Violent Reactions
I shall have my head under the guillotine for this but my better conscience and sense of right have all provoked me to write down what my spirit feels. Recently, some news have come to me about the plans of my alma mater regarding the rotations of the incoming junior interns for 2007-2008. I was told that the college of medicine has decided not to allow the junior interns to undergo rotation at the Bacolod Our Lady of Mercy Specialty Hospital, the hospital where I am currently rotating as a Post graduate Intern, the same hospital the USLS College of Medicine dubs as its base hospital. Instead, the college of medicine has decided to send the junior interns at Riverside Medical Center. I am not sure about the exact details of the plan but I was told by outgoing junior interns that the incoming junior interns will only be allowed 1 week to rotate in BOLMSH and that there are certain departments that will not have any J.I.'s at all.
Earlier, a fellow PGI told me that one of the visiting consultants in BOLMSH told this fellow PGI about the plans of the college. This fellow PGI was of course devastated especially when this fellow PGI was told of the reason why the college's administration decided to pull out its J.I.'s from, ironically, its base hospital. I don't want to write what the "reason" was since it would all be hearsay but whatever the reason provided, the fact remains, no Lasallian J.I.'s for its base hospital this 2007-2008.
I don't know what is going on here but I do have a hint of what has been happening so far. With the limited knowledge I have, let me make some reactions.
1) The decision of the college to limit, if not significantly decrease the number of days for the J.I.'s to rotate in a hospital the school considers officially as its base hospital is illegal and downright unethical. Currently, J.I.'s are rotating 2 weeks per department at BOLMSH, 3 weeks if in OB-GYNE. 6-8 weeks per department in CLMMRH. That alone is already small for a base hospital. Perhaps one of the reasons why the college has limited the number of days for the rotation at BOLMSH is because BOLMSH is not a training hospital and therefore, no residents are present to make follow-ups with the J.I.'s, not to mention the small patient load compared with CLMMRH(which is a public hospital) and RMC.
If the college pushes through with the plan to further limit the alloted time for rotation of the J.I.'s at BOLMSH, it should start considering whether BOLMSH should remain as its base hospital or not. Maybe the college should instead make RMC as its new base hospital if that is the case and stop calling BOLMSH as its base hospital considering that the lack of support and patronage to the said institution is glaring.
During the time we were being matched to various hospitals in our application for our PGIship, we were discouraged not to apply at BOLMSH because of the fact that it is not a training hospital. During the time of the current ourgoing J.I.'s, the discouragement was louder and more discriminating than before. The fact that almost none of them applied for BOLMSH is a testament to this fact, and even if there were who did apply, they seem to be backing out this early already.
Even during the course of my PGIship, those of us who are rotating at BOLMSH have heard so many discriminating comments, most of which from the people we least expected. Their level of confidence is low, especially for those who are rotating at BOLMSH. We are not expected to pass the boards. I wrote an earlier blog about this lack of moral support and loud demoralizing remarks.
This scarcity in affirmation has added more to my personal frustration and increasing disbelief against the profession I was taught to love and accept.
2) Although BOLMSH is not a training hospital, the advantage of training under junior consultants and consultants is that you are more confident that the advice and lectures and instructions at the wards that you receive from them are most likely correct compared with a resident who is training to become a consultant also. And while this is not always the case (considering that their are also consultants who make mistakes --- only human), at least you get to see a variety of approaches to diagnosing and managing a certain illness. Each consultant has a unique way of approaching a patient and by being more observant, an intern can really learn a lot.
While rotating here at BOLMSH, we were trained as if we were first year residents. We were made to make admitting orders, supervised by our junior consultants, made to defend our admitting orders during endorsements or even case presentations, and for house cases and liberated consultants, we were given the free hand to contribute to the management of the case for as long as we can defend it before our junior consultants and with the permission of the consultants themselves.
Besides, whether one is assigned in a hectic hospital or not, it all depends on the individual himself. If he fails to take advantage of the opportunities given to him, then it is not the fault of the hospital or consultant or even resident anymore.
In BOLMSH, it is not always fun and easy-going. There are days when the toxicity level is very high and the entire hospital is busy. In fact, in the absence of residents, the PGI on duty after 5 pm mans the entire hospital: E.R., all 5 floors, southwing and ward, OR or DR or nursery if you are in Surgery, OB-GYNE or Pediatrics. In other training hospitals, PGIs are limited only to taking history and P.E. If there are ward calls and if the PGI is busy at the E.R., at least there are residents to take the ward calls momentarily. Not in BOLMSH. PGIs do everything, the first always in everything and reports for 24-hour duty every 3 days, sometimes, even every other day when a fellow PGI is on leave.
And we never complained. We do not complain.
During the time we were J.I.'s we did complain but when we were told not to complain, we never did afterwards. When we were asked how we were doing, we never made a sound. We never complained. J.I.'s are not allowed to complain. The administration of the college told us that even if we did complain to them they cannot do anything for it is the residents who have the last say with regards to our clinic/ward duties.
3) Lastly, the college should reconsider this move. I fear the repercussions it will have in the future with regards to the status of BOLMSH as the school's base hospital.
Enough said. It really doesn't matter what I think. I am done with my J.I.ship and not matter how much they spin the world topsy-turvy, I still belong to the pioneer batch of the college of medicine.
I have my boards to worry about.
Earlier, a fellow PGI told me that one of the visiting consultants in BOLMSH told this fellow PGI about the plans of the college. This fellow PGI was of course devastated especially when this fellow PGI was told of the reason why the college's administration decided to pull out its J.I.'s from, ironically, its base hospital. I don't want to write what the "reason" was since it would all be hearsay but whatever the reason provided, the fact remains, no Lasallian J.I.'s for its base hospital this 2007-2008.
I don't know what is going on here but I do have a hint of what has been happening so far. With the limited knowledge I have, let me make some reactions.
1) The decision of the college to limit, if not significantly decrease the number of days for the J.I.'s to rotate in a hospital the school considers officially as its base hospital is illegal and downright unethical. Currently, J.I.'s are rotating 2 weeks per department at BOLMSH, 3 weeks if in OB-GYNE. 6-8 weeks per department in CLMMRH. That alone is already small for a base hospital. Perhaps one of the reasons why the college has limited the number of days for the rotation at BOLMSH is because BOLMSH is not a training hospital and therefore, no residents are present to make follow-ups with the J.I.'s, not to mention the small patient load compared with CLMMRH(which is a public hospital) and RMC.
If the college pushes through with the plan to further limit the alloted time for rotation of the J.I.'s at BOLMSH, it should start considering whether BOLMSH should remain as its base hospital or not. Maybe the college should instead make RMC as its new base hospital if that is the case and stop calling BOLMSH as its base hospital considering that the lack of support and patronage to the said institution is glaring.
During the time we were being matched to various hospitals in our application for our PGIship, we were discouraged not to apply at BOLMSH because of the fact that it is not a training hospital. During the time of the current ourgoing J.I.'s, the discouragement was louder and more discriminating than before. The fact that almost none of them applied for BOLMSH is a testament to this fact, and even if there were who did apply, they seem to be backing out this early already.
Even during the course of my PGIship, those of us who are rotating at BOLMSH have heard so many discriminating comments, most of which from the people we least expected. Their level of confidence is low, especially for those who are rotating at BOLMSH. We are not expected to pass the boards. I wrote an earlier blog about this lack of moral support and loud demoralizing remarks.
This scarcity in affirmation has added more to my personal frustration and increasing disbelief against the profession I was taught to love and accept.
2) Although BOLMSH is not a training hospital, the advantage of training under junior consultants and consultants is that you are more confident that the advice and lectures and instructions at the wards that you receive from them are most likely correct compared with a resident who is training to become a consultant also. And while this is not always the case (considering that their are also consultants who make mistakes --- only human), at least you get to see a variety of approaches to diagnosing and managing a certain illness. Each consultant has a unique way of approaching a patient and by being more observant, an intern can really learn a lot.
While rotating here at BOLMSH, we were trained as if we were first year residents. We were made to make admitting orders, supervised by our junior consultants, made to defend our admitting orders during endorsements or even case presentations, and for house cases and liberated consultants, we were given the free hand to contribute to the management of the case for as long as we can defend it before our junior consultants and with the permission of the consultants themselves.
Besides, whether one is assigned in a hectic hospital or not, it all depends on the individual himself. If he fails to take advantage of the opportunities given to him, then it is not the fault of the hospital or consultant or even resident anymore.
In BOLMSH, it is not always fun and easy-going. There are days when the toxicity level is very high and the entire hospital is busy. In fact, in the absence of residents, the PGI on duty after 5 pm mans the entire hospital: E.R., all 5 floors, southwing and ward, OR or DR or nursery if you are in Surgery, OB-GYNE or Pediatrics. In other training hospitals, PGIs are limited only to taking history and P.E. If there are ward calls and if the PGI is busy at the E.R., at least there are residents to take the ward calls momentarily. Not in BOLMSH. PGIs do everything, the first always in everything and reports for 24-hour duty every 3 days, sometimes, even every other day when a fellow PGI is on leave.
And we never complained. We do not complain.
During the time we were J.I.'s we did complain but when we were told not to complain, we never did afterwards. When we were asked how we were doing, we never made a sound. We never complained. J.I.'s are not allowed to complain. The administration of the college told us that even if we did complain to them they cannot do anything for it is the residents who have the last say with regards to our clinic/ward duties.
3) Lastly, the college should reconsider this move. I fear the repercussions it will have in the future with regards to the status of BOLMSH as the school's base hospital.
Enough said. It really doesn't matter what I think. I am done with my J.I.ship and not matter how much they spin the world topsy-turvy, I still belong to the pioneer batch of the college of medicine.
I have my boards to worry about.
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