Acceptance of the Post Graduate Interns in a Tertiary Hospital to undergo Primary Health Care Training.
What are the factors that Post Graduate Interns in Fatima university Medical Center consider so they would proceed on training as Primary Care Physician?
The objective of this study is to assess the acceptance of the Post Graduate Interns in Fatima University Medical Center to undergo the Primary health care Training.
The chapter contains related studies, journals and articles that directed the researcher on constructing and understanding the current research study.
These are important for the researcher to know and understand the barriers, advantages and disadvantages included in the study.
The world health organization describes Primary Health Care as an important health care generally recognized by the individuals and families in the community through actively involving their selves in a cost that the community will manage to pay in every stages of development. According to UNICEF, Primary Health Care refers to the provision of ambulatory or first-contact personal health care services.
In other contexts, it is understood as a set of priority health interventions for low-income populations (also called selective PHC). The ultimate goal of primary health care is to improved health for all and improving PHC has several importance, first is that it allows health system to adapt and respond to a complex and rapidly changing environment, second PHC has proven it’s benefits in tackling the main causes of, and risk factors for, poor health, as well as for handling the problems in health that may emanate in the future. (WHO, UNICEF 2018).
In an article by Katelynn Kenworthy, it was mentioned that only 30% of health professionals are employed by the government who addresses the health needs of the majority. The healthcare system in the Philippines agonizes because of the remaining 70% of health professionals work in the more exclusive privately-run sector.
The National Objectives for Health 2017-2022, one of its essential health services packages is the provision of family health care which it will offer a continuous care across the life-course of all Filipinos that will make every stages of life maintain their health and well-being. By strengthening the gate keeping at primary level of SDN so that it will enable to effectively promote primary health care, assist the Filipinos in the health insurance coverage and provide treatment or facilitate timely referrals to appropriate health facilities as needed. The DOH will utilize the two-way referral mechanisms-arrangement between the physicians at the same level or the different levels of healthcare system. The DOH provided guidelines and protocols that will help facilitate clear communications and coordination between health care providers. In these guidelines, the specific responsibilities, accountabilities and limitations of the referring physician and referred physician.
The Republic Act 11223, Sec 23, where the Department of Health together with the stakeholder will ensure the preparation and the execution of the National Health Human Resources Master Plan that shall give the policies and strategies for the appropriate generation, recruitment, retraining, regulation, retention and reassessment of health workforce in relation to the population health needs of the community. In Sec 25, The Department of Health, Commission on Higher Education and Professional regulation Commission in collaboration with duly-registered medical and allied health professional societies shall reorient medical and allied medical professional educations and health professional certification and regulation towards producing health workers with competencies in the provision of primary health care services.
The Doctor of Medicine degree is a five-year graduate program intended to teach students the essentials of being a Medical Doctor. The program consists of three years of academic instruction, one year of clinical clerkship and one year of post-graduate internship.
To be able to take the Philippine Physician’s Licensure Examination, a graduate of the M.D. program must first undergo a post-graduate Internship. It is a shared responsibility of the medical school and the hospital. The Association of Philippine Medical Colleges Foundation is the supervising body for the post-graduate internship.
Post-graduate intern is defined as a recent medical school graduate who is in their first year of post-graduate on the job-job training. Interns will be rotated in various departments in the hospital to be exposed to the different medical specialties.
Based on the Commission on Higher Education Memorandum Order No. 104 Series of 2017, under the Article VI Section 12 a student intern is defined as someone who has passed the qualification for internship program and taken all his/her major (professional) subjects. Moreover, in Article VII Section 16 a Student Intern qualifies as such when, a student is enrolled in a legitimate Philippine higher education, at least 18 years of age, pass the pre-internship requirements as specified in the internship plan and submit a medical certificate as specified in the internship plan. Also indicated in Article VII Section 16 the student intern shall be considered as an intern and not as an employee for the duration of the internship
In a study entitled Physician experiences and barriers to addressing the social determinants of health in the Eastern Mediterranean Region, one of the main social challenges identified in clinical care in Eastern Mediterranean Regions include poverty, illiteracy, domestic violence, and food insecurity. Doctors attempted to help their patients by providing free medical services and free medications, establishing a donation box, and referring to social workers and support services, where available. Cultural constraints, lack of time, and unavailability of referral resources were often cited as important barriers. The participants stated that Canada is generally better in dealing with the social challenges than their countries of origin.
They have conducted a qualitative research study employing qualitative descriptive methodology and used to recruit 18 physicians purposely, who were trained in Eastern Mediterranean countries but have since moved to Canada. Recruitment continued until data saturation was reached.
Majority of the participants expressed their willingness to help patients in dealing with social challenges, and shared their experiences of tackling such issues, though there were also important barriers reported that would need to be overcome. The Participants suggested that better addressing social challenges in clinical care would require educating both health care providers and patients about the importance of discussing the patient’s social environment as part of the health care encounter, as well as advocating for broader policy approaches by governments to address the underlying social problems.
In another study entitled Attitudes of Medical Interns Towards the Practice of Primary Health Care, it assesses the attitudes of medical interns who have undergone rotation in the Department of Family and Community Medicine of a large university hospital, towards the provision of primary care. A cross-sectional study was carried out on a sample of interns graduated from King Faisal University, at Dammam, Saudi Arabia. During a one-month rotation, the intern is required to attend family medicine clinics under the close supervision of consultants and senior residents in the Department of Family and Community Medicine
As for the result, On the question of attitudes towards the continuity of care, the responses of the interns and consultants were as follows: Nearly all interns and the majority of consultants (90.0%) agreed that patients should always be managed by the same doctor. If a patient called in for advice without a scheduled appointment, 73.6% of the interns would be ready to see him/her, whereas 50.0% of the consultants (p< 0.03) would.
The primary exposure of medical interns to family practice has many advantages. Training in this specialty results in a wide range of experiences in dealing with patients. However, the most valuable is their orientation on the principles of continuity of care, comprehensiveness, and coordination of care and physician’s accessibility to patients in need. This study attempted to assess attitudes of a sample of interns who had undergone training rotation in family practice, towards the above-mentioned aspects of care.
In this study, the researchers utilize the descriptive type of research concern with the description of data and characteristics about a population. It defines and interprets what is concerned with the points of view or attitudes that are held, workplace that exist, practices that prevail, process that are going on, effects that are being fit, or trends that are developing. It observes a very broad range of phenomena. The results are as complete, the presentation and interpretation of statistical tabulations of data generated by survey. Calmorin (2007).
Descriptive study is defined as the most commonly used research method. The basic reason for carrying out descriptive research is to recognize the cause of something that is happening. It is concerned with the description of existing distribution of variables, as opposed to theory building. This type of study focusses on answering the basic questions: Who, what, when, and where, and its goal are the gaining of truthful, exact, and orderly data that can be used in averages, frequencies and similar conditions. Hernandez (2009)
The survey research will be conducted in Fatima University Medical Center. The said hospital is selected on the basis that it is accessible for the researchers and there are various Post Graduate interns that are currently in training at the institution. This study will not necessarily represent other institutions in the NCR.
The target population for this research are the Post Graduate Interns who are 72 in total and are currently in training at Fatima University Medical Center, the said population was selected since they are currently rotating on the different departments in the hospital and if their experience can affect their decision to undergo Primary Health Care training, also at this time they may be deciding on what training or specialization they will pursue.
In this study, the Foreign Post Graduate Interns who are currently in training at Fatima University Medical Center will be excluded since there is a low possibility for them to practice and undergo Primary Health Care training in the Philippines.
Procedures for Measurements of Outcomes
The data collection instrument for this study is a survey questionnaire. It will be the primary source of data, designed to draw out an answer to the questions cited on the statement of the problem.
The participants on this study will include the total 72 post graduate interns who are currently training in Fatima University Medical Center in the National Capital Region provided that they are not foreign post graduate interns
The questionnaire for this study provides possible factors that they may encounter while on Primary Health Care training such as Out Patient Department, manning the Emergency Room, Duty in the Community, and rotations on the different areas of medicine.
The researchers also provided questions on some advantages and disadvantages that the respondents may experience such as in the levels of Primary, Secondary and Tertiary Health Care.
Post-Graduate Intern of Fatima University Medical Center
The answered questionnaire will then be collected and compiled in order to be analyzed. Descriptive statistics will be used to analyze the data collected and will be express in percentage.