Contents

1. The Medical Education System of the Philippines
2. Future Directions for the International Medical Education Directory (IMED)

The Medical Education System of the Philippines[1]

Medical schools in The Philippines have been the source of a large number of physicians who come to the United States for graduate medical education and the practice of medicine. During the 10 year period 1993-2002, ECFMG issued Standard ECFMG Certificates to 4,561 graduates of medical schools in the Philippines. The first medical school established in the Philippines was the Faculty of Medicine and Surgery of the University of Santo Tomas in 1871. Currently, there are 32 Philippine medical schools listed in the International Medical Education Directory (IMED), 30 of which are operating and 2 of which are closed. Three of the currently operating medical schools have been identified by the Philippines Commission on Higher Education as "Centers of Excellence" and one as a "Center of Development" based "on their track record, performance in the licensure examination and excellent faculty."[2] The Centers of Excellence are at the University of the Philippines, University of Santo Tomas and the Cebu Institute of Medicine. The Center of Development is at Xavier University.

We will discuss the role of the Commission on Higher Education (CHED) in medical education and of the Medical Board of the Professional Regulation Commission (PRC), with respect to medical licensure in the Philippines. Additionally, we will provide information on the curriculum in the medical schools, including student admission requirements, and the requirements for a license to practice medicine.

The Role of the Commission on Higher Education (CHED)

The Commission on Higher Education (CHED), established in 1994, oversees both public and private higher education institutions as well as degree-granting programs in all public and private educational institutions. The functions of CHED are to promote quality education; take appropriate steps to ensure that education is accessible to all; and ensure and protect academic freedom for the continuing intellectual growth, the advancement of learning and research, the development of responsible and effective leadership, the education of high level professionals, and the enrichment of historical and cultural heritage. CHED is the agency that authorizes higher education institutions to offer medical education programs. CHED also oversees medical education curricula.

Admission Requirements to a Medical College

The requirements for admission to medical schools in the Philippines are governed by the Medical Act of 1959 and its subsequent amendments.

The current minimum requirements for admission to a medical college are:

1. Bachelor's degree in Sciences or Arts (BS or BA)
2. National Medical Admission Test (NMAT), with score above the percentile cut-off set by the medical school
3. Certificate of Eligibility for Admission to College of Medicine, previously issued by CHED but, effective January 2003, issued by the medical school. To receive the certificate, an applicant must submit to the medical school the following documents:
1. Birth certificate and certificates of good moral character from two professors in college
2. Official transcript of records showing completion of a degree course
3. For graduates of private schools, the transcript of records must be validated by a Special Order (S.O.) from CHED, while for graduates of public schools, the diploma or certificates of graduation must be presented
4. Certified true copy of NMAT score

Transfer students are admitted only with a certificate of honorable dismissal from the previous school, and must complete the final two academic years in the school that will issue the medical degree.

The Medical School Curriculum

The medical school curriculum is a minimum of four years duration, the fourth year of which is a full clinical clerkship.

The following disciplines are included in the curriculum:

• Human Anatomy (including Gross and Microscopic Anatomy and Developmental Anatomy)
• Anesthesiology (including Pain Management)
• Biochemistry, Molecular Biology, Genetics and Nutrition
• Legal and Forensic Medicine, Health Economics and Bioethics
• Internal Medicine
• Microbiology, Parasitology and Immunology
• Neurosciences (basic and clinical)
• Obstetrics-Gynecology (including Women’s Health)
• Ophthalmology and Otorhinolaryngology
• Pathology (Clinical and Anatomic)
• Pediatrics (including Child Protection)
• Pharmacology and Therapeutics (including Alternative Medicine)
• Physical Medicine and Rehabilitation
• Human Physiology
• Family and Community Medicine (including Preventive Medicine)
• Behavioral Medicine (Psychiatry)
• Radiological Sciences (including Imaging Modalities)
• Surgery
• Research and Clinical Epidemiology

Instructional Standards for Clinical Training

The clinical training program must be implemented in a training hospital with a minimum capacity of 100 beds, and functioning clinical departments in Internal Medicine, Pediatrics, Obstetrics-Gynecology, and Surgery.

For every 100 students, there must be at least one full-time faculty member who is board certified in the Philippines in each of the four major clinical departments.

Clinical materials are provided by the outpatient services load of at least 50 patients per day, and in-patient services of one occupied hospital bed per clinical clerk (4th year medical student) at any given time.

In Obstetrics-Gynecology, at least ten maternity cases shall be followed to delivery by each clinical clerk, who must have actual charge of these cases under supervision of a clinical preceptor. The medical school shall also provide extension services in Community Medicine.

The maximum student-teacher ratio is as follows:

1. Lectures:  1:100
2. Laboratory Sessions:  1:25
3. Small Group Discussions:  1:15
4. Problem-Based Learning:  maximum of 10 students to one faculty facilitator

Medical Education Credentials Awarded

The medical degree awarded to graduates of Philippine medical schools is the Doctor of Medicine (M.D.) degree.

Physician Licensure

The Professional Regulation Commission (PRC) of the Philippines regulates and supervises the practice of professions through 42 professional regulatory boards, including the Medical Board (formerly, Board of Medicine.)

According to the regulations of the Medical Board, a candidate for admission to the Board examination must meet the following qualifications:

1. He/she shall be a citizen of the Philippines or a citizen of a country that permits citizens of the Philippines to practice medicine under the same rules and laws as citizens of that country
2. He/she shall be of good moral character
3. He/she shall be of sound mind
4. He/she shall not have been convicted of a crime of moral turpitude
5. He/she shall be holder of the degree of Doctor of Medicine or its equivalent conferred by a college of medicine duly recognized by the government
6. He/she must have completed a calendar year of internship training in hospitals and health centers approved by the Board.

The Medical Board gives registration examinations twice per year, on dates to be determined, but with an interval of at least six months between the first and second examination.

The following subjects are given in the registration examination:

1. Anatomy and Histology
2. Physiology
3. Biochemistry
4. Microbiology and Parasitology
5. Pharmacology and Therapeutics
6. Pathology
7. Medicine
8. Obstetrics-Gynecology
9. Pediatrics and Nutrition
10. Surgery and Ophthalmology, Otolaryngology, and Rhinology
11. Preventive Medicine and Public Health
12. Legal Medicine, Ethics, and Medical Jurisprudence

A candidate is deemed to have passed his/her examination by obtaining an average grade of 75% with no grade lower than 50% in any subject. A candidate who fails for the third time will be required to take a refresher course prescribed by the Medical Board of at least one year in a recognized medical school or college prior to taking subsequent examinations.

The Certificate of Registration issued by the Professional Regulation Commission entitles the physician to practice medicine in the Philippines. The Commissioner of the Professional Regulation Commission, the Chairman, members of the Commission and Secretary of the Medical Board sign the Certificates of Registration and issue them to those who have satisfactorily complied with the requirements of the Board.

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Future Directions For The International Medical Education Directory (IMED)

The Spring 2003 (Volume I No. 1) issue of InMedEd contained an article describing the International Medical Education Directory (IMED). IMED is a web-based resource on the world's medical schools that is freely available on the Web site of the Foundation for Advancement of International Medical Education and Research (FAIMER®) at www.faimer.org. FAIMER is a non-profit foundation of the Educational Commission for Foreign Medical Graduates (ECFMG®). Additional information on FAIMER is available on the FAIMER Web site.

There has been positive feedback on IMED, including comments on its usefulness as a resource for objective information on medical schools. A number of comments indicate that there is significant interest on the part of the medical licensure community in expanding IMED to include additional types of information on medical education systems and individual medical schools throughout the world.

John J. Norcini, Ph.D., President of FAIMER, has stated that FAIMER has initiated the process of expanding IMED's scope. The first step in this process is a survey that FAIMER has recently sent to health ministries worldwide. Through this survey, FAIMER will solicit the most current information on the medical education system in countries throughout the world and secure an up-to-date list of medical schools that are recognized or accredited within these countries. Included in the FAIMER survey of health ministries is a request for information on whether there exists a national system of evaluation or accreditation of medical school programs and the contact information for the accrediting authority in that country.

Dr. Norcini has indicated that, as information is received from the health ministries, FAIMER will follow up with additional surveys directed to the 1,800+ medical schools throughout the world and the accrediting authorities in those countries that have such authorities. Surveys on such a large scale are a massive undertaking. Nonetheless, with the results of these surveys, Dr. Norcini is hopeful that, in the near future, the information in IMED will be enhanced to include quality indicators on medical schools and detailed information on medical school curricula, training sites, faculty and students and resources.

Recognizing that medical licensing boards have expressed interest that IMED provide additional objective information, Dr. Norcini wishes to solicit from the licensure community suggestions for the types of information that should be included in the FAIMER surveys to international accrediting authorities and medical schools. You can email your suggestions to Dr. Norcini at inmeded@ecfmg.org.

Comments or questions? Email us at inmeded@ecfmg.org.

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[1] Information from the Professional Regulation Commission Board of Medicine website http://www.prc.gov.ph/ and the ECFMG medical education credentials reference library.

[2] Letter from CHED to ECFMG, July 2002

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