Over the past few days, Dr. Frederic Ting's blogpost, "10 Reasons Why Every Medical Graduate Should Aim To Do Internship at the University of the Philippines - Philippine General Hospital (UP-PGH)" has been making the rounds on Facebook. I am happy for his success and his completion of what was probably a very difficult year. I do however disagree with him.
I commented on his blog, but the comments need to be vetted/moderated before appearing. To date my comments have not appeared, so i am assuming i either: 1. submitted wrong, or 2. got vetted out. If it's the former, i don't want to keep trying because i'm sure i'll screw up again. If it's the latter, it's his prerogative. However, i do think my comments merit some "airtime," so i've taken the liberty of posting them here, in their unedited glory:
"Hi Dr. Ting,
"Congratulations on completing your internship and good luck with your boards, with your positive attitude I am sure you will do well with your future endeavors.
"While I appreciate your sentiments I respectfully disagree with most of your points. First and foremost I am unsure that "every" medical graduate should aim to go to UP-PGH; every person is of course different and no internship is a one-size-fits-all solution.
"Regarding your points:
"1. It's unfair to say that "we can’t deny the fact that the University of the Philippines is a place where most, if not all, of the brightest people in the country get accepted and enroll." I am not sure if there is a registry where statistics back this up...? If there is I stand corrected, but while I know that UP-PGH probably "accepts" the best and brightest (by their standards), this does not mean the best and brightest necessarily all try (or even want) to go there. UP-PGH people will laud your statement, but it's somewhat insulting to people who actively decided to go someplace else. The notion that not going to UP-PGH makes you somehow mediocre is just flat out wrong.
"As to points 2 through 10, I think you can safely replace "UP-PGH" with {insert hospital name here} and still be mostly correct.
"I see that the intern's job hasn't changed much since I finished my internship there in 2002. Interns still mostly take vitals and draw blood, which is not bad as long as you know what you're getting into. I think interns at other places are doing more though. I turned green with envy when a friend of mine who went to Jose Reyes told me the story of seeing someone in the ER with pneumothorax, doing all the diagnostics, putting in a chest tube, and THEN calling the resident. We can discuss safety issues surrounding this separately, but the fact is that he carried more responsibility and was more of a doctor on many levels than me dutifully running between wards 1 and 3 checking vitals, giving meds, and extracting blood.
"My main frustration with going to UP-PGH was the absolute insularity of the people I met there. Every PGI was regarded with suspicion and they would be "shocked" when an outsider was actually even good. (i.e. "Magaling siya kahit hindi UP, ha.") Again, very insulting and condescending behavior.
"My personal approach to every medical graduate would be to carefully consider where they want to commit the year of their post-graduate life. Look at all the facets of the internship: patient load, exposure to cases, quality-of-life, quality of the faculty - and decide if it's a good fit for you. UP-PGH should be considered on those grounds as well, not just defaulted to because its graduates say it's "the best." If you flatten out the playing field in your mind and stop looking at one institution through rose-tinted glasses, you might be surprised at what you find."
Comments are always welcome!
Link to Dr. Ting's original post here.
I agree. Lots of condescending attitude, discrimination and preferential treatment there.
ReplyDeleteMy thoughts exactly!
DeleteUP PGH alumnus here (within last 10 years). The current system is NOT the best way to learn MEDICINE. Clerks and Interns do what are supposed to be nursing and even nurses' aid jobs (or worse transporter jobs). While I completely understand the necessity of this in our beloved but budget-limited institution, it doesn't necessarily mean that it makes you a better doctor. How about letting nursing students in to do the nursing jobs?
ReplyDeleteThanks for the "insider" comment!
DeleteMy brother graduated from UP-PGH in 1995. If he had his way, he would have had his internship elsewhere. But he had no choice. Internship before graduation was the rule. Interns there were basically the errand people. Interns doing what nurses do. Interns doing what clerks in other hospitals do. But what he did not like the most was the condescending attitude/superiority complex of the homegrowns over there. To Dr. Ting,
ReplyDeleteyou have not really had the full experience of what life is like in UP-PGH. you have not met all the personalities over there.
A few years back, I applied for a fellowship program at UP-PGH. to my surprise, I was the one chosen. I say surprise because it is difficult to get in a cutting specially especially if you are an outsider. And also if you have no backer. Politicking in PGH is very much alive, I tell you.
ReplyDeleteAnyway, from the 1st day of training, I could already feel that the residents were sizing me up. Having finished my residency in another institution, they always question my decisions and my techniques in doing an operation. For them, what is not in THEIR protocol is considered wrong.
It came to a point that I was always shouted at, cursed at, and belittled in front of everyone. The junior consultants .... That is what they do best. My OR time was getting shorter until I had very few cases assigned to me. Not even getting first assists positions since according to them, I did not know how to assist. I would get boxed out of the OR table. I usually end up retracting. These went on and on. Tell me, what kind of training am I getting? Do you think you will be learning in this kind of environment? UP-PGH takes in applicants to train but what kind of training is there....especially if you are an outsider.
I agree...there is definitely a lot of people there with a condescending attitude. Well, this is just my experience. Though I have met a few people who have remained down-to -earth and made me feel welcome. Oh by the way, I resigned. I felt I was not learning. I had a very demeaning experience over there and I decided to walk away before my dignity was stripped to pieces. To Dr. Ting, I wish you well and maybe you will not get the same treatment I got.
Wow, I am sorry to hear that you had to walk away, I hope you found better treatment (and training) elsewhere.
DeleteOh yes. I trained elsewhere. I am now happy with my practice. Looking back at the short stint I had in PGH, I can say that I made the right decision. Yes, patient load was more than adequate but the quality of life while training... No. No one should be treated like scum. No one should be treated like a second rate individual just because he or she did not graduate from the College of Medicine. The quality of training suffers if those who teach think of themselves as being all-knowing and superior to the rest.
DeleteI commend you for this post, for it's a powerful eye opener. This post captures my sentiments. While I agree to some of Intern Ting's insights, I think he presented just one side of the coin. If his goal was to inform/educate readers as to what they should expect in pgh, he should've been less misleading and should've not "sugarcoated" the truth. Internship is not "observership" he says, but aren't we here for Medical Internship and not Nursing/Med Tech/manong internship? To aspiring medical graduates aiming for internship in PGH, be more vigilant. See it for yourself, don't just get carried away easily by other people's testimonies. GO TO PGH during your free time, roam around, ask around, SEE FOR YOURSELF. That's the best advice I could give. Good luck!
ReplyDelete"Manong internship. " Love it!
DeleteI am from UPCM and I don't hate doing nursing work for the patients. But if we justify the system by rationalizing that we are here to serve and that previous generations were able to deal with it anyway, there would be no room for progress in this hospital and I won't be surprised if one day it closes down and becomes nonfunctional. Poor Filipinos.
DeleteI think Fred Ting presented ten reasons wy you should do internship in UP PGH. You can do that or every oyher institution, really, but to take it as an article that misleads future interns? I don't think. Ten reasons are barely enough for anyone to decide. :)
ReplyDeleteAlso, I wouldnt want to do internship in PGH as well, UPCM na ko nyan ah, but Fred Ting reminded us of the good things about that experience. Stick to the idea that youre doing a nurse's job, and you will hate your job. Learning and knowing, however, the extent of the impact that a certain illness does to a patient and his or her family, leading you to do so many social work and nurse jobs (eh konti lang sila eh, aantayin pa ba magtoxic para lang nurse gumawa ng trabaho ng nurse?) which you DONT like and is NOT training you as a doctor, teaches you perspective and character. I think that's what makes the training unique, and truly UP. Is it for everyone? Why not? Would everyone like it? No. :)
Thanks for the comment! I think it's valuable to get the UP graduate's perspective, otherwise I fall into the same trap of just presenting one side.
Deletethat doesn't make training unique to PGH. FYI you get that same experience in any government hospitals. and FYI again, most government hospitals have it worse. Try visiting Jose Reyes and San Lazaro for instance, and you would see how bad it is out there. toxic lang sa pgh because of the amount of scut work. Take all of that out, and it's clear that PGH interns and most especially clerks are treated like babies. This is the point of view from someone who did his residency in PGH, and all of my batchmates in residency share the same perspective.
DeleteTruly UP? looking back at most of the residents and fellows in different departments, especially how they treat patients in the ER, the UP way makes me want to vomit. Let's get real here. Aside from internship, I also did 1 1/2 years of residency in PGH and a lot of residents there regardless of department treated patients like dirt at one point or another. Not all, but A LOT. I couldn't really blame them. I know from experience how cranky a person can get when he or she lacks sleep, when he or she hasn't eaten for 24 hours already... you get my drift. You would reach a point when you don't care about other people anymore. My point is, it's not the proper way to train doctors. I resigned not because of the work load or the sleepless days. I resigned because i did not like the person that i was turning out to be as a result of the PGH way of training.i did not like thinking of my patients as a burden, which you ultimately will at any time during your PGH training.
Very well said, Dr. Chong. I could't agree more.
ReplyDeleteTotally agree!
ReplyDeleteTo future interns: Yes you will learn a lot of different life-changing perspectives in PGH, and will have unending opportunities to do things beyond the call of duty to serve the people -- if that's what you're looking for in a medical internship program, if that's what you think you need the most at this time of your journey to becoming the best doctor you can be--by all means, go for PGH. But if you aim to have maximal hands-on patient management instead of spending most of your days doing scutwork convincing yourself that this is the essence of internship, maybe you should also look into other options aside from PGH. ;)
ReplyDeleteA lot has happened in more than a decade, Dr. Chong... some things remained the same while others changed. I don't agree with everything Dr. Ting said but I appreciate that he still chose to focus his energies not on negativity, but to show his appreciation for the good things that he experienced. Despite the fact that PGH is not perfect and we have all come to recognize the injustices within its walls, our patients teach us about patience, compassion, resourcefulness, while being among the most complicated medical dilemmas in the country. The College of Medicine has constantly sought insights from students on how the manner of teaching could be improved, and they have listened. The various departments have all been very cooperative with adjusting the curriculum and making sure that the students are able to maximize learning, not simply being preoccupied with "menial" tasks that some may think as things that shouldn't be part of the job description of an intern.
ReplyDelete"Every PGI was regarded with suspicion and they would be "shocked" when an outsider was actually even good." -- Perhaps this was the sentiment of individuals during your time in PGH. However, culturally, PGH is changing. We know that there are a lot of bright minds out there, not just in PGH. Why do you think PGH accepts quite a number of non-UP graduates in various residency and fellowship programs?
Doing your internship in PGH has never been just about learning medicine, anyway. I get that some people might have wanted to do their internship elsewhere, as PGH is not for everyone. I still believe that patients in PGH teach you more than medicine and in my humble opinion, there is really more to gain from that.
Thanks for your insight. I sincerely hope that the culture has changed for the better. I've heard a different explanation for why they accept outsiders for residency/fellowship, but i prefer yours.
DeleteOh the "culture" in PGH has not changed. There is still that air of superiority especially where "outsiders" are concerned. I had my medical schooling at the Cebu Institute of Medicine. I applied for a residency spot in surgery. Yes, I was accepted but I decided to pursue my training elsewhere after I was exposed to the pre-residency training for a month. First years are treated so badly. No wonder that those who continue become "vindictive" in a way. Once they reach 5th year, they do unto others what was done to them. And so the cycle continues. And this is carried on til consultancy status. At least for the junior consultants I have met. Yes, cases are aplenty and you learn from these patients. But at what cost... To your dignity, to your life... Some say, ganyan talaga sa PGH. Minumura ka, sinasampal ka (yes, it has happened), tinatakot ka. Is this the PGH way? The faculty may have made some changes to the curriculum... But what about the training programs and those in charge of them? Shouldn't this be looked upon too?
DeleteBut, Surgery is always a different story. I think it is quite unfair to generalize it with the rest of PGH. A few years back, the Department of Obstetrics and Gynecology made a move to have feedback forms for residents, from their peers, patients and consultants. This led to a marked change in how residents relate to each other and how their patients receive medical care. So let us not assume that everyone is vindictive, because that is not the case for all, and perhaps this really is something worth bringing to the attention of the Department Chair.
DeleteI've had the pleasure of having friends from CIM and they are excellent doctors. The younger generation does not necessarily imbibe this seemingly blinded sense of superiority. However, I cannot guarantee the same for the older ones.
To intern, I was only referring to the Surgery training. No generalization intended. I am not in the position to say that this"culture" is present in all departments since I only had my pre-residency training in Surgery. And this was my experience.
DeleteThanks for your feedback!
DeleteIt has always been my thinking that more residents and fellows from other institutions are being accepted in PGH not only because they have "made the cut" but because a lot of our fellow UPCM grads have opted to seek further training elsewhere.
DeleteThank you Dr. Chong for this article. I am also an alumni from UP-PGH, and frankly, I'd say most graduates from our institution develop a certain superiority complex, if not delusions of grandeur.
ReplyDeleteTruth be told, PGH produces remarkable doctors because the applicants it accepts are remarkable to begin with (i.e. cum laudes, board top-notchers, etc who are bound to achieve great things regardless of their medical institution). How big was its contribution to their becoming remarkable, we would not know. But this I tell you -- and anyone who aspires to get into PGH -- throughout my years in the hospital, I have witnessed many, many colleagues who got extremely disappointed with the system but did not back out just because "nasimulan na." In the end, they became bitter and their quality of life suffered. People keep on ranting amongst themselves, but could not share it up-front lest they get flagged.
No wonder the valedictorian of class 2013 could not help but become ungrateful in his speech.
I've wondered before if it was more of an intellectual cumulative advantage than actual schooling. Unfortunately, there's no way to determine that empirically. I wonder what the valedictorian said? I can't find it online...
Deletei agree. I find it more impressive how other medical schools accept average and sometimes even mediocre students and then consistently get high passing rates during board exams. That's proof enough of the quality of medical education that you get. A strict screening process says nothing about medical education and training.You might be rubbing shoulders with the so called cream of the crop, but that doesn't mean you are getting the best medical training possible.
DeleteMaybe he wrote it at the height of his emotion, that he was not able to recognize the other side. He previously posted nasty rantings of his insurmountable ward works in one of his rotations in PGH.
ReplyDeleteI wonder how other non-PGH interns feel about not ever considering PGH. Does it make them feel less of an intern that they ahould be?
Where can the valedictorian's blog be viewed? I'd like to see what he wrote.
ReplyDeleteI don't think he has a blog. He delivered it in his valedictory address, irking many personalities in the field.
DeleteSir i'm not from UP but I got in PGH without "backers" and politics, and I was never treated as an outsider despite the fact that I did not do my internship there. Though I appreciate Dr.Ting's insights, I agree with you that every training institution has their own strengths. I think consultants in UP now recognizes this that's why more and more non UP grads are being accepted based on their performance. PGH has a lot to offer but it does not offer everything.
ReplyDeleteI got accepted without backers and politics as well, and although i myself was never treated as an outsider, i heard people around me say more than once (maybe they forgot i was around?) a comment like - "Ah, magaling rin pala yung school na yan." Or the exact comment "Ang galing niya, hindi UP yan ha!" It always made me wonder if i was truly "in" or if similar comments were being made behind my back. Maybe not though, i was never really a good intern hahaha!
DeleteGaling ako ng PGH. Lahat talaga ng rationalization ay sasabihin namin upang kumbinsihin ang sarili na tama ang aming napasukan. Kaya kung ako ang magbabasa ng mga comment, mas maniniwala ako sa mga UP graduates na nagbigay ng negative comment kaysa taga-UP na inaangat at ipinagtatanggol ang sariling bangko.
ReplyDeleteGaling sa UPCM Class 2007. Iba talaga ang kultura dyan sa PGH. Mayayabang. Pataasan lagi ng ihi yung mga tao dyan. Grabe din ang pamumulitika dyan. Oo, may mga magagaling na mga doktor dyan pero nasasapawan ng mga doktor na masasama ang ugali. Masyadong bilib sa sarili pero wala naman ibubuga. Dinadaan lang lagi sa pagsisigaw, sa pagmumura. Tingin nila siguro sa ganyan paraan matututo ang tao.
ReplyDeleteIto ang nangyayari sa loob ng PGH. Am I being cynical? No, I am just being honest. And this is my view.
Thanks for the feedback.
DeleteGrad from UP Diliman here and in my late plan of getting into medical school, stumbled upon this blog. In response to this: "Iba talaga ang kultura dyan sa PGH. Mayayabang. Pataasan lagi ng ihi yung mga tao dyan. Grabe din ang pamumulitika dyan. Oo, may mga magagaling na mga doktor dyan pero nasasapawan ng mga doktor na masasama ang ugali. Masyadong bilib sa sarili pero wala naman ibubuga. Dinadaan lang lagi sa pagsisigaw, sa pagmumura. Tingin nila siguro sa ganyan paraan matututo ang tao.
DeleteIto ang nangyayari sa loob ng PGH. Am I being cynical? No, I am just being honest. And this is my view."
I guess this kind of culture does not only thrive in PGH. I remember feeling the same "kaangaasan" or "kayabangan" from fellow UP-ians back when I was still in UP Diliman. But being one of the students there, I totally thought it was "normal" until I took my MBA at the UST Graduate School. Two of us were graduates of UP Diliman and I noticed the same thing from him ("maangas" or "mayabang") the first day of class when we had to introduce ourselves. And I just had to breathe to myself "typical UP angas." Taking my masters in a different school was an eye-opener. I met equally smart students outside UP, some of them were even graduates from the provinces. And if you are going to ask me who taught better? I'd say my professors at the UST Grad School were better teachers, not because of their credentials (most of them were practicing businessmen while others were Harvard graduates) but because they really know how to teach. The training I got was excellent. I learned a lot from them especially in accounting though I was a journalism graduate. I could not help but compare to the training I got from teachers in UP when I was still a frosh in UP Diliman. I wouldn't forget my Math I teacher who left us once with questions more than teaching us on a certain math problem. Now I wonder why would a teacher choose to let his students suffer than help them learn? Students are supposed to be guided along the way, especially if the subject is hard. My journ degree did not afford me much training to understand business and accounting terms but I am proud to tell everyone that I accumulated excellent grades because my teachers taught so well.
When will UP students accept and learn that UP is not the only outstanding institution where students get excellent education or training in any field? If I am not mistaken, it is actually the students, not the educational training, that give UP the credence of being the most outstanding institution because only students of outstanding performances get accepted, and not vice versa. I guess it's high time UP students woke up from a delusion that UP graduates are the only ones who excel in everything.
Thanks for the feedback, and good luck with medical school!
DeleteAnother blog is making the rounds in Facebook. It was written by Fred Ting's block mate. It's a lengthy read. It is from a Dr. Rivera.
ReplyDeleteCan you link to the blog?
Deletehttp://apiculturist.tumblr.com/post/83979826004/up-medicine-the-un-easy-life
DeleteThanks for posting that. A lengthy read but definitely worth it.
DeleteSir I would just like to say a something regarding this with all the negativity that I have been reading and forgive me if it’s a little bit off topic but I just have to share them
ReplyDelete1. Let me make it clear that I am not from UPCM; I did my internship in a private hospital but was lucky enough to have my residency in PGH and Fellowship abroad.
2. A lot of anti-PGH sentiments have been going round social media sites and some of them are really unfair. We have to keep in mind that it is not only in PGH where people size you up. I did my internship in a private institution and they did the same. It happens everywhere.
3. The superiority complex we see in UP graduates sometime is a reflection of our inferiority complex. I mean I was never treated inferiorly during my training because I never let them. I showed them that we were equals and our consultants treated us all the same. I pulled my weight and did the work like everybody else and was never treated differently
4. Hindi lang ang mga taga UP and mayabang, minsan yung hindi pa nga taga UP yung nagyayabang. I say this because I have batch mates in residency who really excel yet they have never made anyone feel that they are below them. And to say that mayayabang ang mga tao sa UP is really downright unfair
5. Hindi lang mga taga ibang school ang pinahihirapan sa PGH. People may say that they were single out but I have seen UPCM graduates getting cut out of residency programs because they are not doing their job well. Hindi lahat ng umalis o nag quit sa PGH eh pinahirapan or pinersonal. May rason kung bakit sila napapagalitan at nasisigawan, reality is some of them did not perform well, but the blame always goes to the institution and its system.
6. While I agree to some of the things in Dr. Tings post. I do not agree on how he presented it. Mayabang ang dating. But it’s just one opinion. It’s not a fact. I don’t think future PGI will decide on going to PGH based solely on his blog post. Let us give g\credit to these young adults that they can be able to decide for themselves where they are most likely learn during internship. Let’s not sya “baka isispin ng mga bata na sa PGH lang may magagaling” because they know this to be untrue.
7. There is no registry that the best and the brightest go to UP PGH. And I agree with Dr. Chong not all of them even want to go to PGH. The reason why Dr. Ting thinks so it’s because a lot of the university’s graduates grew up to be great academes and leaders in their own fields, like Drs Ariniego, Litao, Cueto, Cagampan ect. ect.
Why am I stating these points? The post of Dr. Ting is a reflection of the institution through his eyes. We may not agree on the way he chose to present it but it’s just an opinion not a fact, let us not act like it is so. And ganging up on the Institution is just downright wrong. It’s not about the pen …but about the writer in the end.
To Dr. ting – I wish you good luck and hope that you learn a lot from PGH, but keep in mind that other institutions may teach you something magnificent as well. I only pray that you keep your passion in helping out our kababayans
To Dr. Chong – Thank you for giving us insights on the other side of the coin. I know you may not agree with me sir but I’m ok with that. I shall now leave your beautiful pages before I stepped on someone else’s ego and be replied to with another post (“Why I do not agree with you Dr…”)
Thanks for the comment! Don't worry about stepping on my ego, it's been broken for years hahaha.
Deleteagree, especially with the parting message.
DeleteEach one of us, at some point in our lives, was a part of the PGH community. Maybe our timelines crossed for awhile. Our experiences our unique to us. Unique because we are different from one another. They way we see things are never the same. Some of us were called interns. While some were collectively called externs. Our perspective is different and our perspective may change over time. All the comments posted, I believe are true. No one can say otherwise as these are the sentiments of the writer. There are very good consultants in PGH and there are also downright rotten ones. Good for you if you never encountered one who has this superiority complex and condescending manner. But to those who were belittled, cursed at repeatedly, and treated like a ....., I believe you too. And I just hope that your experience made you a stronger person.
ReplyDeleteDr. Chong, I commend you for being brave enough to write about PGH as you saw it. It is never difficult if writing comes from the heart. I have heard a lot of negative comments in the past but remained hearsay only. It is about time the other side of the story is laid out.
ReplyDeleteLooking back at my medical training, from clerkship until i've finished fellowship, going to UP PGH for internship is something i wish i could change. There are so many other hospitals that give better training during internship. In PGH, learning is basically non existent. You are basically there for scut work. Anyone who says other wise is just a narrow minded UP die hard or someone who is so out of touch with reality. I would agree that residency training for most programs in PGH are a cut above the rest, but their internship training program can only be described as MEDIOCRE when it comes to medical training. If these UP grads need further proof, let them try moonlighting for a bit. Ask any staff in most secondary hospitals that offer moonlighting jobs, UP grads are notorious for being only good at theoreticals and seem like lost puppies when it comes to actual patient management.
ReplyDeleteBut we have to forgive Dr. Ting for being so naive. He has just graduated after all. In about 5 years or so hopefully his eyes will be open, and he would realize that he had written such a foolish and narrow minded article.
I'm from UP too and I believe that we should have been given the freedom to choose where to have our internship. If their idea of service to the country means stripping off our freedom of choice, I guess they should explicitly include this in the Alma Mater's mission and vision.
DeleteAgreed.
DeleteI was an extern at PGH almost 20 years ago. An extern was the term used to refer to medical students from other institutions doing internship in PGH. Is this term still being used nowadays? Anyway, I decided to do my internship at PGH thinking I would get more hands-on management in the treatment of patients. I was wrong. What I did was basically the same as what I was doing when I was a clerk at my institution. The closest experience I had to managing a patient was when it was my turn as JAPOD (jr admitting physician on duty) during IM rotation. My whole year as PGI was spent doing scut work. I was usually in rubber shoes since I was usually on my feet going around PGH. And I never liked roaming around the halls of PGH at night. It was so dark!
DeleteThe politically-correct term is now "post-graduate intern," although people still use the term "extern" from time to time.
DeleteI see. I guess there is still discrimination present if "extern" is still used from time to time.
DeleteI was also a postgraduate intern in PGH as well 15 years ago. Did my premed in UP, med in UE, and went back to UP thinking that, hey, I know most of the folks in my batch so I really didn't expect that there will be any sort of discrimination. But the reality was that there WAS a distinct thread of discrimination against interns coming from other institutions, whether the UP folks will admit it or not. "Extern" was a term I heard often, and it was used in a derogatory way. We were already supposed to be called "postgraduate interns" by then. And in yet another example, I was rotating in neurosurgery during residency application season and a friend of mine from UE applied to their neurosurgery residency program. He was head and shoulders above everyone else, and I was the PGI who inadvertently became the fly on the wall when they talked about my friend's application during one of their M&Ms--one attending said he won't vote to accept my friend because, and this is a direct quote: "He was too good to be true." I was so disgusted. Someone here made a comment that he was an outsider who did his residency in PGH and he never felt discriminated against, but chances are, he applied in programs that are not as competitive--family med, IM, peds--where they are desperate to get a warm body and will take practically anyone who has an MD attached to their name.
DeleteThere were a lot more patients than what I would have seen had I stayed in UERM, but the added exposure did not necessarily translate in more learning for me. It was almost like a Ripley's Believe It or Not Museum of the exotica, and these patients were the type you talk about during drunken sessions--"Talo ka pare, may nakita akong..." Resources were so scarce you really can't do anything for most of the poor patients anyway. Lack of compassion to patients was extremely pervasive due to overwork and stress. The "learning" you pick up may or may not be correct since what they teach you are not always the correct management. Lots of scut work, but how many IV lines do I really need to insert to become a successful physician? I'm glad I bit the bullet, took the MLEs and did my residency and my fellowship in the US, where I ended up in Ivy League institutions and unlearned the mistakes taught to me. I'm now a subspecialist in an academic institution, where the roles are ironically reversed: I occasionally get random emails from PGH graduates begging me to help them get "US clinical exposure", being someone they look up to now. I left the Philippines because of the pervasive padrino system, and if anyone wants to be successful in the US, they have to accept the system of meritocracy here.
I still keep in touch with a lot of my co-interns who are now practicing, and unfortunately, those who are still back in the native country still carry this superiority complex that PGH is still the best...I wish I could tell them that, no, they aren't, and they really need to get off that "PGH is Best" mindset if they want to get their standards within touching distance of what the first world can offer. It's a big fish in a small pond mentality. Seeing more patients doesn't necessarily translate to becoming a better physician. I asked someone once why they continued the practices which we abhorred when we were still interns, and the only answer I get is "because it's tradition and should be handed down." I am saddened by the lack of critical thinking. And now that I am a US-educated, licensed academic physician and see the way they manage patients-- I feel truly sorry because their constant need to validate and pat themselves in the back prevents them from becoming better physicians at par with the rest of the developed world.
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DeleteInternship in PGH is basically clerkship part 2. How can you say it's internship when save for a few days in a few rotations, you basically do the same jobs as clerks in PGH? There's a reason why patients only have SICs (students in charge) and no separate clerks in charge and interns in charge. It is because clerks and interns do the same job! Di ba napansin yan ni Intern Ting? buti pa nga ang clerks excused during the afternoons for lectures. at least sila may learning. To those guys who want to repeat their clerkship, go ahead and do your internship in UP PGH. No one's stopping you. But to those people who want to "level up" on their medical training, better seek internship training elsewhere.
ReplyDeleteI just read through most of the comments and I have to say that I agree to most of them. On one side, I get to hear all the glam and glory of UP-PGH in terms of training. On the other side, I see the dark shadow of the critically-acclaimed institution. Truthfully, it's hard to say whether I like the system or abhor it. I'm not a UP-PGH graduate but I took my Post-Grad Internship there and a part of my residency there and I must say that it was like riding a roller-coaster, it has its ups and downs and it has its crazy and silent moments. On the positive side, you get to see a lot of cases here. Hand down to this really. You get to see exciting, rare and bizarre cases usually having not less than 3 lines of clinical impressions and diagnoses on the chart. You get to manage some of them really and you get to feel like the primary physician. During my time also (Batch 2010-2011 PGI), there's not much hierarchy in contrast to the other comments that I have read. Most of my residents were accommodating but a few were really unbearable in terms of their demands and their attitude. My co-interns from UPCM were also nice as well. The negative aspect though are a lot to be desired though. Despite the cases you see, due to toxicity and stress, you can't really read on all of them. Some of your residents/co-interns expect you to be stellar...on a post duty status. Haha! I have mentioned that my co-interns from UPCM were nice but the population is divided from the most nice to the most the most unbearable. There's is a sense of superiority sometimes but it does not bother me that much. Oh yeah, being an intern here is like being a super-clerk. Same job description with the clerks but with added responsibility. I can't say I hate doing scut work or extract or even do ABGs and IV line insertions but doing this while knowing some nurses haven't even tried to insert the IV line was utterly ridiculous. It's like they just sit there and warm up the chair while charting. The only ward I know that nurses do there job well were the Neuro ward and Neuro ICU. Also, learning is not conducive in this institution. Clerks are prioritized over interns here. There should be equal opportunities to be given for both levels. Consultant supervision is nearly absent if not for the rounds during IM or Pedia rotation. Also, PGH is ISO certified and yet a lot of equipment, utilities and a simple form usually runs out easily. Management of patient is also non-ideal as you will always do the alternative one. Truthfully, there were other things needed to be pointed out but those I have stated above were the ones that strikes me most. In reality, PGH is just another hospital really with its pros and cons. It's up to the incoming PGI if they want to train here or not. They just have to know what they'll be entering. And for my final note, UP-PGH is just like being a "brand". It gives a sense of false advertisement sometimes. I'm not saying that the graduates are bad or anything since a lot of doctors from PGH are really good but it doesn't mean that if you're a non-PGH grad, you're mediocre in comparison to them. So to those reading these, you don't have to worry if you graduated or took your internship here or not. What matters is your medical practice after you finish all of these. Then you can gauge whether you're mediocre in comparison to them or not.
ReplyDeleteA testament that UP PGH is not the best training institution as they keep on claiming to be: http://www.prc.gov.ph/news/?id=810
ReplyDeleteCase in point: if you want to become a good laborer, go to PGH. If you want to become a good doctor, go elsewhere (unless you are a true genius and would excel regardless of your training institution, that is).
Thanks for that link. I haven't really kept abreast of the board exam trends.
DeleteE, kung ayaw di huwag ;-)
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DeleteI agree... well said, Dr. Chong
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