IN CONSTANT EVOLUTION TRANSCENDING THROUGH TIME TO REACH GREATER HEIGHTS IN SURGICAL CARE, TRAINING, AND RESEARCH

By: Dr. Ida Marie Tabangay – Lim

The Evolution from the Non-structured Surgical Programs to Establishment of Formal General Surgery Residency Training and Surgical Fellowship Programs

          Alongside the changes in JRRMMC as an institution, and with the vision of the hospital to be a center of excellence in training, the Department of Surgery evolved from one that was purely service-oriented to a department which caters to the training of young surgeons who can become leaders of the field to serve in various parts of the country. During the leadership of the following  chairpersons, namely: Dr. Francisco Guzman, Dr. Constantino, and Dr. Balderrama, no formal training program in Surgery was established yet. The residents performed duties as adjuncts for a period of one year or until such time when there is a vacancy for a full-time resident.

         During the chairmanship of Dr. Nicasio Salang (1978 to 1994), an organizational change was introduced. A formal, structured residency training program for Surgery following the  four-year curriculum of the Philippine College of Surgeons was started in 1987 with one of the graduates of the adjunct program, Dr. Federico Sanchez, playing a pivotal role to lay the grounds of what JRRMMC Department of Surgery is at present—a nationally-recognized center of excellence for specialized surgical care, leader in training and translational research, providing health equity to the community.  Instrumental to the development and implementation of the curriculum were Dr. Federico Sanchez as Vice Chair with Dr. Arturo dela Peña as the training officer of the program. After finishing his training as an Olympus scholar to train in Japan, Dr. Sanchez, together with Dr. dela Peña, helped in the reorganization of the department into sections. It was around the time of the presidency of  Corazon Aquino, with Alfredo Bengzon as DOH Secretary and Usec. Periquet, that the Department of Health intervened to form sections under the Department of Surgery and invited sub-specialists of General Surgery to join the Department of Surgery. They were Dr. Alberto Roxas, Dr. Armando Crisostomo, Dr. Arturo dela Peña,  Dr. Teodoro Herbosa from UP-PGH and Dr. Alex Erasmo, Dr. Narciso Navarro, Dr. Hermogenes Regal, Dr. Jonathan Asprer, to name a few.  The different sections were then formed as follows: GSA - Head and Neck, Breast, and Soft Tissue Surgery; GSB -  Hepatopancreaticobiliary and Upper Gastrointestinal Surgery; GSC - Trauma and Critical Care Surgery; GSD – Colon, Rectal, and Anal Surgery; Plastic, Reconstructive, and Aesthetic Surgery; Pediatric Surgery; and Neurosurgery. During this period, eminent surgeons were produced by the department, including Dr. Robert Domingo who later on became the section chief of Hepatopancreatobiliary and Upper Gastrointestinal Surgery. Another notable product of the program is Dr. Emmanuel F. Montaña, Jr. who later on became the Medical Center Chief of JRRMMC.

Under the chairmanship of Dr. Federico Sanchez, from 1994 to 2012, the department had an agreement with other institutions to form different subspecialty consortia. The Thoracic, Cardiac and Vascular Surgery consortium was formed in 1995. The Plastic, Reconstructive, and Aesthetic Surgery consortium was formed in 2001 through the efforts of Dr. Laurence T. Loh, together with St. Luke’s Medical Center, Far Eastern University Medical Center, and Our Lady of Lourdes Hospital, with Dr. Maria Redencion Bukid-Abella as the first graduate of the program. The Colorectal Surgery Fellowship training program was also established in 2001, with Dr. Andrei Cesar S. Abella as its first graduate.

With the establishment of the Philippine Society of General Surgeons (PSGS) in 1994, the  responsibility of implementing and regulating the General Surgery curriculum as well as the accreditation of General Surgery training programs was relegated to PSGS by the PCS. To standardize all training programs across the nation, the four-year GS residency of JRRMMC was shifted to the current five-year training program starting in 2008.  It was during the chairmanship of Dr. Alex A. Erasmo, from 2013 to 2021, when subspecialty training programs under General Surgery were established including Minimally Invasive Surgery (MIS) in June 2014; Hepatopancreaticobiliary Surgery in 2016, Surgical Oncology in 2016, and a new subspecialty,  Pediatric Surgery in 2018.  Alongside these subspecialty programs, Dr. Erasmo initiated hosting different workshops including the annual Laparoscopic Hernia Repair Masterclass, as well as the Choledochoscopy Masterclass during his time. The last few years of the chairmanship of Dr. Erasmo was affected by the COVID-19 pandemic. Through the resiliency, cooperation, and resourcefulness of the department and its staff, the pandemic only had a minimal effect on the provision of surgical services and conduct of training remaining fully accredited.

The transition of chairmanship to Dr. Ida Marie Tabangay - Lim in 2022 coincided with the emergence from the COVID-19 pandemic. During this time, the Department of Surgery, with its resiliency, adopted to the “new normal,” utilizing the innovations brought about by the pandemic including hybrid conferences, teleconsultations and Zoom webinars, while the department brought the pre-pandemic surgical service and training which the Department of Surgery used to provide. Together with the establishment of the Republic Act 11959 Regional Specialty Centers Act, the Department of Surgery through its dynamic consultant staff,  is supportive of the JRRMMC’s strategic goals of providing quality services and contributions to the following specialty centers: Advanced Comprehensive Cancer Center, Apex Trauma Center, Apex Brain and Spine Center, and the Basic Burn Center, in which faculty members of the Department of Surgery are part of its lead and technical working groups.

A new fellowship program, the Head and Neck Surgery Fellowship has been established in 2024 and the first fellow started in year 2025 to realize further the goals of the Advanced Cancer Center. Despite an ever changing national government and societal landscape, the JRRMMC Department of Surgery continues to transcend the diverse complexities and challenges in a period of transformation and development. As JRRMMC continues to grow and expand economically and successfully, the department will continue to keep its promise to deliver world class comprehensive patient-centered care, through multidisciplinary collaboration, innovation, and national and international linkages. The department shall continue to provide the highest standard of training for surgeons and relevant researches which impact healthcare practices and policies.

Latest Photo taken December 2024. Currently there are 36 consultants in the Department of Surgery, 47 Residents and 9 Fellows in training.

SECTIONS

• Surgical Oncology, Head and Neck, Breast, and Soft Tissue Surgery

• Hepatopancreatobiliary and Upper Gastrointestinal Surgery and Minimally Invasive Surgery

             Trauma and Critical Care Surgery

• Colon, Rectal, and Anal Surgery

• Thoracic, Cardiac, and Vascular Surgery

• Pediatric Surgery

• Plastic, Reconstructive, and Aesthetic Surgery

• Neurosurgery 

 Our trainees and consultants have published research and presented these in both local and international fora.