At the last meeting of the SPSA Governing Board and Members, Dr. Hernan Reyes’ proposal in conjunction with the PCSF-SC (Philippine College of Surgeons- SURE Commission) was approved. We are just awaiting final approval and signing of the Memorandum of Understanding between the 2 parties.

With the COVID Pandemic still very much evident in the Philippines, with quarantines, lockdowns and shortage of volunteer Medical, Surgical and Allied Health Personnel, most of the Medical-Surgical Missions coming from the US and other countries had been cancelled or slowed down to a trickle, making the plight of the patients dire, in the medically underserved regions of the Philippines. It is the vision of the Society, spearheaded by Dr. Hernan Reyes to reach out to our local counterpart, the SURE (Surgery in the Underserved Regions and for Education) Commission of the PCS established in 2019. This is similar to the program initiated by Drs. Francisca Velcek and Hernan with UP-PGH using Senior Surgical Residents going to Rural Hospitals and doing surgery for indigent patients, borne out of necessity from COVID with less patients and fire damaged operating rooms. Below are the particulars of the Program

        Society of Philippine Surgeons in America (SPSA) – Philippine College of Surgeons Foundation-SURE Commission (PCSF-SC)

                                    VOLUNTEER SURGICAL OUTREACH PROGRAM (VSOP)

PROPOSAL: SPSA in collaboration with PCSF-SC will establish a Volunteer Surgical Outreach Program in an underserved community in the Philippines.

NAME:                    SPSA – PCSF-SC VOLUNTEER SURGICAL OUTREACH PROGRAM (VSOP)

MISSION AND GOAL:

1. Provide general surgical services to indigent patients unable to obtain such services in their communities in the Philippines by utilizing recent graduates of General surgery programs in the country. This program is an attempt to help alleviate a serious deficiency in the delivery of life saving specialty care in the region.
2. The program may serve as a potential solution to specialty manpower maldistribution in the country and hopefully provide a sustainable source for an inadequate surgical care in underserved communities as identified and designated by the Department of Health.
3. The program will provide an opportunity for recent graduates of Residency programs in General Surgery to serve a community in dire need of specialty services in the spirit of Volunteerism.
4. The program will further enable the elected surgeon to experience the practice of Surgery and the environmental advantages of living in a Provincial/Rural setting. This experience and exposure may encourage and convince the program’s surgeon to stay on and establish his/her on practice or seek employment in the Provincial Hospital.

DESCRIPTION OF PROGRAM:

                An adequate stipend will be offered to any qualified graduate of a General Surgery residency program based in the Philippines who is willing to serve as a Volunteer General Surgeon to a designated Hospital in an underserved region in the country for a period of 3 to 6 months.

 VOLUNTEER SURGEON SELECTION CRITERIA:

1. Recent graduate of a general surgery residency program in the Philippines.
2. Must be Board certified or eligible for certification by the Philippine Board of Surgery.
3. The candidate must be of good moral character.
4. Letter of recommendation from the Program Director.
5. Must be willing to fully participate in the care of patients at a designated Institution needing General surgery services.
6. Must be willing to consult and in some cases be supervised by the Head of General Surgery at the designated Institution in the management of complex cases where his/her experience maybe limited.
7. Must be willing to sign a disclaimer acknowledging that SPSA – PCSF-SC Surgical Volunteer Surgical Outreach Program and Recipient Institution will not be held liable for any questionable personal and Professional conduct in the course of his/her participation in the program including his/her safety while traveling to and from the recipient hospital and personal safety during the duration of this program.

DURATION OF PROGRAM:

Unless otherwise specified, the duration of the program will be for a period of three months.

1. The program can be extended to six months with the consent of the SPSA and PCSF-SC upon request of the designated Institution and with the agreement of the Program’s surgeon.

PROPOSED BUDGET:

Monthly budget: Total: $2,500.00 USD (pHp: 120,000 based on $1.00 = pHp 48.00)

Monthly expenditure:

1. Volunteer Surgeon stipend:                                                                                    $1,600.00 USD
2. Token, Visiting Consultant.                                                                                         $ 250.00 USD
3. O. R. Supplies:                                                                                                               $ 500.00 USD
4. Miscellaneous expense:                                                                                              $ 150.00 USD

Total budget for three months: $ 7,500.00 USD (pHp 360,000.00). Funds outlined above will be transmitted on an annual basis to cover the three months of Surgical Mission activity or longer from the SPSA Surgical Mission Fund to the PCSF SURE COMMISSION Fund.

VOLUNTEE GENERAL SURGEON RESPONSIBILITIES:

1. The program’s surgeon will conduct an outpatient clinic on a regular basis to: A) evaluate patients for possible surgical intervention, make necessary preparations for surgery which may include required laboratory studies, radiological evaluations and other diagnostic studies and B) Follow-up all postoperative patients.
2. He/ She will keep records of all patients as required by the Host Institution.
3. The Program’s surgeon will be given privileges to perform any general surgical procedure as approved by the Institution’s Chief of Surgery and/or Medical Director.
4. Major cases will be supervised by the Chief of Surgery at the Host Institution or by a Visiting Consultant Surgeon.
5. The Program’s surgeon will arrange transfer or referral of a patient with a complex surgical problem that cannot be safely handled at the Host Institution to a Medical Center equipped to take care of such patients.

VOLUNTEER GENERAL SURGEON SUPERVISION:

1. The volunteer surgeon is fully trained and duly qualified to perform operations on patients with general surgical problems. In some cases where the surgeon’s experience is limited, he/she may require supervision by the Institution’s Chief of Surgery or by a Visiting Consultant Surgeon.

VISITING CONSULTANT SURGEON:

1. A volunteer Senior visiting surgeon from either the PCS or SPSA (members or invited well known clinician/educators) with known clinical expertise and teaching in the field of General Surgery or in any of the surgical sub specialties may from time to time provide short term visit to serve as a consultant to the program surgeon to include outpatient and inpatient consultation as well as in the Operating room. He/ She may provide lectures and seminars to the Hospital staff.
2. The consultant surgeon will not take the role of a primary surgeon in any case. The role will be that of a teaching assistant to the program’s surgeon. A consultant will assume responsibilities of a primary surgeon in complex cases when necessary.
3. In order to allow an SPSA volunteer to serve as a Visiting Consultant Surgeon, the Hospital’s Medical Director following review of the consultant’s credentials will provide a special one- time temporary non-renewable approval to allow the Visiting Consultant privileges as described above.
4. The Visiting Consultant will be provided a token stipend as budgeted.
5. Free board and lodging for the Consultant will be provided by the Host Institution.

DESIGNATION OF HOST INSTITUTION/HOSPITAL:

1. The designated recipient of this program will be a Public Hospital (Provincial Hospital) as designated by the Secretary of the Department of Health. In the event that a Public Institution is not available in the region, a Private Medical Center providing free medical care to indigent patients will be considered as an alternative venue by the program Committee.
2. The volunteer surgical outreach program will be held annually in a hospital located in a different region as designated by the Department of Health as a Health care Underserved community.
3. At least six Institutions should be identified and designated as potential recipients of this program. The designated general surgeon will be rotated annually among these Institutions equally with not one Institution receiving a surgeon during two consecutive years.

RESPONSIBILITY OF HOST INSTITUTION/HOSPITAL:

1. The Institution will be willing to accept the program’s surgeon as a full member of the Junior

Attending Staff during the duration of this program.

• The Department of Surgery will be willing to allocate an operating room to the program’s surgeon on a regular basis with full support from the Nursing staff and other ancillary services related to the services provided.
• The Department of Anesthesia will be willing to fully support this program.
• The program’s volunteer surgeon will be given independent operating and clinical privileges in accordance with the rules and regulations established by the Department of Surgery at the Institution.
• The Institution’s Medical Director will designate an individual who will oversee the program at the Institution.
• The Host Institution will provide free lodging to the program’s surgeon and free board and lodging to the Visiting Consultant surgeon for the duration of their respective assignments.

FUNDING FOR OPERATING ROOM EQUIPMENT AND MISCELLANEOUS SUPPLIES AND DRUGS:

1.  Both organizations will seek donations from local and international sources for operating room equipment, instruments, disposable ancillary supplies and pertinent medications for use during the duration of the program at the Host Institution.

ESTABLISHMENT OF FUNDING:

1. An amount of money will be transferred annually from the SPSA to the PCSF-SC to cover this program as agreed upon by both organizations.
2. An attempt will be made to support this program annually for a minimum period of five years.

PROGRAM AND FUND OVERSIGHT:

A Committee consisting of two or more members from the SPSA and PCSF-SC will provide full oversight of the program to resolve problems, changes in funding taking into consideration changes in the annual cost of living, increase in the number of surgeons assigned to different Institutions or extension of the duration of the existing program and other pertinent matters affecting the organizational structure and overall activity of the Program.

PROCESS REQUIRED PRIOR TO IMPLEMENTATION:

1. Approval of the Program by the SPSA Board of Governors.
2. Approval by the PCSF-SURE Commission and PCS Board to collaborate in the implementation of this program.

GENERAL AGREEMENT OF PRINCIPLES ESTABLISHED:

1. Each organization will designate one or more representatives to review, edit and change, if necessary, the wording and goal of these program to reflect the mission of each organization and submit the final document for approval by each Board.
2. SPSA will transfer to the PCSF-SC the fully agreed funding on an annual basis.
3. SPSA will obtain clearance from the IRS regarding the transfer of SPSA funds to a Foreign Non- Profit organization for tax purposes.
4. SPSA will continue to donate medical supplies to the designated host Institution during the duration of the program.
5. SPSA & PCSF-SC will recruit potential volunteer consultant/teacher to provide their expertise to the program’s surgeon for a period of one week or more as desired. These will be a totally voluntary mission contribution without funding support except as described above from either organization.
6. PCSF-SC will initially evaluate the acceptability of such a program by recent graduates of General Surgery Residency programs in the country.
7. Upon approval for implementation, PCSF-SC will send notices to Program Directors of GS Residency programs soliciting for applicants to the program. The notices will reflect that the program is a collaborative project of SPSA and PCSF-SC.
8. PCSF-SC will be fully responsible in evaluating applicants to the program and appoint the candidate deemed best capable of serving as the program’s volunteer surgeon.
9. PCSF-SC will request the Department of Health to designate six Institutions from different regions in the Country who may be interested to sponsor and be a recipient for designation to participate in this program.
10. PCSF-SC in collaboration with the SPSA will make the necessary arrangements and logistics of this Fellowship with the host Institution /Hospital.
11. An annual report consisting of the experience of the program’s surgeon, evaluation by the Host Institution/Hospital and the status of the Fund will be submitted to the President and Board of each respective organization.
12. Any conflicts regarding this Fund will be resolved by the Oversight Committee from each participating organization and an appropriate report will be transmitted to the President and Board of the SPSA and PCSF-SC.

SPSA/PCSF-SC OUTREACH TO OTHER FIL-AMEICAN ORGANIZATIONS:

Upon establishment of the program, SPSA – PCSF-SC will serve as the principal partner to develop other programs in collaboration with other Filipino – American Medical Associations and Civic organizations based in the United States of America.

MOU SIGNATORIES:

SOCIETY OF PHILIPPINE SURGEONS IN AMERICA                                                   

HONORIO M. CRUZ, MD, FACS

President

DANIEL C. FABITO, MD, FACS

Executive Director

HERNAN M. REYES, MD, FACS

Volunteer Surgical Outreach Program Architect, and Overall Coordinator

PHILIPPINE COLLEGE OF SURGEONS FOUNDATION SURE COMMISSION

VIVENCIO JOSE P. VILLAFLOR, MD, FPCS

Director

PCSF SURE Commission

Director, Volunteer Surgical Outreach Program

RAMON S. INSO, MD, FPCS

Regent in Charge

PCSF SURE Commission