Medical pioneers

The commencement exercises were held last June 2, somewhat atypical in the Philippines, where these rituals are usually held in April. The togas and capes were different, too: as befitting the medical graduates, they had the color green, but this was combined with gray, associated with a business degree.

The graduating class was from the Ateneo School of Medicine and Public Health (ASMPH), the first of a unique program that allows these new doctors to add “MD” as well as “MBA” (master of business administration) after their names.

The brain behind the medical school was Dr. Alfredo Bengzon, who wanted a new medical curriculum that would produce not just excellent clinicians but also public health experts and administrators. It was a 21st-century vision that began in the 20th when Bengzon was building up Medical City from a small hospital to the large medical complex that it is today. Other ideas came in when he was health secretary, the first after the 1986 Edsa revolt, when he had to fight many battles around inefficiency and corruption.

“Our panganay (eldest),” said Dr. Ma. Eufemia Yap, one of the associate deans, with pride and a bit of relief. It wasn’t just taking care of the students through the five years of medical school, but also the many years of planning that went into the medical school.

The Ateneo Board of Trustees approved the creation of the school in 1997, after much discussion. But it was to take another 10 years before the school opened its doors to this first batch. There were numerous meetings and workshops all through those years, literally from one millennium into the next, to discuss how this medical school would be different, and what dual degrees could be offered. An MPH (master of public health) was considered, as well as an MM (master of management). In the end, the choice of the MBA was partly out of convenience: Ateneo already had years of experience with its MBA programs offered in its Makati campuses, including degrees specific for health professionals with strong exposure to public health and management.

I was roped (or, I felt at times, lassoed) in to help think of the inputs for the social sciences and to train teachers and mentors to lecture, with the aim of developing cultural competence, which isn’t just sensitivity to people’s cultures but also the ability to harness people’s own knowledge, and practices, to keep healthy and fight disease.

MBA oath

I was initially uncomfortable with the MBA degree, in part because of public perceptions that an MBA produces business people, and that doctors are already too good at making money. But interactions with the Ateneo MBA staff have convinced me that we need more of these MBA programs for other professionals as well, to run government as well as private companies. The trajectory of today’s MBA is well summarized in an MBA oath first crafted by the 2009 graduates of Harvard Business School and which has since been signed by thousands of other MBA graduates around the world, including, I hope, the new ASMPH graduates.

The oath begins with a recognition of MBA graduates’ role in society: first, “to lead people and manage resources to create value that no single individual can create alone,” and second, that their decisions “affect the well-being of individuals inside and outside [their] enterprise, today and tomorrow.”  The oath has several promises concerning ethical conduct and the protection of human rights and dignity in the pursuit of “value creation.” How appropriate, I thought, for today’s physicians, who create value by keeping people healthy.

Fr. Bienvenido Nebres, who was president of Ateneo de Manila for 18 years, and saw the medical school develop from an idea to what it is today, delivered the commencement keynote, talking about growing up as the son of a physician. He reminded the audience that medicine is the youngest of the sciences—a theme developed by Lewis Thomas in a book with that title—and continues to develop. I thought, indeed, individual medical practice will give way to group practice and larger hospitals and medical centers, but this does not have to mean sacrificing the healing warmth and concern that the family physicians had.

The valedictorian, Jose Mariano Tiu Tan II, talked about how hard he and his classmates had to work, not just to learn organ systems and bones and muscles, but to understand the healthcare system through actual exposure.

“If we do not see, we cannot care,” Tan said, describing their rounds in public and private hospitals and communities. He referred several times to the way these experiences defined them.

So, here were the 62 pioneering MD/MBAs. I remember interviewing some of the applicants for the first batch, and always, panel members would ask why they were applying to a new school, untested and unproven. The applicants were consistent; these were risk-takers intrigued by this new approach. I was particularly impressed with Jasmin Jiji Miranda, who gave up a well-paying job in Singapore involving genetics research, to come home to study medicine so she could revive a hospital in Mindanao started by her father.

Jiji’s case reminded me that pioneers aren’t daredevils. They’re courageous, yes, but they also have vision, and determination. In their five years of medical studies, I would occasionally hear of turbulence, and sometimes I could tell rough sailing was coming because the faculty had taught them “too well.” They were thinking differently, and discovering alternative ways of solving problems.

It’s always hard being the eldest in a family that’s growing. I was told the class this year, which will be graduating in 2017, has 162 students.

‘Kapwa’

At a lecture last year on “Rizal the Scientist,” I mentioned to the audience that Ateneo’s medical school produced its first graduate in the 19th century. It wasn’t Rizal, who did get his bachelor’s degree from Ateneo Municipal but had to go on to the University of Santo Tomas and the University of Madrid for his medical training.

In “Noli me Tangere” we read about the death of Sisa, a woman driven insane by an oppressive society. She left two sons, one of whom, Basilio, reappears in “El Filibusterismo,” this time having studied medicine in Ateneo Municipal. Basilio is the first Ateneo de Manila medical graduate, and this was in the 19th century!

I have to emphasize that Ateneo Municipal did not have a medical school then, but I wonder if Rizal, who never forgot his Jesuit mentors, ever thought that Ateneo should have a medical school, one that could train more Basilios, children of a troubled Mother Philippines. Rizal would have been proud to hear these ASMPH pioneers taking an eloquent pledge, written by Dr. Raymundo S. Baquiran and which talks about sowing the seeds to transform society, to work with all who are troubled, whether of the body or of the soul. The title of the pledge reflects not just the pioneering but also Filipino spirit of the graduates: “Panunumpa ng mga Manggagamot para sa Kapwa.”

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