St. Luke’s College of Medicine

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News and Events

An Interview with the SLCM-WHQM President and Dean, Dr. Brigido L. Carandang, Jr.

IATROS: Hi Dean. I’m Anna, the Features Editor for Iatros. We’d like you to be the first feature for our Doctor of the Month article. So, first things first, for the record, can I get your name? Birthday?

 

DR. CARANDANG, Jr.: What did she say? (laughs)

 

Oh wait. Is it June 18?

 

Sixteenth. Unfortunately it’s on a Sunday.

 

I remember we had a party last year.

 

Yeah yeah.

 

We’re really curious Dean, how did your journey to become a doctor began?

 

Whoo! That’s a long story!

 

Well, we have a lot of time, Doc. Or maybe even just the highlights, if you’d like.

 

Well, that’s because I’m a junior.

 

Junior?

 

That’s a very significant factor. I was named after my father, who, unfortunately, I never got to know because the Japanese executed him when I was barely a year old. But I’ve always had an idealized image of him as a doctor. He finished agriculture in UP Los Baños and completed his medical studies in UST. He survived the infamous Death March but in 1944, there was a move by the Japanese forces in the Philippines to round up all able bodied Filipino men and execute them for fear that they may assist the American forces.

 

I grew up with everybody telling me, “You are going to be a doctor because you’re the junior and you’re the youngest in the family”. So, that became my “path”. However, I’ve always been pretty passive about it, seeing that the decision had already been made for me. Looking back at my life, I thought, if I had not become a doctor, I could have been a musician.

 

Oh, do you play any instruments?

 

Well, I can play the guitar and the ukelele. I can play a little bit of piano. These are things that have been set aside because of the occupation of being a doctor. You can probably say that I had no strong or very significant contribution to my decision of being a doctor. I was predicted to be a doctor and I followed.

 

Can you tell me the story of how you got into your specialty?

 

When I was in medical school, our Dean, Dr. Jose Cuyegkeng, a pathologist, inspired me to become one myself. I was always fascinated by the fact that understanding pathology was the key to understanding the disease process.

 

Right after graduation, I joined the Department of Pathology and became an Instructor. Although I was mixing around with the other pathologists in the department, there was still no formal training program. I felt a bit discouraged because I would do one autopsy after another but I has very little supervision.

 

After a year, I decided to join the Department of Internal Medicine. On my last year of training, Dr. Joven Cuanang came back from his postgraduate training in Neurology. He influenced me to train in Neurology so that I could join him in what he was planning as a new Department of Neurology at UERMMMC.

 

Where did you study Neurology?

 

UC Davis. University of California Davis.

 

You wanted to go into Pathology before, and part of it was to teach students?

 

Oh well, that was part and parcel of my duty as a faculty member and also served as hours of training.

 

But did you enjoy it?

 

I’ve always enjoyed mixing with students because I realized, as a student, that I looked up to people who were enthusiastic about teaching and sharing their thoughts. Even at that time, I realized how important the role of a teacher is in the formation of the students.

 

Can you give us a look on how you were as a student? Were you on the top of the class or just an average student?

 

I would say I belonged to the upper 10% of the class. I could have been better (laughs). At that time, when you graduate, the best students were recruited into Internal Medicine. It was the premier department so I became a recruit of Internal Medicine. That was how I came in. In fact, Neurology was under Internal Medicine at that time. I was a pretty serious student. I was focused on what I wanted to be. They also said that I was a serious and very strict resident.

 

So apparently you have a very busy schedule, how do you balance family and work?

 

How do I balance? I don’t really know (laughs). Well at that time, I was very focused on being a good physician and internist. Like most young, idealistic students who graduate, you dream about how you’d like to be known as a practitioner and so on. Those are dreams that I think everybody shares in their formative years as a physician. Of course, you want to also be known as a scientist, as a researcher and so on. Those were values pounded on us by select people in the faculty. The faculty you admire very well transfer the values to you by virtue of the fact na “Uy, bilib na bilib ako rito, ang galing niya ano?” You look up to these faculty members and say “Gusto ko maging role [mcdtria1] model siya” and so that’s why modeling is so important in education. I think not only for medicine but in all levels of your education.

 

When you have free time, what do you like to do?

 

I used to be an avid tennis player but eventually playing on the courts took its toll on my knees. I shifted to golf 13 years ago and have been playing regularly since then.

 

You’re an outdoors kind of person?

 

Yes, I am an outdoors person. I enjoy swimming for exercise and relaxation.

 

Have you ever tried mountain climbing?

 

During my younger year, I used to go hiking and trekking up mountains, but it’s nothing close to what mountaineers do now. I love to go fishing, either river or open seas particularly when I was in the United States.

 

How about here in the Philippines?

 

Mainly, I go to resorts, and so on. Swimming, beaches…

 

Do you have a favorite beach?

 

I’m a member of Montemar Beach Club in Bataan and my family would frequent the club on weekends to play tennis and go swimming. My favorite place to go to on the weekends is Hidden Valley. Have you heard of Hidden Valley?

 

The one in Batangas?

 

In Alaminos.

 

Oh, Laguna.

 

Yes, in Laguna.

 

It’s pretty secluded.

 

Kaya nga Hidden Valley [laughs]. It has several natural pools all over the resort. The water in the pools is a mix of mountain spring water and volcanic hot springs.

 

At that time, it was still really underdeveloped. We just discovered it because we wanted to go swimming. Through the years it has always been a favorite place of the family. In fact, I’ve brought a lot of my students there, the choir, any of my friends. Through the years I’ve seen it develop and even up to now, I still go. There was a time that we would go at least once a month and because I knew the owners, they’d give me a special discount. Sometimes they’d give me a free room even though it’s just a day tour. Alaminos Hidden Valley is sort of close to my place in Batangas, so it’s an easy drive.

 

When you were doing your duties (clerk/intern), what was the most memorable experience that you had?

 

When I was a clerk/intern, I was doing my duty in the emergency room. Somebody came in; he was gasping for breath. It looked like a bronchospasm attack. My first impression was a severe anaphylactic reaction. There was no resident to call, and I knew that epinephrine was supposed to be given. So I got a dose of epinephrine and injected it intravenously. Of course, the blood pressure shot up! But the guy got relieved of the spasm. He was very thankful. When I told the resident what I did, I was reprimanded. He said, ”Ba’t binigyan mong IV, ganung dose? Sana binigyan mong subcutaneous o IM lang, diba?”

 

Most of my experiences that I remember very well were in the emergency room. Like, I was able to pick up a case of adrenal hyperplasia in the clinics because of the appearance of the person – hypertensive, having moon fascies and so on. I got excited there. I was challenged in sharpening my clinical skills – trying to put [things] together. Maybe, you observe someone walking and say, “Ano kaya ang sakit ng taong ito?” That’s always a challenge to me. I suppose it is the influence of some people who are good clinicians. During my time, a clinician is somebody who can make a diagnosis without doing anything, just looking at you (laughs). You are like Sherlock Holmes. You put together little observations. That’s why I put a lot of emphasis on observing people in general, as part of the skills you must develop as a physician. The epitome of observation of Sherlock Holmes, who can think of all kinds of stories, make it up and say “This is the reason why I came to this conclusion.” The logic thing, I suppose, was very attractive.

 

Is there a quote/philosophy/motto that you live by?

 

You know, there is none (laughs). It was only through my later years – and it’s just in retrospect – that what guided my decisions was that I get bored in doing the same thing over and over again, so I always look for something new. Innovativeness and creativeness – that fascinates me! I’ve always been fascinated with being able to think of something that’s not ordinary, especially now that I’m in medical education because I was never prepared for it. My preparation was my years in the academe as a teacher, but I never really thought that I would end up being [the one] directing the curriculum and so on. That carried me on the challenge of trying something out. It’s extremely important. And then I realized that even more when I became dean. You know, how are you going to change medical education in the Philippines?

 

Can you share to us the plans that you had for SLCM when you became Dean?

 

St. Luke’s is a young school and it didn’t have a good reputation. Yes, it is a renowned school because of St. Luke’s [Medical Center], but I doubt very much if it had the reputation. So how do you turn around the reputation of the school? You do the same things that others aspiring to be good, would do – aim for excellence. However, how do you translate rhetoric into actuality? So, we started with the basic things first. You don’t need to be a rocket scientist. You need to have high standards for admission and an excellent curriculum.

 

During my time, there were only about 5 or 6 medical schools. Now, there are 39. So when you got admitted to any medical school [before], it was already an indication that you were smart, right? I mean, you can be proud of it! Other people would think, “O, natangap sa medicine ang taong ito, he must be smart!” So the glamour of being admitted to medical school, that already – just being admitted – is already an achievement. However, it’s not the case nowadays. When you get into a medical school, it’s probably the easiest to achieve.

 

Now, I'm sorry to say, but it's the truth: there are medical schools that have no standards at all. These schools accept you even if your NMAT rating is so low - which I think is really unfair. So what we did wasselect students that we can be proud of. What do you use? Of course, you will use the NMAT. Some schools will say, "NMAT is not the be all and end all. That does not predict how good a doctor a student will be." And I agree with that because there is a gray area. But to make things easy and predictable - more predictable - just get everybody from 90 above, right? First of all, that's aptitude. And then you measure that individual on the basis of the performance of the rest of the population. So, if they belong to the upper 10%, then we can take a chance there.

 

Going into curriculum delivery: I've been in medicine for so long that I realized when I was a student, this was the same curriculum being taught in all medical schools! You have anatomy, biology, medicine, etc. Along the way, we realized that more often than not, this prevented us from innovating. I said, "How can it be that in the last 30, 40, even 50 years, the curriculum in medicine in the Philippines has always been the same, whereas knowledge in medicine has grown immensely?” Medicine, or education in general, should have evolved. At the back of my mind I said, “Maybe mawawala na ang classrooms, especially the way we see classrooms.” When I first said that, some people said: “No way that’s going to happen!”, but I said “Wait a minute! It’s not the student-teacher interaction that would be abolished. I’m saying the concept of the classroom where someone will be talking and give you ideas and you, the student, will take down notes. We could do away with that.”

 

Think about it. How many 1-hour sessions can you have in 5 years with a teacher/faculty/guide and what’s the value of that hour compared to an hour you spend sitting down, taking notes? I feel that if you really want to train the next generation into better physicians, better thinkers, better scientists, there should be a more intimate interaction with different people.

 

Take for example physiology. All you have to do is sit down with different people who are experts in their fields and talk about the heart. At the beginning you talk about anatomy. Probably the best way to teach anatomy of the heart is to give you a scan, show it in gross picture, and do angiograms and ultrasounds so we can see the heart and the valves opening and closing. After which, we touch on a particular topic. We can talk about the mitral valve – what does it look like, how does it close, and even talk about mitral stenosis. There are so many things you can talk about. In 10 or 15 minutes, you brain will be filled with so many answers to your questions such as “Where’s the mitral valve? How is the flow in the heart? What happens if you obstruct the flow from the mitral valve?” In 15 minutes, you did not talk about the heart in a way that a classroom hour in anatomy would teach. You could introduce all these concepts regarding anatomy, physiology, and pathology. So, when you go back to reading anatomy of heart, you do so with heightened interest, di ba? Iba na yung dating mo.

 

 

What is your advice to the Lukan student body?

 

Simple lang. My only message is be happy. Enjoy your education because when you enjoy the challenge and process of learning, you'd be alright. In fact, you can apply that in almost anything that you do, work, family, just about anything.