Sustaining the gains to provide doctors in GIDAS

(Second of 2 parts)

There were eight SUCs with medical schools when the Doktor Para sa Bayan law was passed in 2020.

There are now 28 SUCs with medical programs, all offering scholarships to financially needy students, equipped with state-of-the-art medical equipment and with new buildings and dormitories for their students.

There are 14 in Luzon (MMSU in Ilocos Norte, UNP in Ilocos Sur, DMMMSU in La Union, CSU in Cagayan, ISU in Isabela, BulSU in Bulacan, NEUST in Nueva Ecija, UP Manila, CavSU in Cavite, BatSU in Batangas, BPSU in Bataan, SLSU in Quezon, BSU in Albay, PSU in Palawan), five in the Visayas (WVSU in Iloilo, CNU in Cebu, BISU in Bohol, SIIM in Samar, UPSHS in Leyte), and nine in Mindanao.

Only the Cordillera Administrative Region lacks a public university offering a medical program, but students can access the program through Saint Louis University.

The instruction in RA 11509 for CHED to facilitate the opening of at least one public medical school in every region has been practically achieved.

Over P1 billion in grants have been awarded to public medical schools for the acquisition of plastinated cadavers, anatomy tables, mannequins and task trainers to ensure the delivery of simulation-based medical education.

By 2026, 3,762 medical students will be supported through the CHED Medical Scholarship and Return Service (MSRS). The program covers free tuition and miscellaneous fees at public universities, offers up to P200,000 for private school students, provides a P177,000 annual stipend and includes comprehensive health and accident insurance.

Recently, DOH Secretary Ted Herbosa sent off more than 200 MSRS medical doctors, who will now serve in underserved areas across the country.

Clearly, this law was well-conceived and properly implemented.

But these initial gains in implementation require adequate and sustained funding, better administration, an improved curriculum and well-targeted interventions to continuously produce doctors who will serve in Geographically Isolated and Disadvantaged Areas (GIDAs).

Funding was sufficient, actually in excess, during the Duterte administration since there were fewer medical schools and therefore fewer scholars to subsidize.

Since 2024, the MSRS scholar budget has not kept pace with the number of financially needy students. CHED has been unable to calculate the MSRS funding required to support the opening of new schools, and DBM has not worked with CHED to ensure sustained funding.

CHED must also improve the implementation of the MSRS to ensure students receive their stipends on time. Medical education is expensive, and poor students who don’t get their stipends on time drop out.

Insufficient funding has also hindered the acquisition of medical equipment for classrooms. An annual budget of at least P500 million is needed, but CHED allocates only P150 million. Senators Pia Cayetano and Joel Villanueva redirected more than P200 million to CHED from 2023 to 2025. As new schools continue to open, spreading these funds across medical colleges will only allow the purchase of basic medical tools.

From 2022 to 2023, CHED provided P436.5 million in equipment grants to three leading medical schools – WVSU, UP Manila and MSU GenSan – through the Simulation-based Education, Training and Collaboration project. These three medical schools have the best medical equipment and laboratories among all public institutions. The 25 other public medical schools must be given the same equipment.

The P10-billion HEDF can be tapped for this purpose. But CHED has allocated this for other purposes.

Second, the expansion of public medical schools is only as strong as the mentors leading them. We cannot produce world-class doctors without a stable corps of world-class educators. Securing world-class mentors to train students is a top priority.

Sustainability hinges on creating competitive compensation packages and tenure tracks for physician-educators, ensuring that teaching in the provinces is as professionally rewarding as private practice in Manila. Without a dedicated faculty, we risk “diploma mills” rather than centers of medical excellence.

This also calls for enhancing Philippine medical education by partnering with international universities. The ongoing collaborations with the University of Adelaide and Duke National University of Singapore-Singhealth should be maintained and broadened to involve additional public and private medical schools.

Third, a bottleneck currently exists in the transition from classroom to clinic. For the program to survive, there must be a seamless integration between SUCs and DOH-retained hospitals.

We need to expand the capacity of government hospitals to accept interns and residents, providing them with the clinical exposure they need to handle the complexities of rural medicine. If students cannot find local placements for their clerkship, the pipeline to community service breaks before it even begins.

The “Return Service Program” is the heart of the Act, but it demands surgical precision in execution. Success depends on strategic matching – pairing graduates with the specific needs of their home provinces or underserved GIDAs.

It is not enough to “send a doctor;” we must ensure that the doctor’s specialty and language skills align with the community’s health profile to prevent burnout and maximize impact.

Finally, the most nuanced challenge is reconciling the curriculum with the demands of community-based primary care. Sustainability requires a curriculum shift: we are not just training clinicians to treat symptoms but health care leaders capable of managing local health systems.

The program must produce “doctor-leaders” who are equally comfortable in a surgical suite and a municipal health board meeting, ensuring that the Universal Health Care (UHC) vision is implemented from the ground up.