Abstract

Background

Despite advances in medicine and public health, glaring inequalities in access to

health care and health outcomes within and between countries persist and have
even widened in some countries, including the Philippines. A major contributor is
the mismanagement of human resources for health, including doctors, nurses, and
community health-care workers. 60% of Filipinos die without seeing a doctor, and
the Philippines has a shortage of trained doctors. Furthermore, doctors in the
Philippines are distributed unevenly and emigration is high. Poor medical
education partly causes the mismatch between competencies of health
professionals and the health needs of the population. Such mismatch leads to
mismanagement of human resources for health and reduces access to the health-
care system. We aimed to gain insights from current medical students about the
present situation and future direction of medical education in the Philippines.
Methods

In response to the 2010 Lancet Commission Health professionals for a new century,

we organised a 3 day workshop that covered the current state of medical
education and human resources for health in the Philippines, and existing and
emerging global and national health challenges. 47 medical students from several
medical schools in the Philippines were selected through an open application
process. The sessions, which included interactive lectures and field visits,
culminated in small group discussions about the present state of medical
education in the Philippines and the participants' recommendations for scale-up.
Findings

The participants came up with three types of recommendation. First, reforms in

human resources for health, from recruitment and training to certification and
deployment. Second, reforms in the different components of medical education:
framework, content, and method. And third, reforms of the different levels of
physician training: medical school, health system, and broader societal
determinants, such as the living and working conditions of doctors. Some specific
changes suggested include: early, prolonged exposure to the community; inclusion
of more social science, public health, and leadership and management subjects in
the curriculum; and provision of environments conducive to interprofessional
learning. The students also proposed institutional reforms such as including
students in the design of the curriculum, and social accountability as a measure of
success of medical schools, instead of traditional licensure exam pass rates.
Interpretation

Medical education needs to change, as more medical graduates aspire to work

abroad or in urban centres, or become specialised. However, the overall approach
to and management of human resources for health in the country should also be
reformed, not just the content and method of medical education. Scale-up of
medical education will need the involvement of the Filipino Government, the
Department of Health, medical schools, and even medical students. The
Philippines should commit to transforming medical education, which is an
important step towards production of new health leaders for national and global
health equity.
Funding

International Federation of Medical Students' Associations.