June 29, 2005, 12:15 p.m.

What do UPCM grads ought to be?

This inquiry was written by Eloy Marcelo, M.D., a class '91 classmate of mine (see contact data at the end) from UP. It's mainly addressed to my fellow UP Medicine alumni...

It started when I proposed that University of the Philippines College of Medicine (UPCM) graduates be made to sign a social contract requiring them to serve for a period of two years (editor suggest 5 years) in an underserved area in the country after graduation. After this period of service, they can opt to do anything they want--even go to the U.S. (Note that this two years will include an informal postgraduate curriculum that nurtures these graduates as they serve the remote barrios--perhaps MPH?, perhaps Masters in Community Health Management?; it will not be a stagnation period).

Why do I propose this?

First, the cost of medical education has gone up (when we paid P10,000 ($400) for our clerkship year the dollar was at P25:$1). Presently, the students pay P11,000 ($200), an increase not commensurate with the peso devaluation over the past 14 years. (editor's note: as you can see the dollar equivalents, the tuition actually halved.)

Second, utilities have gone up tremendously. Our annual P13 M ($230 K) budget is spent mostly on the P1 M ($20 K) monthly Meralco bill. P1 M is left for the annual water bill. Faculty/ departments shell out their own for the paper, whiteboard markers, etc. for the courses they offer. We survive mostly from alumni contributions (this includes the faculty--many of whom have no salary).

Third, the College has been unable to get more subsidy from the government for many reasons but one of them is because we have been unable to demonstrate service very clearly--because half of our graduates are in other countries. It seems showing the service we offer at PGH is not enough to convince them of our value (I myself do not see the value of service purely from just a PGH setting. As residents, we learn as we serve in PGH--the motive is still personal development, not pure unadulterated service).

I think it is the option of any graduate of UP to practice wherever he/she wants (including other countries), but it is also his/her responsibility to show some form of payback for the scholarship that has been awarded. I think two years of government service is enough.

I don't think the issue is that half of our graduates end up in the U.S., but that they tend to leave without a demonstration of service which is expected from a scholar. (The college is not fault free here--the college has failed to provide opportunities for service also).

Having said that, I think it is unfair to require this return of service from graduates who have not been properly informed of this requirement, that was why I was proposed something like a pre-nuptial agreement be cast prior to enrollment (for batch coming in at 2006), with the incoming medical student fully informed of the responsibilities expected after he/she graduates.

What do you think? The school that has made us who we are is in a fiscal crisis. She needs our collective minds, the most brilliant minds this country has to offer, to come together and find solutions.

I expect responses from the 1991 community. Please bear in mind that my ultimate objective is to obtain more funds for the college--not mostly from the benevolence of our alumni, but rather from the contributions of various funding agencies (including congress) because they believe in the values that the UPCM stand for--the highest level of health service to the Filipino people, especially the underserved.

Alvin B. Marcelo, M.D.
Medical Informatics Unit, University of the Philippines, Manila
547 Pedro Gil Street, Ermita, Manila
1000 Philippines

www.linuxforhealth.org/amarcelo
Telefax: 632-522-9231

This letter has been disseminated to all class '91 members. Since other readers will see this blog, it points to just one problem in the Philippine medical educational system, mainly from lack of funding. Concerned Filipinos (fields of education and health and government) are enjoined to think about this problem and act appropriately. It's better to light a candle than curse the darkness.