Near the end of February 2020, the year level 9 coordinator of the Ateneo School of Medicine and Public Health wrote a letter to the incoming interns of batch 2021. It was an invitation to join the third cohort of the Community Enhanced Internship Track, a unique program designed to move learning activities away from the hospital and towards the local health center.
While the CEIP interns would have the same six block rotations as the rest of the batch (the big four, plus family and community health, and ENT-ophtha-radio-psych), half the time would be spent in Barangay Toro Hills. There would be a mix of clinical, preventive and public health programs in the community health center, followed by afternoon didactics.
It was a competitive program. There were only 12 slots. Aside from a letter of intent, which I’ve attached here, there was also a panel interview. And, presumably, a screening based on academic and clinical performance from the year before.
I had very little expectations, but a lot of hope.
A letter of intent
I’ve spent quite a bit of time lately thinking of my “why”, on top of “how”. Since the four days of PLE have finished, I’ve been looking for direction. The days of waking up at 7AM to study are done.
While fixing my files (for pre-residency, which I’m 99% committed to), I came across the last letter of intent that I wrote. And I suppose my younger self —almost pre-pandemic, and still hopeful for a long and fulfilling internship year— was a lot better at this introspection business. I can only hope for the same clarity and surety of purpose.
22 June 2020
The CEIP Committee
YL9 Internship Program
Ateneo School of Medicine and Public Health Pasig City, Philippines
To Whom It May Concern:
I am Gianica Monteagudo, writing to express my intent to join the Community Enhanced Internship Program. I am a physician-in-training. I am also an Atenean, an Iskolar ng Bayan, a Benedictine, a debater, a writer, a daughter, a Filipino.
I view every year of my life as a culmination and practice of all the years that have come before. For more than a decade I lived the words “servant leadership”, “social activism”, and “feminism” in the halls of St. Scholastica’s College. I spent my most formative years breathing the air of Padre Faura, where I practiced honour and excellence with my peers while seeing the true faces of poverty and injustice. I spent time competing in local and international debates to uphold reason above all.
When it was time to choose medical schools, I asked, “which institution trains the best physicians, with the cleanest skills and best grasp in theory?” But I knew that, if I wanted to become the physician my life has been shaping me to become, I needed to ask bigger questions. Where would I learn the tools needed to not only heal the sick, but also to break the long lines of people waiting outside PGH, crawling around the street corner even before dawn?
When I saw the ASMPH application essay prompt, “What is the role of a doctor in changing communities?”, I knew I was heading to the right place. Back in 2015, I wrote how doctors were privileged to be one of the most educated people in any community. They become go- to persons of authority for anything, not just medical concerns. Thus, physicians have the responsibility to reflect fairness in politics, rights, health, and their intersections.
Five years later, this responsibility still stands. The tools provided by ASMPH and AGSB have only validated this. They have allowed me to see how hospitals are crippled by lack of government support. I saw how even private practices are damaged by poor health-seeking behaviors.
During this pandemic, they have allowed me to identify the factors influencing the communication gap between high-minded English-speaking doctors and the everyday Filipino. I can understand the frustrating logistical gaps between ideal disaster responses and operational realities. I see the growing distrust of people against persons of authority, like the DOH.
I am also slowly seeing that my future as a doctor may not necessarily lie only in a hospital residency. I think being part of CEIP will help me answer where this long road will take me. And I know the CEIP will help me answer the “how’s” to my “why’s” of change.
Thus, I look to the Community Enhanced Internship Program for five things.
First, as an academic supplement. Our family medicine rotation in Arkong Bato overlapped with Christmas events, and our community pediatrics rotation was held online. I want to experience how primary care truly fits. Second, as a way of further realising the truths in healthcare that I observed in clerkship, now with the intent of better empathy: how people on the ground think, speak and change, and how communities react to challenges. And I will be able to serve while learning. I will actually be contributing to sustainable community building.
Third, as a way of being part of a long-term patient-health care worker relationship. Hospital rotations often don’t have room for follow-up. Being part of this team will give me the chance to follow members of the community from illness to wellness and so on. Fourth, as a natural extension of this road towards some form of health activism, in a way that complements the traditional experience. How do we best communicate? How can we really effect change?
And fifth, as a holistic formative experience for the self. The direct guidance of strong mentors and the support of like-minded peers can help me better understand “the doctor of the future” in terms of who we are today.
In the grand scheme of things, internship is just another step in the road to becoming a physician. Within or outside the CEIP, I am sure that ASMPH would help me find the right skills and mentors to become a social catalyst, outstanding clinician, dynamic leader. I firmly believe that. But I also firmly believe that the CEIP will transform me in meaningful ways. This may be my best first step leading to the next five years.
It’s a very long letter, isn’t it? It might as well have been designed to be a blog post.
Don’t worry. My sister’s editing and trimming my letter of intent for pre-residency as we speak.
Until next time! ❤️