April 3, 2003 - Third of a series

Arthur's tale

The series at a glance: 1 - It's the teachers turn 2 - Doctors bailing out 3 - Arthur's tale 4 - U.S. nursing shortage 5 - Nurses and recruiters 6 - Aries speaks up 7 - A price to pay C - The real war (and other views)

     Dr. Arthur del Rosario insists he is not a "success". "I just managed to survive," he said when I contacted him for this column.

     Dr. del Rosario, class 1980, is one of a number of alumni currently residing in the United States, whether as a practicing physician or doing something else (like writing a weekly column for this site so as not to fall asleep at work). Arthur, as he would like me to call him, now lives in Las Vegas, Nevada with his wife, Lorraine - a classmate in medical school, and their three daughters. He is a practicing pathologist in this city after 5 years of training and teaching in New York.

     I wanted to delve into the personal experiences of alumni who are now based here in the U.S. to supplement my series on the exodus of Filipinos abroad. I thought of Arthur right away, although I admit I considered myself first. When he told me he doesn't consider himself a success, I had second thoughts. I considered myself a success once after changing a light bulb. His story may be more interesting than mine.

"The economic situation in the Philippines is beyond ridiculous, it needs a miracle. The people in the government are corrupt. I have this funny notion that corruption might be an expression of a chromosomal dominant genetic defect which is consistently present on Filipino officials. I might win a Nobel Prize if I can identify the genetic locus. Then I'll tailor a gene therapy to correct this defective gene."

     I have never met Arthur in person, although I have heard about him when he used to teach Pharmacology at the College of Medicine. I was probably still in Biology then. Lorraine, however, was my professor in pathology, wait, maybe it was microbiology or parasitology...(That says a lot about my attentiveness as a medical student. Another proof, Lorraine could not possibly pick me in a police lineup).

     I will presume during the early 80's, the United States was not really a popular destination for doctors as it is now. I remember during those times, the dollar-peso exchange was so low, my father used to subscribe to Reader's Digest. Today, he cringes everytime he picks up his copy of the Philippine Star. So I asked Arthur what made him decide to go to the United States then. (You have to be a complete idiot if you ask somebody that question now. It's like asking "Hey buddy, why did you put on a shirt today?")

     "I had to fulfill my parents' wishes," he said. "They wanted us to go to the U.S. for training with a plan on coming back someday as "U.S.-trained specialist". Well, I have partly fulfilled that wish."

     Arthur completed his training in Pathology in Albany, New York, but I was taken aback when he clarified what he meant by "partly fulfilled". When he was on his second year of training, his father died of malignant teratoma. In his words, he was devastated and confused, he did not know whether he should stay in the U.S. or not. Since Lorraine and the kids were still left behind in Iloilo City, he wanted to quit the training program. "I am missing them so much," he said.

     After his father's funeral, he discussed the situation with Lorraine and his mother. Should he go on with the training or not? It took him days to finally find an answer to this question. As he was watching his two daughters play with their "U.S.-made toys", he got his answer, " Yes, I should continue the residency program. For their sake and their future and for my beloved wife."

     On his third year of residency, his mom died. It was terrible, he said, but he knew what to do this time. He should finish the training even if his parents who wished for it were no longer around. He was offered a permanent resident status on his 5th year of training which he gladly accepted. He was then able to bring his family over. He worked at Albany Medical Center and Stratton VA Medical Center, in New York, Department of Pathology with a rank of assistant professor in Pathology (later promoted to associated professor) for five years. The snow was getting too much to handle that he and his family moved to Las Vegas. They have been living in Las Vegas for two years now.

     To say that Arthur is a survivor may be an understatement. The path to get a training in the U.S. after taking the Philippine Board Examinations was not a cakewalk, either. After a year of post-graduate internship at Cebu Doctor's Hospital, he went to the "beautiful and pristine" town of Valderrama, Antique to fulfill the Rural Health Practice Program (RHPP), which was then required by the government before your license can be issued. His then girlfriend, Lorraine, went to her hometown in Macrohon, Southern Leyte.

     The board examination results were released in December, 1983, towards the end of RHPP. The following year, on February 14, 1984, Arthur and Lorraine got married in Cebu City. Remembering his parents' wishes, they aimed to go to the U.S. for training.

     They prepared for the ECFMG (Educational Commission for Foreign Medical Graduates) examinations. The cost then was $100.00 (the cost now is $645.00 per step for 3 steps). After passing it, they realized it wasn't good enough. There was another exam to take, the VQE (Visa Qualifying Examination), costing $200.00. Lorraine got tired of this apparent "scam" that she started a formal residency training in Pediatrics at Iloilo Doctors Hospital. Meanwhile, Arthur worked at Benito Lopez Memorial Hospital and also started teaching Pharmacology at the College of Medicine. He very seriously reviewed for the VQE and passed it and thought that was it, he's leaving for the U.S.A.

     He was wrong. After verifying with the U.S. Embassy, he was told he needed to send application forms to various hospitals/medical training centers in the U.S. accredited by the ECFMG under the exchange visitors program (the basis for a J-1 visa). He sent about 50 applications using the postal service, ended up spending a lot of money on mailings alone, but had only one positive reply - from Cook County Hospital in Chicago. The next step was to join the national residency matching program (cost-$50.00). He did not get a match since the notices were about a month late, he could no longer come to the places he applied for interview. Cook County Hospital was kind enough to consider him without the interview, but he did not get a final match in the end. He repeated the application process during the next three years without any good results.

     He already felt stupid. He should have gotten a formal residency training in the Philippines, something to fall back on. By this time, he was blessed with a beautiful daughter. Dr. Tirador of the Iloilo Doctors' Hospital hinted that they have a slot for one medical resident. Arthur just pretended he did not hear anything.

     In the mid-80's, Arthur's brother had gone to the U.S. on a tourist visa. He married his girlfriend who was a nurse at a Methodist Hospital in Brooklyn, New York. The brother who graduated from UP-PGH in 1981 eventually landed on a residency training program at Albany Medical Center in Albany, New York.

     Arthur thought of giving up his dreams. There was not really much choice for foreign medical graduates. His brother was a UP graduate, he thought it's easier for him to find a program. UP was a well-recognized institution and during that time WVSU was virtually unheard of.

     He continued his job teaching Pharmacology at the College of Medicine, up to the time when the faculty and students had to stage rallies on the streets and boycott classes. It was during this time (1988), that his brother became the chief resident of pathology at Albany Medical Center. He was offered a chance to join the program, had a telephone interview with the program director, R. Foster Scott, who has a special place for Filipinos in his heart. He was in the Philippines during World War II. Arthur felt lucky to be accepted. And the rest is history.

     I asked Arthur the obvious question: Do you think your life is better now compared to if you have stayed in the Philippines? "My life is definitely better now," he replied. "My contemporaries there are very successful and live a good life. However, with the exchange ratio of 1:50, it seems that they have to work 50 times more to maintain a comfortable life. Some of my colleagues are studying nursing with a special course tailored for MD's to keep their options open."

     "The economic situation in the Philippines is beyond ridiculous," he continued. "It needs a miracle. The people in the government are corrupt. I have this funny notion that corruption might be an expression of a chromosomal dominant genetic defect which is consistently present on Filipino officials. I might win a Nobel Prize if I can identify the genetic locus. Then I'll tailor a gene therapy to correct this defective gene. The newly-elected officials may have good intentions in the beginning but then they yield to the temptations of corruption."

     Should Filipino doctors be blamed for working abroad or take up nursing courses? "No. Human beings (Filipinos or not) have the basic right to pursue happiness. The vast majority of Filipinos leave their country with the hope of getting a better life. Here in the U.S., if you work hard, you'll get paid accordingly. It is easy to buy 2 new cars here. In the Philippines, my parents loaned me a 2-door Toyota Corona. It got so rusty I could not afford to have it repainted. Not with my WVSU salary and the negligible income from my practice."

     Arthur also shared the experience of another brother, a practicing lawyer, who came over last month to see what's going on in America. After his "one-month tour", he was convinced that he should try to move to the U.S.. He plans to take the exam for lawyers and ask his wife to take Nursing as a second course.

     Does he have any regrets of being a doctor in the Philippines? "None. I was very idealistic then. When I became a doctor, I just wanted to heal the sick (whether they pay me or not). Seeing them get well gave me great pleasure and fulfillment. I love it when they thank you for treating them. Even those who could not afford to pay me, they remembered to come back to me especially during harvest season and gave me a bagful of monggo, some vegetables, eggs, chickens, etc."

     "I also enjoyed teaching. I love it when I see my students enjoy my "supplemental lecture" (as you know, the students are the main lecturers). I know doing just this will lead me to nowhere. One medical school secretary sincerely expressed her concerns - 'kanugon sa imo Art, please get a residency training'. And I also have the kids' future to think about. I just wish I was a millionaire to begin with, so I could just enjoy healing the poor and underprivileged."

     "Speaking in behalf of my wife," Arthur volunteered as we ended our e-mail interview, "her regret is missing her practice. She enjoyed her practice in the Philippines as a pediatrician. She misses being called 'Doc'. Additionally, she misses the helpers/maids. In the U.S. it is expensive to maintain a helper. You've got to get used to the saying 'Ako sugo..ako tuman'. Oh, well. You can't win 'em all."

     Dr. Arthur del Rosario has come a long way from the quiet, little town of Dumangas, Iloilo. Although I have to agree with him if he refuses to call himself a success.

     He is more than that.

     This week's FINAL WORD comes from Dr. Vicente S. Salas (Class 1981):

     "The phenomenon of doctors taking up nursing is not exactly new to WVSC...I remember over 10 yrs ago there was already news of one of the graduates of class 1980 (yes, the 2nd batch of WVSU) taking up nursing. It is probably only the scale of it now, in the past three years particularly, with a relatively large proportion of doctors taking up nursing."

     "The issue of nursing being a 'stepping stone' to becoming a doctor is not exactly correct too - there were very, very substantial differences between medical and nursing education, and continue to be, so there are actually very few nurses who end up taking medicine. Given the thousands who graduate each year it is a handful who eventually go to medicine. There are probably more medical technologists who look forward to becoming a physician, if you just look at the bachelor's degrees of the graduating MDs from WVSU you will see what I mean."

     "But also try to look at the concentration of physicians in the province of Iloilo, where we have the WVSU College of Medicine. When I graduated back in 1981, there were relatively few specialists--and those from my batch who went on to do specialty training and returned to iloilo had the space, as well as the 'turf' in which to operate. Now doctors' signs are so commonplace, the city probably has a physician patient ratio that is one of the highest in the country. So the supply of physicians produced by the two medical schools in Iloilo surely offsets the 2 % rate of growth of the population. It also takes time to build up a practice--people who are established are less likely to give up their turf to younger practitioners--and old doctors just take time to fade away!"

     "We do have to ask the question, though--is the health, life expectancy and nutritional status of the average ilonggo improving at all? Is access to medical care better now in Iloilo ? I doubt it. Maybe we don't need so many doctors after all."

     "As for me, I have taken a conscious decision to leave private medical practice back in 1988, going into public health and international health work, particularly HIV/AIDS programming and I haven't regretted it since. When people say , 'sayang, doktor ka, indi ka na nag-pa-practice...', I can only say, there are many worlds outside the doctors clinic and the hospital."

     "Dare to explore, take risks, and becoming a nurse perhaps is a risk - and a survival strategy in this uncertain times."

     Comments regarding this week's column are welcome. Please fill up the fields below and click Send to Author. Suggestions for future column topics are also encouraged.

     The author's e-mail address is at drgarcia@wvsumedaa.com

     Views expressed on this column and any other by-lined articles on this site are the authors' own and do not necessarily reflect the views of the organization or its members. For comments, please e-mail the author.