Community-based medical education in the Philippines

Article Abstract:

In the Philippines there is a shortage of physicians and nurses, because so many of these professionals leave their country to work in other, wealthier nations. Of the 3,500 physicians who graduate annually from medical schools in the Philippines, over 65 percent emigrate, commonly to the United States, Canada, Australia and Saudi Arabia. The majority of nurses also emigrate. The people of the Philippines are put at risk by the resulting shortage of medical services. An innovative school, the Institute of Health Sciences, was founded in 1976 to counteract the exodus of trained personnel out of the Philippines. It operates separately from the traditional medical school at the University of the Philippines, but is part of the university system. Students train to be physicians, nurses, midwives, and nurse's aides. Each student must lack the financial resources to pay the tuition and is instead sponsored by a small fee from his or her own village. In return, the village receives a guarantee that the student will return to work there upon graduation. The institute curriculum, taught by 17 full-time faculty members, emphasizes clinical and managerial skills. As of May 1989, graduates of the institute included 620 community health workers, 38 physicians and 207 nurse-practitioners. Of the first 25 students to complete the MD program, 23 passed the national exam; this resulted in the institute ranking fourth in the country out of 27 medical schools. The cost of attending was well under the cost of attending other medical schools. The Institute of Health Sciences is clearly achieving its objectives, and could serve as a worthy model for other developing countries with similar shortages of medical personnel. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Education, Curricula, Developing countries, Nursing, Medical colleges, Medical schools, Philippines, Public health personnel

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Clinical interventions in tobacco control: a National Cancer Institute Training Program for Physicians

Article Abstract:

Smoking, the main preventable cause of death in the US, kills more than 1,000 people each day and costs $52 billion each year in health care and related costs. Although few physicians have been trained in techniques to help patients stop smoking, evidence exists that such efforts would be worthwhile. The National Cancer Institute (NCI) has issued recommendations for physicians who want to help patients stop smoking. These recommendations are based on clinical trials involving more than 1,000 physicians and 30,000 patients; the results of these trials showed that physician intervention had a beneficial effect in reducing smoking rates. Long-term smoking cessation rates as high as 15 percent were achieved in some cases. To achieve smoking cessation, physicians needed not only specialized training, but also routine reminders to intervene with smokers. Smoking cessation is not a single event; rather, it is a process and requires time. The intervention plan for physicians (''the four A's'') states that they must: Ask their patients about smoking; Advise all smokers to stop; Assist patients who want to stop now; and Arrange follow-up visits. The NCI has produced a manual of smoking cessation techniques. Its training program aims to train 100,000 physicians. Additional information for physicians and professional organizations can be obtained by calling 1-800-4-CANCER. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Planning, Smoking cessation programs, Smoking cessation, United States. National Cancer Institute

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Preparing for medical consequences of terrorism

Article Abstract:

Physicians were urged to train for disaster medicine at the First Harvard Symposium on Medical Consequences of Terrorism in Apr, 1996. Citing the World Trade Center and Oklahoma City bombings, military and government officials challenged doctors to take their hospital's disaster plans seriously. Many emergency departments may be unable to cope with the dozens of casualties that may result from a terrorist attack. Fewer than 1% of physicians are trained to treat injuries from chemical weapons and many will have to learn to collect forensic evidence during triage. Physicians should never go to the scene of a terrorist attack until the area has been secured by law enforcement personnel.

Care and treatment, Victims of terrorism, Disaster medicine

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