Connexus A.Y. 2017-2018 by Connexus XUJRPSM

TABLE OF CONTENTS Editorial

Mental Health Stigma

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Advocacy of Mr and Ms Med 2017

Med Ball & PLE Passers

Intramurals Standouts

Stressing out and bouncing back: Hinigalaay 2017

Marawi Evacuee Health Updtate

Emergence of Gonococcal Superbugs

Med Week in a nutshell

News Briefs

PAASCU Accreditation

Etiology and mechanisms of an atypical course

Experience of a senior clerk, PGI, and new doctor

Note-taking through writing by hand or typing on a computer. Reading the printed word or on a glowing screen. Learning by the traditional or outcomes-based curriculum. Between old and new methods, asking which reigns supreme would yield varied answers. Disregarding established ways is unwise; it has handed down the prototype for innovative ideas and the wisdom to guide neophytes of a path’s essence. It is the starting point of ideas whose effects have trickled within our grasp.

While sticking to the traditional confers a sense of comfortable familiarity, adapting to change which might have been unthinkable paves way for then unimaginable improvement. In more progressive times, ‘normal’ pertains to not solely operating a decades-old machinery routinely but also re-thinking how it can be tweaked for increased

Med Hacks/student council corner

than reacting to feedback and unlearning anachronistic ways.

Vox pop: “What made you decide to enter med school?”

Bloopers and Everyting in Between

tailored responses to different demands. No clear-cut criteria exist on the superiority of either old or new ways, provided these are grounded on the purpose these were and upgrade their quality of life. Words by Louren B. Aranas Photo by Maricor Gin O. Edma

Publishers: Subscribing students of Xavier University – Dr. Jose P. Rizal School of Medicine Editorial Board: Karen S. Tanseco Editor-in-Chief, Louren B. Aranas Associate Editor, Deamond Daffney M. Palabrica News Editor, Jessell Fatima D. Cane Features Editor, Chassylou Alea A. Evangelista Entertainment Editor, Staff Writers and Contributors: Lowell A. Batoon (Contributor), Shan Berjam Erm R. Calingasan (Contributor), Ian Gabrielle M. Cuyno, Asley Kate L. Doong, Danica Elaine B. Ebarle, Maricor Gin O. Edma (Contributor), Seneca G. Ejera, Ness Dareen N. Fuentevilla, Crisbelle Ann E. Irag, Ken Jeryle M. Papelleras (Contributor), May B. Pingol, Gian Paolo L. Portal, Ayesha F. Radam, Charissa D. Santiago (Contributor), Stephen RB C. Sapiera (Contributor), Ma. Coralene Rose T. Silverio, Linsid Angelou A. Tapongot, M.D. (Contributor), Norbainie A. Usman, Nomaelle Jenn B. Valencia, Anna Bianca Marie F. Watanabe (Contributor), Photo Contributors: Dan Exerlin E. Bonete, Paul Benedict V. Budiongan, Mary Claire R. Losorata, Shaldan Chlokie A. Pendon, Janica G. Regalado, Photojournalists: Jan Tristan M. Acenas, Maricor Gin O. Edma, Digital Artist: Rizalyka Joanne M. Waminal, Cartoonist: John Vincent P. Anino II, Layout Artists: Evan B. Aranas, Mohamad Nur M. Ali, Moderator: Dr. Agaton T. Panopio

Editorial

Relentless Pursuit of Excellence Excellence. Such a ubiquitous term. Every institution prides itself of having entrenched it into its daily routine and ratingdefining performance. But do we really understand its meaning? Simply put, excellence is the fuel that drives us not only to be our best version yet, but also to strive how to be better with an eye to deliver quality results. How we deliver is as important as what we deliver. Excellence is not achieved overnight; it is cultivated through years of hardwork and paves the way for improvement. Ideally, we glorify in it as a corollary of passion and performance. The recent Level III reaccreditation of the Xavier University – Dr. Jose P. Rizal School of Medicine (XUJPRSM) by the Philippine Accrediting Association of Schools, Colleges, and Universities (PAASCU) corroborates the institution’s relentless pursuit of excellence. This makes XUJPRSM to be the first medical school outside Metro Manila to be given such an honor, much to the joy of the XUJPRSM community. This momentous accomplishment is the product of the collaborative efforts of the administration, faculty and staff, and students. Indeed, for these efforts to attain external accreditation by PAASCU affirms the high quality of education and training provided by the school in its desire to form five-star physicians. This sterling record of achievement comes with prestige as well as implications. Level III reaccreditation should serve to remind the school that it should not rest on its laurels but rather work on its improvement to become a better educational institution. Having reached this level is a challenge for the school to provide and maintain better facilities, a competent faculty, excellent methods of instruction, outstanding licensure exam performance, and therefore produce physicians who are competent and socially engaged. Suffice to say, excellence is bigger than that bubble of rocketing to medical school ranks, beating our personal best in exams, or accelerating to the next level. It is not limited to numbers – as a community, it includes re-evaluating longheld methods, prioritizing overlooked yet significant aspects, and welcoming innovative ideas. If this practice has always been done this way, is it worth retaining or must it be modified? Besides, isn’t that a question worth pondering in the more complex field outside the confines of the academe? Still, experiencing a topnotch academic training requires tangible efforts not only by the administration, faculty and staff, but also by the students. Micro efforts produce macro effects. If we develop excellence in little matters, then we are going to achieve excellence in big things. To quote the great philosopher Aristotle, “Excellence is not an act but a habit.” With the dynamic changes in medical education and the bar continuously set higher by the medical profession, medical schools must tirelessly adapt and conform to the changing times to produce competent and resilient physicians capable of answering the call of a noble profession. It might do well to give the reminder that there is always room for improvement and to never lose sight of why one signed up for this commitment. After all, the pursuit of excellence is a journey, not a destination.

By Ian Gabrielle M. Cuyno

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‘Yong depression gawa-gawa lang ng mga tao ‘yan. Gawa nila sa sarili nila […] Pabayaan niyo (People impose depression upon themselves. They just made up the condition. Leave them alone.),” said comedian Joey de Leon during a noontime TV show, after hearing the story of a contestant whose mother was said to have suffered from depression. This episode stands in stark contrast to a news report only the day before: a young woman had jumped to her death in a mall in Mandaluyong City. Suicides seem to be featured in the news every other day.

portrayed in almost all forms of media ranging from movies (Disney’s Inside Out) to drama series (Netflix’ Thirteen Reasons Why) to Broadway musicals (Dear Evan Hansen). What seems to be the problem is, despite the publicity, mental health issues are still being stigmatized. De Leon’s comments may be jarring but just as mental health issues come in a wide spectrum, so does stigma – from outright dismissal, to avoidance of people with these problems, to apathy.

To emphasize its weight in numbers: Depression currently ranks third in the global burden of disease, with 300 million people suffering from it worldwide, and is projected to rank first in 2030. In the Philippines, 3.3 million people live with depression, while three million people live with anxiety. Annually, roughly 3,000 people in the Philippines and 800,000 worldwide choose to deliberately terminate their lives. A majority of those who died of suicide belong to the 15-29 years old age bracket. The World Health Organization (WHO) and the Philippine Department of Health (DOH) acknowledge that even these figures may be an underestimate due to underreporting.

In an article on Psychology Today, three common stigmatizing beliefs were found regarding mental health: people with mental health problems were dangerous, mental health problems were self-inflicted, and people with mental health problems were generally hard to talk to. More troubling is the fact that in the same article, people with depression reported experiencing the stigma most of the time from their own families, peers, and teachers – the very same people who depressed people first turn to, according to various studies. A 2018 study by the US Journal Social Science and Medicine shows that in campuses with high levels of stigma, students with depression are less likely to seek out help or support, and are more likely to commit suicide.

Clearly, this is no laughing matter. Depression is not merely ‘made-up,’ a product of one’s imagination, or a call to pray more. It would be passé at this point to say mental health issues need increased visibility or press; mental health issues are

With the impending passage of the Mental Health Act of 2017 into law – which is awaiting the President’s signature as of writing – Filipinos might soon have greater access to mental health care in government health institutions. But much

work still needs to be done: at present, only 700 psychiatrists in the country are available for its population of 103 million. Resources have to be mustered to address the lack of facilities and staff. Management of mental health issues involves professional help, medication, and support from institutions. But more than that, it involves this readily available resource: social support. Social support cannot and should not replace professional help in these situations, but as a first step, it goes a long way. It might be difficult to find the right things to say to a person who is depressed but if we can, at the very least, reduce the social stigma – by talking more openly about mental health issues, encouraging those diagnosed or experiencing depression to open up and treating them with unconditional positive regard once they do – we can make them feel accepted or keep them from the brink. *** While the outrage over de Leon’s comments have long come and gone, the implications of that episode should raise questions on how we deal with someone who opens up about depression: Will we shrug them off, thinking depression is a made-up disease just like he did? Will we avoid them or make them feel like a burden? Or will we start doing what seems to be a foreign concept in this country – to simply be there and listen?

#InspireANDInfluence By Karen S. Tanseco

hen was the last time you’ve read the morning paper? Watched the evening news? Or listened to news broadcasts on the radio? As a medical student whose time is spent solely on poring over large, thick books filled with highfalutin words, trying to understand the intricacies of the human body and its synergistic processes, I guess your answer would be “A long, long time ago.” In this modern world, the art of reading newspapers seems to be dying out as more potential readers turn to other sources of information, particularly articles and posts shared on social media sites. With the advent of technology in which gadgets grow smaller and thinner every year, receiving news through social media is just a matter of a few clicks and taps away. We have more access to information now than at any other point in history. Yet, many members of the online society fall into the traps of misand disinformation, more commonly referred to as fake news. Last March, I attended a communicators’ congress. One of the speakers, Raisa Marielle Serafica, head of MovePH, shared various ways to be able to distinguish true from fake news. First, check multiple sources. We have a sea of information at our fingertips. Before jumping into

conclusions, it would be sensible to check multiple sources¬¬— learn to cross-examine facts and fish out the fake from trustworthy. Second, grab the opportunity to learn. The internet is a portal to worlds (or websites) that offer quality and reliable content. It would be worthwhile to immerse ourselves in these sites in order to add something to our depot of knowledge. Third, engage. Engage yourself in meaningful and logical conversations. There is so much to be gained from taking part in a discussion that deals with relevant and timely issues. Almost without a doubt, social media has become a significant part of our lives as millennials. Some (usually the older generations) deem social media as a counterproductive time suck, a source of trivial rubbish, and an online battlefield where comment sections are riddled with ad hominem attacks and expletives. In point of fact, there is some bit of truth about that. However, if used properly, various social media platforms can serve as powerful tools that can inspire people, propagate ideas, and even influence lives. Take for example the story of Ryan Arebuabo, the stroke victim whose viral photo of himself watching his daughters eat in a popular fast-food chain touched the hearts of

millions around the world. The photo perfectly captures the selfless love a father has for his children. After the photo circulated online and became viral, help in various forms poured for the family. This is a concrete example of civic engagement i.e., the power of social media clamor and the ripple effect that ensues. Like enzymes in biochemical reactions, we netizens should serve as catalysts for change. With the current issues our country is facing, the least that we can do is to harness the power of social media to inspire change; not to serve as purveyors of fake news spewing lies right and left and sowing discord. We must take the helm in forwarding the truth and extend our hands to pull people out of ignorance. *** Be a responsible social media user. If you can’t say it in person, then don’t post it. Share your stories and ideas to influence people and to initiate change and inspiration. Always remember that one small act can go a long way. At the end of the day, it’s not about how many likes your post has garnered, but how it was able to inspire and influence people. Turn that online noise into a vehement offline action. #InspireAndInfluence

Planning and talking: Advocacies of Mr and Ms Med ‘17 By Seneca G. Ejera

hat do you feel strongly about? Beyond gorgeous faces, dashing costumes and awe-inspiring talents, candidates of Mr and Ms Medicine 2017 spoke of socially relevant advocacies. Eight pairs bearing the blazing fire to fight for the title and crown clashed on September 11, 2017 at XU Covered Courts. Through the eyes of the judges and the crowd, Christian Aves and Nathalie Curtny Valdehueza of the senior clerks reigned supreme in the circus-themed competition. Moved by the sight of children asking for alms, Aves perceives poor family planning as the root cause of the problem. “I see street children begging in the streets. It saddens me whether or not there are parents caring for them or even waiting for them at home. If these parents would have just properly planned [sic] their family size and provided for these hungry children, we wouldn’t be seeing cases like this,” he imparts. These are the basic principles of family planning: responsible parenting, respect for life, birth spacing, and informed choice. Men and women of reproductive age, around 15 to 49 years old, ought to know this information. Recognizing the pressing need to raise awareness on family planning, Aves says he takes every opportunity to do so. “When I meet with and talk to friends, relatives, or even acquaintances and upon reaching 4

topics like sexuality, family, and raising a family, I share some knowledge about […] family planning methods [whether] natural or synthetic,” he shares. He also sees teaching and counselling Filipino families in numerous barangays as keys to have tangible results. On the other hand, Valdehueza

talked fluently about her heart’s desire to treat depression through psychotherapy, or “talk therapy.” “Being a 4th year [medical] student, it’s very difficult to have this advocacy as a different entity,” she says. “Because seeing patients every day, especially those having chronic diseases, and seeing their families, you can tell how they handle these problems and often these people manifest moments of

depression. […] All you have left to do and all you can allow yourself to do is to listen.” Depression is not a trivial matter. In fact, the World Health Organization recognizes depression as one of the most burdensome diseases in the world. Being one of the senior clerks, she did not make it as an excuse to act as if the need does not exist but responded through little acts of kindness to her patients whenever she has a chance to interact with them. “To be honest it’s very difficult for me to act on this now because being a 4th year student requires all your energy, mind and body [and] to focus on your hospital work,” Valdehueza expounds. “You are, for lack of a better phrase, a ‘slave’ to the hospital. But this has its ups, [for one] you get to interact with a lot of people especially your patients, so maybe it’s the little things you do: talking to them, listening to them and encouraging your fellow clerks and students to do the same.” *** The night of glamour offered more than a visual experience; it raised awareness on issues medical students are expected to know. Needless to say, their advocacies resonated with current and future doctors alike. Addressing these issues, family planning and depression, is the howl of not just two wolves but of the whole pack.

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Just like tonight, have time to enjoy and find other things to do than just reading books – Alonsabe By May B. Pingol

he annual Medicine Ball is one of the entertainment and recreational breaks doctors and aspiring doctors of XUJPRSM should attend to cope with the demands of the profession, as advocated by one of the resource speakers of the event, Dr. Ma. Orpha Alonsabe. It was held on September 16, 2017 at Grand Caprice Restaurant. More than a culmination of Med Week 2017 themed “Cirque du Medicine: Redefining the Doctors of Tomorrow,” Med Ball was a time to put all books down, stash all white coats away, and step into long gowns and tailored suits. It was also a time to welcome new members of the community; for fellowship and thanksgiving.

Adorned with circus-inspired embellishments, the hall held hundreds of students, faculty, and guests, all dolled-up and excited to witness the lineup of performances and speeches specially crafted for the gathering. The event particularly showcased the talents of students who performed their own renditions of some famous Broadway musicals such as Grease and Miss Saigon. In between presentations were inspirational talks from Dr. Alonsabe, Dr. Myra Maria Peralta, and clinical clerk Ralph Ryan Dela Rosa. Among all the performing groups, the mentees of Dr. Andresul Labis, Dr. Gina Itchon, and Dr. Edith Muro were hailed as the best performers of the night. Convincing the crowd to never stop believing, the group

neatly executed a medley of Mamma Mia and Rock of Ages. The night did not end without the veterans welcoming the med school neophytes. As tradition has it, XUJPRSM warmly welcomed 149 aspiring doctors into the commu-nity with cheers and good wishes for their newest adventure. As another school year starts anew, the XUJPRSM community was reminded yet again on how to balance life and choose entertainment wisely through the hustle and bustle of med school.

XUJPRSM ranks 7th in Sept 2017 PLE By Asley Kate L. Doong

UJPRSM placed 7th on the list of top performing schools in the September 2017 Physician Licensure Examination (PLE).

Fifty-four out of 56 takers passed the board exam, giving XUJPRSM a passing rate of 96.43%. The passing rate increased from the previous year’s 91.43%, as well as the overall ranking of XU in the PLE.

The Professional Regulation Commission (PRC) announced that 3,340 out of 4,064 examinees passed the board examination, with a national passing rate of 82.18%. The PLE was conducted by the Board of Medicine on September 9-10 and September 16-17, 2017 in Manila, Baguio, Cebu, Cagayan de Oro, and Zamboanga.

Congratulations to the new Xavier physicians! Ad majorem dei gloriam. Antoniette G. Ababon Fatima U. Abduljalil Hidaya E. Alawi Esther Ruth D. Alcazar Lilyka Vic P. Arceta Danica Riah C. Arquisola Mark Andrew B. Atup Aila O. Barba Alvani B. Benito Nicanor M. Cacho Jr Janssen D. Calalang Eula N. Calvez Dyanna Vieve M. Conde Krizza Marie A. Creayla Lizalou G. Curig Linley M. Dajao Jr Darrell Jay S. Dajay Settie Jamalia A. Eppie

Charisse Elden M. Gaid Klarc Patrick B. Gontiñas Krizzia Lei P. Japos Martina Aurea M. Jugador Ma Jenrah Faith Q. Libago Karl Lloyd P. Licup Giorgio Andro Y. Lim Andrew Anthony A. Lumang Karen Ashley A. Ma Norkhalisa S. Mastor Sittie Norhaya C. Maunting Francine Marie G. Nonan Francis Dominic O. Oliveros Marieto Austin G. Paasa Jr Faina Marie T. Pacana Mary Ena D. Palen Shiela Mae J. Piit Beethoven C. Pondoyo Maneka Jazz E. Rago

Robert S. Ramos Jr Kristine Mae E. Rana James Theodore T. Retuya Tristan Diego L. Saavedra Sarah Ruth S. Sabenecio Mae Cielito P. Saliot Peter B. Santos Kent B. Seriña Jeanjoe H. Serrano Jr Gerard Adonis C. Superable Aianne Ed T. Tabanao Linsid Angelou A. Tapongot Kwen Zee Bern C. Tautho Rochelle Mae L. Torres Allen Khadir O. Uy Ma Evita G. Zaportiza

By Nomaelle Jenn B. Valencia and Louren B. Aranas

merging fifth out of ten colleges, the Medicine Wolves prove they have leaped high from the bottom of the University Intramurals totem pole. With Med Week and academic requirements clamoring simultaneously for their time, the atheletes obtaining 374 points – a few points away from the College of Agriculture’s 392.50 points – is a noteworthy victory. The Connexus interviewed medical student athletes who showed how Wolves are far from being tamed and why the Intramurals intensified the indomitable spirit of the XUJPRSM community. Mikhail Aleksandri M. Labuntog – Track & Field (Men) Currently in 3rd year, this sports enthusiast played track and field way back in college. Alek was also a basketball varsity player who represented his high school alma mater for two years. “I usually do it for fun and this one’s my motivation as a med student,” he says. Being competitive, he got the hang of both diligence and sportsmanship. “Gaining a hundred points in med [Intramurals team] means a lot,” he remarks on the 100 meter dash being his most memorable event of Intramurals 2017. While his streak of competition and discipline made him stay in his chosen journey, he remains grateful for everything he strived for. Arianne Claire S. Alvarez – Badminton Singles (Women) Born from a family of athletes, this junior med student would see to it that she enjoys every moment of the game and triumph would follow naturally. Arianne has been playing a myriad of sports since grade school: badminton, table tennis, lawn tennis, takraw, basketball and soccer. She finds her overall experience in the Intramurals memorable because of the bunch of friends she

met and the support she earned from XU-JPRSM community. Her will and curiosity paved the way to ignite the passion within her. Since then, she noticed the more time she alloted for play, the more inspired she was in studying. “Never let it rest, until your good becomes better and your better becomes the best,” she remarks. Francis Derrick B. Alcantara – Lawn Tennis (Men) Brought forth by his fondness for lawn tennis since five years old, Francis becomes a different person when playing. Often called Kankan by his friends, he becomes remarkably focused yet relaxed. With his racket and accurate swings on court, he made the Intramurals an event drowned by loud cheer and filled with blazing excitement. Aside from lawn tennis, this sophomore channeled his prowess as an athlete in basketball and soccer. “Believe in yourself – they said it was impossible but I made it possible,” he states. Charmaine Dancesport

Kate

Tubongbanua

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Armed with the moves to set a historical record, Charmaine and Felrod, her dancesport partner, conquered the ballroom in Intramurals 2017. This pair of clinical clerks did not disappoint and reigned as champions – a first for the Medicine Wolves. Charmaine, a dancer since high school, takes a break from seemingly unending hospital duties through dancing. For her, dancing means breathing fresh air and embracing the ambiance of passionate music, steps, and beats. She shares, “Just dance not to impress but to express.” Ana Monica P. Tan – Taekwondo (Women) Taekwondo is more than a sport to Nikki. To

her, it not only entails passion and love for the sport but also serves as an arena to develop herself as a person. This ravishing wolf, who also participates in beauty pageants, was instrumental to bringing the team to the championships. Taught by her uncle who is now in the Philippine Basketball Association, she first learned how to play basketball. She imparts her insights on sports, “There’s no I in TEAM; you need discipline, respect and indomitable spirit; and offer every game to Him.” Selin B. Salih – Swimming (Women) Selin has been immersed in the world of sports since her childhood. She started swimming in grade school and played soccer in high school. On top of these, she also plays basketball and takraw. Amid the competitive atmosphere in sports events, this sophomore never played without having fun. Enjoyment is a reward in itself. In the Intramurals 2017, finishing a hundred meter butterfly was her most memorable moment. Bagging the gold medal is an additional win. She remarks, “When you’re having fun, you’ll never lose a game.” Riva Via Absuelo – Badminton Doubles (Women) Via has sharpened her skills beyond the realm of medicine such as sports and music. She has become remarkably able in badminton. Having smashed opponents since representing the College of Arts and Sciences in the Intramurals, Via has learned to predict her opponents’ move. With honed athletic skills, this second year student triumphed as champion in the game.

Stressing out and bouncing back: Hinigalaay 2017 By Deamond Daffney M. Palabrica and Jessel Fatima D. Cane with reports from Louren B. Aranas

or the 7th regional APMC-SN (Association of Philippine Medical Colleges Student Network) Convention, brains were tested, friendships were formed, and, most important, stronger bonds among medical schools in Mindanao were forged. True to its name, Hinigalaay 2017 aims not only to continue the tradition of establishing camaraderie among medical students but also as an avenue for aspiring and current health professionals to unite in addressing perennial, often overlooked, challenges – all to up the quality of healthcare in the country. Themed “Stronger APMC, Stronger Mindanao: Resilience Amidst Diversity, Strengthening the Mindanaoan Doctor”, Hinigalaay 2017 was more than the usual social and academic gathering. It was held on January 6 to 7, 2018 at Dynasty Court Hotel and at the XU Gym. The participating schools were: Brokenshire College of Medicine, Davao Medical School Foundation (DMSF), Mindanao State University (MSU) College of Medicine, Liceo de Cagayan University (LDCU) College of Medicine, and XUJPRSM. LDCU is the newest member of the network, with attending students part of its pioneering batch. The XU Cultural Dance Troupe, clad in colorful clothes characteristic of the Filipino culture, moved to an upbeat rhythm of metal and wood for a traditional Bukidnon dance in the opening salvo. The opening message set an inspiring tone, as Dr. Ruth S. Beltran, Dean of XUJPRSM, emphasized the essence of resilience and faith in times of crisis especially in Mindanao.

Stitches and burning resiliency

Dr. Hanizah G. Guro, a surgeon at Amay Pakpak Medical Center who continued to serve amid the turmoil in the Marawi siege, shares her experience. The war erupted during a conference at the hospital. Because the chief of hospital ordered all nonMuslim personnel to hide, Guro took over the surgery of a mountain fighter whose surgeon is a Christian. She recalls, “It was a night of terror. […] Contrary to reports, the military didn’t take over the hospital. Rebels were dominating.” In light of the siege, she stressed the importance of keeping a level head in times of crisis and that resilience is a quality that should be sustained even long after medical school. She adds how one person handles difficult situations can often make or break everyone else’s chances of survival, with two types of reactions to be expected in crises: either hysteria or level-headedness. To medical personnel working in armed conflictridden areas, Guro notes one “must be prepared mentally and physically.” Qualifications go beyond competence in the academe: professionalism, common sense, and adaptability. For medical students, she advises, “Being resilient is vital. What we can do is to help others become more resilient. First is to learn the ABCs and share these to others. Med students with high resilience levels have better quality of life.” The ABCs of resilience, she says, helps one analyze the situation through three aspects: adversity, belief, and consequence. People react differently to the same adversity or situation. Beliefs could be re-evaluated to heighten optimism. Consequences, on the other hand, can be reframed.

For her, the Marawi siege’s “positive consequence was to alleviate the suffering of people.” “There is no magic wand to make these adversities easy to handle,” Guro states. “We can either give up, put up, or step up […] Stepping up is we bounce back, fully recovered, and do whatever it takes to make the challenge. It makes a stronger person. That’s what resilience is about: bouncing back.” Stressing stress

In lieu of Dr. Maria Grace Sison, Dr. Maria Eufemia Yap discussed two topics far from being technical but are equally crucial in medicine: stress and burnout in medical school and interprofessionalism. Burnout is defined in plentiful ways. These include, she enumerates: accumulation of stress from the demands of daily life, manifests of personal exhaustion, and low personal accomplishment. She mentions burnout can become a problem in the workplace, not just a personal issue, as it can lead to impaired functioning, medical errors, and even high staff turnover rates. Yap emphasizes on recognizing the signs of burnout and on self-awareness of one’s own fatigue being the important first step toward its management. “Many factors lead to burnout. The external factors are plenty. That which we can control is ourselves,” she elaborates. “Know ourselves. How do we cope with stressors? You must be aware about the symptoms and behaviors that manifest when you are exhausted, burned out. Awareness allows us to understand better how to cope with stressors.” Burnout is also closely tied with selfcare. She quips caring for one’s self is not limited to “drinking until 4 a.m.” or “sleeping until noon” but “to make sure you respect your body as an instrument to carry out your vision.” Regular aerobic exercise, she cites, is a good habit for mental and physical health. Ultimately, she aims to inculcate the sustainment of one’s “compass” or reason for being in a current path in life to deal with stress. Addressing the how to be in line with one’s compass, she illustrates, “If you don’t constantly define what your north star is, you won’t know why you need to do what you are doing. […] By the end of the year, ask yourself: How am I now as a person compared to when I began? Am I better? Do I know more? That is to refreshen and renew oneself.” Focusing on steps students can use to combat the daily stresses and frustrations of life in medicine, Yap recommends training the mind and spirit to improve one’s attitude toward their work and seeking out support from peers and family. Ikigai – the Japanese concept of the realization of what one hopes for – served as a perfect concluding slide for the topic. Captain no more

“Collaboration between physicians, nurses, and other health care professionals increases team member’s awareness of each other’s type of knowledge and skills, leading to continued improvement in decision-making,” says Yap on the importance of interprofessionalism in the medical field. She states communication is the key; lack thereof often

causes problems in patient safety, like medical errors and surgical complications. Inter-professional care aims to improve patient satisfaction, the health of the population, as well as reducing the costs of healthcare by preventing service duplications. Effective clinical practice, Yap says, goes beyond diagnosis and treatment – it involves efficient communication. “You are doing a disservice to the patient when you find talking in person with other health workers a waste of time and would rather communicate through charts,”she elaborates. “We do not talk anymore because we think we must be fast-paced about this.” Charts, for instance, are an easy way to communicate the patient’s progress to other doctors and nurses yet are prone to misinterpretation. Miscommunication can occur when one wrote less clearly what he meant to say; this, in turn, can lead to unsatisfactory patient care. Although difficult to monitor on a larger scale, she says developing a commitment to the common goal of collaboration is the best way to overcome barriers in establishing a more connected health care team. In the same light, she debunks the common perception of a doctor being the “captain of the ship.” “Because the world of medicine and health care has become so specialized, many kinds of workers are attending to the needs of the patient. […] There is a clear recognition each one can bring something to the table for the care of the patient. If you do it just because you have to but you don’t believe you’re equal to everyone else in the team, there can never be genuine interprofessional care.” Mind games and beyond

Setting a good start to the annual national research competition, the PAGSUHID Regional Research Competition presented studies in basic sciences, and translational medicine and public health by students from DMSF and XUJPRSM. To conclude the first day on a lighter note, medical students changed into their denim attire for the Socials Night. Laughter and cheers filled the room as they joined parlor games such as “Bring Me” with modified mechanisms. For a pageant with a twist, the schools’ representatives for Mr. and Ms. Hinigalaay 2017 were chosen on the spot. Meanwhile, the 2nd day of Hinigalaay 2017challenged the knowledge of med students in the ClinicoPathologic Conference Competition (CPC) and PAUTAKAY Regional Quiz Bee. Students, in a cohesive, logical manner, dissected the patient history and tackled facts in ruling in and out differential diagnoses. Having bested 9 participants, Brokenshire College will represent Mindanao in the APMC National Convention. PAUTAKAY turned out a cutthroat competition particularly between MSU and XUJPRSM vying to qualify for the championship round. DMSF reigned as champion with MSU landing second place. *** Truly, the 7th Hinigalaay paved way and served the purpose of APMC-SN: building networks of student doctors for future endeavors and, of course, strengthening bonds that would furnish resilience in tackling the future of medicine.

By Maricor Gin O. Edma

“

There is still hope for Marawi.”

Amid the turmoil that affected the daily living and health of hundreds of thousands, Francisco Duque III, secretary of the Department of Health (DOH), assured that they have been working on the city’s health concerns as top priority. Marawi City is home to 500,000 people. On May 2017, the city was ravaged by an insurgent group, later identified as the Maute group, armed with heavy weapons and a dogma of terror. After landmarks turned into debris and bloodshed transpired, Filipino soldiers declared a cessation of hostilities on October 2017 – a glimpse of long-lasting peace shone. Nevertheless, remnants of war remain ubiquitous and pressing. These include people’s health.

Bigger than numbers

“We thought the conflict would last only for few days. [The] 1970’s was the last time I’ve been displaced but both displacements have been destructive,” Babao Aisa, a local of Marawi, shares her story. Moreover, a freshman of XUJPRSM tells his life-changing experience, “…thanks to God we are safe. [It’s ] so sad, because Marawi is the only [place] that [shows] our identity as Maranao.” Since June 2017, the DOH has housed over 20,000 families in evacuation centers surrounding the Marawi City capital. While many sought shelter with relatives in adjacent areas such as Iligan City and Cagayan de Oro City, majority are in 68 evacuation centers. Around 100,000 residents ended internally displaced. The congestion and lack of sanitary facilities provide a fertile ground for

developing and aggravating diseases. In a statement issued in December 2017, the DOH reports, “A total of 86 deaths has been recorded at evacuation facilities from May 23 up to the present, with the common causes being pneumonia, sepsis, cardiovascular diseases, acute gastroenteritis, and prematurity.” Clearly, the health burden extended to nearby hospitals. Eight hundred eighty-two patients were referred for treatment mostly in Iligan City. The Department also estimates that 16,411 affected residents during the five-month siege were admitted to nearby health facilities. Before 2017 ended, 18,000 families from 40 barangays in Marawi returned to their homes. With the armed conflict leaving their hometown in ruins, evacuation centers are projected to be needed until the end of 2018. Relocation sites have been mapped but will still be in the works until the second half of the year. Eduardo del Rosario, Secretary of Housing and Urban Development Coordinating Council, highlights, “1,100 transitional shelters for Marawi evacuees will start construction on first week of September.” The DOH guaranteed the public of continuing full health coverage, from monitoring to treating, for those in the centers. As of December 3, 2017, the Department of Social Welfare and Development (DSWD) said 66 evacuation centers are operational in 17 municipalities in Lanao del Norte and Lanao del Sur. Rebuilding homes and hope

Duque stresses t h a t lack of clean water supply and access to sanitation remain a barrier in health delivery. "We have to make sure that we can address the

health needs of the people there, especially the damaged health delivery infrastructure,” he stated in The Philippine Star on October 2017. Aside from physical health, a big emphasis was given on mental and emotional health: stress debriefing of soldiers and residents, especially children were provided. Judy Taguiwalo, DSWD Secretary, pointed out the importance of play therapy for children. As of press time, the DOH, along with different non-government organizations, conduct sessions to keep the survivors’ mental health in tiptop shape. In rehabilitating Marawi, a staggering amount of money is needed to rebuild it the way residents have known and loved it to be. Budget Secretary Benjamin Diokno said in a press conference that the budget for Marawi Recovery and Rehabilitation Program sums up to P20 billion. Other countries have extended assistance; Australian Foreign Minister Julie Bishop has announced their aid to amount to $20 million. In a bilateral meeting at the Malacañang Palace on November 2017, China agreed to grant ¥100 million. To ensure transparency in rebuilding the city, the Department of Works and Public Highways said on April 16 it will live-stream the efforts through drones and geotagging. *** Currently, the reconstruction of infrastructure has started, particularly churches and bridges that connect people of various religions and cultures. It has been six months since the fallen city has reclaimed its liberty. Still, Filipinos rejoice for despite this unprecedented circumstance, the force of love and camaraderie proved to be stronger than the clout of terror.

By Crisbelle Ann E. Irag

etiological agents as its feat of antimicrobial resistance poses major threats to the global health security.

effective in the long run. These expensive antibiotics are also unavailable in many lowresource settings.

40% of the global burden of gonorrhea infections. Its incidence and magnitude clearly instigate a global collaborative action against a minute organism.

The infection may be either asymptomatic or cause mild manifestations easily relieved with a single dose of antimicrobials. Its being asymptomatic largely contributes to extensive transmission and persistence. Since clinical manifestations are often absent or obscure, thus warranting no medical attention, infection may be left untreated, and (PID), infertility, and ectopic pregnancy – may arise. Gonococcal infections in pregnant

With the looming health crisis brought by an antimicrobial-resistant superbug, it is imperative that we initiate sustainable efforts to heighten international collaborative actions for its control. This encompasses reduction of infection risks, effective prevention strategies, early detection, and proper antibiotic use. Prudent antibiotic use is important to note: the higher the treatment rates are, the faster the spread of antibiotic resistance. Hence, treatment recommendations for N. gonorrhoeae should carefully balance the prevention of infection and avoidance of resistance spread. The emergence of this superbug calls for the

espite medical advances, sexually transmitted diseases (STDs) remain a leading cause of disease burden worldwide. Risky sexual behavior and early onset of sexual activity are two key factors that contribute to the spread of STDs such as gonorrhea. In 2012, the World Health Organization (WHO) estimates 78 million new cases of gonorrhea among people 1549 years of age. Its most recent data show 35.2 million new infections annually in the

Sealed with a pus

Gonorrhea is a purulent infection of mucous membrane surfaces, mainly in the urethra in males and the cervix in females, caused by Neisseria gonorrhoeae. Aside from sexual contact, it is spread via vertical transmission (mother to child) during childbirth – it has become highly adapted to genital tract colonization thus transmitting the virus to the child passing through the birth canal. Neisseria gonorrhoeae is an inconspicuously virulent microorganism that can evade and adapt to host defense systems; survive for a long time without causing immediate, debilitating damage to the host; and be easily transmitted to other hosts. This ability to elude immune responses is brought about exchange resulting to high variability in terms of genotype, phenotype, and antigen, several strains have evolved and emerged – most of which have become resistant to widely used therapeutic agents. The widespread emergence of antimicrobial resistance has been compromising effective treatment and control. For this reason, N. gonorrhoeae

maternal death and severe neonatal eye fold increase in the risk of transmission Virus (HIV) and Human Papillomavirus (HPV) has also been documented. Beating the bug

Although gonorrhea has been treated successfully by single-dose antimicrobial therapy for the past 70 to 80 years, Neisseria gonorrhoeae has now become a superbug, developing resistance not only to the less expensive antibiotics like the sulfonamides, penicillin and tetracyclines but even to In most settings, the third-generation class of cephalosporins, especially ceftriaxone monotherapy for gonorrhea. Thus, recommendations to use dual antimicrobial therapy with ceftriaxone and azithromycin have now been introduced in many countries. Unfortunately, the gonococcal susceptibility to ceftriaxone has been widely decreasing and resistance to azithromycin is already prevalent. Therefore, these dual antimicrobial regimens might not remain

crucial and correct use of antimicrobials among healthcare providers, even among medical students like us. A critical aspect of disease surveillance is developing a systematic monitoring of treatment failures and detection of antimicrobial susceptibility especially in poorly structured health systems. It is also necessary to gain insights on how it develops drug resistance. Further research on its mechanisms will bridge knowledge gaps that will eventually aid in discovering a more effective therapy. *** We may still be in medical school but we must already inculcate the importance to holistically learn and practice good clinical judgment, especially in the diagnosis and management of such diseases which imperatively includes counseling and education about the patient’s lifestyle behaviors and practices. Trying to or killing superbugs is only part of the battle.

Med Week ’17 in a nutshell By May B. Pingol and Ma. Coralene Rose T. Silverio

Mr. and Ms. Medicine Talent Night September 8

Mr. and Ms. Medicine Coronation Night September 11

The XUJPRSM community witnessed a sneak peek of Medicine Week 2017 as candidates of Mr. and Ms. Medicine walked the runway. The candidates fearlessly showcased their never-beforeseen talents, proving that medical students can also conquer the stage with skills beyond the boundaries of medicine. In the end, level one candidates, Michelle Anayron and Deric Jazon, outshined them all through an interpretative dance relating to nature.

The new faces of XUJPRSM were named in a night full of glamour, excitement, and cheers. Mr. and Ms. Medicine 2017 candidates flaunted their casual, creative, and formal wear as judges selected six contestants who would advance to the final round. Nathalie Curtny Valdehueza and Christian Dale Aves, both from level four, captured the hearts of the judges and the crowd and proved they both deserved to be crowned Mr. and Ms. Medicine 2017.

Dr. Jose P. Rizal Memorial Lecture September 11

Medicine Day September 13

What better way to officially start the weeklong celebration than to welcome and get inspiration from one of XUJPRSM’s esteemed alumni? Dr. Lampa I. Pandi reminded the students of emulating the school of medicine’s namesake, Dr. Jose P. Rizal, by using their knowledge and skills for the common good. As catalysts in redefining the future of medicine, students were invited by Dr. Pandi to heed the call to serve where the need is greatest: in far flung areas of the country.

Medicine Day was definitely not a typical day for a medical student. An entire morning was spent by Level 1, 2, and 3 students away from books and studying; instead, all were busy interacting with acquaintances and friends from other batches, purely de-stressing and having fun in the physically- and mentallychallenging Amazing Race. It tested their physical endurance as well as their coordination with teammates – it showed beyond doubt that teamwork knows no boundaries. In the end, the Red Team emerged as champion of the Amazing Race, proving that teamwork is key to their success.

Med Minds September 11 Surely, medical students do not only keep themselves abreast with the latest advances in the medical field but in other disciplines as well. This was put to the test when 25 teams joined Med Minds, an everything-under-the-sun trivia quiz. After three challenging yet exciting r o u n d s, Roch Bandala, Paul Budiongan, Vanessa Chenfoo, Marionne Poblacion, and Joshua Villaroya bested all the other teams, and were hailed as champions of this year’s Med Minds competition. As a reward, they received additional points, gift certificates, and bragging rights.

Medicine Ball September 16 The culmination of a weeklong celebration, the Medicine Ball was a night to remember as current and aspiring doctors traded their daily uniforms for long gowns and suits. The Ball served as a celebration of the success of Med Week 2017 and as a welcome to new members of the XU-JPRSM community. An enthralling part of the night was students showcasing their talents in dancing and singing through their renditions of some famous Broadway musicals.

By Louren B. Aranas, Jessel Fatima D. Cane, and Karen S. Tanseco with reports from Charissa D. Santiago chaired by appointed faculty members o meet the demands in health Reaccreditation process with Dr. Maria Luisa B. Tan as the overall particularly in Mindanao, XUJPRSM Preparing for reaccreditation is not solely chairman for the PAASCU reaccreditation. has been offering medical education shouldered by the school of medicine; rather, A common denominator in the preparation since 1983. It aims to achieve excellence it is a university affair, with the university of the different committees is the self-rating by, among others, shifting its curriculum of PAASCU-standard rating sheets and to outcomes-based learning and providing as the overseer of PAASCU matters. As with any application process, paperwork brainstorming in order to come up with lectures by established physicians. All these are in line with its vision of forming a forms the bulk and core of reaccreditation. recommendations. Data were collated and “community of physicians of conscience, Administration personnel Mrs. Concesa presented to the faculty and students, making commitment and competence in the delivery B. Surdilla shares, “Preparation is geared the process an inclusive one. towards standardization. Records need to be of health care services.” updated […] because this is for the school Bigger and better To keep itself attuned to the changing also, [and] not just for PAASCU.” Dr. Isabelo Sabanal, Jr., head of the times and demands in medical education, XUJPRSM must continuously strive to According to Mr. Ram Gustilo, the point Physical Plant committee, believes that the maintain and provide quality education. One person for the preparation of documents School did its best in implementing past way of doing so is through coordinating and and coordinator between the School of recommendations in order to improve the Medicine and the QMO, preparation for school facilities and be worthy of the Level organizations such as the Philippine reaccreditation started as early as 2016 III reaccreditation. Accrediting Association of Schools, Colleges with a series of meetings with the different Past recommendations included the and Universities (PAASCU). How did the PAASCU chairs. Preparations should be school fare lately? started as early as possible because addressing provision and expansion of rooms. This the recommendations cannot be done pushed for the establishment of bigger and P overnight. However, the school of medicine more numerous lecture rooms with better What is PAASCU? acoustics such that lectures in adjacent rooms PAASCU is an organization whose objective PAASCU (e.g., improvement of facilities) would not be disturbed. More than just the is to accredit academic programs that are able because it is still partly dependent on improvement of the discussion rooms, the to meet their standards for quality education. university decision-making, especially now Accreditation Team also recommended Its evaluation of an institution places that cost-cutting is practiced university-wide that the ventilation of the Student Council more emphasis on the degree by which the as a repercussion of the K-12 education. institution’s avowed purposes and objectives Aside from paperwork and documentation, faculty room be provided, and the laboratory are matched by actual practice. several committees were formed. These technicians be given additional training. committees serve to deliberate and address Finally, it was suggested that more prominent the recommendations given by PAASCU signs appropriate to XU-JPRSM’s prestige during their last visit. The committees were be furnished with the school’s name proudly

displayed.

in research.”

Five years passed and the school has acted on many, if not all, of the recommendations given. According to Dr. Sabanal, the most

All recommendations given by PAASCU during their last visit for the area of research were implemented except for the peer-

of the school was the complete turnover of the building to the School of Medicine after the departure of the Committee of German Doctors in the 1st quarter of 2017. This allowed for the renovation of

constraints. Dr. Itchon comments, “Maybe we can implement that in time when the budget is okay.”

student lounge, Level 1 faculty room, and of the building was also renovated in order and a large lecture room that is convertible to 3 small-sized lecture rooms. Just last include 4 new multi-media capable SGD rooms, a new medical library, and a wellventilated Gross Anatomy laboratory with new learning models for clinical skills development. The School of Medicine also now holds a proud sense of identity having installed the large silver brass signage carrying its complete name on the ledge of School struggled in addressing were scouting for training opportunities for the laboratory communication facilities such as an intercom and handheld two-way radios. With regards to future improvements, it can be expected that more multi-media capable SGD rooms will be constructed and more learning models will be acquired. In the area of infrastructure, the faculty room on the

The research aspect

Research is an integral part of medical education. With the growing appreciation that researchers make better clinicians, medical students are honed in the art of research. As such, this is one aspect of the school that PAASCU looks into. Dr. Gina S. Itchon, head of the research committee, shares, “We were busy preparing because evidences must be exhibited, such as journals, research awards of students and faculty members, [including] class schedules showing that research is part of the curriculum.” She further adds, “One of our strengths is that we have a very good training

Another recommendation that was not implemented was the partnership with Central Mindanao University for the use of their animal house for experimental researches. Instead, the School of Medicine opted to establish a partnership with Manresa Farm for such purpose because of the ease of accessibility. The School of Medicine may be strong in its training in the area of research, but Dr. Itchon believes that there is still room for improvement. She expounds, “One of our faculty members doing research. However, the caveat here is that the faculty members are very busy and there is no protected time for [doing] research.” Protected time means that a faculty member allots his time solely to research. Therefore, he will not handle any teaching load. This poses a problem on the employ a full-time professor to handle the subject load of the faculty member who has to go into research. Room for learning

“Although it’s already relocated to a bigger area, it still cannot accommodate all [XUJPRSM] students,” she notes. As she recalls, students’ most salient suggestions include faster Internet service and extended library hours. It is open from 8:00 a.m. to 7:00 p.m. For now, some make use of the new student lounge to study late at night. Many also recommend setting up a mini café in which they can have breaks. Vanessa Tangon, a sophomore, comments, “Ganahan kaayo ko naa’y snacks and coffee [available upstairs]. Dili na hassle i-saka kanaog if mag-buy ug pagkaon.” Lastly, many deem the library more conducive for studying if noise within and around the library is better controlled. Erin Sophia Emata adds, “Sometimes dili ma-contain ang kasaba […] If ang students saba, dili pud sila gakabadlong.” last accreditation, the library still leaves much to be desired which includes incorporating discussion rooms. “The rest of the library will be an area for individual study,” Dr. Aranas states. “Those who prefer to study in groups can discuss in these rooms. When the library is full already, discussion rooms can also be used to accommodate students.” As of writing, recommendations from PAASCU have yet to be sent. Training beyond the tests

While the term ‘clinical training’ gives an

A conspicuous change in XUJPRSM is its library’s renovation and relocation to the 5th

procedures in the hospital, its scope expands beyond this area of work.

Eve Aranas, head of the library committee, says the School “continues the development of library resources to meet increasing needs of students, faculty, and alumni.” These resources include more online journal databases such as OVID.

For one, to broaden the students’ horizon apart from the medical realm, the school has “adopted” Brgy. Baybay, Alubijid for community work. It involves all year levels in which students have been doing community diagnosis, program planning, implementation, evaluation, and research. One result of the students’ involvement is the community addressing a public health concern on proper garbage disposal and sanitation. Having an “external validator” helps the local government unit (LGU) tackle problems, which directly or indirectly affect people’s health that may have been overlooked.

Dr. Aranas states another recommendation from PAASCU that has been implemented, “The development of a marketing plan that spells out strategies on how to reach out to users with the aid of technology and electronic resources.” For one, the XUJPRSM library has its Facebook page that displays changes in library hours and list of new acquisitions. With around 300 students, however, accommodation remains a challenge.

Stephen RB Sapiera, clinical clerk, opines, “I hope that we would have more health consults with the people, and not to be

focused on paper work. If there will be paper work, I would rather do extensive research on the health needs of the marginalized communities.” With mal- or undernutrition being a perpetual health problem, the Vegetables Go to School (VGtS) Program provides nutritious and affordable meals to elementary children while they are in school. XUJPRSM has signed a contract with Swiss Tropical And Public Health Institute to implement VGtS. Even level one students assist by implementing one session in several public schools. Meanwhile, although the XU Community Health Center-Committee of German Doctors has ceased its hospital services in the city, its TB treatment facilities remain available. Clinical clerks spend two weeks directly handling TB patients. In 2015, concurrent to having had an additional rotation in psychiatry at Vicente Sotto Memorial Medical Center in Cebu, senior clerks’ community medicine rotation increased to two months. As of press time, the PAASCU committee recommended that the School’s agreement with the LGU include allowing the students to stay in the homes of host families. This option will not only further the students’ immersion in the community but also improve their understanding on families

should they seek medical consult, as students witness firsthand the living conditions and dynamics. Faculty preparation and facing the challenges

Dr. Myra Maria Peralta, head of the committee on faculty, shares that, in preparation for the accreditation, previous output from the 2012 visit was thoroughly reviewed, with an emphasis on the recommendations. She states that the information gathered from the previous visit, especially on faculty improvement, was largely the basis for this year’s output. When asked about the challenges faced during the preparation period, Peralta expresses, “The number one challenge was in collating evidences for appendices and exhibits. Most of the data was either incomplete or not easily accessible. But with the help of the admin staff, we were able to collect everything [that] we needed.” In terms of improvement, she shares, “Faculty-wise, we are in a better place, around 8.5 out of 10. The main area that still needs improvement is our international linkages […] due to costcutting [initiatives] in the University and foreign travel delays because of the current peace and order situation in Mindanao.” Establishment of international linkages with leading educational institutions aims to optimize the students’ learning

experience. Accreditor vs. accreditation

“Opening a medical school is easy, all you But over and above that is PAASCU,” shares Dr. Agaton Panopio, one of the pioneering faculty members of XUJPRSM. Having had the most experience when it comes to these visits on both the giving and the receiving about the whole process. When asked about the difference between being the accreditor or being part of the school faculty preparing for accreditation, to prepare for a visit than to be the one visiting, “Ideally, it takes about one year in preparation for accreditation, because that’s about how long it takes to prepare the evidences. Collection of all the data needed was extended even up to the last minute.” Being in charge of the area of curriculum and instruction for this year’s PAASCU visit, a lot of paperwork had to be collated and readied for the visitors. “All modules and syllabi must be present,” Dr. Panopio emphasizes. Even examinations given within the semester were also reviewed. He adds, “We have to make sure that we have a table answer key, and results.” Notwithstanding the stress associated with preparation,

Dr. Panopio comments, “We welcome accreditation.” Truly, reaccreditation is one way to assess the School’s services in order to continually improve. The students’ role

Aside from faculty and facility checks, students were also given the opportunity to share their thoughts about the general situation in XUJPRSM to the PAASCU accreditors through a closed-door inquiry. A random mix of around 40 students from all year levels was requested to attend. May Pingol, one of the freshmen in the bunch, shares, “It was our responsibility to honestly and fairly respond to the questions of the visitors, [who were] hoping to see continuity of [the] good practices currently being employed by the school.” On the other hand, Jan Tristan Acenas, a sophomore, quips, “I was really nervous to face them, thinking that we would be interviewed individually and I would say something that could ruin the school’s accreditation status. […] Fortunately, the panelists were accommodating and they gave us a 'safe space' to share suggestions to better the school facilities and system.” When asked about the accreditors’ general responses to the student’s answers and sentiments, a junior medical student comments, “I think the accreditors already had their minds made up before the with what they were seeing; hearing it from Stephen RB Sapiera, a clinical clerk, found

the whole experience surreal. “Being a senior medical student, it's a privilege to sort of leave a legacy for the school. To be part of the forum was nerve-wracking really, and all of us wanted to do well. What I appreciated though was the accepting atmosphere of the accreditors which allowed us students to be frank about our needs and wants,” he shares.

Reaccredited. So what? Unbeknownst to many, reaccreditation is not all about to services is granted to an institution once it attains reaccreditation from PAASCU. This includes authority to offer new courses related to existing Level III courses; to revise the curriculum and to graduate students without the need for prior approval (provided is duly informed); to offer new graduate programs, open learning or distance education, and extension classes; and to be able to participate in the transnational education, among others. XUJPRSM’s current standing

After more than a year spent in preparation, the collective effort of the administration, faculty and staff, and students paid off XUJPRSM was able to maintain its Level III status. As of press time, the De La Salle Health Sciences Institute and XUJPRSM are the only medical schools in the country accredited with Level III status by PAASCU.

The next step

Dr. Ruth Semilla-Beltran, dean of the School not something new. In fact, the School has been involved in PAASCU accreditation for a long time as part of a cycle wherein reaccreditation is required as a previous one expires. When asked what the next step is for XUJPRSM, she replies, “Either maintain Level III or go to Level IV.” It’s no secret that medical schools across the country have their eyes set on the ultimate prize— that is, achieving the Level IV status. “The major hurdle we have to overcome in attaining Level IV status is to be able to establish linkages with international institutions,” she adds. Establishing

linkages

with

esteemed

areas intimidate and scare foreign professors to go here. “The least [that] we can do is to improve the school’s Wi-Fi connection to enable cyber lectures and allot rooms for that purpose,” she concludes. *** Having achieved a Level III status does not mean we have reached a standstill. The need and opportunities for improvement are vast – not only to maintain the prestige we have attained and achieve Level IV but, most important, to mold aspiring doctors to become competent, compassionate, and conscientious in every sense of the word.

hen I graduated from high school, I was resolute in studying a discipline that entailed neither maths nor thick textbooks but a lot of field work and writing. The thought of studying alone replacing hours of sleep and social gatherings was horrifying. I had only a faint idea of what Development Communication was but it appeared most appealing. Basically, it uses theories and media in communication to improve people’s lives. Graduates ideally, among others, bridge the knowledge gap between the experts and lay people, and work in the field of communication and nongovernment or humanitarian organizations. We learned mostly from community work, exposure to the media, and the process itself of creating an output like a magazine and radio program. Needless to say, it was far from an “ideal” pre-med course.

hindsight, I probably did it for eligibility to serve as editor-in-chief of the University’s official student publication.

I then took up MA Sociology as suggested by my mentors, but soon discovered that I lacked the motivation to finish it, evidenced

Although my classmates and I are proficient in our respective fields, some experiences remain universal. These include that pang of regret after changing the first answer that was actually the right one; the struggle in managing time efficiently to keep the grades in all subjects apart from PBS afloat; the guilt after a planned 15-minute power nap turned into hours; and the accomplishment or dejection upon seeing one’s ID number in a page of ranked scores. Most importantly, we all aspire to become doctors in 2022.

by me shying away from new, complex topics, instead of trying to understand these. In the first place, my intention for enrolling was vague; in

Given my background, profoundly lacking in medical experience, people often ask: why? My parents never encouraged, let alone dropped subtle hints, most likely because they knew the extent of stress medical school induced. I’d be lying if I said it was a childhood dream. I considered the thought but never acted upon it. I had convinced myself that I was “not made for” a discipline that required most of my waking hours poring over the intricacies of the human body. But why not? I saw how my parents alleviated people’s burdens through their expertise. It hit two of my criteria for satisfactory work: practicing one’s skills while serving others. The fulfillment of it, unparalleled, I imagined.

In more challenging times, such as exam results that fall short of the passing score or my expectations, I do find myself wondering how things would have turned out had I taken another course. What if I took up biology and had a better foundation of life sciences? What if I studied medical technology and found that identifying specimens and interpreting lab values like almost second nature? What if I took up nursing and were knowledgable in hospital work like performing physical examinations? What if I took up pharmacology and drug names are familiar rather than a bizarre concoction of letters? These alternative scenarios can feed frustration and

amplify insecurities, particularly when I feel like I am the only one having a difficult time understanding a topic and many seem to have grasped it almost immediately. It is easy to attribute my lapses to my life sciences-lacking undergrad course (i.e., “Nabagsak/naglisod kay dev com man.”) but I figured it is a counterproductive justification as it gives me a convenient excuse to settle for less when I can always do more. Knowledge can be mastered and skills can be developed. As Khan Academy succinctly put it, “You can learn anything.” Knowledge in specific sciences is an advantage in medical school yet factors paramount in this pursuit are to be learned beyond the rigors of academics. The discipline to prioritize and steer clear of online and offline distractions. The humility to ask for help, admit mistakes and say one does not know everything. The self-awareness and -compassion required to cope healthily with stress, and acknowledge the root cause of overwhelming emotions that can interfere with studying. The will to power through taxing demands regularly even without the guarantee of results reflective of one’s efforts. The resilience to continue studying even if the light at the end of the tunnel seems perpetually remote and dim. In the grand scheme of things, when one will have been practicing in a hospital, working in humanitarian organizations, studying for research or sharing expertise in the academe, the pre-med course is but a distant memory. I have been told that, patients focus not on a doctor’s quantitative and ranked records but on how one is competent, conscientious, and empathetic enough to ameliorate their suffering. I’m unsure how development communication would benefit my future practice. But this I am sure of – one’s driving force and everyday determination to become a doctor knows no course. *** To put in medical parlance: Regardless of one’s genesis to and mechanisms in this course, the prognosis is optimistic as long as the host’s innate response is strong, no matter how aggravating the endo- and exogenous factors get.

Sneak peek: Stages in medical studies By Ma. Coralene Rose T. Silverio

For medical students whose weekday routine revolves around lectures, discussions, and exams, clerkship and beyond seem such a foreign, remote period. Past student doctors share their experiences on “what med school made them do.”

High (and low) fives Ken Jeryle M. Papelleras, Senior Clerk

Here are five things I always remember during clerkship: 1. We are not the “lowest form of animal” in the hospital. Hierarchy dictates so but we don’t have to feel sorry for ourselves or normalize “other forms of animals” treating us like crap. No one deserves to be treated that way. Always remember that you are part of a team; in the center of that team is the patient. Our role is vital, just like everyone else’s. 2. Clerkship is not magical most of the time, unlike what we see on TV series. No slow-mo moments or a perfect soundtrack. Everything happens so fast. But cherish and live in the few magical moments.

3. It’s the best time to learn how to become a good doctor. Not great, but good. Not inevitably good in technical procedures but a good friend and colleague. Remember: One can be great but not always good. When you are good, greatness follows. 4. It changes your mindset. I always thought that I was going to become a surgeon. Clerkship opened my mind and widened my horizon. 5. It’s like high school – it’s fun but I wouldn’t want to go through it again. It has most of our firsts as future doctors: scrub out, baby out, retract, among many others.

I bet after we say “Good riddance school,” we will only have begun. Still, getting through clerkship means finishing med school and that is definitely worth looking forward to.

My “Brok” experience Lowell A. Batoon, PGI

One of the hardest decisions I made during clinical clerkship was choosing a hospital for post graduate internship. When a friend told me about a hospital commonly known as Brokenshire Hospital in Davao City, I hesitated at first. However, listening to good endorsements from its previous interns convinced me to place it as my first choice. Fortunately, I was accepted. I do not regret my decision. Being an intern in that particular medical institution has many advantages: monthly stipend and food allowance, free dormitory prioritized for those

living outside Davao City, and health benefits. However, I consider highyield learning as the “stronghold” of the institution. The consultants and residents are accommodating and willing to review the basics in Medicine, discuss the pathophysiology of diseases, and come up with individualized patient care. I can truly appreciate how doctors treat patients based on the management mentioned in textbooks, the guidelines, and their experiences. I became confident in explaining the patient’s condition and treatment. Overall, my internship was enjoyable. I myself would endorse the said institution to future interns.

Another beginning Linsid Angelou A. Tapongot, MD Our four years in medical school and one year internship come to fruition in a single examination – physician licensure exam. It determines whether we reap what we’ve sown in around five years. You might be a bit unnerved but the best way to prepare for the boards is doing your best in med school. When you know the basics, you can learn better from patients. Learn from residents during rounds and case conferences. Don’t be afraid to be inquisitive but read on your cases and communicate with your patients. Because of the academic calendar shift, our batch had 60, instead of 90, days to cram four years’ worth of learning. I loved that the review center formulated a study schedule so we wouldn’t miss out on any subject. Despite those grueling 3 a.m. caffeine-induced zombie-like state, we made it! We

even placed 7th among top performing schools nationwide. With the glory of finally attaching an MD after your name comes the pressure to give back, to work, and, in millennial’s slang, to “adult.” It’s a different world where you’re caught between helping pay for house bills and splurging or treating yourself. It can be daunting but with Ignatian values like magis (to do more) etched in our consciousness, success will be inherent. *** Our journey in medicine is never-ending. Life-long learning bears greater meaning than an outcome included in the portfolio. We commit to a lifetime of learning and self-improvement. In hopes of making a difference the way we know best, each line of highlighting should serve as a step toward saving patients with the stroke of a scalpel.

UNDER THE MICROSCOPE:

Dr Jojie Tan By Crisbelle Ann E. Irag

he overrules the odds with her gentleness and humility – a trait evocative of a mother. Aside from her brilliance in microbiology, Dr. Maria Luisa “Jojie” Tan is one of the most resilient and kindest doctors. Patchy path

Dr. Tan has always been inspired by the motivation and determination of her father who aimed to be a doctor. He dreamt of owning a hospital for the poor. However, his family's finances were insufficient to send him to med school; instead, he took up mechanical engineering. Eventually, his children thrived in health-related careers– one of whom is Tan who was filled with hope to fulfill her father's dream. She graduated cum laude with a degree in biology from the University of San Carlos. She was ready to sail the bumpy waves of medicine at the Cebu Institute of Medicine when plot twists

unfolded. Days before starting med school, her mother died of breast cancer. Tan was devastated but such adversity did not stop her in pursuing medicine. In her second year, she braved another storm as her father succumbed to lung cancer. “Quitting med school was always at the back

constraints,” she says. “With these trials in life, who would not? I really believe that we all have these moments of doubts as medical students challenges in medical school.” Road to recovery However, Dr. Tan found financial, emotional and moral support from her siblings who she likens as the wind beneath her wings. She also considers God’s mighty hand as her well of strength and courage that guided her through her toughest years. After her post-graduate internship (PGI) at the Perpetual Succor Hospital in Cebu City and passing the physician licensure examination, she worked as resident physician at the pediatrics department of the Phillips Memorial Hospital in Bukidnon. She then applied and worked in the same department at Metro Cebu Community Hospital. She loved in senior clerkship; not to mention, she met her current husband during their pediatrics rotation in a government hospital.

attention to her then one-year old daughter. With their family returning to CdOC, she worked at the Community Health Care Center where she considers treating patients genuinely as her way of fulfill HER father’s dream of helping the poor. For her, seeing her patients getting well is of utmost reward. She recalls patients telling her they do not mind waiting in the long queue as long as they can consult with her. Although she found such remarks heartwarming, she realized coming home exhausted after seeing 60 to 80 patients a day was not the life she wanted. While rethinking which track to tread, she found the road leading to XUJPRSM worth following. She grabbed the opportunity to teach microbiology and parasitology and started teaching in June 1997. For her, being in the

dream – not exactly how she originally planned but by becoming a role model of kindness, she can have "multiples" of herself who can help the poor when they, the students, become doctors. For two decades, she has taught students in XUJPRSM not only the different types of clinically important microorganisms and elusively harmful parasites but also encouraged them to do best in their studies and never give up. Nonetheless, she has reached the point where she felt the need to enjoy life in other ways. Emphasizing the importance of her family, she prioritizes visiting her children – her son taking up his masters in Australia and her daughter to have her PGI in Cebu – without worrying much about work. She also sees herself traveling to places she has never been to. Thus, she has decided to retire early but still plans of teaching part-time.

Deliberate diversion As much as she loves treating children, she says, “Family is my priority.” She eventually discontinued her residency to give more quality time and

*** Her gentle manner belies a strength of character and a tenacity of purpose, which led her to become a living proof that no matter how stormy the weather can be or how unkind life may be, we can always overcome the challenges and trials. We can get through all these because as what she lives all the time.”

Med Hacks 101 Tips and tricks from someone who knows your struggle By Gian Paolo L. Portal

Tip #1: Stubborn stains

Wearing that white uniform can make you feel like a real doctor, but specks or blemishes can ruin your game. You might be surprised that a solution used for cleaning wounds can also be used to remove smudges on your uniform. Just rub a cotton ball soaked with hydrogen peroxide and let the magic happen. It can remove ink, dirt, and even blood stains! It’s a handy, affordable stain manager. Tip #2: Sparkle up old shoes

Buying a new pair of shoes can be expensive and looking for a good one can sometimes be a hassle. Try this simple tip to save some cash and a great deal of time: brush your shoes to remove dirt then wipe with olive oil to make the leather slick, soft, and supple. Using any oil or oil-based shoe care product will also help your footwear survive for a longer period of time in med school. Tip #3: Coffee or nap? Why not both?

It’s called “coffee nap”. I know. You were taught that coffee before hours-long sleep doesn’t help but a nap after having a cuppa is another story. Adenosine builds up as a byproduct of brain activity and is cleared out when you sleep. Caffeine doesn’t need to compete for receptors to work but it takes around 20 minutes to get that wake-up punch of energy, so the challenge

is to time it just right. Here’s how you do it: drink your coffee, set an alarm for 20 minutes, take a nap, and wake up without that groggy feeling! Studies show that this technique increases alertness and the level of performance better than coffee or naps alone. Tip #4: The brighter, the better

Sleeping becomes a luxury when you’re confronted with a tall pile of books for an upcoming exam. Luckily, you can hack your internal clock to your favor. Studying in a well-lit room, preferably with a bright lamp with white light, can help keep you awake as it stimulates the suprachiasmatic nucleus (SCN) of the hypothalamus. SCN entrains our circadian rhythms such as the sleepwake cycle and secretion of melatonin. On the contrary, blocking all light, including those from gadgets, prior to bedtime can help you sleep better. Manipulating our sleep-wake patterns through how our body reacts to light grants us access to ruling both night and day. Tip #5: Snooze no more!

Can’t wake up even with your alarm clock? One of the best solutions is to change your phone’s alarm sound every couple of days or so then placing it far from you but still loud enough to get yourself up and awake. Help yourself, do not hesitate, and get out of bed by starting your day right and early. You can also download a wide

array of alarm applications to your phone, some requiring a math problem to be solved before the alarm would shut off. Tip #6: Be gone or belong

Are you tired of chasing the passing score endlessly? Do you feel like you are losing against your dream of becoming a doctor despite your efforts? Don’t be afraid to ask for help! Find a group of people who can encourage you to do better, pick you up when times are low, and cheer for you in times of triumph. Learn and develop your inner fighting spirit with them. This profession doesn’t need a soloist—rather a team player who is willing to learn and grow with others in their team. *** The human body is surprisingly capable of withstanding almost any type of stress but when pushed to the limit, it might do more harm than good. If you end up feeling worn out at some point in your med school journey, listen to your body’s needs—let it rest but do not quit. Burnout is not to be taken lightly so help a friend out by sharing these MedHacks whenever the need arises too! https://www.youtube.com/watch?v=CaI5LWj6ams https://www.youtube.com/watch?v=EHgZr9-YpEs

By Stephen RB Sapiera

e all have our reasons on deciding to go into med school – fulfill a childhood dream, serve a bigger community, among others. We most likely know why our classmates did. Wouldn’t it be nice to know the reasons of medical students from other schools? Are these any different from ours? I asked Philippine medical students from various universities on why they decided to take up medicine. #WeAreNotAlone Editor’s note: Some answers were edited for brevity and clarity. LJ Merquillo, Cebu Institute of Medicine

”Being a doctor is part of my childhood dream and I [have always] wanted to pursue it. But what really pushed me to love it more was when my mom got admitted for typhoid fever while being pregnant. [I saw] how a medical team tried their best to save my mom and my sister.” Donabella Manahon, Silliman University

“The reason I pursued medicine is, after graduating [with a degree in] med tech and passing the boards, I worked at a free-standing lab for awhile. I realized med tech was not for me. I wanted to do more and do something big. Deciding to study medicine is not easy. […] Yes, even dreaming and wishing to become a doctor [is not] especially now that we have a feel on how it’s not a smooth ride. But hey, if your dreams don’t scare you, they’re not big enough.” [Respondent cites the last line from a book of Bo Sanchez.] Lulu Galacan, West Visayas State University

“I don’t know exactly. I knew since [I was] young that I want to be able to figure

out what’s wrong with a sick person and what to do to cure them. Eventually it evolved to wanting to help the sick [people] of the world. To be of service to humanity, basically. […] It would be nice to do something about it. Being a doctor is just one way to help the world but it’s a path I chose to take.” Aldrin Reyes, Saint Louis University

“I would like to help other people na nangangailangan ng serbisyo ng mga doctor. I’ve been into a situation na we need a doctor for my tatay but unfortunately walang ganoong klase ng doctor sa ospital na ‘yon and the fee is not affordable rin. Personal experience din talaga nagtulak sa akin to purse my dream to become a doctor.” Anthony Imperial, Our Lady of Fatima University

“I took up medicine because it was seen as the most noble profession at the time. I was a less serious kid back then and didn’t study much; because of this, people didn’t believe in my potential. In a way it was egotistical and I just wanted to prove to everyone I could be someone great. […] Malamang I [also] wanted to help people.” Ourlad Tantengco, University of the Philippines-Manila

“Childhood dream ko talaga’ng maging doctor. Kaunti lang ang doctors sa family namin at sa town […] Then come college, BS Biology sa UP-Diliman. The curriculum is super research-oriented. I became interested in research and ended up under the Mammalian Cell Culture Laboratory. I did my thesis with cancer cell lines and naging interested ako sa cancer research. I think medicine can open a lot of doors

for cancer research plus I get to help a lot of people. Sakto lang na may MD/ PhD program. I can be a physician and a researcher at the same time.” Gabriel Viray, Angeles University Foundation

“I decided to take [up] medicine not solely because I wanted to but because of the events that led me to go to med school. It is all about taking chances and grabbing opportunities. Back then, I was already working while waiting for the grad school to start (MS Agriculture). But I saw a scholarship grant to a medical school. I grabbed the opportunity and left my work and grad school behind, not knowing what lies ahead. Fortunately, I was granted the scholarship and [then] everything was a blur. Right now, I am a third year med student and the reason I continue is my parents. I want to honor them by becoming a doctor.” JC Gardiola, Pamantasan ng Lungsod ng Maynila

“I remember during my recognition day sa preschool: each of us had to stand onstage and tell everyone what we wanted to be when we grow up. I told them, ‘I want to become a doctor.’ Then life happened and I forgot about it and just decided to choose practicality over passion. But life seems to point me to a direction I’ve almost forgotten. I failed at all the other schools I applied for in college except for one. I passed my pre-med course and told myself, ‘Sige, go na.’ I took it as a sign. Every time I was not so sure about it, I ask God for a sign [and] He never fails to give me one just like how I passed at the only med school I applied in. Looking back at my preschool recognition day, I should have told everyone, ‘When I grow up, I will be a doctor.”

Bloopers & everything in between Yes, medical students find—or are the subject of—comic relief amid the stress med school entails.

OSCE bloopers •Ang patient wala kabalo sa iyang symptoms so pag-ask nako asa dapit ang sakit, nitanaw pa siya sa iyang phone para mag-check. Nakwaan nuon ko’g pila ka seconds hahaha •Where to find the lateral malleolus :( •FORGOT TO TURN ON THE MICROSCOPE!!!

•*While taking a patient’s BP in the Physio station* Me: *introduces self, asks for Px’s name, asks for consent* Px: Para asa diay nang BP gang?

•Blood pressure taking [with] crossed legs!

Me: *smiles because wala ko kabalo sa tubag* Mag BP nalang ta sir ha?

•Nag-gamit ko ug two ka exam papers kay nataranta ko sa gamay nga superimposition. Nisulod dayun si Doc Vince. Kahilakon na dayon ko sa kakulba kay dili man diay pwede. I thought extra to tanan naa dadto. :(((

•Studied and memorized very well the blood circulation from thumb to thumb then from one side of the lower limbs to the other. But none of them came out. Time lended for it was merely for my prayers huhu

Anecdotes •7 inches is the best and most memorable measurement. •Nag-lecture mi sa FCM abi namo boring pero naa si Doc Uba. Bahala na nga wala mi kasabot sa iyang discussion ug mga corny jokes basta nakasabot mi nga lipay kaayo mi boys adto nga day. GO TEAM UBA! •Got to school late and worried

only to find out that I came in 1 hour early (my watch was playing with me!) •Unta ang mga effort sa pag-apilapil ug mga events kay maka-plus points jud kapoy baya huhuhuhu.. : (((((( •Achievement unlocked: 2-4 hours of sleep O_O every night

‘Sabaw’ moments •In the anatomy lab, Doc Sabanal asked us, "Where is the scapula?" With confidence, I answered, "Scapula, Doc" while passing him a scalpel. Na-shookt si Doc. "Ahh no, no. In the cadaver," he answered awkwardly before leaving the classroom to laugh. •ANG NAILCUTTER NAHIMONG STAPLER. •Nag-question si Doc Permites sa ako about sa G-protein, pero dili ko kabalo unsaon pag-answer, so gi-ignore nako si Doc and ga-pretend ko nga ga-type ko sa laptop, hoping nga magtawag siya ug lain. Pero ga-wait jud siya sa ako, and naa dayon awkward silence for pila ka minutes, hantud sa niingon siya nga "***n***, are you there?" Then namugnaw samot ako paminaw. So nitan-aw dayon ko kay Doc and nag-answer na lang dayon ko ug medical jargons hoping nga maka-igo ko gamay. Then na-realize dayon nako after (nga) dili na jud ko mag-laag before sa SGD. :( •Fighting my eyes from shutting during FCM night classes

Inspiration •The Doctors – a novel written by Erich Seagal •Stories of all the doctors in XU-JPRSM. Seeing them already serves as my inspiration. •Gaka-inspire ko magstudy if nabagsak ko sa day before or if mas taas ug grado ako mga friends. Bahala na gamay grado basta kami tanan gagmay. :))) •The “Humans of Medicine” Facebook page– an online platform where Filipino medical students feature their inspiring stories. The stories highlight those students who faced daunting challenges but still maintained a positive outlook in life. •I had a good time in med school. Though hard, I will not quit!! “NEVER SAY DIE” runs in my veins.