WE remember with fondness the “Doctor to the Barrios” program in the 1970s of the Department of Health, when underboard doctors (and nurses) served in the rural areas while waiting for the results of their board examinations. It was a way to serve the rural folk before they get the results of the exams and work in the cities, or more likely, fly overseas for work.
Later, there were also sporadic scholarships from the Department of Health and the Commission on Higher Education (CHEd). The University of the Philippines in Manila instituted the return service system of UP Manila, which required their medical school graduates to stay in the country for three years after graduation.
But there was nothing systematic about all of these, and no guaranteed budget, until the enactment and implementation of Republic Act 11509, the Doctor Para sa Bayan Law. It expanded access to medical education and provided scholarships and grants to medical students and schools.
CHEd began offering scholarships to medical students in 2018, when Senators Ping Lacson and Loren Legarda realigned P8.3 billion of DPWH infrastructure funds for the ARMM to CHEd during the GAA deliberations. Fully P300 million was allocated for medical scholarships in state universities and colleges.
Doktor Para sa Bayan mandated CHEd to 1) set up one public medical school in every region; 2) provide scholarships for financially needy medical students; 3) require a return service agreement for students who avail of government assistance; 4) instruct CHEd and DOH to collaborate in the placement of medical school graduates for their return service upon passing the licensure examination.
The then-CHEd chairman J. Prospero de Vera III said that “if we open public medical schools, strict standards must be imposed so that quality is never compromised; subsidies and grants must be provided so SUCs have laboratories and medical equipment that rival those of premier private schools.” The Senate concurred. Funds for construction of buildings for newly opened medical schools were given directly to the SUCs.
Before the Doktor Para sa Bayan Law, there were only eight public medical schools nationwide. There are now 28 SUCs with medical programs. They offer scholarships, provide state-of-the-art medical equipment, and have new buildings and dormitories for students.
By 2026, 3,762 medical students will be supported through the CHEd Medical Scholarship and Return Service (MSRS). The program covers free tuition and miscellaneous fees at public universities, offers up to P200,000 for private school students, provides a P177,000 annual stipend, and includes comprehensive health and accident insurance.
But de Vera said this program “requires sustained funding, better administration, an improved curriculum and well-targeted interventions to continuously produce doctors who will serve in Geographically Isolated and Disadvantaged Areas (GIDAs).”
Unfortunately, since 2024, the MSRS scholar budget has not kept pace with the number of poor students. CHEd was not able to calculate the MSRS funding required to support the opening of new schools. DBM should sit down with CHEd to ensure funding.
CHEd should ensure that students receive their stipends on time. Medical education is expensive, and poor students who don’t get their stipends on time drop out. An annual budget of at least P500 million is needed, but CHEd allocates only P150 million. The P10 billion Higher Education Development Fund (HEDF) can be used for this.
Second, public medical schools need good faculty who are well-compensated. We cannot produce world-class doctors without excellent educators. Sustainability hinges on having competitive compensation packages and tenure tracks for physician-educators. This will ensure that teaching in the provinces is as rewarding as private practice in Manila.
This also calls for our medical schools to partner with international universities. The collaboration with the University of Adelaide and Duke National University of Singapore-Singhealth should include more public and private medical schools.
We also need to expand the capacity of government hospitals to accept interns and residents. This will provide them with the clinical exposure they need to handle the complexities of rural medicine. As de Vera said, “If students cannot find local placements for their clerkship, the pipeline to community service breaks before it even begins.”
Finally, we have to reconcile the curriculum with the needs of primary care. A curriculum shift is needed. We are not just training clinicians to treat symptoms, but also leaders capable of managing local health systems.
We have neglected the rural areas for too long. Many people in the islands, hillsides and mountaintops, and far-flung towns are born and die without ever seeing a doctor. This has to change.
