History of Orthopaedics in the Philippines

HISTORY OF ORTHOPAEDICS The practice of Orthopedic surgery in the Philippines began after World War 2. In 1948, a group of physicians has formed a society just after they finished their training in the United States and England, and named it the Philippine Orthopaedic Association (POA). This group of foreign-trained physicians were introduced as the first officers of the POA. They include Jose de los Santos, Rodolfo Gonzales, Ambrosio Tangco, Augusto Besa, Francisco Aguilar, Luis Martinez, Deogracias Tablan and General Basilio Valdez - along with Dr. Jose de los Santos as the first President of the POA. During that time, there was only one training institution for Orthopaedics in the country - the National Orthopaedic Center (NOH). Dr. Jesus Tamesis has established the first residency training program at the NOH in 1956. Since the NOH was under the Department of Health (DOH), it was the only institution which had a training program for Orthopaedics until 1970. In June 1971, Dr. Ambrosio Tangco advocated the establishment of the Department of Orthopaedics at the University of the Philippines College of Medicine – Philippine General Hospital (UPCM-PGH). The Board of Regents of the University of the Philippines (UP) passed a resolution qualification exam recognizing Orthopedics department as a separate operating department from the Department Department of Surgery. This successful recognition has started the chapter of the first university-based Orthopaedic training program. THE EVOLUTION OF THE ORTHOPAEDIC SPECIALIST In 1972, the POA officers organized an independent board to guide the practice of Orthopaedics in the country - the Philippine Board of Orthopaedics (PBO). The PBO was eligible to give accreditation to training institutions that provide high standards of Orthopaedic training. Only physicians who have completed a 9-year doctoral degree program in Medicine and passed the Philippine license examination are qualified to enroll in a 4-year Orthopaedic residency program in any of the accredited training programs. Under the umbrella of the eligible training programs, Philippine Orthopaedic Association Ellewellyn Pasion PBO examiners visiting the training center during accreditation A Treasure of History a total number 21 Orthopaedic training institutions were established in the entire Philippines. Nine (9) are currently located in Metro Manila while twelve (12) are located in various provinces. All these Orthopaedic institutions undergo yearly accreditation by the PBO, ensuring that high standards of training is maintained. The establishment of Orthopaedic training programs in the provinces helped to address the uneven geographical distribution of Orthopaedic practitioners in the country. Most graduates of residency programs in the provinces usually choose to practice in their city, or region. In the past, the majority of Orthopaedic program graduates would practice in the metropolitan areas, mostly in the capital city, where the big & recognized medical centers are located. But at the present time, there are well-equipped medical centers in the cities outside of Metro Manila and in the provinces. Despite of all this, there is still shortage of Orthopaedic surgeons, a total of 797 Orthopedic surgeons for the growing Filipino population. There is only 1 Orthopaedic surgeon for every 136,763 Filipinos. Hopefully, the POA and the PBO will find. 9 programs, the trainees undergo rotations in different Orthopaedic sub-specialties such as Trauma, Adult Orthopaedics, Spine, Pediatric Orthopaedics, and Hand. Every year, an Inservice Training Examination (ITE) is conducted by the PBO to assess the knowledge and competency of trainees throughout their years of residency training . After completing the 4-year residency program, the trainee sits for a Diplomate examination consisting of 3 parts: a written part, an oral part , and finally a practical examination part administered by the PBO. Only successful candidates earns the certificate of Diplomates in Orthopaedic surgery. After a year of Orthopaedic practice and fulfillment of all the requirements, they can apply for any of the Fellowship programs held by the Philippine Orthopaedic Association (FPOA). Under the supervision of the PBO, more Orthopaedic training programs were accredited throughout the years. The number of Orthopaedic graduates started to increase and has overcome the shortage of orthopaedic physicians in the country. By the end of 2021, a PBO Written Exam 9 (Pre pandemic) PBO Virtual visit of a training center during the Pandemic The POA has always played an active role in the establishment of regional Orthopaedic associations in the Asia Pacific region. During the 2nd Pan Pacific Rehabilitation Conference in 1962, Philippine delegate Dr. Catalino Jocson invited Orthopaedic surgeons from Japan, Hongkong, Malaysia, South Korea, and South Vietnam to his home and has proposed to them to form an association. Within few months of that meeting, the Western Pacific Orthopaedic Association (WPOA) was established . Prof. Isaharu Miki of Japan was elected as the first President. From April 2-7, 1970, the 3rd Congress of the WPOA was hosted by the POA in Manila. General Basilio Valdez was elected as the first Filipino President of the WPOA, but unfortunately shortly after his election, General Valdez had suffered from a fatal heart attack and passed away on 26 January 1970. "Fortunately, in all their adversity, the Philippine Fellows were able to find a man of the hour to step in place of General Valdez... Dr. Francisco Aguilar who accepted the role of President of the WPOA and of the 3rd Congress in Manila." (taken from the writings of Dr. Deogracias Tablan┼, Honorary Secretary, WPOA, 1973-1992). In 1987, the POA again hosted the WPOA Congress in Manila during its 25th founding Anniversary. During the 50th Anniversary Congress of the POA in 1999, WPOA President Prof. Robert Bauze of Australia proposed to rename the WPOA to the APOA during the special WPOA Council Meeting in Manila. In 2000, the WPOA has officially changed its name to the APOA during the Congress in Adelaide. With the new name, 10 find the ultimate solution to this. Currently, there are 6 regional chapters of Orthopaedics outside of the National Capital Region (NCR) which are: North and South Luzon chapters, the East and West Visayas chapters, and the North and South Mindanao chapters. Each of these chapters alternate in hosting the mid-year meetings & events of the POA. They have their own set of officers and are responsible for evaluating and maintaining the high standard of quality of Orthopaedic training, service, and research in their representative regions. Up to date, there are twelve (12) POA Specialty societies. Orthopaedic resident graduates who underwent further postresidency training abroad for a subspecialty of interest has paved the way to form various Specialty societies like arthroplasty, spine, sports & arthroscopy, pediatric Orthopaedics, hand, etc. All these specialty societies hold their own regular meetings and annual conferences, but at the same time, they continue to fully support their mother association - the POA. As a matter of fact, there are a total of 797 POA Fellows, 62 of whom are women. In fact, the Philippines has the most number of female Orthopaedist in the Asia Pacific region. It is noteworthy to mention that in 2016, Filipino women Orthopaedists organized the Philippine Society of Women Orthopaedic Surgeons, Inc. (PSoWOSI) to promote gender equality in the practice of Orthopaedics in the country. This advocacy goes well with 2022 being declared as the Year of Women. POA INVOLVEMENT IN REGIONAL ORTHOPAEDICS the APOA and the AOA. It strongly established the ties with international Orthopaedic associations like the Societe Internationale Chirugie Ortopedie et Traumatologie (SICOT), American Academy of Orthopaedic Surgeons (AAOS), European Federation of Orthopaedics & Traumatology (EFORT), whose annual congresses many Filipino Orthopaedic surgeons attend and participate. In the end, I would like to thank all the past POA Presidents, all 59 of them, for all their contributions in making the POA what it is today. The young generation of Filipino Orthopaedic surgeons will continue to cooperate, collaborate and strengthen the ties with our Orthopaedic allies in the Asia Pacific to promote further advancement of Orthopaedics in the region. 11 name, the APOA decided to include all countries in the Asia Pacific region, and accept Federal (country) membership. This made the APOA the largest regional Orthopaedic association in the world, with a total number of 25 countries as members . From a total 1,200 individual members in 1992, the APOA has grown to over 60,000 members in 2021. In 1981, through collaborative efforts among the Orthopaedic leaders of the Association of Southeast Asian Nations (ASEAN) countries, the ASEAN Orthopaedic Association (AOA) was established in Manila, with Indonesia, Malaysia, Philippines, Singapore, and Thailand as the founding member countries of the AOA. Dr. Jose M. Pujalte of the Philippines was the founding President of the AOA. Later on in the 2000s, Vietnam, Brunei, Myanmar, and Cambodia have joined as Federal members. The POA has been actively involved in the activities of these two regional associations - the WPOA Congress 1989 (L-R) Lewy Pasion (ASEAN OA President), M. Sivananthan (MOA) Deogracias Tablan (WPOA Hon. Secretary] and Chhab Hilmy (WPOA President Elect 1989-1992) WPOA Congress 1989: (L-R) Deogracias Tablan (WPOA Hon .Secretary, Kamal Bose ( WPOA President 1989-1992), Lewy Pasion (ASEAN OA President) Yeo Cheow Tong (SG Health Minister), and Sim Fook Lam (WPOA Treasurer) Ellewellyn Pasion APOA 1st Vice President Philippinnes