Dr. Pablo O. Torre Memorial Hospital, more commonly known as Riverside, is a 300-bed private tertiary hospital located at the heart of Bacolod City. The hospital has continually produced exemplary doctors who have undergone 1 year intensive training under their postgraduate internship program. Currently, the institution is training their 44th batch of postgraduate interns.
The usual departments where PGI rotates are:
1. Pediatrics (2 months)
2. Surgery (2 months)
3. Community and Emergency Medicine (2 months)
4. Internal Medicine (2 months)
5. Obstetrics and Gynecology (2 months)
6. Pathology (2 weeks)
7. Radiology (2 weeks)
8. Anesthesia (2 weeks)
9. Otorhinolaryngology (2 weeks)
10. Orthopedics (2 weeks)
As prescribed by the APMC, we do not have 24 hour duties. For most departments, we only have 12 hour duties either 8AM-8PM or 8PM-8AM. NO NIGHT DUTIES for the minor rotations. But for IM, we have a straight 16 hour cinderella duty (8AM-12MN). From Duty and On Call statuses are only half day during weekends and holidays. On duty interns go on skeletal duty during these times. Usual duty pattern is: Duty AM, OC, Duty PM, FD, OC. This pattern is flexible and sometimes your group will have an extra on call or from duty if you have 6 members in a group. Duties are every 3 days for IM. From duty interns are untouchable (except for IM and OB because they need to see OPD patients) but still need to attend conferences and endorsements. Because of this schedule and due to the limited number of PGIs, we go on single duties in almost all rotation.
The patient bulk is a little heavy. We do not have too many patients compared with public hospitals but not too few compared with the other private hospitals. Caseload is very varied. You can see patients admitted for simple allergic rhinitis to toxic patients admitted because of hypovolemic shock secondary to ruptured abdominal aortic aneurysm. Since there are plenty of rich people in Negros, sometimes you will be shocked to know that your patients is actually the owner of one of the biggest enterprises in Negros. Nevertheless, charity cases, albeit limited, are also existent allowing interns to have a better chance to learn ideal management from these cases.
Rotating in every department is really rewarding. The On Duty PGIs are the first call to see patients whether in the OPD, Acute care unit or in ER. On call PGI usually see direct to room patients first. Generally for all the patients that we see, we are required to have our own assessments and plans which our residents will gladly approve or correct if needed. For bedside procedures, PGIs are allowed to perform IV insertion, foley catheter and NGT insertions, etc. Ward calls include IV to follow, wound dressing, bedside procedures, accompanying toxic patient to imaging services, hospital transfers, referrals, medical abstracts, etc. We do not do q4, q2 and qhrly monitoring as these are nurses’ jobs.
For ward calls, we assess the patient first and then try to troubleshoot the problem if we are able to do so. We refer directly to our residents if needed. Minor rotations such as ENT and Ortho have no residents, thus PGIs act like one and refer directly to consultant. In minor rotations, we admit patients ourselves, see and manage patients at the OPD ourselves, follow-up ward patients ourselves and directly refer to the consultants if needed.
In terms of surgical cases, we scrub in almost all surgeries. Since there are only few surgical residents, we get to be the first assist often. Cases are very varied. Common cases include appendectomies, chole, mastectomy, herniorrhaphy, cysto-TURP, etc. Thoracovascular surgery, reconstructive surgery and organ transplant are also performed in our hospital. This is another plus for you if you wish to go on surgical training later on.
In the OB department, you will definitely master the art of fetal monitoring since it will be your job to perform NST, CST and CTG monitoring. Nurses do the labor watching so another plus points to those who do not want to be placed in such a socially awkward situation with a prepartum patient. There are limited charity cases in OB but you are free to ask your resident to perform NSVD do episiotomy or episiorrhaphy to uncomplicated charity cases.
For the Department of Emergency Medicine (DEM) rotation, you get to see patients yourself independently. You are free to perform necessary work-up, laboratory or imaging and manage them accordingly by yourself. You are even free to refer them to other services if needed or to advise admission if deemed necessary. Since there are no DEM residents, you get to refer directly to consultant if your are not able to manage the case yourself. In the ER, PGIs are the first line compressors during CPR but nurses also help. Sometimes, you are also given the chance to intubate patients yourselves. Community Medicine is integrated with the DEM rotation. We see and manage patients ourselves in the community without the need to refer to our residents if the case is not so complicated.
We also have daily conferences, each day for a different department. Topics discussed in conferences are must knows for the board exams. Endorsements are also vital in major departments such as Pedia, Surgery, OB and IM. Questions during endorsements are mostly pearls for the board exam. A formal review for the boards is offered towards the later part of the year for all interns. In Riverside, you will definitely have a lot of free time, it’s just up to you whether you will choose to spend your free time in studying or in other matters.
Finally, the best part of having your PGIship in Riverside: FOOD and MONEY. Daily conferences means daily feeding program. Your weight will surely suffer once you have signified to join this institution. Furthermore, there will be a lot of RTDs, interhospital conference and events that will sure add another problem to your ever dilemma of loosing those extra pounds you have.
Bacolod in general is a PGI friendly place. All hospitals offer huge stipend (or meal allowance as we call it) to their interns. While Riverside may not be offering the biggest stipend of them all, I believe you will surely be happy to line up at the cashier during the first day of each month to receive the your Php6000 allowance. Furthermore, it has also been agreed that interns will be paid Php50 for each medical abstract (Php100 for extra copies). However funds will be pooled and be used as your common fund with the other interns. During Christmas, caroling to consultant’s houses is common allowing the batch to earn hundreds of thousands which will also be pooled in the intern’s funds. At the end of the year, it is your batch’s discretion on how to use or to divide this fund.
At the end of the year, deserving interns will be awarded as outstanding interns. Most department offer a sure residency spot to those who has gained the award. For the overall most outstanding intern, he or she will gain a sure spot to any residency program he chooses which being offered at Riverside. Apart from this, being part of the alumni association of this institution, all interns will get to have the perk of being able to network with the biggest names in the medical industry in the province.
The biggest downside however of having your internship at DPOTMH are the massive amount paperworks. We make clinical histories to all our admitted patients. In other institutions this is the job of the clerks. In our hospital, PGIs as well as the resident residents make their own histories since the institution believe that there is no better way to learn medicine than to go back to the basics of history and PE. We also accomplish medical abstracts of our patients (but with a fee). We also make referral notes, progress notes (in some departments), and sometimes going home instructions. The most daunting paperwork probably is accomplishing hundreds of discharge summaries per rotation. Personally I don’t see this as a con since I am able to review what has been done to my admitted patients which I believe not most of the interns are able to do so.
Currently, Riverside is on the process of upgrading their facility and adding more hospital beds. In the next few years, the title of being the premier hospital in Negros will not be limited to the island anymore. Lucky for the incoming new interns since new advancement are being made in the hospital. Local and international accreditations are also in the pipeline. In the next few years (or months), Riverside will be one of the the biggest and most technologically advance healthcare training institution in the country. To sum it up, If you want a hospital that would guide you step-by-step in attaining your goal to becoming a good physician, expose you to what is ideal and to train you with the best facilities while at the same time give you a great degree of independence in terms of patient care and developing you clinical acumen, then Riverside is definitely the best place for you to have your PGIship.
#check out my post on the requirements and what to expect in Post Graduate Internship
This article was written by Aljeirou Alcachupas, MD upon the request of his friend. 😊
