In the era of modern medicine, non-surgical endoscopic procedures have become useful in the evaluation, screening/surveillance and management of digestive diseases
By DR. MARIE MICHELLE SIMBOL-CLOA
The journey to becoming a full fledged Gastroenterologist entails knowledge and skill in doing digestive endoscopy. The twenty-three or so years spent to become an Internist from elementary (plus two more years now with the K +12) to residency prepares the budding Gastrointestinal (GI)-Endoscopist for additional training to acquire the knowledge and skill in gastroenterology and digestive endoscopy.
This facet of medical practice that combines clinical with endoscopic ability to manage patients lures Internists to go into two years of further subspecialty training. After training, one has to pass both the written and oral examinations conducted by the Joint Specialty Board of the Philippine Society of Gastroenterology (PSG) and Philippine Society of Digestive Endoscopy (PSDE) to become qualified members of both Societies as Diplomates. Another two years of significant practice, the Diplomate is then invited to become a Fellow of the Society.
How did subspecialty training in digestive endoscopy began? It was on April 27, 1976, in the historic Club Filipino, that the Philippine Society of Gastrointestinal Endoscopy (later renamed Philippine Society of Digestive Endoscopy) was born with Dr. Florencio M. Pineda as its first President. A group of 21 doctors signed up as founding members.
One would recall that during that time, our country was in turmoil because of the declaration of Martial Law a few years back. There was “brain drain” wherein professionals stayed away from the country and sought greener pastures abroad. But undaunted by fears and uncertainties, some enterprising and patriotic gastroenterologists banded together to organize a local society with special interest in endoscopy.
It was also the dawn of fiberoptic endoscopes from the use of rigid to semi-rigid endoscopes. (Dr. Felix Za?0: Archives: Philippine Society of Digestive Endoscopy) In 1978, during the term of Dr. Fernando Piedad mechanics for the subspecialty training for gastroenterology were formulated and the first diplomate exam was given under Dr. Federico Leelin’s term in 1982. The first five Diplomats of Gastroenterology were: Dr. Venancio I. Gloria, Dr. Remigio M. Olveda, Dr. Judy Y. Lao-Tan, Dr. Evelyn B. Dy and Dr. Daniel M. Paruñgao.
Currently there are 13 accredited Training Institutions. These training centers have differing number of trainees and various combinations of first and second year fellows-in-training depending on case and patient loads of the institution and number of consultants. The trainee is expected to be skilled in performing gastroscopy and colonoscopy after finishing the program.
The PSDE together with PSG, through the Joint Accreditation Committee, evaluates and accredits the different training centers. The PSG-Committee on Training and PSDE-Committee on Basic and Advance Training provide the program for training in gastroenterology and digestive endoscopy.
PSDE holds regular inter-hospital conferences among the different training institutions called Endoscopic Radiologic Conferences (ERC). It has added pathology in the correlative discussion of featured cases. The general atmosphere in these conferences is relaxed to make learning fun and interesting.
Oftentimes there are games and prizes to be won when a trainee is able to answer well. Here the fellows-in-training gets to appreciate cases and mingle with other trainees. It is the host training institution that provides the venue, theme, and valuable consultants to share their expertise.
At the end of the training year, during the Joint Annual Convention (JAC) of PSG, PSDE and Hepatology Society of the Philippines (HSP), the Best ERC is announced. For the last three years, Chinese General Hospital has been awarded the Best in ERC. During the JAC, the new Diplomates and New Fellows are sworn in and inducted.
Once a trainee graduates, one may opt to go into further training in Advance Endoscopy to include ERCP (Endoscopic Retrograde Cholangio-Pancreatography), Endoscopic Ultrasound (EUS) etc.
Currently there are three training centers: ERCP-Metropolitan Medical Center, ERCP/EUS-University of Santo Tomas Hospital. The latest addition is UP-Philippine General Hospital which offers ERCP/EUS. In the future, there are plans to further increase the opportunities for advance endoscopy training in the Philippines.
As advances in non-surgical, miniinvasive procedures continue to evolve and the challenges of international cooperation come into fore, PSDE shall continue to keep pace to promote and advance the science of endoscopy beginning with providing good training for future GI endoscopists.
”As advances in non-surgical, miniinvasive procedures continue to evolve and the challenges of international cooperation come into fore, PSDE shall continue to keep pace to promote and advance the science of endoscopy beginning with providing good training for future GI endoscopists”
March 2018 Health and Lifestyle