Introducing JOINT: The Journal of INTernship (1998-1999)
After four years of medical school, the last requirement before taking the Philippine Physician Licensure Examination (also known as the medical boards) is a year-long internship^ at a hospital accredited to provide the doctor-to-be adequate clinical training. At that time, internship in all Philippine training hospitals starts on May 1, and ends on April 30.
For graduates of the University of the Philippines College of Medicine (UPCM), the Philippine General Hospital (PGH) is the host training hospital which certainly provides more than adequate clinical training. You see everything – all sorts of patients with diseases ranging from run-of-the-mill to the exotic… because it is THE national referral center for the ultimately most difficult cases that community hospitals are unable to handle. Calling to mind the old medical saying “If you hear hoofbeats think horses, not zebras”: PGH is where you see the zebras.
Most medical schools in the Philippines graduate their students after fourth year, when they are clinical clerks or sub-interns. The UPCM holds on to their students till after internship, graduating them after the year-long stint at the PGH. Medical interns from other schools who choose to do their internship at PGH are thus called post-graduate interns, or PGIs. Each block of 9 interns (designated blocks A to Z) consists of 5 UPCM interns and 4 PGIs, although there were some blocks which had 4:5 or 6:3 proportion instead.
The year’s 52 weeks are divided into 26 2-week time periods corresponding to the number of blocks. This is the basic “unit” of a clinical rotation. The shortest clinical rotations (e.g., Orthopedics, Psychiatry) last 2 weeks, while the longest (Internal Medicine) is allotted 10 weeks.
I knew internship was going to be the most difficult year of medical school – perhaps the most difficult year of my life in the clinics – so I decided to document as much of it as I could. I wrote JOINT as a journalistic project to tell friends and relatives (“subscribers” via email) about life as a medical intern at the PGH, especially since they wouldn’t get to see me much that year. I guess in a way it was also a coping mechanism for the physical and mental stress, putting these words to paper being somewhat cathartic. At some point I thought my purpose in life was to write stuff down*, and being in the hospital and seeing patients was merely the topic I was going to write about – I confided as much to my forever blockmate Ly-ann (hi, Ly-ann!). She is my “forever blockmate” because one’s surname dictates who you work with the most: students are grouped by alphabetical order in almost all academic activities, from cadaver dissection in Anatomy all the way to internship clinical rotations. Needless to say, we were in block Z because we were at the tail end of the class. Our block of 9 interns worked a lot with blocks W, X, Y, and also blocks A, B and C at the other end of the alphabet.
To the reader: I hope you learn from and enjoy reading about what internship was like in the late 1990’s. For those of us who survived the crazy year, these may or may not be good memories – you have been warned 🙂
^ Those in the United States familiar with graduate medical education will recognize this model as a “rotating internship” in which you spend time in multiple clinical departments throughout the year. In 1998-1999, the only available internships were rotating internships. More recently, “straight internships” have been established in core departments like Internal Medicine and Surgery, at least at the Philippine General Hospital.
* Perhaps the beginning of an ethnography? Maybe I already had an anthropological bent early on and didn’t know it yet.
