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Residents-in-Training Code of Discipline and Manual
           Baguio General Hospital & Medical Center




                                 Training Office 2011
                                 Baguio General Hospital & Medical Center
                                 Gov Pack Road Baguio City
Residents-in-Training Code of Discipline and Manual
                                                           Baguio General Hospital & Medical Center


    Code of Discipline & Manual for Residents-in-Training
                   Baguio General Hospital & Medical Center


Title                                                                                              Page


   I.   Vision, Mission, Objectives    ………………………………………………………………………………. 3

  II.   Core values     ……………………………………………………………………………………………………… 4

 III.   BGHMC History, Vision & Mission; The BGHMC logo …………………………………………… 7

 IV.    BGHMC Structure & Organizational Chart ………………………………………………………….. 15

  V.    The Resident’s organization …………………………………………………………………………….. 16

 VI.    Residency training programs …………………………………………………………………………….. 22

VII.    General training guidelines & policies          ……………………………………………………… 22

VIII.   Requirements for residency training …………………………………………………………………. 38

 IX.    Job description of Residents-in-training        ……………………………………………………… 40

  X.    Evaluation & Promotion of Residents-in-training ………………………………………………. 44

 XI.    Disciplinary Measures & Sanctions      ………………………………………………………………… 49

XII.    Certification & awards         …………………………………………………………………………….. 58

XIII.   APPENDICES ……………………………………………………………………………………………………. 60




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Residents-in-Training Code of Discipline and Manual
                                                           Baguio General Hospital & Medical Center


INTRODUCTION

Vision, Mission, Objectives of this Residents-in-training Code of Discipline & Manual

   a) VISION
       i)   The Vision of this Residents-in-training Manual is to create a perfect guide which is appropriate,
            competent & adaptive to the changing regional needs and culture of specialty training & dynamic
            enough to meet the demands of technology change, innovations in management & medical
            advancement.


   b) MISSION
       i)   To produce socially responsible, morally upright & medically competent resident graduates.
       ii) To provide a high standard of training that would equip residents-in-training with the skills,
            attitudes & knowledge that translates to quality medical service.
       iii) To assure an adequately prepared residents-in-training, competent enough to pass their specialty
            board exams
       iv) To lead & encourage residents-in-training to upgrade & uplift their discipline & specialty
            instructions beyond expected requirements.


   c) OBJECTIVES (of the Resident’s Manual Commission )
       i)   To create a manual of Residents-in-training that would contain policies, guidelines, protocols &
            regulations of accredited residency training
       ii) To publish a handy guide for residents-in-training
       iii) To serve as a code of discipline & reference for evaluating, promoting, sanctioning & certifying
            residents-in-training
       iv) To convene scheduled meetings for the Training Core of BGHMC & update and amend this
            Residency Training Code of Discipline & Manual
       v) To consult the various departments with regards their training requirements & update their
            policies.
       vi) To monitor competency of this training manual through regular training core/committee meetings




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Residents-in-Training Code of Discipline and Manual
                                                            Baguio General Hospital & Medical Center

2) Core values of this Residents-in-training Code of Discipline & Manual

   a) This code of discipline & training manual adheres to the BGHMC values of appropriate & accredited

        medical training for residents; produce quality research & provides selfless service to the community.

   b) This code of discipline & training manual follows Civil Service laws of the Philippines; and employs

        current, appropriate & updated human resource evaluation & promotion processes.

   c) This code of discipline & training manual molds residents-in-training to adhere & perform their duties

        & responsibilities in accordance with the highest standards of Philippine Medical Association Code of

        Ethics & respects specialty Society policies on residency training.

   d) This code of discipline & manual believes that academic discipline & excellence forms the very

        foundation of competent residency training.

   e) This code of discipline & manual upholds a commitment & dedication to life & improvement of health

        care.

   f)   This code of discipline & manual affirms that respect & courtesy to superiors complete the highest

        form of personal excellence & sense of self worth.

   g) This code of discipline & manual recognizes a highly motivated & research-oriented residency training

        program as a means to cope with the advancing demands in medicine.

   h) This code of discipline & manual champion comprehensive quality health care through competent,

        evidence based specialty training.



3) Definition of terms
   a) Residents-in-training
        i)   They are physicians who are duly licensed to practice medicine in the Philippines who have fulfilled
             admission requirements by the specific specialty department.
        ii) They are graduates of an accredited internship program & duly licensed by PRC to practice
             medicine.



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Residents-in-Training Code of Discipline and Manual
                                                          Baguio General Hospital & Medical Center

     iii) They may be temporary employees of the BGHMC & are required to submit departmental
          requirements annually for renewal.
     iv) They maybe rotator physician, observers, lateral entrants, NPE’s & PE’s, department scholars or
          Sponsored trainees & are required to submit departmental & hospital requirements (for
          reappointment/renewal).
b) Non-purposive entry (50% BGHMC residency training plantilla)
      (1) Salaried residency position filled by up trainees in accordance to the standards set by BGH MC
c) Purposive Entry( 50% BGH MC residency training Plantilla)
      (1) Salaried residency position filled up by residency training applicants coming from the underserved
           areas, who shall return to these areas after completion of their residency training
d) Lateral entrants ( plantila from other hospital)
     i)   Straight Residency
      (1) A MOA between the sending agency and the residency training applicant stipulating among
           others that the applicant shall serve the sending agency for at least two (2) years for every year
           of training.
     ii) Modular Residency
      (1) A MOA between the sending agency and the residency training applicant stipulating among
           others that the applicant shall serve the sending agency for at least four (4) years after the last
           year of training.
e) Rotator Physician from other institution who have MOA with BGHMC
     i)   This shall include physicians (foreign graduates) who have undergone clearance from the
          Professional Regulation Commission (PRC) and the Department of Health (DOH).
f)   Observers
     i)   They are physicians or other professionals, and other individuals who are authorized by the
          sending hospital to observe facilities, procedures, tests, & other specific consultant expertise
          which are not available in the sending hospital.
     ii) They shall not participate, except to observe, in BGH MC. They shall not perform any procedure or
          operations; shall not make public opinions or interfere with patient care.
     iii) Their active participation during conferences & meetings shall be upon invitation/permission of
          the concerned staff members.
     iv) Shall have access to hospital documents only with the permission of the concerned department or
          unit.

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Residents-in-Training Code of Discipline and Manual
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     v) Knowledge of his activities & whereabouts in the host institution shall be the responsibility of an
          assigned consultant/staff member.
g) Active medical staff
     i)   This comprises the Consultants (plantilla) fulltime & part-time consultants
h) Medical Center Chief (MCC)
i)   Chief, Medical Professional Staff (CMPS)
j)   Chief, Training Officer (CTO)
k) Training Core
     i)   All Department Training Officer
l)   Selection, Promotion & Placement Board (SPPB)
     i)   CMPS, CTO, Dept Chair ; HR
m) Medical staff
     i)   All consultants (all consultants including visiting consultants) & Residents in training
n) House staff
     i)   Residents in training
o) Department Scholar
     i)   Sponsored Resident (‘drug fellow’)
      (1) A MOA between the sending agency and the residency training applicant stipulating among
           others that the applicant shall render post-residency service.




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Residents-in-Training Code of Discipline and Manual
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BGHMC History, Vision & Mission; The BGHMC logo

BGHMC History


                                                                 In July 1900, on orders of William Howard Taft,

                                                                 Head of the Second Philippine Commission,

                                                                 Dean Conant Worcester with three other

                                                                 companions set forth to discover a cold place

                                                                 up in the Cordillera...Baguio, the mountain

                                                                 paradise.




An excellent vacation and recuperation center for government officials, employees and American soldiers,

Baguio saw the establishment of a 15 bed hospital located at the site of the former Pines hotel in 1902 under

Dr. H. Eugene Stafford. The rise of the Baguio Sanatorium heralded the beginning of a long history of what is

to become the Baguio General Hospital & Medical Center.


The need to have a medical facility that is low cost and accessible was envisioned early on in the city's history,

so that as early as 1907, the building phase for the hospital began. When the project started, the vision and

objective was clear cut: to provide high quality yet affordable service for the people of the city and the

neighboring towns.




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                                                             After being renamed Baguio Hospital in 1907,

                                                             expansion proceeded in the construction of a

                                                             Nurse’s Home and six 3-room cottages for

                                                             Tuberculosis patients.



                                                             In 1915, Dr. Silverio Garcia became the very first

                                                             Filipino to assume hospital directorship. The

                                                             hospital was turned over to the Bureau of

                                                             Health. Several other Filipinos then took turns in

                                                             handling the reins of the hospital.



In 1937, with Dr. F. Esquivel as Director and Miss I. Francia as Chief Nurse, the name of the hospital was again

changed to Baguio General Hospital. It was this year when construction of the main hospital building,

promised earlier in 1930 by Pres. Manuel Quezon, started. It took 4 years after that cornerstone laying

ceremonies by then Vice President Sergio Osmeña before the building was finally inaugurated on February 22,

1941.




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Residents-in-Training Code of Discipline and Manual
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                                                               During the latter part of the second world war,

                                                               hospital operations transferred to the St. Louis

                                                               High School building behind the Cathedral after

                                                               the Japanese forces commandered the hospital

                                                               building. In April 1945, the hospital closed due

                                                               to       heavy   artillery   fire       and       carpet

                                                               bombardment. After the liberation in May

                                                               1945, the hospital was re-opened at Paules

                                                               Frates, La Salle Compound in Legarda St., as the

                                                               main hospital building had been severely

damaged.

The main hospital building was reconstructed with the aid of the Americans and the hospital was able to

operate at the main building in 1948. The 35 bed Contagious Disease Pavilion further expanded hospital

services in 1952. In 1955, the first BGH Advisory Board Officers were

inducted with Mrs. Ethel Herold as the Chairman of the Board. The Board was conceived to help in improving

operations as well as to act as liaison between the hospital and the community. In 1958, BGH, was designed as

one of the 11 training hospitals in the Philippines. Training programs of the different departments began to

take shape.




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Residents-in-Training Code of Discipline and Manual
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                                                                   Building construction and establishment of

                                                                   new services continued for the next 3

                                                                   decades. The School of Nursing Bldg., OR

                                                                   complex, OPD bldg., and bunkhouse in 1962,

                                                                   Alumni Bldg. in 1963.          In 1966, the

                                                                   Psychiatry, Physiotherapy & Brace Shop and

                                                                   Cancer Detection Clinic. It was in 1970

                                                                   when the BGH was converted into a Medical

                                                                   Center and expansion continue unabated.

                                                                   Ac hapel in 1972, Family Planning Bldg.,

                                                                   Coronary Care Unit in 1973. ER annex and

                                                                   CobaltTherapy Bldg. in 1977, X-ray annex in

                                                                   1978, Under Six and Administration Bldg. In

                                                                   1979, the Orthopedics & Traumatology in

1981. The Administration Bldg. was burned in 1985 and was rehabilitated in 1987.

The 1990’s was ushered in by the killer quake on July 16, 1990. The earthquake damaged and caused the

demolition of several hospital buildings. 14 other structures, including the main building, needed major

repairs. Another disaster struck a year later during typhoon when a landslide damaged and flooded parts of

the main building.




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Residents-in-Training Code of Discipline and Manual
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In 1992 BGHMC was the first in Asia to be awarded as the Mother and Baby Friendly Hospital Initiative (MBFHI)

by the United Nations Children’s Fund (UNICEF) of which the breastfeeding program of the hospital became

the prototype of the UNICEF. It was on May 26, 1995 that the Under Five Clinic of BGHMC was awarded

National Wellness Award for Excellence by DOH Center for Wellness Program and GAWAD PAGASA on October

1, 2002 during the Civil Service Commission 102nd Anniversary.



The hospital continues to expand in terms of physical structures and services. On September 17,2007, the first

floor of the Flavier Building was occupied by the: Emergency Room Department, Ultrasound Area of the

Radiology     Department,       Laboratory,    Admitting     Unit,      Cashier;     and      the     Pharmacy.

The 2nd phase of transfer of services at the Flavier Building was done on October 8, 2008 of which the 2nd

floor was occupied by the Pediatric Department; -while the 3rd floor was assigned by the Internal Medicine -

including the Pay Consultation Offices.



It was on the last week of March 2007, when the operation of the Psychiatry Department was transferred to

the new Psychiatry Building. Public comfort rooms at the Flavier Building were made available on the 2nd

quarter of 2008. Renovation of the old main building was completed on the first floor of the: OB Minor

Operating Room Complex including the Labor Room; and the 2nd floor: Surgical Ward (left and right wings),

Pediatric Surgical Ward, OR complex and the Recovery Rooms.



The new Infectious Disease Building that was inaugurated on March 16, 2009 houses the OPD of the Psychiatry

Department and the Drug Rehabilitation Unit.




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Residents-in-Training Code of Discipline and Manual
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It is the objective of the hospital to value the time of the patients/clients through the provision of a “one stop

shop”, hence the old ER will be renovated to house the support services such as the: Cashier, Billing/PHIC; and

Medical Records.



Sub-specialty services are already being offered and all training programs are accredited by respective

specialty societies. The Post Graduate Training Program (Nurse Fellow) for licensed nurses was instituted in

2004 and still ongoing.



It was approved for 500 bed capacity through R.A 8634 of 1998 but due to manpower deficiencies the actual

implementing is 400.



To this day, BGHMC has continuously provided Comprehensive Quality Health Care, Training & Research not

only to the City of Baguio but to the provinces of northern Luzon. BGH MC has continually aimed to be the

model people oriented hospital and has remained true to this endeavor. (http://www.doh.gov.ph/bghmc/)




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BGHMC Logo


              Elements of the BGHMC logo


The logo is divided into three (3) equal parts representing the three

major divisions of the Baguio General Hospital & Medical Center: the

Medical Division, the Nursing Division & the Administrative Division.


The Human icon represents the Administrative division; it also gives an

insight of a family which is the focus of comprehensive quality

healthcare, training & research.


The cadecues is the symbol of the medical profession: a winged herald ’staff with two snakes wrapped around

it. The nurse cap represents the nursing division.


The façade of the main building represents the health facilities & services which BGHMC was created for.


The outer circle contains the name of the hospital - Baguio General Hospital & Medical center - & the date

when the hospital was founded while the inner circle points to the agency & the region where BGHMC

belongs.


The circle further symbolizes infinity, without beginning or end an idea of unending services & support

committed to the community BGHMC serves. It symbolizes a perfect framework, a world where BGHMC

shares.




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                                                            Baguio General Hospital & Medical Center

MISSION

                     “Provide Comprehensive Quality Health Care, Training & Research”

                     In the realm of the Northern Philippines…

We are the hospital of the people dedicated to serve the healthy & the sick, that provides high quality
standard of specialized but holistic health care in the atmosphere of compassion, comfort, & social
understanding.

We are committed to the betterment of the people of Northern Philippines through public health activities, &
through involvement in health policy formulation & coordination with other institutions with similar interest.

As a hospital of the people, we shall be open, resourceful, fair & efficient in the sourcing, allocation &
utilization of resources entrusted to us by the people through effective management, & to the equitable
delivery of basic & specialized health services through cohesive, satisfied, goal driven, values-oriented & highly
motivated employee staff.

We shall offer comprehensive & excellent training in the medical & paramedical fields as we strive to keep
pace with the advancements in the technological knowhow, and do our share as we indulge in clinical &
hospital management research.




VISION

             “BGH MC : A Model People Oriented Medical Center”

In the realm of the Northern Philippines…

We are a model institution of health maintenance that provides comprehensive, high standard, equitable,
compassionate, holistic, specialized health care that continually strives to be competitive in technological
capability and competence.

We are a model government institution in terms of financial stability, resource management, bureaucratic
flexibility & transparency, operational efficiency & personnel satisfaction.

We maintain our status as the best provider of medical & paramedical human resource development relevant
& to become an academic institution that is also noted for clinical & hospital/management research.

We shall be a major force in regional health policy formulation & health manpower development as we
maintain our role as the premiere health referral center of the area.




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Residents-in-Training Code of Discipline and Manual
                                                            Baguio General Hospital & Medical Center

4) BGHMC Structure & Medical Organizational Chart
   a) Residency Training Organizational Structure (2012 Training Office format strategy)



                                         Medical Center
                                             Chief


                                         Chief, Medical
                                          Professional
                                              Staff


                                         Chief Training
                                            Officer



                             Training                 Department
                           Committees                 Chairperson



                                                       Department
                                    Research
                                                     Training Officer



                                                      Residents-in-
                                      ERC
                                                        training



                                                             Post-graduate
                                  Training Core
                                                            interns &clerks




5) Strategies to achieve objectives (2011-2013) of the Resident’s Manual Commission
   a) Standardized training manual
   b) Strict code of discipline
   c) Enhancing Quality research activities
   d) Effective communication of the various training programs & the BGHMC Training office
   e) High standard of patient care
   f)   Training highly competent & proficient specialist
   g) Disseminating specialty knowledge to allied medical workers.

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The BGH MC Resident’s Organization

Constitution & By-Laws of the BGH MC Resident’s Club

In accordance with the rules and regulations of Baguio General Hospital and Medical Center, the officers of the

Resident’s Club 2010 hereby promulgates this Constitution and Bylaws.


Section 1. Name of the Organization


This Organization shall be known as The Residents Club, the official organization representing the Resident

Physicians of BGHMC.


Section 2. Location of Office


The domicile and principal office of the Residents Club shall be at the Baguio General Hospital & Medical

Center.


Section 3. Objectives


The Residents Club shall be the supreme organization promoting and defending the Rights and Welfare of all

Resident-Physicians-in-training in BGHMC and specifically:


          a. Serve as the liaison organization between the Residents and the BGHMC Administration

          b. Serve as a model for the Senior Interns and Junior Interns also in training in BGHMC

          c. Promote among its members responsibility, discipline, honesty, camaraderie and the other values

              that the BGHMC upholds.

          d. Assist the Administration and the DOH regarding information drive; public health concerns; and

              other activities that the organization may be of help.




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Section 4. Members


All Resident Physicians of BGHMC who are accepted in the Residency Training Program of the different

departments automatically becomes members of the Residents Club.


Section 5. The Residents Club Officers


       a. The officers of the Residents Club shall be composed of Residents-in-training who have been duly

           elected by its members through a popular vote except for the position of the President

       b. The President of the next organizational year shall automatically be the President – Elect of the

           current organizational year-

       c. The President Elect shall be a junior of the current batch of Residents-in-training.

       d. The Adviser/s shall include Consultant-Physicians of the BGHMC whom the officers shall elect.

       e. Any vacant positions shall be filled in by appointees of the current President of the Organization

Section 6. Removal or Disqualification


Any member is subject for removal or disqualification from the Residents Club Officers on any of the following

grounds:


       a. He/she has shown gross neglect of duty in the performance of his/her duty.

       b. He/she has committed an act that is detrimental to the integrity and dignity of the organization.

       c. He/she deliberately violated any of the provisions in the Constitution and Bylaws.

       d. A member shall cease to be part of the organization in the following cases: (1) after the approval of

           his/her resignation; (2) Termination from the Residency Training Program (3) misrepresentation of

           the Residents Club.




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Section 7. Organization

         The Residents Club Officers shall be composed of the following:

         a. President
         b. President-Elect
         c. Secretary (2)
         d. Treasurer
         e. Press Relations Officer (2)
         f. Events and Affairs Manager (2)
         g. Adviser/s
         The Adviser/s shall include Consultant-Physicians of the BGHMC whom the officers shall elect.

Section 8. Duties and Responsibilities

    a. President
           1. Supervises the activities of the entire organization

             2. Calls and presides over meetings involving the activities of the organization

             3. Comes up with the final decision in consultation with the adviser/s in case the members are

                 divided in certain matters; and

             4. Informs and reminds the officers of the stipulations embedded in this Constitution and Bylaws.

    b.    President - Elect

             1. Assists in carrying out the functions of the President;

             2. Assumes the responsibility of the President in his/her absence or inability to carry out such

                 responsibilities;

             3. Manages all outreach missions to be attended by the members of the organization.

             4. Prepares a plan of activities of the Resident’s Organization for the incoming year.

    c. Secretary

             1. Keeps all supporting documents and records regarding meetings and activities of the

                 organization.

             2. Prepares reports/papers needed by the organization & submits a copy to the Training Office

             3. Takes the minutes of the meeting

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                                                             Baguio General Hospital & Medical Center

             4. performs other functions as deemed necessary

    d. Treasurer

             1. He/She shall take care of collections and management of logistics of the organization

             2. Prepares the statement of the operations and other relevant financial reports before the end

                 of his/her term

             3. Makes an audit on the statement of operations and other financial statements.

    e. Press Relations Officer

             1. Coordinate with the Administration and other offices in connection with relevant organization

                 activities

             2. Assist in information dissemination to members regarding activities participated by the

                 organization

             3. Shall manage/coordinate activities regarding information drive and Public Health Teaching

             4. Performs other functions as deemed necessary.

    f.   Events and Affairs Manager

             1. Coordinate with other officers regarding planning and execution of organization’s activities

             2. Performs other functions as deemed necessary.

Section 9. The Adviser/s


         The Adviser/s of the Residents Club shall have the following duties and responsibilities:


         a. Serve as the liaison officer/s between the Residents Club and the BGHMC Administration

         b. Provide guidance on matters pertaining to duties, welfare, activities, and legal affairs

         c. Assist the President regarding disputes among decisions of the members of the organization.

Section 10. Election


         Section 10.1 An annual election of officers shall be conducted during the second quarter of each year


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       Section 10.2 All resident physicians-in-training are allowed to run in any position they are qualified


       Section 10.3       The following positions may be applied for:


           Section 10.3.1

                  One (1) Vice President

                  Two (2) Secretaries

                  One (1) Treasurer

                  Two (2) Press Relations Officer

                  Two (2) Events and Affairs Managers

       Section 10.3.2 Those running for the position of Vice President should be a junior resident of the

Residency training program of their respective Department (and become the President – elect)


       Section 10.4 Winners will be determined through a popular vote by the members of the organization


       Section 10.5 Newly elected officers shall assume office only after proper endorsement by the

immediate past organization officers


Section 11. Residents Club Operation Time Frame


The operation of the Residents Club shall start upon the recognition of the organization by the BGHMC

Administration.


Section 12. Amendments


The Constitution and Bylaws can be amended anytime as deemed necessary by a majority vote of the total

number of members of the Residents Club Officers and made effective upon submission to, consultation with,

and approval of the proper BGHMC Administration.



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Section 13. Separability Clause


Should any provision of this policy be declared invalid, the other provisions, so far as they are separable shall

remain in force.


Section 14. Effectivity Clause


This Constitution and Bylaws shall take effect immediately upon approval of the majority vote of the members

present and the proper BGHMC Administration.


Upon approval, this policy shall cover all Residents Club transactions.




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The BGH MC Residency Training Programs

BGH MC is a tertiary medical center that provides quality healthcare to all.

BGH MC is a training institution for the following accredited residency training program.

        i)    Department of Surgery
        ii)   Department of Internal Medicine
        iii) Department of Pediatrics
        iv) Department of Obstetrics & Gynecology
        v) Department of Orthopedics
        vi) Department of Otorhinolaryngology – Head & Neck Surgery (ENT-HNS)
        vii) Department of Ophthalmology
        viii) Department of Psychiatry
        ix) Department of Radiologic Imaging
        x) Department of Pathology
        xi) Department of Anaesthesiology



General guidelines & policies for Residents – in –training

GUIDELINES:


         (1) The purpose of residency training shall be to provide a well-rounded, ethical, updated & relevant

              specialty training that shall develop the necessary skills, competence, compassion, knowledge &

              attitudes to prepare residents-in-training for specialty board certification.

         (2) The Resident-in-training shall follow the rules, policies & guidelines of this Resident Code of

              Discipline & Manual as well as specific departmental policies.

         (3) The Resident-in-training shall be governed by the policies of the Civil Service, Professional

              Regulation Commission (PRC) & Department of Health (DOH).

         (4) The Resident-in-training shall be subject to performance evaluation by the specific department

              AND the requirements set forth by the BGH MC Training Office.
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        (5) The Resident-in-training shall be subject to certain BGHMC benefits & privileges as well as the

            sanctions & disciplinary measures set forth by this residency training code of discipline & manual.

        (6) All graduates of the BGH MC Residency training program are encouraged to take the certifying

            examination given by their respective specialty boards within two (2) years following completion

            of training.


Official Working Hours & Duties


        1. Resident trainees are not covered by Republic Act 5901 (40-Hours a Week Law).

        2. Due to the nature of the medical services, trainees may be on-call at any time.

        3. All residents-in-training are mandated to attend the flag ceremonies every Monday.

            All trainees are expected to be at the main entrance of the BGH MC, every Monday at 7:30 am.

        4. The regular working hours on Mondays to Fridays is from 8am to 12nn and 1pm to 4pm, unless

            otherwise required by department. Regular working hours during Saturdays is from 8am to 1pm.

            During Sundays & holidays, working hours are from 9am to 11am.

        5. Residents-in-training who are on 24 hour duty are required to report to their post from 8am to

            8am the following day. Residents will return to their regular working post after their 24 hour duty.

            Trainees are only allowed to leave their post after proper endorsement of ward/hospital duties to

            their colleague on 24-hour duty. Frequency of 24 hour duty should not be less than every two (2)

            days.

        6. All departments shall submit to the Training Office & the CMPS a schedule of duties of the

            Consultant & the Resident Trainee for the coming month at least seven (7) days before the last

            day of the current month. Substitution of duties is discouraged.




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          7. In case of illness or other life-threatening emergencies, the trainee shall notify the department

              chairperson and the department training officer. The TO shall make the proper arrangements for

              substitution of duties.


Standard Hospital attire


     1.          Residents-in-training shall be neat and well groomed at all times during the performance of

                 their medical duties.

     2.          Residents-in-training shall wear the institution’s prescribed attire appropriate for conferences,

                 surgeries (surgical gown, scrub suits), and the performance of department & hospital activities

                 (white smock gown/white blazer). Revealing attire, inappropriate facial makeup & hair dyes

                 shall be discouraged.

     3.          DRESS Code of all BGHMC Employees (Hospital Memorandum 2010-010; CSC Memo Circ no.

                 14, s.1991; DOH Dept Memo nos. 2008-0075 & 2008-0075-A)

            a. Dress Code of the CSC MC No.14.s.1991 PROHIBITS the following:

                i. Party attire, picnic clothes, sandos, t-shirt (no collar), tight fitting, seductive, micro-mini &

                    gauzy/transparent dresses (by female personnel)

                ii. Walking shorts, pedal pushers, leggings, tights, jogging

               iii. Too much costume jewelry, flashy bangles & similar accessories

               iv. Ostentatious display of expensive jewelry

                v. Slippers, sandals, step-ins & bakya

            b. DOH Department Memo Nos. 2008-0075 & 2008-0075-A (circularized under Hospital

                Memorandum No. 38 s. 2008 issued on August 27, 2008)

                i. “officials & employees who consistently fail to wear the official DOH uniform shall be

                    subjected to appropriate disciplinary action for violation reasonable office rules &



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           regulations per Section 12, Rules XIV; Discipline of the Civil Service Law & Rules. An

           employee fails to wear his/her uniform at least ten (10) times in a month for two (2)

           consecutive months , is considered habitually disobedient hence can be subjected to

           disciplinary action by the Head of Office.

    1. In addition to above rules, residents –in – training are required to wear their smock

        gowns/white blazers & their hospital IDs during hospital/department conferences; during ward

        rounds & during consultation/work at the out-patient department.

    2. Residents –in-training of the Department of Anesthesia, Surgery, Obstetrics & Gynecology,

        Orthopedics, Ophthalmology, Otolaryngology-Head & Neck Surgery, & Pediatrics & Internal

        Medicine shall wear their prescribed scrub suit/operating room uniform when performing

        their OR tasks/duties. They shall wear this ONLY inside the Operating Room & other specialized

        areas (LR/DR/Nursery).

        a. Residents-in-training shall use at all times the BGH MC official identification cards,

            provided by the HR, worn in the prescribed manner, for the safety & security of hospital

            staff & clients.

        b. The use of personal ornamentation & unnecessary accessories during work hours shall be

            discouraged as these may interfere with efficient & safe management of patients.

        c. Hair styles should not interfere with the maintenance of sterility and cleanliness during

            ward rounds/clinical duties/procedures/surgeries.




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Policies on Proper decorum & conduct


The Residents-in-training shall behave professionally at all times. They shall carry out their duties efficiently &

faithfully.


    1. All DOH, BGHMC, specialty society, department memos, guidelines & policies, rules & regulations shall

         be observed. In case of conflicts, resolution shall be clarified by the BGH MC Training Office.

    2. Courtesy, respect, consideration and understanding to all shall be encouraged.

    3. Public humiliation/reprimand of any hospital personnel for discourtesy, inefficiency or neglect of duty

         shall not be allowed. Such actions shall be reported to the appropriate office concerned.

    4. The Medical staff shall be treated with utmost respect. Complaints/grievances shall be directed to

         appropriate offices for actions.

    5. Comments about other physicians/institutions and their clinical/surgical management shall not be

         made in the presence of patients & non-medical individuals to avoid misinterpretations.

    6. Information on patients shall be kept confidential. Documentation in whatever form or medium that

         may    reveal   a   person’s       identity   shall   not   be   made     public    without    the   attending

         consultant’s/patient’s/guardian’s/ nearest kin’s consent.

    7. No information regarding training-related incidents and unusual events shall be given to anyone

         without prior approval of the Department/office concerned. Inquiries on major decisions regarding

         patient’s status/management shall be referred to the consultant-in-charge at all times. Trainees shall

         not give unauthorized statements, interviews, or medical bulletins regarding status of the patient.

    8. Examination of patients & performance of procedures shall be done in accordance with the clinical

         practice guidelines established by the department AND only after proper explanation with properly

         obtained consent of patient and/or responsible relative.




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9. Patients requiring examination in a closed room by a Resident-in-training shall be accompanied by a

    co-trainee/nurse/staff member of the same sex as the patient.

10. Trainees may assist in the care of private patients, either admitted or in the clinic. However, they shall

    not be allowed to handle the care of such patients without consultants consent and/or supervision.

11. Unruly/inappropriate behavior shall not be tolerated. As much as possible, speaking shall be kept at

    levels comfortable to normal hearing. Obscene, profane or abusive language shall not be permitted.

12. Alcoholic intoxication, gambling & smoking shall not be allowed within hospital premises.

13. Illegal possession, distribution and/or illicit use of narcotics & dangerous drugs are prohibited.

14. Illegal possession of firearms & deadly weapons is prohibited.

15. Acts of perversion, lasciviousness, & sexual harassment shall not be allowed in any place of training

16. When attending to a critically ill or dying patient, training staff & trainee shall be calm & collected.

    They shall observe caution in their communications with the patient/relatives to avoid causing alarm,

    misinformation, misinterpretations or undue stress.

17. Personal matters shall not influence or compromise residency training, care & service to patients.

18. Trainees shall not engage in private medical practice. They shall not accept or charge medical and

    professional fees from anyone.

19. Use of instruments, equipment, & appliances on patients shall not be for personal financial gain.

20. Trainees shall not give unauthorized lectures/teachings activities outside of their respective

    departments.

21. In unusual circumstances, residents-in-training may remain beyond scheduled duty to continue to

    provide care for a single patient; justifications are limited to required continuity of care for a patient

    who is severely ill or whose condition is unstable, academic importance, or humanistic attention to the

    needs of a patient or family. This should be understood as an attempt to balance concerns and to




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        teach residents to learn their own limits and not to be criticized as the limitation as being harmful to

        doctors' education leading to less-skilled physicians. (ACGME 2011)


Hospital Training Activities


     a. Attendance in hospital activities shall be given due importance as provided for by the hospital’s

         training policies. All trainees are required to attend hospital conferences. ONLY those detailed at the

         ER/OPD, performing surgery at the OR or those attending to seriously ill patients are excused from

         the hospital conferences/activities.

     b. Trainees shall come on time for these activities. Attendance shall be checked by the BGHMC training

         office. An infraction maybe incurred may be for unexcused late arrival in a required hospital activity.



         i. Hospital Grand Rounds

              1. A formal monthly meeting activity held every last Monday of the month, involves medical

                  education and inpatient care, consisting of presenting the medical problems and treatment

                  of a particular patient to an audience consisting of consultants, residents, and medical

                  students.

              2. A senior resident discusses the clinical case of one or more patients. This is where new

                  information is taught and clinical reasoning skills are enhanced. They are an integral

                  component of medical education & residency training. They present clinical problems in

                  medicine by focusing on current or interesting cases.

        ii. Research Paper Contest

              1. Held annually during the 2nd week of December of every year.

              2. The Technical & Medical Research Committee shall create policies & guidelines with regards

                  this activity.



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      3. All graduating residents MUST submit their entry on the last week of October at the Training

          office.



iii. Case Report Contest

      1. Held annually during the first week of December of every year.

      2. The Technical & Medical Research Committee shall create policies & guidelines with regards

          this activity.

      3. All first year residents are required to submit their entry on the last week of October at the

          Training office.

iv. Research Lecture Series

      1. Held every other month & are scheduled during weekends.

      2. All residents-in-training are required to attend all lectures (6 meetings)

      3. Lectures may include:

             a. research designs: held during the last weekend of January

             b. research protocol writing: Held during the last weekend of March

             c. research/journal appraisals: held during the last week of May

             d.     statistical analysis: held during the last week of June

             e. how to read journals: held during the last week of August

             f.     how to use scientific articles: held during the last week of October

v. Hospital Week Activity

      1. Held every August 6 – 12 of every year (department circular 2010-0233)

      2. Activities related to the theme provided by the DOH

      3. Health Research related contest maybe held during this week.

vi. Hospital Research Week


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      1. Held during the first week of December every year

      2. The ERC & the Technical & Medical research committee shall create the guidelines & policies

          with regards this activity.

      3. This activity shall encourage academic excellence in healthcare research

      4. It shall promote interaction between clinicians and other medical allied personnel in the

          hospital

      5. It shall provide opportunities for researchers in different disciplines (scientific, clinical,

          nursing and allied health) to present their work at the same forum

      6. Outputs during this activity shall contribute to evidence-based healthcare

      7. This activity highlights the range of research technologies and resources that draw the

          various departments of the hospital together.

      8. The annual residents’ paper contest & case report contests, poster contests, medical &

          surgical innovations & instrumentations contest are held during this week.

      9. This will also be the venue of the elections of the next batch of BGHMC residents’

          organization.

      10. All research output for the year shall be included & published in the BGH MC Annual

          Research journal.

vii. Midyear Review

      1. Shall be held annually during the first week of July of every year

      2. This shall be a formal presentation by the BGH MC Residents Organization of their activities

          during the first half of the year.

      3. This activity shall also recognize the achievements of ALL residents-in-training.

      4. This activity shall be organized jointly by the BGH MC Training Office & the BGH MC

          Residents Organization.


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viii. Resident’s Forum (Year End Report)

       1. Shall be held annually during the first week of December of every year

       2. Shall precede the Resident’s Recognition Activity

       3. This activity shall be a formal presentation & endorsements of the outgoing officers of the

           BGH MC Resident’s Organization.

       4. Research & Training outputs; Financial status, etc.. shall be presented by the BGH MC

           Residents Organization during this activity.

       5. This activity shall be organized jointly by the BGH MC Training Office & the BGH MC

           Residents Organization.

 ix. Resident’s Recognition

       1. Shall be held annually to recognize deserving graduating trainees.

       2. This activity shall immediately follow the Residents Forum

       3. The Activity shall be jointly organized by the BGH MC Training Office & the Residents

           Organization.

 x. EBM hour

       1. Held every other month & are scheduled during weekends.

       2. All residents-in-training are required to attend all lectures (6 meetings)

       3. Lectures may include:

              a.   PICO format & the clinical question : held during the last weekend of February

              b. Writing your own research protocol : Held during the last weekend of April

              c. Your personal CAT bank : held during the last week of June

              d.   NNT’s; SPins & SNouts : held during the last week of July

              e. Likelihood ratios : held during the last week of September

              f.   EBM in your department : held during the last week of November


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        xi. Inter-department conference

              1. Held at any time, when at least two (2) departments hold a joint conference.



       xii. Department training activities

              1. Journal club appraisal

                     a. Presentation & discussion of selected journal articles by trainees, moderated by

                          assigned consultants & held at least once a month.

                     b. Journal articles are properly appraised & copies are sent to the all department staff &

                          trainees at least one week before the presentation.

              2. Staff meeting

              3. Morbidity/Mortality Review and/or Audit

              4. Case Conference

              5. Research discussion

              6. Resident’s hour

              7. Specialty national conventions & postgraduate courses


Medical & Surgical Procedures


All residents-in-training shall be familiar with basic medical procedures & the hospital’s guidelines & policies

related to each procedure.


       i. IV/IM injection; insertion of IV, NGT & IFC, Skin test interpretations, wound dressing

      ii. All residents-in-training shall be familiar with the hospital’s/department’s protocols in handling &

          disposal of hazardous materials/equipments.




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Court Call


    1. All residents-in-training are required to respond to Court calls.

    2. Trainees, usually the resident-in-charge are summoned by the court of law to appear as the witness,

        who by virtue of medical education, specialized training, medical or surgical skill or experience, is

        believed to have expertise and specialized knowledge in a particular subject beyond that of the

        average person, sufficient enough that others may officially and legally rely upon the witness' opinion

        about an evidence or fact issue within the scope of his expertise.

    3. Once the resident-in-charge has graduated and/or no longer connected with the BGH MC, the chief

        resident will answer the court call.


Resuscitation


         1. All residents-in-training shall be familiar with resuscitation techniques & the BGHMC’s guidelines

               on activating & performing a Resuscitation Code

         2. All residents-in-training shall have training on Basic Life Support (BLS) & Advanced Cardiac Life

               Support (ACLS)


Interdepartmental Referral System


       1. All residents-in-training shall attend to referrals.

       2. Referrals regarding medically/surgically unstable patients, or patients with life-threatening

             conditions shall be considered STAT.

       3. All residents-in-training concerned must respond to STAT! referrals immediately. For non-urgent

             referrals, residents shall respond & answer the referral within twenty-four (24)hours

       4. To facilitate immediate response to the referral/s, the department shall establish a flowchart with

             regards the hierarchy of responders , which shall be known & understood by other departments.


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             a. ER referral – ER physician on duty shall respond first. The more senior resident / subspecialty

                   resident shall be summoned as the need arises.

             b. Interdepartmental referral

             c. Other departments

             d. Subspecialty referral – resident in charge of the subspecialty shall respond

             e. resident on duty (if referral was done after 4pm)

             f.    any resident – if referral was done during office hours (8am to 4pm)

             g. a hospital / department locator chart may be required for each department or area

             h. If after several attempts to contact the resident fail, the PAGING SYSTEM will be utilized to

                   summon the resident responder.


Patient - related responsibilities


    1. All residents-in-training shall strictly conform to the BGH MC Medical Records Committee policies on

        documentation & charts.

    2. Use of rubber stamp (Trodat) is mandatory whenever the Resident- in- training signs any document.

    3. All residents-in-training are required to read & understand the Patient’s Bill of Rights.

    4. All patients consulting at the ER & OPD must be seen personally by ER physician/OPD physician/any

        physician of the department concerned. For subspecialty cases, the subspecialty resident rotator

        concerned must be notified for final disposition.

    5. The resident trainee shall be responsible for all his/her orders & prescriptions that he/she signed.


Patient’s charts


    1. This shall be completed upon discharge (Clinical history & PE, OR technique, Discharge instructions,

        HAIR, etc..)

    2. No part of the chart shall be removed.

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a. Chart orders

      i. Entries shall always be clear & legible

      ii. Date & time shall always be included

      iii. Only internationally accepted abbreviations & terms shall be used

      iv. All entries shall be signed by the trainee (printed name/TRODAT & below the signature).

      v. The resident trainee shall ask the Consultant –in-charge to sign the chart prior to discharge.

      vi. The use of white ink/erasures are not allowed. Changes in chart orders shall be written as new

        entries. Wrong entries, may be superimposed with one line & counter-signed &/or labeled as

        “error.”

      vii. New entries shall be immediately & clearly endorsed to the Nurse-on-duty

      viii. Discharge Orders shall include discharge instructions; home medications, date of follow-up &

        patient education.

b. Phone orders

      1. All residents-in-training are not allowed to give orders by phone except in situations where any

          delay may cause harm/compromise to the patients

      2. Phone orders (if allowed by the department) should be countersigned within one hour

c. Verbal orders

      1. All residents-in-training are not allowed to give verbal orders except for situations allowed by

          the department

      2. All verbal orders (if allowed by the department) should later be written in the chart &

          countersigned within one hour.

d. Discharge summaries

      i. These shall be the responsibility of all residents-in-training

      ii. These shall be completed upon patient’s discharge


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         iii. Patients and/or their guardians are required to sign on the physician’s order sheet upon

           receipt of a copy of the discharge summary.

         iv. It shall contain clearly written discharge plan and home instructions for the patient/caregiver

           for proper use/conduct of medications, therapies & supportive measures at home..



e. Clinical abstract

         i. Clinical abstracts shall be accomplished by the resident-in-charge/ resident-on-duty as required

           in the following cases:

                  a. PCSO / PDAF request for medical financial assistance

                  b. Transfer of patient to another hospital

                  c. For insurance/medical benefit claims (SSS, GSIS)

f.    Medical certificates

         i. For discharged patients, the medical certificates shall be prepared by the Medical Records

           section & signed by the resident-in-charge

         ii. For In-patients, the resident in charge/ward resident shall prepare and then sealed by the

           Medical records section.

g. Medico-legal certificates

           i.   ER resident shall issue temporary/provisional medico-legal certificates & accomplished in

                two copies (one copy attached to the ER blotter; another copy issued to the patient and/or

                police officer). Final medico-legal certificates shall be released by the medical records &

                signed by the ER resident.

h. Birth certificates

         i. The birth certificate shall be accomplished by the nurse & signed by the resident –in- charge as

           soon as possible.


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     i. Death certificates

               1. All residents-in-training shall expeditiously accomplish and sign the death certificates.

               2. All residents – in-training shall be oriented with regards filling up of Death certificates.




      J. Out-on-Pass


             1. PHIC patients are not allowed to go out-on-pass.

             2. All residents-in-training shall be aware & should be oriented with regards hospital policies

               regarding out-on-pass (24 hours only; patient signs waiver).


Patient conduction


            1. Resident/s shall accompany patient for diagnostics outside of the hospital

            2. For hospital transfers (within or outside city boundaries), the resident shall accompany patient

                & the travel shall require a hospital order. Travel Insurance is included in the hospital order.


Hospital property related responsibilities


       1. All residents-in-training are responsible to all hospital documents, equipments, and other property

           & shall take care of hospital properties as their own as stated in the institution’s rules & regulation.


Department related responsibilities


    1. All residents-in-training are required to attend ALL department conferences.

    2. All residents-in-training shall familiarize themselves with the proper use & care of department

        documents/forms as well as equipments & facilities

    3. They shall use the equipments / facilities / official department forms only for their intended purposes

        unless otherwise allowed by the department chairperson.


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    4. They shall not remove from the hospital premises any department-owned teaching aids, research

        materials, instruments, office equipment/furniture/supplies without permission from the department

        chairperson.




Staff related responsibilities


    1. All residents-in-training shall strive to work harmoniously with other staff member.

    2. All residents-in-training shall strictly observe hospital rules on safety so as not to jeopardize his/her

        health as well as that of the staff members.

    3. All residents-in-training shall agree to a physical examination & other necessary tests at any time, to

        ascertain physical & mental fitness & capability to undergo training & duties in a hospital setting. The

        consultant staff of the department shall determine the need for the necessary tests.

    4. All residents-in-training shall receive, except when contraindicated, the necessary vaccinations to

        prevent/minimize the risks of acquiring & spreading certain diseases to others.

    5. All residents-in-training shall make known to the department chairperson/TO any disease contracted

        during the time of training for appropriate action.


Requirements for Residency training application & appointment

GUIDELINES:


    1. The Department concerned shall receive the application letter & all required documents for residency

        training applicants.

    2. The Department shall screen the applicants & then recommend to the SPPB the selected candidate/s

        for training.




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   3. The BGH MC SPPB shall recommend to the Medical Center Chief the approval of the appointment of

        the Residency training applicant.

   4. Applicants accepted for training shall read, understand & sign the following:

              a. A statement attesting to the Trainee’s having read & understood this Residency Training

                  Code of Discipline & Manual; has attended the orientation for new Residents-in-training; and

                  has fully understood the specific policies of the specialty department. (Appendix)

              b. A one – year contract (renewable) for Trainees upon their appointment (Appendix)

              c. Shall receive a copy of this Residents-in-training Code of Discipline & Manual.

   5. Applicants approved for appointment, rotation, residency training, observation, lateral entry or

        department scholar/sponsored trainee shall complete the requirements needed by the Human

        Resource Office AND the BGH MC Training Office within 30 days.

   6. Residents-in-training shall be appointed for a year based on criteria recognized by the department

        AND the requirements set forth by the BGHMC Training Office. Residents-in-training shall apply for

        renewal annually.

   7. Residents-in-training shall repay/reimburse the government all salaries & allowances received if

        he/she resigns without valid reasons during the first two years of training.


REQUIREMENTS (for BGH MC residents – in – training)


   a. Diploma from an accredited & recognized medical school in the Philippines or abroad

   b. PRC license (updated/latest photocopy)

   c. Board certificate from the PRC

   d. PRC Board rating or RA 1080 certificate

   e. Certification of PMA membership & local component society

   f.   Certification of completion of (senior) Internship from an APMC recognized hospital or its equivalent.



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   g. Certificate of good moral character from the medical school

   h. Recent 2x2 colored picture (3 pieces)

   i.   Letter of intent

   j.   ACLS / BLS certification

   k. Completed Personal Data sheet

   l.   Transcript of records (certified true copy)

   m. Community tax certificate

   n. NBI clearance

   o. Medical certificate & Neuropsychiatric clearance

   p. MOA from the sending hospital/agency/office/sponsor*

   q. Copy of CME policies/training policy of sending hospital/agency/office/sponsor*

                     *for non-plantilla appointments




Job description of Residents-in-training


   The position of the resident-in-training involves a combination of supervised and independent patient

   evaluation and management function, formal medical/surgical educational and research activities.

   Provision of care provided by the resident-in-training is commensurate with the trainee’s level of

   advancement and competence, under the general supervision of appropriately privileged attending

   teaching staff.

1. ROLES, FUNCTIONS & DUTIES:

         1. Participates in safe, effective and compassionate patient care

         2. Demonstrates an understanding of ethical, socioeconomic and medical/legal issues that affect

             graduate medical education

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       3. Applies cost containment measures in the provision of patient care

       4. Participates in the educational activities of the training program, and, as appropriate, assumes

           responsibility for teaching other residents and medical interns & students

       5. Participates in research activities as required by the Training Program

       6. Participates in BGH MC committees and other tasks as assigned

       7. Should undergo accredited Basic Life Support training or ACLS renewal

       8. Maintains / renews physician licensure

       9. Performs duties in accordance with the established practices, procedures, and policies of the BGH

           MC residency programs

       10. Attends specialty societies postgraduate courses & activities



2. CORE Competency

       1. Organizational Commitment

       2. Integrity

       3. Quality service focus

       4. Teamwork

       5. Stewardship of Resources

       6. Attention to communication

       7. Self-development




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3. Functional Competency Profile

         1. Knowledge

                  i)   It is important for resident trainees to have good decision-making and customer service

                       skills, as they must deal with patients on a daily basis.

                  ii) Being amiable and working well under pressure, resident physicians should be

                       emotionally stable, analytical and self-motivated.

                  iii) Excellent oral and written communication skills are required

                  iv) ability to work efficiently in teams

                  v) Residents should also have strong leadership skills, since they may serve as mentors to

                       medical interns & medical students.

         2. SKILLS

                  i)   Clinical diagnosis
                  ii) Disease/medical indicators & treatment
                  iii) Drugs & medicines
                  iv) Diagnostic procedures
                  v) Occupational hazards & safety standards practices
                  vi) Computer software applications
                  vii) Research

Trainees should be cognizant & internalize the National Drug Policy and Generics Law, Cheaper Medicine Law,

Medical Act of 1959, PMA Code of Ethics & Patient’s Bill of Rights.


4. Behavior

                  (i) Managing performance
                  (ii) Building a successful team
                  (iii) Building strategic working relationships
                  (iv) Building trust
                  (v) Planning & organizing


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Residents-in-Training Code of Discipline and Manual
                                                            Baguio General Hospital & Medical Center

                  (vi) Decision making
                  (vii) Work standards


5. Motivation - Job has opportunities for:

                  (i) High responsibility/accountability

                  (ii) Achievement

                  (iii) Challenging work

6. Key result Area

                a. Medical examination & diagnosis

                b. Patient treatment & care management

                c. Patient’s medical documents

                d. Monitoring & evaluation of patient’s health

                e. Research




Job description of Residents-in-training
(as defined by the Civil Service Commission for Medical officer III)

    1. Attends to emergency calls on field.

    2. Performs medical examinations and requests for diagnostic work-ups or laboratory examinations as

        needed to diagnose health ailments.

    3. Assists and/or performs surgical operations within own limitations as determined by the Chief of

        hospital or Head of Department.

    4. Conducts daily rounds to observe the progress and condition of patients.

    5. Prescribes medicine and treatment procedures and techniques within his/her field of specialization.

    6. Seeks information for treating difficult and complicated medical cases through consultation with

        supervising officers.


       Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011        43
Residents-in-Training Code of Discipline and Manual
                                                             Baguio General Hospital & Medical Center

   7. Disseminates information during medical conferences.

   8. Accomplishes relevant medical documents such as clinical records upon admission and discharge of

       patients, as well as medical, legal, birth, or death certificates.

   9. Educates medical and paramedical students, and trains and mentors medical students, externs, and

       intern physicians on a particular field of medicine.

   10. Conducts and participates in hospital research projects.

   11. Performs other related functions as may be assigned.




Evaluation & promotion of Residents-in-training


Department’s semi-annual evaluation report


   1. The performance of the trainee will be evaluated by all department consultants or to the consultant

       (subspecialty rotation) to which they are assigned.

   2. Trainees are given formal written & oral examination semi-annually. Results are given to the Training

       Office.

   3. Final results/grades of the oral & written examination together with their Performance Evaluation

       Sheet (PES) & other pertinent department and hospital requirements are submitted to the Training

       Office. The department chairperson, the department Training Officer & the Chief Training officer

       jointly recommends satisfactory evaluation results to the Medical Center Chief for reappointment.

       Remedial measures are given to unsatisfactory/failing results.




      Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011          44
Residents-in-Training Code of Discipline and Manual
                                                           Baguio General Hospital & Medical Center


BGHMC TRAINING OFFICE COMMITTEES


     1. The BGHMC Training Core (Standards & Quality Residency Training Committee)

          a. Each department shall form their own training core who report to the BGHMC training core

          b. A committee created to guarantee that all residents-in-training comply & act in accordance to

                the contents of this code of discipline & training manual.

          c. The committee makes final decisions after due process & gives sanctions or remedial

                measures to erring residents-in-training.

          d. Unsatisfactory performance of a trainee is sufficient cause for termination of appointment.

          e. Trainees, performing below par shall be identified during the first two years of training. Their

                reappointment becomes conditional thereafter. They may be terminated at any time for any

                violations and/or failure to accomplish remedial measures as required.

          f.    Members are the respective Training Officers of the departments or their representatives.



      2. The BGHMC Code of Discipline & Training Manual Commission

               a. A committee created to amend, revise & evaluate the competency of this training manual

                   & code of discipline.

               b. Amendments & revisions shall be done every two years.

               c. Any changes or revisions done by the committee to this manual shall be effective

                   immediately & implemented without delay after approval by the Chief Training Officer.

               d. Evaluation & revision of the mission, vision, core values, strategies & objectives of this

                   manual shall be done every three years after a strategic planning session of the

                   committee.

               e. Members are selected representatives of each department



     Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011          45
Residents-in-Training Code of Discipline and Manual
                                                      Baguio General Hospital & Medical Center

 3. The BGHMC Technical & Medical Research Committee

        a. A committee created by hospital order committed to review all applications for research;

             advise & make technical recommendations on submitted protocols; performs revisions;

             monitors progress of individual research and evaluates the scientific quality & socio-

             medical impact & importance of the paper.

        b. All research protocols must undergo review by this committee prior to start of study. A

             certification will be sent to the researcher to confirm ‘start of study.’

        c. A copy of the finished study must be submitted to the Technical & Medical Research

             Committee for final evaluation & for filing & recording purposes.

        d. To advise & recommend to the Chief Training Officer the completion of research paper

             requirement of resident- in-training.

        e. To perform other functions & activities conferred by the BGH MC training office to carry

             out its objectives.

        f.   Members are the training officers or their representatives or the assigned consultants per

             department.



 4. The BGHMC Ethics Review Committee (ERC)

        a. A committee created by hospital order, dedicated to the rights and well-being of research

             subjects

        b. All research protocols must undergo review by this committee prior to start of study. A

             certification will be sent to the researcher to confirm ‘start of study.’

        c. A copy of the finished study must be submitted to the ERC for filing & recording purposes.

        d. To advise & recommend to the Chief Training Officer the completion of research paper

             requirement of resident- in-training.


Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011         46
Residents-in-Training Code of Discipline and Manual
                                                          Baguio General Hospital & Medical Center

              e. To perform other functions & activities conferred by the BGH MC training office to carry

                   out its objectives.

              f.   Members are selected by hospital order & are appointed to a 3 –year tenure




Research paper requirements


     1. As prerequisite to graduation/promotion, each Resident-in-training is required to submit AND

         present a scientific paper at a designated date during the academic year. These are presented

         during the Annual research paper contest.

     2. The trainee must choose his/her own Consultant/advise who may or may not be a co-author of the

         research paper. The trainee is guided by the assigned/chosen consultant from protocol making until

         the accomplishment of the final research paper.

     3. All research paper protocols should be submitted on time & presented to the BGH MC Ethics &

         Review Committee (ERC) AND The BGHMC Technical & Medical research Committee.

     4. All trainees are required to submit their presentation at least a week before their oral presentation

         to the Training office.

     5. Senior authorship goes to the main investigator who conceived the project/paper and gave the

         most intellectual contribution, protocol preparation, actual work, paper writing & final writing of

         the scientific manuscript.

     6. Co-authorship is the collaboration of researchers to combine the strength of different

         disciplines/departments to undertake research & do a scientific paper that neither could do

         individually. Co-authorship may be possible within a department if collaboration is done by

         different subspecialties. (Measuring interdisciplinary research: analysis of co-authorship for

         research staff at the University of York, Bioscience Horizons Volume2, Issue2 Pp. 99-112). Co-


      Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011           47
Residents-in-Training Code of Discipline and Manual
                                                          Baguio General Hospital & Medical Center

          authorship between trainees within the department & submitting the same paper individually as

          their requirement is inappropriate & is therefore discouraged.

      7. Research Assistants are the helpful trainees who are colleagues within the department who

          cooperated & collected data for another researcher. They are not counted as authorship/co-

          authorship of a scientific paper. They should be acknowledged as research assistants in the final

          writing of the scientific paper.


Paper submission schedule


      1. 1st year residents-in-training

             a. They are required to submit a case report which could be a rare disorder or disease; a

                 previously unrecognized syndrome or disease; a difficult case & managed successfully; an

                 innovation in treatment or surgery or a new surgical instrumentation or technique.

             b. They are required to submit & present their case report during the annual Case Report

                 Contest.

             c. Case Reports should be submitted as part of their renewal/reappointment requirements for

                 promotion to 2nd year residency training. Failure to submit this may delay promotion.

      2. 2nd year residents-in-training

             a. They are required to choose their consultant adviser for their research protocols.

             b. It is encouraged that research protocol submission & revision are done during this stage of

                 training. Quality research papers are well written, properly checked, tested over a duration

                 of time & has passed multiple reviewers.

             c. Experimental & semi-experimental research; Correlational research; Meta-analysis &

                 Systematic reviews are encouraged.




      Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011       48
Residents-in-Training Code of Discipline and Manual
                                                                 Baguio General Hospital & Medical Center

                  d. Descriptive studies may be done & accepted as long as it has statistical validity, it is scientific

                      & has medical impact.

                  e. An ERC approved AND Technical & Medical Research Committee approved research

                      protocol should be submitted as part of their renewal/reappointment & promotion to 3rd

                      year residency training. Failure to submit this delays promotion & results to retention

         3. 3rd year & 4th year residents-in-training

                  a. It is expected that during their final year of training, final collection of data & data analysis

                      for completion of research paper is accomplished.

                  b. Graduating trainees are required to submit & present their final research papers during the

                      Annual BGH MC Paper Contest.

                  c. Research papers should be submitted as part of their graduation/residency training

                      requirement. Failure to submit this in a designated time causes delay in the release of

                      training certificates & result to retention.


DISCIPLINARY MEASURES and SANCTIONS


    I.        Deficiencies


A trainee incurs a deficiency when he/she fails to meet a requirement of the training program at the

designated point of training


             i.    Deficiencies which are satisfactorily made up for by a trainee before the end of the year level

                   during which the deficiencies were incurred shall not be a cause for failure to be promoted to

                   the next level.

             ii. Deficiencies which are not satisfactorily made up for by a trainee before the end of the year

                   level during which the deficiencies were incurred may be a cause for delay of promotion to the



         Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011             49
Residents-in-Training Code of Discipline and Manual
                                                              Baguio General Hospital & Medical Center

                 next level. Other deficiencies may be made up at any time depending on department residency

                 training policies.

             iii. Deficiencies which are not satisfactorily made up for by a graduating trainee before the end of

                 the year level (during the last quarter of the year and/or during department deliberations on

                 the candidate’s graduation) shall cause delay of graduation.

             iv. Incurrence of deficiencies may be a consideration in disqualifying a trainee as candidate for an

                 award/honor/incentive. Similarly, such incurrence may be reason to withhold an

                 award/honor/incentive. No compensation will be given during the extension.


Remedial measures


These measures shall be implemented by the department AND the Training office concerned to address

deficiencies.


Examples of such measures are given below:


1) An extra research paper (separate from the training requirement)

2) A paper/report on a designated topic to be submitted to the TO & presented during a conference.

3) An extension of training, beyond the regular duration of the program, which may consist of the following:

        i)    Additional surgeries and/or patient consultations within the hospital or in an official rotation

        ii) Enrollment in courses/workshop similar in topic & coverage to those that were missed. An echo

              lecture shall be given to the department.

        iii) Attendance/participation in the specialty society CME activities

        iv) Participation in an outreach or in-hospital missions

        v) An additional 12-hour evening duties.

        vi) Weekend duties



       Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011           50
Residents-in-Training Code of Discipline and Manual
                                                                Baguio General Hospital & Medical Center

         vii) One-on-one tutorial with designated consultants which may include assisted surgeries/procedures

                & additional clinic duties with said consultants.

4) At no time shall the training of the resident in the regular program be compromised by the needs of a

   trainee in an extended program.

5) Trainees maybe required participation in courses that cover topics which the specialty department deems

   necessary to aid & assist the trainee’s complete development as a specialist. Educational courses may

   include the following:

         i)     Research production & Statistics

         ii) Attitude & personality development

         iii) Speech training

         iv) Stress management

         v) Computer skills development



   II.          Infractions

               i. These are violations of the BGHMC policies, Residency Training Code of Discipline & Manual and

                  departmental policies & guidelines. These are cited & recorded by the department consultant

                  staff AND reported to the BGHMC Training office.

              ii. Infractions are documented by incident reports and/or verbal statements reported &

                  documented at the BGH MC Training Office. The department AND the Training office shall act on

                  the complaint/infraction within 24 hours.

              iii. Any infraction/complaints against any resident shall pass through the BGHMC Training office.

              iv. Appeals for reconsiderations may be made through the appropriate channels as mandated by

                  hospital procedures (thru the BGHMC Training Office AND the Department TO).




         Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011          51
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents
BGH MC Manual for residents

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BGH MC Manual for residents

  • 1. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Training Office 2011 Baguio General Hospital & Medical Center Gov Pack Road Baguio City
  • 2. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Code of Discipline & Manual for Residents-in-Training Baguio General Hospital & Medical Center Title Page I. Vision, Mission, Objectives ………………………………………………………………………………. 3 II. Core values ……………………………………………………………………………………………………… 4 III. BGHMC History, Vision & Mission; The BGHMC logo …………………………………………… 7 IV. BGHMC Structure & Organizational Chart ………………………………………………………….. 15 V. The Resident’s organization …………………………………………………………………………….. 16 VI. Residency training programs …………………………………………………………………………….. 22 VII. General training guidelines & policies ……………………………………………………… 22 VIII. Requirements for residency training …………………………………………………………………. 38 IX. Job description of Residents-in-training ……………………………………………………… 40 X. Evaluation & Promotion of Residents-in-training ………………………………………………. 44 XI. Disciplinary Measures & Sanctions ………………………………………………………………… 49 XII. Certification & awards …………………………………………………………………………….. 58 XIII. APPENDICES ……………………………………………………………………………………………………. 60 Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 2
  • 3. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center INTRODUCTION Vision, Mission, Objectives of this Residents-in-training Code of Discipline & Manual a) VISION i) The Vision of this Residents-in-training Manual is to create a perfect guide which is appropriate, competent & adaptive to the changing regional needs and culture of specialty training & dynamic enough to meet the demands of technology change, innovations in management & medical advancement. b) MISSION i) To produce socially responsible, morally upright & medically competent resident graduates. ii) To provide a high standard of training that would equip residents-in-training with the skills, attitudes & knowledge that translates to quality medical service. iii) To assure an adequately prepared residents-in-training, competent enough to pass their specialty board exams iv) To lead & encourage residents-in-training to upgrade & uplift their discipline & specialty instructions beyond expected requirements. c) OBJECTIVES (of the Resident’s Manual Commission ) i) To create a manual of Residents-in-training that would contain policies, guidelines, protocols & regulations of accredited residency training ii) To publish a handy guide for residents-in-training iii) To serve as a code of discipline & reference for evaluating, promoting, sanctioning & certifying residents-in-training iv) To convene scheduled meetings for the Training Core of BGHMC & update and amend this Residency Training Code of Discipline & Manual v) To consult the various departments with regards their training requirements & update their policies. vi) To monitor competency of this training manual through regular training core/committee meetings Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 3
  • 4. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 2) Core values of this Residents-in-training Code of Discipline & Manual a) This code of discipline & training manual adheres to the BGHMC values of appropriate & accredited medical training for residents; produce quality research & provides selfless service to the community. b) This code of discipline & training manual follows Civil Service laws of the Philippines; and employs current, appropriate & updated human resource evaluation & promotion processes. c) This code of discipline & training manual molds residents-in-training to adhere & perform their duties & responsibilities in accordance with the highest standards of Philippine Medical Association Code of Ethics & respects specialty Society policies on residency training. d) This code of discipline & manual believes that academic discipline & excellence forms the very foundation of competent residency training. e) This code of discipline & manual upholds a commitment & dedication to life & improvement of health care. f) This code of discipline & manual affirms that respect & courtesy to superiors complete the highest form of personal excellence & sense of self worth. g) This code of discipline & manual recognizes a highly motivated & research-oriented residency training program as a means to cope with the advancing demands in medicine. h) This code of discipline & manual champion comprehensive quality health care through competent, evidence based specialty training. 3) Definition of terms a) Residents-in-training i) They are physicians who are duly licensed to practice medicine in the Philippines who have fulfilled admission requirements by the specific specialty department. ii) They are graduates of an accredited internship program & duly licensed by PRC to practice medicine. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 4
  • 5. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center iii) They may be temporary employees of the BGHMC & are required to submit departmental requirements annually for renewal. iv) They maybe rotator physician, observers, lateral entrants, NPE’s & PE’s, department scholars or Sponsored trainees & are required to submit departmental & hospital requirements (for reappointment/renewal). b) Non-purposive entry (50% BGHMC residency training plantilla) (1) Salaried residency position filled by up trainees in accordance to the standards set by BGH MC c) Purposive Entry( 50% BGH MC residency training Plantilla) (1) Salaried residency position filled up by residency training applicants coming from the underserved areas, who shall return to these areas after completion of their residency training d) Lateral entrants ( plantila from other hospital) i) Straight Residency (1) A MOA between the sending agency and the residency training applicant stipulating among others that the applicant shall serve the sending agency for at least two (2) years for every year of training. ii) Modular Residency (1) A MOA between the sending agency and the residency training applicant stipulating among others that the applicant shall serve the sending agency for at least four (4) years after the last year of training. e) Rotator Physician from other institution who have MOA with BGHMC i) This shall include physicians (foreign graduates) who have undergone clearance from the Professional Regulation Commission (PRC) and the Department of Health (DOH). f) Observers i) They are physicians or other professionals, and other individuals who are authorized by the sending hospital to observe facilities, procedures, tests, & other specific consultant expertise which are not available in the sending hospital. ii) They shall not participate, except to observe, in BGH MC. They shall not perform any procedure or operations; shall not make public opinions or interfere with patient care. iii) Their active participation during conferences & meetings shall be upon invitation/permission of the concerned staff members. iv) Shall have access to hospital documents only with the permission of the concerned department or unit. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 5
  • 6. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center v) Knowledge of his activities & whereabouts in the host institution shall be the responsibility of an assigned consultant/staff member. g) Active medical staff i) This comprises the Consultants (plantilla) fulltime & part-time consultants h) Medical Center Chief (MCC) i) Chief, Medical Professional Staff (CMPS) j) Chief, Training Officer (CTO) k) Training Core i) All Department Training Officer l) Selection, Promotion & Placement Board (SPPB) i) CMPS, CTO, Dept Chair ; HR m) Medical staff i) All consultants (all consultants including visiting consultants) & Residents in training n) House staff i) Residents in training o) Department Scholar i) Sponsored Resident (‘drug fellow’) (1) A MOA between the sending agency and the residency training applicant stipulating among others that the applicant shall render post-residency service. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 6
  • 7. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center BGHMC History, Vision & Mission; The BGHMC logo BGHMC History In July 1900, on orders of William Howard Taft, Head of the Second Philippine Commission, Dean Conant Worcester with three other companions set forth to discover a cold place up in the Cordillera...Baguio, the mountain paradise. An excellent vacation and recuperation center for government officials, employees and American soldiers, Baguio saw the establishment of a 15 bed hospital located at the site of the former Pines hotel in 1902 under Dr. H. Eugene Stafford. The rise of the Baguio Sanatorium heralded the beginning of a long history of what is to become the Baguio General Hospital & Medical Center. The need to have a medical facility that is low cost and accessible was envisioned early on in the city's history, so that as early as 1907, the building phase for the hospital began. When the project started, the vision and objective was clear cut: to provide high quality yet affordable service for the people of the city and the neighboring towns. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 7
  • 8. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center After being renamed Baguio Hospital in 1907, expansion proceeded in the construction of a Nurse’s Home and six 3-room cottages for Tuberculosis patients. In 1915, Dr. Silverio Garcia became the very first Filipino to assume hospital directorship. The hospital was turned over to the Bureau of Health. Several other Filipinos then took turns in handling the reins of the hospital. In 1937, with Dr. F. Esquivel as Director and Miss I. Francia as Chief Nurse, the name of the hospital was again changed to Baguio General Hospital. It was this year when construction of the main hospital building, promised earlier in 1930 by Pres. Manuel Quezon, started. It took 4 years after that cornerstone laying ceremonies by then Vice President Sergio Osmeña before the building was finally inaugurated on February 22, 1941. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 8
  • 9. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center During the latter part of the second world war, hospital operations transferred to the St. Louis High School building behind the Cathedral after the Japanese forces commandered the hospital building. In April 1945, the hospital closed due to heavy artillery fire and carpet bombardment. After the liberation in May 1945, the hospital was re-opened at Paules Frates, La Salle Compound in Legarda St., as the main hospital building had been severely damaged. The main hospital building was reconstructed with the aid of the Americans and the hospital was able to operate at the main building in 1948. The 35 bed Contagious Disease Pavilion further expanded hospital services in 1952. In 1955, the first BGH Advisory Board Officers were inducted with Mrs. Ethel Herold as the Chairman of the Board. The Board was conceived to help in improving operations as well as to act as liaison between the hospital and the community. In 1958, BGH, was designed as one of the 11 training hospitals in the Philippines. Training programs of the different departments began to take shape. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 9
  • 10. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Building construction and establishment of new services continued for the next 3 decades. The School of Nursing Bldg., OR complex, OPD bldg., and bunkhouse in 1962, Alumni Bldg. in 1963. In 1966, the Psychiatry, Physiotherapy & Brace Shop and Cancer Detection Clinic. It was in 1970 when the BGH was converted into a Medical Center and expansion continue unabated. Ac hapel in 1972, Family Planning Bldg., Coronary Care Unit in 1973. ER annex and CobaltTherapy Bldg. in 1977, X-ray annex in 1978, Under Six and Administration Bldg. In 1979, the Orthopedics & Traumatology in 1981. The Administration Bldg. was burned in 1985 and was rehabilitated in 1987. The 1990’s was ushered in by the killer quake on July 16, 1990. The earthquake damaged and caused the demolition of several hospital buildings. 14 other structures, including the main building, needed major repairs. Another disaster struck a year later during typhoon when a landslide damaged and flooded parts of the main building. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 10
  • 11. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center In 1992 BGHMC was the first in Asia to be awarded as the Mother and Baby Friendly Hospital Initiative (MBFHI) by the United Nations Children’s Fund (UNICEF) of which the breastfeeding program of the hospital became the prototype of the UNICEF. It was on May 26, 1995 that the Under Five Clinic of BGHMC was awarded National Wellness Award for Excellence by DOH Center for Wellness Program and GAWAD PAGASA on October 1, 2002 during the Civil Service Commission 102nd Anniversary. The hospital continues to expand in terms of physical structures and services. On September 17,2007, the first floor of the Flavier Building was occupied by the: Emergency Room Department, Ultrasound Area of the Radiology Department, Laboratory, Admitting Unit, Cashier; and the Pharmacy. The 2nd phase of transfer of services at the Flavier Building was done on October 8, 2008 of which the 2nd floor was occupied by the Pediatric Department; -while the 3rd floor was assigned by the Internal Medicine - including the Pay Consultation Offices. It was on the last week of March 2007, when the operation of the Psychiatry Department was transferred to the new Psychiatry Building. Public comfort rooms at the Flavier Building were made available on the 2nd quarter of 2008. Renovation of the old main building was completed on the first floor of the: OB Minor Operating Room Complex including the Labor Room; and the 2nd floor: Surgical Ward (left and right wings), Pediatric Surgical Ward, OR complex and the Recovery Rooms. The new Infectious Disease Building that was inaugurated on March 16, 2009 houses the OPD of the Psychiatry Department and the Drug Rehabilitation Unit. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 11
  • 12. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center It is the objective of the hospital to value the time of the patients/clients through the provision of a “one stop shop”, hence the old ER will be renovated to house the support services such as the: Cashier, Billing/PHIC; and Medical Records. Sub-specialty services are already being offered and all training programs are accredited by respective specialty societies. The Post Graduate Training Program (Nurse Fellow) for licensed nurses was instituted in 2004 and still ongoing. It was approved for 500 bed capacity through R.A 8634 of 1998 but due to manpower deficiencies the actual implementing is 400. To this day, BGHMC has continuously provided Comprehensive Quality Health Care, Training & Research not only to the City of Baguio but to the provinces of northern Luzon. BGH MC has continually aimed to be the model people oriented hospital and has remained true to this endeavor. (http://www.doh.gov.ph/bghmc/) Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 12
  • 13. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center BGHMC Logo Elements of the BGHMC logo The logo is divided into three (3) equal parts representing the three major divisions of the Baguio General Hospital & Medical Center: the Medical Division, the Nursing Division & the Administrative Division. The Human icon represents the Administrative division; it also gives an insight of a family which is the focus of comprehensive quality healthcare, training & research. The cadecues is the symbol of the medical profession: a winged herald ’staff with two snakes wrapped around it. The nurse cap represents the nursing division. The façade of the main building represents the health facilities & services which BGHMC was created for. The outer circle contains the name of the hospital - Baguio General Hospital & Medical center - & the date when the hospital was founded while the inner circle points to the agency & the region where BGHMC belongs. The circle further symbolizes infinity, without beginning or end an idea of unending services & support committed to the community BGHMC serves. It symbolizes a perfect framework, a world where BGHMC shares. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 13
  • 14. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center MISSION “Provide Comprehensive Quality Health Care, Training & Research” In the realm of the Northern Philippines… We are the hospital of the people dedicated to serve the healthy & the sick, that provides high quality standard of specialized but holistic health care in the atmosphere of compassion, comfort, & social understanding. We are committed to the betterment of the people of Northern Philippines through public health activities, & through involvement in health policy formulation & coordination with other institutions with similar interest. As a hospital of the people, we shall be open, resourceful, fair & efficient in the sourcing, allocation & utilization of resources entrusted to us by the people through effective management, & to the equitable delivery of basic & specialized health services through cohesive, satisfied, goal driven, values-oriented & highly motivated employee staff. We shall offer comprehensive & excellent training in the medical & paramedical fields as we strive to keep pace with the advancements in the technological knowhow, and do our share as we indulge in clinical & hospital management research. VISION “BGH MC : A Model People Oriented Medical Center” In the realm of the Northern Philippines… We are a model institution of health maintenance that provides comprehensive, high standard, equitable, compassionate, holistic, specialized health care that continually strives to be competitive in technological capability and competence. We are a model government institution in terms of financial stability, resource management, bureaucratic flexibility & transparency, operational efficiency & personnel satisfaction. We maintain our status as the best provider of medical & paramedical human resource development relevant & to become an academic institution that is also noted for clinical & hospital/management research. We shall be a major force in regional health policy formulation & health manpower development as we maintain our role as the premiere health referral center of the area. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 14
  • 15. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 4) BGHMC Structure & Medical Organizational Chart a) Residency Training Organizational Structure (2012 Training Office format strategy) Medical Center Chief Chief, Medical Professional Staff Chief Training Officer Training Department Committees Chairperson Department Research Training Officer Residents-in- ERC training Post-graduate Training Core interns &clerks 5) Strategies to achieve objectives (2011-2013) of the Resident’s Manual Commission a) Standardized training manual b) Strict code of discipline c) Enhancing Quality research activities d) Effective communication of the various training programs & the BGHMC Training office e) High standard of patient care f) Training highly competent & proficient specialist g) Disseminating specialty knowledge to allied medical workers. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 15
  • 16. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center The BGH MC Resident’s Organization Constitution & By-Laws of the BGH MC Resident’s Club In accordance with the rules and regulations of Baguio General Hospital and Medical Center, the officers of the Resident’s Club 2010 hereby promulgates this Constitution and Bylaws. Section 1. Name of the Organization This Organization shall be known as The Residents Club, the official organization representing the Resident Physicians of BGHMC. Section 2. Location of Office The domicile and principal office of the Residents Club shall be at the Baguio General Hospital & Medical Center. Section 3. Objectives The Residents Club shall be the supreme organization promoting and defending the Rights and Welfare of all Resident-Physicians-in-training in BGHMC and specifically: a. Serve as the liaison organization between the Residents and the BGHMC Administration b. Serve as a model for the Senior Interns and Junior Interns also in training in BGHMC c. Promote among its members responsibility, discipline, honesty, camaraderie and the other values that the BGHMC upholds. d. Assist the Administration and the DOH regarding information drive; public health concerns; and other activities that the organization may be of help. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 16
  • 17. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Section 4. Members All Resident Physicians of BGHMC who are accepted in the Residency Training Program of the different departments automatically becomes members of the Residents Club. Section 5. The Residents Club Officers a. The officers of the Residents Club shall be composed of Residents-in-training who have been duly elected by its members through a popular vote except for the position of the President b. The President of the next organizational year shall automatically be the President – Elect of the current organizational year- c. The President Elect shall be a junior of the current batch of Residents-in-training. d. The Adviser/s shall include Consultant-Physicians of the BGHMC whom the officers shall elect. e. Any vacant positions shall be filled in by appointees of the current President of the Organization Section 6. Removal or Disqualification Any member is subject for removal or disqualification from the Residents Club Officers on any of the following grounds: a. He/she has shown gross neglect of duty in the performance of his/her duty. b. He/she has committed an act that is detrimental to the integrity and dignity of the organization. c. He/she deliberately violated any of the provisions in the Constitution and Bylaws. d. A member shall cease to be part of the organization in the following cases: (1) after the approval of his/her resignation; (2) Termination from the Residency Training Program (3) misrepresentation of the Residents Club. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 17
  • 18. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Section 7. Organization The Residents Club Officers shall be composed of the following: a. President b. President-Elect c. Secretary (2) d. Treasurer e. Press Relations Officer (2) f. Events and Affairs Manager (2) g. Adviser/s The Adviser/s shall include Consultant-Physicians of the BGHMC whom the officers shall elect. Section 8. Duties and Responsibilities a. President 1. Supervises the activities of the entire organization 2. Calls and presides over meetings involving the activities of the organization 3. Comes up with the final decision in consultation with the adviser/s in case the members are divided in certain matters; and 4. Informs and reminds the officers of the stipulations embedded in this Constitution and Bylaws. b. President - Elect 1. Assists in carrying out the functions of the President; 2. Assumes the responsibility of the President in his/her absence or inability to carry out such responsibilities; 3. Manages all outreach missions to be attended by the members of the organization. 4. Prepares a plan of activities of the Resident’s Organization for the incoming year. c. Secretary 1. Keeps all supporting documents and records regarding meetings and activities of the organization. 2. Prepares reports/papers needed by the organization & submits a copy to the Training Office 3. Takes the minutes of the meeting Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 18
  • 19. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 4. performs other functions as deemed necessary d. Treasurer 1. He/She shall take care of collections and management of logistics of the organization 2. Prepares the statement of the operations and other relevant financial reports before the end of his/her term 3. Makes an audit on the statement of operations and other financial statements. e. Press Relations Officer 1. Coordinate with the Administration and other offices in connection with relevant organization activities 2. Assist in information dissemination to members regarding activities participated by the organization 3. Shall manage/coordinate activities regarding information drive and Public Health Teaching 4. Performs other functions as deemed necessary. f. Events and Affairs Manager 1. Coordinate with other officers regarding planning and execution of organization’s activities 2. Performs other functions as deemed necessary. Section 9. The Adviser/s The Adviser/s of the Residents Club shall have the following duties and responsibilities: a. Serve as the liaison officer/s between the Residents Club and the BGHMC Administration b. Provide guidance on matters pertaining to duties, welfare, activities, and legal affairs c. Assist the President regarding disputes among decisions of the members of the organization. Section 10. Election Section 10.1 An annual election of officers shall be conducted during the second quarter of each year Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 19
  • 20. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Section 10.2 All resident physicians-in-training are allowed to run in any position they are qualified Section 10.3 The following positions may be applied for: Section 10.3.1 One (1) Vice President Two (2) Secretaries One (1) Treasurer Two (2) Press Relations Officer Two (2) Events and Affairs Managers Section 10.3.2 Those running for the position of Vice President should be a junior resident of the Residency training program of their respective Department (and become the President – elect) Section 10.4 Winners will be determined through a popular vote by the members of the organization Section 10.5 Newly elected officers shall assume office only after proper endorsement by the immediate past organization officers Section 11. Residents Club Operation Time Frame The operation of the Residents Club shall start upon the recognition of the organization by the BGHMC Administration. Section 12. Amendments The Constitution and Bylaws can be amended anytime as deemed necessary by a majority vote of the total number of members of the Residents Club Officers and made effective upon submission to, consultation with, and approval of the proper BGHMC Administration. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 20
  • 21. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Section 13. Separability Clause Should any provision of this policy be declared invalid, the other provisions, so far as they are separable shall remain in force. Section 14. Effectivity Clause This Constitution and Bylaws shall take effect immediately upon approval of the majority vote of the members present and the proper BGHMC Administration. Upon approval, this policy shall cover all Residents Club transactions. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 21
  • 22. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center The BGH MC Residency Training Programs BGH MC is a tertiary medical center that provides quality healthcare to all. BGH MC is a training institution for the following accredited residency training program. i) Department of Surgery ii) Department of Internal Medicine iii) Department of Pediatrics iv) Department of Obstetrics & Gynecology v) Department of Orthopedics vi) Department of Otorhinolaryngology – Head & Neck Surgery (ENT-HNS) vii) Department of Ophthalmology viii) Department of Psychiatry ix) Department of Radiologic Imaging x) Department of Pathology xi) Department of Anaesthesiology General guidelines & policies for Residents – in –training GUIDELINES: (1) The purpose of residency training shall be to provide a well-rounded, ethical, updated & relevant specialty training that shall develop the necessary skills, competence, compassion, knowledge & attitudes to prepare residents-in-training for specialty board certification. (2) The Resident-in-training shall follow the rules, policies & guidelines of this Resident Code of Discipline & Manual as well as specific departmental policies. (3) The Resident-in-training shall be governed by the policies of the Civil Service, Professional Regulation Commission (PRC) & Department of Health (DOH). (4) The Resident-in-training shall be subject to performance evaluation by the specific department AND the requirements set forth by the BGH MC Training Office. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 22
  • 23. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center (5) The Resident-in-training shall be subject to certain BGHMC benefits & privileges as well as the sanctions & disciplinary measures set forth by this residency training code of discipline & manual. (6) All graduates of the BGH MC Residency training program are encouraged to take the certifying examination given by their respective specialty boards within two (2) years following completion of training. Official Working Hours & Duties 1. Resident trainees are not covered by Republic Act 5901 (40-Hours a Week Law). 2. Due to the nature of the medical services, trainees may be on-call at any time. 3. All residents-in-training are mandated to attend the flag ceremonies every Monday. All trainees are expected to be at the main entrance of the BGH MC, every Monday at 7:30 am. 4. The regular working hours on Mondays to Fridays is from 8am to 12nn and 1pm to 4pm, unless otherwise required by department. Regular working hours during Saturdays is from 8am to 1pm. During Sundays & holidays, working hours are from 9am to 11am. 5. Residents-in-training who are on 24 hour duty are required to report to their post from 8am to 8am the following day. Residents will return to their regular working post after their 24 hour duty. Trainees are only allowed to leave their post after proper endorsement of ward/hospital duties to their colleague on 24-hour duty. Frequency of 24 hour duty should not be less than every two (2) days. 6. All departments shall submit to the Training Office & the CMPS a schedule of duties of the Consultant & the Resident Trainee for the coming month at least seven (7) days before the last day of the current month. Substitution of duties is discouraged. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 23
  • 24. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 7. In case of illness or other life-threatening emergencies, the trainee shall notify the department chairperson and the department training officer. The TO shall make the proper arrangements for substitution of duties. Standard Hospital attire 1. Residents-in-training shall be neat and well groomed at all times during the performance of their medical duties. 2. Residents-in-training shall wear the institution’s prescribed attire appropriate for conferences, surgeries (surgical gown, scrub suits), and the performance of department & hospital activities (white smock gown/white blazer). Revealing attire, inappropriate facial makeup & hair dyes shall be discouraged. 3. DRESS Code of all BGHMC Employees (Hospital Memorandum 2010-010; CSC Memo Circ no. 14, s.1991; DOH Dept Memo nos. 2008-0075 & 2008-0075-A) a. Dress Code of the CSC MC No.14.s.1991 PROHIBITS the following: i. Party attire, picnic clothes, sandos, t-shirt (no collar), tight fitting, seductive, micro-mini & gauzy/transparent dresses (by female personnel) ii. Walking shorts, pedal pushers, leggings, tights, jogging iii. Too much costume jewelry, flashy bangles & similar accessories iv. Ostentatious display of expensive jewelry v. Slippers, sandals, step-ins & bakya b. DOH Department Memo Nos. 2008-0075 & 2008-0075-A (circularized under Hospital Memorandum No. 38 s. 2008 issued on August 27, 2008) i. “officials & employees who consistently fail to wear the official DOH uniform shall be subjected to appropriate disciplinary action for violation reasonable office rules & Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 24
  • 25. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center regulations per Section 12, Rules XIV; Discipline of the Civil Service Law & Rules. An employee fails to wear his/her uniform at least ten (10) times in a month for two (2) consecutive months , is considered habitually disobedient hence can be subjected to disciplinary action by the Head of Office. 1. In addition to above rules, residents –in – training are required to wear their smock gowns/white blazers & their hospital IDs during hospital/department conferences; during ward rounds & during consultation/work at the out-patient department. 2. Residents –in-training of the Department of Anesthesia, Surgery, Obstetrics & Gynecology, Orthopedics, Ophthalmology, Otolaryngology-Head & Neck Surgery, & Pediatrics & Internal Medicine shall wear their prescribed scrub suit/operating room uniform when performing their OR tasks/duties. They shall wear this ONLY inside the Operating Room & other specialized areas (LR/DR/Nursery). a. Residents-in-training shall use at all times the BGH MC official identification cards, provided by the HR, worn in the prescribed manner, for the safety & security of hospital staff & clients. b. The use of personal ornamentation & unnecessary accessories during work hours shall be discouraged as these may interfere with efficient & safe management of patients. c. Hair styles should not interfere with the maintenance of sterility and cleanliness during ward rounds/clinical duties/procedures/surgeries. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 25
  • 26. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Policies on Proper decorum & conduct The Residents-in-training shall behave professionally at all times. They shall carry out their duties efficiently & faithfully. 1. All DOH, BGHMC, specialty society, department memos, guidelines & policies, rules & regulations shall be observed. In case of conflicts, resolution shall be clarified by the BGH MC Training Office. 2. Courtesy, respect, consideration and understanding to all shall be encouraged. 3. Public humiliation/reprimand of any hospital personnel for discourtesy, inefficiency or neglect of duty shall not be allowed. Such actions shall be reported to the appropriate office concerned. 4. The Medical staff shall be treated with utmost respect. Complaints/grievances shall be directed to appropriate offices for actions. 5. Comments about other physicians/institutions and their clinical/surgical management shall not be made in the presence of patients & non-medical individuals to avoid misinterpretations. 6. Information on patients shall be kept confidential. Documentation in whatever form or medium that may reveal a person’s identity shall not be made public without the attending consultant’s/patient’s/guardian’s/ nearest kin’s consent. 7. No information regarding training-related incidents and unusual events shall be given to anyone without prior approval of the Department/office concerned. Inquiries on major decisions regarding patient’s status/management shall be referred to the consultant-in-charge at all times. Trainees shall not give unauthorized statements, interviews, or medical bulletins regarding status of the patient. 8. Examination of patients & performance of procedures shall be done in accordance with the clinical practice guidelines established by the department AND only after proper explanation with properly obtained consent of patient and/or responsible relative. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 26
  • 27. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 9. Patients requiring examination in a closed room by a Resident-in-training shall be accompanied by a co-trainee/nurse/staff member of the same sex as the patient. 10. Trainees may assist in the care of private patients, either admitted or in the clinic. However, they shall not be allowed to handle the care of such patients without consultants consent and/or supervision. 11. Unruly/inappropriate behavior shall not be tolerated. As much as possible, speaking shall be kept at levels comfortable to normal hearing. Obscene, profane or abusive language shall not be permitted. 12. Alcoholic intoxication, gambling & smoking shall not be allowed within hospital premises. 13. Illegal possession, distribution and/or illicit use of narcotics & dangerous drugs are prohibited. 14. Illegal possession of firearms & deadly weapons is prohibited. 15. Acts of perversion, lasciviousness, & sexual harassment shall not be allowed in any place of training 16. When attending to a critically ill or dying patient, training staff & trainee shall be calm & collected. They shall observe caution in their communications with the patient/relatives to avoid causing alarm, misinformation, misinterpretations or undue stress. 17. Personal matters shall not influence or compromise residency training, care & service to patients. 18. Trainees shall not engage in private medical practice. They shall not accept or charge medical and professional fees from anyone. 19. Use of instruments, equipment, & appliances on patients shall not be for personal financial gain. 20. Trainees shall not give unauthorized lectures/teachings activities outside of their respective departments. 21. In unusual circumstances, residents-in-training may remain beyond scheduled duty to continue to provide care for a single patient; justifications are limited to required continuity of care for a patient who is severely ill or whose condition is unstable, academic importance, or humanistic attention to the needs of a patient or family. This should be understood as an attempt to balance concerns and to Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 27
  • 28. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center teach residents to learn their own limits and not to be criticized as the limitation as being harmful to doctors' education leading to less-skilled physicians. (ACGME 2011) Hospital Training Activities a. Attendance in hospital activities shall be given due importance as provided for by the hospital’s training policies. All trainees are required to attend hospital conferences. ONLY those detailed at the ER/OPD, performing surgery at the OR or those attending to seriously ill patients are excused from the hospital conferences/activities. b. Trainees shall come on time for these activities. Attendance shall be checked by the BGHMC training office. An infraction maybe incurred may be for unexcused late arrival in a required hospital activity. i. Hospital Grand Rounds 1. A formal monthly meeting activity held every last Monday of the month, involves medical education and inpatient care, consisting of presenting the medical problems and treatment of a particular patient to an audience consisting of consultants, residents, and medical students. 2. A senior resident discusses the clinical case of one or more patients. This is where new information is taught and clinical reasoning skills are enhanced. They are an integral component of medical education & residency training. They present clinical problems in medicine by focusing on current or interesting cases. ii. Research Paper Contest 1. Held annually during the 2nd week of December of every year. 2. The Technical & Medical Research Committee shall create policies & guidelines with regards this activity. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 28
  • 29. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 3. All graduating residents MUST submit their entry on the last week of October at the Training office. iii. Case Report Contest 1. Held annually during the first week of December of every year. 2. The Technical & Medical Research Committee shall create policies & guidelines with regards this activity. 3. All first year residents are required to submit their entry on the last week of October at the Training office. iv. Research Lecture Series 1. Held every other month & are scheduled during weekends. 2. All residents-in-training are required to attend all lectures (6 meetings) 3. Lectures may include: a. research designs: held during the last weekend of January b. research protocol writing: Held during the last weekend of March c. research/journal appraisals: held during the last week of May d. statistical analysis: held during the last week of June e. how to read journals: held during the last week of August f. how to use scientific articles: held during the last week of October v. Hospital Week Activity 1. Held every August 6 – 12 of every year (department circular 2010-0233) 2. Activities related to the theme provided by the DOH 3. Health Research related contest maybe held during this week. vi. Hospital Research Week Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 29
  • 30. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 1. Held during the first week of December every year 2. The ERC & the Technical & Medical research committee shall create the guidelines & policies with regards this activity. 3. This activity shall encourage academic excellence in healthcare research 4. It shall promote interaction between clinicians and other medical allied personnel in the hospital 5. It shall provide opportunities for researchers in different disciplines (scientific, clinical, nursing and allied health) to present their work at the same forum 6. Outputs during this activity shall contribute to evidence-based healthcare 7. This activity highlights the range of research technologies and resources that draw the various departments of the hospital together. 8. The annual residents’ paper contest & case report contests, poster contests, medical & surgical innovations & instrumentations contest are held during this week. 9. This will also be the venue of the elections of the next batch of BGHMC residents’ organization. 10. All research output for the year shall be included & published in the BGH MC Annual Research journal. vii. Midyear Review 1. Shall be held annually during the first week of July of every year 2. This shall be a formal presentation by the BGH MC Residents Organization of their activities during the first half of the year. 3. This activity shall also recognize the achievements of ALL residents-in-training. 4. This activity shall be organized jointly by the BGH MC Training Office & the BGH MC Residents Organization. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 30
  • 31. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center viii. Resident’s Forum (Year End Report) 1. Shall be held annually during the first week of December of every year 2. Shall precede the Resident’s Recognition Activity 3. This activity shall be a formal presentation & endorsements of the outgoing officers of the BGH MC Resident’s Organization. 4. Research & Training outputs; Financial status, etc.. shall be presented by the BGH MC Residents Organization during this activity. 5. This activity shall be organized jointly by the BGH MC Training Office & the BGH MC Residents Organization. ix. Resident’s Recognition 1. Shall be held annually to recognize deserving graduating trainees. 2. This activity shall immediately follow the Residents Forum 3. The Activity shall be jointly organized by the BGH MC Training Office & the Residents Organization. x. EBM hour 1. Held every other month & are scheduled during weekends. 2. All residents-in-training are required to attend all lectures (6 meetings) 3. Lectures may include: a. PICO format & the clinical question : held during the last weekend of February b. Writing your own research protocol : Held during the last weekend of April c. Your personal CAT bank : held during the last week of June d. NNT’s; SPins & SNouts : held during the last week of July e. Likelihood ratios : held during the last week of September f. EBM in your department : held during the last week of November Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 31
  • 32. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center xi. Inter-department conference 1. Held at any time, when at least two (2) departments hold a joint conference. xii. Department training activities 1. Journal club appraisal a. Presentation & discussion of selected journal articles by trainees, moderated by assigned consultants & held at least once a month. b. Journal articles are properly appraised & copies are sent to the all department staff & trainees at least one week before the presentation. 2. Staff meeting 3. Morbidity/Mortality Review and/or Audit 4. Case Conference 5. Research discussion 6. Resident’s hour 7. Specialty national conventions & postgraduate courses Medical & Surgical Procedures All residents-in-training shall be familiar with basic medical procedures & the hospital’s guidelines & policies related to each procedure. i. IV/IM injection; insertion of IV, NGT & IFC, Skin test interpretations, wound dressing ii. All residents-in-training shall be familiar with the hospital’s/department’s protocols in handling & disposal of hazardous materials/equipments. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 32
  • 33. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center Court Call 1. All residents-in-training are required to respond to Court calls. 2. Trainees, usually the resident-in-charge are summoned by the court of law to appear as the witness, who by virtue of medical education, specialized training, medical or surgical skill or experience, is believed to have expertise and specialized knowledge in a particular subject beyond that of the average person, sufficient enough that others may officially and legally rely upon the witness' opinion about an evidence or fact issue within the scope of his expertise. 3. Once the resident-in-charge has graduated and/or no longer connected with the BGH MC, the chief resident will answer the court call. Resuscitation 1. All residents-in-training shall be familiar with resuscitation techniques & the BGHMC’s guidelines on activating & performing a Resuscitation Code 2. All residents-in-training shall have training on Basic Life Support (BLS) & Advanced Cardiac Life Support (ACLS) Interdepartmental Referral System 1. All residents-in-training shall attend to referrals. 2. Referrals regarding medically/surgically unstable patients, or patients with life-threatening conditions shall be considered STAT. 3. All residents-in-training concerned must respond to STAT! referrals immediately. For non-urgent referrals, residents shall respond & answer the referral within twenty-four (24)hours 4. To facilitate immediate response to the referral/s, the department shall establish a flowchart with regards the hierarchy of responders , which shall be known & understood by other departments. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 33
  • 34. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center a. ER referral – ER physician on duty shall respond first. The more senior resident / subspecialty resident shall be summoned as the need arises. b. Interdepartmental referral c. Other departments d. Subspecialty referral – resident in charge of the subspecialty shall respond e. resident on duty (if referral was done after 4pm) f. any resident – if referral was done during office hours (8am to 4pm) g. a hospital / department locator chart may be required for each department or area h. If after several attempts to contact the resident fail, the PAGING SYSTEM will be utilized to summon the resident responder. Patient - related responsibilities 1. All residents-in-training shall strictly conform to the BGH MC Medical Records Committee policies on documentation & charts. 2. Use of rubber stamp (Trodat) is mandatory whenever the Resident- in- training signs any document. 3. All residents-in-training are required to read & understand the Patient’s Bill of Rights. 4. All patients consulting at the ER & OPD must be seen personally by ER physician/OPD physician/any physician of the department concerned. For subspecialty cases, the subspecialty resident rotator concerned must be notified for final disposition. 5. The resident trainee shall be responsible for all his/her orders & prescriptions that he/she signed. Patient’s charts 1. This shall be completed upon discharge (Clinical history & PE, OR technique, Discharge instructions, HAIR, etc..) 2. No part of the chart shall be removed. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 34
  • 35. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center a. Chart orders i. Entries shall always be clear & legible ii. Date & time shall always be included iii. Only internationally accepted abbreviations & terms shall be used iv. All entries shall be signed by the trainee (printed name/TRODAT & below the signature). v. The resident trainee shall ask the Consultant –in-charge to sign the chart prior to discharge. vi. The use of white ink/erasures are not allowed. Changes in chart orders shall be written as new entries. Wrong entries, may be superimposed with one line & counter-signed &/or labeled as “error.” vii. New entries shall be immediately & clearly endorsed to the Nurse-on-duty viii. Discharge Orders shall include discharge instructions; home medications, date of follow-up & patient education. b. Phone orders 1. All residents-in-training are not allowed to give orders by phone except in situations where any delay may cause harm/compromise to the patients 2. Phone orders (if allowed by the department) should be countersigned within one hour c. Verbal orders 1. All residents-in-training are not allowed to give verbal orders except for situations allowed by the department 2. All verbal orders (if allowed by the department) should later be written in the chart & countersigned within one hour. d. Discharge summaries i. These shall be the responsibility of all residents-in-training ii. These shall be completed upon patient’s discharge Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 35
  • 36. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center iii. Patients and/or their guardians are required to sign on the physician’s order sheet upon receipt of a copy of the discharge summary. iv. It shall contain clearly written discharge plan and home instructions for the patient/caregiver for proper use/conduct of medications, therapies & supportive measures at home.. e. Clinical abstract i. Clinical abstracts shall be accomplished by the resident-in-charge/ resident-on-duty as required in the following cases: a. PCSO / PDAF request for medical financial assistance b. Transfer of patient to another hospital c. For insurance/medical benefit claims (SSS, GSIS) f. Medical certificates i. For discharged patients, the medical certificates shall be prepared by the Medical Records section & signed by the resident-in-charge ii. For In-patients, the resident in charge/ward resident shall prepare and then sealed by the Medical records section. g. Medico-legal certificates i. ER resident shall issue temporary/provisional medico-legal certificates & accomplished in two copies (one copy attached to the ER blotter; another copy issued to the patient and/or police officer). Final medico-legal certificates shall be released by the medical records & signed by the ER resident. h. Birth certificates i. The birth certificate shall be accomplished by the nurse & signed by the resident –in- charge as soon as possible. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 36
  • 37. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center i. Death certificates 1. All residents-in-training shall expeditiously accomplish and sign the death certificates. 2. All residents – in-training shall be oriented with regards filling up of Death certificates. J. Out-on-Pass 1. PHIC patients are not allowed to go out-on-pass. 2. All residents-in-training shall be aware & should be oriented with regards hospital policies regarding out-on-pass (24 hours only; patient signs waiver). Patient conduction 1. Resident/s shall accompany patient for diagnostics outside of the hospital 2. For hospital transfers (within or outside city boundaries), the resident shall accompany patient & the travel shall require a hospital order. Travel Insurance is included in the hospital order. Hospital property related responsibilities 1. All residents-in-training are responsible to all hospital documents, equipments, and other property & shall take care of hospital properties as their own as stated in the institution’s rules & regulation. Department related responsibilities 1. All residents-in-training are required to attend ALL department conferences. 2. All residents-in-training shall familiarize themselves with the proper use & care of department documents/forms as well as equipments & facilities 3. They shall use the equipments / facilities / official department forms only for their intended purposes unless otherwise allowed by the department chairperson. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 37
  • 38. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 4. They shall not remove from the hospital premises any department-owned teaching aids, research materials, instruments, office equipment/furniture/supplies without permission from the department chairperson. Staff related responsibilities 1. All residents-in-training shall strive to work harmoniously with other staff member. 2. All residents-in-training shall strictly observe hospital rules on safety so as not to jeopardize his/her health as well as that of the staff members. 3. All residents-in-training shall agree to a physical examination & other necessary tests at any time, to ascertain physical & mental fitness & capability to undergo training & duties in a hospital setting. The consultant staff of the department shall determine the need for the necessary tests. 4. All residents-in-training shall receive, except when contraindicated, the necessary vaccinations to prevent/minimize the risks of acquiring & spreading certain diseases to others. 5. All residents-in-training shall make known to the department chairperson/TO any disease contracted during the time of training for appropriate action. Requirements for Residency training application & appointment GUIDELINES: 1. The Department concerned shall receive the application letter & all required documents for residency training applicants. 2. The Department shall screen the applicants & then recommend to the SPPB the selected candidate/s for training. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 38
  • 39. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 3. The BGH MC SPPB shall recommend to the Medical Center Chief the approval of the appointment of the Residency training applicant. 4. Applicants accepted for training shall read, understand & sign the following: a. A statement attesting to the Trainee’s having read & understood this Residency Training Code of Discipline & Manual; has attended the orientation for new Residents-in-training; and has fully understood the specific policies of the specialty department. (Appendix) b. A one – year contract (renewable) for Trainees upon their appointment (Appendix) c. Shall receive a copy of this Residents-in-training Code of Discipline & Manual. 5. Applicants approved for appointment, rotation, residency training, observation, lateral entry or department scholar/sponsored trainee shall complete the requirements needed by the Human Resource Office AND the BGH MC Training Office within 30 days. 6. Residents-in-training shall be appointed for a year based on criteria recognized by the department AND the requirements set forth by the BGHMC Training Office. Residents-in-training shall apply for renewal annually. 7. Residents-in-training shall repay/reimburse the government all salaries & allowances received if he/she resigns without valid reasons during the first two years of training. REQUIREMENTS (for BGH MC residents – in – training) a. Diploma from an accredited & recognized medical school in the Philippines or abroad b. PRC license (updated/latest photocopy) c. Board certificate from the PRC d. PRC Board rating or RA 1080 certificate e. Certification of PMA membership & local component society f. Certification of completion of (senior) Internship from an APMC recognized hospital or its equivalent. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 39
  • 40. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center g. Certificate of good moral character from the medical school h. Recent 2x2 colored picture (3 pieces) i. Letter of intent j. ACLS / BLS certification k. Completed Personal Data sheet l. Transcript of records (certified true copy) m. Community tax certificate n. NBI clearance o. Medical certificate & Neuropsychiatric clearance p. MOA from the sending hospital/agency/office/sponsor* q. Copy of CME policies/training policy of sending hospital/agency/office/sponsor* *for non-plantilla appointments Job description of Residents-in-training The position of the resident-in-training involves a combination of supervised and independent patient evaluation and management function, formal medical/surgical educational and research activities. Provision of care provided by the resident-in-training is commensurate with the trainee’s level of advancement and competence, under the general supervision of appropriately privileged attending teaching staff. 1. ROLES, FUNCTIONS & DUTIES: 1. Participates in safe, effective and compassionate patient care 2. Demonstrates an understanding of ethical, socioeconomic and medical/legal issues that affect graduate medical education Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 40
  • 41. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 3. Applies cost containment measures in the provision of patient care 4. Participates in the educational activities of the training program, and, as appropriate, assumes responsibility for teaching other residents and medical interns & students 5. Participates in research activities as required by the Training Program 6. Participates in BGH MC committees and other tasks as assigned 7. Should undergo accredited Basic Life Support training or ACLS renewal 8. Maintains / renews physician licensure 9. Performs duties in accordance with the established practices, procedures, and policies of the BGH MC residency programs 10. Attends specialty societies postgraduate courses & activities 2. CORE Competency 1. Organizational Commitment 2. Integrity 3. Quality service focus 4. Teamwork 5. Stewardship of Resources 6. Attention to communication 7. Self-development Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 41
  • 42. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 3. Functional Competency Profile 1. Knowledge i) It is important for resident trainees to have good decision-making and customer service skills, as they must deal with patients on a daily basis. ii) Being amiable and working well under pressure, resident physicians should be emotionally stable, analytical and self-motivated. iii) Excellent oral and written communication skills are required iv) ability to work efficiently in teams v) Residents should also have strong leadership skills, since they may serve as mentors to medical interns & medical students. 2. SKILLS i) Clinical diagnosis ii) Disease/medical indicators & treatment iii) Drugs & medicines iv) Diagnostic procedures v) Occupational hazards & safety standards practices vi) Computer software applications vii) Research Trainees should be cognizant & internalize the National Drug Policy and Generics Law, Cheaper Medicine Law, Medical Act of 1959, PMA Code of Ethics & Patient’s Bill of Rights. 4. Behavior (i) Managing performance (ii) Building a successful team (iii) Building strategic working relationships (iv) Building trust (v) Planning & organizing Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 42
  • 43. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center (vi) Decision making (vii) Work standards 5. Motivation - Job has opportunities for: (i) High responsibility/accountability (ii) Achievement (iii) Challenging work 6. Key result Area a. Medical examination & diagnosis b. Patient treatment & care management c. Patient’s medical documents d. Monitoring & evaluation of patient’s health e. Research Job description of Residents-in-training (as defined by the Civil Service Commission for Medical officer III) 1. Attends to emergency calls on field. 2. Performs medical examinations and requests for diagnostic work-ups or laboratory examinations as needed to diagnose health ailments. 3. Assists and/or performs surgical operations within own limitations as determined by the Chief of hospital or Head of Department. 4. Conducts daily rounds to observe the progress and condition of patients. 5. Prescribes medicine and treatment procedures and techniques within his/her field of specialization. 6. Seeks information for treating difficult and complicated medical cases through consultation with supervising officers. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 43
  • 44. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 7. Disseminates information during medical conferences. 8. Accomplishes relevant medical documents such as clinical records upon admission and discharge of patients, as well as medical, legal, birth, or death certificates. 9. Educates medical and paramedical students, and trains and mentors medical students, externs, and intern physicians on a particular field of medicine. 10. Conducts and participates in hospital research projects. 11. Performs other related functions as may be assigned. Evaluation & promotion of Residents-in-training Department’s semi-annual evaluation report 1. The performance of the trainee will be evaluated by all department consultants or to the consultant (subspecialty rotation) to which they are assigned. 2. Trainees are given formal written & oral examination semi-annually. Results are given to the Training Office. 3. Final results/grades of the oral & written examination together with their Performance Evaluation Sheet (PES) & other pertinent department and hospital requirements are submitted to the Training Office. The department chairperson, the department Training Officer & the Chief Training officer jointly recommends satisfactory evaluation results to the Medical Center Chief for reappointment. Remedial measures are given to unsatisfactory/failing results. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 44
  • 45. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center BGHMC TRAINING OFFICE COMMITTEES 1. The BGHMC Training Core (Standards & Quality Residency Training Committee) a. Each department shall form their own training core who report to the BGHMC training core b. A committee created to guarantee that all residents-in-training comply & act in accordance to the contents of this code of discipline & training manual. c. The committee makes final decisions after due process & gives sanctions or remedial measures to erring residents-in-training. d. Unsatisfactory performance of a trainee is sufficient cause for termination of appointment. e. Trainees, performing below par shall be identified during the first two years of training. Their reappointment becomes conditional thereafter. They may be terminated at any time for any violations and/or failure to accomplish remedial measures as required. f. Members are the respective Training Officers of the departments or their representatives. 2. The BGHMC Code of Discipline & Training Manual Commission a. A committee created to amend, revise & evaluate the competency of this training manual & code of discipline. b. Amendments & revisions shall be done every two years. c. Any changes or revisions done by the committee to this manual shall be effective immediately & implemented without delay after approval by the Chief Training Officer. d. Evaluation & revision of the mission, vision, core values, strategies & objectives of this manual shall be done every three years after a strategic planning session of the committee. e. Members are selected representatives of each department Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 45
  • 46. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 3. The BGHMC Technical & Medical Research Committee a. A committee created by hospital order committed to review all applications for research; advise & make technical recommendations on submitted protocols; performs revisions; monitors progress of individual research and evaluates the scientific quality & socio- medical impact & importance of the paper. b. All research protocols must undergo review by this committee prior to start of study. A certification will be sent to the researcher to confirm ‘start of study.’ c. A copy of the finished study must be submitted to the Technical & Medical Research Committee for final evaluation & for filing & recording purposes. d. To advise & recommend to the Chief Training Officer the completion of research paper requirement of resident- in-training. e. To perform other functions & activities conferred by the BGH MC training office to carry out its objectives. f. Members are the training officers or their representatives or the assigned consultants per department. 4. The BGHMC Ethics Review Committee (ERC) a. A committee created by hospital order, dedicated to the rights and well-being of research subjects b. All research protocols must undergo review by this committee prior to start of study. A certification will be sent to the researcher to confirm ‘start of study.’ c. A copy of the finished study must be submitted to the ERC for filing & recording purposes. d. To advise & recommend to the Chief Training Officer the completion of research paper requirement of resident- in-training. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 46
  • 47. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center e. To perform other functions & activities conferred by the BGH MC training office to carry out its objectives. f. Members are selected by hospital order & are appointed to a 3 –year tenure Research paper requirements 1. As prerequisite to graduation/promotion, each Resident-in-training is required to submit AND present a scientific paper at a designated date during the academic year. These are presented during the Annual research paper contest. 2. The trainee must choose his/her own Consultant/advise who may or may not be a co-author of the research paper. The trainee is guided by the assigned/chosen consultant from protocol making until the accomplishment of the final research paper. 3. All research paper protocols should be submitted on time & presented to the BGH MC Ethics & Review Committee (ERC) AND The BGHMC Technical & Medical research Committee. 4. All trainees are required to submit their presentation at least a week before their oral presentation to the Training office. 5. Senior authorship goes to the main investigator who conceived the project/paper and gave the most intellectual contribution, protocol preparation, actual work, paper writing & final writing of the scientific manuscript. 6. Co-authorship is the collaboration of researchers to combine the strength of different disciplines/departments to undertake research & do a scientific paper that neither could do individually. Co-authorship may be possible within a department if collaboration is done by different subspecialties. (Measuring interdisciplinary research: analysis of co-authorship for research staff at the University of York, Bioscience Horizons Volume2, Issue2 Pp. 99-112). Co- Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 47
  • 48. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center authorship between trainees within the department & submitting the same paper individually as their requirement is inappropriate & is therefore discouraged. 7. Research Assistants are the helpful trainees who are colleagues within the department who cooperated & collected data for another researcher. They are not counted as authorship/co- authorship of a scientific paper. They should be acknowledged as research assistants in the final writing of the scientific paper. Paper submission schedule 1. 1st year residents-in-training a. They are required to submit a case report which could be a rare disorder or disease; a previously unrecognized syndrome or disease; a difficult case & managed successfully; an innovation in treatment or surgery or a new surgical instrumentation or technique. b. They are required to submit & present their case report during the annual Case Report Contest. c. Case Reports should be submitted as part of their renewal/reappointment requirements for promotion to 2nd year residency training. Failure to submit this may delay promotion. 2. 2nd year residents-in-training a. They are required to choose their consultant adviser for their research protocols. b. It is encouraged that research protocol submission & revision are done during this stage of training. Quality research papers are well written, properly checked, tested over a duration of time & has passed multiple reviewers. c. Experimental & semi-experimental research; Correlational research; Meta-analysis & Systematic reviews are encouraged. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 48
  • 49. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center d. Descriptive studies may be done & accepted as long as it has statistical validity, it is scientific & has medical impact. e. An ERC approved AND Technical & Medical Research Committee approved research protocol should be submitted as part of their renewal/reappointment & promotion to 3rd year residency training. Failure to submit this delays promotion & results to retention 3. 3rd year & 4th year residents-in-training a. It is expected that during their final year of training, final collection of data & data analysis for completion of research paper is accomplished. b. Graduating trainees are required to submit & present their final research papers during the Annual BGH MC Paper Contest. c. Research papers should be submitted as part of their graduation/residency training requirement. Failure to submit this in a designated time causes delay in the release of training certificates & result to retention. DISCIPLINARY MEASURES and SANCTIONS I. Deficiencies A trainee incurs a deficiency when he/she fails to meet a requirement of the training program at the designated point of training i. Deficiencies which are satisfactorily made up for by a trainee before the end of the year level during which the deficiencies were incurred shall not be a cause for failure to be promoted to the next level. ii. Deficiencies which are not satisfactorily made up for by a trainee before the end of the year level during which the deficiencies were incurred may be a cause for delay of promotion to the Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 49
  • 50. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center next level. Other deficiencies may be made up at any time depending on department residency training policies. iii. Deficiencies which are not satisfactorily made up for by a graduating trainee before the end of the year level (during the last quarter of the year and/or during department deliberations on the candidate’s graduation) shall cause delay of graduation. iv. Incurrence of deficiencies may be a consideration in disqualifying a trainee as candidate for an award/honor/incentive. Similarly, such incurrence may be reason to withhold an award/honor/incentive. No compensation will be given during the extension. Remedial measures These measures shall be implemented by the department AND the Training office concerned to address deficiencies. Examples of such measures are given below: 1) An extra research paper (separate from the training requirement) 2) A paper/report on a designated topic to be submitted to the TO & presented during a conference. 3) An extension of training, beyond the regular duration of the program, which may consist of the following: i) Additional surgeries and/or patient consultations within the hospital or in an official rotation ii) Enrollment in courses/workshop similar in topic & coverage to those that were missed. An echo lecture shall be given to the department. iii) Attendance/participation in the specialty society CME activities iv) Participation in an outreach or in-hospital missions v) An additional 12-hour evening duties. vi) Weekend duties Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 50
  • 51. Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center vii) One-on-one tutorial with designated consultants which may include assisted surgeries/procedures & additional clinic duties with said consultants. 4) At no time shall the training of the resident in the regular program be compromised by the needs of a trainee in an extended program. 5) Trainees maybe required participation in courses that cover topics which the specialty department deems necessary to aid & assist the trainee’s complete development as a specialist. Educational courses may include the following: i) Research production & Statistics ii) Attitude & personality development iii) Speech training iv) Stress management v) Computer skills development II. Infractions i. These are violations of the BGHMC policies, Residency Training Code of Discipline & Manual and departmental policies & guidelines. These are cited & recorded by the department consultant staff AND reported to the BGHMC Training office. ii. Infractions are documented by incident reports and/or verbal statements reported & documented at the BGH MC Training Office. The department AND the Training office shall act on the complaint/infraction within 24 hours. iii. Any infraction/complaints against any resident shall pass through the BGHMC Training office. iv. Appeals for reconsiderations may be made through the appropriate channels as mandated by hospital procedures (thru the BGHMC Training Office AND the Department TO). Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 51