Post Graduate Internship

So it's already that time of the year when clinical clerks get busy for post graduate internship application. So what are the things you need to know before clicking the submit button in your online form? How do you choose the hospital best for you? Keep reading as I share to you the important things to note.

Post graduate internship is one of the most exciting milestones in one's medical training. You start with a thrilled heart as that newly acquired MD starts to sink in and you end it with heebie-jeebies as the board exam schedule hits you. Some say that PGIship is a break after that gruelling year of clerkship and a time to recharge yourself in preparation for more years of training in residency but some believe it is the best time to gain new skills and improve your clinical eye, and to prepare for the most important exam in medicine - the physician licensure exam. Nevertheless, choosing the right hospital is vital to get you to whatever goal you have.

Here's the schedule for 2018 Application:

•November 1, 2017-January 31, 2018: Application for the 1st round of matching

•February 16-April 15, 2018: Application for the 2nd round of matching

•May 1-June 30, 2018: Walk-in application period

How to apply?

Last year, the Association of Philippine Medical Colleges (APMC) launched the online application for internship. This is way better from years ago when medical clerks had to fill up hardcopy of forms and submit them to their respective schools for final submission to APMC. This way, you are able to track the progress of your application in real time while schools get to have a more convenient way of organizing and submitting requirements to APMC.

1st step is to register an account in the National Internship Program System (e-NIPS) here. and fill out the necessary details. Just make sure that you choose "Medical Student/Intern" option  in the --Select User Role-- so your application will be valid.

Also, don't forget to prepare a softcopy of your passport size photo to be uploaded in your profile. Then, you have to wait until your school validates and approves your account before you can start applying for a hospital.

Once approved, you can already access the long list of different hospitals you can choose from. e-NIPS only displays the hospitals with available slots, so don't wonder if the hospital listed during the 1st round is gone in the 2nd round. Below are photos taken from APMC-SN page containing the list of hospitals (1, 2, 3, 4)  and their corresponding slots.

You can choose up to 3 and rank them according to your preference. Aside from deciding which hospital to choose, the rank is also very crucial in the application since it will determine which hospital will be matched to you if you happened to be accepted in all 3 hospitals. Processing of applications is simultaneously done by hospitals, in contrary to what others believe that processing depends on the order of your hospital preference (some think that the 1st hospital of choice will be processed first and once denied, the application moves on to the next hospital of choice). So it is really possible that you will be accepted in all 3 hospitals simultaneously but the one matched to you is the hospital with the highest preference. So be sure with your preference before submitting because once matched, the unmatching process is so much of a hassle that you don't want to go through it. Also for this year, e-NIPS might not show your results in your other choices and will only display the one matched to you, unlike what they did last year that the applicants can see if they are accepted or not in each choice and they have the option to accept or refuse the assigned hospital. Apparently, e-NIPS has removed that option. So this year, if you want to change your hospital, you have to be unmatched first with the assigned hospital (write a formal letter to them), then repeat the application process but you will be allowed during the walk-in period only.

So for those still confused with the terms, let me make it simple. Being "accepted" to a hospital doesn't necessarily mean that you are already matched to it. You can be accepted in a hospital but not matched yet. The final status will be given when all the hospitals of your choice have submitted their final evaluation and e-NIPS will automatically "match" you to the hospital of higher preference. So being matched is the goal and again, once matched you can't reapply in the next round until you have unmatched yourself.

It is also important to remember that there are hospitals that post results early but there are buzzer beaters too so don't fret if your classmates are already matched during the first month of application while you are still waiting anxiously for your results. How will you know if your result is already final? Once accepted in the hospital with the highest preference, your status will automatically become "matched to _________ hospital" but if you were accepted in your lower-ranked hospital and your higher-ranked hospital is yet to release results, you will be given "pending" status. However, if your status indicates that you are "matched" to your lower-ranked hospital, it means that your higher-ranked hospital has already released results and did not accept you.

What if you only have one hospital in mind, are you really required to choose 3? You have the prerogative to choose only one and be charged with cheaper fees because you process only one set of requirements (TOR, Certificate of Eligibility from the Dean's Office and class ranking) or maximize choosing 3 institutions and get higher chance of getting matched because "probability" but pay higher fees for additional set of requirements. By the way, I'll leave the fees part to your school because charges may vary.

What can you do if you were not matched during the first round? You can still reapply in the 2nd round without paying additional fees. To those not matched in both rounds, you have to directly apply in your preferred hospital as walk-in applicant during the indicated schedule and once accepted, you have to inform the APMC for recording in e-NIPS. What if you were not able to make an online account and failed to apply in the 1st round? You can still register an account but you will be allowed for walk-in application only.

How to choose a hospital?

There are different kinds of training hospitals, the ones that will give you unlimited errands, hone your skills and train you to accomplish 5 different tasks in a minute; those which will let you sit with training doctors, study with them and get the Einstein out of you; or those which will demand you to work tirelessly while simultaneously being bombarded with series of reportings, endorsements and a consultant ready to prey on the remaining soul in you. But hey, you already got that MD and there's no room for backing out because you are already a step away from that license. What's even better is that APMC has ordered training hospitals to give not more than 12 hours of duty hours for post graduate interns. However, there are still remaining hospitals that give 24hr duties to interns. That, you have to know in your prospect hospital because it would still matter depending on your priorities.

In choosing a hospital, you have to first identify your strengths and the things that you already know, those skills you can confidently perform in any situation and of course your weaknesses, what were not taught to you that you want to learn and the things you want to improve on. From there, you can lay down your goals. Knowing what you want to specialize later on is also a good starting point.

Location: There are many hospitals to choose from north to south, you have the freedom to apply in any of those. This will matter if you already have a preferred place to settle down in the near future. Being able to train in your future hometown will give you the advantage to introduce yourself as a doctor and eventually start building your network of patients. Language is also an important factor here because medical terms have to be relayed to patients in their vernacular version, so you will be trained to talk to the patients more comfortably. There are also those who aim to be able to communicate to a wide variety of patients so they choose to train in places with different language. For instance, a doctor who is fluent in bisaya and hiligaynon chooses to train in Manila for flexibility and become language-ready.

Stipend: Hospitals give stipends as high as 10 thousand pesos with additional compensation with every paperwork you do and as low as free meals only. This depends if the priority is to earn as early as PGIship (but application screening might be more competitive) or if other goals outweigh this factor. If you are contented with free meals only, then you have one less problem in choosing your hospital.

Specialization: Each hospital has its own flagship program and you might consider one depending on the specialization you want. With this, you get to be immersed in the culture of the department and get acquainted with your possible future colleagues (residents and consultants). It will also help you reassess your passion for that field and give you the advantage of being familiarized with the know abouts in the department. The number of cases a hospital receives is also important here. There are hospitals that have a good number and variety of IM cases whereas some hospitals are known to have good training in trauma care because of the influx of trauma patients.

Type of hospital:  Being able to manage or handle patients directly may depend if the hospital is government or private. Interns may be limited in doing procedures in private institutions compared to public ones. However, there are hospitals which cater to both pay and service/charity patients so interns can do procedures with the latter. There are also other hospitals that, despite their public status, offer limited procedures to interns because of having fellowship programs wherein fellows have to perform the procedure themselves (e.g thoracentesis). On the other hand, being exposed in private hospitals will give you the advantage to observe the ideal management because they are able to request the necessary labs and procedures to patients freely. You also get to be exposed in modern equipment and technology, which will be a plus for your residency training.

Schedule: I think this is one of the most important things to consider especially if you are coming from afar. Some start as early as 5am and as mentioned earlier, some still have 24hr duties. There are also hospitals that conduct weekly board exam review for interns and some have weekly off the floors status/ interns' hour for educational purposes. This also includes the length of every rotation because some hospitals allow interns to rotate every month per department while some rotate every 2 months. Some offer elective sched as long as 2 months while some are only given 2 weeks of free electives.