Post-training Reflection
Rolando V.
de Guzman, M.D.
November 27, 2003
Introduction
I started my residency training in General
Surgery at OMMC on January 1, 1998.
It’s been six years since then, years of hard work and training. I am lucky because during my training I have
seen how the department has evolved to have a structured training program. So as I go out of my training I would like
to admit that I was not able to learn everything there is to learn in general
surgery. However, I hope I have
acquired and imbibed the basic frameworks and core values expected of me to be
a rational, effective, efficient, holistic and humane community surgeon.
This
reflection paper would show how much I have learned during my training.
Objectives of paper:
Results:
Basic frameworks:
Patient management process
During the early years of my
training, my approach to patient management was not structured. There were
times that I was able to arrive to a correct diagnosis but the process was not
clear and the approach was often not rational. With the introduction of this
process in my training, patient management became so easy, systematic and
structured. Recognizing the beauty of
this process made me adhere to its principles and from there it became a habit
that I used in every patients that I had. There were times that my diagnoses
were wrong but with this approach to patient management I can always have a
sound and rational one. Mastery of the principles of patient management process
has made me a better physician.
Operation-surgery process
Part of being a good surgeon is the
mastery of operation surgery process.
My six years training at OMMC has made me realize that surgery is not
just the act of operation. My training
has provided me with strong foundation to handle different surgical problems.
This process has taught me the following: formulation of a rational
preoperative surgical plan with adequate preparation, precise intra-operative
execution of the operative plan with rational decision making and adequate
post-operative management. Our “How I
will do it” and the “How I did it” program has helped me to master a surgical
procedure before even trying to do one.
As a surgeon trained in this institution and with adequate training in
operation surgery process, I believe I am ready to face the challenges outside
OMMC with pride.
Problem-based and self-directed learning process
Medicine is not an exact science, it
is dynamic and there are many controversies.
My training has taught me how to handle and process controversies and
how to cope up with the advances of medicine, with me as the principal actor in
the learning process. Medicine is a
never ending learning process and residency has taught me to be always open and
critical to new information. Our
debates and action researches are examples of problem based and self directed
learning activities of the department which helped me improve my clinical
performance.
Physician-teacher process
During my training I realized that
teaching is part of my profession and I believe that the optimal learning
process can be achieve through interactive exchange of ideas. My training has provided me enough
opportunities to teach and educate my patients, junior residents, medical
students and myself. For me, one can
never claim that he has learned a lot unless he’s able to pass on the knowledge
to his subordinates. I may not end up
being a formal educator in the future but I will certainly use this physician
teacher process for my continuing medical education.
Physician-researcher process
Research was the least appealing
field of medicine to me, maybe because of the statistical side of it. Before, I have never imagined myself doing
research but with structured training and dedicated teacher I was able to produce
3 action research papers. The introduction
of the action research methodology in my training has made me realize and
appreciate its usefulness to clinical practice. My training has definitely laid down the foundation for me to
pursue to become a physician researcher.
Physician-manager process
Residency
has given me a chance to develop my leadership attribute, we were provided with
small scale venue to harness our administrative capabilities. We were taught how to run a department, how
to handle administrative problems and most of all how to encourage others to
work towards the fulfillment of the goals and objectives of the
department. You have shown us the
attributes of a good leader, an animator and a change agent.
Community surgical health management process
Our training has provided me with
enough exposure in dealing with community surgical health problems and the
process involved in providing the solution.
Our advocacies and information dissemination programs have awakened my
social consciousness. As part of our
social responsibility program we provided quality surgical health service
through operation pinoy. With this framework that I have imbibed I am now ready
to participate in community surgical health management in my locality.
Core values:
Respect for human lives and human being
“Primum Non Nocere” is one of the
policies of the department. During the
course of my training, we were always taught to respect human lives by always
being humane in our approach to patient management with a goal of having a live
patient. Our regular morbidity and mortality conferences with quality analysis
were a constant reminder to us how valuable life is.
Honesty and sincerity
Our residency has been extended due
to intellectual dishonesty and we suffer the consequence. “No dishonesty” has been the policy of the
department since the new stewardship; with this policy I learned the importance
of honesty and sincerity in medical practice and the repercussions for not
doing so. I always tried to be honest
to myself and humbly accept my limitations.
Ethics and integrity
My training
has given me the opportunities to develop a good work ethics and to value the
integrity of my profession by not engaging in any act that would destroy my
reputation. Good interpersonal relationship with patients and colleagues has
helped me developed and gain their trust and confidence. I tried to live the ideals of my profession
and act accordingly.
Professionalism
Residency has taught me to follow
certain rules and regulations. I have learned to respect my patients,
colleagues and myself. We were trained to perform our duties and
responsibilities as a person, doctor and surgeon and sometimes even beyond the
call of duty.
Continual improvement to achieve quality and excellence
Setting standards with regular
monitoring and evaluation has pushed me to the limits and helped me in
improving my craft. Residency has
taught me the importance of continual learning for improvement to achieve
quality and excellence in medical practice. OM has provided me with good
environment for professional growth.
Teamwork
During residency, I learned how to
work with others, either as a follower or as a leader. We were given group
activities and projects to develop our teamwork and interpersonal skills. Most of all, we were trained to act
collectively to achieve a common goal.
Through teamwork we were able to regain our accreditation and build up
the reputation of the department.
Social consciousness
Our department is known to have
sense of social consciousness. My
training has made me aware of my social responsibilities. We were constantly
reminded of our obligation to the community.
We were taught how to develop a community surgical health programs from
simple information dissemination and health advocacies to medical assistance
program for indigent patients in the form of free surgical mission for the
urban poor.
Summary:
I
have presented a reflection cum self-evaluation paper after my training in
general surgery at the Ospital ng Maynila Medical Center. The objectives are to
reflect on how much I have imbibed the basic frameworks and core values
expected of me as part of my learning objectives in the training program and to
formulate strategies for continual improvement after graduation. The basic
frameworks consisted of: 1) patient management process; 2) operation-surgery
process; 3) problem-based and self-directed learning process; 4)
physician-teacher process; 5) physician-researcher process; 6)
physician-manager process; and 7) community surgical health management process.
The core values consisted of: 1) respect for human lives and human being; 2)
honesty and sincerity; 3) ethics and integrity: 4) professionalism; 5)
continual improvement to achieve quality and excellence; 6) teamwork; and 7)
social consciousness.
This
reflection cum self-evaluation is a good learning activity for the graduating
residents to review and consolidate whatever learning have we acquired and to
reassess ourselves how far we have gone based on the structured standards, in
short it is a summative evaluation of our training. The other benefit that I got from the self evaluation was getting
an idea where I stand which in turn motivated me to go for continual
improvement. Although you will have the final judgment on my evaluation, I
believe I have imbibed the basic frameworks and core values needed for me to
become what you have envisioned us to be, a rational, effective, efficient,
holistic, and humane community surgeon.
To
all my consultants, thank you, for your untiring and unselfish efforts to teach
me the art of our profession, for the knowledge and habits that you have
inculcated in me and for the totality of what I have become. Again thank you
very much.
To
my co-residents and colleagues, thank you very much for the memories and for
being a family, it’s been wonderful working with you. I will surely miss you, I love you all.