Division
of
Head and Neck, Breast, Esophagus, and Soft Tissue Surgery

(General Surgery I)

Department of Surgery

U.P. College of Medicine
Philippine General Hospital
University of the Philippines

The GSI Oncology Training Programs

The 1999 Surgical Oncology Training Program

Core Consultant Staff

Reynaldo O. Joson, MD, Chief
Arturo S. dela Pena, MD, Vice-Chief
Adriano V. Laudico, MD
Michael J. Liquete, MD
Nelson D. Cabaluna, MD
Rodney B. Dofitas, MD
Mark R. Kho, MD
Ma. Lourdes de Leon-Matsuda, MD

Description

One postgraduate surgical oncology training position is available every two years. A two year comprehensive surgical education program combining research and clinical experience in cancer is offered for surgeons who have completed their basic training in General Surgery. Candidates for appointment must be eligible for examination or already certified by the Philippine Board of Surgery.

This training program is designed to appeal to the applicant who has had a broad training experience in general surgery and who wishes to concentrate on surgical oncology. The program entails hands-on performance of major oncologic operations and responsibility for pre-, intra- and post-operative care of cancer patients. The trainee will also gain experience in the use of chemo-, immuno- and hormonal therapy and be exposed in the field of radiation oncology. Most importantly, the program attempts to instill a philosophy of proper multimodality management including the prevention, detection, and diagnosis of cancer, and compassionate care of cancer patients needed in the trainee's future career as a consultant of his/her community or in the academic setting working within the context of the National Cancer Control Program (NCCP). Therefore, it is highly preferred that the trainee to be taken in is already a faculty of a surgical training program accredited by the Philippine College of Surgeons.

Another emphasis of the program is clinical cancer research in which the trainee will be taking advantage of the numerous and varied cases of the Philippine General Hospital towards publication in peer-reviewed journals and/or presentation in scientific meetings both local and international.

An additional opportunity is offered towards a Masters degree in Surgery granted by the University for those who will take the necessary units in didactics and complete their thesis. Additional year(s) may be required for this.

Specific Goals

  1. To provide the trainee with experience in the multimodality approach to solid tumor management with emphasis on surgical management, including chemo-/immuno-therapy and radiotherapy as developed and practiced at the UPCM-PGH Medical Center.
  2. To provide the trainee with the proper knowledge, skills and attitude in the management of cancer using evidence-based medicine and within the context of the National Cancer Control Program (NCCP).
  3. To develop an experience in new therapeutic approaches reflecting the important relationship between basic scientific and clinical research.
  4. To study the organization of cancer programs in a major cancer institute including education programs for both medical and non-medical personnel.
  5. To have the ability to develop clinical or research programs for the understanding and management of cancer problems.

Basic Two-Year Curriculum

Discipline/Rotation

Duration

Medical Oncology

2 months

Radiation Oncology

2 months

General Surgical Services (GS I, II, III)/Research

18 months

Elective (Thoracic, Urologic, Plastic and Reconstructive, Neurosurgical, Gynecologic, Pediatric, Transplantation, Orthopedic)

2 months

Teaching Conferences (mandatory attendance)

The trainee will be required to attend and participate actively in these conferences all throughout the two-year program. This partial list includes:

General Surgical Services (GSI, II, III)

The Surgical Services in the Division of General Surgery are divided into three - GS I (Head and Neck, Breast, Esophagus and Soft Tissue), GS II (Colon and Rectum), GS III (Gastro-intestinal and Hepato-biliary). Each service also has a team of senior and junior surgical residents, interns, and students providing the trainee with a good opportunity for learning interaction. The educational objectives are to:

  1. Manage patients with difficult, rare or complex cancer presentations, including the clinical evaluation, surgical management, and adjunctive therapy wherever appropriate.
  2. Perform complex operations involving cancer treatment. Trainees will generally not perform operations they have already learned during their GS residency such as standard colon resections and mastectomies. They will however be asked to teach these operations to GS residents, along with faculty supervision.
  3. Plan appropriate cancer treatment on an individual basis based on the knowledge of the natural history of the disease, proper staging, and integration of multidisciplinary care.

Research

The trainee will be expected to conduct research at either the laboratory or clinical investigation level. Skills essential to completing their projects are developed concurrently, as in the oral and written skills necessary to communicate the information gathered. It is expected that he/she will have completed manuscripts ready for publication prior to completing his training program.

An optional laboratory rotation can be made by the trainee selecting from among several laboratories either within the University or in other basic science laboratories. Some trainees may elect to spend their extra research time learning the principles of clinical investigation and may do this towards a masteral degree in Surgery. This would include learning the principles of biostatistics, epidemiology, design of clinical trials, form design and data management, use of computers for research, and writing a protocol for active clinical investigation. The trainee may also perform a clinical research project that might be continued beyond the duration of the two year program.

Radiation and Medical Oncology

This is a two month rotation each with the faculties of the Radiation and Medical Oncology at the UPCM-PGH Medical Center. The trainee should gain a broad experience in the radiation and medical oncology therapy management of patients with solid tumors, especially those relevant to the practice of the general surgical oncologist. In addition, there will be a self-tutorial program for learning principles of radiation biology, clinical pharmacology (including the indications, risks, benefits of different chemotherapeutic drugs used for adjunctive or palliative treatment), immunotherapy and the use of radiation/medical oncology as part of multidisciplinary treatment of the cancer patient.

Electives

This two month rotation provides an overview of surgical management of other solid malignancies such as lung, kidney, prostate, brain, ovary and cervix or familiarity with the various post-oncologic reconstructive procedures that can be done. The trainee will learn the staging systems for these malignancies, current chemotherapy and radiation therapy strategies and operative approaches used in the management of such cancers.

Education Responsibilities

Refinement of teaching skills and participating educational functions are an important part of the training program. The trainees are responsible for some diagnostic and tutorial teaching to the medical students assigned to the various Divisions. They are expected to teach principles of surgical technique in the operating room and at the bedside to the GS residents. It is also expected that the trainee participate in a self-instructional program to improve their knowledge through books and journals, reading lists, and audiovisual material available within the University.

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