I was invited to give an "inspirational" talk to medical students in Cebu. They wanted to know how one can be a sub-specialist and still be involved with public health... Here I share my more organized thoughts on the topic.
FIND YOUR PASSION
I went to college at the University of the Philippines Los Banos and I took up Bachelor of Science in Agricultural Chemistry. I once had that dream of owning a plot of land where I can grow herbs and vegetables and take care of cows, goats, pigs, chickens, ducks and even fisheries - for a sustainable agriculture in a microcosm. That dream didn't florish to fruition, but I realized that this sustainable system can also be applied to healthcare, where each sector supports each other and we can all together help to improve the healthcare system make it sustainable.
I was focused on academics and research in college, but it was on my last year of college that my father was diagnosed with lung cancer. I had planned to go abroad to pursue masteral and doctoral degrees in science and research... but I wanted to stay close to family. So I decided to choose another course that would allow me three things:
1. that whatever I study can enable me to serve the people
2. that whatever I learn can be directly applied to my work
3. that whatever I achieve will allow me to find work in the Philippines
I realized that pursuing a medical degree will fulfill these three conditions. So I informed my mother that I intended to take up medicine, and we started looking through medical schools. I applied at several schools, but ended up enrolling at the royal and pontifical University of Santo Tomas. This was a good thing too, because I appreciate the Catholic and ethical medical education with attention to detail (we were often labelled as obsessive-compulsive by other medical students).
In medical school, I tried to find
myself and my passions. I joined AMSA and FilChiMSA, and served in medical and surgical missions.
I joined the Terpsichorean Circle (dance club). Unfortunately, I realized that I couldn't dance. My body parts were not coordinated and I wasn't the least bit graceful in movement. The most that I achieved was the white gloved pantomime where we formed images with our hands...
I joined athletics like the basketball team and the swim team... but then my chubbiness pulled our teams back from winning... Finally, I joined the UST Medicine Glee Club and eventually became the musical director. When medical students started auditioning, it was whispered that they were afraid of the terror lady at the keyboard. This was the first time I realize that I was being endorsed to other students already.
I discovered that I can teach, and this became my passion...and I have been teaching ever since - to my residents in training, to my medical students (both in reproductive module and research) as well as to the scholars of The Share A Child Movement, Inc.
WHAT WOULD YOU DO IF MONEY WAS NO OBJECT?
I have spent childhood summers in Cebu. I enjoy summer camps with the street children and scholars of different NGOs. It seemed but natural for me to
volunteer to ensure that Lola Sising's legacy of The Share A Child Movement, Inc continue to help poor but deserving children of Cebu to finish their education, and to be active advocates of children's rights.
There is a sense of volunteerism, that need to discover ways where your can help and offer your services for free. During my first year of residency training, we had a lot of patients who died from pregnancy-related hemorrhage, and there was not enough blood units for transfusion. So I walked from school to school along Taft Avenue all the way to Mendiola, getting in touch with heads of student councils to organize voluntary blood letting activities. I approached parish priests to help announce during the masses that there were blood donation drives. These would literally save lives of patients. This we continue in Cebu. We do this, not because we are required to do it, but because we want to
SERVE THE PEOPLE.
I am lucky to have a jobs that make me happy. At the hospital training residents and at school teaching research, these I would do even if money was no object. Self-care is not about salt baths, massages and vacations. It is about making choices that make you happy with your life, not something to run away from. It is when you have passion for your work that it ceases to be work.
Being a physician is a vocation, not just a job, because the doctor-patient relationship is a fiduciary relationship, based on trust.
HOW TO FIND YOUR NICHE AND PROFIT FROM YOUR PASSION
People often ask me if I relocated to Cebu because of my husband. I have to politely inform them that I am single, and that the reason I settled in Cebu was to fulfill a promise to my idol, my Lola Sising... that I would spend more time with her soon as I finish training.
So I wondered how would all my training and schooling be put to best use in the academic and clinical community in Cebu? I keep thinking "
if God brings you to it, He will lead you through it..."
WHAT ARE THE HATS I WEAR?
- I am a training officer and a clinician. I train residents to become competent and compassionate obstetrician-gynecologists, especially in tertiary government hospitals where we are public servants.
- I am a teacher and mentor. I teach first year residents how to make research projects. Hopefully they learn how to assess situations and identify health problems and formulate solutions to address these.
- I am a social development worker. Most determinants of health are not medical in nature. We want to make society better for our children and Cebu a livable place. We need to add value to education and youth-oriented activities so that they learn to claim their own rights.
- I am an infectious disease specialist and HIV advocate. I am well-positioned to make an impact on prevention, treatment and care of people living with HIV to mitigate the spread of HIV infection and to reduce stigma and discrimination.
DREAM BIG DREAMS!
I was inspired by one of my clinical clerks in PGH before, who became a doctor to an under-served isolated barrio in Quezon. Dr Lopao Medina talked during the 47th APMC Conference about reforms in medical education, and how a lot of DOH programs are carried out by one person if he is the only doctor in the locality. So these are things which should have been taught in medical school.
My role in Cebu was somewhat clarified then. What Dr Medina was doing at the grassroots level - reforming systems to improve healthcare... I was doing at the tertiary level. My effort is in trying to improve health service delivery at the tertiary hospital level so that when a patient is referred from the barrio, that patient would receive the best care which the government hospital can provide, regardless of who the patient knows high up the political ladder. So I told Dr Medina "I am preparing the tertiary level of care to receive referrals from the primary level.." At present, we have pushed for reforms and changes to improve maternal healthcare at our tertiary government hospital.
"I'd rather have a life of oh wells'than a life of what ifs"
Working for reforms to improve health systems is not easy. People don't always like change. Just like in love and romance,
"It's better to have loved and lost than never to have loved at all..."
Anyway, we know that what doesn't kill you makes you stronger. So we say to patients, colleagues, trainees and hospital administrators:
"I want to be your favorite hello and your hardest goodbye."
A good prayer to whisper to remind yourself of one's limits:
God grant me the
SERENITY
to accept things I cannot change;
COURAGE
to change things I can;
and the
WISDOM
to know the difference.
Therefore, if you want to know whether you should become a specialist and apply for residency training or choose a public health career to work in government or go into masteral studies for research work, I say
"You can be anything you want to be and do what you want to do so long as you put your mind, heart and soul into it!"
Take a deep breath and PUSH!
After all your birthing pains, know that your labor will give birth to a new you, ready to serve the people!
The Commission on Higher Education (CHED) Memorandum Order 18 implements the shift to outcome-based education in 2016, so that medical education in the Philippines can become more socially accountable to the health needs of the population. It specifies program outcomes expected of Doctor of Medicine graduates. Hence, faculty of different medical schools revisited their curriculum to develop the most effective teaching strategies to adapt to outcome-based education.
Last month, we were lucky to have Dr Iris Thiele Isip-Tan over in Cebu to talk to us about the "flipped classroom". Traditionally, our classes consist of long lectures and students are assigned homework to submit on the next school day. In the flipped classroom, content input is provided as homework, such as a video to watch online or reading assignments prior to class. It then allows us to maximize our time in the classroom to supervise the student’s work, addressing questions and difficulties, which is the most crucial part of learning. This alternative teaching strategy seems to sit well with our students, as evidence by a research paper conducted by our students where their preferred learning style was solitary (independent study time) and their preferred teaching strategy was alternative methods/small group discussions. This pedagogy is most consistent with outcome-based education where direction is student-centered with emphasis on evidence of outcomes in objectively verifiable indicators.
