The Residency Training Program in Psychiatry
An exemplary residency training program for psychiatrists who will competently serve the mental health needs of the Filipino people
To develop competent, ethical, creative, compassionate, resilient, culture-sensitive psychiatrists, who are committed to lifelong learning, research and service
- Ethical behavior and professionalism
- Compassionate, competent, creative, and culture-sensitive patient care
- Respect and advocacy for patients’ rights
- Collaboration with other health care professionals
The World Health Organization (WHO) has long asserted that mental health is an integral and essential component of health, and this was emphasized by its inclusion of mental wellbeing as among the triumvirate, along with physical, and social well-being, of fundamental elements that define a healthy person. However, the provision of services to address the mental health needs of Filipinos has been a constant struggle.
The enormous task of caring for the mentally ill and promoting psychological wellness has long been a concern for local health providers, political leaders and other stakeholders in Western Visayas, particularly the province of Iloilo. Before 1994, mental health services in the province and the rest of the region were provided by a sprinkling of psychiatrists in private practice, and two publicly-financed institutions: the Pototan Mental Health Unit, located about 30 kilometers from Iloilo City, and the psychiatric unit of the Western Visayas Medical Center, in Mandurriao district. However, most of the doctors who manned these units had little formal training in Psychiatry; neither did they undergo rigid supervision during their tenure as psychiatry residents.
In 1994, therefore, local psychiatrists initiated the bold move of opening a Residency Training Program in Psychiatry as a collaborative effort between the West Visayas State University College of Medicine (WVSU COM) and West Visayas State University Medical Center (WVSUMC) and the Western Visayas Medical Center (WVMC). This effort was in response to the imperative of providing mental health services which had special sensitivity to the needs and culture of the local population. Thus, the birth of the WVSU- WVMC Psychiatry Training Program Consortium.
The Residency Training Program officially started on January 1, 1995 with three residents: two from WVMC and one from WVSU. As the program dealt with the inevitable birth pains, it was provided generous support by the University of the Philippines-Philippine General Hospital Psychiatrists Foundation, Inc. (UPPFI), the Department of Health (DOH) and the Philippine Psychiatric Association (PPA). Other psychiatrists and institutions, like the University of Sto. Tomas Department of Neurology and Psychiatry and the National Center for Mental Health, also provided inputs to enhance the strength of the training program.
Over the years, it has harnessed its own local resources to make the program truly relevant to the Ilonggo cultural milieu, even as it continued to welcome help from outside sources to further invigorate its training activities. Many of its graduates are now part of the training program as consultants, although qualified graduates from other training centers are also invited to enrich the program.
The Medical Center is a 400-bed service and training institution located in Mandurriao, Iloilo City. It is about four kilometers away from the West Visayas State University Medical Center. It is a government hospital catering mainly to service patients although it also has a 17-bed Medicare Ward as well as private rooms for pay patients. The main hospital has service wards for Internal Medicine, Surgery, Pediatrics, Orthopedics, ENT-Ophthalmology and Psychiatry. The Obstetrics and Gynecology Department has its own two-storey building adjacent to the main hospital. A Heart-Lung Institute is expected to open soon, delayed only by the pandemic. The outpatient department is in a separate building across the main hospital building. It also has a library and an air-conditioned main conference room adequate for 50 persons.
The hospital has laboratory facilities for routine and blood chemistry examinations. Public health aspects of the laboratory like water analysis and special laboratory examinations like those for hepatitis and AIDS are available. Histopathology and biopsy examinations are also done. There are radiologic and ultrasonographic facilities available, including a Cobalt Therapy machine and a CT Scan Unit. An electroencephalography machine is also available.
The hospital has fully accredited residency training programs in Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, Orthopedics, Radiology, Anesthesiology, Pathology, Eyes-Nose-Throat (ENT), Ophthalmology and Psychiatry.
The Department of Psychiatry at WVMC was established in June 1983. It was conceived to offer inpatient and outpatient services, and to serve as a training ground for residents, postgraduate interns and clinical clerks. The department’s inpatient and outpatient facilities are located at the farthest end of the Medical Center’s left wing. The ward has a 24-bed capacity. The offices include three interview cubicles, a conference area and the offices of the chairman and the residents. An Electroconvulsive Therapy machine is available at the minor operating room.
This facility provides training for acute inpatient management of the
psychiatrically ill, psychiatric emergencies, outpatient management, and
consultation-liaison psychiatry in a general medical care hospital.
Because of the designation of WVMC as the main Covid referral center for Panay, major changes in the conduct of the operations of the medical center were instituted. The Psychiatry inpatient section was transformed into a Covid facility. Psychiatric Acute Care Unit remained at the WVMC. All admitted in-patients were transferred to the Pototan Mental Health Unit, WVSUMC or other medical facilities. The outpatient section was transferred to the nearby Tres Mavicas building, a structure being rented by the Medical Center.
Pototan Mental Health Unit
The Pototan Mental Health Unit (PMHU), located 27 kilometers from Iloilo City, opened on December 10, 1966 initially as a psychiatric ward of the Dona Trinidad Bolivar Memorial Hospital. The latter was a general hospital tasked to open a psychiatric unit for mental services in the Visayas as part of the decentralization program of the National Mental Hospital. Twenty-five patients from the National Mental Hospital in Mandaluyong were the first to occupy the 25-bed unit at the basement of the hospital.
Two years after the psychiatric unit opened, a separate building for the mental unit was constructed through the efforts of the late Congressman Ricardo Ladrido on a lot donated by Atty. Jose Ma. Delgado in Brgy. Rumbang, two kilometers away from the general hospital in the town proper. This unit formally opened on August 9, 1969 and it became known as the Pototan Mental Health Unit.
In 1988, the administration of the unit was transferred to the Western Visayas Medical Center, only to be remanded to the Iloilo Integrated Provincial Hospital (IIPH) in 1991. In July 1995, WVMC again took full administrative responsibilities over the unit, with the chairman of the WVMC Department of Psychiatry as head of the unit. Under the new leadership, the mental health unit was overhauled in terms of its physical structure and operational policies to make them more responsive to present needs.
The inpatient building has a separate ward for male and female patients.
The nurses’ station is located strategically near the wards. The building also
houses the residents’ quarters and a work area for junior and postgraduate interns.
The unit has a 25 – bed inpatient capacity. On the average, 20 - 25 patients come for outpatient consultation and follow-up every day. Resident physicians of the consortium rotate in the unit to further enrich their training. This facility is a rich training ground for the management of a government psychiatric ward for the chronic mentally ill patients, and management of psychiatric emergencies, inpatients and outpatients.
In June 2020, admitting procedures were revised to comply with the DOH Memorandum No. 2020-0258-A. In the memorandum, all vulnerable patients including those that will be admitted to mental institutions like PMHU are mandated to undergo RT-PCR testing for COVID-19. While awaiting their results, the patients are stabilized at the WVMC Acute Psychiatric Care Unit. Those with negative results are then transferred via ambulance to PMHU. Those tested positive are transferred to COVID Wards of Western Visayas Medical Center.
Western Visayas Medical Center and Pototal Mental Health Unit
The Department of Psychiatry of the Western Visayas Medical Center and Pototan Mental Health Unit were reorganized in November 2020. Manpower was merged to facilitate the ease of delivery of services. The department has three full time consultants and three part time consultants. The Department Chair, the Training Officer and the rest of the regular consultant staff are all diplomats of the Philippine Board of Psychiatry and fellows of the Philippine Psychiatric Association. All the other consultants of the WVSUMC Department of Psychiatry are also members of the visiting staff at the WVMC. Five junior members of the department have appointment as medical officers. Two residents had their residency extended due to the service demands of the COVID-19 pandemic.
The Department presently has ten resident physicians. It has two psychologists, four psychometricians, twelve nurses, ten nursing attendants, one social worker and one occupational therapy technician. There are also complementary administrative, security and housekeeping personnel assigned to the department.
The operation of the residency training program allows it to offer a wide range of mental health services to the general public. These services are offered namely:
Emergency Patient Care
Emergency psychiatric care is provided at the emergency rooms of the three facilities for patients who require immediate psychiatric attention. The patients seen are those suffering from primarily psychiatric conditions presenting as emergencies, or referrals from other ER sections for patients with medical illnesses but who have psychiatric symptoms and disorders as well.
For patients whose circumstances demand hospitalization, the three facilities provide inpatient care. WVSUMC has a ten-bed psychiatric unit, WVMC has a 24-bed facility, while PMHU can accommodate 25 patients. Charity patients are admitted to these units. Pay patients are admitted to private rooms of WVSUMC and WVMC.
Patients well enough for their treatment to continue at home are seen at the outpatient section of the three facilities. The patients follow a schedule for their visits, although visits outside of the schedule are allowed depending on the need of patients, and the availability of medical staff.
Child and Adolescent Psychiatry
Psychiatric needs of patients below 18 years of age are met by the Child and Adolescent Psychiatry facilities available at WVSUMC and WVMC. Child patients at the PMHU are referred to the two other facilities. Residents are supervised by two child and adolescent psychiatrists in the consultant staff.
Psychiatric services are also offered to patients in the geriatric age group. The consortium works with other experts in the field, like geriatricians and social workers, to provide optimum care for the elderly.
Psychiatry residents and consultants are available to answer referrals from other hospital sections of WVSUMC and WVMC. These usually involve patients with medical illnesses, but who also present with psychological symptoms, or are having a co-morbid psychiatric disorder. Psychiatric liaison services are presently not yet available.
Social and Community Psychiatry
Residents and consultants gain exposure in Social and Community Psychiatry by their collaborative work with government and nongovernment institutions. Among these efforts are the consortium’s involvement in the psychosocial managements of disaster victims and its collaborative efforts with the Bureau of Jail Management and Penology to provide care for inmates with psychological problems. Previously, it was also involved in the Tatap Buang project of a local nongovernmental organization, which took care of vagrant psychotics in Iloilo City. It provides training for health personnel in Iloilo on the recognition and treatment of mental illness. It is presently involved in the drug rehabilitation efforts of the city government of Iloilo.
Cases involving the courts and the legal system are taken care of by the consortium’s expertise in forensic psychiatry. Consultants and residents regularly answer court calls as ordinary or expert witnesses in cases involving psychiatric patients.
WVMC, WVSUMC and PMHU have capacities to take care of substance abuse cases, in the inpatient or outpatient sections. The consortium is deeply involved in the community-based drug rehabilitation efforts of the city and province of Iloilo. The consortium also works closely with the Department of Health – Treatment and Rehabilitation Center (formerly Substance Treatment and Rehabilitation Center (SATRC)), a substance abuse care facility whose offices are in Pototan, Iloilo, adjacent to PMHU. The staff psychiatrists of the center are also graduates of the residency training program.
Occupational therapy technicians are presently in the staff to provide occupational therapy services to patients. One is at the WVMC, and the other at PMHU. Both are being supervised by a licensed Occupational Therapist.
Psychological testing is provided for patients, as well as the general public. Psychologists are in the staff of WVMC and PMHU to make services available. WVSUMC patients are referred to the other two facilities when they need to undergo psychological tests.
An electroconvulsive therapy (ECT) machine has been made available to the consortium by the Doctors-to-Doctors program. The Doctors-to-Doctors Program is an initiative of health professionals based in California, USA, headed by Dr. Robert Dolgoff, a psychiatrist from the University of California San Francisco. The collaboration has allowed doctors, psychologists, pharmacologists and other health workers from the Doctors to Doctors Program to come for lectures, consultancy and dialogues with their local counterparts. Patients who could benefit from ECT treatment are referred for evaluation, and treatment for qualified patients are done at the WVMC.
Psychiatry research is a core component of the training program and residents are compelled to do research work as part of their requirements for graduation. Consultants and residents also take part in research activities, some of which are sponsored by pharmaceutical companies. The consortium also provides assistance as mental health experts to other researchers who may require such.
The consultant staff is heavily involved in the three Schools of Medicine in Iloilo City, namely those of the West Visayas State University, Central Philippine University, and the Iloilo Doctors College. The chairmen of the Psychiatry departments of all three medical colleges are consultants in the consortium. Residents are also involved in pedagogy and medical education by their participation in the training of junior interns and postgraduate interns affiliated with their institutions.
CONSULTANTS, RESIDENTS AND STAFF OF THE DEPARTMENT
WESTERN VISAYAS MEDICAL CENTER
DEPARTMENT OF PSYCHIATRY AND POTOTAN MENTAL HEALTH UNIT
Rowena G. Cosca, M.D., FPPA (Life)
Valerie Heena D. Andora-Quilaton, M.D., FPPA
Assistant Training Officer:
Elna L. Tecson, M.D., FPPA
Ma. Anabellee B. Salanatin, M.D., FPPA
Daisy C. Daquilanea, MD, FPPA
Donaldo Nicanor L. Tugbang, MD, FPPA
Henrietta C. Española, M.D., FPPA (Life)
Eufemio E. Sobrevega, M.D., FPPA (Life), FPNA
Mariano S. Hembra, M.D., FPPA
Japhet G. Fernandez de Leon, M.D., FPPA (Life), FPSCAP
Victor A. Amantillo Jr., M.D., FPPA
Ruby P. Jaen- Bitoonon, M.D., FPPA
Diosdado V. Amargo, Jr., M.D., FPPA
Aimee C. Chua, M.D., DPBP
Rey M. Mollenido, M.D., FPPA
Ma. Theresa V. Castaneda, M.D., FPPA
Ruel E. Malata, M.D., FPPA
Ma. Corazon A. Jardiolin M.D., FPPA
Jeffrey L. Gellada, M.D., FPPA
Ali C. Robles, M.D., FPPA
Mary Christine G. Te, M.D.
Charisse Christine L. Lasaleta, M.D.
Ira B. Villanueva, M.D.
Janice T. Taleon, MD
Mary Camille E. Reyes, M.D. (extended)
Mikkaela C. Daquilanea-Chin, M.D. (extended)
Ken Patrick I. Ingles, M.D. - Chief Resident
Christian Faith U. Gayatgay, MD
Arlene M. Resano, MD
Billy Joe P. Rodriguez, MD
Mabini AC R. Briones III, MD
Catherine Jane L. Eraldo, MD
Glysdi Seth B. Panton MD
Karey Louise Charisse B. Valencia MD
Trina C. Cabilitasan, MD
Sarah Cabigo-Valencia, MD
Cheryl B. Vacante, RPsy, RPm
Leobe H. Java, RPsy, RPm
Lezhiel Mae A. Tabera, RPm
Pshelanne Audrey S. Palma, RPm
Fitriani L. delos Santos, RPm
Rholene Shane C. Florel, RPm
St Jude Ward
Nurse: Acute Psychiatric Care Unit
Joel S. Payba, R.N. – Head Nurse
Keanne Floyd Mangyan, R.N.
Alexander Mislang, RN
Mavis Dawn Martinez, RN
Mark Andrew Posa, RN
Emmily Panganiban, RN
Casey John Jocsing
Jeff Michael Kenneth Laza
PMHU In Patient Unit
Rohear Alvin Lopez, RN – Head Nurse
Leah Rico, RN
Jessy Lyn Janeo, RN
Louella Laballe, RN
Jan Michael Porras
Queenie Lyn Hubahib
Social Welfare Officer I
Jose Carlito Carmen
Adelaida S. Yumang (PMHU)
Jessel Ruego (WVMC)
Richard P. Gaylan
Hannah Joy Quinto
Ananias M. Pena
Alma Pena Jowell Ignacio
Raffy Jason Penaflorida
Cleoh John Balino
Jose Stephen Depita
Joe Van Paches