Manual For Residents

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
Code of Discipline & Manual for Residents-in-Training

Baguio General Hospital & Medical Center
Title I. II. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. Vision, Mission, Objectives Core values
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BGHMC History, Vision & Mission; The BGHMC logo 7 BGHMC Structure & Organizational Chart .. 15 The Residents organization .. 16 Residency training programs .. 22 General training guidelines & policies 22
Requirements for residency training . 38 Job description of Residents-in-training 40
Evaluation & Promotion of Residents-in-training . 44 Disciplinary Measures & Sanctions Certification & awards 49
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APPENDICES . 60
Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011
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 Residents 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
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.
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, NPEs & PEs, 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
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) j) Chief, Medical Professional Staff (CMPS) Chief, Training Officer (CTO)
k) Training Core i) l) All Department Training Officer
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.
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.
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 Nurses 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 Osmea before the building was finally inaugurated on February 22, 1941.
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.
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 1990s 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 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 Childrens 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 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/)
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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 faade 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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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.
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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 Committees
Department Chairperson
Research
Department Training Officer
ERC
Residents-intraining
Training Core
Post-graduate interns &clerks
5) Strategies to achieve objectives (2011-2013) of the Residents 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
The BGH MC Residents Organization

Constitution & By-Laws of the BGH MC Residents Club
In accordance with the rules and regulations of Baguio General Hospital and Medical Center, the officers of the Residents 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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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 yearc. 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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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 Residents 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
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 organizations 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
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.
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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.
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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) ii) Department of Surgery 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
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.
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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 institutions 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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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.
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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 persons identity shall not be made public without the attending
consultants/patients/guardians/ nearest kins 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 patients 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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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
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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 hospitals 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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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
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
Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center viii. Residents Forum (Year End Report) 1. Shall be held annually during the first week of December of every year 2. Shall precede the Residents Recognition Activity 3. This activity shall be a formal presentation & endorsements of the outgoing officers of the BGH MC Residents 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. Residents 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. NNTs; 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 31
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. Residents hour 7. Specialty national conventions & postgraduate courses Medical & Surgical Procedures All residents-in-training shall be familiar with basic medical procedures & the hospitals 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 hospitals/departments protocols in handling & disposal of hazardous materials/equipments.
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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 BGHMCs 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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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 Patients 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. Patients 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
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 patients discharge Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 35
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 physicians 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
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 institutions 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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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.
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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 Trainees 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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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. j. Letter of intent 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 trainees 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
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
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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 & Patients 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
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. Patients medical documents d. Monitoring & evaluation of patients 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

Departments 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.
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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
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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 & sociomedical 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). CoBaguio 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/coauthorship 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.
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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
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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 candidates 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
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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 trainees 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).
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center v. A resident-in-training may have to assume sole responsibility or liability for consequences of his/her own actions. vi. A resident-in-training may have to pay for the expenses incurred by a patient, the hospital, or the department as a result of the infraction.
III.
Levels of Disciplinary measures & sanctions a. A resident-in-training shall receive sanctions appropriate to the level of infractions that they commit. b. A department (consultant staff meeting) may exercise flexibility in the imposition of sanctions for level 1-3. Details of circumstances leading to the infractions & an offenders degree of involvement may differ such that a lighter or heavier penalty may be imposed. c. The BGHMC training office shall exercise all its right & responsibilities for imposing sanctions for levels 4 6.
i. Level 1 REPIMAND 1. First offense for refusal of service, including medical procedures, surgeries, beyond regular working hours. 2. Failure to perform official duties 3. First offense for unauthorized substitution of duties 4. First, second, third unexcused late arrival for required department/hospital activities 5. First offense of unauthorized collection /fund raising from individuals or other entities using the name of the department. 6. First offense of failure to comply to the general guidelines of this resident training manual. Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 52
Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center ii. Level 2 ADDITIONAL WRITTEN REPORT 1. The Department Training Officer (TO) or its assigned consultant shall assign a topic and set a deadline for submission of a written report. At the discretion of the TO, the trainee may be asked to present the report orally during one of the departments conferences. 2. The following are grounds for additional written report a. Second offense of unauthorized substitution of duties b. Three to six unexcused late arrivals for required department/hospital activities c. First offense of failure to accomplish pre-operative requirements resulting in postponement of a scheduled operation/procedure.
iii. Level 3 ADDITIONAL DUTY HOURS 1. ADDITIONAL DUTY HOURS may be staggered or continuous depending on the Trainees work load 2. The schedule shall be mutually agreed upon by the trainee and the department TO 3. The following are grounds for additional duty hours a. Second offense of refusal to render service, including medical procedures/surgeries, beyond regular working hours b. Third offense for unauthorized substitution of duties c. First offense for unauthorized departure from hospital or area of responsibility within the hospital during regular/extended working or duty hours d. Seven to nine unexcused late arrivals for required department/hospital activities e. First, second, third unexcused absences f. First offense, for out-of-post (leaving post without endorsement)
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center g. Second offense of failure to accomplish pre-operative requirements resulting in postponement of a scheduled operation/procedure. h. Two or more offenses of failure to comply with examination of patients and performance of procedures i. Use of instruments, equipments, and appliances on patients for personal financial gain
iv. Level 4 SUSPENSION FROM REGULAR FUNCTIONS 1. After due deliberation by the BGHMC Training Office, a trainee may be disallowed from doing certain functions for a specified period of time. This shall extend his/her stay with the department beyond the regular period of residency training. 2. The following are grounds for Suspension a. Second offense of unauthorized solicitation/monetary collection/fund raising from individuals or other entities using the name of the department and/or hospital. b. Ten or more unexcused late arrivals for required department/hospital activities c. First offense of smoking within the hospital premises d. Fourth unexcused absence e. Refusal/repeated failure to perform official duties f. More than two offenses of failure to accomplish pre-operative requirements resulting in postponement of a scheduled operation/procedure g. First offense of intake of alcoholic beverages while at work or on duty h. Making comments about other physicians/institutions & their management made in the presence of patients & non-medical individuals.
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center i. Public humiliation/reprimand of any hospital personnel for discourtesy, inefficiency, or neglect of duty. Such actions shall instead be reported to the department/office concerned. j. Failure to give consultants/superiors the utmost respect. Complaints/grievances shall be directed to the appropriate department/(training core) concerned. k. Insubordination l. Violent behavior resulting in minor injury to another person or minor damage to department/hospital property. m. Possession of banned weapons/implements within the hospital premises. n. Conduct prejudicial to the best interests of the hospital/department
v. Level 5 RETENTION 1. A resident-in-training may not be promoted to the next year level for a specified period of time. 2. Retention shall result in the prolongation of the Trainees program without compensation. 3. The following are grounds for retention a. Fourth unexcused absence b. Failure to pass training requirements c. Conduct prejudicial to the best interests of the hospital/department.
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center vi. Level 6 DISMISSAL 1. A trainee after due deliberation by the Training Office, may be removed permanently from the BGHMC residency training program. 2. The following are grounds for dismissal a. Acts of grave dishonesty b. Sexual harassment c. Repeated violent behavior resulting in minor injury to another person or minor damage to department/hospital property. d. Possession of banned weapons/implements within the hospital premises with clear intent to cause harm to property or other persons e. Conviction of a crime under the courts of law f. Negligence in the practice of medicine, resulting in harm or death to a patient or another person. g. Practicing medicine for personal profit h. Practicing medicine as a specialist without completion of the required training (private practice during residency training). i. Tampering with, falsification, mutilation or destruction of official department/hospital documents. j. Unauthorized disclosure of confidential information
k. Misuse of confidential information for personal gain or to give undue advantage to another person. l. Ten or more unexcused late arrivals/absences
m. Frequent refusal to perform official duties n. Gross insubordination Baguio General Hospital & Medical Center Gov Pack Road Baguio City | Training Office 2011 56
Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center o. Abandonment of duty p. Absence without leave q. Gross professional negligence r. Failure to pass training requirements
s. Gambling or use of prohibited drugs within hospital premises t. Alcohol intake resulting in alcoholic intoxication while at work or on duty
u. Conduct prejudicial to the best interests of the hospital or the department
IV.
Benefits & privileges a. Benefits i. Hospital services 1. Annual physical examination for all residents-in-training during the month of birth
ii. A trainee may be provided with the following: 1. Lodging (within the departments premises) during duty days 2. Authorized leaves 3. Monthly stipend or similar financial support from the institution or other sponsoring agencies 4. Application fees for narcotic license & yellow pad fees; uniforms & meals if the institution/department or sending agency is capable 5. Accident insurance coverage for activities outside the institution 6. Medical/surgical care ; legal assistance
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center b. Privileges c. Leaves i. Trainees are entitled to specific leaves as defined by hospitals provision, rules & regulations. However in consideration of the demanding nature of medical services & training & to avoid delay in or failure of accomplishment of hospital services/activities, they shall be encouraged to minimize the duration of leaves. ii. Extended leaves (including maternity/paternity leaves that cannot be covered by unused vacation/sick leaves) shall be cause for extension of training for the equivalent number of days
V.
Requirements for Residents-in-training for Training Office Certification a. At least Satisfactory Performance evaluation rating (based on the Performance Evaluation Sheet) b. Certification from the department for completion of training c. Certification from the ERC & Technical & Medical Research Committee for completion of paper/research duly signed by Research chairperson AND ERC chairperson d. Certification of completion of other requirements & clearance from the Human Resource department.
VI.
Certification & awards a. Certification i. A certification of BGHMC residency training shall be issued ONLY upon: 1. Satisfactory completion of ALL department training requirements AND upon recommendation of the Department chairperson and;
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center 2. Satisfactory completion of ALL BGHMC training requirements AND upon recommendation of the Medical Research Committee; Ethics Review Committee & the Chief Training Officer. 3. Clearance from the Human Resource department & other hospital offices. 4. The BGH MC Certificate of Residency Training shall be signed by the Medical Center Chief, CMPS & the Chief Training Officer & Department chairperson.
VII.
Civil Service Directives; Labor Laws, PRC memos & DOH Policies a. AO 29 series 1994 Medical Human Resource Development and Placement Program (MHRDPP) in the Department of Health (Appendix) b. PD no. 1424 The Residency Training Program (1978) c. Department Circular #144-A, S.1994 Implementing Rules and Regulations governing AO 29 S 1994 d. Residents-in-training are not covered by the 40 hours a week law (RA 5901) e. Republic Act No.2382, the Medical Act of 1959 f. Patients Bill of Rights
g. BGH MC Memoranda
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Residents-in-Training Code of Discipline and Manual Baguio General Hospital & Medical Center VIII. APPENDICES a. Statement of Understanding of the BGH MC Residency Training Program i. A trainee at the beginning of his/her training program, read the assigned documents/manual/code of discipline and attend the designated orientations to understand the hospital & department policies, rules, regulations, schedules, in-hospital activities, out-ofhospital activities, and the specialty board requirements. This shall prepare him/her for the demands of the training program and minimize attrition or dropping out. b. Contract for BGH MC Residents i. All incoming trainees or newly promoted trainees are expected to sign this contract after attendance to the hospital AND department orientation AND after having read and understood the training program. ii. This contract is signed annually.
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STATEMENT of UNDERSTANDING of the BGH MC Residency Training Program

Code of Discipline & Training Manual
I, ______________________________________, of legal age, a Resident-in-training of the department of ___________________________, hereby state that I have understood the Residency Training Manual & Code of Discipline and that I am prepared to undergo the prescribed training program and fulfill all the requirements for the next ___________ year/s. I am committed to complete my residency training within the time designated by my specialty board.
______________________ Signature of Trainee
__________________________ Chief Training Officer Baguio General Hospital & Medical Center
_____________________ Date signed
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APPLICATION FOR AND TERM S OF CONDITION FOR ACCEPTANCE TO THE BGH MC RESIDENCY TRAINING PROGRAM
I, _________________________________, of legal age, Filipino/non-Filipino citizenship, licensed to practice in the Philippines/permitted to train under supervision in the Philippines, wish to apply for acceptance in the BGH MC Residency Training Program under the department of __________________. I understand & fully agree that, if accepted, the terms & conditions of my acceptance are as follows: 1. I am employed in the hospital under a temporary status of appointment as Medical Officer III that is under the residency training program of the Medical Division; 2. I shall not be covered by the forty (40) hour week law because of the nature of my profession and the skills I am aspiring to acquire in the specialty of ______________, where close & continuous monitoring of patients assigned to me is vital and a necessary discipline in my training; 3. I shall be provided with temporary quarters during my tour of duty for better supervision and more efficient performance of my duties; 4. I am bounded by the rules, regulations & laws of civil service commission, DOH, PRC & the internal policies of the hospital; 5. Although the full period of training is __________years and I commit myself to complete this training, the term of my acceptance is annual and shall depend on my overall performance which shall be based on regular evaluations carried out by the department & the Training Office of the BGH MC and in consonance with the department policies as well as BGH MC rules and regulations.
____________________________ Signature over printed name/date
________________________ Chief Training Officer Baguio General Hospital & Medical Center
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Manual For Residents

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

Training Office 2011

Code of Discipline & Manual for Residents-in-Training

Requirements for residency training . 38 Job description of Residents-in-training 40

k) Training Core i) l) All Department Training Officer

n) House staff i) Residents in training

o) Department Scholar i) Sponsored Resident (drug fellow)

Department Training Officer

Post-graduate interns &clerks

The BGH MC Residents Organization

The BGH MC Residency Training Programs

General guidelines & policies for Residents in training

Requirements for Residency training application & appointment

k. Completed Personal Data sheet l. Transcript of records (certified true copy)

Job description of Residents-in-training

Job description of Residents-in-training

1. Attends to emergency calls on field.

Evaluation & promotion of Residents-in-training

BGHMC TRAINING OFFICE COMMITTEES

Research paper requirements

DISCIPLINARY MEASURES and SANCTIONS

u. Conduct prejudicial to the best interests of the hospital or the department

STATEMENT of UNDERSTANDING of the BGH MC Residency Training Program

______________________ Signature of Trainee

_____________________ Date signed

____________________________ Signature over printed name/date

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