize health, even during a pandemic. Photo by Joaquin Arriola, UPCM 2026. Although telemedicine is here to stay, there are still no laws or legislation governing telemedicine in the Philippines. The NTHC began advocating with Congress for such a law beginning in 2009. Eventually what was proposed included House Bill No’s. 6366 (Telehealth Act of 2012) and 4199 (Telehealth Act of 2014), and Senate Bill No. 1618 (The Philippine eHealth Systems and Services Act in 2016). Unfortunately, they have been left to gather dust. Although telehealth / telemedicine became more explicitly stated in the DOH National Objectives for Health and DOST- DOH National Unified Research Agenda beginning 2011, the question remains: whose responsibility is it when the telemedicine system faces complications? The country needs leaders that can take accountability for these programs. To be within sight of a disease-free country, the dawn of these promising opportunities must be held close by trailblazers who can purposefully bring Filipinos the quality of life they deserve.

Med to Lead: The Makings of a Medical Student Leader in the Time of a Pandemic

By Kariza Abu, Class 2024You were going about your typical everyday routine when your professor suddenly announced on Zoom that you will have a group presentation the next day. You view your class Telegram chat to see that your liaison officer is looking for representatives to lead their respective groups. You think to yourself, “Oh, someone else will probably volunteer,” and go on with your day of studying for your exams and assessments.Most medical students are boxed in the academic aspect of our education. We bury ourselves in books, transes, and lectures, and we often forget that as future medical professionals, we also need certain skills that can only be honed through experience. While it may be daunting to most, taking up small opportunities to lead is a key skill. Now more than ever, student leaders are playing a big role in guiding the student body through the pandemic.Leadership in the Medicine Student CouncilThe transition to an online setting was made possible through the efforts of our hardworking administration, faculty, staff, as well as our student leaders who worked behind the scenes to greatly contribute to student welfare during this pandemic. A notable leader at this time was Danee Mangila, UP Medicine Student Council (MSC) Chairperson for academic years 2019-2020 and 2020-2021. She had the feat of easing the transition to online learning for students when the pandemic struck. Prior to the pandemic, most of the projects organized by the MSC were geared towards unifying the student body through creating activities to help students unwind from academic requirements and initiating academic projects to help enhance our learning. The council’s priority then drastically shifted to addressing student needs to make sure that no student gets left behind. Various needs such as course packs, data allowances, laptop loans, and financial aid arose because of the online set-up. According to Danee, what helped her and the council overcome these challenges was proper communication with all the stakeholders involved, including the administration, the class presidents, the faculty, and the staff.Being a medical student is already filled with many growing pains, but Danee was inspired to step up to this immense role because she believes that being a leader is the best way to hone her skills and values outside of academics. She also found this to be a great opportunity to help others. She shares, “Our profession is more than being a clinician. In one way or another, we will also function as leaders at the different levels and stages in our career. We will be leaders of our blocks, our residency batch, our clinics, our RHUs, or even our own hospitals. The challenges and learnings from leadership experiences help us improve and grow holistically.”Back during COVID-19’s onset, then-UP Medicine Student Council Chairperson Danee Mangila steered the student council to shift gears towards aiding those students most vulnerable to the pandemic. Being at the helm of such a daunting task, she seized this opportunity to both maximize her own skills while exerting her best to help those in need. Leadership in Organizations, Fraternities, and SororitiesEqually important in helping UPCM students adapt to the pandemic are the student leaders of organizations, fraternities, and sororities (OFS). Six OFS presidents shared their insights regarding how it is like to lead an organization in the time of COVID-19: Iya de Claro, editor-in-chief of UP Medics; Mica Gonzales, Most Exalted Sister of the Mu Sigma Phi Sorority; Matt Hernandez, Most Exalted Brother of the Mu Sigma Phi Fraternity; Aya Dicali, chairperson of the Regionalization Students Organization (RSO); Lara Castillo, Superior Sister Exemplar of the Phi Lambda Delta Sorority; Allen Lichauco, Superior Exemplar of the Phi Kappa Mu Fraternity; and Joana Cruz, president of the UP Physician-Scientists Association (PSA). All student leaders expressed the challenge of transitioning on-campus projects to the online setting without losing its intended goals and objectives. They shared their different approaches to overcoming this problem. Similar to Danee’s response, Joana, Matt and Lara emphasized on communication being essential in maintaining the bond between members in their respective groups. By constantly checking up on their constituents, they were able to keep their organization active and purposeful. Iya, on the other hand, became more hands on with tasks by continuously following up on her members to keep them involved during the pandemic. As for Mica, she focused more on the underlying organizational aspect of leadership. She says that the key to overcoming hurdles is the willingness to reevaluate existing systems and having the flexibility to make day-to-day changes until a good balance of output and member welfare is attained. Facing the challenge of transitioning her sorority into a pandemic setup, Lara Castillo, Superior Sister Exemplar of the Phi Lambda Delta Sorority, deemed it essential to first check up on the welfare of her constituents. Doing so was the initial step to invigorating the sorority to pursue their purpose and stay true to their values. Recognizing the importance of maintaining the bond between its members, Aya Dicali, President of the Regionalization Students Organization, notes how leading the organization during the pandemic entails coming up with ways to adequately simulate the spirit of being an Igsuon online, as these values are often best showin in person. Why aspire to be a student leader?There are countless reasons for becoming a student leader, and these are brought together by the intention to serve. Iya shares that as an ambitious person, she had always wanted to become the president of an OFS since LU2. Allen notes that watching those who came before him serve also spurred him to follow in their example. Mica, on the other hand, says that her own growth in her sorority brought out her desire to have others have the same empowering experience. In an organization, motivation comes from peers too, as Joana found her calling when her friends encouraged her to run for president. In the same way, Lara shares that her love for her sisses and the advocacies they share with each other are what pushed her to step up and take on a leadership role in her sorority. This is similar to Allen who was also inspired by his brods’ desire to serve, lead, and excel in their respective pursuits. Why is it so important for medical students to take charge? Akin to Danee’s response, Iya seconds that learnings from today’s leadership experiences seep into tomorrow’s professional life. Mica’s perspective further builds on this concept: the day-to-day tasks of an organization leader help students develop quick-thinking, problem-solving, and the ability to navigate through the nuances of team communication, integral skills in becoming an effective six-star physician upon graduation. Allen adds that leadership also teaches us the value of accountability, which is indispensable as a future health professional. As Lara puts it, “Leadership is the sine qua non of being a good healthcare professional.” Leadership, however, is not only for personal growth. Joana shares that being a leader allows one to influence others, learn from them, and collaborate with them. Matt highlights how being exposed to an environment that nurtured leadership qualities, as well as being a part of the executive council for the previous years, drove him to also take charge and inspire future generations to be leaders in their own right. With these viewpoints in mind, leadership is a skill to be gained, one that simply cannot be learned inside the classroom.For Mica Gonzales, Most Exalted Sister of the Mu Sigma Phi Sorority, the often routine tasks of being a leader are long-term investments for becoming an effective six-star physician. Quick-thinking, problem-solving, and fostering healthy communication among team members are a few of the essential skills that build effective healthcare professionals once they leave the halls of medical school. Allen Lichauco, Superior Exemplar of the Phi Kappa Mu Fraternity, views leadership as an opportunity to practice accountability of one’s actions. This is especially essential as the actions of healthcare professionals could spell the difference between the life and death of a patient. According to Joana Cruz, president of the UP Physician-Scientists Association, aspiring to be a leader is not always confined to seeking personal growth. Leadership also entails fostering a healthy and empowering team spirit that brings about the growth of everyone involved.What makes a great leader?The path of a great leader is not without the tough balancing act of managing academics and extracurricular life. Now, especially, leading entails a careful consideration of how the activities will fit into the virtual setup. Aya remarks that fostering bonds has become more challenging, not just in the absence of face-to-face interactions, but also under looming duress of zoom fatigue. These responsibilities are juggled with personal struggles, which Aya describes as "another barrier we have to overcome."The consensus among the student leaders is that knowing how to prioritize is key. Holistic leaders are able to make time for things that are most important to them, while still being able to serve in their organizations. Allen notes how, much like in tackling medical problems, the priority lies in the most pressing concern at the moment. However, there will always be difficult times when all priorities seem to be of primary importance; thus, it is also necessary for leaders to know when to ask for help. Lara shares, “leadership entails the humility to acknowledge one’s limitations and mistakes, openness to take accountability, and acceptance of criticism without pride.” Being a leader does not mean that one has to do everything alone. Knowing how to collaborate and delegate tasks to others is equally a form of good leadership. Matt also highlights the importance of being able to maintain a sense of accountability, while also keeping an open mind as some of the core qualities of a good leader. After hearing of these astounding leaders in our midst, one may probably wonder, “Am I qualified enough to be a leader?” The answer is yes. Each student is capable of being a captain of their own ship. Mica brings clarity to this dilemma by sharing that all medical students already have an edge thanks to our training with systems-based thinking and our approach to problem identification and solving. In having one’s own vision and opinions, Joana emphasizes the importance of acting on these viewpoints, listening to one’s constituents, and being open to opportunities for change especially in times of crisis. At the core of this is the willingness to learn and serve. Iya imparts that this can sometimes be a thankless task, but being a great medical student leader is about heeding the call towards a greater good, not just for the sake of being in power. Perhaps a relevant introspection is to turn the tides from “Why?” to “Why not?” and from “Not me!” to “If not me, then who?”Matt Hernandez, Most Exalted Brother of the Mu Sigma Phi Fraternity, highlights how being exposed to an environment that nurtured leadership qualities, as well as being a part of their executive council for the previous years, drove him to also take charge and pay it forward by inspiring future generations to be leaders in their own right.Iya de Claro aspired to become a president of an OFS since she was in LU2. Now, as the Editor-in-chief of UP Medics, she traces this ambition to her core of being willing to learn and to serve. It’s not about merely amassing power; it’s about using that power for the benefit of the greater community.The Role of Student Leaders in Nation BuildingThe upcoming election is pivotal for the nation’s future. Filipinos deserve competent candidates to preside over the country. Within our microcosm of a nation in school, proficient organizational student leaders can rally their fellow students to evoke change, especially with how the pandemic is being handled. Using the platforms available to them, medical student leaders are called to speak up and be the voice of future medical professionals. As Mica mentions, “Nation-building starts with Filipinos who are well-informed and aware of the steps needed to move forward as a nation and can decide properly with whom in the government those steps can be taken.” By educating our fellow Filipinos, medical students can help others empower themselves to make an informed decision to make the possibility of quality and effective healthcare a reality. Equipped with this knowledge, one may be daunted by the enormity of the roles and responsibilities that come with leadership. However, leadership does not always have to start with grandiosity. Each person comes with their own story, from humble beginnings to new heights achieved as a leader. The next time someone asks for a member to step up in your group, take the chance. You’ll never know if you’re made for it if you don’t try.

On Greener Pastures: Med Students’ Perspectives on a Community Practice

Joseph Rem C. Dela Cruz, UPCM 2024The future is filled with uncertainty, now more than ever. The post-pandemic world has highlighted concerns regarding resources and other aspects of the healthcare system that may prove to be detrimental to the delivery of services in all levels of community practice. As healthcare professionals in the province struggle to provide the best possible care in low resource settings, medical students from these same areas feel a calling to serve despite these limitations, and through this a brighter future may be on the horizon.Resources, manpower, and support may be wanting, but this was not enough to deter Jyna Trumata from Leyte. “At first, it was just the will to serve and to give back to my hometown that drove me—feelings I can’t really explain or justify to other people. Now that I am a medical student, though, it has evolved into a much more detailed plan with a sound rationale. In my hometown, I’ve seen the lack of physicians and how it has affected healthcare provision, not only in Sogod but also in the nearby towns. We have a few doctors, but we still need to ask some physicians or specialists from cities to come here once a month if they can,” she recalled.Indeed, behind the serenity of nature, tight-knit culture, and the inner peace that the province brings, the system still is in shambles. Access to health remains remote for many as Tiki Salcedo from Bicol recounts, “The pandemic has actually led me to be dubious of this commitment to serve, but my resolve was reaffirmed just last June. I was riding a bangka just off the coast of the Pacific Ocean with my family, and as we marveled at the idyllic work of nature, our bangka cruised past this quaint community sitting on a secluded island. I was then reminded of my why. I am here for the people.”First blood drive after almost 1.5 years in Brgy. Batangan, Valencia, Bukidnon. The pandemic has not only made frontlines out of the provincial communities, but it has laid bare the systemic holes we have not plugged—and people are falling through.Rekindling the passion to serveMeanwhile, Aya Dicali from Lanao del Sur and her batchmate Sael Rodriguez from Davao del Sur each had their own epiphanies during the pandemic as well. Sael himself had been turned away from a hospital while experiencing appendicitis in the middle of the pandemic, but he soon found—writhing in pain—that he was still fortunate. “I was able to witness an unconscious old woman rushed to the emergency room. ‘Unsay nahitabo? (What happened?),’ asked the doctor. The bantay, who apparently was a compassionate neighbor of the patient, replied ‘Nahimatay na siya Doc unya kagahapon pana siya wala kamata (The patient fainted and has been unconscious since yesterday).’ They had to rent a jeep just to transport the patient from the highlands. With scant resources and vacancies, the hospital couldn’t do very much but attend to only what was necessary. They were actually turned down and had to find another hospital to accommodate them, one with more rooms and resources, but that meant finances would be an issue considering the patient was not privileged enough. This got me thinking that the only thing that separates me from that old woman was privilege. Had it not been for my parents being able to afford a house in the city, I would have succumbed to complications from waiting for transportation. Had it not been for privilege, I don’t think I would be in this position trying to expose my thoughts. These stories actually made me think of how broken the system is for healthcare.”Truly, the pandemic has not only made frontlines out of the communities and the provinces, but it has laid bare the systemic holes we have not plugged—and people are falling through. Aya, a Moro displaced from her home during the Marawi Siege, described Lanao del Sur as having little to no access to treatment and insufficient manpower to tackle schistosomiasis, cancer, and other diseases. She recalled, “When I went back to Bubong, Lanao del Sur to get vaccinated, I was pulled out last-minute when they knew I was a medical student. They said they needed help, and true enough, there was a court filled with people waiting to get vaccinated with only a handful of medical workers and volunteers. I had to help… I remember at that moment, I wanted to be of service. My passion sparked again just like the day I was interviewed for UPCM admissions.”Immersion in Brgy. Laligan, Valencia, Bukidnon. The truth of why provinces need wide-eyed doctors who are eager to serve and carry the skills that ensures commitment and the ability to thrive in low-resource settings.Going where we are neededInspiring stories such as these highlight one truth: provinces need wide-eyed doctors who are eager to serve. However, sentiment only carries one to the provinces, but skill ensures one can stay and thrive. Adaptability is key as Ellpi Rosales from Cebu and Ford Galano from Cagayan point out. “I think the essential skill is [being] able to understand the limitations in the province, particularly in the diagnostic and treatment phase. From there, you can devise ways to arrive at a diagnosis and provide the available treatment options at a given time,” Ellpi said.In addition, leadership and management skills are necessary to deal with the gargantuan task of serving as the only doctor for miles. However, no one has to do it alone, as Jyna points out, “From what I observed, there are three necessary support systems in order to establish good practice in my town: the community, the local healthcare workers, and the local government.” To bridge this gap with stakeholders and their interests, a community practitioner’s finest tools are often proper communication, networking, and pakikipagkapwa tao. Aya retold how banking on relationships with her often shy but warm and receptive fellowmen often is the best way to practice in Muslim Mindanao. All this, of course, without compromising one’s people-centered values, as Tiki notes, “Without a doubt, the healthcare system in Philippine provinces is marred by political interests, and so, as a future practitioner, I always remind myself to strive for a just system when my time comes and to never surrender my truth.”Considering the expansive skill set necessary to succeed in a practice of community medicine, it’s understandable that many do not feel confident enough to pursue it. Yet again, the resolve to serve comes first. “With the pandemic, I lost a hefty amount of opportunities to start practicing and immersing myself in communities. I do think there is a need to establish rapport and a need to understand firsthand what is actually happening in the communities. The best solutions you can come up [with] are through involving the community and learning from them. Although I have experience in community work, it was not specific to my region or province. I don’t have that many experiences in serving my community aside from time-limited volunteer programs for public health education, vaccination programs, and medical missions. I might not have the confidence to do so right now, but I think I’ll get there somehow,” Sael shares. Ford puts it best: “When the time comes, I have no choice but to be very confident because they deserve a confident doctor, and I can't afford to fail them.”Put down your roots. Thrive. The Countryside is waiting. The province is a green pasture rich with experiences. All this generation’s doctors need are support systems. Our approach to health should be overhauled to give fertile soil in which young doctors can be planted. Growing strongAdded to the immense pressure of serving as a community’s paragon, one must bear having to see multiple opportunities pass—or is this just a myth? Opportunity costs such as sacrificing one’s passions are certain, but these do not deter Aya. “I want to try a fellowship or specialization abroad. This could be a boon or bane to my aspiration, but hopefully it will be the former. Of course, I'll work consciously on bringing something useful abroad to my hometown. This would possibly become a stepping stone to helping my own community instead of a barrier,” she said. Meanwhile, Tiki remains optimistic in a life immersed in the arts, “An apprenticeship from renowned contemporary artists is something I look forward to, and I’m seeing a Parisian école on the horizon. After all, lifelong learning is a concept that extends well beyond the field of medicine.”One may miss much, but the province is a green pasture rich with experiences and opportunities. All this generation’s doctors need is ample assistance—especially from their own support systems and provinces. “One thing I noticed in my community (some of my relatives and patients I’ve talked to) is that people put doctors who work in big cities and abroad into a higher pedestal than those who work in the community. It’s hard to understand because I know that being a community physician is a difficult feat,” Jyna laments. Add to that, the frontlines remain undersupplied, understaffed, and unprepared for the influx of patients, especially due to the pandemic. In response, our approach to health should be overhauled to give fertile soil in which young doctors can be planted. According to Sael, “It’s vital for a healthy healthcare system in general which aspires to take care not only of the patients but also doctors.”At the moment, life in the province for students remains the path less traveled, but that’s precisely where the true frontiers of development lie. Perhaps paving this road is not for everyone, but those with grit and wit will often find themselves enamored with the immense sense of purpose the province offers—knowing one’s contributions do not just benefit individuals but communities. There may truly be no shortage of things to do, but one finds growth, respect, and belongingness in a provincial practice. All one has to do is ask themselves, “How can I serve?”

Engineering the Future of Medicine: From Blueprint to Bedside Nationwide

Jonathan Chan, UPCM 2022Without a sliver of doubt, the 21st century has been transformed by an inexorable march of innovation. We live in a world where advanced tech is ubiquitous—it is on a level that would exist solely in the realm of science fiction to laymen just a few decades ago. We often take for granted the computing power of the phone in our pockets which eclipses that of what was available to scientists who first launched rockets to the moon. In the field of medicine, we now have handheld ultrasound machines to visualize images real time on our smartphones. We also have 3D-printed prosthetics that can be customized to suit a patient’s own, unique needs.Unfortunately, such devices are only imported from beyond our shores. There is yet to be a tech company in the Philippines that manufactures advanced medical machinery. A potential reason why innovation in healthcare technology moves at such a glacial pace here is the lack of partnership between engineers and medical doctors. It often happens that a medical doctor identifies a problem in the clinics—one that may easily be addressed by technological equipment or innovation of sorts—but lacks the technical skills to design such a solution. Conversely, an engineer might devise a machine that doctors in the field do not necessarily need. This lack of synergy is precisely what the UP Surgical Innovations and Biotechnology Laboratory, or UP SIBOL, is set to resolve.The people behind UP SIBOL pave the way for the re-engineering of Medicine. The UP SIBOL is the umbrella program responsible for the invention of innovative medical devices synergized by UP Diliman Engineers and Scientists in response to health-related challenges. Photo by: UP Surgical Innovation and Biotechnology (UP SIBOL).UP SIBOL is a collaboration between the clinicials of the College of Medicine in UP Manilan as well as engineers and scientists from the College of Engineering and College of Science in UP Diliman. Its primary purpose is to join the brightest minds in the country and create novel healthcare solutions. This new initiative was spearheaded by Dr. Edward Wang, a Professor of Orthopedics in the UP College of Medicine and an active consultant at the Philippine General Hospital. The groundwork for UP SIBOL was patterned after the highly innovative institutes of the National University of Singapore (NUS). In NUS, they have the Biomedical Institute for Global Health Research & Technology as well as the Advanced Surgical Training Center.The first foray into this new endeavor started with the initial Conversations Leading to Innovations and Collaborations, or CLIC, held in March 2019. In this meeting, stakeholders from both fields discussed current issues in the hospital and how clinicians are currently solving these problems. For instance, the lack of vacuum assisted closure devices in the surgical wards compelled some doctors to come up with a low-cost alternative involving cling wrap, kitchen foam, and wall suction. The contraption is endearingly called Wall Suction Assisted Closure, or WASAC. This spark of creativity—almost a prerequisite in practicing medicine in the third world—is what differentiates us from developed nations. It likewise begs the question: Can this ad hoc contraption be fashioned into a formal low-cost device, ready to be deployed to other hospitals? Such is the spirit of innovation and creativity that the UP SIBOL is founded on.Preparations to kickstart the initiative were well on their way at the end of 2019. Talks between the engineers and physicians resulted in different project proposals, which naturally formed committees within UP SIBOL. Some had already drafted proposals to funding agencies to finance their projects. However, everything changed in early 2020 as the COVID-19 pandemic response shifted into full gear. Amidst the challenge of the ensuing months, UP SIBOL was uniquely suited to aid in the national response as the country then faced novel problems requiring equally novel solutions. Instead of becoming a hindrance, the pandemic even catalyzed the teams working under UP SIBOL.Under the three main themes of Protect, Disinfect, and Distance, different projects were proposed by the interdisciplinary teams. As an example of a proposal under the theme of Protect, a team headed by Engr. Leslie Diaz and Dr. Manuel Jorge focused on reusable face masks. Under the theme of Disinfect, Dr. Edward Wang, Dr. Catherine Co, Engr. Eduardo Magdaluyo, and Engr. Jason Pechardo were able to launch a prototype of a self-contained disinfecting cubicle. The device, SaniPod, was showcased in PGH as a way to quickly disinfect health workers in the COVID wards. Lastly, under the theme of Distance, a team composed of Dr. Nathaniel Orillaza, Engr. Prospero Naval, and Engr. Luis Sison is currently working on a telepresence device for use in the COVID wards. The prototype has a screen mounted on a remote-controlled, wheeled-machine that can go around the wards. Aptly nicknamed myBESHIE (My Bot Ensuring Safety and Health in Isolated Environments), the device is envisioned to minimize exposure between patients and health workers while still allowing them to freely interact in a safe manner through the screen.To foster stronger collaboration between physicians and engineers working across different projects, the CLICs still continue to this day. Dr. Eva Maria Cutiongco-de la Paz, the Executive Director of the National Institutes of Health, has lauded this initiative. After all, friendships and conversations lead to meaningful research collaborations. The idea of CLICs is to stimulate the free exchange of ideas. It links physicians who have medical problems to solve with engineers who are eager to propose solutions. This is preferably done in a cafe, over a hot cup of coffee, but since this is currently not feasible, the environment is simulated over virtual meeting rooms. Some of the initiatives, including the Hand Pose and Telerehab Movement Detection project, were born from this auspicious meeting of minds.UP SIBOL is an upscale innovation hub for medical devices such as UP SIBOL face mask, MyBeshie (My Bot Ensuring Safety and Health in Isolated Environments), Prone pillow, and Clean-tubate. The facemask is made of a nanofiber material that could be used up to 30 times. Photo by: UP Surgical Innovation and Biotechnology (UP SIBOL).The Clean-intubate is a device used to disinfect laryngoscope blades used in intubation. Photo by: UP Surgical Innovation and Biotechnology (UP SIBOL).The Prone pillow plus is a supportive pillow that allows safe and comfortable prone positioning for obese and pregnant women in acute respiratory failure. Photo by: UP Surgical Innovation and Biotechnology (UP SIBOL).Beyond joining physicians and engineers to work on projects, UP SIBOL also helps students in both fields nurture their interests in the nexus of Engineering and Medicine. As mentioned in another article found on this issue, entitled “Sowing Seeds of Innovation: The ECE 197/297 Experience,” experts under UP SIBOL also helped launch a new course back in A.Y. 2020-2021. The course was named “ECE 197: Introduction to Systems Design for Healthcare” for undergraduates and “ChE 297: Process Systems Design for Healthcare” for graduate students.Outside the elective, UP SIBOL also holds virtual lectures on “Innovations in Health” every third Thursday of the month. Last February, Dr. Jacinto Blas Mantaring III gave a crash course on Health Technology Assessment. Meanwhile, Engr. Maria Cecila Matienzo spoke about Medical Device Regulation in the Philippines last May. One of the lectures given this August was about how orthopedic surgeons and engineers work on designing prosthetics. The discussion was led by Dr. Ilustre Guloy Jr. and Engr. Jude Sasing, as both shared their experiences collaborating across disciplines.None of these initiatives would make an impact if the devices prototyped do not make it to the market. Beyond ensuring that the products are technically and mechanically sound, they must also be commercially viable. As such, UP SIBOL also works with the UPSCALE Innovation Hub, a partnership between UP and DOST, which aims to foster innovation by assisting startups and multidisciplinary collaborations. In particular, they help link fledgling companies with government institutions and private entities to bring forth their products from conception to commercialization.UP SIBOL is the first step in the dream to locally design and manufacture advanced biomedical devices in our country. It leverages the brightest minds and diverse range of expertise within the University to push the envelope of biomedical technology in the Philippines. With UP SIBOL serving as an avenue for close collaboration between the two fields, its primary goal is to hopefully usher in a golden age of research and development at the nexus of Engineering and Medicine.

2021 Gawad Chancellor Awards

By: Joaquin Julio Reyes, UPCM 2025We celebrate UP Manila Day and the anniversary of the autonomy of the Health Sciences Center every 22nd of October. In conjunction with this, the University celebrates numerous individuals from the community who have exemplified the nature of excellence. This year’s awarding ceremony was hosted by Dr. Melfred Hernandez, Director of the Office of Alumni Relations, and Dr Emily Dicolen, a representative from the National Teacher Training Center for the Health Professions.The 39th UP Manila Foundation Day and 42nd Anniversary of the Health Sciences Center was celebrated last October 22, 2021 and was hosted by Dr. Melfred Hernandez, Director of the Office of Alumni Relations, and Dr Emily Dicolen, a representative from the National Teacher Training Center for the Health ProfessionsThe first speaker of the day was Dr. Cornelio Banaag who spoke about the impact of the COVID-19 pandemic on the Filipino family. Dr. Banaag emphasized the multiple roles that individuals hold in the household especially in the time of this pandemic which in turn add to the stress each of us feel everyday. In the context of our country, Dr. Banaag highlighted research conducted by faculty from the UP College of Medicine together with Philippine One Health University Network and Southeast Asian On Health University Network. It was found that NCR students had experienced more stress, depression, and anxiety from the pandemic. Moreover, Dr. Banaag also highlighted the factor of parental burnout as an inciting factor in the poor mental health of our country. This parental burnout is caused by a distress or discomfort that results from demands associated with the role of parenting. Burnout begins when this stress becomes chronic and overwhelming.In spite of these barriers for the Filipino family, Dr. Banaag also highlighted the creative and resourceful ways that families have thrived during the pandemic. He cited an instance of sixth graders in the Philippines using remote- controlled robots to hold cyber graduations. This is an example of how digital technologies can be used to support schools. Furthermore, he also highlighted the heightened awareness of some families to create healthy habits and take care of one’s body which has resulted in an example of self-directed health.Resilience is a word often overused in this day and age, but Dr. Banaag made it a point to differentiate this concept from post-traumatic growth which may be what we want to achieve in post-pandemic. Resilience, he says, is the ability to resist and recover readily from a traumatic event. Post-traumatic growth however is a much deeper experience wherein positive psychological change helps people become stronger in order to live more meaningful days (Tedeschi & Calhoun, 2004).Taking these ideals into the context, it is important to see that these awardees from our College have shown growth despite the pandemic and they prove to be examples that we too can rise above the blows that all of this has dealt us.There were three awardees from the student body of the College. Leandro Salazar, currently a medical intern in the Philippine General Hospital, bagged the Outstanding Student award for his exemplary performance both inside and outside the classroom. Mr. Salazar was instrumental in the 7th Philippine Conference on Community Health and the National Health Resource Masterplan. He was also the Medical School Representative in the passing of the Republic Act no.11509. He has shown what it means to be a holistic and well-rounded student by excelling at his academics while being at the helm of numerous student organizations. Mr. Salazar served as the Chairperson of the 42nd Medicine Student Council, the National President of the Alliance of Philippine Pre-medical Societies, and he was also recognized by the Asian Pacific Medical Colleges’ Student Network as “Mga Natatanging Mag-aaral ng Medisina sa Pilipinas” and “Natatanging Mag-aaral ng Medisina ng Pilipinas sa Larangan ng Liderato.” Given these achievements among many other smaller ones that we may not have heard of, Mr. Salazar is a rightful recipient of this award.Leandro Salazar from UPCM 2022 received the 2021 Gawad Chancellor Award for Outstanding Student for his exemplary performanceThe second recipient of a “Gawad Chancellor Award” from the student body was William Thomas Lara from UPCM LU4. He was awarded as Outstanding Athlete for his contributions to the UP Men’s Varsity Swimming Team. Mr. Lara was a consistent podium finisher during his 5-year stint with the team. He amassed consistent gold, silver, and bronze medals in the Philippine Swimming Inc. Long Course and Short Course National Championships. Furthermore, he also finished silver in his first year competing in the UAAP Swimming Tournament and bronze in all his succeeding years. In his graduating year, Mr. Lara finished summa cum laude with a degree in Sports Sciences. Mr. Lara continues to shine in medical school as a student and as a leader as he holds a place in the Executive Council of the Mu Sigma Phi Fraternity.William Thomas Lara from UPCM 2025 received the 2021 Gawad Chancellor Award for Outstanding Athlete award for his contributions to the UP Men’s Varsity Swimming Team Lastly, the Mu Sigma Phi Sorority was awarded the Most Outstanding Student Organization for their service to the community. Projects such as the Health Education and Literacy Campaigns have helped improve patient education and health-seeking behavior in the communities that were served. Other projects such as Sine Gamutan and COVIDgilance webinar series proved that service could prevail online in spite of the pandemic. Furthermore, Mu Relief has raised more than Php 4,000,000 in cash and in kind to help the frontliners and communities that needed it urgently at the onset of the pandemic. The Mu Sigma Phi Sorority embodies tenacious service undeterred by challenges brought about by the pandemic. They continue to show that relevant service can still be rendered even with barriers left and right.The Mu Sigma Phi Sorority of the UP College of Medicine garners the 2021 Gawad Chancellor Award for Outstanding Student Organization. The plaque was received by Micaella Maria Gonzales, Mu Sigma Phi Sorority 2022, Most Exalted Sister Our esteemed faculty were also awarded. Dr. Maria Julieta Corazon Victoriano-Germar, better known as Ma’am Jayjay, was awarded Outstanding Teacher. She has been teaching for 18 years, and she has been known for her development of clinical teaching and student evaluation. She designs simulation-based education modules using high-fidelity simulators to teach and she has also created low-cost alternatives for commercially available task trainers. Furthermore, she also helped provide training modules on basic clinical skills to student volunteers from UP Manila and individualized learning plans for students from the Department of Obstetrics and Gynecology. During the pandemic, she also designed the UPCM-OB-Gyn virtual simulation learning kits which covered procedures such as pap smears, pelvic exams, and episiotomies. She further supplemented their learning with checklists and online workshops. Her published works on online courses for health practitioners have displayed her prowess and ingenuity in creating new ways for students to learn. Currently, she is the head of the UP College of Medicine Clinical Simulation center. Dr. Maria Julieta Corazon Victoriano-Germar, better known as Ma’am Jayjay, was awarded the 2021 Gawad Chancellor Award for Outstanding Teacher. “Kung sa tinagal-tagal ng iyong pagdadalubhasa ay natutunan mong tumangis sa kahirapan at kalungkutan ng iyong mga kababayan, kung natagpuan mo sa iyong puso na maglingkod sa kanila nang kahit paminsan-minsan ay walang inisip na katumbas na kabayaran, ikaw na marahil ang isa sa maitatanghal na tunay na bayani ng ating pangkasalukuyang Lipunan.”Dr. Emmanuel P. Estrella from the National Institutes of Health was awarded Outstanding Researcher. Dr. Estrella is currently practicing reconstructive microsurgery. From 2016-2020, Dr. Estrella had published seven scientific articles and had authored six reputable papers on topics such as fractures, injuries, and microsurgeries such as nerve transfers for shoulder reconstruction in brachial plexus. These publications have cumulatively received over 50 citations. He is currently in the editorial board for several scientific journals and he was awarded UP Scientist I from 2015-2017. He was also awarded with the Promising Star award in 2017 from Thomas-Reuters and he has been named as one of Asia’s Top 100 Scientists.Dr. Carmencita D. Padilla, Professor 12, and current UP Manila Chancellor received the Service Award from the College of Medicine.Dr. Diana R. Tamondong Lachica was awarded Outstanding Teacher in Extension Service for her contributions to patient safety and quality of care in the institutions she is a part of. She was involved in formulating evidence-based standards of care and policies for hospitals as well as clinical practice guidelines on lifestyle intervention, COVID-19 living treatment, and adult sepsis. She has also served in the DOH Technical Group for the National Patient Service Program and has been involved in the DOH Drug Price Advisory Council on Government Policies and Interventions of essential price reductions. Her staunch involvement led to the signing of Executive Order 104 on the Maximum Drug Retail price. In our hospital’s time of need, she spearheaded the Patient Query arm of the COVID Operations - Bayanihan Center Hotline which has helped PGH services nationwide deal with the pandemic.From how these awardees have been described, it is evident that they have grown through this pandemic in more ways than one. Despite the obstacles that they have been faced with, they have shown grit, creativity, and consistency.To end, as Dr. Germar quotes her own teacher Dr. Augusto Manalo,“Kung sa tinagal-tagal ng iyong pagdadalubhasa ay natutunan mong tumangis sakahirapan at kalungkutan ng iyong mga kababayan, kung natagpuan mo sa iyong puso na maglingkod sa kanila nang kahit paminsan-minsan ay walang inisip na katumbas na kabayaran, ikaw na marahil ang isa sa maitatanghal na tunay na bayani ng ating pangkasalukuyang Lipunan.”Most honorably, these awardees have exemplified compassion for those who have been affected most in our country. They have gone above and beyond what has been asked of them to ensure that we can continue to grow after the blows dealt by this pandemic.

Pagkilala: Faculty Recognition Ceremonies 2021

By: Stephanie Noelle Blanco, UPCM Class 2024On December 7, 2021, the UP College of Medicine proudly recognized and awarded faculty and departments who garnered significant achievements from academic years 2019-2020 and 2020-2021. The first ever Dr. Evangeline Olivar Santos Memorial Awards were also presented. This year’s ceremony entitled “Pagkilala” was conducted via Zoom.The UPM College of Medicine recognizes the significant achievements from its faculty and departments from academic years 2019-2020 and 2020-2021. It began with introductions from the Masters of Ceremonies, Dr. Angela S. Aguilar and Dr. Benjamin P. Sablan Jr., followed by performances of the UP MedChoir for the invocation, national anthem, and college hymn. College of Medicine Dean, Dr. Charlotte M. Chiong, UP Manila Chancellor, Dr. Carmencita D. Padilla, and PGH Director, Dr. Gerardo D. Legaspi delivered the welcome remarks and opening messages. They commended the faculty for their contributions in fulfilling the College’s mission—especially in the face of unprecedented challenges due to the pandemic—and serving as inspirations and mentors.Masters of the Ceremonies, Dr. Benjamin P. Sablan Jr. (left) and Dr. Angela S. Aguilar (right), proudly begin the program for “Pagkilala: Faculty Recognition Ceremonies” held December 7, 2021 via Zoom. The first group of awardees recognized were the Faculty Achievers—faculty who received awards, both locally and internationally, and served as heads of their respective specialties and societies from 2019 up to July 2021. There were 84 recognized faculty across 16 departments.From the Department of Anesthesiology were the following: Dr. Maria Lourdes Josefina K. Cabaluna, Dr. Grace Anne B. Herbosa, Dr. Geraldine Raphaela B. Jose, Dr. Catherine Renee B. Reyes, Dr. Maria Dolma G. Santos, Dr. Edgard M. Simon, and Dr. Benjamin Daniel S. ValeraDepartment of Biochemistry & Molecular Biology: Leslie Michelle M. Dalmacio, PhD Gracia Fe B. Yu, PhDDepartment of Clinical Epidemiology: Dr. Marissa M. AlejandriaDepartment of Dermatology: Dr. Claudine Yap-SilvaDepartment of Family & Community Medicine: Dr. Karin E. Garcia Dr. Leilani A. NicodemusDepartment of Medicine: Dr. Albert B. Albay, Jr., Dr. Jubert P. Benedicto, Dr. Regina P. Berba, Dr. Joselito R. Chavez, Dr. Mark Anthony A. De Lusong, Dr. Lenora C. Fernandez, Dr. Gabriel V. Jasul Jr., Dr. Elizabeth S. Montemayor, Dr. Jaime C. Montoya, Dr. Deborah Ignacia D. Ona, Dr. Felix Eduardo R. Punzalan, Dr. Bernadette Heizel M. Reyes, Dr. Evalyn A. Roxas, Dr. Evelyn O. Salido, Dr. Anthony Russell T. Villanueva, and Dr. Aileen D. WangDepartment of Neurosciences: Dr. Carissa Paz C. Dioquino, Dr. Peter Paul D.P. Rivera, and Dr. Ma. Cristina Z. San JoseDepartment of Obstetrics and Gynecology: Dr. Angela S. Aguilar, Dr. Ira Dominique T. Alatraca-Malonzo, Dr. Doris R. Benavides, Dr. Sybil Lizanne R. Bravo, Dr. Ma. Bernadette O. Cruz, Dr. Maynila E. Domingo, Dr. Ana Victoria V. Dy Echo, Dr. Florante P. Gonzaga, Dr. Maria Antonia E. Habana, Dr. Cecilia A. Ladines-Llave, Dr. Erlidia F. Llamas-Clark, Dr. Ricardo M. Manalastas Jr., Dr. Virgilio M. Novero Jr., Dr. Lisa Teresa T. Prodigalidad-Jabson, Dr. Filomena S. San Juan, Dr. Maria Lilibeth L. Sia Su, Dr. Agnes L. Soriano-Estrella, Dr. Gladys G. Tanangonan, Dr. Jean Anne B. Toral, Dr. Maria Julieta Corazon M. Victoriano-Germar, and Dr. Regina Rosario P. VitrioloDepartment of Orthopedics: Dr. Peter B. Bernardo Dr. Czar Louie L. GastonDepartment of Otolaryngology-Head and Neck Surgery: Dr. Arsenio Claro A. Cabungcal, Dr. Charlotte M. Chiong, and Dr. Jose Florencio F. Lapena, Jr.Department of Pediatrics: Dr. Eva Maria C. Cutiongco-Dela Paz, Dr. Leonila F. Dans, Dr. Ma. Liza Antoinette M. Gonzales, and Dr. Bernadette MadridDepartment of Pharmacology and Toxicology: Dr. Maria Stephanie Fay S. Cagayan, Dr. Cleotilde H. How, Dr. Irma R. Makalinao, Dr. Jose Paciano Baltazar V.T. Reyes, and Dr. Richard Henry P. Tiongco, IIIDepartment of Psychiatry & Behavioral Medicine: Dr. Alma L. Jimenez, Dr. Constantine D. Della, and Dr. Antonio C. SisonDepartment of Radiology: Dr. Lorelie L. Chavez, Dr. Manuel Martin L. Lopez, and Dr. Leizl B. ValerioDepartment of Rehabilitation Medicine: Dr. Teresita Joy P. EvangelistaDepartment of Surgery: Dr. Jose Modesto B. Abellera III, Dr. Crisostomo E. Arcilla, Jr., Dr. Allan Dante M. Concejero, Dr. Daniel A. de la Paz, Jr., Dr. Arturo S. de la Pena, Dr. Teodoro J. Herbosa, Dr. Reynaldo O. Joson, Dr. Adrian E. Manapat, Dr. Orlando O. Ocampo, and Dr. Francisco Manuel T. RoxasNext was the UPMASA Outstanding Teacher Awards for AY 2019-2020, whose faculty recipients were chosen by the students from each year level. Awardees received a certificate of recognition and a cash award from the UP Medical Alumni Society in America. A Hall of Fame Award was also given to those previously awarded as UPMASA Outstanding Teacher for more than five times consecutively.The Hall of Fame awardees for LU 3 were Dr. Blesile Suzette S. Mantaring and Dr. Jose Leonard R. Pascual V, while the recognized Outstanding Teachers in LU 3 are Dr. Ronnie E. Baticulon and Dr. Rafael C. Bundocーall belong to the Department of Anatomy.The Hall of Fame awardees for LU 4 are Dr. Cecilia A. Jimeno and Dr. Maria Concepcion C. Sison, both from the Department of Pharmacology. Meanwhile, the Outstanding Teachers in LU 4 are Dr. Jose Leonard R. Pascual V of the Department of Neurosciences, and Dr. Paolo S. Macasaet of the Department of Pathology.The UPMASA Outstanding Teachers in LU 5 are Dr. Cecilia A. Jimeno of the Department of Pharmacology, and Dr. Maria Julieta Corazon M. Victoriano-Germar of the Department of Obstetrics and Gynecology.Dr. Cecilia A. Jimeno was also recognized by the UPMASA as Outstanding Teacher in LU 6, along with Dr. Felice Katrina T. Ranche of the Department of Ophthalmology.The Dr. Augusto A. Camara Best Teacher in the Basic Sciences was then awarded. It is given annually to honor Dr. Augusto A. Camara of UPCM Class 1944. He graduated summa cum laude from the College of Medicine, topped the medical board exam, served as an eminent cardiologist, and was a concert pianist. The award itself was given to Dr. Blesile Suzette S. Mantaring. This year, a Hall of Fame award was also given, recognizing Dr. Jose Leonard R. Pascual V as its recipient.Dr. Blesile Suzette S. Mantaring is awarded the Dr. Augusto A. Camara Best Teacher in the Basic Sciences; the Hall of Fame award is given to Dr. Jose Leonard R. Pascual V. For the first time, the Dr. Evangeline Olivar Santos Memorial Awards were conferred by former UP College of Medicine Dean Cecil Tomas. Dr. Evangeline Olivar Santos of UPCM Class 1965 became a researcher after graduation at the Philippine Eye Research Institute and served as Chair of the National Committee for Sight Preservation for many years. She garnered many accolades for her work in bringing basic ophthalmologic services to the provinces. The respective categories under the Dr. Evangeline Olivar Santos Memorial Awards are the Best Student Research Paper and the Meritorious Publications in Peer-Reviewed Journals.Former UPCM Dean Cecil Tomas confers the first ever Dr. Evangeline Olivar Santos Memorial Awards to Dr. Maria Llaine Callanta for the Best Student Research Paper Category, and to Dr. Harvey Siy Uy and Dr. Emmanuel P. Estrella for the Meritorious Publications in Peer-Reviewed Journals Category. The Best Student Research Paper intends to encourage students to pursue high-impact research. This was awarded to Dr. Maria Llaine Callanta, who conferred her MD-PhD in Molecular Biology this 2021, for her research “The Role of SMAD2/3 in Vascular Remodeling of Kawasaki Disease Murine Models.” She also received the DOST-PCHRD Award for Most Outstanding MD-PhD Dissertation.The Meritorious Publications in Peer-Reviewed Journals aims to encourage faculty to publish their research in index peer-reviewed journals adhering to high standards of scholarships. This year, there were two recipients. Dr. Harvey Siy Uy, Clinical Associate Professor, Department of Ophthalmology & Visual Sciences, was recognized for his publication in The Journal of Clinical Ophthalmology entitled, “Comparison of Two Different Intravitreal Injection Techniques.” Dr. Emmanuel P. Estrella, Clinical Professor, Department of Orthopedics, was recognized for his publication entitled “Quality of Life of Patients with Traumatic Brachial Plexus Injuries” in the International Journal of the Care of the Injured.Before the final segment, a special intermission number was performed by colleagues from the Department of Obstetrics and Gynecology. Dr. Rani M. Cadiz and Dr. Florida F. Taladtad performed a duet of the song “Tuloy Pa Rin” by Neocolors.The final awards given were the Silver Cup Awards for the Most Outstanding Departments for AY 2019-2020, an initiative of the UP Medical Foundation, Inc. (1993). The criteria for outstanding departments are contributions to (1) academic excellence, (2) research integrity and relevance, (3) staff development, (4) university and college extension services, and (5) the public persona of the UP College of Medicine. Dr. Paolo Maria M. Pagkatipunan, President of the UP Medical Foundation, Inc. conferred the Most Outstanding Basic and Clinical Departments.The Top 3 departments of the Basic Sciences were the Department of Anatomy, Department of Clinical Epidemiology, and Department Pharmacology, with the Department of Pharmacology bagging the award.As for the Clinical Sciences, the Top 3 departments were the Department of Neurosciences, Department of Otolaryngology-Head and Neck Surgery, and Department of Surgery. The award was given to the Department of Surgery.Marking the end of the ceremony, closing remarks were given by College Secretary Dr. Abner Chan, followed by UP Naming Mahal led by the UP MedChoir. Taking from the message of Dr. Chan, “What a blessing it must be to have found your true calling early in life, to love what you do, to be able to work on it on a daily basis, and ultimately, achieving excellence, if not perfection. To one day be recognized for it is definitely a bonus.”Becoming a six-star physician does not have shortcuts nor is it achieved by luck. The faculty are examples of what persistence, passion, and continuous work together can achieve.

Asa Ko Makatabang?: Learning Opportunities During the COVID-19 Pandemic

By: Karl Gerard Reyes Crisostomo, UPCM 2023, Executive Editor of UPCM InSPIRE MagazineAs the first news of the coronavirus reaching Philippine soil started flowing in during the early months of 2020, Ianne Keziah Agripo, a then-LU4 student, felt a sense of unease and uncertainty. “We did not realize the impact of the pandemic until it hit the two-week mark, when all the classes were cancelled for a prolonged period of time,” she would later say. As soon as reality set in, she noted that there was a strong sense of helplessness. As a medical student, she felt compelled to help in whatever way she could. However, she was limited as she, much like her other classmates, was not yet a licensed physician. This was compounded by the fact that the pandemic took away opportunities for face-to-face training. However, equipped with a drive to learn and a willingness to serve, Keziah took it upon herself to find ways in the midst of a pandemic.The first opportunity came to Keziah through one of her organizations in the UP College of Medicine, the Regionalization Student’s Organization. She was able to assist in sourcing laboratory materials for COVID-19 testing, including cryogenic vials, microcentrifuge tubes, and filtered tips, supplied to provinces to further capacitate the labs that were not as well-equipped as their urban counterparts at the start of the pandemic. “The difference at the provincial levels was the [COVID-19 RTPCR] testing. At the time, there were no testing centers, only one in Cebu and one in Davao… all the rest were in Luzon or in NCR. We were thinking of how to address and help capacitate [these hospitals] in terms of their laboratories,” she remarked. While she felt she was able to contribute to the pandemic efforts—and she was able to interact with and form connections all over the country through sourcing these materials—she often asked herself if there was more she could do to further assist in these efforts.Another chance came from the APMC-SN and Asia eHealth Information Network, through which she was able to participate in driving advocacies digitally, particularly one for telehealth. Here, she was able to co-head an international digital health conference with Vince Tiu and Nonot Nacionales, in collaboration with Dr. Alvin Marcelo on the incorporation of hybrid care through telemedicine and the digital health strategy. When asked about her takeaway from this activity, she said “Telehealth can be used to [equip] remote areas—connect even the most specialized doctor to the most rural areas with no remote professionals.”While many opportunities were provided in the digital landscape to integrate and innovate in the field of medicine, she found herself searching for ground-level work, where she would be able to interact with and approach patients. While she appreciated everything that she learned previously, she noted that there was a particular dimension with regards to connecting and understanding patients that was difficult to elicit in a telemedicine setting. As luck would have it, an opportunity presented itself through the pilot vaccination program that was being conducted in the LGU of Keziah’s hometown, Valencia, Bukidnon. The information and knowledge gleaned from this program would then go on to be used in vaccination programs nationwide as a means to make the existing setup more efficient. To this end, she was assigned to be part of the COVID-19 information drive that would be occurring throughout the vaccination program as various individuals waited for their turn to get vaccinated.Valencia Mass Vaccination Center at the City Gymnasium. From left to right: Ms. Venadyl Hera Fuego, R.N., Ms. Keziah Agripo, Dr. Gretchen Dale Eduave-Abas, Hon. Policarpo Murillo IV, M.D., Dr. Rhogieh Nomus, Mr. Yobrem Silvano, R.N.“The challenging part was how do you bridge scientific jargon to layman’s terms na kaya ma-intindihan or ma-gauge ng mga tao all about immunization… bakit safe ‘yung vaccine.” She felt it was a big responsibility for her as the knowledge that she would imbibe upon those present would also be shared with their respective families at home. “...[A]ndun na talaga ‘yung responsibility to you, na you are holding the mic, and what you are saying is what gets to the patient,” she noted. Her efforts necessitated her to clarify misconceptions regarding the vaccine, and she climbed the steep learning curve that pushed her to keep informed. Through this, however, she felt that it gave further relevance to what she had learned over the course of her medical education, giving her an opportunity to learn and teach accordingly.While there were plenty of learning opportunities, she noted that volunteering while also pursuing her medical education was no easy task. “First and foremost, I was not living at home… kasi if volunteering, ayoko maexpose ‘yung family.” Keziah would find herself waking up as early as 5:00 a.m. before sunrise, drinking her morning coffee as well as perusing through her readings for class on that day. Afterwards, she would head early to the vaccination center to assist in the setup. Depending on whether there was a lecture or SGD in her rotation that day, she would often come earlier to attend the session in the vaccination center so as not to worry about preparations or travel time needed. The orientation and information drive would start at around 9:00 a.m., and—oftentimes, with two other volunteers—she would spend 15 to 30 minutes giving an overview of all the precautions and contraindications for vaccines in a manner that would be easily digestible to laypeople. They would also actively make an effort to clarify all the misconceptions that were often reported, along with any adverse effects that would make the daily news. Her days would often end at 5:00 p.m., after which she would get to bond with other healthcare volunteers; they would then discuss unique cases that they had all encountered over the course of the day, along with learnings that would help further enhance their approach to these patients in later sessions. On some days outside of the vaccination schedule, they would even go out to other barangays to educate.Zone 1: Orientation Zone at Valencia City Mass Vaccination Center. From left to right: Ms.Venadyl Hera Fuego, R.N., Ms. Keziah Agripo, Mr. Yobrem Silvano, R.N. Despite the challenges, Keziah felt the situation was ripe with many opportunities for learning. Throughout her service in the LGU, she was able to apply learnings from class and from her various SGDs when advising patients during post-vaccine monitoring, specifically regarding breastfeeding after getting vaccinated, as well as possible drug interactions with medications. She also appreciated being able to interact with various patients while also learning about their various experiences with COVID-19 that further influenced their decision to get vaccinated. Learning about various reasons for initial hesitancy such as a death in the family or a severe experience from the pandemic further motivated her to make a greater effort in learning. “...[O]nce I get to understand a patient’s story, it gets me motivated by learning more… about how to take care of them,” highlighting how medicine was not just about curing the underlying condition but ensuring the proper care and quality of life for the patient. Keziah was also provided many opportunities outside of the virtual medical setting through her various interactions with her fellow healthcare professionals. “Rapport building with colleagues and soon-to-be colleagues was very vital kasi sobrang humbling siya,” noting how they proceeded to offer her many chances to learn in a face-to-face setting. Outside of her duties in the vaccination drive, she was given the opportunity to observe and assist in a live birth, assist in blood drives, and suture in the outpatient department, among other things. She made active efforts to look for opportunities to learn, observe, and absorb information that would prove to be relevant in her future practice.The mass vaccinations were held strong by these community doctors of Bukidnon. From left to right: Dr. Mimi Lazardo, Dr. Carren Emirose Solidor, Dr. Pat Hamilton Abella, Dr. Marlyn Valdez Agbayani, Dr. Claire Rica Ree, Dr. Gretchen Dale Eduave-Abas, Keziah Agripo, Dr. Juniver Flores.Help, Learn, and Teach. The everyday mantra of a medical student’s daily grind.Featuring post-emergency outpatient department suturing and first blood donation drive in Valencia City since the start of the pandemic.Through all these experiences, Keziah reaffirmed how the experience helped her develop into a six-star physician. Through learning about research opportunities in medicine in the local setting, interacting with patients, learning how to communicate adequate information for the better health of her patients, as well as working alongside other healthcare providers in a setting that fostered holistic patient care, she was able to apply theoreticals from medical school in a real life setting. Most importantly, she highlighted the importance of healthcare as a team effort, not just an individual undertaking. In fact, she noted the most important question to be asked in these moments was “asa ko makatabang: how can I help?”, a question applying not only to patients in need but also to colleagues in the field of healthcare. In the end, Keziah notes the social aspect of medicine as an important part of health, sharing the experience with the patients, their families, as well as her future colleagues in a holistic, collaborative effort. In the same way that the oft-repeated adage states how “it takes a village to raise a child,” it takes a community to ensure that its members are always in the best of health.

We Need More Than Science To Emerge From This Pandemic

By Angela G. Sison-Aguilar MD MSc MBA, Faculty Editor-in-Chief, UPCM InSPIRE MagazineThe pandemic is far from over and we are nearing our third year of battle. Yet, unlike before, we are more confident, less fearful of the enemy.We imagined we would emerge from it like survivors from a post-apocalyptic scenario, akin to the Hiroshima and Nagasaki residents who survived a nuclear holocaust. Counting heads, many of us are still here, albeit scarred from battle. The virus, which took a bite at the edges of humankind at our most vulnerable, had not finished us off. It however has transformed us immensely, far more than we are willing to admit.Our college is still here, continuing our work, celebrating our triumphs, no mean feat in this era. Our last INSPIRE issue for 2021 is full not just of hope, but of determination. To say that the College is resilient is to under-assess what it has done not just to survive; it has flourished and spurred our community to do better: Continuing our work, as … a community of scholars, recognizing heroes from among our ranks, our faculty and student achievers, in our virtual fetes…. Paying tribute to our forebears, ….inspired by love, compassion and respect, memorializing their contribution and honoring them…..by conferring the Dr. Evangeline Olivar Santos Research Award, one among many we bestow… Placing faith in our future, heartened by the emergence of leaders from among our youth, whose voices we hear in this issue… Adapting to the environment by using innovations in medical education, navigating this new world through technology and media, and fulfilling our mission to serve the underserved, embodying our heightened social consciousness, with actual service and commitment seen in the stories of UPCM students.As we go about our daily work, we know that there is a nagging feeling, goaded by no less than our Dean’s untiring drive, that we still have a lot of work to do.We just cannot approach another year of this pandemic using our old playbook. This is a world we had not imagined. How can we face the challenging times with a “business-as-usual” attitude?Though we are buoyed by the new developments, rapid diagnostics, vaccines, and antivirals, all developed through collaborative efforts and distributed worldwide, we know we still are far from conquering this scourge. There are challenges in health access, debates in efficacy of proposed interventions, widespread misinformation and what have you— certainly these are not minor. Nevertheless, in our minds and hearts, we have an increasing certainty that these are NOT insurmountable.We know that, in the coming issues of InSPIRE, we will be writing about actions that our community has undertaken to manage our transition from pandemic to a new health order. We know that we, the UPCM, will be working with the global community towards attaining health not just for the nearby catchment area of our university hospital but also for the barely accessible segments of the population, reaching out not only to the educated but enlightening likewise the misinformed, providing services favoring not only the privileged but preferentially assisting the less fortunate.We know that pure science does not solve pandemics— public health is meaningless without political will, and that good intentions do not always result in positive outcomes.We have to go beyond science to fulfill our mission. We have to lend our voice to policy. We have to contribute to the discourse. We have to channel our energies to support effective social movements.It is not enough that we are commandeered to pick up the sick and dead on the battlefield. Why settle for that when we can actually influence how this war is fought? It is not enough to wait passively for resources, sometimes crumbs and leftovers, when we should be asserting how allocation should be directed. Our role is much bigger than we care to admit or even dare to assume.We, the UPCM community, should not only wrack our brains to solve these issues. We should look into our empathetic hearts, delve into our courageous souls, and strengthen our resolve to join the collective struggle. Our aim is to help deliver humanity from the grip of this pandemic and from the old world order that keeps many in a state of poor health.

[OPINION] Tenets

By Joanna Mae Cepcon, UPCM 2023, Chief Editor of UPCM InSPIRE Magazine2022—a new year that does not feel new at all.In a month, we witnessed how the highly transmissible Omicron (B.1.1.529) variant has scrapped any budding relief from low COVID numbers that took months to realize via vaccination. Yet again, record single-day cases were being reported… more than two years into the pandemic. At one point, it seemed as though everyone in the country was either sick or caring for someone who was. With alert levels raised, travel bans imposed, and lockdowns implemented, this year began as an egregious déjà vu.Then again, there is a noticeable difference. Buildings and billboards are now decorated with prominent faces and taglines. Telling colors are vibrant on masks and various items. Criticisms, acclaims, insults, and accusations alike are ubiquitous across social media platforms. There is a charge of anticipation, as news on COVID-19 seemingly took a backseat to that on the national elections.“… Going forward, countries should do everything they can to hold elections as scheduled, as enough lessons have been learned to make it possible to conduct elections safely and effectively.”— The Democracy & Human Rights Working Group of the McCain Institute for International Leadership, Arizona State UniversityCome May 9, we will be able to cast our votes to elect the highest officials in our country. We know very well that voting in the coming elections is the most basic political participation of an individual. But in the nearing elections in the COVID-19 era, are we health care professionals—present and future—expected to do more?Health is a right.The Egregious Déjà vu: A humanitarian tragedy on the relentless wave of COVID-19 cases at the Philippine General Hospital.Photo by: Brent VirayHealth is a fundamental human right. It has been since before it was included in the Constitution of the World Health Organization 75 years ago [1]. It is a no-brainer concept.As health care workers, we have a unique personal familiarity with healthcare equity issues that have existed since pre-pandemic times. Our technical knowledge from years of medical education, combined with patient interactions and clinical training, enable us to gain perspective on the systemic problems that continue to block the best possible health outcomes. The sad truth of it is they have not been uncommon encounters in the national government referral center [2].We may even have our own striking, possibly tear-jerking anecdotes from PGH duties. In fact, in a span of three months, the current clerks have had experiences of bargaining for the approval of mech-vent requests and scrounging unavailable materials for simple procedures. In our limited face-to-face training, we have already become too acquainted with the phrase “ideally, but here in PGH…” and the compromises that came after.On a larger scale, these compromises can ultimately sustain the same dysfunctional system. We could argue that some compromises are necessary and ethically acceptable to arrive at “common good” solutions [3]. Perhaps, in the long run, we would be able to champion our advocacies without much friction. Looking at it from this angle, what indeed is a small compromise if there were an opportunity to help reverse the inadequate health budget allocation, understaffing and low employee wages, lack of equipment and proper facilities, and other long-standing problems?A fair number of individuals with sincere and good intentions must have tried.In this pandemic alone, many recommendations have been given and discarded [4,5]. Though some concessions may be minor, they collectively adjust our limits over time. Despite the urge to look the other way, we see this now among ourselves—fueled by similar goals, but divided by differences in what we can and cannot tolerate.In a particularly polarizing election year and despite mounting barriers to the ideal, it is part of our social responsibility to advocate this non-negotiable truth: health is a right.Health is multifactorial.Veritas Liberabit vos | The truth will set you free: Health is a right. Health is Multifactorial. Health is political.Photo by: Brent VirayThis is a lesson taught as early as our first year in medicine, repeated over and over until it is embedded in us by firsthand experiences. Health is multifactorial; hence, a multidisciplinary approach is warranted. With new information from ongoing studies that lead to evolving protocols, no one can yet confidently claim sole, superior expertise in this novel pandemic [6].This is where comprehensive consultations should enter. In our culture where professional titles are incongruously used as honorifics, physicians are privileged with an almost reflexive authority. Corollary to this, we in the system are accountable for how our public statements are perceived and interpreted, as these can influence health campaigns. We should learn to be receptive to ideas and be sorry for our blunders—unintentional and otherwise. Even the top U.S. infectious disease specialist can apologize for careless remarks [7]. We should thus keep in mind that although COVID-19 is a disease, medical doctors do not have the monopoly of knowledge on it.Public health interventions remain the subject of debates in papers and social media. While unfortunately, some of these can come down to a nauseating exchange of “my horse is bigger than yours,” it is better to keep the conversation going on accessible platforms. It need not be exclusive to health experts.We need to endorse the consideration of inputs from grassroots organizations in the drafting of policies. It will be instrumental in effecting changes at local and regional levels [8,9]. Let us invite responses from allied health care workers, health economists, public health professionals, communication specialists, engineers, physicists, administrative staff, and the average Filipino without a title before or after their name.As a population directly affected by such interventions, and later, by a major change in the national administration, we are all well within our rights to take part in relevant discussions. Engage, criticize, and learn. Do not simply yield when asked to sit down.Health is political.“Politics, for better or worse, plays a critical role in health affairs”— T. Oliver in the Annual Review of Public Health, 2006; 27.In “Dying in a Leadership Vacuum” published by the New England Journal of Medicine in 2020 [10], the editors of the prestigious journal boldly criticized the leaders of the U.S. for their failed COVID-19 response. The article ended on a strong call for action to use the elections to ax the incompetent and demand consequences. This was considered an unprecedented move. The involvement of health professionals in political protests is usually discouraged and contested in several circles, including our own [11].“The dissection of truth and the anticipated resistance is the novelty of polarizing movements”. Featuring a PGH surgical team on a complicated operation.Photo by: Keziah AgripoTraditionally, the medical community is regarded as competent, compassionate, and, importantly, non-partisan. For over two years, its members have been hailed heroes and brave warriors at the frontlines of this global crisis. Medical societies and health experts have collaborated with government units in formulating plans, programs, and protocols as part of the pandemic response [12]. This proactive participation has influenced policy-making and raised widespread awareness of the state of our healthcare system. The pandemic reinforced a frequently overlooked reason for medical workers to engage in political discussion: health is political.Policy-making is a key determinant of health. And, like a physician’s clinical judgment, our choice in political engagement should be allowed to reflect the core of our integrity, competence, and capability. Recognizing areas of improvement and campaigning for the reform we believe in are still in line with the biopsychosocial approach to patient care.“… So long as when the physician treats patients, they do not let their advocacy efforts interfere with the care of that patient, [addressing policy failures and social ills through engagement in political advocacy] is a trade-off they should be allowed to make in their best judgment.”–M. Rock in the Georgetown Medical Review, 2021; 5(1).True to the mission of the College, we are professedly committed to community-oriented medical education, research, and service directed to the underserved. The strength of our commitment will, in some ways, be measured in the imminent momentous elections. It is unlikely that we will be singled out to count the ways we did more, but we should be cognizant of how little actions in this period can snowball into policy-changing, life-altering results.We should elect leaders who believe in these same basic tenets. Our votes should be dedicated to candidates who plan on applying the principles of the primary health care approach to address the gaps in our healthcare system, especially in our fight against COVID-19. We owe it to Dr. Amor Trina Dait, Dr. Raul Andutan, and several other doctors who have unjustly lost their lives to violence. We owe it to our own alumni, Dr. Bobby Dela Paz and Dr. Johnny Escandor, and to other victims of Martial Law.We owe it to the health care workers who died in the COVID-19 line of duty. To us who remain, our hard work and individual sacrifices—from maximizing learning in a restructured medical education system to juggling administrative tasks, teaching future doctors, and managing long patient lists—all these and our lost opportunities should not be disregarded.We owe the victory of this fight to ourselves, too.References[1] WHO. WHO remains firmly committed to the principles set out in the preamble to the Constitution. Available from: https://www.who.int/news-room/commentaries/detail/health-is-a-fundamental-human-right. [Accessed 2nd Feb 2022][2] Baticulon RE. Opinion: The Philippine health care system was never ready for a pandemic. [Internet]. CNN Philippines Life. CNN; 2020 [cited 2022 Feb 04]. Available from: https://cnnphilippines.com/life/culture/2020/3/20/healthcare-pandemic-opinion.html[3] Raus K, Mortier E, Eeckloo K. In defence of moral pluralism and compromise in health care networks. Health care analysis: HCA: Journal of Health Philosophy and Policy. 2018; 26(4): 362-379. https://doi.org/10.1007/s10728-018-0355-0[4] Cole D. Fauci admits earlier COVID-19 mitigation efforts would have saved more American lives. CNN Politics [Internet]. CNN; 2020 Apr 12 [cited 2022 Feb 04]; Available from: https://edition.cnn.com/2020/04/12/politics/anthony-fauci-pushback-coronavirus-measures-cnntv/index.html[5] Mandavilli A. 239 Experts With One Big Claim: The Coronavirus Is Airborne. The New York Times [Internet]. NYT; 2021 Oct 01 [cited 2022 Feb 04]; Available from: https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-coronavirus-is-airborne.html.[6] Lavazza A, Farina M. The role of experts in the COVID-19 pandemic and the limits of their epistemic authority in democracy. Frontiers in Public Health. 2020;8:356. https://doi.org/10.3389/fpubh.2020.00356[7] BBC. Dr. Fauci apologises for saying UK ‘rushed’ coronavirus vaccine – video. The Guardian [Internet]. 2020 Dec 04 [cited 2022 Feb 04]; Available from: https://www.theguardian.com/world/video/2020/dec/04/dr-fauci-apologises-for-saying-uk-rushed-coronavirus-vaccine-video.[8] Achremowicz H, Kaminska-Sztark K. Grassroots Cooperation During the COVID-19 Pandemic in Poland. DisP – The Planning Review. 2021; 56(4): 88-97. https://doi.org/10.1080/02513625.2020.1906062[9] Satpute J, Poddar T. Grassroots organisations are essential to empowering the communities they serve. The Elders; 2020 Dec 07 [cited 2022 Feb 04]; Available from: https://theelders.org/news/grassroots-organisations-are-essential-empowering-communities-they-serve[10] Editors. Dying in a Leadership Vacuum. New England Journal of Medicine. 2020;383(15):1479-1480. doi:10.1056/nejme2029812[11] Rock M. The Physician’s Role in Political Advocacy. Georgetown Medical Review. 2021; 5(1). https://doi.org/10.52504/001c.21357[12] Department of Health [Internet]. DOH; 2020 Aug 06. DOH Updates on collaboration with healthcare workers, deployment of C.O.D.E. protocol [cited 2022 Feb 04]. Available from: https://doh.gov.ph/press-release/DOH-UPDATES-ON-COLLABORATION-WITH-HEALTHCARE-WORKERS-DEPLOYMENT-OF-C-O-D-E-PROTOCOL.

Purpose of UPCM Inspire

As the official publication of the University of the Philippines College of Medicine (UPCM) community, the magazine aims to create a sense of community among various constituents of the UPCM faculty, students, alumni, and administrative staff.

This community magazine's namesake came from Dean Charlotte M. Chiong's strategic vision of the UPCM as discussed in detail in her inaugural speech in September 2018. Through this publication, the editorial team aims to share the progress of the many projects and endeavors that the college has initiated in pursuit of this goal.

Origins of te UPCM InSPIRE Magazine

The UPCM InSPIRE magazine, formerly known as the UPCM Newsletter, is the official magazine of the University of the Philippines College of Medicine (UPCM). This was an initiative started by Dean Charlotte M. Chiong at the start of her term. With the goal of engaging and connecting the UPCM community as a whole, including its students, alumni, and faculty, through shared experiences and stories, the magazine realized itself as a biannual publication, released in both digital and printed formats. Aside from a core team consisting primarily of current faculty and students, the magazine also includes various guest contributors from all sectors of the UPCM community.

In late 2018, the office of the dean collaborated with a team of medical student volunteers for the release of the first issue. This student team, then composed of 14 medical students from different learning units, formed the editorial board and was able to publish the first issue. Eventually, the first faculty Editor-in-Chief, Dr. Angela S. Aguilar, was appointed to head the team.

While still retaining some elements of the old newsletter, the first issue was successfully released during the UPCM fundraising concert, “Musika ni Ryan, Medisina ng Ating Bayan,” on Sept 21, 2019. Given the experience earned in the first issue, the UPCM InSPIRE team reorganized itself and recruited more student volunteers to bolster its capacity and fill up additional roles. Furthermore, the magazine strived to distinguish itself further from the old newsletter format by focusing on engaging features and visuals. In the interim, plans were materializing for the eventual release of the UPCM InSPIRE website, which was launched on June 24, 2020. The second issue involved extensive collaboration with the University of the Philippines Medical Alumni Society (UPMAS) and was released to coincide with the annual homecoming celebrations of the college in December 2019. Recently, the magazine is currently working on its website and preparing for its third issue in time for the July 2020 college graduations.

In the coming years, the UPCM InSPIRE magazine hopes to further improve itself and to become a medium where the whole UPCM community can participate and connect.

Dr. Amparo "Ampy" Buenaventura-Kenny

Dr. Amparo “Ampy” Buenaventura-Kenny, 90, died peacefully in her sleep on July 7, 2020, in Antipolo City, Province of Rizal.

Ampy was born on October 31, 1930, in the City of Manila to Catalino F. Buenaventura and Carmen R. Buenaventura. She attended the University of the Philippines (U.P.) and graduated in 1952 with her medical degree, belonging to the first batch of post-World War II graduates. She took her medical residency training at the U.P. Philippine General Hospital – Department of Pathology. She then went to the University of Illinois College of Medicine and the Wesley Memorial Hospital both in Chicago, Illinois for her fellowship training in clinical hematology.

She got married in 1964 to Dr. Brian James Kenny, and the couple had two (2) children. From 1971 to 1992, she practiced medicine at the Kinderspital (Children’s Hospital) Immunology Department in Zurich, Switzerland. Ampy returned to the Philippines in 1995 and established a medical clinic in Alaminos City, Province of Pangasinan, providing free healthcare service to indigent community members.

In 2005, she was the recipient of a Special Award for Community Service given by the U.P. Medical Alumni Society. She dedicatedly continued her medical mission in Pangasinan until she reached the age of 84.

Ampy is survived by her husband Brian; their children, Anna and Urs; and her grandchildren, Roisin, Ronja and Juri. She is preceded in death by her parents, Catalino and Carmen; her sisters Ma. Luisa, Ma. Angeles, and her brother, Ramon.

May her family and friends take comfort in the truth that she showed sincere dedication as exemplified in her lengthy medical service mission towards her fellow countrymen.


Dr. Antonio R. Lahoz

He found joy as a servant-leader and a thought leader

Dr. Antonio R. Lahoz (Tony) was born on January 27, 1925 in Vigan, Ilocos Sur, the second of three sons of Jose Lahoz and Lourdes Reyes. He attended local public schools for his elementary and high school education. In 1944, Tony began his Pre-Med studies at the University of the Philippines (UP) as a university scholar and a member of the varsity basketball team. He obtained his MD degree from the UP College of Medicine (UPCM) in 1953. Tony went on to train in General Surgery at the UP Philippine General Hospital (UP-PGH), becoming Chief Resident in 1957. During residency training, he met his future wife, Trinidad Rasay, an operating room nurse.

In 1958, Tony returned to his hometown with his wife and young family to establish a rural practice and begin blazing new trails. In April 1959, Lahoz Clinic was inaugurated; a private clinic with 10 inpatient beds was a relatively new concept at that time.

Unlike other physicians in town, Tony did not make home visits. He was a General Practitioner in the morning and a surgeon in the afternoon. In 1969, with a growing practice, he relocated and expanded Lahoz Clinic and Hospital. He was loved by patients and their multi-generational families.

Tony dedicated himself to improving health care and achieved this in so many ways. As President of the Ilocos Sur Medical Society (ISMS) (1963-1967, 1971-1973), he pioneered two projects. For Operation Salun-at (meaning health), ISMS members ventured to remote towns of Ilocos Sur to provide free consultations and free medicine, and conduct public health information campaigns. Operation Salun-at is the forerunner of ISMS’s ongoing medical missions. For the Medical Aid to Rural Indigent Areas (MARIA) Project, Tony partnered with the Philippine Medical Association to build medical aid stations in underserved areas that were staffed with physicians trained in community development.

Another way Tony improved health care was through education. He returned occasionally to UPCM to share his experiences in rural practice. He took charge of the UPCM regionalization program for Region I. He invited UPCM faculty to offer post-graduate courses to ISMS members. Locally, he started teaching in the nursing program at the University of Northern Philippines (UNP). Later on, he helped create UNP’s Step-Ladder Curriculum for Health Professionals that eventually became the foundation for the establishment of UNP’s College of Health Sciences and its College of Medicine. Through his leadership in the Rotary Club of Vigan and other civic organizations, these entities were able to expand their community outreach endeavors exponentially.

Tony peacefully joined his creator on May 4, 2020. He is survived by his wife, 9 children (four of whom are UPCM/UP-PGH trained physicians blazing their own trails in the Ilocos region), 15 grandchildren, and 7 great grandchildren.


Eduardo Reyes Mercado, MD, FAFN, FAANS

UPCM 1972

April 24, 1947 - June 24, 2020

Eduardo Reyes Mercado, UPCM Class of 1972, passed away peacefully on May 24, 2020 after a short battle with complications of lung cancer. He was 73.

He had a friendly outgoing nature yet he engaged everyone with thoughtful and deliberate attention. His neurosurgical operative technique was meticulous. His bedside manner and diligence endeared him to his patients. His calm demeanor, love for teaching, and incredible enthusiasm inspired colleagues.

He was “Eddie” to family and “Cadô” to friends and colleagues. Born in Benguet, Eddie was the third of five children of Doctors Pablo Mercado and Paciencia Reyes Mercado. He attended Grade School and High School at the Ateneo de Manila University at Loyola Heights.

A consistent college and university scholar, he completed BS Pre-Med at UP Diliman in 1967 and proceeded to the UP College of Medicine. At the UP College of Medicine, he performed well and his scholastic achievement was exceptional. He was a Rockefeller Foundation Exchange Scholar to the Kansas University Medical School from 1968-1969. After graduating in 1972, he spent two years as a general surgical resident at the Philippine General Hospital before he left for the United States to pursue neurosurgical training.

He was accepted to a straight surgical internship at the Presbyterian University of Pennsylvania Medical Center in Philadelphia. He qualified for a residency position in the neurosurgical service at Tufts Medical Center (then Tufts-New England Medical Center). Residency positions were competitive in Dr. Bennett Stein’s Neurosurgery Department and there was just a single slot available yearly. Eddie Mercado was accepted a year before the position was available. While waiting for the position to open, Eddie, upon Dr. Stein’s recommendation, completed a Neurosurgery Fellowship at the Long Island Jewish Medical Center in New York with Dr. Joseph Epstein who was known for his work in spine surgery.

From 1976 to 1981, he was a Neurosurgical Resident at Tufts Medical Center. Dr. Stein’s chief interests were arterio-venous malformation and pineal tumor surgery. His influence would have a profound impact on Eddie. While at Tufts, he was in the company great neurosurgeons. Dr. Volker K. H. Sonntag, was his chief resident. Volker eventually established the spine fellowship program at the Barrow Neurologic Institute in Arizona and was responsible for major publications in spine surgery. Dr. Kalmon D. Post, Eddie’s consultant at Tufts, was already internationally known for his work with pituitary, parasellar and cerebello-pontine angle tumors. Dr. Post, who would be the future Chairman of Neurosurgery at Mount Sinai Medical Center, had a far-reaching influence on how Eddie performed his pituitary surgeries.

After completing his Chief Residency, he returned to the Philippines the next year. He was an Associate Professor at the Section of Neurosurgery, Department of Surgery, UP Philippine General Hospital from 1982 to1988. For a time, he was Dr. Faustino Domingo's Training Officer at the Neurosurgical Section. He took on academic and executive positions in several other institutions. He served as Chief of Neurosurgery in several hospitals and eventually had two stints as Medical Director of the Cardinal Santos Medical Center. He was chair of the Cardinal Santos Medical Center-Brain and Spine Institute for over a decade.

Cadô performed the very first micro-neurosurgical procedure in the Philippines, an STA-MCA bypass. Over the length of his career, he performed more than a thousand transphenoidal surgeries, the most by any Filipino neurosurgeon to date. He worked tirelessly to enhance neurosurgical education and training in the country and served as the Chairman and eventually the Executive Secretary of the Philippine Board of Neurological Surgery.

Inspired by his former chief, Dr. Bennett Stein, he was an eloquent advocate for developing the different sub-specializations of Neurosurgery. In 1996, Cadô Mercado together with a core group of neurosurgeons, radiation oncologists and other specialists worked to make Stereotactic Radiosurgery more readily available to Filipinos. The result was the Philippine Gamma Knife Center at the Cardinal Santos Medical Center which opened in 1998, today a center of excellence for Stereotactic Radiosurgery in the country.

In 2005, his encouragement helped establish the Philippine Movement Disorder Surgery Center. For the very first time, Filipinos had access to Deep Brain Stimulation procedures for Parkinson’s Disease and Dystonia.

Cadô was instrumental in creating the Brain and Spine Tumor Center at Cardinal Santos Medical Center, which championed the multidisciplinary team approach to managing patients with neoplasms of the brain and spine. Established in 2008, the Center organizes yearly symposia promoting unbiased, multispecialty, comprehensive neuro-oncology care.

An excellent Spine Surgeon, his best quality was his ability to meticulously discern a good surgical candidate from someone who was not. “Treat the patient, not the MRI,” he would always say. Very early in his career, he realized that true progress in the field of spine surgery in the country could only be achieved by collaborating and establishing a harmonious relationship with his orthopedic spine colleagues. In 2010, he established the Cardinal Santos Medical Center-Spine Center, a multidisciplinary endeavor of spine surgeons from both Orthopedics and Neurosurgery. The center has organized educational spine workshops and monthly case-management conferences.

Cadô Mercado believed in academic excellence as a path to excellence in patient care. In 2015, he established the first neurosurgical fellowship programs in the country: one year programs for both Stereotactic Gamma Knife Radiosurgery and Spine Surgery.

“Patient first!” was a maxim for Cadô. Recognizing that majority of our countrymen lacked resources for neurosurgical care, he spearheaded the establishment of the Cardinal Santos Charities Foundation and the Philippine Alliance for Brain and Spine Tumors, both registered foundations assisting marginalized neurosurgical patients with imaging, chemotherapy, radiotherapy and even surgery.

Skilled, competent, honest and compassionate; Eduardo Mercado was a steadfast friend and colleague. He was a pillar of Neurosurgery in the country and a beloved mentor to many generations of neurosurgeons.

He is survived by his sons, Luigi, Joaquin and Eric, his siblings Rolando and Rosario, and long time companion, Sharon Dunn.


Johnny Yee Fong, MD

September 14, 1946 - April 29, 2020

The World was His Table but Family First

On April 29, 2020 Johnny Y. Fong UPCM ’71 succumbed to complications arising from a subdural bleed. He leaves Grace behind, his enduring wife and partner in life for the past 40 years, 9 children, 17 grandchildren, and innumerable loved ones.

By many measures Johnny lived an extraordinary life. At heart he was a natural entrepreneur. Not just in the business of his profession but in the business of life.

Starting in 1971 with a residency in Pediatrics at the University of Illinois, his path first led to a pediatric private practice in Chicago. Then in 1976 he made a seminal move to the West Coast, and the city of Fresno, California became the capital of his life and his dreams.

He became a picture of the modern renaissance man. His mind ventured into many directions, reveling in innovation, opportunity, risk. He established several clinics, extended healthcare to underserved areas, took on the business of medicine. His interest segued into medical education. He helped establish a medical and nursing school in the Philippines, a nursing school in Saipan, and a vocational school for medical assistants in California.

He invented a safe restraint for children undergoing lumbar punctures and developed software for tracking immunizations. He loved playing lead guitar and drums. He enjoyed cartoons and wrote and published a children’s fairy tale book. His philosophy on the importance of family and community rooted him to personal agendas he considered imperative. He started the Tamaraw Lions Club in Fresno, diligently served at local and national Filipino American organizations, his medical alumni association the UPMASA, and his Phi Kappa Mu fraternity. He was generous with his time, ideas and service.

At his core he was an extreme family man, an indulgence borne from the supreme respect he bore his parents, a wellspring for the kind of family intimacy he engendered by years of dedicated family conversations, dinners and road trips, the fount of his overwhelming drive to care for his children’s wellbeing, careers, future and happiness. Of them he would say that his greatest accomplishment was the strength of his children. True, he was stern, and when he made up his mind, his direction could be painfully unwavering and unforgiving. One had to look beyond that agony to find burning sincerity and love.

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