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My Post-training Reflection
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POST TRAINING REFLECTION

 

Roderick S. Mujer, M.D.

 

INTRODUCTION

 

Having spent my surgical residency at OMMC for almost three years from January 2003, the day I started, it was not surprising that I have great pride and affection for this organization.

 

Although, I cannot escape from encountering difficult biased people and/or uncertainties at work I am richly benefited from the surgical training. I just look at it as challenging and a great adventure.

 

To further show my appreciation this POST TRAINING REFLECTION is hereby submitted. To follow:

 

OBJECTIVES

 

A.   To point out the progressive acquisition of surgical skills and the core values learned in the training program;

 

B.    To contribute and formulate techniques and strategies to the enhancement of surgical-training program and working environment.

 

 

 

 

 

 

OUTCOME:

 

BASIC FRAMEWORKS

 

 

PATIENT MANAGEMENT PROCESS

 

            By History and tradition surgeons are expected to do his/her fair share to ensure that all ill persons should receive appropriate treatment.

 

            When I think about this, I realize that nearly years have already passed since my approach to patient management process was not quite well. I have experienced difficulties in discerning the appropriate diagnosis. However, the OMMC is equipped with tested guidelines and procedures, and for this I learn to embrace the techniques and start to savor the principle in its beauty and value.

 

            Nevertheless, I am still on the process of discovering other skills at all points.

 

OPERATION-SURGERY PROCESS

 

            They say good surgeons are products of many surgeries performed. And I’m glad surgical residency in the OMMC has a strong emphasis on clinical acquisition of skills. I am only a junior resident but I almost have performed various surgical cases, major or minor one. Although, I’m still looking forward to have in my hand unusual and difficult one, which is usually entrusted to seniors, I know somehow I will be given the same opportunity.

 

 

PROBLEM-BIASED AND SELF DIRECTED PROCESS

 

            Besides surgical skills learned from practice what good in the OMMC surgical program is its openness to medical advances. It recognizes the valuable lesson of how to learn while developing the skills necessary to succeed in surgical profession. Its debates and action researches and or those knowledge learned synthesis and/or redefining further learning needs have a great help in the improvement of my clinical performance.

 

PHYSICIAN-TEACHER PROCESS

 

            I do not imagine myself lecturing in front of audience. This kind of situation makes me feel unease. But the program-teacher process really helps me to gain my confidence and enhances my teaching skills. And because of this, it shows me the function of the future consultative role.

 

By tradition and history residency in the OMMC has similar atmosphere to military system where motto is “Obey First before Complaint”. Residents usually give high regard to their seniors. During working-hours juniors or freshmen were just doing the task-assigned solely without expecting any voluntarily help from those in a higher position. Sometimes questions to be asked left unanswered. But this program-teacher process gives residents opportunity to interact with their seniors and/or co-physicians, interns and/or other hospital personnel. This has become a very helpful and contributory to the learning process.

 

 

 

 

 

PHYSICIAN-RESEARCH PROCESS

 

            Surprisingly, research has been one of my interests. I always like researching synthesizing and re-defining learning needs. However, the interest I have for it, is quite less. Looking the other side of it, the statistical side of research really makes my stomach upside down. Nevertheless, I’m trying to improve more and to know the basic of analyzing variables, for I know, research provides the opportunity for residents to learn, in depth, the fundamentals tested procedures as applied to clinical surgery.

 

 

PHYSICIAN-MANAGER PROCESS

           

            This teaches residents to be competent leaders not only to patient-physician relationship but also toward co-physicians and personnel.

 

Physician is expected to handle cases in a critical conditions and handling a case requires a “decision-making” skills. And each case could only be successfully done if a physician is competent enough to lead and decide. Such skills to lead and decide are learned on this program and it has been so ideal to have this program.

 

 

COMMUNITY SURGICAL HEALTH MANAGEMENT PROCESS

 

Surgical Residency in the OMMC not only teaches responsibilities to the patient, to the residents, to the referring physicians, but also to the community. This really shows that the OMMC has a room for nationalism and generosity. And for this, I take pride to be part of this organization. This program really awakens my social consciousness and gives me opportunity to help people although in a little way while gaining skills on it.

 

 

 

CORE VALUES

 

 

RESPECT FOR HUMAN LIVES AND HUMAN BEINGS

 

“Orimum Non Nocere” this only reflects that the OMMC department has a heart and soul. For this I completely give my trust to this institution.

 

HONESTY AND SINCERITY

           

            I am honest and sincere in nature. But sometimes, because of grueling hours in the hospital, I was tempted to do some dishonest but shortcut accomplishments. And because of these virtues that are strictly observed in the surgical-program, I have left no recourse but to comply all the requirements with honesty and sincerity. And it makes me proud to be part of the OMMC. Residents are not only trained to be competent surgeons but also to be better persons.

 

ETHICS AND INTEGRITY

 

My training teaches me how noblest my profession was and which I should treasure and should not put it in a great peril.

 

 

 

 

 

PROFESSIONALISM

 

As a physician-in-training, I was able to develop a personal sense of what it means to be a professional. Its competence in surgical skills, its acknowledgement to specific duties and responsibilities toward the patients, co-physicians or individuals it serves and toward the society.

 

 

CONTINUAL IMPROVEMENT TO ACHIEVE

QUALITY AND EXCELLENCE

 

I further take pride to the ultimate objective of the OMMC Surgical Program and that is to train residents to become high caliber surgeons who will be successful in either in academic and private practice concerns.

 

 

 

TEAMWORK

 

            Residency in the OMMC recognizes “HIERARCHY”. It is similar to military atmosphere where seniors are extremely respected. However, this program balances the system. It reminds those who are benefited by the system, to understand that everybody in a group has to play a significant role. This is really contributory to learning process and to a healthy working environment.

 

 

 

 

 

 

SOCIAL CONSCIOUSNESS

 

            I am not a journalist. As a matter of fact, I hate writings articles. Although it is a dream to become a writer, it is not my goal to be one. But OMMC really pushes me to do things I really do not want to do. Now I learned to embrace it. And I feel good, because I know somehow I am helping many in my own little way.

 

DISCUSSION  

 

This paper is a post-training reflection cum self-evaluation. There is such a thing as learning through reflection as well as learning through self-evaluation.  

In the process of reflecting on the learning that I may have acquired during my training years to become a general surgeon, I was able to re-synthesize and reorganize.  

Re-synthesize in the sense that I was able to put parts together to form a new whole. At the start of my training, I was made aware of my learning objectives. However, with the learning period spanning 2 years and with the learning objectives necessitating repeated readings and practices, the learning activities that I went through can be described as piecemeal and supposedly cumulative. Before this reflection paper that I did, I just have a general feeling that after 2 years of residency, I learn new things and many things at that. If I were to be asked what I learned, I will have difficulty answering the question in a concise manner. I will probably try to enumerate all the things that I think I learned, that come spontaneously to mind, even the smallest things, with the tendency to repeating the same thing over and over again, and to the point that I cannot enumerate them all and in exasperation, just say “and other things.” With this reflection paper, I was able to have a clearer idea of what I have learned by grouping or categorizing the bits and pieces that I have learned. 

Reorganize in the sense that I was able to relate the values of the department to those that I previously held before I joined the department and before the new steward came in and then to bring them into a harmonious and internally consistent philosophy. I have imbibed the basic frameworks and core values as spelled out by the present department chairperson. I am sure that there are other frameworks and core values that may prop out in the future. However, for the moment, these frameworks and core values are sufficient to serve as my foundation to be a rational, effective, efficient, holistic, and humane community surgeon as well as a springboard for my further learning and continual lifetime improvement. Before these basic frameworks and core values were taught by the present department chairperson, I was just concerned with my training to be a general surgeon, just to be able to operate. I had a vague idea of what a quality general surgeon and a quality surgery department should be. With this reflection paper, I now have a clearer idea what a quality general surgeon and a quality surgery department should be. I fully concur with values of the present Department of Surgery of OMMC and its present chairperson and I have imbibed them. 

After reflecting on what I should have learned, I did a self-evaluation. In the process of doing the self-evaluation, I was able to get a much clearer picture of what I should have learned. Before I made a self-evaluation on certain basic frameworks and core values and gave concrete examples and situations to show how much I had learned, I had to know very well the concept of each of the frameworks and values. Thus, in the process of doing the self-evaluation, I learned the nitty-gritty or details of what I was supposed to learn. 

The other benefit that I got from the self-evaluation was getting an idea where I stand which in turn motivated me to go for improvement.  

This reflection cum self-evaluation is really a kind of learning strategy which may turn out to be the greatest but often unrecognized force to consolidate whatever learning that has been attempted (through the process of synthesis, organization, and self-evaluation) as well as the starting point to propel further learning (through motivation brought about by the self-evaluation). 

As a resident of the general surgery program of the Department of Surgery of the Ospital ng Maynila Medical Center, with my first-hand experience and with my belief of its usefulness, I strongly recommend that this procedure of asking all prospective graduates and non graduating resident of all departments of surgery to do a reflection cum self-evaluation paper be adopted. 


 

 

 

 

SUMMARY

 

I have presented a reflection cum self-evaluation paper after my training in general surgery at the Ospital ng Maynila Medical Center. The objectives are to reflect on how much I have imbibed the basic frameworks and core values expected of me as part of my learning objectives in the training program and to formulate strategies for continual improvement after graduation. The basic frameworks consist of: 1) patient management process; 2) operation-surgery process; 3) problem-based and self-directed learning process; 4) physician-teacher process; 5) physician-researcher process; 6) physician-manager process; and 7) community surgical health management process. The core values consisted of: 1) respect for human lives and human being; 2) honesty and sincerity; 3) ethics and integrity: 4) professionalism; 5) continual improvement to achieve quality and excellence; 6) teamwork; and 7) social consciousness. Although my faculty will have a final judgement on my self-evaluation, I confidently say that I have imbibed the basic frameworks and core values which I think could serve as a foundation for my being a rational, effective, efficient, holistic, and humane community surgeon as well as a springboard for my further learning and continual lifetime improvement. With my first-hand experience, I believe this reflection cum self-evaluation is another kind of learning strategy which may turn out to be the greatest but often unrecognized force to consolidate whatever learning that has been attempted (through the process of synthesis, organization, and self-evaluation) as well as the starting point to propel further learning (through motivation brought about by the self-evaluation).

The surgical residency in the OMMC has an extraordinary standard. Expectations of resident performance and professional behavior are appropriately high and include dedication to patient services, maintenance of personal academic standards, development of teaching skills, self-discovery and improvement, research and to public and/or community, as well as the progressive acquisition of skills. Nevertheless it is very fulfilling to be one among OMMC residents and for these, my loyalty and willingness to overvalue the organization will be unreservedly given.

             

 

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Last modified: 11/09/05