Medical-Surgical Education

MEDICAL-SURGICAL EDUCATION

Medical-surgical Education – ROJoson’s Exceptional Achievements and Excellent Contribution to Society in the Local, National and International Level

How ROJoson Got Involved in Medical-surgical Education

During ROJoson’s surgical residency years in the Philippine General Hospital (PGH) from 1976 to 1981, with a positive influence from his late mentor, Dr. George Eufemio, he got into medical photography as a habit for documenting his learning experience. He would take slide pictures of the patients he had seen and operated on as well as surgical specimens and diagnostic images. With the slide pictures, especially those interesting ones, he would make use of them in teaching, particularly medical students of the UPCM rotating in the Department of Surgery of PGH. He would also make use of them in making case reports and case series and other research papers as well as in surgical conferences. A memorable example is during his senior surgical residency year, he was invited to give a lecture on Management of Facial Injuries using his collection of slide pictures in a joint Department of Orthopedics and Department of Surgery Seminar (Advances in the Management of the Multiple Trauma Patient) in December 12, 1980.

After graduation from his general surgery residency in 1981 from PGH, he was invited by Dr. George Eufemio to become a faculty staff of the UPCM and PGH. This marks the start of ROJoson’s journey in the field of medical-surgical education.

ROJoson’s Achievements and Contributions to Society in the Local and National Level

From 1982 to 2019 (37 years), ROJoson was deeply involved in medical-surgical education to undergraduate medical students, surgical residents and fellows, and medical school faculty. He has taught basic medical education (Surgery and Management); general surgery (for residents); surgical oncology and head and neck surgical oncology (for fellows); and medical profession education (for medical school faculty).

He has done at least the following:

· Faculty and consultant, UPCM and PGH (1985 – 2014 – with post-retirement appointment up to present - 2019)

· Faculty, Medical Education Unit, UPCM (1993 to 2014)

· Director, Postgraduate Institute of Medicine (1989-1991)

· Chief, Division of Head and Neck, Breast, Esophagus, and Soft Tissue Surgery, Department of Surgery, Philippine General Hospital (July 13, 1994 - 2000) (Acting Chief – 1992 – 1994)

· Chairman, Committee on Graduate Program, Department of Surgery, UP College of Medicine (2004 – 2014)

· Chairman, Year Level 7 Committee, UPCM (1988)

· Supervising Training Officer, OMMC, 1992 to 2000

· Consultant, Department of Surgery, Ospital ng Maynila Medical Center (1989 to 2014)

· Chairperson, Department of Surgery, Ospital ng Maynila Medical Center (2001 – July 11, 2009; 2014)

· Chairman Emeritus, Department of Surgery, Ospital ng Maynila Medical Center (2010 – 2019 - )

· Consultant, Department of Surgery, Manila Doctors Hospital (1984 to present – 2019)

· Training Officer, Department of Surgery, Manila Doctors Hospital (1985 to 1987)

· Consultant, Department of Surgery, ManilaMed (1982 to present – 2019}

· Designer and Developer of an innovative medical curriculum (problem-based, competency-based, community –based) and Faculty Trainor of Zamboanga Medical School Foundation / Ateneo de Zamboanga University School of Medicine (1993 – 1996)

· Designer and Developer of a Distance Education in General Surgery, Zamboanga City Medical Center (1991-1997) – with a pioneering project in telemedicine

· Director, A General Surgery Course in Tondo Medical Center (1993-1995)

· Educational Consultant, Problem-based Learning Curriculum, Bicol Christian College of Medicine (1995 to 2013)

· Educational Consultant, Problem-based Learning Curriculum, Southwestern University College of Medicine (1995 - 2000)

· Examiner of the Philippine Board of Surgery (circa 1985 to 1997)

ROJoson has used the following teaching-learning strategies and activities in his medical-surgical education:

· Large group learning

· Small group learning (inclusive of small group discussion)

· Individualized instruction

· Active learning

o Problem-based learning (See ROJoson’s Pioneering Effort in Problem-based Learning) [Links: https://rojosonmedicaleducation.wordpress.com/2017/05/12/problem-based-learning-in-medicine-rojosons-notes/; https://sites.google.com/site/problembasedlearninginmed/home; https://rojosonmedicaleducation.wordpress.com/2017/05/25/incorporation-of-the-problem-based-learning-approach-into-the-present-year-level-iv-surgery-curriculum/; https://rojosonmedicaleducation.wordpress.com/category/problem-based-learning/]

o Self-directed learning

o Demonstration and return demonstration

o Debate (See ROJoson’s Pioneering Effort in Debate as a Teaching-learning Activity) [Links: https://rojosonuppghgs1filesandnotes.wordpress.com/debate-as-a-teaching-learning-activity-in-a-department-of-surgery-in-the-philippines/; https://rojosonuppghgs1filesandnotes.wordpress.com/2013/07/29/tele-debate-pgh-gs1-and-zcmc-breast-cancer-october-3-1994/]

· Lecture

· Blended learning (combined face-to-face and online learning)

· Distance education in medicine and surgery [Links: https://rojosonmedicaleducation.wordpress.com/2017/04/03/distance-education-in-medicine-rojosons-course-pack/; https://sites.google.com/site/rojoson70memoir/distance-education-in-general-surgery---an-accomplishment---a-legacy; https://rojosonommcsurgeryfilesandnotes.wordpress.com/2018/04/02/distance-and-on-line-education-in-a-department-of-surgery-in-the-philippines-abstract/]

· Narrative Medicine (See ROJoson’s Pioneering Effort in Narrative Medicine – Medical Anecdotal Reports) [Links: https://www.slideshare.net/rjoson/medical-anecdotal-report-as-a-teachinglearning-tool-to-develop-holistic-professional-and-compassionate-physicians; https://www.scribd.com/document/251392007/Medical-Anecdotal-Reports-Volume-1; https://www.scribd.com/doc/251391679/Medical-Anecdotal-Reports-Volume-2; https://ommcsurgerymar2017.wordpress.com/2018/03/29/completion-of-rojosons-project-medical-anecdotal-reports-march-29-2018/]

· Modules and self-instructional programs, printed and online

· Books

ROJoson has pioneered the following innovative teaching-learning strategies in medical-surgical education in the Philippines:

· Problem-based learning in medicine and surgery

· Innovative medical curriculum – problem-based, competency-based and community-based medical curriculum

· Distance education in medicine and surgery

· Debate in teaching and learning surgery

· Narrative medicine (Medical Anecdotal Reports)

ROJoson was responsible for the establishment of the first Head and Neck Surgical Oncology Fellowship Program in the Philippines in 1990 [Link: https://rojosonuppghgs1filesandnotes.wordpress.com/category/head-and-neck-surgical-oncology/].

He also established the first formal Surgical Oncology Fellowship Program also in the Philippines in 1994. [Link: https://rojosonuppghgs1filesandnotes.wordpress.com/2015/09/20/surgical-oncology-fellowship-program-pgh-gs1/]

ROJoson has received the following awards and recognition in medical-surgical education:

· UPMAS 2003 Outstanding Educator Award

· UPAA 2004 Professional Awardee in Medicine

· UPAA 2015 Lifetime Distinguished Achievement Awardee

· Lino Ed Lim Award for the Most Outstanding Medical Teacher in Clinical Sciences – UPCM – 2004

· Most Outstanding Teacher in Oncology – Philippine Society of Oncology – 2006

· Centennial Professorial Chair, UP Manila – 2008

· Recognition of ROJoson’s Contribution to Zamboanga Medical School Foundation (ZMSF) / Ateneo de Zamboanga University School of Medicine (ADZU-SOM) – 1994 - 2019

· Finalist, Dr. Jose P. Rizal Memorial Awards in Academe and Research, Philippine Medical Association – 2004 and 2005

· Hall of Fame Award, Surgery Consultant, Department of Surgery, PGH – 1986

· 4^th Dr. Rodolfo C. Dimayuga Memorial Lecturer, Angeles University College of Medicine - February 22, 2001

· 16^th Alfredo T. Ramirez Memorial Lecturer, UP-PGH Department of Surgery - September 7, 2016

IMPACT:

Overall, ROJoson’s medical-surgical education endeavor promotes development at least if not produces, rational, effective, efficient, cost-effective, compassionate and community-oriented physicians and surgeons in the Philippines. This redound to better or improvement of health care delivery services in the Philippines through the medical and surgical students that he has positively influenced.

ROJoson’s Narrative Medicine Project (Medical Anecdotal Reports) promotes development of holistic, professional and compassionate surgeons for the trainees in the Department of Surgery of Ospital ng Maynila Medical Center.

ROJoson’s Distance Education in General Surgery in Zamboanga City Medical Center from 1991 to 1997 has produced 7 trained general surgeons added to the pool of 3 original trained surgeons that served the 3 million population of Western Mindanao in 1997.

ROJoson’s designing and developing the innovative medical curriculum (problem-based, competency-based, community –based) of Zamboanga Medical School Foundation / Ateneo de Zamboanga University School of Medicine (1993 – 1996) has produced the following outcome and impact:

· Majority of graduates are practicing in the region - 80% are practicing in the underserved municipality in Western Mindanao.

· Graduates are serving as municipal health officers in underserved communities in the region.

· 55% increase (n=20 to 31) in the number of municipalities of Western Mindanao with a doctor, mostly graduates of the medical school.

· Improved infant mortality rate in the region. The information that I gathered, the infant mortality rate in the region has decreased by approximately 90% in 2011 compared with a national change of approximately 50% in the same time period

· First medical school in the Philippines with a dual MD-MPH degree program which started in 1998; has produced 381 MD-MPH graduates as of 2018.

· 2nd medical school that has offered a Master in Health Profession Education in the Philippines; has produced 16 Masters in Health Profession Education from 1999 to 2018.

· The medical school is has a Charles Boelen International Social Accountability Award from the Association of Faculties of Medicine of Canada (AFMC).

· Feedback of Dean Fortunato Cristobal on the 25^th anniversary of the ZMSF/ADZU-SOM in July 2019:

o “I still feel that ADZU SOM owe much to you for setting us 25 years ahead of the rest of the Medical School in the country. What they are talking now about Terminal Competencies, 5 star physicians and Outcome Based education, OSCE etc, you had well articulated them in the ADZU SOM curriculum. These cannot be erased in our history."

o "Looking back your mind set was way ahead of our times by 20 year+. It is only now the other medical schools are considering seriously about Terminal Objectives, and about the 5-star physicians, when in fact you were the first to introduce the terms: Physician Clinician, Physician Manager, Physician Researcher, Physician Leader / Manager, and Physician Teacher ..... You were also the first to introduce PBL, competency-based, and COME curriculum in the Philippines, not to mention assessments like OSCE."

ROJ@19sept28