Introduction: The 'first generation' physician gathers a lot of strength to venture into a world unknown to him. Unlike a physician born to a family of physicians who has a family to guide him, the 'first generation' physician only has himself to survive this endeavor. Through the life worlds of a select group of 'first generation' physician-in-training, this study seeks to answer the following central question: How do 'first generation' Filipino physicians collectively characterize their liminal spaces in transition from medical school to clinical practice?

Methodology: Anchored on the Theory of the Rites of Passage, this phenomenological inquiry, intends to surface the lebenswelt or essence of the experience of being the only physician in the family. Respondents comprised a purposive sample of physicians-in-training (residents and fellows), who are the only physicians in the family. Data were gathered using semi-structured interviews. Triangulation and member checking procedures were done to ensure the data reliability. Data were then subjected to cool (categorization) and warm analysis (thematization) using the Colaizzi's method.

Findings and Discussion: With all the transcribed experiences summarized and those with the same meaning analyzed, the following categories and themes were generated: The Intending Facet / Purpose: From Uncertainty towards Redefinition; The Thinking Facet / Process: From Perplexity towards Self-efficacy; The Relating Facet / People: From Isolation towards Integration; and The Transforming Facet / Power: From Vulnerability towards Empowerment. It was shown that a 'first generation' physician in this liminal space undergoes challenges and struggles during his training in medicine. This served as his Rite of Passage to transition him to someone dreaming only to become a physician, to become redefined with conviction, supported and integrated into the health system, empowered and transformed to the physician he is meant to be.

Recommendations: Physicians undergo a lot of challenges and mental stress and it means a lot for trainers to enter into the trainees' life-world, especially that of a 'first generation' physician, so that they can build socio-emotional learning and mentoring programs and counselling services that address different facets of liminal space that the trainees go through.

Background: The COVID-19 is a significant stressor for the resident physicians. This public health issue augmented the already rigid and demanding residency training. Objective: To determine the coping strategies employed by the resident physicians at the Southern Philippines Medical Center during the COVID-19 pandemic. Methods: The study was a cross-sectional design using the descriptive-survey research method. A total of 200 resident physicians participated in this study. The instruments used were a self-made sociodemographic profile questionnaire and the 37-item Filipino Coping Strategies Scale, adopted with permission from the developer. The study used frequency and percentage for categorical variables and mean and standard deviations for continuous variables. Results: The respondents were primarily female resident doctors (56%), unmarried (83%), with an average age of 30, and with the majority living with their immediate family (54%) with mostly three to four family members at home (64%). Most resident doctors were assigned to COVID-19 wards (52.5%) and managed COVID-19 patients directly (73%). Twenty percent of these respondents working in COVID-19 wards have reported and claimed having pre-existing health conditions. The most prevalent coping strategies employed were religiosity (3.15 ± 0.66) and problem-solving (3.11 ± 0.50). On the other hand, resident doctors rarely turned to overactivity or substance use. Conclusion This study has shown that residents most frequently utilized problem-focused (problem-solving) and emotion-focused (spirituality, relaxation/recreation, and tolerance) strategies. Coping is necessary for resident physicians to confront threats of COVID-19 infection. Psychological-emotional support for the well-being of resident doctors must be in place in every residency training program.
Physicians

Questionnaires were distributed and direct interviews were held. Some results were drawn and some recommendations were made to improve the effectiveness of the policy
Physicians ; Questionnaires

Background and Objective: Palliative care is a human right. In the local setting, only a few data have been published regarding its practice among healthcare workers. This study aimed to determine the gaps and potential barriers in palliative care services among resident physicians. Methodology: A cross-sectional study design using a 27-item interview-based questionnaire was conducted from July to September 2019 among resident trainees in seven departments of four hospitals in Manila, Philippines. The data gathered were tallied using Microsoft Excel and analyzed using STATA Statistical Software with p-value of 0.05 as statistically significant. Results: A total of 200 physicians participated in the study. Majority of the respondents referred patients to palliative care services, primarily for symptom control and home care upon the diagnosis of a terminal illness. Sixty percent of respondents correctly identified patients eligible for hospice care. The 3 services rated as most important in palliative care were pain control, symptom control and psychological support. Most of the respondents perceived that palliative care is underutilized, and yet they felt that attending doctors know when referral to such is appropriate. The discrepancy is due to their lack of knowledge on the nature of its scope of care and eligibility criteria. The common barriers for referral to palliative care were “no time to refer secondary to rapid demise of the patient”, “difficulty in accurately predicting death”, and “lack of time to discuss issues of dying and hospice care”. These presumed barriers contradicted the respondents’ perceived practices in advance care planning, particularly on confirming the goals of treatment with the patient and family. Conclusion The prevailing illiteracy on palliative care that poorly translates to actualization is alarming as it deprives many patients of their right to a dignified and quality of life given their limited days. The inexcusable lack of awareness must be the impetus to a massive knowledge drive to impact clinical practice.
Hospices ; Physicians

No abstract available.
Humans ; Physicians, Family*

Humans ; Physicians ; economics

No abstract available.
Humans ; Physicians, Family*

Andrology ; manpower ; Physicians

No abstract available.
Acupuncture* ; Humans ; Physicians, Family*

Quality improvement is the current trend in health care delivery. The Donabedian Model calls for assessment of quality of care along Structure, Process, and Outcome. Objective: To determine and compare the perception, practices and impact of quality improvement among physicians in Pangasinan. Methods: This is a cross-sectional study conducted from November 27, 2010 to February 4, 2011. Family physicians (GPs as well) and Specialists of Pangasinan (20% of the population) composed the samples. They were given a self-administered questionnaire designed by the researchers. Results: From the socio-demographic profile, there is almost an equal distribution of sexes among the respondents. There were more generalists than specialists who were able to participate. Most of the specialists are internists, pediatricians, and surgeons. Majority of the generalists (61.2%) are older (belonging to age ranging from 41-60 years old; while majority of the specialists (58.2%) are in the 31-50 years old. The generalists (73.2%) and specialists (85.45%) are usually in private clinic or hospital practice, with almost the same frequency of being in government hospital practice. Only general practitioners or family physicians are employed in government clinics (the MHOs or RHUs). Both groups have almost equal length of practice with the generalists (71.6%) and specialists (74.4%) belonging to 6- 30 years of practice. Majority of both groups have knowledge on morbidity/mortality conference, random chart checks, and RIO/lectures. Both groups agreed that quality activity is useful in their practice, but more generalists look at QA as a useful activity in their practice than their counterpart specialists. There was no difference in the response of both the generalists and specialists and they agreed to the same degree that practicing QA improves patient care. Both groups do agree in their perception that QA places additional time in their practice. Both respondents agreed that financial and honorific incentives are best for physicians to engage in QA. lack of good incentives and time and non-sustainability appear the greatest barriers to QA. The respondents agreed that PhilHealth, the specialty society and Department of Health can conduct QA. All the physicians agreed that lectures and workshops are two of the most acceptable, sustainable and preferred QA activity. Conclusions: The findings showed the positive impact of quality assurance on the practice and perception, and possible future development of QA in the life of Pangasinan physicians. Agreeing in severa! instances in their responses, the GPs/ Family Physicians also have significant differences with their specialist colleagues.
Human ; Adult ; PHYSICIANS