This is Dean Agnes Mejia’s End-of-Term Address to the UP College of Medicine (delivered last June 1, 2018).

 

Video directed by Dr. Rafael Bundoc

 

Almost six years ago, we embarked on what I called a shared journey of enrichment. Today, rather than celebrate the end of that journey, we would like to view this occasion as a hand-off to the next management team who will pursue the next phase of a never-ending institutional odyssey. And it is with heads held high that my team and I pass the baton, so to speak, supremely confident that the UP College of Medicine has taken a huge leap forward since 2012 and 2015.

As you can glean from the video, we have achieved close to 90 percent of what we set out to do across two administrative terms. Anything less would have been unacceptable because, what we launched six years ago was not Mission Impossible. The challenges were formidable, to be sure, but we focused on goals and key projects that could be reasonably accomplished within those three-year periods.
As I have said many times before, I am more of a doer than a dreamer. Like you, my fellow stakeholders of the College, I have been guided by the UPCM Vision and Mission, which are big dreams in and of themselves. To translate those lofty ideals into concrete programs that could be completed in three years, my team and I undertook a strategic planning session in 2012—and another one in 2015, following the extension of my term. Those two sessions were enough to give us a macro view of what we needed to achieve for optimum impact. The monitoring and tweaking of programs that we undertook in the subsequent years constituted the equally vital micro steps that would guarantee high level of performance, based on discrete and tangible output. These entailed constant follow-up and evaluation of outcomes. In simple terms, these micro steps could be summed up in three words: getting things done.

To underscore the obvious, the College’s giant strides would not have been possible without the commitment of the dean’s management team and the cooperation of all the other stakeholders up and down the line. And, in this thanksgiving celebration, nothing could be more apt than to express my gratitude to everyone who helped make the journey enriching for the College as a whole.

Let me begin with my core team. Those of you who know me well enough would attest that, as head of any project or task group, I prefer to work with a small team. I am not particularly fond of big or multiple committees, each of which can be so difficult to convene—let alone bring to a consensus. I choose to work with a few reliable people who share values like mutual respect, trust and accountability. I am drawn to colleagues who believe in honest work—the kind who would not resort to anything irregular or manipulative to achieve ostensibly beneficial ends. In the realm of leadership, a bias for a manageable group of able and principled people is not rocket science. Again, this can be encapsulated in three words: keeping things simple.

 

In the context of UPCM, the team’s compact size and professional quality had to be complemented by a third attribute: diversity. I made it a point to pluck the members of my team from various disciplines and affiliations. Only a wealth of perspectives could make objective and collegial decision-making work—unfettered by parochial pressures—and bring to fore a genuine culture of consultation. Our meetings were characterized not by frequency but depth, not by excessive length but by sharp focus. Every discussion was free-wheeling but always geared toward achieving consensus, driven by what we collectively deemed best for the College. In rare cases of an impasse, the final decision rested on my shoulders, and I could rest assured that they would all back me up, regardless of each one’s personal disposition. We may see something from different angles, but, in the end, we act as one.

In 2012, I described my perception of the dean’s role as that of an enabler. Surrounding myself with brilliant, competent and passionate professionals, I really had little else to do other than to enable each of them to do what he or she did best. In their respective spheres of responsibility, I gave them the freedom to devise their own strategies, as long as these were aligned with our roadmap for the College. While they could tinker with the details, they knew that the deliverables were non-negotiable. In this dynamic process, they all brought to the table strengths that blended well with my forte in making action plans that are very practical—grounded in strong fundamentals, not overly ambitious and labor- intensive—and fully cognizant of limitations down the road.

 

 

My dream team

I may not be prone to going overboard on dreams, but I would recognize a dream team when I discern the makings of one. Allow me to take you briefly through the thought process that spawned my version of a dream team.

As far back as 2010, when I started contemplating the prospect of deanship, my gut told me that there could be no better college secretary than Dr. Salome Vios. Apart from being a respected neurologist and physiologist, Sally even then had a wealth of experience as former head of the department of physiology and of major committees like the ethics board and the research board. I could see that she was calm and level-headed—just the temperament required of an effective college sec. There was just one problem: when I recruited her, she said that I was not her first choice as dean. Appreciating her candor, I sought to win her over by, among others, sharing some literature that would give her a glimpse into my style of thinking and leadership. I must have made enough of an impression because, ultimately, she decided to give up her sabbatical to join my team. Looking back, I can only look upward with a broad smile in gratitude for an answered prayer. Sally, with her keen knowledge of government regulations and other tedious matters that minds like mine find hard to grasp, has become a valued adviser. She has also been my “buffer”— heading the administrative personnel board, taking charge of disciplinary actions, and hiring non- academic staff.

Another reluctant, though supremely qualified, member of my core team is Dr. Madeleine Sumpaico, the associate dean for faculty and students. Although we graduated together as part of Class 1977, Didit and I barely got to work together out of sheer alphabetical circumstance, plus the fact that she would specialize in pediatric allergology, while I pursued nephrology. We also had differing organizational affiliations: she is a PHI and I am a MU, but we call ourselves half-sisters. Even from a distance, I could tell that Didit had a sharpness and managerial skill that had yet to be fully harnessed. It is widely known that she declined to chair the department of pediatrics because she preferred to work behind the scenes. Beyond these work choices, a heavy personal burden was holding her back from making external commitments at that time: her sister was dying of cancer. Empathizing with her difficult situation, I offered her a slot in the dean’s management team—not to add to her burden but to give her a sanctuary from the rigors of palliative care. While she would continue to look after her sister, she would also have this avenue to keep her mind and spirit engaged elsewhere. Like Sally, Didit gave up her sabbatical and joined the team. And am I glad she did! She is soooo good—highly organized, practical with simple strategies, quick to grasp the crux of issues, and consistent in policies. Thanks to her, our faculty and student welfare programs have been able to cover unprecedented new ground.

As my associate dean for planning and research, I picked Dr. Armand Crisostomo, a surgeon who can just as skillfully dissect teaching-learning issues in the medical field. His master’s degree in health profession, specializing in education, plus his innate gifts as a team player, makes him uniquely qualified for the position. Building on the great progress we have made in keeping UPCM in step with the University’s thrust toward excellence in research and service on top of academics, Armand is being counted upon to deliver the definitive review of the College’s grading system, which is the last milestone in our roadmap. This he had accomplished superbly.

In the same vein, the post of associate dean for academic development fits Dr. Coralie Therese Dimacali to a “T”. Her impressive credentials include the key role that she played in the design of the organ system integration (OSI) curriculum. A fellow nephrologist and a masteral student of the National Teacher Training Center for the Health Professions, Coralie has an enthusiasm that is difficult to match in her advocacy of medical education. One might say she is passionate almost to a fault. Very clear in her discourse, Coralie has functioned as an excellent steward of academic concerns over the past six years.

 

To be effective, any team would need a jack-of-all trades-type of player who can plug potential gaps in operations or attend to stuff that do not appear in the job description of any of the line officers. Dr. Francisco Tranquilino, a cardiologist who served as my assistant chair in the department of medicine from 2009 to 2012, has taken on this vital role as the special assistant to the dean and the college secretary. Very reliable, trustworthy and loyal, he has superbly handled assignments, such as the UPCM newsletter, DZUP, and the annual report, that have kept the larger community apprised of developments within the college.

Last but certainly not the least is Dr. Rody Sy, my confidant and the team’s solid rock. Although retired, he agreed to stay on as president and board chairman of the UP Medical Alumni Foundation, Inc. and to take on the role of project leader of the UPCM Academic Center. His superior skills in fund-raising and in nurturing the financial investments of the college have made it feasible for us to pursue our strategic programs at a sustainable clip.

With all the bases covered by this dream team, it is not surprising that we were able to deliver on most of the strategic goals that we set out to achieve in 2012 and 2015. You can all look at each of us in the eye and ask the fundamental question: is the UP College of Medicine in better shape today than it had been six years ago? Without blinking, we would reply in unison with a resounding “YES!” Not a boastful “yes” but one brimming with a “tribal” sense of pride and fulfillment at having helped elevate the institution that we all love and having laid the solid foundations for sustained growth in the years to come.

 

 

Learning to work effectively within the UP System

In terms of infrastructure, we lament the Academic Center disaster that alerted us to the ease by which our innate kindness as physicians can fall prey to the guile of outside “experts” we deemed worthy of our faith. The breach of trust on the part of our contractor inflicted a deep wound not just on our College and our team, but on the many kind benefactors who lent support to the project. Dr. Rody Sy and I take full responsibility for having been blindsided by this predator and vow to steward the completion of the Academic Center beyond our retirement.

Fortunately, even as that structure was the biggest ticket item among our planned projects, we never placed it front and center of our roadmap. To us, what is of paramount importance in planning infrastructure is the attention we devote to corollary issues like maintenance and staffing, which are key to their sustainability. The last thing we would like to do is to put up a magnificent building, get credit for it, and let subsequent college administrations worry about how to maintain it. Unfortunately, this is a recurring weakness in government agencies which often pay scant attention to such concerns, given the meager budgets at their disposal. Having worked within the UP system for decades, we understand the problem. We appreciate all the effort and hard work that have gone into the construction of facilities and the acquisition of new equipment. It behooves us, along with future generations of UPCM leadership, to make sure that those investments do not go to waste, that those past gains would be sustained.

This mindset explains why most of our infrastructure projects have been of the low-key variety. Termite control and elimination, improving our laboratories, and renovating Calderon Hall, Salcedo Hall, and the office of the dean may not sound glamorous or exciting, but getting these basic things done has been long overdue. Much as we would have wanted to allocate as much of our funds as possible for mainstream operations, we simply could not allow the very foundations of our aging heritage buildings to crash right underneath us. Furthermore, we knew that simple enhancements in our learning and work environments would yield benefits that are difficult to quantify in terms of return on investment.

An equally important cog of program sustainability has to do with staffing. This sounds self- evident, yet so many fundamental things in this regard have been taken for granted over the years. We are fortunate to have reliable and loyal staff in the College; the sad part is that there are not enough plantilla items for them, and they have no viable career path and no vigorous staff development program to afford them long-term job security. What often happens is that every time a staff member becomes fully competent after training on the job, he or she transfers to another college or unit where there is an opening. It is not easy to break free from this vicious cycle, knowing the glacial pace of bureaucratic reform, but we have taken steps to upgrade administrative staff development, sending many of them to train on the basis of their qualifications, not their affiliations.

On a parallel front, we have laid the groundwork for instituting improvements in the college’s system of procurement, which has historically impeded the timely delivery or achievement of program output. We have reviewed the processes and algorithms and hired staff to concentrate on this, but much remains to be done—in terms of re-educating personnel and mastering the pertinent laws—to make the UPCM procurement system truly responsive.

There remain two major projects awaiting fruition, as we prepare to complete our term.

The first is the accreditation of the UPCM medical program by the ASEAN university network (AUN). The process will be highlighted by the visit of the AUN Quality Assurance team of program assessors this August. We are confident that we will obtain AUN accreditation, but we are not taking this for granted. Apart from supplementing our Level 4 status under the Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU), it will enhance our college’s regional standing, in step with institutional growth in the era of ASEAN integration.

The second is the center for health care quality and patient safety, which has been approved as a program by the Board of Regents. The first phase of that program, spanning 2013-2017, has entailed the completion of researches to support patient safety, both in clinics and basic sciences. We are now in the second phase, “Assessment of Performance Measures and Indicators of Patient Safety in Select Government and Private Hospitals in the Philippines” which is being funded to the tune of P23 million by the Department of Health under its Advancing Health through Evidence-Assisted Decisions with Health Policy and Systems Research (AHEAD-HPSR) Program. The third phase, which hinges on the passage of the health bill in the Senate, will institutionalize the Center and guarantee its financial sustainability.

 

 

Taking care of our core stakeholders

Even as we celebrate the great strides that our programs have taken, we have never lost sight of the overriding importance of the well-being of the College’s core stakeholders: our faculty and our students.

With respect to the former, it is well worth asking: is the UPCM faculty better off than it had been in 2012?

And our unequivocal reply would be: yes, our faculty is in much better shape today.
In this area, our single greatest source of fulfillment is the fact that the 42-year phenomenon—or, should I say, aberration—called clinical associate professors without compensation (WOCs) is now a thing of the past. It was a long, uphill advocacy battle, but finally we obtained authorization to allocate half of the funds from the incremental tuition fee to grant our clinical faculty incentives or honoraria commensurate to the number of hours they spend teaching, mentoring, and advising students, in addition to participating in myriad official UPCM projects and activities.

The plantilla shortfall, of course, is expected to persist for decades to come out of sheer bureaucratic inertia. To fill the gap a bit more, we have endeavored to accelerate the awarding of faculty and travel grants over the past six years and have tapped external endowments to increase the number of professorial chairs that are available. We have also actively funded faculty-initiated researches, books, and creative videos.

Invoking the “up or out” principle, we have taken up the cudgels for faculty members who, in our view, have been unfairly deprived of tenure. We succeeded. In addition, we have been able to expedite the process of selecting and rewarding faculty members who deserve merit increases, while remaining consistent with University criteria.

 

None of these interventions in favor of the UPCM faculty is particularly heroic or extraordinary. They all boil down to doing what’s right.
Our gains in terms of student welfare, on the other hand, are more difficult to assess and quantify.

Like schools everywhere else, UPCM has had to come to grips with the challenges of educating the so-called millennial generation. We can debate all day about teaching strategies that are best suited for young men and women who have been stereotyped— rightly or wrongly—as incorrigible multi-taskers, obsessed with digital gadgets and social media and spoiled by the techno-driven prospect of instant gratification. The truth is that, in the grand scheme of things, the general mold of students and the nature of learning have been in a constant state of flux across many centuries. Schools and teachers have had to play catch-up at every turn—but adapt they have, slowly but surely. It has been no different at UPCM.

For example, recent years have witnessed our efforts to jumpstart the virtualization of medical education, our expansion of the Clinical Skills Simulation Laboratory and the overhaul of the Resource and Learning Center with the help of our partners. These are just a few of the ways by which we are harnessing technology to empower our students within their comfort zones. At the same time, members of our faculty are learning to be adept at using these tools, along with more inclusive and flexible teaching methods.

In line with empowering our students, we have made it a point to rope them into the consultation loop in matters affecting their welfare. We have conducted periodic student assemblies for them to express their opinions and to air their concerns. We have reached out as well to student organizations on a regular basis. We have endeavored to be student-friendly in our policies, seeking basically only two things in return: discipline and intellectual honesty.

But all these gains must take a backseat to a far larger imperative: molding holistic healers.

At the end of the day, the success of UPCM will be gauged in terms of the quality of our “product”. And by that we do not mean how many of our students make it to the top 10 in the medical boards or what percentage of them passed, as compared to those from other medical schools. Nor will they be judged mainly by their skills in medical diagnosis and treatment. Above all, they will be evaluated many years into their careers in the context of what is expected of graduates of the University of the Philippines College of Medicine.

Beyond making sure that our curriculum and methods build topnotch competence in different fields, we have talked about the need to strike a balance between IQ and EQ from the get-go. In deciding what types of applicants to admit to the College, we have had to shed our implicit bias for cornering the market for undergrad summas and magnas. With our mission and vision calling for commitment to the health needs of the underserved and to the development of Philippine society, it is clear that what matters is not just the quality of our students’ minds but also the capacity of their hearts and the strength of their character.

Thankfully, our 18-month effort to revamp our admissions policy in response to the growing need of our nation for service-oriented health professionals has borne fruit. Starting school year 2017-18, the number of new students admitted to UPCM increased from 160 to 180. Qualitatively, we modified the interview process and used an adjustment factor in computing the pre-medical general weighted average of applicants to give students from different courses and colleges a fair chance to get into UPCM.

But the challenge on this fundamental front remains formidable.

 

Our difficulty in monitoring compliance to the Return Service Obligation Program (RSOP), in spite of the strong “Kamusta Na Bayan” initiative, is a symptom of a deeper malaise. If many of our students are inclined to evade rather than to embrace the program, to pay up rather than to give back—which I hope is not the case—we would have to seriously re-evaluate our admissions policy and our whole approach to medical education. The magnitude of the obstacles in health care delivery in the margins of society calls for our graduates to step up to the plate not just as physicians but as leaders who can bring together people from other fields and from other schools to come up with innovative strategies and practical solutions.

The kind of graduates we need would know how to distinguish ethics from law—men and women who would value integrity over legality, what is honorable over what is permissible. The spirit of the Regionalization Program, for instance, is for aspiring students from areas in dire need of doctors to be given a chance to enter UPCM with the expectation that, after graduation, they would serve as health professionals, leaders, and educators for at least five years in the region which nominated them. Technically, this involves a social obligation—not a legal contract. Their acceptance to UPCM is contingent not only on their academic credentials and much more on their commitment to give back to the community which recommended them. Sadly, some of them have left the country without notice, citing the loophole that they never signed a contract.

Let me state it plainly. Reneging on one’s promise is as shameful as having no qualms about cheating in school. Ethical ambiguity has no place in our profession and in our College. The stakes are too high and the resources too meager for us to waste time and talent quibbling over fundamental principles that underpin our very reason for being.

 

Lest I be misunderstood, it is not my intention to cast our students in a bad light. By and large, they deserve to be here, they see the bigger picture, and they know what’s on the line. Like their fellow millennials, they tend to view age-old problems with a lens that’s vastly different from that which my generation has been accustomed to. There is great comfort in knowing that many of these young men and women dedicate a large part of their lives to causes—like saving the environment and empowering the poor—that are far bigger than themselves. It is my hope that the same creative energy and imagination that have turned businesses like taxis, hotels, and food delivery upside down for the benefit of consumers would someday spawn innovations that can revolutionize health care delivery in areas most in need.

And, so, to our medical students, I say, thank you for giving one hundred percent effort in the lecture rooms, labs, wards, communities and extra-curricular activities—even as you don’t really have a choice—and for buying into what we stand for as a College. It is far from easy, I know. But you are UPCM students. That makes you special and uniquely equipped, more than any other group aspiring to be physicians, to confront the immense challenges ahead. I wish you all Godspeed.

 

 

The wind beneath my wings

Before leaving the walls of the Pedro Gil, I would be remiss if I do not give due recognition to the ever-reliable support of the College Council and the administrative staff, who have kept UPCM operations humming seamlessly from day to day. My profound thanks to all of you.

In the same vein, I would like to cite the tireless efforts of the Philcare team and our security guards in keeping our campus grounds tidy, safe, and conducive to learning and productive work. Malaking bagay po ang tulong at pagmamalasakit ninyo sa Kolehiyo. Maraming, maraming salamat po!

Beyond the College walls, I wish to express my boundless gratitude to all the University officials who have helped UPCM climb to the next level under our watch. We are fortunate to have served under two UP Presidents— Alfredo Pascual and Danilo Concepcion—and two UP Manila Chancellors—Dr. Manuel Agulto and Dr. Carmencita Padilla—who have tested the strength of our convictions and enriched us with their perspectives.

A special word of thanks to the Board of Regents for their understanding and open mindedness. Seven proposals from my office were elevated for their consideration, and every single one was approved unanimously, giving UPCM student and faculty welfare a huge lift. In this regard, I am deeply indebted to my advisers who helped me “package” those proposals—applying the brakes, whenever necessary, along the way to keep my passions “under control”.

To UPCM’s loyal alumni, I extend my arms in a grateful embrace for their unstinting support to our programs. Over and above their generosity and the fruitful relationships we have developed with alumni groups led by UPMAS and UPMASA, we are indebted to them for their vigilance in keeping us on our toes in matters of accountability. I hope that we did not disappoint them.

To my classmates, Class ’77, the road to deanship began – without my knowing it – 40 years ago in your company. Your faith and generosity boosted our accomplishment – the student scholarships, a room in PGH dedicated to me, several rooms under Operations Wildfire and of course, a room in the Academic Center. I’m proud to belong to Class ’77. Magaling magpagaling @40.

Finally, let me stretch my arms upward in praise and gratitude for the abundance of grace that we have all been showered with over the years. No matter what faith we draw strength and inspiration from, each of us, I would like to believe, has been guided by an innate sense of giving of ourselves for our country and our people through the UP College of Medicine. Deep in our hearts, we know that our every act to advance the interests of the College has been animated by an absolute certainty: God is good. And we are all instruments of His (or Her) unconditional love for humankind.

At this point, allow me to turn home, where I have consistently drawn strength as a person, as a professional, as a leader. Growing up, I had been nourished by the love and support of my family. And it energizes me just to see my Nanay and my sisters Cynthia, Liza and Nanette who flew in from Michigan and Sydney to join us today.
To my husband, Jimmy, forever a full time family man and a part-time engineer, thank you for simply being there, for keeping me on even keel, whether in the face of elation or adversity.

To our children—Olivia, Kittina and Jimboy—thank you for pushing yourselves to the best of your abilities, enjoying it and thereby sparing me and your Papa from wondering and worrying about what you’re doing with your lives.

I am proud to say that both our daughters have been molded well by UPCM, competent in their respective fields—Olivia, now an ORL surgeon, and Kittina, an aspiring nephrologist— and showing undeniable love for their profession and admirable empathy in their practice. Their liberal thinking, drive and conviction got them through college and residency on their own. Both landed in the top 10 of their specialty boards. And not once did they compromise my position as dean or as mother. I am grateful to the University, to the College, their departments and their mentors for giving them their wings.

Our son, Jimboy, has also earned his way to the University—making his mark not just on his chosen academic track in civil engineering but in the athletic field as well.
In my first speech as dean, I shared an amusing anecdote from 2003 when I asked then six- year-old Jimboy how he felt about my accepting the post of chair of the department of medicine. His disarming reply was: “Mama, puede kang mag chairman, pero di ka puede maging BOSS!” It was a child’s way of telling his mother to remain the same no matter what title was bestowed upon her. In more sophisticated terms, it served as a reminder for me to stay grounded and to be always true to myself.

In this, my last speech as dean, it seems only proper that I come full circle.

Jimboy is now a full-grown man. At 21 years of age, he has garnered his share of success and adulation as a UP track athlete. As his biggest fan, I have learned to draw inspiration from the tests he has undergone on and off the track. From training with monobloc chairs in narrow corridors in Grade 4 in UPIS, he went on to set three sprint and hurdles records in the UAAP juniors and has earned a place in the UP senior track team. From a distance, I could see him prep for higher and higher levels of competition, aspiring to be a better version of himself every step of the way. In August 2017, he relished the opportunity to go up against some of the best college athletes in the world as part of the Philippine contingent to the University Games in Taipei—only to find himself sidelined by dengue. Sitting by his bedside at the ICU, I found the opportunity to reflect on his journey as a runner, side by side with my own journey as dean. All of Jimboy’s races, except the 4×400 relay, were over in less than a minute; at that hospital bed, he had no chance of vying for medals, but he got to rediscover the value of life at a normal pace. On a parallel track, it seemed as if my two terms at the helm of UPCM were going by like a flash; that’s when I woke back up to the reality that our stint here is but part of an endless relay run to heal our ailing nation. What’s important is that we’ve done our part to the best of our God-given talents.

So, today, we prepare to pass the torch, firm in our conviction that we have run our stretch well and laid the groundwork for the next UPCM administration to sustain—and build on— the gains we have made. It is my hope—and my prayer—that their journey would be every bit as enriching as ours.

Mabuhay ang KOLEHIYO NG MEDISINA, UNIBERSIDAD NG PILIPINAS!
Maraming salamat po.