Welcome to the College of Medicine (Bicol Christian College of Medicine) of Ago Medical Educational Center - Bicol Christian College of Medicine (AMEC-BCCM). The College of Medicine was established in 1980 in Legazpi City, Philippines, by Dr. Damaceno J. Ago. It is a privately owned medical school. It is the only College of Medicine in Bicol ?Region V? which consists of 6 provinces and 3 cities. It is a member of the Association of Philippine Medical Colleges Foundation, Inc. Internationally, the college is registered with the World Health Organization and is accredited with the Foundation for the Advancement of International Medical Education and Research. BCCM has two base hospitals, Ago General Hospital, which is just beside the school, and Ago Foundation Hospital in Naga City, which is 74 Km from the school. It is affiliated with 2 government hospitals, the Bicol Regional Training and Teaching Hospital, which is 500 meters from the school and Bicol Medical Center, which is about 80 km from the school. The college has graduated not only physicians practicing in the Bicol Region but all over the country and the world. It has produced physicians from Thailand, Korea, Taiwan, Nepal, Iran and US.
The Board of Trustees and Faculty of the Bicol Christian College of Medicine believe that;
1. Man exists not only for himself but also for other people in the community.
2. Society exists for the welfare of men.
3. Health is a fundamental right of every person.
4. Every person and every community will always have a health problem at one time or another.
5. The medical school shall help solve the health problems of the community through its administrators, faculty, students, and graduates using the primary health care approach.
6. Medical students shall be treated as adult learners.
7. All adults are capable of learning, given the proper guidance and support.
8. Active learning teaching strategies yield the best results.
9. Learning to become a competent physician is best achieved through a problem-based and a competency-based learning approach.
10. Learning to be a community-oriented physician is best achieved through a community-based learning approach.
11. Medical education is a life-time learning process.
12. All physicians should have competency in self-directed learning.
To produce a basic health physician who is conscious of and responsive to the health needs of the community; and can undertake general practice of medicine; pursue postgraduate specialization; and engage in medical research.SPECIFIC OBJECTIVES
At the end of the program, the student should;
1. Be oriented to the –
1.1 Bicol Christian College of Medicine – its
1.1.1 Administration and faculty
1.1.3 Medical curriculum
1.1.4 Student Progress Report
1.1.5 Rules and regulations
1.2 Medical profession
1.3 Health status of the Bicol Region
2. Be motivated to become a physician as envisioned by the BCCM –
2.1 An effective, efficient, and humane physician
- Willing to solve the health problems of the community
2.2 A community health problem solver
2.3 A physician-teacher
2.4 A physician-learner
2.5 A physician-researcher
2.6 A physician-manager
2.7 A Philippine Board of Medicine passer
3. Have acquired the skills to plan –
3.1 To become a physician
3.2 To manage a patient
3.3 To conduct research
4. Have acquired the skills to use the “Management” framework/foundation.
To manage himself
To manage his profession
To manage a patient
5. Have acquired the skills in
5.1. Establishing rapport
5.2. Clinical diagnostic process
5.2.1. Obtaining accurate history and doing complete physical examination
5.2.21 Selecting appropriate paraclinical procedure
5.3. Treatment process
5.4. Giving advice
5.5. Making referrals
5.6. Dealing with the following issues:
Clinical management issues
Psychosocial or behavioral issues
Since its foundation until 1995 15 years, BCCM has been implementing the traditional curriculum. In 1995, leading medical schools around the world started to shift to a different teaching approach; which was the problem-based learning strategy. The administration of BCCM decided to follow the trend.
The decision to shift curriculums was influenced by stories on the personal experiences of the “founding fathers”. They recalled usually being unable to remember the facts ?by which they had passed exams? from the first years of medical school, for application to patients in the clinical years. They also remembered the difficulty of “integrating” knowledge from a range of disciplines in the management of a single clinical problem.
Problem-based Learning (PBL) stimulates the learning process that a person utilizes at attempts to solve problems he encounters in life; he must get information, look for cues, analyze and synthesize available data, develop hypotheses, and apply strong deductive reasoning to the problem at hand. The learning acquired in PBL is better remembered ?because of relevance and direct contact?, recalled faster, easily transferred and applied to a future problem.
There is evidence that retention is enhanced when facts are learned in a context which closely approximates real life; e.g., a clinical problem.
The present curriculum utilizes the:
Problem based learning approach
Community-based learning approach
Competency-based learning approach
Self directed learning strategy
Active learning strategies utilizing group discussion, direct patient contact, direct
community contact, preceptorship, etc.
The overall design of the instruction:
1.It begins with an overview, progressing to framework, foundation, development
of knowledge, and ends in mastery.
2.There is supervised self-directed learning through a problem-based learning approach, self-instructional programs, and independent study.
3.There is emphasis on active learning teaching strategies such as group discussions, direct patient and community contacts, practicum, and projects.
Problem-based learning (PBL)
PBL is the learning that results from the process of working toward the understanding or resolution of a problem.
The problem is encountered first in the learning process and serves as a focus for the application of problem-solving or reasoning skills, as well as for the search for information needed to understand the mechanisms responsible for the problem and ways to resolve it.
In the process the following are attained:
1.Structuring of knowledge for use in clinical context.
2.Acquisition of an integrated body of knowledge related to the problem.
3.Development of an effective clinical reasoning process.
4.Development or application of problem-solving skills.
5.Development of effective self-directed learning skills.
6.Increased motivation for learning.
The problem based learning process
1.The problem is encountered first in the learning sequence, before any preparation or study has occurred.
2.The problem situation is presented to the student in the same way it would in a real clinical setting.
3.The student works with the problem in a manner that permits his ability to reason and apply knowledge to be challenged and evaluated, appropriate to his level of learning.
4.Needed areas of learning are identified in the process of work with the problem and used as a guide to independent study.
5.The skills and knowledge acquired by this study are applied back to the problem, to evaluate the effectiveness of learning and to reinforce learning.
6.The learning that has occurred in work with the problem and in individualized study is summarized and integrated into the student’s existing knowledge and skills.
In general, it seems that health professionals have limited motivation and skills to continue their learning. This becomes more apparent as they get older.
Medical information becomes obsolete as new knowledge supercedes or contradicts the old. Within a decade of graduation, only a small proportion of the knowledge used by physicians has been learned in medical schools.
Research in education suggests that there is enormous variation in which individuals learn, both in terms of content and “style”. It is therefore important to allow for flexibility and “individualization” of the learning arrangement.
The objectives of this course are to orient, motivate, give an overview, build a framework and lay down the foundation, and facilitate learning to become a physician. The course contains modules on the history of medicine, the concept of a physician, how to study, overview of strategies in learning and the different medical curricula. An overview of the management process and function is introduced to enable the future physician to solve the health problem of a patient and the community. These competencies are developed through self-directed, independent study and group discussion with a facilitator.
HEALTH MANAGEMENT (2 weeks)
The course includes learning the concept of health and disease, the concept of primary health care and the importance of role modeling of physician in health promotion. The student learns how to formulate management plans for the health of individuals, families, communities, and the health for all movement.
MANAGEMENT OF A PATIENT (2 weeks)
The general objective of the course is to learn how to manage a patient. At the end of the course the student is expected to demonstrate mastery of the steps and concepts in management of a patient learned in the previous course on Health Management. The student is expected to develop skills in screening for health problem and the process involved in making a diagnosis and in managing a patient with health problem. The student is introduced to history taking and physical examination and the bases for laboratory procedures. Activities include independent study, simulated patient management and practicum on actual history taking; and group discussion under supervision of a facilitator.
PHYSICIAN-ADMINISTRATOR-MANAGER (2 weeks)
The course enables the student to apply the principles and functions of management through exercises on management of self, time, people and project. The student is asked to analyze and critique the management work of a rural health officer, hospital director and other administrative people. The learning process is reinforced by actual community work in the course on Community Health Management. The students are assigned to manage the health problems of a community (Barangay) throughout the 4 years.
PHYSICIAN-TEACHER-LEARNER (2 weeks)
The course prepares the student, the future physician, for his role as an educator to future physicians, co-physicians, individual patients and the community. The student learns how to study (problem based learning and self-directed study), how to prepare and conduct presentation or lecture, and how to prepare instructional plan and visual aids.
PHYSICIAN RESEARCHER (2 weeks)
Students learn basic research methods. They are introduced to using evidence-based medicine approach in answering clinical questions on clinical diagnosis, paraclinical diagnostic procedures, and treatment. At the end of the course the student is expected to be able to formulate an action research proposal using primary health care approach.
COMMUNITY HEALTH MANAGEMENT (4 weeks/course)
There are 7 CHM courses in the entire 4-year curriculum, one for each semester during the first 3 years and the last during clerkship. A small group of students are assigned to a community. The community assignment is the same throughout the CHM courses. The general activities consist of a community diagnosis and the formulation and implementation of a 4-year comprehensive community health plan. The group is expected to come up with a documented solution of a health problem in the community at the end of the 4-years through a primary health care approach. The students are expected to apply the various biomedical and social health sciences they have learned in school.
EMERGENCY MEDICINE (2 weeks)
The students are oriented to emergency management as early as the first year. They learn the principles of basic life support. They are introduced to the common emergency problems encountered. As part of their active learning they are allowed to observe in the emergency room of a hospital.
TRAUMA (3 weeks)
The student is introduced to the concept of trauma as cause of health problems affecting the psychological well being of an individual, which may lead to disability or death and may affect the socioeconomic productivity of the individual and his family. The trauma may be physical, psychological or sexual. The course enables the student to recognize and manage the different forms of trauma health problems that may arise from burn, vehicular accidents, penetrating injuries, bites, falls, near-drowning, poisoning, child abuse, battered spouse, rape and disasters.
MATERNAL HEALTH (4 weeks)
The course is introduced with thorough study of the anatomy and physiology of the pelvis and the reproductive organs including neuro-endocrinology of menstruation and ovulation. The course enables the student to acquire a working knowledge of the morphologic and functional development of the placenta and fetus. The students are guided through the diagnosis of pregnancy, prenatal care, techniques to evaluate fetal health, the physiology and mechanism and conduct of normal labor and delivery, and postpartum care. The student is introduced to high-risk pregnancy, especially the common, possibly life-threatening complications of pregnancy. Problems in pregnancy are discussed with emphasis on prevention, and treatment. Recognition and management of difficult labor and delivery and the factors associated with them are discussed. Family planning, its methods and indications, are included in the course.
CHILD HEALTH(3 weeks)
The course aims to enable the student to acquire fundamental and basic knowledge of child and the adolescent according to the core curriculum as suggested by the Philippine Pediatric Society. Emphasis is given on problems of growth and development, genetics and the newborn. Preventive pediatrics, nutrition and immunizations are also emphasized. Problems on the organ systems are included in the systems courses. Knowledge is reinforced in the third year, in the Clinical Pediatric Course.
INFECTION AND INFESTATION(4 weeks)
The course enables the student to recognize and manage the common types of infections and parasitic infestations. He is expected to be able to write an overview and personal perspective on infectious and parasitic problems as health problems in the community. The student is expected to have a thorough knowledge and understanding of the nature of microorganisms and parasites; especially those that cause diseases in humans. The different infectious diseases are introduced through hypothetical and actual patients presenting problems like fever and certain localizing manifestations. Anatomy, physiology of organs and systems involved, pathophysiology and clinical manifestations of the infectious disease under study, and basic epidemiology, are basic competencies, which the student is expected to study. Discussion of drugs and antibiotics commonly used is part of management. The students are introduced to IMCI and TB-DOTS programs of the Department of Health.
Cancer is now recognized to be a major cause of death worldwide. The course introduces the student to all forms of cancer and to the heterogeneity of their presentations. The types of cancer are presented by organ system. Emphasis is put on recognition and detection as well as rational management. The course includes study of the normal and pathologic tissues.
GASTROINTESTINAL PROBLEMS(3 weeks)
The student is introduced to the common gastrointestinal problems through problem-oriented modules, namely: abdominal enlargement, abdominal mass, inguinal mass, jaundice, bleeding through the mouth, bleeding through the anus, and problems in eating and bowel movement. With hypothetical and actual patients as triggers, the discussion covers differential diagnosis with emphasis on the pathophysiology and mechanisms of disease. A good working knowledge of anatomy, histology and physiology is a requisite to the discussion of the diagnosis and management.
NUTRITIONAL PROBLEMS(1 weeks)
The course introduces the importance of nutrition in health and in disease. It includes basic nutrition, the functions of the nutrients and nutritional requirements. Common nutritional problems, their causes and pathophysiology and management, are discussed.
PULMONARY PROBLEMS (2 weeks)
The course enables the students to diagnose and manage respiratory problems with emphasis on the differential diagnosis of shortness of breath and hemoptysis. Thorough study and discussion of the anatomy and histology, physiology of the structures of the respiratory system is done at the start of the course. Through hypothetical cases, the student is guided on the proper history taking and physical examination. Discussion of the mechanism or pathogenesis of the presenting signs and symptoms and the related structural changes forms a part of the discussion of the differential diagnosis. The student is introduced to the laboratory diagnostic procedures that help in diagnosis and management.
CARDIOVASCULAR PROBLEMS (3 weeks)
The course is introduced with a discussion of cardiovascular anatomy and cardiac physiology. This then becomes the basis for understanding normal and abnormal ECG tracings. The different cardiac disorders are then discussed in the module on dyspnea as a presenting problem of congestive heart failure. Other modules included are on high blood pressure, myocardial infarction, palpitations and leg pain. Discussions on the module include differential diagnosis, etiologic factors, pathophysiology, physical examination and diagnostic aids.
ENDOCRINE AND METABOLIC PROBLEMS (2 weeks)
The course starts with a study of the anatomy and physiology of the endocrine organs. Emphasis is made on the more common disorders, namely, diabetes mellitus, thyroid problems, adrenal glands disorders, pituitary gland disorders and obesity.
NERVOUS SYSTEM PROBLEMS (4 weeks)
The course stars with thorough study of neuro-anatomy and neuro-physiology. Neurological disorders are discussed through differential diagnosis of problems presented through hypothetical patients in the different modules. Among these are modules on seizures, headache, altered sensorium, paralysis, and one-sided paralysis. Students are exposed to actual patients where they can practice their skills in history taking and neurological physical examination.
MIND PROBLEMS (4 weeks)
The course enables the student to have a grasp of psychiatry. Short lecturettes are given to introduce the different problems in psychiatry. Each lecturette is then followed by case discussion and discussion of the differential diagnosis of patients presented through hypothetical cases.
EYE PROBLEMS (2 weeks)
The course acquaints the student with the diseases of the eye. Emphasis is given to anatomy, physiology, methods of examination of the structures of the eye. Pathology and symptomatology of the diseases of the eye are discussed thoroughly to enable the student to diagnose and treat the more common, simple and non-surgical disorders.
EAR, NOSE AND THROAT PROBLEMS(2 weeks)
The course introduces the student to the diseases of the ear, nose and throat and surgical and non-surgical problems of the head and neck. Emphasis is given to anatomy, physiology, pathology and symptomatology. Discussion of the differential diagnosis is initiated by problems.
MUSCULOSKELETAL PROBLEMS(2 weeks)
The course aims to provide students with the necessary knowledge and skills in recognizing diseases and abnormalities of the musculoskeletal system. The course consists of modules on joint pain and swelling, muscle pain, muscle weakness, congenital and acquired musculoskeletal disorders, and postural abnormalities. The learning process consists of independent study and small group discussions guided by facilitator. The problems are introduced through hypothetical and actual patients. Study and discussions cover basic sciences such as anatomy, physiology, pathogenesis, laboratory diagnosis, and pharmacotherapeutics of commonly used drugs for musculoskeletal disorders. Correlates in the form of lectures are given as needed.
HEMATOLOGIC PROBLEMS(2 weeks)
The course enables the student to recognize common hematologic disorders. The student is expected to be able to discuss hemopoiesis, its physiology and pathology. Common hematologic disorders are discussed through presentation of problems through hypothetical and actual patients in the following modules: pallor, pallor with jaundice, plethora, petechiae and ecchymosis and other bleeding, lymphadenopathy, and hepatosplenomegaly. The student is expected to be able to discuss an overview of the immune system and be able to recognize common immunologic problems.
RENAL PROBLEMS(4 weeks)
The objective of the course is to enable the student to recognize and manage common problems of the urinary system. The course starts with in-depth study and discussion on the anatomy and physiology of the renal system. Thorough and good working knowledge of fluid and electrolyte physiology is also a prerequisite. The disorders of the renal system are discussed through hypothetical and actual patients in modules, namely, Anuria/Oliguria, Easy Fatigability, which focus on acute and chronic renal failure. The other modules, Hematuria, Periorbital edema, Anasarca, Dyssurria, cover discussion of the rest of the renal diseases. Lectures are given as needed to facilitate learning.
SKIN AND SOFT TISSUE PROBLEMS(2 weeks)
The course enables the student to have a working knowledge of the structure of the skin and its appendages. Through hypothetical and actual patients and visual aids, the student is expected to be able to diagnose different causes of pustular fluid skin lesions, bullous fluid filled skin lesions, red palm or sole with generalized rash, chronic granulomatous lesions, maculopapular rash accompanied by fever, and other types of lesion in the skin.
SEXUALITY (2 weeks)
A person’s sexuality depends on the interplay of four factors, namely; sexual identity, gender identity, sexual orientation and sexual behavior, in relation to the biological, genetic, psychological make-up of the individual. The course enables the student to acquire good working knowledge of how these factors affect the sexuality of a person and to recognize and be able to manage a patient with sexuality problems.
INTEGRATED PATIENT MANAGEMENT(2 weeks)
The course allows the student to integrate and correlate the knowledge he acquired from the courses he has taken. The student is exposed to actual patients. He applies his ability to take a comprehensive history and perform physical examination. Presentation and discussion of the clinical diagnosis and differential diagnosis follow.
CLINICAL PEDIATRICS (3 weeks)
The students are introduced to clinical work through actual patient management. Their skills in history taking and physical examination are reinforced and refined. The students are able to apply the basis and clinical knowledge on the different organ system problems studied in the previous courses, with focus on Pediatrics. They are then given the opportunity to review and reinforce the working knowledge in Pediatrics. The students are also introduced to pediatric procedures.
CLINICAL MEDICINE(3 weeks)
The students apply what they have learned in the previous courses. They are introduced to clinical work practice their skills in history taking physical examinations on actual patients assigned to them. They are asked to discuss the clinical diagnosis and differential diagnoses of a patient assigned to them. They are allowed to observe in the performance of common procedures. Periodic written examinations are given as review of internal medicine.
CLINICAL OBSTETRICS AND GYNECOLOGY (3 weeks)
The course is a review of the normal and abnormal obstetrics taken in maternal and gynecologic problems taken in cancer and maternal health courses. The course allows discussion of problems missed in the previous courses. The students are given opportunity to observe in the delivery room and obstetric ward.
CLINICAL SURGERY(3 weeks)
The course allows the students to focus on the basic principles of surgery and principles in pre-operative and post-operative care. The course enables the students to review surgical procedures. They are allowed to observe and assist in the ward, out patient clinic and operating room.
CLINICAL CLERKSHIP ROTATION (UNDERGRADUATE INTERNSHIP)(48 weeks)
Clinical clerkship or undergraduate internship is the final year before the degree of doctor of medicine is conferred. The program includes hospital rotation in the different specialties for 10 months (40 weeks) and completion of community work for 2 months (8 weeks). The student can now apply and relate his knowledge on basic and clinical sciences with actual patients and actual situations in the hospital and develop the skills he needs to become a basic physician. Hospital rotation includes Internal Medicine, Pediatrics, Surgery, Obstetrics and Gynecology, Psychiatry, Pathology, Radiology.