Archive for the ‘Filipino doctors’ Category

Filipino doctors in USA, 2nd to India among IMGs

March 23, 2009

We are quick to assert that among the international medical graduates (IMGs) in the United States, Filipinos are 2nd to doctors from India as the most represented ethnic group in the profession. This is a very good record for our country who has distinguished itself as one of the most prolific doctor suppliers of America. About ¼ of doctors in USA are IMGs.

Top Ten Countries of Medical Education for IMG Physicians

India———————————— 19.99%———————-47,581
Dominican Republic——————3.3%————————–7,892
Russia———————————-2.5%————————- 6,039
Source: American Medical Association (AMA) Masterfile 2007

Philippines—————————— 9%—————————21,081
Mexico———————————- 6%—————————13,980
Dominican Republic——————-3.7%—————————8,618
Source: American Medical Association (AMA) Masterfile 2008

The 2008 American Medical Association (AMA) IMG record shows the Filipino doctors rank second to India in number—-9% and 21% respectively of the total number of foreign medics who train in the United States. That’s a total of 21,081 Filipinos vs. 41,247 Indians. Because of the sharp difference (double) in numbers between the two groups, Filipino physicians in USA looks scarcer compared to the Indians.

The current distribution of Filipino doctors will probably stay for a while since the boom of the nursing profession in the Philippines has lured more doctors to come to USA as nurses. Former Sec of Health Dr. Jaime Galvez Tan confirmed this trend when he revealed in 2007, “My latest study, there are 9,000 doctors who have become nurses. Six thousand of them (6,000) have left the Philippines mainly for the U.S. to work as nurses.” Majority of these MD-nurses come from government hospitals, keeping the pool of United States Medical Licensure Examination (USMLE) takers and residency seekers from new graduates relatively intact.

A coincident fall of medical student enrollment, as much as 40% in some schools, has caused the lack of physicians in the Philippines, but not so much in USA since it remains to be a favored job destination of Filipino health professionals for more than 50 years. What is astounding is even if Filipino IMGs are second to the Indians, their number is small—less than half of the latter.(Photo Credit: Jandentonchua) =0=


Reflect Rather Than be Outright Ashamed To Be Filipino

October 24, 2008

I cannot fault FilAm Liberal Democrat (FLD) for being ashamed to be a Filipino. But this is self-defeating. We have only one country—and let’s not make any mistake about it. Philippines is again the odd man out in another unflattering way. We are out touch with rest of the world. Just like Sarah Palin, we are out of the league. I’ve got this feeling that if polls were taken here in the Philippines, Palin will have higher favorabilty rating than even Barack Obama. Talk of identification. That’s how out of touch this country is. Rather than condemn, we have to do something.

I invite you to weigh in. Just what is fundamentally wrong with country? I will blog on this later after I attend to some urgent matters. We cannot bask in our virtue and uniqueness and simply dismiss that we and the Georgians are right and to heck with those from 68 other countries.

See you later.

Nurse glut made worse by apathy & self-interest

September 1, 2008

Almost everyone knows it is coming. The nation produces about 100,000 licensed nurses per year. The joblessness of 400,000 board-certified nurses is expected as students enrolled in the course has surged to more than 450,000 since 2006 in the Philippines which can only employ 60,000.

But few people want to talk about the nurse problem—either they are apathetic or they just wanted to move ahead on their own. There has been inadequate public national debate on the issue, in the government and even among interest groups. Perhaps, they are intimidated.

The apparent lopsided popularity of nursing didn’t dissuade students against choosing the course, among them, second-courser doctors who wanted a shot at higher paying jobs abroad, even if they had to downgrade their positions in the healthcare ladder. Acceptable to many, they had their career plans on hold, wasting away time before they could be productive. They believe the situation was only temporary; once they escape their jobs for high paying jobs abroad, it would be OK.

But we’re seeing the full-blown effects of failure in planning and labor-allocation. The exceedingly high number of unemployed nurses translates into millions of lost productivity. Since overseas labor is a major leg that shores up the Philippine economy, the impact of joblessness is staggering.

The Education Department was slow in averting the mass unemployment when it recognized the folly of loosely permitting new schools to open until its ban 2004. Legislators sat on the side (even allowing their relatives to join the nursing tide) without coming up with solution(s) to the profession’s freak overrepresentation in the workplace.

In a matter of few years, positions filled up, leaving thousands without jobs. Like beached whales in the sand, nurses with plans to work as overseas foreign workers (OFWs) quietly looked at their situation with worry and trepidation, hoping the bottle neck of employment would ease up. For survival, others had taken local jobs in alternative professions. On their own, they wonder what the government could do to alleviate their plight.=0=

RP’s 40% drop in med school enrollment & the foreign doctors

August 27, 2008

It seems a good thing that doctors from the Association of Southeast Asian Nations (ASEAN,) a group of sovereign states in partnership with the Philippines, are coming to the country for study. This development is timely when at least 5,000 doctors have left the country since 2004 and about 6,000 have shifted to study nursing for jobs abroad. In the last three years, a staggering 40% drop in medical enrollment is noted. Asian Journal Online (08/26/08)

An uncertain number of foreign doctors who come from Iran, India, Malaysia and Indonesia and other neighboring countries have sought training in Philippine hospitals, many in the provinces, even if no Department of Health (DOH) guidelines are existent to regulate them.

According to Philippine Medical Association (PMA) president Reynaldo Santos, M.D., the arrival of these foreign medical trainees attests to the high quality of education in the country. But this is doubted in the wake of a sharp decline of the number of hospitals, a marked rise in patient load for doctors and nurses, a low passing rate of Filipinos in the United States Medical Licensure Examination (USMLE,) an over-crowding of patients and trainees, lack of budget, equipment upgrade, and medical facilities in many hospitals. See related article on medical diploma mills below.

If the Department of Health (DOH) and the Education Department (CHED) don’t act fast, it will not be long before foreigners will be able to judge for themselves the quality of education and healthcare in the Philippines compared to that of their countries of origin. It is deleterious for the country to rely on foreigners to solve the shortage of physicians or seek them to shore up dwindling medical enrollment. Without infringing on the physicians’ rights, measures to reverse the brain-drain of local doctors must be high in the priority. (Photo Credit: Doctian) =0=


A disturbing article entitled Medical School for Sale? was written by Emil Jurado of Manila Standard on July 26, 2007. It’s unclear whether the Department of Health (DOH) and school authorities (CHED) took satisfactory remedial action to prevent further erosion of credibility with the alleged proliferation of diploma mills in the country.

In concordance with the requirement of ASEAN’s Mutual Recognition Agreement (MRA)mandating to honor medical licenses and credentials among member nations, this highlights the need to write the long-overdue guidelines needed for the regulation, hiring, and training of local and foreign doctors in the Philippines. Here’s a part of Jurado’s riveting piece that needed verification plus action from the government:

The Times of India, a very prestigious newspaper, published an article, “Now showing: Manilabhai MBBS*.” The article is very derogatory about our kind of medical education. The latest MBBS scam to appear on the medical scene in India is based in the Philippines. “And this one’s even less complicated than the others.”

The article says: “There is no entrance test for admission, now, will you need to attempt the screening test in return?” says Upveen Harpal, accounting executive, HCMI, which is sending students abroad.

The article adds, “So, anybody with 40 percent in Class XII examination and who could pay Rs 16 lakhas (about P1.6 million) upfront could head for the Philippines for an MBBS and come home to practice. No questions asked, and Harpal claimed that this was a three-party tieup among HCMI, a medical school in Manila and a medical school in Tamil Nadu, India.”

To add insult to injury, Yogesh Sharma of Gujarat Global News Network, Ahmedabad wrote an article entitled, “The Philippines dangles carrots to Gujarat students: Be doctor for Rs 20 lakh.” The article implies that there are no more requirements to enter an MBBS program in the Philippines since the title gives the impression that all one needs is Rs 20 lakh or P2,000,000 to become a doctor, courtesy of fly-by-night or spurious Philippine medical schools, and diploma mills for sale. “ *N.B. M.D. in the Philippines is equivalent to MBBS in India. Manila Standard (07/25/08, Jurado, Emil; Photo Credit: PaulCooperBland)

Quotes to ponder

June 9, 2008

The inflation rate will still go up before it goes down and there is a very good chance that it will breach 10 percent. The ten percent is an important threshold. Beyond this level, the psychology of the people changes and it becomes more difficult to control their expectations of price increases.”

-Cayetano Paderanga, UP economist who predicts the difficulty of controlling inflation in what analysts call RP’s brewing “perfect economic storm.” abs-cbnNewsOnlineI/AFP (06/09/08).

Life is not a battle. I love it; I want more of it. That’s all I ask, just a little more.”

-Rudy Fernandez, Filipino actor shortly before he died of periampullary cancer on June 7, 2008. PDI (05/14/08, Velarde, EG)

“You may be a Frenchman, but you can’t outthink a Filipino.”

-Sen. Juan Ponce Enrile rebuking Hubert D’Aboville, spokesman of Joint Foreign Chamber and president of European Chamber of Commerce for urging Pres. Gloria Arroyo not to renegotiate government contracts with independent power producers or allow amendments to the Electric and Power Industry Reform Act (EPIRA). Enrile interprets this as foreign interference to RP’s legislative process. (06/06/08, Uy, V.)

Hippocrates, Maimonides and the Perfume Canister Incident

April 25, 2008

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.” —Oath of Hippocrates (400 B.C)

Removal of lodged foreign objects in body orifices is expected in medical practice, but it occurs quite uncommonly. Whether it’s a little boy crying with a corn kernel trapped on his nose, or a grandmother in pain with a spiky fishbone stuck in her throat, or a homosexual humiliated with a light bulb caught in his butt, doctors and nurses always remove them. It’s their duty. Knowing their role, they defer judgment and blame. In these situations, there’s no cause to make fun of the patient.

We know there’s nothing more heart-rending than the sight of a patient in pain. We feel lucky not to be in the patient’s shoe. The doctor’s instinct is to allay suffering. They often do anything to help human beings in distress.

The nurses don’t invite on-lookers to break the dictates of hospital privacy. As a general rule, nobody is allowed to take pictures on patients having treatments. Hospital workers are expected not to gossip on patients in the corridors. They must earn trust. Patients can’t imagine a hospital where they can be put to shame.

Like the sin box of neighborhood churches where confessions are heard, our hospitals are supposed to be sacred grounds for respectful patient-doctor relationships. What goes on in the doctor’s room is protected by confidentiality and trust. Yet regrettably, at times, something goes wrong and we start asking why.

Primum non nocere. (trans. First, do not harm.)

That’s the first lofty ethical advice that doctors and nurses remember. We expect our care-givers to heed the holy caveat of comforting the sick first before they institute cure. Thy must abide with this rule similar to the pledge of the great physician Hippocrates and the prayer of the rabbinic philosopher-physician, Moses Maimonides (1135-1204 A.D.) which, in part reads:

“Grant that I may be filled with love for my art and for my fellow men. May the thirst for gain and the desire for fame be far from my heart. For these are the enemies of Pity and Ministers of Hate. Grant that I may be able to devote myself, body and soul, to the children who suffer from pain.

Preserve my strength, that I may be able to restore the strength of the rich and the poor, the good and the bad, the friend and the foe. Let me see the sufferer the man alone.

When wiser men teach me, let me be humble to learn, for the mind of man is so puny and the art of healing is so vast. But when fools are ready to advise me or to find fault me, let me not listen to their folly. Let me be intent upon one thing, O Father of Mercy, to be always merciful to thy suffering children.”

The ancient aphorisms embody what ethical medicine must be for all of us today. But we couldn’t fully understand why the clear moral norms set in medicine had been violated in Cebu’s government-run Vicente Sotto Memorial Medical Center.

A group of doctors and nurses assisting in the removal of a perfume canister in a patient’s rectum were caught jeering in glee and making fun of the patient during the procedure. The disgraceful footage landed in cyberspace’s You Tube embarrassing the patient, the nation, and the whole world.

Although there are tenets in the Hippocratic Oath and the Maimonides Prayer which aren’t strictly followed today (partly because medical practice has evolved through the ages,) humility, respect, and mercy for patients remain integral in the great physicians’ core exhortation. For their truism, such rule of conduct has been adhered to since pagan times.

The perfume canister controversy made us reassess our moral values. The overwhelming majority who learned of the incident thought it was sickening and downright wrong. Many condemned the hospital personnel’s arrogant indiscretion and blamed them for brushing aside the golden rule:

Do unto others what you want others to do unto you.”

For the infamy we earned, the Department of Health (DOH) called for an investigation and planned for a disciplinary action. A priest-spokesman of the Archdiocese of Cebu laid blame on the victim’s behavior and opined the incident shouldn’t have occurred if he didn’t engage in bestial sex. While others recommended those involved be stripped of their licenses, the priest asked for a review of the ethics curriculum under which the hospital personnel were taught.

Swept with emotional trauma, the patient, a florist, sued the hospital, a move that could have easily assured him of hefty damages if the case happened in a different country. Friends of the erring doctors and nurses however believed those involved don’t deserve punishment for they already “suffered enough for their misdeed.”

Ladlad, an irate group of lesbians and homosexuals plus the Bagong Alyansang Makabayan disagreed and demanded full disclosure of the doctors’ and nurses’ names—something the authorities often won’t ordinarily do for reasons that weren’t justified. But they did it anyway for this case.

There were those who couldn’t forget the protests incited by ABC’s Terri Hatcher’s suggestion in a TV sitcom that our doctors aren’t competent. According to them, the incident proved that Terri was correct after all and we have little basis to whine. Some were convinced it would be hard to keep the world supporting us if there had been other evidence that cast doubt on our medical professionals’ integrity.

Yet, whatever the outcome of this case, the need to upgrade our medical ethical standards is self-evident. By any means, our mistake isn’t tenable and a re-calibration of our moral compass is required.

Hippocrates and Maimonides still speak to us on ethics and moral behavior that have applications outside the hospital setting. But the hideous perfume canister incident makes us wonder if similar incidents would happen again.=0=