ORGANISATION MONDIALE DE i SANTE WORLD HEALTH ORGANIZATION Bureau Regional Pour le Pacific Occidental Regional O±'f ice 1 For The Western Pacific 5ai.gon 30 September 195.2 25 TECHNICAL DISCUSSION S The Education and Training of Medical and Public'Health Personnel. THE EDUCATION AND TRAINING OF MEDICAL AND PUBLIC HEALTH PERSONNEL IN THE PHILIPPINES SECTION I MEDICAL EDUCATION ' A. Undergraduate. There are four (4) Colleges of Medicine Yin the'Philippines . One is in. the State University and the three others are in•private universities. Informations available only for the College of Medicine of the State University.2 The course is of four years , plus one year of internship. *Owing to the length of the document and in order to keep the information in line with that submitted by other countries, detailed description of the various :courses of study has not been reproduced.here; however the full description shall be available for consultation by the representatives during the discussions. Another College: was opened.. on July 1952 and gives courses only for first.year medical students for the school year 19521953. The College, called Institute of Medicine is in a private University. Coilcge,.of'Medicine, University of the Philippines. obtained in interview.. of the531st recommended this examination, on the academic background, and on the results of an In this connection, the following provision is quoted from the Minutes Meetifig'ofthe'-Bdard, ef-Regents: "tConditions being equal, candidates by provincial hospitals on the basis of promise of future service will be given preference in appointmentsn.. Two Special Residents for each of these departments will be appointed on a yearly basis., renewable upon the recommendation of.the department,head. Each resident will serve a maximum of two years in Pediatrics, and three,years.in Gynecology, Surgery, Obstetrics and E.E. N.T. Applications should be filed not later than hpril 16, every year, together. with a„transcript of the applicantts,,records in medical school. The refresher course islimited:to 25,.registrants, the residency is limited to two for each department; and attendance at the postgraduate assembly is not limited. -4SECTION II EDUCATION AND TRAINING IN PUBLIC HteLTH (Given at the Institute o' Hygiene, Unpiversity of the . Philippines) 0BJE'CT:IVES The Institute `6-f =hygiene serves as: (1) a graduate school for the formal instruu'tidri`nd training'=of medical and non-medical graduates in order to prepare them for administrative, field, laboratory, teaching, and research work in the various fields of public Health; .(2) a schoolfor the preparation of pars-medical personnel whose main function will be to assist' physicians (especially health offic0rs) in the performance of their duties; (3) a service unit of the university furnishing instruction in hygiene and preventive medicine to'the students, of the Colleges of Medicine, Dentistry, Education, Nursing, Pharmacy, and the School of Nursing; and (4) an agency to promote the advancement of knowledge of public health in the Philippines. PRACTICAL DEMONSTRATIONS To provide students with field training, two health demonstration units have One station has been established in a representabeen organized in the year,l929. tive section of the City of Manila to serve as a center of study for public health problems peculiar to urban communities; another in a•municipality within easy reach from the City of Manila, serves as a place for study of public health problems peculiar to rural communities. To meet the above purposes more satisfactorily, it was decided to reestablish in 1949 the activities of the two above-named stations in Quezon City. In February, 1950, the different activities of the demonstration were consolidated and enlarged under the Rural Health Demonstration and Training Center operated The new Center covers an area of 140 with WHO-UNICEF-Sweepstakes assistance. square kilometers around the U.P. 01 ORGANIZATION The Institute of Hygiene is presently organized as follows: 1. The Department of Epidemiology, Biostatistics and Public Health Administration. 2. The Department of Sanitary Bacteriology and Immunology, 3. The Department of Sanitary Engineering, Industrial Physiology and Chemistry. 4. The Department of Parasitology with Divisions of Medical Protozoology, Medical Helminthology, Medical Entomology, Malariology and Venomous Animals. The full-time members of the faculty of the Institute of Hygiene constitute presently the Department of Hygiene of the several colleges and schools of the University of the Philippines to furnish undergraduate instruction in hygiene, and public health and preventive medicine to the students of the said colleges and schools until the University shall have formed the regularly appointed department to serve the needs of undergraduate instruction along these lines. -SCIASSIFIChTION OF STUDENTS Students are classified under one of the following: 1. Regular students ( a) . Candidates for Bachelor of Science in Hygiene. (b) Candidates for the Certificate in Public Health. (c) Candidates for the degree of Master of Public Health or Master of Science in Hygiene. 2. Irregular students who may ultimately be candidate for the B.S. Iyg.,, C.P.H., and the M.P.H. or the M.S. Hyg. degree. 3. Special students who are non-candidates for the B.S. Hyg. , C. P. H.) M.P.H. or M.S. Hyg. Special students will not receive credit for work done in the Institute during the time they are classified as special students and they are not obliged to take the final examinations. 4. Undergraduate students from other U.P. Colleges and Schools:- These students ark"those taking the various hygiene courses in the Institute for the Colleges of,^iedicine, Nursing Pharmacy Liberal Arts Dentistry and Education and the School7bf Nursing. DEGREES The Institute of Hygiene offers courses leading to the following degreess 1. Bachelor of Science in Hygiene:- This degree will be conferred upon candidates who have satisfactorily completed the prescribed course of study The candidate must have at least 2 academic years of residence in the University of the Philippines. iThe requirement for admission is the satisfactory completion of the twoyear preparatory hygiene course as given in the College of Liberal Arts of this University, or the equivalent of this course. 2. Certificate in Public Health;- This degree will be conferred upon candidates who have fulfilled all requirements leading to that degree and at least one academic year of residence in the University of the Philippines. 3. Master of Public Health or Master of Science in Hygiene:- This degree will be conferred upon candidates who have satisfactorily completed the course leading to the degree of M. P. H. or M. S. Hyg, and at least one academic year of residence in the University of the Philippines. The requirement for admission to the C.P.H. and M.P.H. course is an M. D. degree obtained from a Medical School of recognized standing. However, a limited number of qualified veterinarians., dentists, engineers, pharmacists , nurses and health educators may also be admitted under the following special conditions= (1) after having first filled up the quota of qualified M.D. applicants; (2) the applicant must have graduated from a recognized institution of higher learning with at least a baccalaureate degree in science ; (3) that the applicant must already be employed in any phase of public r^w health work or be 'a member of a faculty of an approved institution or if not so employed must be certified`to'bb'a recognized organization that the applicant will have an opportunity to be employed on completion of the course, Under exceptional conditions, a student who can complete all the required course leading to the C. P. H. with a grade of "2" or better in every subject and an approved masterts thesis in the-same year may be granted the degree of Master of Public Health or Master of Science in Hygiene. ,The above shall'also hold for the granting of a masterts degree to C.P.H, graduates. who are not Doctors of Medicine, except that instead of the degree of Master of Public Health (M.P.H.), the degree of Master of Science in Hygiene (M.S,Hyg.)' shall be granted. .^-. SECTION III NURSING EDUCATION Two levels of Nursing Education are given. These are: 1. Tn^oe_')ear Course leading to the title of Graduate Nurse. 2, Four Years and one Summer Course leading to the degree of Bachelor of Science in Nursing. Nursing Education is given by both Government and Private Schools and Colleges of Nursing. There is one Government College of Nursing. It is in the State University (University of the Philippines). There are six Government Schools of Nursing, five of these are under the Department of Health and are connected with Government Hospitals and one is with the Philippine General Hospital which is under the University of the Philippines. The Schools of Nursing under the Department of Health, spread over the country are: School School School School of of of of Nursing, North General Hospital (IMianila) Nursing, Zamboanga General Hospital (Zamboanga) Nursing, Southern Islands Hospital (Cebu) Nursing, Baguio General Hospital (Baguio) School of Nursing, Occidental Negros Provincial Hospital (Bacolod, 0ce. Negros) There are 3 private Colleges of Nursing in 3.private Universities. These are: 1. 2. 3. College of Nursing of the University of Sto. Tomas College of Nursing of Manila Central University College of Nursing of the Siliman University Three other Colleges and one private University offer the two-year course to Graduate Nurses for the Bachelor of Science in Nursing degree. These are: 1. 2. 3. 4. The Central Philippine Colleges The Philippine Union 'Colleges The Southwestern Colleges The Philippine Women's University The seven private Schools of Nursing, all connected with private hospitals are: 1. 'Chinese General Hospital School of Nursing (Manila) 2. Mary Johnston Hospital School of Nursing (Manila) 3'. St. Luke's Hospital School of Nursing (Manila) 4, Manila ,anitarium Hospital School of Nursing (Pasay City) 5. Iloilo Mission Hospital School of Nursing (Jaro, Iloilo) 6. St. Pawl's Hospital School of Nursing (Iloilo City) 7. Emmanuel Hospital School of Nursing (Capiz, Capiz) SECTION IV EDUCATION AND'TRAINING IN MIDWIFERY There is one Government School of Midwifery. It is under the Department of Health and is connected with the Maternity and Children's Hospital (in Manila) of the Bureau of Hospitals. The course is for one year and a half and the title of Graduate Midwife-1s given.at the.end of the course. There are four private Schools' 'of Midwifery and are connected with four private hospitals. These are$ 1, 2, 3. Sta. Teresita Hospital School of Midwifery (Quezon City) Emmanuel Cooperative` Hospital School of Midwifery (in Manila) Binondo Maternity Hospital School of Midwifery (in Manila) 4. Clinica Lopez School of Midwifery (in,Manila) The course is given for one year and graduates,arp given the title of Graduate in Midwifery. 1. Requirements for Admissions (A) For the Government School of Midwifery. , (a) Each applicant must be not less than .20. nor more than 35 years of age. (b) She must have completed the High School. in the public or private school recognized by the government. (c) She must be of good health and of good moral character. (d) She must be not less than 4 feet and 9 inches tall. (e) She must be single. (f) She must have good grades in the High School card, (g) She must pass the entrance examination given by the school. (B) For the private Schools of Midwifery: Completion of the Academic Secondary Course. 2. Number of Students Admitted: (A) For the Government School of Midwifery The school admits not more than 120 students every school year. For the school year 1951-1953, 79 students were,. admitted as extern students for the first time. These .79 students live outside and report to the hospital for duty and classes ag scheduled, Iaformat,on for private Schools of Midwifery is obtained from the Director of Private Schools. Selection is made by a committee of five and the basis of selection are: (a) (b) (c) Entrance Examination Personal Interview Physical Examination The first 120 students who get the highest rating are admitted or selected4: They are given free quarters and subsistence in•the hospital. ;. (B) For the private Schools,of.Midwifery In all the schools, students are limited according to admission requirements, maternity cases available, and dormitory facilities. 3. Faculty: (A) (B) fit-Government School of Midwifery: -members .''Students.are divided into A for intern students attended by B - for extern students attended by The faculty is composed of 12 two sections, namely; Section 6 faculty members and Section the other 6 faculty members, At the Private Schools of Midwifery: 1, Sta. Teresita Hospital School of Midwifery - There are 8 faculty members, 60% of whom are on full time basis. The school is affiliated with the Philippine General.Hospital, the North General Hospital and the Little Clinic. 2.., ;F^nmapuel 'Cooperative Hospitalchool of Midwifery There are 8 members:. of. the faculty, 60% of whom are on full time basis. The school is affiliated with the Maternity and Children's Hospital. 3. Binondo Maternity Hospital Sahool`of Midwifery - There are 4 members of the faculty. The school is affiliated with the Lanuza Health., Center. 4. Clinica Lopez School of Midwifery - There are five members of the faculty.:,No.affiliation is needed. -10- There' ` is ='one 'Govern nient or "State X ollege of Pharmacy which is,under the It gives two (2 ) courses in pharmacy, namelys University of the Philippines. (1) Four years leading--to the degree of Bachelor of Science in `Pharmacy. (2) Five years leading to the degree of Bachelor in Industrial Pharmacy. There are sixteen ( 16) private colleges of pharmacy under private universities or colleges. They all give fdur.'year course in pharmacy leading to the degree of Bachelor of Science in Pharmacy. COLLEGE OF PHJRMACY• University of the Philippines. 1. Requirements for admission: Students seeking admission to this College must be graduates of ,a standard four-year high 'school course.--- The subjects for entrance are as follows; English Social Science Mathematics Natural Science Electives - 5 units - 2 1.1" - 2 It -- 5.5" -- 16 units To make up the total number of units required for entrance, history, government , botany., zoology, chemistry, mathematics, language., literature, economics , general .science, geography, psychology, pedagogy, agriculture, bookkeeping, business law, domestic science, drawing, manual training or music may be offered. 2. Number of Students Admitteds Admission automatic for those high school graduates possessing an average of 82% and belonging to the first 20% of the class, Admission by entrance examination to the others who do not qualify under above. Limit for admission to first year pharmacy is about 100. ♦.1i- PRIVATE COLLEGES OF PHARMACY The sixteen private Colleges of Pharmacy are under the following private universities and colleges: 1. Centro Escolar University - Mendiola St., Manila 2. Philippine Women's University - Taft Ave., Manila 3'National'University - Lipa St., Sampaloc,'Manila 4. 5. 6. 7. 8. 9. 10. 11. 12. Adamson University - 213 San Marcelino, Ermita, Manila Manila Central University - Zurabaran, Sta. Cruz, Manila University of Sto. Tomas, Espana, Manila Holy Ghost College, Mendiola St., Manila University of San Carlos - Cebu City Cebu Institute of Technology, Cebu City Southwestern Colleges ' -. Cebu City Immaculate Conception College - Davao City Colegio de San Agustin - Iloilo City 13. Iloilo City Colleges - Iloilo City 14. Central Philippine Colleges - Jaro, Iloilo 15. Lourdes College - Cagayan de Oro City 16. Occidental Negros Institute - Bacolod City 1. Requirements for Admission: Valid credentials showing completion of the Academic Secondary Course. Students who have deficiencies in high school Physics and Mathematics are required to cover up these deficiencies before enrolling in the courses which require such prerequisites. 29 Number of Students Admitted: With the exception of the University of Santo Tomas and the Centro Escolar University in Manila, Colegio de San Carlos in Cebu City, and Oolegio de San Agustin in Iloilo City, which can afford large enrolments because of sufficient quarters, apparatus, and equipment, the rest of the schools limit their enrolment to the capacity-and equipment accommodation. -14- SECTION VII IN-SERVICE AND PRE-6ERVICE TRAINING FOR'MEDICAL AND PJBLIG HEALTH PERSONNEL (Given by: the Department of Health and the Bureaus and Offices under it). I Objective: A - To afford opportunity for all personnel of all categories in the Department of Health and in the Bureaus and Offices under it for advancement of their.. knowledge of public health through the adoption of the most recently accepted methods and procedures in the prevention and control of diseases par";;icularly those communicable in character. B -- to review existing methods and-procedures in Public Health Administration with the aim in view of comparing them with recently accepted ones and to adop t ! , at are more practical, r:ore efficacious, and t W'JJ'v perhaps less expensive,. II - Categories of Personnel to be trained: A - Physicians:-- (field health officers, hospital physicians, maternity charity clinic physicians, puericulture center physicians, and those of the staff in the central office of the bureaus and offices under the Department.) B - Nurses:- (Public health nurses , hospital nurses , puericulture center nurs e, maternity and charity clinic nurses.) C - Sanitary Inspectors D - Midwives E - Laboratory Technicians F - Sanitary engineers G - Clerical Personnel III - General Description of the Course or Subjects Given and Approximate Amount of Time Allocated (a) Didactic, (b) practical or field work. The course of pre-service and in-service training varies in the length of time for the different categories. For example:- for physicians and nurses , a course of 12 weeks has been prepared; for sanitary inspectors10 weeks; for clerks - 8 weeks ; for sanitary engineers and laboratory technicians from 8 to 12 weeks. Practically 1/3 of the time allocated for the course will be utilized for didactic teaching while the remaining 2/3 of the time will be dedicated to practical work and field visits. During the first two weeks of the training period, all the categories will be grouped together for lectures, demonstrations and field visits covering subjects common to all. Thus the first two common weeks will be spent fcr a review of the organization, administration, and functions of the Department and of each.bureau and office under it, From the 3rd week to the end of the course, each category will follow a schedule prepared specifically for that category. -13- Dentistry, Centro Escolar University - Mendiola, Manila Oral and Dental Surgery -- Oroquieta , Manila Dental College - Azcarraga , Manila. Dentistry , Southwestern Colleges , Cebu City Dentistry , Iloilo City Colleges , Iloilo City Dentistry , Central Philippine College - Jaro , Iliilo 8. 9. College of College of Philipp: ine C611ege of College of College of 1, Requirements for Admission: 4. 5. 6. 7.. , Prior to 1951 admission requirement to all private dental., colleges is the completion of a four -year high school course, Effective' July, 1951,` requirement for admission to dentistry ' proper is the completion of a two-year pre-dental or its equivalent in college units deemedsufficient by the board of dental examiners, 2. 'Number of Students Admitted: For each of the private Colleges , the limitation in the number of students is in relative to their facilities. 15The trainees of all categories will be divided into batches of about 100 individuals per batch. For one such batch, it is contemplated to include 25 physicians from both the i;iureau of Health and the Bureau of Hospitals, 50 nurses from the two bureaus and other offices, 15 sanitary inspectors and 10 clerical and other personnel, Each batch will be called to Manila or any regional training center, to undergo training for the length of time according to the category. After the termination of the training of one batch, the next batch will be called, and so on, until all personnel of all categories shall have been made to undergo the training. It is contemplated that, as facilities become available , more trainees will be handled at any one training period later in such a way that , in about 5 years more or less, the training of all personnel shall have been completed. Then, later, these same pers onnel will be called for a refresher courses once every five years for ooviou s reasons* h^ schedule of lectures , demonstrations and field visits has been prepared for each and every category, by day and by the hour. The officials to give lectures and demonstrations and to guide the trainees during field visits are employed in the Depa.r+.mpnt and in the different bureaus and offices under it. However , every once '^. a while , outsiders will be requested to extend cooperation in '-Ahis training by giving one, or two lectures on their ,s starting point , a central training center in respective specialties, Manila and on e regional training center , may be somewhere in Northern Luzon, will handle the first batch of trainees. It is aimed to establish 5 regional training centers altogether - one in central Luzon , one in Southern Luzon, one in East Visa.yas, one in West Visayas, and one in Mindanao. The utilizatlon the ' cstablishment of these different regional training centers will be c?eperdent upon the av,.ilability of staff members and facilities or ,cd for the training. It is envisaged that those who commodities +.o be util-,7 have gone through the trainin : during the first batch will be included in the membership of the staff to be organized later in the various regional training cen''ers . Thus , not only will the training of all personnel of all categories be made more complete and within a comparatively shorter period of time but also the enhancoirent or strengthening of local health services in the areas where said training centers are established will be insured and hastened,