Monday July 16, 2018

Homegrown surgeons

THE First Alumni Homecoming of the Southern Philippines Medical Center (SPMC) Department of Surgery is a testimony to the ability of the local medical community to grow and nurture its own.

With a training program for general surgeons first established in 1980 when Dr. Jose Tiongco was appointed chair of the department of what was then the Davao Medical Center (DMC).

There was no training program before that and Dr. Tiongco came fresh from a scholarship in Vienna.

"It was a department in name only, there was really no training program. People were saying why are you going home, (President Ferdinand) Marcos is there and I said the reason I'm going home is because there's Marcos," Tiongco said in an interview during the homecoming.

Before that, he was a volunteer consultant of the hospital from 1976 TO 1977.

At that time, there was only one wing housing the Department of Surgery, Medicine, Obstetrics, and Pediatrics, the so-called major departments.

When he arrived, the consultants were the ones operating on the patients, while the residents merely assisted.

What was going on there at that time was more like a consultants' training program where the consultants "were training themselves on our patients".

"Whatever they mishandled outside in the private hospitals, after mahurot na ang kwarta (when the patients' money runs out) and all the complications come in, they would go to DMC and die there and say, 'Kaya ka namatay'," Tiongco said, with public medical service suffering the brunt.

They simply had to stop the practice, and face the problem head-on.

"So when we would find a patient who was mishandled financially and physically and the patient died, we called a meeting, in a conference and we discussed this patient in front of everybody in the surgical community. They stopped doing it. They were put to shame," he said.

From there, they built their training program, which was accredited by the Philippine College of Surgeons. He also broke up the department to give more focus on each specialty, thus the Anesthesiology, Neurosurgery, Orthopedic, and some other specialty surgery were given their own departments. At the same time, residents were sent to Manila to train for pediatric surgery, cardiovascular surgery, and several other subspecialty trainings.

Tiongco left as department chair during President Corazon Aquino's term in 1989. He was considered too radical. Present SPMC medical Center Chief Dr. Leopoldo Vega took his place.

What Tiongco witnessed and tried to correct along with like-minded health practitioners is a reality that plagues public hospitals to this day, but which SPMC was able to get out of: the reputation that public hospitals give the worst care.

The doctors themselves cannot be blamed. The national government was not giving them much attention, many are not even properly compensated.

Much like the department's training officer Dr. Fitzgerald Arancel who recalled that when he joined DMC, he served for seven years as consultant without getting any pay. All he got were from the Philippine Health Insurance Corporation (Philhealth). It was only three years ago when he got a plantilla position.

This also showed on their number of graduates during the worst years when there are very few paid pubic doctors.

"There are years where there are no graduates especially the years, 1980s to 1990s madalang ang budget, walang lalaban pag walang sweldo (Budget was scarce. No one’s going to put up without pay). Unlike now, the government is very magnanimous with plantilla items," Dr. Arancel said.

The major change came under the Administration of President Rodrigo Duterte.

Arancel said the department's first graduate was Dr. Ruben Robillo. Todate, they have a total of 106 graduates.

Of the 106, 90 took the general surgeons training program, eight underwent general surgery program and graduated from some specialty program, another eight came from outside and trained with SPMC in the subspeciaty program.

Department chair Dr. Reynaldo Espino, in his welcome remarks, said that when the department started, there were just around 6-8 resident doctors. Now, they have 39 plantilla surgical residents coordinated by seven junior consultants.

The numbers may sound overwhelming, but the job of the department is even more overwhelming.

"Our last record shows that a total 4,500 or almost 4,600 operations were done in a year or an average of 12 to 15 surgeries a day, seven days a week including Sundays and holidays, everyday," Espino said.

Their subspecialty programs are also accredited to conduct their own trainings programs. The Neurology first got accredited in 1998 but lost this because they did not have any residents who applied for the training in 2010. The department was re-accredited in 2014.

The Neurosurgery also got its accreditation in 2009 after which it produced one graduate. But since there was no applicant afterwards, it lost the accreditation again and regained it this year with two residents.

The Colorectal Surgery got its accreditation for a training program in 2011 and already has six graduates and present has three fellows under the colorectal fellowship training program. The pediatric surgery got its training program accredited in 2011 and now have one graduate and two fellows. The Plastic and Reconstructive Surgery had its accreditation in 2015, while the Surgical Oncology got its accreditation for its training program three years ago.

"By next year, expect more subspecialty training program under the Department of Surgery," Dr. Espino said.

Indeed, the history of SPMC and its departments is a story of how a community can change everything for the better for as long as they hold on to a vision of excellence.

"It's undeniable that sometimes we injure our patients only to show that we cannot be at level with God. Our intention is simple, always to heal, and never to cause more harm," Dr. Espino said.

The department's chief resident is Dr. Kliendo Rovillos.

The residents are:

  • Ronan Wong

  • Honey Lee Tan

  • Rex Rodrigo Navarro

  • Julie Mae Javier

  • Carl Joseph Uy

  • Benjamin Pagarigan III

  • Delbrynth Mitchao

  • Kim Recoli delos Reyes

  • Shendy Dal

  • Chery Lou Cabanero

  • Charmaine Cahterine Valdez

  • Earl Stephen Ralph Tinapay

  • Samantha Cunanan

  • Cecile Malasig

  • Bonnie Pedregosa

  • Stephen Matthew Santos

  • Cornelius Ryan Paglomutan

  • Eric Paolo Palabyab

  • Justin Roel Reoyan

  • Jaymar Tan

  • Jake Clemente Metran

  • Noe Abraham Paez

  • Conrad Earl Cabahug

  • Joseph Babatid

  • Paulo Nebres

  • Anthony Araneta II

  • Angelica Mary Joan Labradores

  • Marc Lester Ibanez

  • Mike Anthony Tillo

  • Robern Isaiah Cruzado

  • Maria Katrina Raisa Larrazabal