At Large : No more doctors?
Rina Jimenez-David
Inquirer News Service
A SURGEON connected with a teaching hospital has a story to tell to illustrate not just why more and more doctors are emigrating to developed countries, chucking their medical degrees and re-enrolling for nursing courses, but also why enrollment in medical schools has slipped drastically in recent years.
One of his interns, said the surgeon, approached him one day and asked: "Is there any specialty that won't require me to stay up late and where I can still earn lots of money?" Taken aback, the older doctor counseled the young man: "It still isn't too late. You can still shift and choose another profession, if that's your attitude towards Medicine."
"The values of young people today have changed," the doctor sighed. Indeed, where before medical freshmen would confess unabashedly that they were going through the rigors of medical school to "serve" humanity or "heal" people, today the primary motive has boiled down to making pots of money, or at the very least to recover their and their families' investment in their medical education.
And with other trades and callings offering high salaries without need of investing more than a decade of hard work in basic training and specialization, it's no wonder fewer and fewer students today are choosing to go into medicine. In a paper written last year on "The Philippine Phenomenon of Nursing Medics," Dr. Jaime Galvez Tan and his co-authors noted with alarm a "decrease in the number of examinees of the National Medical Admission Test by 24 percent from 2002 to 2003." The decrease in first-year medical school enrollment ranges from 18 percent in some schools to as high as 74 percent. "Three medical schools have already closed down. Two private medical schools located in the rural areas are contemplating on closing down due to severely low enrollment of less than 20 this school year," Tan et al. add.
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FRONT-PAGE reports yesterday saying that the Department of Health has finally expressed alarm at the situation need to be taken in the context of the overall deterioration of the country's "health human resources."
Indeed, the situation is alarming, what with latest statistics showing that some 6,000 doctors are currently enrolled in nursing classes, with a nursing job in the United States, Canada or Europe as their goal. And with no prospect of replenishing the country's supply of doctors, what with the erosion in medical enrollment, it may not be too farfetched to anticipate the day when we would no longer have any doctors here. Health Secretary Francisco Duque is right when he says that the situation is "extremely threatening to the health care system."
The problem seems even more desperate when we consider how the exodus of doctors for abroad or to nursing has been paired with a similar exodus of nurses and other health care personnel.
"While the Philippines traditionally produces a surplus of nurses for export since the 1960s," notes Tan, "the large exodus of nurses in the last four years has been unparalleled in nurse migration history."
Nurses who are leaving are not being replaced. Tan says just as disturbing as the accelerated departure of nurses is the "deteriorating quality of nursing education." Though the number of nursing schools in the country has increased tremendously, this increase in the "supply" of nursing graduates has not translated into an equal increase in the "supply" of qualified nurses.
In the 1970s and 1980s, says Tan, the proportion of nursing graduates passing the board exams ranged from 80-90 percent. Since 2001, though, the proportion of passers has hovered around 44-48 percent. While some 50,000 Filipino nurses are estimated to have left the country in the last four years, the number of new licensed nurses in the same period has reached only 20,000.
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ANECDOTES and testimony bear out the disturbing statistics.
So desperate are medical schools for enrollees, perhaps to make full use of their expensive facilities and equipment, that they are offering scholarships to nursing graduates. Even then, the would-be nurses are turning down the offers, preferring the more lucrative offers from abroad.
Doctors and medical administrators talk of how difficult it has been to hire new personnel, with some provincial hospitals forced to close down due to their failure to hire new doctors or nurses. "I even find it difficult to hire new nursing aides!" says Dr. Cecile Llave, director of the University of the Philippines' Cancer Institute.
Tan et al. have several suggestions for addressing the situation. One is the forging of bilateral agreements with the governments of "receiving" countries or with foreign medical institutions that would compensate the Philippine government or medical institution with funds to be used for medical and nursing scholarships for destitute students.
Another is a National Health Service Act that would require compulsory medical service from graduates of state-funded medical institutions. "A compulsory, instead of voluntary service, is called for since the situation now is more critical and entirely of a different nature from the past decades of health professional migration," notes Tan.
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"ONCE on This Island," the noted musical with a "fabulous" cast that received rave notices in its earlier staging, returns to the stage starting tonight until Aug. 14 at the RCBC Theater in Makati City.
The good news is that while the same cast, composed of stage veterans as well as newcomers who're proving to be the discoveries of the moment, will be performing, improvements in staging and direction have been made for an even better viewing experience. Direction is by Bart Guingona.
Those interested should text Hendri at 09178155794 for more information and reservations.
6,000 doctors studying to be nurses; DoH alarmed (Aug. 4, 2005)
