[UNIT 13]: F.

08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II

THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
OUTLINE C. HISTORY
I. SLU-HSH DEPARTMENT OF SURGERY ➢ May 10, 1977: Saint Louis University-Hospital of the Sacred
A. VISION Heart was opened to the people of Baguio and the rest of CAR
B. MISSION as a private hospital.
C. HISTORY ➢ 1981: Four major departments opened (Internal Medicine,
Pediatrics, OB-Gyne, Surgery).
D. DEPARTMENTS
• 1981: Started the Surgical Training Program
II. DEPARTMENT OF SURGERY • 1992: Accredited Training Program
➢ ORGANIZATIONAL CHART ➢ DOH Accredited since 1977
➢ PHILIPPINE SOCIETY OF GENERAL SURGEONS ➢ PhilHealth Accredited
➢ VISION ➢ Total Number of Hospital Beds before renovation: 240
➢ MISSION • Category 3
➢ DEPARTMENT CHAIR ➢ Total Number of Hospital Beds during renovation: 120
➢ Total number of surgical beds before renovation
➢ LIST OF GRADUATES OF THE PROGRAM
• Private beds: 26
➢ RECENT GRADUATES OF THE PROGRAM
• Service beds: 20
➢ ACCREDITATION ➢ When choosing residency program, it is the same as when you
➢ SURGICAL STAFF were interns. You should select an institution where the
a. LAPAROSCOPY – MIS program is accredited, that is very important.
b. SURGICAL ONCOLOGY ➢ Existing Departments:
c. HEPATOPANCREATICOBILIARY SURGERY • Internal Medicine, OB-Gyne, Pediatrics, Anesthesiology,
d. HEAD AND NECK SURGERY Pathology: Accredited
• Radiology: For re-accreditation
e. COLORECTAL SURGERY
օ Not re-accredited due to poor performance but has
f. BREAST SURGERY
an excellent training program.
g. UROLOGY
օ Accreditation is currently on-hold because there is
h. NEUROSURGERY no MRI. But once the new hospital building is ready
i. PEDIATRIC SURGERY for occupancy, there will be 2 MRI machines. That is
j. ORTHOPEDIC SURGERY the only reason why the radiology department is not
k. CARDIOVASCULAR SURGERY yet currently accredited.
l. PLASTIC AND RECONSTRUCTIVE SURGERY ➢ Total hospital admission (2017): 10,831
➢ Total surgical admission (2017): 1586
m. ORGAN TRANSPLANT AND VASCULAR ACCESS
➢ Total hospital admissions (2018): 9831
SURGERY ➢ Total surgical admissions (2018): 1635
n. TRAINING CORE MEMBERS
o. COMMITTEES D. DEPARTMENTS
p. RESIDENTS ➢ Information and Admitting Section
q. RESIDENT’S ROTATION MATRIX ➢ ER-MOR Department
r. 2018 CONFERENCES AND ACTIVITIES ➢ Hospital Internet Access
➢ Out-Patient Department
s. SCIENTIFIC RESEARCH OUTPUTS
• Number of OPD Surgical Consultations per year: 1400
t. CASE REPORT OUTPUITS patients/year
u. PBS-RITE 2018 ➢ OR-PACU Complex
v. PBS-RITE 2017 • Number of Operating Rooms: 5
w. PSGS-CERES 2017 օ 1 OR Room for Emergency Cases
x. RESIDENT’S QUARTERLY EXAM 2018 • Number of PACU Beds: 5
y. RESIDENT’S QUARTERLY EXAM 2019 • Lap tower: 2 units
z. NSAT • C-arm: 1 unit
aa. 2019 OPERATIONS (FIRST QUARTER) • Harmonic scalpel: 1 unit
• Operating microscope: 1 unit
➢ QUESTIONS FROM SURGICAL CLERKS
➢ Department of Laboratory and Pathology
➢ COMPONENT SOCIETIES
• Services: Routine tests, blood chemistry, serum enzymes,
➢ SPECIALTY DIVISIONS AND SPECIALTY SOCIETIES Microbiology, tumor markers, apheresis, Clinical
I. LOGOS OF SPECIALTY SOCIETIES AND DIVISIONS Microscopy and Parasitology,
Cytopathology/Histopathology, Serology and
I. SLU-HSH DEPARTMENT OF SURGERY Immunology, Blood Bank, rush frozen section,
A. VISION immunohistochemistry
➢ We envision the Saint Louis University Hospital of the Sacred ➢ Radiology Department
Heart as a premier academic medical center • Services: Tomography, Non-cardiac percutaneous
procedures, Fistulography, pacemaker implants, Visceral
B. MISSION peripheral angiography, Sialography, Retrograde
➢ To inspire hope and contribute to the well-being of everyone cystography, Operative and post-operative
providing the best care through integrated leading edge cholangiography, Cerebral angiography, Endoscopic
healthcare delivery retrograde pancreatography, Retrograde urography,
Lymphography, Lymphagiography, Ultrasonography,
Sonomammography, Computed tomography

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
• Radiology Configurations: C. VISION
օ General Radiology: Max mA: 500, Max kVp: 150 ➢ The Department of Surgery of Saint Louis University Hospital
օ General Radiography (portable x-ray): Max mA: 200, of the Sacred Heart envisions itself to be a prime private
Max kVp: 100 surgical training institution committed in developing
օ Radiology Fluoroscopy (C-arm): Max mA: 640, Max competent, socially-involved, dedicated professionals with
kVp: 150 high ethical and moral values steadfast in providing the highest
quality of surgical care imbued with the Christian Spirit.
օ Computed tomography: Max mA: 300, Max kVp: 140,
cut slices: 8
D. MISSION
օ Ultrasonography:
➢ The Department of Surgery of Saint Louis University Hospital
▪ ClearVue 350 and ClearVue 550
of the Sacred Heart shall be a committed SURGEON:
▪ Imaging options: Anatomic M-mode,
• S – Socially active in community service
Continuous-wave Doppler, Exam protocols,
• U – Uphold strong leadership values
Freehand 3D, High Q Automatic Doppler
• R – Respect and uphold patient’s autonomy
Analysis, Panoramic Imaging, Physio, Pulsed-
Wave Doppler, Pluse Inversion, SonoCT Real- • G – Globally competent in research
Time Compound Imaging
E. DEPARTMENT CHAIRMAN
օ Upper and Lower GI Endoscopy
➢ Jose A. Ramos, MD, FPCS (1975-1985)
օ 2D Echo Unit ➢ Jose C. Bugayong Jr., MD, FPCS (1986-1995)
օ Breast and Stone Center ➢ Lindo T. Mensalvas, MD, FPCS (1995-1997)
օ Nuclear Medicine Center ➢ Paul Adlai Quitiquit, MD, FPCS, FPSGS, FACS (1997-2002)
օ Ongoing bidding: MRI, LINAC, Mammogram ➢ Sherry Ong-Cunanan, MD, FPCS, FPSGS, FPALES, FACS (2003-
օ Rehabilitation Unit 2015)
օ Palliative Care Unit ➢ Francis B. Yabut, MD, FPUA (2016-2017)
օ Surgical ICU ➢ Pablo A. Candelario, MD, FPCS, FPSGS, FPSO (2018-2019)
➢ Medical Records Department
• How long are charts preserved? 14 years F. LIST OF GRADUATES OF THE PROGRAM
• Charts and medical records are discarded after 14 years.
Recording is now automated (HIMS).

II. DEPARTMENT OF SURGERY

A. ORGANIZATIONAL CHART

Figure 1. Dr. Cinio is currently the Chairman of the Department of

Surgery and Dr. Noli Velasquez is the Training Officer.

B. PHILIPPINE SOCIETY OF GENERAL SURGEONS

➢ Component society of the Philippine College of Surgeons
• Other component societies are subspecialties such as
Philippine Obstetrics and Gynecology Society (POGS)
• Cutting division
➢ Vision
• To be globally-recognized organization of General
Surgeons in the Philippines by 2020
➢ Mission
• Ensure the development of General Surgery as a premiere
and distinct specialty
• Pursue world-class, competent, and ethical surgical
education and training to our residents and fellows
• Deliver safe and compassionate service to our patients

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022

Figure 3. List of Diplomates and Fellows of the PSGS and PCS.

G. MISSION

Figure 4. Recent graduates of Surgery.

H. ACCREDITATION
➢ Fully accredited up to April 26, 2024

Figure 2. Graduates of Surgery.

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND
THE DEPARTMENT OF SURGERY
Dr. Cinio
05.02 - 06.2022
I. SURGICAL STAFF
Figure 5. Surgical staff in General Surgery.
a. LAPAROSCOPY -MIS
Figure 6. Laparoscopic surgeons.
➢ Residency program ⇒ board exam for General Surgery (given
by the Philippine Board of Surgery) ⇒ 1 written exam ⇒ passed
⇒ oral exam ⇒ passed 2 exams ⇒ Diplomate of Philippine
Board of Surgery (DPBS) ⇒ after 2 years of practice as a
surgeon ⇒ apply as a fellow ⇒ Fellow of the Philippine Society
of General Surgeons (FPSGS): no exams but there is a
committee that reviews cases ⇒ passed ⇒ induction. ⇒ apply
for the Fellow of the Philippine College of Surgeons: only
requires recommendation letters, no exams
➢ For laparoscopy ⇒ Fellow of the Philippine Association of
Laparoscopic and Endoscopic Surgeons (FPALES).
➢ FACS (Fellow of the American College of Surgeons)
b. SURGICAL ONCOLOGY
➢ Pablo A. Candelario, MD, FPCS, FPSO
• FPSO: Fellow of the Philippine Society of Oncologists
➢ Joey S. Lucas, MD, FPCS, FPSGS, FPALES, FSOSP
c. HEPATOPANCREATICOBILIARY SURGERY
➢ Fidel A. Baldovino, MD, FPCS, FPSGS, FPALES, FPAHPBS
➢ Jeff J. Fontanilla, MD, DPBS, AmPAHPBS, AmPSUS
➢ If a general surgeon is capable of doing cancer surgery, then he
can practice that as well.
➢ Example: Dr. Cinio, he is not a surgical oncologist. However, he
does breast cancer surgeries.
➢ All of us should know his/her limitations. Example, Dr. Cinio
does not do Whipple’s procedure, he asks for help from the
hepatobiliary surgeon to do this Whipple’s procedure.
Lo, Umali, Fianza
SURGERY II
Saint Louis University
School of Medicine
➢ The same way for our subspecialists. How? 2 subspecialists,
for example Dr. Noli Velasquez (transplant and vascular
surgeon) he has a patient with rectal cancer. On further
evaluation he noted that during the conduct of the procedure,
on pre-operative evaluation he will encounter some problems.
So what will he do? He will ask for help from our colorectal
surgeon.
➢ That’s how we do it, we ask for help from one another.
d. HEAD AND NECK SURGERY
➢ Samuel C. Cosme, MD, FPCS, FPSGS, FPSO
➢ Paul L. Ponadon, MD, FPCS, FPSGS, FPSO, FSOSP, MPPAI
➢ Dr. Vanadero MD, FPCS, and member of the executive
committee of the hospital
e. COLORECTAL SURGERY
➢ Lydana C. Casuga, MD, FPCS, FPSGS, FPCRS
f. BREAST SURGERY
➢ Sherry T. Cunanan, MD, FPCS, FPSGS, FPALES, FACS
g. UROLOGY
➢ Subspecialty of surgery that deals with the urinary system
➢ Benito V. Sunga, MD, FPCS, FPUA
➢ Ener U. Baysa-pee, MD, FPALES, FPUA
➢ Terence Depaynos, MD, DPBU, FPUA
➢ Carlos F. Dumlao, MD, DPBU, FPUA
➢ Darwin Henry V. Galuba, MD, DPBU, FPUA
➢ Francis B. Yabut, MD, DPBU, FPUA
➢ Percival J. Yang-ed, MD, DPBU, FPUA
➢ For example, Dr. Francis Yabut has a patient coming in to his
clinic, complaining of RUQ pain. On further evaluation, he noted
that this patient has cholecystitis secondary to gallstones. So
Dr. Francis can admit the patient but he cannot do the
procedure. He can actually assist, but cannot do the procedure
on his own as the lead surgeon.
➢ These are their limitations because some urologists underwent
directly into urology without going through a basic 2-year
general surgery rotation.
➢ Some urologists can do renal transplant but others cannot
because of their training. Not all of the urologists can do renal
transplant.
h. NEUROSURGERY
➢ Dave Anthony P. Diomampo, MD, DPBNS, FAFN
➢ Roel Anthony T. Domingo, MD, DPBNS, FAFN, FPCS
➢ Servando Andres D. Liban III, MD, FAFN
➢ Just like urology, our neurosurgeons cannot perform general
surgery cases, they are confined to neurosurgery.
i. PEDIATRIC SURGERY
➢ Alfredo M. Igama, MD, FPCS, FPSPS
➢ Bayani B. Tecson, MD, FPCS, FPALES, FPSPS
➢ Ma. Zsarin D. Tuason, MD, DPBS, DPBPS
➢ In contrast to other subspecialties, pediatric surgeons CAN
perform general surgery procedures, oncologic procedures.
Again in contrast, comparing now General Surgeons from
Pediatric Surgeons. For example, Dr. Cinio (GS), has a case of
a 2 y/o patient which he evaluated as having acute
appendicitis. He can operate on the said patient on his own
without the help of a pediatric surgeon. However, if in Dr.
Cinio’s evaluation, it is probably not appendicitis but needs to
be operated on, then he will call the help of Pediatric Surgeons.
➢ Another example, a patient came to Dr. Cinio’s clinic, and on
further evaluation the patient is suffering from biliary atresia,
he CANNOT perform the procedure, it has to be REFERRED to a
pediatric surgeon.
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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
➢ There is actually an overlap between specialties and b. Orthopedics
subspecialties and it is very complicated actually. Why can our • Dr. Antonio Tactay
pediatric surgeons perform general surgery procedures? • Dr. Jean Pierre Leung
Because before becoming pediatric surgeons, they underwent • Dr. Justiniano Bai
general surgery training. That is the reason why they can • Dr. Leo Franco
perform such procedures. • Dr. Jasper Fernandez

j. ORTHOPEDIC SURGERY c. TCVS

➢ Reynaldo R. Cariaga, MD, FPC, FPOA, FPCS • Dr. Rochie Hojilla
➢ Amado I. Dizon, MD, FPC, FPOA • Dr. Israel Yasay
➢ Justiniano S. Bai, MD, FPOA
➢ Leo Anthony M. Franco, MD, FPOA d. Neurosurgery
➢ Jean Pierre F. Leung, MD, FPOA • Dr. Roel Domingo
➢ Jasper Jo R. Martinez, MD, FPOA • Dr. Dave Diomampo
➢ James C. Paggao, MD, FRC, FPOA, FPCS
➢ Antonio T. Tactay, MD, FPC, FPOA, FPCS o. COMMITTEES
➢ Arnold S. Wanson, MD, FPOA ➢ An updated committee:
➢ Orthopedic surgeons are not confined to surgery of the bones
• Blood: Dr. Gerarld Libatique
or joints (i.e., fractures, compartment syndrome, dislocations),
• Infectious: Dr. Noli Velasquez
they can also operate on oncologic cases like sarcoma of the
• Tissue: Dr. Jason Ngalob
extremities that is part of the extent of their practice. But they
cannot operate for example on appendicitis (EMERGENCY • Therapeutics: Dr. Paul Adlai Quitiquit
APPENDECTOMIES) which is the most common emergency • Relations: Dr. Quinn Dahilan
surgical procedure in the hospital. The most common elective • ER/OPD Hazards: Dr. Abraham Cinio
procedure in surgery is CHOLECYSTECTOMY, now more on • Quality Assurance: Dr. Pablo Candelario
laparoscopic techniques are done. Orthopedic surgeons • Research: Dr. Pablo Candelario/Dr. Noli Velasquez/Dr.
cannot perform also cholecystectomy. Jason Ngalob

k. CARDIOVASCULAR SURGERY p. RESIDENTS

➢ Joseph J. Bautista, MD, FPCS, FPATACSI
➢ Rochie L. Hojilla, MD, FPATACSI, FPCS
➢ Israel C. Yasay, MD, FPCS, FPALES, FACS, FPATACSI
➢ For Dr. Cinio, his guide to know if the subspecialist can perform
general surgery procedures, we have to look back to their
training. If they have undergone training for general surgery,
and if they themselves are capable, confident that they can do
the general surgery procedures, then they can do such
procedures.
l. PLASTIC AND RECONSTRUCTIVE SURGERY
➢ Gene L. Estandian, MD, FPCS
➢ Paul Adlai B. Quitiquit, MD, FPCS, FACS
m. ORGAN TRANSPLANT AND VASCULAR ACCESS SURGERY
➢ Noli V. Velasquez, MD, FPCS, FPSGS
n. TRAINING CORE MEMBERS
➢ Members who are actively helping residents to become more
competent, compassionate surgeons in the future.
➢ Mark Lester Flores, MD – 5th year
➢ Stephen Joseph Villanueva, MD – 5th year
➢ Anton Jan Bautista, MD – 4th year
➢ Jerold Chan, MD – 4th year
➢ Betina Ramos, MD – 4th year (Chief Resident)
➢ Laurenze Kevin Cereno, MD – 3rd year
➢ Danielle Dirige, MD – 2nd year
➢ Matthew Acop, MD – 1st year
➢ Chief Resident is Dr. Betina Ramos a 4 th year surgical resident.
Why the bypass? It is not actually a bypass, it depends on the
evaluation: 1st and 2nd year residents are the Junior Residents,
3rd year is the Intermediate Resident, 4 th and 5th year residents
are the Senior Residents. It depends on the performance and
evaluation of the residents. The chief resident is actually a very
important position, we choose from our senior residents who is
capable and is qualified to become a chief resident. Becoming
a chief resident entails a lot of responsibility, and it is actually
a privilege to be called as such.
q. RESIDENT’S ROTATION MATRIX

A. General Surgery r. 2018 CONFERENCES AND ACTIVITIES

➢ Pre-op/Post-op/Grand Rounds/Case Presentations
• Dr. Sherry Ong-Cunanan Date Topic
• Dr. Paul Adlai Quitiquit Case Presentation: Iatrogenic diaphragmatic
Jan 15
• Dr. Pablo Candelario hernia presenting as complete bowel obstruction
• Dr. Noli Velasquez Post-op Conference: Choledochal cyst and its
Feb 12
management
• Dr. Jason Ngalob
Post-op Conference: Extraluminal fibroma of the
• Dr. Abraham Cinio Feb 20
colon presenting as complete bowel obstruction
• Dr. Quinn Dahilan May 21 Post-op Conference: Trichofolliculoma
• Dr. Jeff Fontanilla Oct 5 Case Presentation: Tongue Carcinoma
• Dr. Gerarld Libatique
➢ Census Conferences
• General Surgery Audit (Monthly: Total of 11)
B. Other Subspecialties
• Subspecialty Audit (Monthly: Total of 10)
a. Urology
• Dr. Francis Yabut
• Dr. Ener Baysapee

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
➢ Tumor Conferences (6 out of 4)
Date Topic
Jan 22 Small Bowel GIST presenting perforation Mar 12
April 16 Hemangiopericytoma of the upper extremity
Tumor Conference: Recurrence? A 61 year-old woman
Jul 9
with a retroperitoneal tumor
Tumor Conference: Gatric Adenocarcinoman with D2
Aug 13
resection post chemotherapy
Sept 17 Tumor Conference: Appendiceal carcinoid

➢ Mortality and Morbidity Conference (6 out of 6)

Date Topic
Mar 19 Acute Mesenteric Ischemia
Pneumoperitoneum is a post TEPP patient
June 18
presenting as an acute surgical abdomen
Iatrogenic bladder injury in a post TURP patient
Oct 15
Oct 22
Acute Kidney Injury in a 63 year-old male with
Nov 12 renal cell carcinoma of the left kidney s/p radical
nephrectomy
Nov 21 Acute kidney injury on a patient with an abdominal
Date Topic
Nonsurgical management of appendicitis with a
Apr 23
diameter of <10mm via CT scan and ultrasound
June 11 Good research training
T tube drainage vs primary closure after open
Aug 10
CBDE (review)
s. SCIENTIFIC RESEARCH OUTPUTS
Aug 28 Updates on surgical oncology (breast) ➢ Regular weekly programs for continuing medical education
Axillary dissection vs non-axillary dissection in
Oct 24
patients with positive SLN biopsy PROGRAM STRUCTURE 5-YEAR GS RESIDENCY
Nov 9 Sentinel node biopsy on early breast cancer
April July-
October-
January-March - Septembe
➢ Other Department Activities/Attendance to PSGS and other December
Post Graduate Conventions June r
Date Topic 1st
March Philippine Society of Colorectal Surgeons – 9th PSCRS yea General Surgery, OPD, Ward
15-16 15-16 r
Mar 24 Basic surgical skills workshop 2nd Jan-Feb 28: GS
Medical Outreach Missions Foundation, Inc. (MOMFI) Subspecialty (Uro, Ped Surg, Ortho,Plastic,
April 21 yea Mar 1:
Surgical and Dental Mission TCVS, Neurosurgery)/ER
r Subspecialty
Soft Tissue Management PSGS Northern Luzon
April 21 Jan 1-Feb 28:
Chapter Apr 24 3rd
MISTAH Foundation and Medical Outreach Missions Subspecialty/E
April 28 yea General Surgery/ER/OPD/Ward
Foundation, Inc. (MOMFI) RMarch1: GS-
r
April 28 Alpha Phi Omega-Pi Gamma Medical Mission ER
Philippine College of Surgeons 44th Midyear Sep 1-Oct
May 4-5
Convention: Enhancing the Culture of Safety in Surgery 4th 31: General
Lepanto Consolidated Mining Company-Surgical General
May 7-8 yea ITRMC Surgery/ER/OPD/War
Mission Surgery/ER/OPD/ Ward
r Trauma d
May 11- Laparoscopy day and PALES Zero Bile Duct Injury Rotation
12 Campaign PALES Northern Luzon Chapter
5th
May 19 Ensure-Strength Ambassadors Forum
yea General Surgery/ER/OPD/Ward
r

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THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022

w. PSGS-CERES 2017

t. CASE REPORT OUTPUTS

➢ Each resident is required to pass 2 research papers. One a case
study but not necessarily a case study, another should be a
research

x. RESIDENT’S QUARTERLY EXAM 2018

u. PBS-RITE 2018

y. RESIDENT’S QUARTERLY EXAM 2019

➢ Residents have their in-house quarterly exams but what is
important are the 2 exams given by our specialty societies.
First we have the RITE which is a resident’s exam given by the
Philippine Board of Surgery (PBS) and then the CERES which is
given by the Philippine Society of General Surgeons (PSGS).
Each resident is given the raw score and the percentile ranking
with the residents of other institutions NATIONWIDE
➢ IN-SERVICE EXAM: Surgery has 2 yearly exams, 1 given by PCS
and the other by PSGS
➢ IN-HOUSE EXAM: For training

v. PBS-RITE 2017
➢ Not just a case report should be a research, ANY type of
research, but not another case study or case report

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
z. NSAT
➢ NSAT is the entrance exam pre-pandemic

aa. 2019 OPERATIONS (FIRST QUARTER)

➢ Breakdown of Operations
➢ Total operations:
• Elective: 312 (MC: CHOLECYSTECTOMY)
• Emergency: 34 (MC: APPENDECTOMY)
օ Trauma: 1
օ Non-trauma: 33
• Operations done by Consultants:
օ Private cases: 209
օ Service Cases: 11
• Operations done by Regular GS Residents:
օ Private Cases: 77
օ Service Cases: 49
• Operations done by Straight Rotators in the Institution: ➢ Our residents are exposed to a variety of cases and we have our
Not Applicable Manual of Operating Procedure and Guidelines and we should
• Operations done by residents in outside rotation: Not meet thebasic requirements. The residents keep record of their
applicable cases and after graduation they will pass this to the Philippine
• Operations done in outreach surgical mission: Not Board of Surgery, Philippine Society of General Surgeons to be
applicable evaluated if they have successfully completed their
requirements – the basic training or cases required in order to
become a general surgeon.
➢ Our trainees have their rotations in ITRMC (Memorandum of
Agreement between Ilocos Training and Regional Medical
Center) and currently we have 3 hospitals to rotate in:
• ITRMC in La Union
• Batac (Mariano Marcos Memorial Hospital and Medical
Center)
• Tarlac General Hospital

J. QUESTIONS FROM SURGICAL CLERKS

➢ The following are questions of the previous third year medical
students who are now either interns or they already have
passed their board exams, and these are answered by the
clerks during that time.
• How can a surgical clerk maximize the two-month
rotation in the department of surgery, to acquire basic
➢ As private institutions, we have lesser number of cases as skills and at the same time enhance his/her medical
compared to public or government institutions. So (it’s) the knowledge in preparation for the comprehensive oral and
same as knowing where to go for your internship, it is knowing written exam, and most importantly, the board exam?
your strengths and weaknesses, your goals and what are the օ As clerks, it is our responsibility to read on cases
obstacles. Again, it is situational, it depends. Apply to an assigned to us in the department in order to maximize
institution where you know your skills will be enhanced. our rotation. Usually before the surgical procedure
begins, we must have read on each cases because
some of the consultants or residents tend to ask
basic board questions during the procedure. Reading
during your spare time will also help you during your COWE
1 and Oral Exams and will refresh your knowledge in basic
anatomy and surgery etc.

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05.02 - 06.2022
• Describe a typical day as a surgical clerk. What should we
expect during our rotation?
օ DUTY – Duty clerks usually stay in the emergency
room inthe morning (non-duty hours). They are the
ones who do minor OR procedures such as incision
and drainage, circumcision, excision of mass, etc and
they are the ones who admit and deck patients to each
clerk in charge. All emergency OR procedures during non-
duty hours will be attended by the surgical clerks on
duty. Duty clerks assigned in the wards areresponsible
for the monitoring of all in-patients, dressing wounds
at 4 am (or as needed) and other procedures in the ward
such as IV insertion, IFC insertion, NGT insertion, etc.
օ FROM – from duty clerks are assigned to attend OPD
procedures at the OR or attend procedures of their
own decked patients (usually scheduled procedures are
decked to each clerk in the group, regardless of status.
օ FLOATER – Floater clerks are assigned in the ward to
monitor and discharge patients (Discharge instructions
and medical certificates) and do procedures and
paperwork requests in the ward. IV re-insertions and
other procedures are also done bythe floaters. All ward
concerns are also attended to by thefloaters. This is
a little bit modified because of the COVID Pandemic.
You are not allowed to attend to COVID patients or
COVID suspect patients.
• What are the common struggles of a medical clerk? What
are the common reasons to fail in clerkship? What is to be
expected of a clerk? How will we know when to refer and
to whom will we be reporting to? How to deal with
mistakes incurred during surgical clerkship/ internship/
residency?
օ Just suck it up and move on . Learn from your
mistakes and never do it again. Mistakes are inevitable
during clerkshipand it is important for you to take is a
learning experience.
օ Always remember that while you want to self-loathe
for that one mistake, you have 29 more patients in the
ward needing your full attention. In this profession
thatdeals with life and death, you have to learn to forgive
yourself. You have to learn from the good and the bad
experiences, and move forward for your future
patients.
• What are the most interesting/funny/happy/enjoyable
part of surgical clerkship/internship/residency?
օ The most interesting part of surgery is when we
assist actual surgical procedures and appreciate the
things we’ve learned in the academe. From the initial
presentation of the patient to the time that the
patient is operated, we could see how the disease
progresses and learn when surgical intervention is
indicated.
• How would we properly prepare the patient and ourselves
prior to an operation?
օ You should know the patient’s history. It doesn’t
matter if he/she is your own patient who is currently
admitted in theward or if the procedure is done as OPD.
If you are assistingin the procedure, it is important that
you know the history ofthe patient. Also, read about the
case, review the anatomy and sometimes, even the
physiology of the organ/s involved in the procedure.
օ Example:
▪ For thyroidectomy : blood supply, drainage,
innervation, synthesis of thyroid hormone, etc.
▪ For ortho cases : anatomy and stages of bone
healing etc.
Lo, Umali, Fianza
SURGERY II
Saint Louis University
School of Medicine
օ Be there 1 hour ahead of time . Aside from demerits
for late entry, once the patient is inside the operating
room youwill assist the anaesthesiologist in hooking
the patient to a cardiac monitor (BP app, pulse ox and
LLA, RUA, LUA). Stay with the patient to make sure
that he or she is safe while waiting for everyone to
arrive.
օ Bring your tools. There are instances where they would
askthe clerk to take the manual vital signs before and
during theoperation. And of course, you will need your
tools in the recovery room.
օ Follow the sterile technique religiously . You wouldn’t
want to be sent out of the operating room because you
are unsterile.
• It has been said that surgery is one of the departments
that embrace the idea of hierarchical organization. Is there
really a needto follow this, and what are the advantages
and disadvantages of following such set up? I think this is
a question of just one clerk who has a fetish for hierarchy.
օ If you think, for one second, that hierarchy in the
hospital isnot necessary then your rotation is a disaster
that’s waiting to happen. In any department, respect
hierarchy, respect your seniors. To foster a healthy work
environment, you can’t be friends all the time, and you
can’t be equals all the time. These people you call seniors
are ahead of you in experience. Wehope that you do not
look at them as oppressors but as people who will guide
you through your journey that is clerkship.
օ It all comes down to perspective really. Hierarchy
facilitates chain of command. Having said that, it does
not mean thatbecause they are your seniors, they are
your bosses. As youcome in as blank slates, all of you
will be trying to figure out how to survive this new
environment. Having seniors means that you have
someone to turn to, someone to ask, someoneto depend
on and sometimes, someone to take responsibility for
you. Remember, they’ve been through it before and
survived it, now they’re doing it again and more.
Imaginegoing through clerkship on your own, with no
one to answeryour questions. The residents are there but
they have so much on their plates that sometimes it’s
almost impossible to get intouch with them, especially
when they are in the operatingroom.
• Imagine entering a patient’s room only to find him/her
without a pulse, bleeding heavily from a previous
operation, unarousable or screaming in pain and tour
residents are out of reach. What would you do? One
morning you were asked to remove the central line for
post mortem care, to declog someone’s CTT, or measure
CVP? How do you assist in codes? How do you fill out
forms properly?
օ Most of the questions you have prepared for us to
answer, our seniors answered for us while in the
hospital.
➢ As you enter the hospital as clerks, know that your seniors
recognize that you are indeed knowledgeable individuals but
because you are new to this environment, there is so much to
learn and so much more to experience.
➢ We do not tolerate/support making anyone inferior in any way.
Inthe hands of the right people, hierarchy is good. It is meantto
maintain order, respect and a healthy flow in the work
environment. It’s unfortunate, however, that in every batch
there will be unjust individuals. We cannot deny the fact that
sometimesit’ll feel like your senior are abusing their power. But
the truth is, you will encounter people like that no matter where
you are, who you are.
➢ Experience is the best teacher.
Page 9 of 15
 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
K. COMPONENT SOCIETIES • Philippine Society of Allergy, Asthma, & Immunology
➢ Northeastern Luzon Region • Philippine Rheumatology Association
• Cagayan Medical Society • Philippine Heart Association
• Ifugao Medical Society • Philippine College of Chest Physicians
• Isabela Medical Society • Philippine College of Geriatric Medicine
• Apayao Medical Society ➢ Other specialty societies covered by PMA Board Resolution
• Nueva Vizcaya Medical Society #079
• Santiago City Medical Society • Philippine Psychiatric Association
• Kalinga Medical Society • Philippine Academy of Rehabilitation Medicine
• Quirino Province Medical Society ➢ Philippine College of Surgeons
➢ Northwestern Luzon Region • Philippine Society of General Surgeons, Inc.
• Abra Medical Society • Philippine Orthopaedic Association, Inc.
• Baguio-Benguet Medical Society • Philippine Urological Association
• Ilocos Norte Medical Society • Philippine Society of Otorhinolaryngology Head and Neck
• Ilocos Sur Medical Society Surgery, Inc.
• La Union Medical Society • Philippine Society of Pediatric Surgeons
• Mountain Province Medical Society • Academy of Filipino Neurosurgeons
• Pangasinan Medical Society • Philippine Association of Thoracic & Cardiovascular
• Southern Ilocos Sur Medical Society Surgeons,Inc.
➢ Central Luzon Region • Philippine Society of Colon & Rectal Surgeons
• Angeles city Medical Society • Philippine Association of Plastic Reconstructive &
• Aurora Medical Society AestheticSurgeons
• Bataan Medical Society • Philippine Society for Vascular Surgery
• Bulacan Medical Society • Philippine Academy of Ophthalmology
• Nueva Ecija Medical Society • Philippine Society for the Surgery of Trauma
• Olongapo City Medical Society • Philippine Academy for Head and Neck Surgery, Inc.
• Pampanga Medical Society • Philippine Society of Laparoscopic & Endoscopic
• Tarlac Medical Society Surgeons
• Zambales Medical Society • Philippine Hp and Knee Society
➢ Quezon City Region • Philippine Society for Transplant Surgeons
➢ Manila City Region • Surgical Oncology Society of the Philippines
➢ Central Tagalog Region • Philippine Spine society
➢ Rizal Region • Philippine Society of Ultrasound in Surgery
➢ Southern Tagalog Region • Association of Women Surgeons of the Philippines
➢ Bicol Region • Philippine Association of Training Officers in Surgery
➢ Eastern Visayas Region ➢ Philippine Academy of Family Physicians
➢ Central Visayas Region • Philippine College of Occupational Medicine
➢ Western Visayas Region • College of Emergency Medicine
➢ Southeaster Mindanao Region • Society of Hospice and Palliative Medicine
➢ Caraga Region • Academy of Physicians in School Health, Inc.
➢ Northern Mindanao Region ➢ Philippine Pediatric Society
➢ Western Mindanao Region • Philippine Society of Pediatric Metabolism and
➢ Northcentral Mindanao Region Endocrinology
• Pediatric Nephrology Society of the Philippines
L. SPECIALTY DIVISIONS AND SPECIALTY SOCIETIES
• Philippine Academy of Pediatric Pulmonologists, Inc.
➢ Philippine Society of Pathologists, INC.
• Pediatric Infectious Disease Society of the Philippines,
➢ Philippine Obstetrical and Gynecological Society
Inc.
➢ Philippine Society of Anesthesiologists
• Philippine Society of Pediatric Cardiology
• Philippine Society Cardiovascular Anesthesiologists, Inc.
• Society of Pediatric Critical Care Medicine
• Society for Obstetric Anesthesia of the Philippines
• Philippine Society of Pediatric Gastroenterology and
• Pain Society of the Philippines
Nutrition
• Philippine Society of Pediatric Anesthesiologists
• Child Neurology Society of The Philippines
• Philippine Society of Cardiothoracic Anesthesiologist, Inc.
• Philippine Society of Pediatric Oncology
➢ Philippine College of Physicians
• Philippine Society of Pediatric Surgeons
• PCP Diabetes Philippines
• Philippine Society of Newborn Medicine
• Philippine Dermatological Society
• Section on Allergy and Immunology
• Philippine Society of Endocrinology, Diabetes, &
• Section of Genetics
Metabolism
• Philippine Society of Adolescent Medicine Specialist
• Philippine Society of Gastroenterology
• Section on Developmental Pediatrics
• Philippine Society of Nephrology
• Philippine Society of Pediatric Hematology
• Philippine Society of Nuclear Medicine
• Section of Ambulatory Pediatrics
• Philippine Society for Hematology and Blood Transfusion
• Section of Community Pediatrics
• Philippine Society of Medical Oncology
• Philippine Society of Developmental and Behavioral
• Philippine Society Neurological Association
Pediatrics
• Philippine Society of Microbiology and Infectious
Diseases

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
➢ Philippine College of Radiology
• Philippine Society of Vascular and Interventional
Radiology
• Ultrasound Society of the Philippines
• Computed Tomography Magnetic Resonance Imaging
Societyof the Philippines
• Philippine Radiation Oncology Society

➢ The Philippine Board of Surgery (first picture) - governing body

for giving the exams after training in general surgery
➢ Philippine Society of General Surgeons (second picture)
➢ Philippine College of Surgeons (third picture) - main society for
the cutting division
➢ For the logos of the other societies, proceed to the last page (M.
Logos of Specialty Societies and Divisions)

➢ Highest – Orthopedics (Cardiology in the Philippines)

➢ Lowest – Pediatrics
➢ Even though this is in dollars, it’s the same (in peso). But I don’t
believethis. It depends on the individual. This is just a general
census by Medscape. But then again, it doesn’t matter. You
have to know your actual role and goal as a physician

➢ Lifestyle Surgery = Uncontrollable

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022

➢ Top earners (unknown date)

III.

Malpractice claims for the cutting division is very high

➢ Some surgical cases can now be treated medically due to

advancements in medicine.
➢ During residency training, you will be able to learn techniques
that are not mentioned during our stint in the school of
medicine.

➢ We have the latest techniques in surgery. Aside from surgery,

we have some of the surgical cases previously can now be
treated medically due to advancements in medicine

➢ This is questionable actually (unknown date)

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 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022

Robotics

During residency
training, we will be
able to learn
techniques that are
not mentioned
during our stint in Some members of the teaching staff. Dr. Vanadero with Dr. Cinio (lower
the school of right image)
medicine

Gallstones
When you become clerks or interns rotating in any institution. Be
responsible for your own things:
PLEASE TAKE CARE OF YOUR BELONGINGS
!!! This is actually prohibited in the hospital premises !!!

In this case, what

specialty is in
charge?
Orthopedics?
General surgeon?
Vascular surgeon

Tendon cyst in the

wrist? Who is going
to operate? General
surgeon? Pediatric
surgeon?

Lo, Umali, Fianza Page 13 of 15

 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022
SOME CASES IN SURGERY

Abdominal Cases

Body fluids everywhere. Smelly, but some are not

Breast Cancer Cases

Peptic ulcer Disease

Hemorrhoids, another very common case

Probably a fluid
Incision and drainage of extracted from the
abscesses biliary tree

The surgical team

Surgical Resections

Do we operate this case?

This is you

Lo, Umali, Fianza Page 14 of 15

 [UNIT 13]: F.08 THE FILIPINO SURGEON (Part 2) – SLU-HSH AND SURGERY II
THE DEPARTMENT OF SURGERY Saint Louis University
School of Medicine
Dr. Cinio
05.02 - 06.2022

BUT OF COURSE, we also have our own lives!

CHECKPOINT
MULTIPLE CHOICE
1. What does ITRMC stand for?
A. Ilocos Training and Regional Medical Center
B. Iloilo Training and Regional Medical Corporation
C. Information Technology Resource Medical Council
2. In the 2019 first quarter operations, how many operations were done
by residents in outside rotation?
A. Elective: 312 C. Service: 11
B. Private: 77 D. Not applicable
3. Specialty societies give 2 exams to residents namely:
A. RITE & MED C. RITE & HABEAS
B. RITE & CERES D.CERES & CORPUS
Proposed new building of SLU-HSH 4. Each resident is required to pass how many research papers?
Which is clearly near its completion A. 1 C. 3
B. 2 D. 4
5. This surgical clerk usually stays in the emergency room in the
morning and perform minor OR procedures.
M. LOGOS OF SPECIALTY SOCIETIES AND DIVISIONS
A. Duty clerk C. Floater clerk
B. From duty clerk D. NOTA

IDENTIFICATION
6. Date wherein Saint Louis University-Hospital of the Sacred Heart
was opened to the people of Baguio and the rest of CAR as a private
hospital.
7. Number of OPD Surgical Consultations per year
8. How long are charts preserved?
9. Total Number of Hospital Beds before renovation
10. Total Number of Hospital Beds during renovation

10. 120
9. 240
8. 14 years
7. 1400 patients per year
6. May 10,1977
1-5. ADBBA
ANSWERS

-END OF SURGERY II-

SEE YOU IN CLERKSHIP!

Lo, Umali, Fianza Page 15 of 15