Surgery

Vision

To be the leading center of excellence in the field of surgery responsive to the needs of the Filipino people.

Mission

The Department of Surgery shall:

1. teach the students if Surgery to become competent, humane and ethical health professionals, educators, researchers and leaders
2. nurture its faculty and alumni to become highly motivated, competent and committed.
3. generate relevant and outstanding researches
4. render quality health care
5. practice governance that is transparent and participatory
6. augment our resources to support the different activities of the Department

CORE VALUES

Academic Excellence
Professionalism
Social Responsibility and Accountability
Compassion
Leadership
Integrity
Nationalism.

The Department of Surgery was born when the Philippine Civil Hospital was established on October 1, 1901 by virtue of Act 247 of the Philippine Commission. In 1905, Act 1415 authorized the creation of a medical school; hence, on June 10 1907, the Philippine Medical School was formally opened.

The Department was for a time called the Department of Surgery and Gynecology with separate male and female wards. Dr. Guazon, who was in charge of the female wards, became a proficient gynecologist while Dr. Jose Eduque, who was in charge of the male ward, became a pioneer urologist. In 1923, a separate Department of Gynecology was established. The surgical department was then renamed the Department of Surgery.

The Department of Surgery is now the biggest clinical department of the Philippine General Hospital. It continues to grow and provide the highest quality of surgical care and training for a variety of health professionals. It provides the largest and the most extensive training of surgery in the Philippines. Further expansion and acquisition of professional expertise has enabled the department to provide the most comprehensive service in nearly all surgical specialties which include surgical oncology, colorectal surgery, hepatopancreaticobiliary surgery, trauma, pediatric surgery, urology, plastic surgery, thoracocardiovascular surgery, transplant surgery, burns, endoscopy and minimally invasive surgery, surgical critical care, and surgical ultrasonography. Its training program has become a model for other surgical training programs in the Philippines.

Over the years, the Department of Surgery’s outputs have shown progressive improvements with a significant increase in patient admissions, operations performed, outpatient visits, and resident physicians trained.

A. Residency Training Program

General Surgery

A 5-year residency training program designed for the trainee to develop a satisfactory level of clinical maturity surgical judgment and technical skill which will upon completion of the program render him/her fit for the safe and independent practice of General Surgery in the country. At the end of the training the resident will have met the requirements set by the Philippine Society of General Surgeons and will qualify him/her to take the diplomate examination of the Philippine board of Surgery.

Urology

The 6-year Urology residency training program covers experience and graduated responsibility for the care of patients with surgical diseases of the male and female urinary system the adrenal and the male genital tract. The experience covers 2 years of General Surgery and 4 years straight Urology training covering patients of all ages. The program aims to produce competent urologists with adequate training on the basic principles of Urology and includes Pediatric Urology Urologic Oncology Uroradiology Uropathology and Nephrology.

Plastic and Reconstructive Surgery

The 6-year residency training program in Plastic and Reconstructive Surgery provides adequate education and training experience for providing specialized and competent care of patients with reconstructive and aesthetic concerns. The experience covers 3 years of General Surgery and 3 years of Plastic and Reconstructive Surgery. The program addresses the care of the functional and/or aesthetic correction of defects or deformities whether acquired or congenital. These include congenital anomalies of the face head and neck hands external body surface and genital organs traumatic conditions of the head and neck and other external body parts including burns; scars and keloids as well as post-tumor resection defects. The program also includes clinical exposure in various aspects of aesthetic surgery reconstructive neurosurgery and rational use of alloplastic materials.

B. Fellowship Training Program

Thoracic and Cardiovascular Surgery

The 3-year fellowship training program in the Thoracic and Cardiovascular Surgery (TCVS) provides experience in the surgical management of diseases of the thoracic viscera (heart lungs great vessels mediastinum neck trachea esophagus thoracic cage and diaphragm) and the peripheral vascular system including thoracic and vascular trauma. The program is designed to prepare the trainee to diagnose and surgically manage thoracic and cardiovascular diseases. The program provides a wide variety of surgical cases that ensure a level of competency in each subspecialty. All our graduates are expected to pass the specialty board examination of the Philippine Board of Thoracic and Cardiovascular Surgery (PBTCVS). The program offers two tracks of entry into the TCVS training program proper. The lateral entry track is for a graduate of an accredited General Surgery residency training program who wishes to pursue subspecialty training in TCVS. Board certification or eligibility is preferred but not prerequisite. The straight TCVS track is intended for a licensed medical graduate who has decided on TCVS as a specialty at the outset and has no intention to practice General Surgery. This track requires the trainee to undergo 3 years of General Surgery training at PGH prior to entering the TCVS program proper.

Pediatric Surgery

The 2-year specialty training program aims to train surgeons who expressed desire to concentrate their practice in the management of general surgical diseases in infants and children. The program offers intensive and holistic training in the management of congenital and acquired pediatric surgical conditions such as Hirschsprung’s disease anorectal malformations intestinal atresias diaphragmatic hernias and tumors both benign and malignant. The trainee is expected to have a solid grasp of embryology and anatomy in addition to comprehensive knowledge of common and important pediatric surgical conditions.

Colorectal Surgery

The 2-year comprehensive program is offered to graduates of accredited General Surgery training programs. The experience includes a well supervised exposure to all aspects of the management of benign and malignant diseases of the colon rectum and anus which include major abdominal surgeries anorectal procedures laparoscopy lower gastrointestinal endoscopy (colonoscopy flexible sigmoidoscopy proctoscopy) and endorectal ultrasonography.

Hepatobiliary and Pancreatic Surgery

The 1-year specialty training program is designed to provide the General Surgery graduate with a rich and comprehensive educational experience in the management of hepatobiliary and pancreatic (HBP) conditions. The trainee is provided an immersion into the different complementary modalities essential in the holistic management of a wide array of HBP problems. Learning opportunities are available in perioperative and intraoperative ultrasonography choledochoscopy diagnostic and therapeutic endoscopy (including endoscopic retrograde cholangiopancreatography [ERCP]) and laparoscopic surgery.

Head and Neck Surgery

The 1-year specialty training program is designed for board certified general surgeons who have keen interest in the treatment and research of tumors of the head and neck. The training is focused on clinical exposure on the medical and surgical treatment of head and neck tumors both benign and malignant. Exposure to reconstruction including free tissue transfer medical and radiation oncology are included. Research consists of training in research methodology and exposure to clinical trials.

Surgical Oncology

The 2-year comprehensive specialty program combining research and clinical experience is offered for general surgeons who wish to concentrate on surgical oncology. The program entails hands-on performance of major oncologic operations and responsibility for perioperative care of cancer patients. The trainee also gains experience in the use of chemo- immuno- and hormonal therapy and exposure to Radiation Oncology. The program instills the philosophy of multimodality management of cancer and the compassionate care of cancer patients.

Trauma Surgery

The Trauma fellowship training program provides the clinical opportunity for training in the specialized field of trauma care. The program aims to prepare competent Trauma surgeons adept in trauma management indigenous to our particular national setting consistent with the objectives of the Philippine College of Surgeons and the DOH. By the end of the program the trainee is equipped with an advanced level of skill in the management of surgical and non-operative therapy of injured patients preoperative and postoperative care of the injured patient requiring critical care use of advanced technology in physiologic monitoring of trauma patients and the medical care of catastrophes as well as ethical economic and legal issues related to trauma care.

II. ADMISSION REQUIREMENTS

The Departmental Training Committee supervises the selection of residents into the training programs and recommends qualified applicants to the Chair and the Chairman’s Advisory Committee. Requirements for admission into the residency training programs include a degree of doctor of medicine from an accredited college or university certificate of completion of the internship program from an accredited hospital and passing the Philippine Medical Licensure Examination. Applicants to the subspecialty training programs must have graduated from an accredited General Surgery training program and requirements of the governing subspecialty body must be met. The applicants are expected to undergo the application process as prescribed by the Office of the DDHO. The applicants will then undergo a selection process conducted by the Departmental Training Committee consisting of interview written exams and a structured pre residency program.

Officers:

When the nation was faced with the present pandemic, the University of the Philippines-Philippine General Hospital (UP-PGH) was designated as a COVID-19 Referral Center along with other Department of Health (DOH) hospitals of smaller capacity. This was in response to the plea of several hospitals to the DOH which were being overwhelmed by a sudden influx of patients with a disease everyone was unprepared for. Despite the limited resources and the speed with which the hospital had to adjust, the PGH was able to allocate manpower and institute infrastructure renovations to prepare its facilities for moderate to severe and critically ill patients. The UP-PGH and its personnel were able to successfully live up to expectations despite the limited amount of time allotted for infrastructure improvements and manpower adjustments.

By allotting 130 beds (approximately 10 percent of its total bed capacity) and significant hospital space, realigning assignments its staff, and focusing its efforts on the COVID-19 crisis, the UP-PGH has inevitably been unable to effectively cater to the needs of nonCOVID-19 patients. Many of these patients are dependent on the low-cost yet highly-specialized care provided by the institution.

The pandemic has strained the resources of the UP-PGH primarily due to the complexity in managing COVID-19 patients who are moderately- and severely-ill—the subset of patients our institution has been mandated to receive and render care to. On top of this is the hospital’s commitment to ensure the safety and well-being of its health care workers. Nonemergent clinical services, including outpatient diagnostics and elective specialist surgery, ceased to be of priority. Our ability to provide medical care to nonCOVID-19 patients is further compounded by government-imposed quarantine and lockdown measures.

The Department of Surgery has been severely affected by the adjustments the PGH had to make. Both surgical wards 2 and 4, including the SICU have been appropriated and desgnated for Covid use. 5 administrative offices being used by various subspecialties of the Department, including the Command Center of Surgery, the Chairman’s Office Complex behind Ward 2 have been rendered inaccessible, along with various training equipment of the Department. The Department has been unable to provide elective surgcial services to the indigent patients dependent on PGH, and surgeries have been limited to those urgently in need of intervention. The outpatient surgical clinics which cater to hundreds of patients have virtually shut down.

Reduction in the number of services the Department was able to provide does not however, reflect the service and sacrfice the Department of Surgery contributed to this effort. Upon the assumption of PGH as a Covid center, the department made preparations to designate Covid and non covid teams. Surgery residents were sent to the frontlines, having been trained in managing Intensive Care Unit patients, a distinction it shares with only one surgical specialty, the Neurosurgery. The Department leadership took steps to prepare the residents by providing them didactics and workshops on preparing against Covid, including handling patients, ICU processes, and protective equipment. The Department was able to come up with a manual for Covid which even now is being utilized by other institutions. The department has put emphasis on protecting everyone, supervising the residents from a relocated office assuming the role of safety officer, surgeon assist for an emergency case and training officer at the same time. Safety issues are regularly addressed, ensuring fit testing for everyone, regular OR simulations and flu vaccination for residents and fellows. The Department of Surgery leadership in this time of need was called upon by the director to augment the officials of his administration by creating a Covid Crisis Committee tasked to carry out plans crafted by the Department of Health and the PGH administration. Majority of the leadership positions in the Committee are occupied by the officers of the Department. The Donations Arm of the Bayanihan Center, providing essential logistical support to the Covid operations , are likewise being run by officers of the Department. The ER and ORMAT operations are likewise being run by officials of the Department.

While these contributions are highly commendable, it diverts precious manpower and infrastructure to Covid which comprise a small segment of our bed capacity. The Department regularly makes adjustments, regularly conducts online case management sessions, webinars and participates in continuing medical education sponsored by surgical societies. The SCORE has proven invaluable in providing much needed continuity.

It is imperative that we prepare to restore services that cater to other patients requiring our care and attention. Without a doubt, the needs of this subset of patients must be given attention. It is expected that the threat of COVID-19 will remain in the absence of effective treatment, long-term containment, or vaccine development. The UP-PGH, by virtue of its century-long obligation to the nation, must progressively increase its capability to embrace and take care of the rest of our Filipino patients. The Department must again step up and exert all efforts to help in the resumption of services. Failure to serve our patients and trainees who depend on us will render our efforts incomplete.