The Official School Publication of Xavier University - Dr. Jose P. Rizal School of Medicine A.Y. 2018 - 2019
Table of Contents A.Y. 2018 - 2019 Editoral Board: Ian Gabrielle Cuyno. Editor-in-Chief Nomaelle Jenn Valencia. Associate Editor Roch Angelo Bandala. News Editor Fretzene Arances. Feature Editor Jonathan Estorba. Photographer
3 Editorial 4
APMC - Student Network Updates
6
A new vaccine
Photo Contributors: Dan Exerlin Bonete Mary Rose Estrada Felix Benedict Fabunan
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Passion and Excellence
Staff Writers & Contributors: Kathleen Ann Acma Jaime Asuncion Mickaela Frances Daclag Maricor Gin Edma Diovince Paulo Kinaging Princess Shajehan Macabunar Ayesha Radam Pauline Blaise Roxas Princess Antonette Sotelo Karen Tanseco
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Moderator Dr. Agaton Panopio, Jr. Publishers: Subscribing students of Xavier University - Dr. Jose P. Rizal School of Medicine Circulation: 500 copies For inquiries, contributions, comments and suggestions: Publication Dr. Jose P. Rizal School of Medicine, Xavier University - Ateneo de Cagayan Mortola - Hayes Streets, Cagayan de Oro City, 9000 connexus.jprsm@gmail.com /connexusjprsm
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5 News 7 10
12 16 17 18
20 20 21
22 23
Break the Wheel
Medicine and More Portfolio
No Longer the Underdogs From Ink to Scalpel
Medicine and Motherhood
Batch Advocacies ‘18 - ‘19
XU - JPRSM Mental Health Agenda The APMC-SN Semicolon Project Reading Assignments Entertainment Corner Review of Systems
The Cover Starbooks. A haven in the Medicine Building for exhausted medical students who want to relax and talk with friends over some coffee and ensaymada. Hundreds of medical journals and books line its walls, in stark contrast to the future doctors who go here to take a break and breathe, whether coming from or going towards yet another exam or lecture. No matter how busy medical school gets, one should always find some time to breathe, get coffee with a friend, and laugh over the latest gossip. The road to medicine is hard but one shouldn’t have to be too hard on oneself; after all, doctors are human too. Words by Ian Gabrielle Cuyno Photo by Jonathan Estorba Models: Carene Joy Sera, Edinah Nadell Cagas
EDITORIAL
Beneath the White Coat New York Times ran an article last April 29, 2019 entitled “Why Your Doctor’s White Coat Can Be a Threat to Your Health”. The said article mentioned various studies pointing out that the white coat is a particularly dangerous fomite, carrying numerous pathogens from one patient to another. No less than the American Medical Association has long studied the possibility of abandoning the long white coat, much to the chagrin of doctors. One doctor puts it succinctly: “The coat is part of what defines me, and I couldn’t function without it,”. This reaction is not entirely unexpected: after all, white coats have a crucial role in the mythos of the medical profession, signifying the integrity and professionalism of the wearer. It is also seen as a status symbol, earned after over a decade of education and training, and thus seemingly marking the wearer to be above everyone else in the hospital. According to studies, while 25% of physicians wear the white coat to be easily recognized in the hospital, 7% wear it primarily to reinforce their status as doctors. No wonder then that the word “clinical” also means coldly detached. It could also be argued that the white coat is the physical embodiment of the physician-patient barrier, lending its name to the eponymous White Coat Syndrome. To be a doctor is to put the health and welfare of others before oneself; why is it then that some doctors place more value on white coats than patient safety? Why is it that doctors continue to wear their white coats even in settings where these are not needed such as outside the hospital, violating the principal doctrine of medicine: primum no nocere (Do no harm)? While the road to a medical degree is undoubtedly not easy, does this justify the perpetual wearing of the white coat, seemingly as a bragging right? Despite some doctors, such as pediatricians and psychiatrists, forgoing the white coat in order to close the gap with their patients, white coats are unlikely to be abandoned any time soon. However, what needs to go is the attitude of doctors towards the white coat, and to an extent, to the medical profession itself. Doctors need to be comfortable without their metaphorical white coat - without the status, prestige, or power that comes with being an M.D. - in order to be able to truly serve humanity. Doctors also need to learn to let go to let go of their white coats every once in a while, and embrace their inner self; they are not just doctors, they are also parents, partners, friends. Medical training should put this into consideration, allowing for a less stifling schedule with actual breaks or rest periods in order to allow doctors to simply be themselves, without the burden or the expectations that come with the white coat. ■
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NEWS
APMC - Student Network Updates XU-JPRSM joined the 8th Association of Philippine Medical Colleges – Student Network (APMC-SN) Regional Convention, hosted by Brokenshire College of Medicine last January 18-20, 2019 in Davao City, with the theme “GIYA: Gearing towards Bolder Mindanaoan Physicians.” Highlights of the event include the Mindanao leg of the Semicolon Project, a national
caravan on mental health, and new nonacademic events, such as the Med Groove / Med Rhythmia Competition (MGMR), in which XU-JPRSM won 1st Runner Up for both contests, and the Medlympics. National Convention The APMC-SN 52nd National Convention was held last February 9-10, 2019 at the De La Salle Medical Sciences and Health Institute, Cavite, with the theme “ADLAW: Fostering
Mental Health in Medical Education”. This year’s convention focused on Mental Health, with plenary session topics such as Suicide Mitigation, Community Mental Health. Ben Aguilar won 2nd Runner Up in the National Medical Student Research Competition: Translational Medicine Category for his study entitled “Winning back the health of Filipino Schoolchildren: the relationships between the Department of Education’s Wash in Schools Program, School Based Feeding Program, and Philippine Informal Reading Inventory.”
XU-JPRSM hosts APMC-SN 2019 Nat’l Planning and Evaluation Seminar XU – JPRSM successfully hosted the Association of Philippine Medical Colleges – Student Network (APMC – SN) National Planning and Evaluation Seminar (PLEVSEM) last June 20-22, 2019. Over 200 student leaders from the various APMC - SN member schools nationwide attended the 3-day convention at the Xavier Ateneo Main Campus, which was also the first PLEVSEM to be held in Mindanao.
explained the significance of this year’s theme (“CIRCUM SOLEM: Around and beyond the APMC-SN”): “Bilang mga doktor, tungkulin natin hindi lamang manggamot kundi magtanggol para sa mga karapatan, hindi lamang para sa kalusugan, kung hindi para mabuhay. Ang pagtitipon natin ngayon
ang nagbubuklod sa atin patungo sa isang pangarap at isang adhikain – ang gumawa ng higit sa inaasahan para sa bayan. Let us not just make our marks, but lead the sparks that will change the community, the country, and the world. As one network, let us go around and beyond the APMC-SN.”
The event consisted of formal talks and workshop sessions aimed at promoting networking and capacity-building among the represented medical student councils in order for the student network to plan for the projects for the coming fiscal year. The gathered student leaders also discussed political issues such as the recently passed Universal Healthcare law, Philippine Mental Health Act, and the new HIV and AIDS Policy Act. During his opening remarks, APMCSN National President Leandro Salazar
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XU - JPRSM officers (represented by May Pingol, Student Council President, and Diovince Paulo Kinaging, Senior Representative) with the APMC-SN National Executive Board. Photo © Armand Ansaldo Photography.
Photo © Marzel Digital Studios
Regional Convention
NEWS
XU-JPRSM holds Blood Drive By Roch Angelo Bandala of voluntary blood donation because the country is in a state of blood supply crisis. For Region X alone, which has a population of 4,689,302 (as of 2015), it would usually need 1% of that number (or 4,689) in terms of blood units to be available for medical procedures .
Forty-eight bags of blood were donated by medical students as well as from other donors in the “Every Drop Counts: A Blood Donation Forum and Blood Letting Activity” organized by the XU JPRSM Student Council last March 23, 2019 at the Xavier University Medicine Building. Dr. Ryan Lim of Northern Mindanao Medical Center (NMMC), emphasized the importance
The blood drive was in line with the Juan Blood, Juan Life Blood Drive program of the APMC-SN. According to Emmanuel Dave Claudio, the national project head, “We want to make sure that the spirit of volunteerism will continue to grow in our schools, our communities, our regions and in our country; because every day, patients from across the country are in need of blood.” The gathered blood bags were sent to the Northern Mindanao Medical Center, the partner organization during the event, to augment their blood bank supply.
Alima 2019: Medical Mission at El Salvador City True to its motto of being “Doctors for Others”, XU-JPRSM conducted its annual Medical Mission (Alima 2019) last May 1, 2019 at El Salvador City, Misamis Oriental. Hundreds of El Salvador residents availed of the free services offered during the event, such as medical consultation, circumcision, and VIA (Visual Inspection with Acetic Acid). Medical students were given the chance to perform and assist in the said procedures, under the supervision of the XU-JPRSM Faculty. Aside from these procedures, medical students also provided blood pressure monitoring, feeding, and mini-lectures on hand washing. XU-JPRSM spearheaded the event, in partnership with the LGU and City Health office of El Salvador, Del Monte Philippines, and Rotary Club of Cagayan de Oro Premier.
CONGRATUL ATIONS!
To our XU-JPRSM graduates who passed the September - October 2018 Physician Licensure Examination: Dino James P. Abong Mariane Faye M. Acma Farrah M. Adap Fahad Emmanuel R. Ambor Abouben Jan A. Balondo Nicca Marie B. Basilio Lowell A. Batoon Hannah E. Bazer Ma. Luisa Y. Buot Aldous Dominic C. Cabanlas John Marlon M. Daguipa Clarence Joy M. Debarbo Enrique Miguel M. Degamo Merianne Mae P. Dela Cruz Christel P. Ello Ranillo V. Gamutan Jr Katrina Paola B. Guarin Yanka Patricia B. Guarin Quinzy Mae B. Guba Hannah Lyn D. Gumapon Melanie C. Hora Xuxa J. Jadol Riegel Mae C. Jaraula Melanie F. La Victoria Naimah O. Lomondaya Justin Reene R. Magallon Katrina Gracia B. Mangubat Adrienne Nicole S. Militante Donald V. Naldoza Aljane B. Nano Juan Miguel S. Nellas Imma Kristine L. Nonot Mark Dell H. Ompad Ma. Abigael B. Ong Heirah J. Pagalan Ariane Cel Feb R. Pagaura Abulheir M. Paitao Zacaria B. Pario Jr Neil Roger T. Pascua Bj Grace Marie A. Pitogo Katrina May S. Plaza Marra Elysse V. Rico Frederick B. Rivera Dulcenia G. Soloveres Beardmore J. Tagarao Luv Roed T. Tahil Janice Rachelle C. Tan John Robert B. Ty Louisse Lynn Antoinette V. Young XU (First-Timers): 49/49 (100%) National: 3,717 / 4,542 (81.83%)
The activity gave XU-JPRSM students the opportunity to deliver health services to the community, in line with the school’s mission of addressing the health needs of society, particularly in Northern Mindanao.
To our March 2019 Examination passers:
Physician
Licensure
Niña Daffodil C. Gawat Mary Diana Rose L. Sablaon XU (First-Timers): 2/2 (100%) XU (Total): 2/3 (66.67%) National: 1,209/1,579 ((76.71%)
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OPINION
A new vaccine By Ian Gabrielle M. Cuyno Despite efforts by public health officials and the medical community, vaccination rates worldwide have plummeted, undoing decades worth of successes in disease prevention and control. In the Philippines, the Dengvaxia issue could be considered as the inciting event, while in the Western countries, antivaxxers (anti-vaccination advocates) are gaining clout alongside other science denialists. Why would people suddenly mistrust vaccines, and by extension, the medical and scientific community? The answer is simple, but unfortunate: misinformation spreads faster than any virus could. With regards to Dengvaxia, Health authorities such as the DOH and UPPGH tried to reassure the public, by giving thorough explanations through press conferences. However, the expert panel did not stand a chance to Acosta’s impassioned claims painting the vaccine as the culprit, nor to the public that have already made up their minds to side with Acosta. After all, she wept alongside the childrens’ parents, which in this country is a guarantee that the public will be on your side. The Dengvaxia issue is more than just a medical or technical issue; it is a textbook example of a political issue tainted by Post-truth politics and media hype. Post-truth is defined by Cambridge Dictionary as “relating to a situation in which people are more likely to accept an argument based on their emotions and beliefs, rather than one based on facts”. Today’s media environment can best be described as a non-selective medium (pun intended): statements and ideas are broadcasted across all platforms, regardless as to who said them, regardless if they are true or not.
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Whether you’re a medical doctor, or a keyboard warrior, or a random netizen, your comments or opinion will only matter to another person if they fit their preconceived notions; it will take nothing short of a miracle for a netizen to actually change their mind.
or no medical background may be able to understand it. The challenge for doctors now is how to engage the public & relay accurate medical information, without resorting to sensationalism or clickbait. Several physicians are already using
“Sadly, in this post-truth era, public discourse is no longer about credentials or credibility or even truth; it’s about who could grab the public’s attention and provide answers in 280 characters or less. But, one might ask, medical doctors trained for much longer than the average netizen; their practices are rooted on evidence-based medicine. Shouldn’t their opinion matter more compared to non-doctors? Why is evidencebased medicine even competing in the public arena alongside the emotional or pseudoscientific claims of non-experts? Sadly, in this post-truth era, public discourse is no longer about credentials or credibility or even truth; it’s about who could grab the public’s attention and provide answers in 280 characters or less. Instead of digging their heels in their ivory tower, members of the medical community should learn to step up their game: media (in all its forms) is simply a tool, albeit an incredibly powerful one especially in information and education, and public health authorities will lose the narrative if they refuse to adjust to this new reality. Doctors need to remember that it is their duty to convey complex and highly technical information into a simpler form so that a patient (or a hundred million citizens) who may have limited
social media to engage the public in order to discuss issues such as vaccines, antimicrobial resistance, HIV and sexually transmitted diseases, and mental health, through online discussions, tweetorials (topic explanations in the form of a tweet thread), and even memes. However, much remains to be done in restoring vaccine confidence and improving the public’s understanding towards vaccines and other public health measures. It is an uphill battle, given the public’s bias against vaccines, and to some extent, medical professionals, as exemplified by the numerous viral doctor-shaming incidents by media personalities and private citizens. However, it is a battle the medical community cannot afford to lose: how many children have died because doctors lost control of the narrative? To prevent the next outbreak of dengue and other preventable diseases, doctors and health professionals need to administer a new vaccine to the public: one that protects against the effects of sensationalism and fake news.
OPINION
Break the Wheel By Karen Tanseco Medical hierarchy is commonplace in the field of medicine. It is the elephant in the room– it is obviously there, but nobody wants to talk about it. Medical students, being the “lowest form of animals” in the hospital, are anchored firmly at the bottom rung of this social ladder, with residents in the middle and the consultants on top. With their precariously low position in the ladder, medical students are rendered functionally powerless. Although students have a “voice,” they are apprehensive to use it. Students’ grades and evaluation – determinants of their progress up the ladder – are partly dependent on those in the higher rung.
“In this system, we are bred not to show weakness; we do not tire, we do not appear unhappy, we do not make mistakes.” The hierarchical construct is arguably one of medical education’s biggest challenges. It is not unusual to hear about that one “toxic” or “malignant” resident or consultant. Because of students’ great respect, or fear, of their higher-ups, they would rather choose to remain silent whenever they witness a questionable procedure, medication, or test being ordered rather than to challenge an obstinate resident or consultant.
Because the students’ progress are dependent on favorable reports from their higher-ups, getting on their good side now becomes a primary focus, often at the expense of other priorities such as reporting errors or potential problems, and at its crux, maximizing patient safety.
In the hit series Game of Thrones, in a genuine attempt to help the oppressed, Daenerys Targaryen said, “I’m not going to stop the wheel. I’m going to break the wheel.” In the context of the aforementioned predicament, however, we do not need to “break the wheel.”
We often hear about the healthcare system dehumanizing patients, but what about physicians or future physicians? In this system, we are bred not to show weakness; we do not tire, we do not appear unhappy, we do not make mistakes. It seems like some have forgotten that we are also human. It is an open book that medical students and doctors are more prone to depression and suicide.
Medicine needs structure, and this structure exists for a good reason. It allows for organization, accountability, and efficiency. What needs to be broken is the “toxic” hierarchy. I firmly believe that it should be balanced in favor of teaching and learning instead of exercise of power.
What if we change the structure of medicine into one that is healthier for those in the institution? What if we create a ‘safe space’ by letting the positive attributes of this medical hierarchy govern? Some would argue that since all of our predecessors have gone through the same process, why fix what’s been working for years? However, over decades, this trial by fire has brought about unnecessary stress and pressure into our learning system. This ‘rite of passage’ may have worked in the past generations, but for the mental and emotional well-being of current and future generations, this noxious practice needs to change.
Students and physicians alike function best in a nurturing environment– one where mentors teach with passion, kindness, respect, and empathy; where mentors inspire us to do our best for the sake of the patient rather than shame us for not knowing. If we medical students value this issue as early as now, we will be equipped with the right mindset to make changes in the future. We could help to positively transform the system and help steer the wheel in the right direction. The time will come for us to cut the cord and raise the level of awareness that every member of the healthcare team should be treated with respect and encouragement that would ultimately result to better health care for patients.
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CHAPEL GOALS. The graduates of XU-JPRSM Class of 2019 (Batch Invictus) are all smiles as they pose for a photo with with the Administration, Faculty, and Staff. Photos courtesy of Xavier University Communications and Promotions Office
Passion and Excellence: 33rd XU-JPRSM Commencement Exercises
Transcript of Dr. Tan-Reyes’ Commencement Speech to the Xavier University - Dr. Jose P. Rizal School of Medicine Class of 2019 (Batch Invictus) during the 33rd Commencement Exercises held last June 14, 2019 at the University Church of the Immaculate Conception of the Blessed Virgin Mary. ***
Thank you, Dean Beltran for the kind and generous introduction. University President, Fr. Roberto C. Yap, VP for Higher Education, Dr. Juliet Dalagan, Dean of the School of Medicine, Dr. Ruth SemillaBeltran, University Registrar, Dr. Verna Lago, the Master of Ceremonies, Dr Jovy Bacot, Fr Amanence, the University Chaplain, other academic officers, the faculty members of the Dr. Jose P Rizal School of Medicine, the Graduating Class of 2019, their families and loved ones, honored guests, the Ateneo de Cagayan community, ladies and gentlemen, Maayong buntag kan-inyong tanan! First of all let me thank XU-ADC administration, Dean Beltran and the School of Medicine faculty for the distinct honor and privilege of inviting me to deliver an inspirational message to the Graduating Class of 2019. I extend my heartfelt congratulations to all members of the Graduating Batch of Medicine Class 2019! Your paramount goal of becoming professionals through years of assiduous schooling has been carried out into fruition through blood, sweat and tears.
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I am honored to be here with you today to share in your joy and triumph and to witness the celebration of a new dawn in your life. This event is one of your significant milestones in your professional and personal life.
You my dear graduates and I are on the same mission. We have selected a service – oriented profession – to deliver service to humanity. It takes more than mental aptitude and erudition to become a doctor. It demands certain personal qualities, character, and values to truly belong to the medical field. Whatever career path you will go into whether as a clinician, academician, researcher, leader-manager, or health advocate or even in a non-health related career do it with passion and excellence. Put your heart into it. Do not settle for mediocrity. There is no absolute certainty of one’s destination as you go through life’s journey. You may not achieve what you aspire to be. Do not let dejection, rejection, and frustration bring you down; for every dark cloud there is a silver lining. The best laid plans do not always come into fruition. Just like the proverbial seeds, you are not planted where you want to be, but where you need to be in order for you to optimize and reach your full potential to be of service to mankind. I honestly did not dream of becoming a dean. I passed the ECFMG. I was accepted to a pediatric residency program. One could not apply for a teaching position until you get invited by our seasoned faculty. I accepted their invitation for a faculty position thinking that 2-3 years would suffice as payback time for
my student scholarship as a benefit from my father who was among the pioneer faculty and department chair of our institution. This never materialized as many graduates were leaving for US training, no additional faculty could be recruited. Through the years, I was swamped with tasks as member and subsequently chair of almost all the standing committees, including directorship of the research office to the point I was called the “superwoman”. I was diligently nurtured and mentored by then Dean Fernando Sanchez and the other experienced faculty. These prepared me for something else, I never dreamed of becoming. I rose from the ranks from Asst. Instructor to Professor Emeritus; from Dept. Chair to College Secretary to being the Dean after the position was offered twice. For my love for and loyalty to my Alma Mater my goal was to bring it to greater heights. Uncle Ben Parker (from Spiderman) said “With great power comes great responsibility”. My school is now PAASCU accredited and identified by CHED as a Center of Excellence. As your life’s journey as a doctor continues, let not your personal motivation of financial wealth be your primary goal but service to your fellow men. Bear in mind that it was through your patients that you first learned your initial clinical skills. Treat them holistically with dignity, respect, compassion and genuine care and not just another case number or bed number. Let us also be reminded of what Dr. William Osler, the father of modern medicine said, “The good physician treats the disease, the great physician treats the patient who has the disease”.
As you continue to practice your profession, uphold the principles and highest standards of professionalism and ethics, foremost of which is your commitment to excellence, honesty, integrity, social justice and equitable service. Serve with humility and compassion. Espouse the values of competence, social responsiveness, commitment and moral uprightness in accordance with the Jesuit philosophy. Be respectful, sensitive to culture and gender, as well as to the world of the patients. Whatever career paths you take, give honor to the good values ingrained by your families. These include values of love of God, of country, and of families that have strengthened us Filipinos. As what Fr Gabriel Gonzalez mentioned in his homily, “The Lord is with you. He gives comfort and strength as you go through life’s journey.” Continue to excel in your chosen field. Excellence is about dedicating yourself to a life of never-ending learning experiences through Continuing Professional Development. Recognize that there is still something new to learn. Continue your passion for learning and you will never cease to grow. Keep abreast with current research evidenced-based knowledge and skills, and state of the act technologies and modalities of patient management. These will ensure your competence in improving the quality of health services and promoting safety of our patients and of society. You owe it to them to give your best. You will be working with people from various health disciplines. They too have equally enriched themselves with knowledge in their respective fields of discipline. Work with them with an open-mind. Collaborate and be a good team player. All of you have the end goal of improving the quality of life of your patients.
Be mindful of your health. One of the big challenges that physicians, residents and medical students face today is burnout. As Dr. Stephen Ray Mitchell, Dean of Medical Education of Georgetown University School of Medicine said, “The name on your coat is not for your patients. It is to remind you who you are. Periodically, you need to give to yourself, and take care of yourself.” Your Alma Mater has provided you with quality education upon which you can build your notable career. It looks forward to your active participation as alumni in achieving its vision, mission and objectives. Love and loyalty to the institution is a testament to your shared philosophy and values as you acquired you degree in medical education. Last but certainly not the least, your aspirations and dreams of becoming doctors wouldn’t be achieved if not through other people’s great sacrifices, efforts, support, encouragement and unconditional love as they travelled with you in your journey. My esteemed salutations to the proud parents and the families who always had the best intentions for their children. You have been not just a source of financial support but have served as their inspiration and moral compass that guided them in their lowest and hardest times. I congratulate the faculty and mentors for a job well done. They taught and guided you well, and may have stressed you out, but they had the best intentions for you. To the faculty, continue your passion for excellence and be not just good or superior or excellent but be great teachers who can inspire and transform your students as well as nurture, mentor, and prepare them to become successful professionals molded through the Jesuit education.
Your truest friends and classmates also became your source of strength and comfort. You all knew what all of you were going through. May I request the graduating class to please rise, turn around and face your parents and loved ones. Give them a warm applause and say “Daghang salamat kan-inyong tanan”. Now turn and face your faculty, mentors and administrators, too. Thank them and give them a warm applause. To your batch mates, hug them if you can and say thank you for the good times through thick and thin. Let me end by quoting the resonating inspirational message of the legendary educator from ADMU, Dr. Onofre R. Pagsanghan with his engaging question that you, as well as the rest of us can ask ourselves, “Why have I chosen to be in this profession? The answer to this question will decide that kind of professional you will be. It is what will give meaning to your life. It will be your song of joy.” I am now entering my 47th year in the medical academe. I have no regrets. I still take time to continue mentoring the medical students, the young faculty and prospective leaders and current medical deans in the hope of bringing out the best in them. I still continue to serve our country having been appointed by CHED as Chair of the Technical Committee for Medical Education, and appointed by APMC as Chair, National Internship Program Committee. Bear in mind that what determines your excellence and success is how you touch people’s lives and how much difference you make in contributing to the betterment of humanity as a whole. And in doing so will you find your own fulfillment. “The power is in your hands.” To the graduates of Medicine 2019, my best felicitations for a job well done! My warmest wishes for your success as you continue your life’s journey and embark on new challenges in your chosen careers. Dare to dream. Take actions in your dreams with vision. Go and spread your wings! Once again, Congratulations to all of you and Mabuhay kayong lahat! *** ALFARETTA LUISA T. REYES, M.D., FPSECP Professor Emeritus and Past Dean, College of Medicine, UERMMMCI Chairperson, Technical Committee for Medical Education, CHED Chairperson, National Internship Program Committee, APMCI
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Medicine and More By Princess Antonette Sotelo Few can be as determined or as resilient as medical students. The pursuit of the MD costs a lot in terms of finances, sanity, and time, especially quality time with their loved ones. Thus, there are some who are so focused on becoming a doctor that medical school often becomes the singular aspect of their lives. However, it is inspiring to know that there are those who are able to find a balance, maintaining their academic standing, their personal and social lives, and even their advocacies. How to be you, po? Here are some advices from fellow students whose examples are worth following.
1. Learn to Prioritize
“I asked the same question from a higher up before the start of the school year and he told me to start by listing my priorities... and to count how much time I spend on each of my daily activities. If I add up the time spent on social media, that’s already time I could spend doing things that are more important to me like going to the gym or catching up with my family and friends. If I add up the time spent on watching series, that’s probably a few more chapters read from Harrison’s or William’s. That’s when I realized that we have to be self-disciplined in carefully choosing how we spend our time. One might ask how we can finish all our readings and have time for extra curricular activities. The answer is simple: Minimize, if not totally avoid, activities that are at the bottom of our priorities. – Bianca Watanabe, Batch Astra
2. Work with others
“I have a lot of personal advocacies especially sa communities. Sa atong country, we have a lot of pressing concerns baya. Locally, katong blood shortage, karon pud kay ang vaccines. Di ko mahimutang na wala ko’y mabuhat bitaw.” (In our country, we have a lot of pressing concerns. Locally, the blood shortage, and now, vaccines. I feel restless if I am not able to do anything). “Lucky for me, I am part of an organization which shares the same passion as I do especially in serving. You’d feel more inspired sad and hopeful if you’re with people who share the same passion as you do.” –Nikki Diocampo, Batch Invictus
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3. Study Smart “Effective studying is individualized. Different people have different styles. Choose what is more comfortable to you, or the method on which you can understand better and score higher. As for me, I prefer at home, or in library as long as the environment is quiet.” “If burned out? Do not force it. Useless man gud. If tired? You rest, sleep or nap then study again. When discouraged or don’t meet expectations or grades? I would just think that there are many ways to increase grades.” “I read for the sake of learning. This is the most important part: to translate what we’ve learned into good practice in the future.” - Stephen Jay Perez, Batch Dilaab
4. Ask for help “I am very close with my mentor. Mentoring is very helpful because sometimes when you feel alone or like dili nimo matell sa imong friends because you undergo same struggles, you can tell it to your mentor, and especially to us na naa sa layo, walay direct access to family, they could be our family.” “When things are not into your favor, go back to the reason why you did it first because we all know that in our field we tend to be burned out, and even now that we are still studying we feel tired, we feel that we want to give up. When those things strike you, think of the first moment why you are here. Be strong and put everything to Him.” - Dan Exerlin Bonete, Batch Dilaab
You’ve all heard it said: There aren’t enough hours in the day. That adage holds true especially for medical students. But with dedication and strategic use of time, dedication and sacrifice, academics, extracurricular and socio-civic activities can be integrated. May we medical students be able to find balance and get the most out of our journey towards the MD.
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PORTFOLIO Xavier Cup, September 2018
Dr. Jose P. Rizal Memorial Lecture, September 17, 2018
Open House, September 18, 2018
Medicine Minds Champions 2018
Mr. & Ms. Medicine 2018: Michael Paul Roque & Nikki Diocampo
Arianne Alvarez: Medicine MVP 2018
Packapella Champions, Medicine Ball, September 24, 2018
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Walk for Stroke, October 28, 2018
Pink Run, October 7, 2018
Frankie Dizon Memorial Lecture, November 9, 2018
APMC-SN Regional Convention, January 2018
Panaygon: A Christmas Special, November 30, 2018
Alima: Medical Mission, May 1, 2019 For more of our coverage, Like us on Facebook! Blood Donation Drive, March 23, 2019
facebook.com/connexusjprsm
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Days and days of skirmish, and an arid land laid to waste is what remains of the battlefield where ten different species fought for dominance. In the end, a tribe of warriors claimed their superiority over the rest. But just behind them something unseen lurked, prowling closer than ever before: the wolf. Bloodied, exhausted, but never defeated.
and other needs, all before formal classes even began for the School of Medicine.
In the 2018 Xavier Cup, the Dr. Jose P. Rizal School of Medicine made history when they bagged the overall second place with an astonishing 506.5 points. This was the first time the Medicine Wolves achieved said rank, an incredible upgrade from last year’s fifth place finish with a score of 374 points. So what happened? What did the pack do right this time to soar to heights previously thought almost impossible to achieve, given the added burden of the concurrent Medicine Week and the ever-present academic workload of being medical students?
“Each game was crowded with supporters and it gave our athletes the confidence they needed to perform at their best level. The athletes were able to feed off the energy given off by the crowd, and in my opinion, that made all the difference,” Tolod added.
“I think the difference was the tremendous support that was shown this year by the XU-JPRSM community.” says Jose Gabriel Tolod, former Head of the Department of Sports of XUJPRSM’s Student Council.
The Medicine Wolves struggled, and the result became the by-product of their hard work. This proves that once the pack unites, little could stop them. And so the wolf awaits once more, bidding its time and honing its skills, until the moment comes when it can finally pounce to the top in the 2019 Xavier Cup.
Maren Shalina Sabal adds, “It’s super cliché to say that winning was never the goal but truly, it never was. I am just so grateful that we made history through greatness but still remembered to be humble in our victories.”
“Last year, we were in sa top 5 noong Intrams, so this time we (sportscom) were pressured to maintain the spot or aim higher this year.” says Jan Arthur Sendaydiego, one of the former Associate Sports Heads of the XUJPRSM Student Council. Some of the measures implemented include holding tryouts for sports events, and securing the budget and schedule for jersey fittings, practices,
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Arianne Alvarez: Alpha Wolf ‘Love and passion’, Arianne Claire “Aya” Alvarez deems that these attributes helped her bring out her own meaning of “magis” in the field of sports. No wonder she bagged the award of becoming the MVP of the Year during the Medicine Ball last September 2018 as she nabbed medals after medals since her freshman year, making her one of XU-JPRSM’s greatest athletes of all time.
This ardent alpha wolf has been smitten with sports since her elementary. school days. Badminton, Table tennis, Lawn tennis, Sepak takraw, Basketball, Soccer - her list of sports goes on and on. Added to it is the constant support from her family of sport enthusiasts. Her experiences in various tournaments have molded her fortitude and finesse during her victories in the Xavier Cup. “Enjoying the game, making new bonds, learning through other athletes’ strength, and improving my weaknesses are at the core of my love and passion for sports,” she explains. As a 4-year recipient of German Doctor Scholarship and to top it off; as a clinical clerk, juggling studies and sports proved a challenge. “I can’t really explain how I managed to get through a week-long of playing many events while going back to graveyard shifts. But as I could recall, even after a long day of playing, my energy is still at its peak once I go back to do my hospital duties.”
“Balance is the key!”, Alvarez added. “Just like the previous years, even after a tiring day, I am more inspired to read and study. I always remind myself that as a ‘student athlete’, being a student comes first before being an athlete.” However, Aya described the 2018 Xavier Cup as a ‘bittersweet experience’. “Yes, bittersweet in a sense that it would be my very last playing year. Bittersweet because who’d have thought that my second to the last game was actually the very last because of getting an ACL tear (Anterior Cruciate Ligament) which has then led me to a knee surgery. Bittersweet in a sense that I’d be confidently leaving the pack because I am overwhelmed of how talented and good the younger wolves are and that they’d continue to bring pride and raise the banner of the school of medicine,” she expresses. Despite the grief-stricken incident, Aya is grateful to be part of the medicine wolves; a multitalented pack as she describes. Aya left a note for her juniors to keep the passion burning, to be humble in every victory, and to be grateful in every defeat. “Be a model and an inspiration to the undergraduates because we can’t deny it, we are the tito’s and tita’s of intramurals. And just like your eagerness to win a game, give out your best in achieving that white coat! God bless, Wolves! Awooooo! Awooooo!” she adds.
s g o d r e d n u he By: Ayesha Radam & Princess Shajehan M. Macabunar
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From Ink to Scalpel By Mickaela Frances Daclag She braved the seas when the tide seemed to be against her – Katrina Rachel “Katz” C. Lorenzana, renowned tattoo artist, is now a medical student. A very peculiar, yet usual, question people ask ‘why the change of heart?’ Katz grew up in a family who excelled in academics. Her mother is a Pediatrician who is a graduate of University of the Philippines – Manila. Having 4 scientifically-inclined siblings, she decided to become the “artist” of the family. Because of her curiosity since childhood, she already had thoughts of getting into a medical course. However, she pursued Studio Arts major in Painting in UP-Diliman and graduated Bachelor of Fine Arts, cum laude. She worked in her own tattoo studio in Manila and has been in the business for 11 years, catering to a wide range of clients, including famous personalities such as Jay Contreras, vocalist of the band Kamikazee, and actor Jericho Rosales. A few years back, her family faced a medical crisis. Her father, who seemed to be perfectly healthy, was suddenly rushed to the hospital. She could never forget the moment she was standing in front of her father’s brain scans showing progressing damage. “My mom and my Dad’s neurosurgeon were saying medical things I could not understand. They need to immediately come up with a decision. Everything happened so fast and my mom immediately decided to stop resuscitating”. Her father passed away in less than a day.
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Photo courtesy of Ms. Lorenzana
Feeling helpless and puzzled, she researched a lot of ways on how they could have saved his father; but it could only go as far as Google could reach. She eventually realized that her mother did what’s best for her dad. “She is a physician; Of course, she knew what she was doing. I did not understand these things. Thus, I was challenged to take up medicine”. However, tattooing made her happy too, and she thought that maybe medicine was for another lifetime. Years have passed, and still this dream was bothering her. Continuing on with life, she got married a year ago and found full support from her husband. This paved way for her to pursue her dream in her husband’s hometown, Cagayan de Oro. And as much as she loves tattooing, she finally found the courage to study medicine. Katz shares on how she spends hours and hours tattooing, only stopping when she
needs to sleep; only to wake up and tattoo again the whole day. “It was tough on my neck, my back, and most especially my hands. But afterwards, it was exhilarating to see your finished work… The trust the person gave you and the finished artwor is enough of a reward.” The hardest thing to do, she says, “...is leaving something that I really love doing because studying is now my topmost priority. I actually did not give up tattooing; it’s just that it’s hard because I don’t get the opportunity to do it anymore.” She has this advice for those who are in a similar situation to hers: “If you really want to take up medicine, be 105% sure that you can let go of the thing that you are currently doing. If ever you choose medicine, don’t do it because of the title or the money; Do it because it will make you happy. It is never too late. ”
Medicine and Motherhood
By Maricor Gin Edma
“What can be more noble than the service of healing?” It was a curious question. She was silent, paused a bit but answered honestly. “I really don’t know. I believe being a doctor is noble in itself, but experiencing motherhood right now, I realized that I can sacrifice a lot for another human being. And I think it’s noble.” More than just a calling. It was her childhood dream to be a doctor, to wear the white coat and be able to serve her fellow countrymen. “Others think it’s cliche, but I was very young when I decided that I wanted to be a doctor. Being a sickly child, I had my frequent visits to the pediatrician and that inspired me more to be just like her. Ever since, it has been my childhood dream.“ She laughed. Currently, Vanessa Lumacang is a Senior Clerk. She entered the halls of XUJPRSM last June 2016. She knew it will be hard, but she was determined. She has prepared her heart and mind. However, God braced her for another surprise. Motherhood! “Do you have any regrets?” I asked. “None at all,” She replied without hesitation. “I consider this a blessing and a challenge! There are a lot of sacrifices, but I know all of these are temporary.” Despite criticism. As she strugged her way through medicine, she gracefully carried not just her load of books but also a life inside her waiting to be born. It was not typical in fact, it was a burden for those who were not on her shoes. Yet, she brushed off the negativity. “How did you juggle medical school and pregnancy?” It was a question everyone would love to ask.
“I listen to my body. When I wanted to eat and sleep, I do it. I never pressure myself. I know others think pregnancy was a disadvantage for me because I’m a student. In the same way, my parents wanted me to stay at home for a while until I gave birth. I refused!” “What made you decide not to stop school?” I continued. “ I followed my heart. For me, it’s a waste of time. I told my parents that I can do it. I made a choice and they supported me.” She answered. Her greatest inspiration. Soon, Vanessa will be receiving her diploma. Her dreams are almost within her reach but for her it already came true. “If you have to choose between Medicine and Motherhood, what would it be?” It was a serious question, but she answered it with her heart. “Can I choose both? Because I would choose both,” She paused for a moment. “To be a doctor was really my dream and I never considered motherhood as a hindrance. In fact, it became my greatest inspiration. My son is now part of my dream. Right now, every sacrifices I am making is not only for myself but also for my child and his future. ” Presently, her son is already 2 years of age. Though time and distance have been separating her from him, she has always been determined to pursue and reach her dreams. She wanted to reach the finish line and finish it strong and proud together with her parents and her son. I asked her if she could offer any words of wisdom. Instead, she ended the interview with her favorite qoute. It was her mantra in life. “Remember why you started,” she smiled. “Because it will help you reach the end when you lose your way in the middle.”
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batch advocacies ‘18-’19 Mental Health & Wellness 1ST YEAR
By Mary Rose Estrada We decided to do an advocacy that is relatable to our current situation: academicrelated mental stress. We have chosen an advocacy that we think addresses a societal issue; we wanted to raise awareness and understanding on the academic stresses of students, and what we can do to help those in silence but are in great need for help. We already conducted an info drive last December 2018, during which, we gave out flyers containing information about the effects of stress, and what one should do about it.
We also conducted a treat-giving activity during which we gave sweet treats with inspirational messages to medicine students during the bimonthly exams. This is to give encouragement and inspiration to them during that stressful time. Currently, the batch is working on other projects that were planned that are rooted towards understanding and addressing academic-related stresses. Right: One of the sweets given during the treat-giving activity.
Higala sa Lumad By Diovince Paulo Kinaging & Dan Exerlin Bonete, Batch Dilaab Batch Dilaab’s chosen advocacy is called “Higala sa Lumad”. We wanted to provide aid and assistance to the displaced Lumads from Lagonglong, Misamis Oriental. The first thing that we did was to immerse with the evacuees – we listened to their situation, how they were displaced, what their lives were in their area, and what are their needs and pleas as of that moment. After our immersion, we organized an event during which we were able to distribute hygiene kits and clothes. We also held talks about proper sanitation, handwashing, etc. We conducted an art therapy session with the Lumad kids and just bonded with the evacuees. Afterwards we conducted a feeding program to the evacuees.
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Lastly, we had a video documentation of the situation of the displaced Lumads and our shared experience with them in the hopes of bringing their situation to a much wider audience. We were also able to win the Christmas Caroling contest and give the price to the evacuees.
This project served as an eye opener for us. Aside from that, our batch learned an important lesson - Resilience. As they still fight their battle towards autonomy, we continue to pray for them, that they may reclaim what is truly theirs and live in peace and harmony.
Protected Together By Kathleen Ann Acma, Batch Astra Our batch chose immunization as our advocacy. The Dengvaxia crisis, the decline in vaccination numbers, and now the measles outbreak filled the different media platforms. We wanted to empower others by giving them enough information of the different vaccines offered in the country. We decided that the best way for us to do this is through social media, particularly through Facebook, given our desire to reach a wider audience with the limited time and resources we have. We feature one vaccine every month on our Facebook Page Protected Together. For each week during a given month, we post various information about the featured vaccine, the diseases it prevents, and other facts that we felt the public needed to know.
Also, we wanted to influence others to be an advocate for this cause by simply sharing in their own pages. It was not an easy task; we struggled at first as to how we were going to promote immunization in a way that would be understandable to our audience. But, with the cooperation of the batch, the facebook page was a success. We hope that our page have made an impact to the people it reached. Follow us on Facebook! h t t p s : / / w w w. f a c e b o o k . c o m / p g / ProtectedTogether
Bata, bata, ‘wag muna gumawa By Pauline Blaise Roxas, Batch Invictus Teenagers are curious regarding sex but have no one to ask or turn to when it comes to this topic as it is considered taboo. Thus, we chose to have a small communitybased campaign against teenage pregnancy by creating a module to conduct peer education. We partnered with the LGU of Alubijid, particularly the Sangguniang Kabataan (SK). The project involved student leaders teaching their peers regarding their options for the prevention of pregnancy as well as regarding sexual health in general. At first, skepticisms were high from the community, blaming the internet, porn, teenage mentality and the stigma against Millenials.
However, as the project progressed, the feedback has been good. The PopCom even asked to partner with the batch to borrow the teaching materials to continue the project.
Our hope for future projects is to extend sexual health education to include LGBT groups, rape cases, STIs and other issues related to teenage sexual health.
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Help is Here: XU-JPRSM Mental Health Agenda Last February 6-8, 2019, medical school faculty and students from the Association of Philippine Medical Colleges (APMC) member schools gathered at De La Salle Health Sciences Institute for the 52nd APMC Annual Convention, with the theme “Fostering Mental Health in Medical Education”. In response to the call to promote mental health in medical schools, XU-JPRSM is now gearing towards the development and implementation of several mental health programs. CONNEXUS interviewed XU-JPRSM Dean Dr. Ruth Beltran last April 16, 2019 to talk about these plans. C: What are the mental health interventions raised during the convention that XU-JPRSM is planning to adopt? Dr. Beltran: “Many of the medical schools during the convention find that mentoring is really good in helping students. There are also
many things that could be done: Mindfulness, yoga, pet therapy, art therapy. [With regards to higher referral], We do have a problem with the number of psychiatrists around; if we need their assistance, we might not be able to get that. We could collaborate with the counseling office of the university. We have all these plans…but we need to place the guidelines and recommendations. Realistically speaking, we have to limit ourselves with what can be allowed by the University, [and also] the availability of resources. The students also need to be active with regards to self-care; there are some examples of interventions wherein the administration works with the students.” C: How soon can we expect these plans to be implemented in XU-JPRSM? Dr. Beltran: “These plans will not take effect right away; we are looking forward to implementing some of these interventions as soon as guidelines are prepared. Hopefully
we will be able to come up with some of those plans in the next school year” C: What is your advice to the students with regards to Mental Health and Wellness? Dr. Beltran: “I would say that a greater part of it has something to do with self awareness; you have to be aware of yourself, what are your strength and weaknesses, and what you are getting into. Med school…is not handed to you on a silver platter; there is an overload of topics to study which students may find overwhelming. However, there are what we call the “non-negotiables”: readings, skills to acquire, which are for your own good. We cannot skip chapters. After all, being a doctor entails having to handle lives of people. Know your deficiencies and work on them. Bottom line, it is really developing the grit, the resiliency to bounce back, and not to be pulled back by setbacks.”
The APMC - SN Semicolon Project Recent trends in mental health have led to more open discourse and have introduced a bold message of hope: “It is okay to not be okay; rest if you must, but don’t you quit.” What better way to encapsulate this message than the semicolon, a punctuation mark used as a pause between clauses? It is thus appropriate that this is the namesake of the Semicolon Project, the Association of Philippine Medical Colleges - Student Network’s initiative to address mental health among medical students. “The Semicolon Project is a national workshop caravan which focuses on enabling individuals to be mental health advocates equipped with skills and to hopefully build a healthier community, one school at a time,” says Leandro Salazar, APMC-SN National President. “We realized that we have done so much to raise awareness on the matter and that it was high time for action,” Salazar added.
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The aim of the project is to equip the medical students with the knowledge and skills needed to help someone in psychological distress, as well as the warning signs to watch out for. In contrast with other advocacy programs which involve plenary discussions, the Semicolon Project utilizes a forum theater approach in order to fully involve participants in scenarios simulating people in actual distress. To carry this out, the APMC-SN enlisted the help of the Foundation for Advancing Wellness, Instructions and Talents (AWIT Foundation, Inc.) and the Philippine Educational Theater Association (PETA). The workshop was rolled out among the four regions of the APMC-SN (Luzon, Visayas, Mindanao, and NCR). The Semicolon Project was one of the highlights during the APMC-SN Regional Convention held last January 2019 at Brokenshire College, Davao City.
“I think the best part about the seminar was when the audience was given the chance to act out a certain scenario in a way that it changed for the better,” says Ayesha Radam, one of the workshop attendees. “It gave the whole thing a more intimate view on how you would deal with someone who needed your help. Everyone was cooperative, giving their two cents so the seminar was a very interactive one,” she added. Asked regarding what’s next for the Semicolon Project, Salazar says “So far, we have heard positive feedback on the project. It is a challenge for the new APMC-SN National Executive Board to think of not only effective but sustainable projects that will forward the campaign further. In the light of the release of the IRR the Mental Health Act, we aim to crusade and demand for the recognition of our rights to mental health especially in our respective academic institutions.”
Reading Assignments
by Fretzene Arances
There’s nothing more inspiring than reading a good book, but we medical students know that the required references in med school can get tedious to read at times, being overly biomedical and often devoid of heart. Medicine is an art as much as it is science, and for those who would like to take a break from Harrisons, or to simply read a good book, here is a list of great books definitely worth your time. 1. This Side of Doctoring: Reflections from Women in Medicine 2001 by Eliza Lo Chin, M.D. (Editor) In the span of time, women physicians have overcome challenges both from their careers and in their personal lives. This Side of Doctoring: Reflections from Women in Medicine is one of the best compilations of stories, poems and testimonies featuring the passionate drive of women in the medical field from the struggles of entering medical school in the 19th century to being dedicated moms and wives at work in this day and age.
2.
With Scalpel and the Sword 1997 by Lincoln D. Nelson, M.D. (Author)
A journey fueled by passion to serve and faith in God. A written account of experiences from the viewpoint of an American doctor named Dr. Nelson, who served at the U.S Navy hospital in the Philippines in the 1950’s and treated many Filipino patients including President Emilio Aguinaldo.
3.
Gifted Hands: The Ben Carson Story 1996 (Movie: 2009) by Ben Carson, M.D.
An Inspiring story of a Detroit boy who passionately worked his way into becoming a world-renowned neurosurgeon famous for neurosurgical breakthroughs that helped save many patients even when hope is lost in some of them. Dr. Carson’s story touches the hearts of the readers with a strong dedication to be successful in one’s own field. 4.
And the Band Played On: Politics, People, and the AIDS Epidemic 1987,2007 (Movie:1993) by Randy Shilts (Author)
An international bestseller that relates the story of the AIDS epidemic in 80’s and exposing real conflicts between government organizations, health care institutions, and of AIDS patients as they struggle with the disease and the stigma.
5. Gesundheit!: Bringing Good Health to You, the Medical System, and Society through Physician Service, Complementary Therapies, Humor, and Joy 1993 (Movie 1998) by Patch Adams, M.D. with Maureen Mylander (Authors) Insightful and fun, the book and movie will make you ponder about the meaning of life and laughter in regards to health. His unique approach in improving the health care system in which doctors need not be emotionally detached to patients and provide patient comfort and amusement will surely inspire you to be a better doctor. Dr. Adams is the founder of Gesundheit Institute in West Virginia. CONNEXUS 2019 | 21
Entertainment Corner Word Search It is important for medical students to be able to take care of their own mental health and wellness. There are 10 wellness-related terms in the puzzle which were used throughout the magazine. Can you find them all?
Where is the Lesion?
Cat Lady @ilovelumpia
*OSCE on Hypertensive Patient* Me: What other symptoms do you have? Patient: My feet are swollen. Me: *actually looks for the edema; puzzled that there is none* Doc: Um…remember that this is just OSCE. We are just pretending that the patient has edema. Me: Patient: Patient’s non-existent edema:
Cat Woman @bartonellahenselae
*Neuro Physical Exam* Me: *performs pinprick sensation testing on my partner* Doc: Is that how you properly do the exam? Me: Yes Doc. Doc: By pricking the patient with your own nails? Is that even legal? Master Bates @maldets *OSCE Cardio PE* Me: *prepares to perform PE on the patient, sees a green robe, starts to put it on* Doc: The gown is for? Me: For the examiner, Doc? Doc: ...it’s for the patient.
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Experience Excellence @dalagangpilipinayeah
*Sensory Neuro OSCE* Me: *prepares to perform Weber and Rinne tests* Also Me: *forgets how to strike tuning fork, panics, strikes it harshly on chair* Everyone else: *moves, thinking it was the bell* Metabolic Syndrome @atorvastatin Lain lagi ang tela sa FCM shirt kay nagadugay kay nagagamay.
Mind Blown @manterandgatz
*during SGD* Classmate1: Identify the part of the limbic system shown in this picture. Classmate2: HippocamClassmate3: Hippopothalamus!
Every Med Student @thespiritofthewolf
Huy taas kaayo ang basahunon sa book tapos gamay ug font tapos wala man lang memes.
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Publication Dr. Jose P. Rizal School of Medicine, Xavier University - Ateneo de Cagayan, Mortola - Hayes Streets, Cagayan de Oro City 9000
