Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
Second Regular Session

5160

HOUSE BILL NO.

Introduced by Hon. GABRIEL LUIS R. QUISUMBING

EXPLANATORY NOTE

The decreasing enrollment of students in the field of medicine in the Philippines has
been showing an alarming trend. Add to that the recent phenomenon of doctors
forgoing their medical education and training in order to pursue nursing abroad, and
what we have is a country faced with a crisis in health service provision. Some
government and private hospitals were reportedly filling up their medical resident
vacancies by hiring foreign dactors, In a survey dene by the Department of Health
(DOH), among its retained training and teaching hospitals, 12% of plantilla positions for
medical residents remain unfilled. It is feared that with Filipinos opting for out-of
residency training, there will no longer be Filipino medical specialists in the Future

Filipina doctors shift to nursing and work abroad just so they could earn larger amounts
as compared to what they would earn as doctors in our country. Aside from a measly
monthly salary of P19, 168.00 as a Medical Officer IIL in government hospitals, doctors
are said to be living in inhumane conditions. Resident doctors are the main workforces
in hospitals and as such, they are sometimes on duty for three, straight days, during
which meals and slecp are missed. Surely, these dismal conditions make raising a family
and living decently a very difficult endeavor for Filipino doctors in the country.

Changes must be made so that a potential health crisis may be averted. This bill seeks to
upgrade the salary and benefits of doctors while upgrading the quality of their training
as well.

‘These could be made by the creation of an agency attached to the Department of Health
that would oversee and standardize the accreditation of specialties and sub-specialties,
a task currently being performed by specialty societies. The agency shall also look after
the welfare of medical residents and shall enforce the provisions of this bill, which seek
to provide them a more decent salary and more humane living conditions for medical
residents.

This bill seeks to make our Filipino medical residents stay in the country in order for
them to continue looking after the heaith of Filipinos. Through this bill, it is hoped that
our country will produce competent medical specialists who are willing to stay in the
country and serve their fellow citizens.



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS:
Second Regular Session

SIOUSE. BILL NO. 5160

Introduced by Hon. GABRIEL LUIS R. QUISUMBING

AN ACT TO PROMOTE AND STRENGTHEN THE MEDICAL RESIDENCY TRAINING
PROGRAMS IN THE PHILIPPINES

Be tt enacted by the House of Representatives and the Senate of the Philippines in Congress
assembled:

SECTION 1, Short Title. This Act shall be known as the “Medical Residency Act of
2011."

SECTION 2. Declaration of Policy. It is the declared policy of the State to protect and
promote the right to health of the people and instill health consciousness to effectively
carry out the health programs and projects of the government essential to the growth
‘and health of the people. Pursuant to such State policy, the quality of medical residency
training in the Philippines might be uplifted and at the same time protect the rights of
medical residents to a decent compensation and benefits including the proviston of
humane working conditions.

SECTION 3. Definition of Terms and Abbreviations. The terms and abbreviation
used in this Act are as follows:

a DOH- Department of Health

b. DOLE- Department of Labor and Employment

Foreign graduates of Medicine- a graduate of Doctor of Medicine who earned
his/her degree abroad or a non-citizen of the Philippines who earned his/her
degree in Philippine medical schools.

@. Medical Residency Training-Training undergone by licensed physicians in
accredited haspitals before they can practice their specialty.

e. Medical Residents- pertain to physicians undergaing medical residency training
in any field of specialization.

{  PMAC-Philippine Medical Accreditation Councit

PRC- Professional Regulations Commission

Specialties/ Subspeciaities-specialty pertains to field of medicines such as

surgery. internal medicine, obstetrics and gynecology, pediatrics, general

medicine and other medical fields. Subspecialty pertains to highly specialized

fields of medicine.

ra

SECTION 4, Creation of the Philippine Medical Accreditation Council (PMAC).
‘There shall be established an attached agency to the Department of Health to be called
the Philippine Medical Accreditation’ Council (PMAC) which shall ensure the: quality of
medical residency training for all specialties and subspecialties of medical residents.
PMAC will ensure that policies will be enforced to provide better compensation and
benefits and promote humane working conditions of medical residents. PMAC will also


ensure that medical residency training of doctors will be responsive lo the current
health service needs of the Philippine population.

SECTION 5, Roles and Functions of the PMAC. The roles and functions of PMAC shall
include but will nat be limited to the following:

a. set the standards of medical residency training for all specialties and
subspecialties

b. ensure that the standards set for medical residency training are at par with
international standards such as the World Federation for Medical Education
{WEME);

accredit all medical residency training programs for all specialty and
subspecialty;

d. assess and create a data base of doctors who have started the residency training
program and monitor/ ensure that they have satisfactorily completed the
training in either government and private hospitals;

e. issue certificate to doctors who have satisfactorily completed the residency
program;

f screen foreign graduates of medicine who will undergo residency training in the
Philippines and assess the equivalence of their hasic medical education to the
standard curriculum prescribed in Philippine schools of medicines;

g develop and ensure implementation of policies that will provide better
compensation and benefits and humane working conditions for medical
residents;

h. receive and act on complaints of medical residents as well as complaints of
patients against medical residents;

i ensure that the medical residency training will be responsive to the health
service need of the population;

j. maintain a registry or data base of medical residents and accredited residency
training programs;

k. monitor and evaluate residency training programs regularly, and prescribe
remedial measures to deficient training programs; and

L_ provide mechanisms that will promote equitable distribution af medical
specialists into the various parts of the country

SECTION 6. Organizational Structure. ‘There shall be a Governing Council in the
PMAC which shall be composed of representatives from the Professional Regulation
Commission (PRC), the Department of Labor and Employment (DOLE), specialty
societies, hospital assuciations and medical residents as members and the Secretary
of Health as Chairperson. Under the Governing council the following Committees
and Secreta shall be created to assist the PMAC in carrying out its roles and
functions.

a. Committee on Accreditation-It shall be composed of representatives from the
different specialty and subspecialty societies. It shall be responsible for
accrediting residency training and development of standards for approval of the
Council;

b. Committee on Training and Certification, It shall be composed of training
officers or their equivalent in both private and government hospitals. it shall
determine the satisfactory completion of a medical resident and sbal! issue the
certificate of completion of appropriate specialty or subspecialty medical
residency training;

c. Committee on Policies, Standards and Ethics. It shall be composes of
representatives from the committee on Accret tion and committee on
Training and Certification, DOLE, PRC, and medical residents. . This committee
shall formulate standards of medical residency training programs, policies on



compensation/ benefits and working conditions of medical residents and other
policies related to the scope of practice of medical residency. It shall act on
complaints of medical residents and patients and submit recommendations to
the Council for approval. In would also screen foreign graduates of medicine
who would like to undergo medical residency training in the Philippines:

d. Secretariat. The DOH shall provide a Secretariat for the PMAC, which shall he
composed of technical and administrative staff. The Secretariat shall coordinate
the activities of the different committees and provide administrative support for
the effective and efficient coordination of the programs, projects and activities
among the different t committees of the PMAC.

SECTION 7. Accreditation of Medical Residency Training Programs. Medical
residency training programs shall only be conducted in accredited teaching and
training hospitals. The PMAC is the only recognized organization that shall be given
the full authority to accredit residency-training programs. Upon approval af the
Implementing Rules and Regulations of this Act, a period of one year shall be given
to allow time for the transfer of accreditation from the different specialty and
subspecialty societies to the Committce on Accreditation of the PMAC.

SECTION 8. Training Curriculum of Medical Residency Training Programs. The
‘Training officers of their equivalent Medical Residency Program shall prepare
training curriculum that shall meet the standards set by the Committee on Policies,
Standards and Ethics of the PMAC. The training curriculum shalll be at par with
international standards and shall be responsive to the health service needs of the
population, The Committee on Policies, Standards and Ethics shall be given one year
from the time of its creation to prepare the standards of medical residency training
programs, which will be uniform for al! specialties and subspecialties,

SECTION 9, Qualifications of Applicants to Medical Residency Training
Programs, The following shall be the minimum qualifications of applicants to
medical residency training programs:

a. apassing score in the licensure examination for physicians

b. no previous criminal or administrative record

c. clearance by the PMAC for foreign graduates of Medicine.

PMAC may set other qualifications that it may deem necessary.

SECTION 10. General Conditions for the Medical Residency Training of Foreign
Medical Graduates. The following general conditions shall be applied to foreign
medical graduates of medicine undergoing medical residency training in the
Philippines.

a. Accredited residency training programs shall be allowed to accept foreign
medical graduates in cases wherein no Filipino physicians are applying for the
same vacancy. Filipino physicians shall he given first priority in filling up
vacancy for medical residents.

b. Foreign graduates of medicine shall secure clearance from PMA prior to
application to any accredited residency training program;

cc Foreign medical graduates shall undergo basic language course in Filipino/or
the dialect that is used in the locality where the accredited institution is located
before commencing his/her medical residency. Certificate of proficiency in
Filipino and the dialect of the locality shall be obtained by the foreign graduate
of medicine from a CHED- accredited state university or tertiary education
institution located in the locality where foreign graduate of medicine wishes to
undergo residency training before PMAP may issue a clearance to the foreign
graduate of medicine. For accredited institutions located in areas wherein



Filipino is the language used by the majority, proficiency in a dialect shall no
longer be required.

d. Foreign graduates of medicine shall be required to undergo a seminar on
Philippine history, culture and government as well as the Philippine health care
delivery system prior to the commencement of his/her residency.

SECTION 11. Salary and other benefits. The minimum base pay of all medical
residents in government haspitals shall not be lower than salary grade 21 as per
Joint Resolution 4 modifying the compensation and classification system for civitian
personnel. They shall he entitled to overtime pay and night differentials pay for
services rendered beyond the eight (8) hours or hours of duty at night. Hazard pay
shall be given as stipulated in Republic Act 7305 otherwise known as Magna Carta
for Heaith Workers for medical residents of public or private hospitals.

SECTION 12. Working conditions of Medical Residents. The following working
conditions of medical residents shall be observed by all accredited institutions.

a. No medical resident shall be allowed to go on duty for more than 16 hours
straight except in extraordinary cases to be determined by the hospital
administrator.

b. Medical residents shall be entitled to one day off from hospital duty every week,
or after a 16 hour continuous duty;

Medical residents shall be given standard quarters in the hospital where he/she
can stay during his duty.

d. Medical residents should be given administrative support by the Human
Resource Department of the hospital especially in following up forms or regular
documents necessary in getting pay slips or other related documents for
submission and upkeep of the Human Resource Department of the training
institution,

‘e. Medical residents shall perform only functions that are related to his/her
residency training. Superiors are forbidden from ordering errands that are not
related to the training of the medical resident or demeaning to a medical
residents dignity as a person. The PMAP shall receive and investigate
complaints of this nature from medical residents.

{Medical residents are also entitled to enough time for personal break, meals and
observing hygiene during hour of duty.

g Since medical residents are considered to be on training they shall be supervised
by their superiors at all time especially when performing critical procedures to
patients. In case of Junior residents, the senior residents or consultants shall
always be available for supervision and assistance and in the case of senior
residents, his/her consultant.

bh. Medical residents shall be treated equally. No medical resident shail be
discriminated because of his/her gender.

i Medical residents should always wear their proper uniform white gown with
nameplate for proper identification.

SECTION 13. Professional Conduct of Medical Residents. The Medical resident
even though they are on training shall observe the following professional conduct at
al] times;

a. The medical resident shall always uphold the dignity, privacy and rights of

his/her patients.

Medica! resident shall always perform his/her functions with utmost diligence

especially those related to care of patients so as not inflict any harm on the

patient.

cc. Since medical residents are on training, they shall not receive any form of
payment from patients.



4. Medical residents shall nat engage in the following:
accepting commission from laboratories, diagnostic facilities, pharmacies for
referring patients to these facilities.
- getting excess and unused medicines, drugs and other materials from patients
without their permission.
= selling medicines, drugs and other materials to patients or their relatives.
- selling free samples of drugs or other medicines; and
-Receiving money or any form of incentives from any pharmaceutical company

for prescribing their brand of drugs, medications and other materials.

e. Medical residents should treat their patients with utmost respect.

£. Medical residents should observe the Generics Act of 1988 and Quality Medicine
Act of 2008,

g. Medical residents shall render full time service to the hospital where he/she is
employed. As such, he/she shall not engage in any part-time job outside of the
hospital.

SECTION 14. Respon:

are the responsibilities of the accredited institutions:

a. The accredited training institutions shall observe all the provisions of Section
11, which pertains to the working conditions of the medical residents.

b._ In relation to the preceding provision, training officers or their equivalent
together with the medical residents shall prepare a schedule of their duty at the
start of the year to ensure the pravisions of Section 11 shall be observed at all
times. Periodic evaluation of competencies gained shail be conducted per year
level;

¢. The accredited training institutions shall | submit the names of their medical
residents, their level, and other relevant information related to their medical
residency training program to the PMAC for the proposed registry or database:

ad. The accredited institution shall provide the necessary logistics, equipment and
other medica! supplies.

SECTION 15. Handling of Complaints. Anybody can file a complaint against
medical residents and or accredited training institutions to the PMAC. The
Committee on Policies, Standards and Ethics shall handle the complaint and if
deemed necessary, shall conduct an investigation. It shail come up with a report and
recommendations to the Chairperson of the PMAC within thirty (30) working days
upon receipt of the complaint. The Chairperson shalll issue the final decision
regarding the filed complaint,

SECTION 16. Violations. Any accredited training institutions and or their medical
residents that have been found violating any provisions of this Act shall have the
following penalties:

1® offense- reprimand

204 offense- suspension with duration depending on the gravity of the offense but
not exceeding six (6) months

3ed nffense-revocation of the training institution. In the case of medical residents,
he/she shall not be given certificate of completion of residency training by the PMAC
and shall be removed from the residency training program.

SECTION 17. Appeal. Both parties, complainant and respondents may appeal to the
Secretary of Health within fifteen (15) working days upon receipt of the copy of the
decision. The absence of any appeal within the specified period shall render the
decision as final and executory.

SECTION 18. Creation of Plantilla Position. There shall be created plantilla
positions in the DOH needed for the iyplementation of the purpases of this Act.


SECTION 19. Budget Appropriations. The Department of Health shall submit to
Congress the necessary budgetary estimates ta implement the provisions of this Act
and every year allocate a portion of their annual budget for the support of this Act.

SECTION 20. Implementing Rule and Regulations. The DOH together with DOLE
and PRC shall draft the implementing rules and regulations of this ACT within a year
after the effectivity hereof.

SECTION 21. Separability Clause. If any provision or part hereof, is held invalid or
unconstitutional, the remainder of the law or provisions and otherwise affected shal!
remain valid and subsisting.

SECTION 22. Repealing Clause. Any law, presidential decree or issuance,
executive order, administrative order, rule or regulation contrary to ur inconsistent
with, the provisions of this Act is hereby repealed, modified or amended accordingly.

SECTION 23. Effectivity Clause. This Act shall take effect fifteen (15) days after its
publication an at least two (2) newspapers of general circulation.

Approved.