Post Grad Internship Matching: Things to consider before clicking your hospital of choice

'Tis the season to be jolly, falalala lalala. LOL.

Indeed guys it's the season to be jolly because it's already Christmas season and at the same time, it's the APMC Matching season for all medical students in their clerkship year for the upcoming post graduate internship July 2019 - June 2020.

For those who are still kind of confused as to how does APMC matching works and why is it important for medical students to engage in it, I'll quickly give a brief overview and some links to help you in your application which was well written by APMC-SN

All clinical clerks who want to do their internship after right after finishing clerkship, are required to register in E-NIPS in order to be included in the scheduled online matching process to be match in their respective hospital of choice. It's not mandatory for every medical student to participate in it, such as for those who are not planning to do their internship here in the Philippines and for those who wish to delay their internship for the time being.

APMC-SN already posted the schedule of matching for the Regular National Internship program  which will be running from July 2019 - June 2020. The 1st round of matching already started last November 05, 2018. You may click this link APMC National Internship Program Primer if you wish to know more of the step-by-step process created by APMC-SN as a guide for the online matching process. Below are pictures posted by APMC-SN in their facebook page for your guidance of the  July 2019-June 2020 Internship Program.

Now let's go to the heart of this entire post, which I hope will guide you as to which hospital is best to have your internship done cuz during my time I didn't know what things should I consider in choosing the hospital. I was looking for some tips from various blogger, I'm not sure if I was able to find one but that's the reason why I wrote this blog, to help future medical students who'll be undergoing the same process in time. 

In contemplating your hospital of choice, there are a few questions to ponder on about yourself such as; What type of active learner are you?What is your priority during internship, to learn more theoretically or clinically? Where are you planning to take your residency, if there's any? Do you want to experience less or more toxic duties than your clerkship rotation? Do you want to go where there is a higher monthly allowance? These are just some of those things which I'll quickly tackle. 

Each and every student's learning ability are different from one another. Some says they learn best when they are expose to various cases rather than simply reading it from our books. So in turn they chose government hospitals where there are a lot of rare cases such as PGH, Jose Reyes, Ospital ng Maynila, DOH and etc. Some students, especially those who came from private institution, wants to learn more clinically and be able to perform a lot of various clinical procedures that they weren't able to perform frequently or not at all during clerkship such as doing thoracentesis, closed tube thoracostomy, spinal tap, intubation, epidural anesthesia, minor surgeries such as wound debridement, I & D, excision biopsy and a lot more. You can do a lot more of these in public hospitals due to a lot of cases and fewer manpower to do all these procedures. 

A lot of my senior interns, residents and consultants personally advised me stay in our school's own hospital institution because it has a balance experience in terms of being exposed to a lot of cases and having that benignity to study them since our institution only has 12 hours max during duty status. After which we have a lot more time to study & prepare for the board exam. As they said, learning to confidently perform various clinical procedures shouldn't be my priority at all as I will be able to learn them when I proceed to residency. However, some seniors and mentors also told me that having their internship in public hospital prepared them to confidently managed cases on their own which helped them during their moonlighting. So this is something you need to answer within you regarding as to what is your main objective in your internship.

You also need to consider the field you want to pursue and where you are planning to pursue it. They said it'll help you during your residency application if you had your internship in that said hospital also because you were able to form a close bond with the residents and consultants. Though at the end of the day, residency application is still a competition especially in institution where there are a lot of applicants. Another advantage is you are able to witness how the residency training is in that institution. Is it still something you want to get into? If not, then maybe you can start reconsidering other institution for your residency after internship.

Some students felt like they were too benign during their clerkship and felt as if they learn only a few than what they were expecting, so they decided to pursue internship in hospitals where they see fit they'll learn a lot more. Some however, felt like they got really burnt out from all the clerkship toxicities they had, that they considered to lay low and have their internship in private hospitals, thought not all, mostly are benign compared to public hospitals. Some highly took into consideration the monthly stipend they'll get from an institution regardless its toxicity. 

For my experience, I chose to have my internship in PHMC-Las Pinas, it is our school's owner hospital situated behind our school building, the Tamayo Tower. Originally I was matched in a different institution because PHMC was honestly not in my top 3 choices in the online matching. I was originally planning to have my internship done outside to get a different clinical experience than I once had during my clerkship. However, due to practical reasons, since it's nearby our house, about 5 minutes away from home and also because I actually plan to have my residency in this institution. So why not stay instead. I wrote a separate blog regarding the process we went through in order to be un-matched from our previously matched hospital and be rematched to another.  Since it's a private institution, we only get to perform fewer clinical procedures compared to what other interns does in other public hospital. But honestly, our residents and consultants are really kind enough to let us do the clinical procedures when we ask permission from them. If you are confident enough to do it after reading and watching how the procedure is done, take the initiative to volunteer. It's a very effective learning process. 

May be you are wondering, how did my internship went? Do I have any regrets staying in the same institution? Honestly, I thank God we made the right decision. I don't have any regrets. I am on my 3rd rotation already (Internal Medicine). Major rotations came first. We only have 12-hour duty on our duty status. On that 12 hours, I maximized my time to learn the best I can from the cases I see clinically. I'm not too tired after duty compared during clerkship when we had a minimum of 30 hours straight. I have the balance of seeing a lot of different cases and being able to study in preparation for the boards when I get home. Our institution is supportive enough as well to help us when we organized for review classes every Saturday. May be in the near future I'm gonna write on how I study and prepare for the boards during my internship period. :) Lastly, we get a small amount of stipend each month. 

My message is that, wherever you may go into for your internship, make the best out of it. It's upon us if we will take the initiative to learn. If it's toxic make the most out of that toxicity, read on all the cases you see in the wards, ER, OPD. If you are lucky enough to have a benign duty, study on your free time and read on the clinical cases you see. It's easier than done, but let's develop in ourselves the discipline to study not just for the board exam but as what most med student's favorite quote says (my personal favorite as well)

"Student, you do not study to pass the test. You study to prepare for the day when you are the only thing between a patient and the grave"

- Mark Reid

Disclaimer: This is just my personal opinion or realization that I've come up with from my experience as an intern and from the advised I got from my seniors/mentors before. Probably not everyone will agree with me as each of us has our own experiences. If you have other suggestions/comments/advise please comment down below. I'll gladly appreciate it a lot. Thank you :)