COLLEGE OF MEDICINE
University of the Philippines
Manila
PRIMER ON THE
REGIONALIZATION
PROGRAM
Annex to the Acceptance to Serve
and
Assumption of Liability (ASAL)
Agreement
TABLE OF CONTENTS
Part I Page
Vision-Mission-Goals of the UPCM 1
The Regionalization Program (RP)
- Historical Background 2
- Scheme 3
- Who May Apply to the RP 4
- Application Procedures 5
Part II Implementing Rules & Regulations
Rule I Inclusion Criteria 8
II Obligations of Medical RP
Students 9
III Return Service 10
IV Coordinating, Monitoring
Evaluation and Placement 11
V Pre-Termination and
Penalties for Breach of
Obligations 12
VI Student Records Prior to
Completion of Return Service 13 VII Arbitration Committee/
Proceedings 14
VIII Dispute Settlement 15
IX Terms of Payment 16 X Effectivity 16 XI Amendments 16 Part III ASAL Agreement 17 Part IV Suretyship Agreement 21 Reply Slip 23 Glossary 25 Officers of Administration
VISION, MISSION AND GOALS OF THE
COLLEGE OF MEDICINE VISION
A community of scholars
highly competent in the field of medicine with a heightened social consciousness;
imbued with moral, ethical and spiritual vigor; dedicated to a life of learning;
committed to the development of Philippine society; inspired by love, compassion and respect for the dignity of human life, and anchored on the principles of Truth, Freedom, Justice, Love of country and the Democratic way of life. MISSION
Guided by moral, ethical and spiritual values, we commit ourselves to excellence and leadership in community-oriented medical education, research and service, using the primary health care approach, intended especially for the underserved.
SUMMARY MISSION STATEMENT
“Towards Leadership and Excellence in Com munity-Oriented Medical Education Directed to the Underserved”.
UPCM VISION The UPCM shall be:
1. A Center of Excellence for graduate medical education in
the country;
2. A leading medical school in the ASEAN region;
3. A recognized medical institution in the global community.
Committed to produce excellent and socially responsible doctors in the Philippines, especially in underserved areas.
The REGIONALIZATION PROGRAM
Historical background
The University of the Philippines Manila, College of Medicine (UPM -CM) and its teaching hospital, the Philippine General Hospital (PGH) are institutions that are heavily supported by the government. The Fili-pino tax payers subsidize the medical education of its students. In re-turn, medical graduates of the UPM-CM must therefore perform a role that is relevant to national development in a way that its unique re-sources enable it, even mandate it to accomplish.
In the past, majority of students admitted to the UPM-CM and who eventually graduated came from the National Capital Region (NCR) resulting in the inequitable distribution of medical graduates in the var-ious regions of the country. The Admissions Committee of the Col-lege in 1979 under then, Dean Gloria Aragon took on the challenge to address this inequity by proposing the creation of the Regionalization Program. It was in 1984 under the term of Dean Alberto Romualdez when the Regionalization Program was approved by the College and the University System as a category for admission to the UPM-CM. The program was implemented the following school year of 1985-1986. Initially, only five regions were included in the program but this eventually involved every region of the country including the ARMM and the CAR. Even in it its inception, there was already a recommenda-tion to formulate a contract with the recipients of the program that stip-ulates that the graduates will serve their regions for an equal number of years of their medical education. Failure to do so will mean that the graduates will reimburse the College the amount spent for their education.
Through the years, a social contract to serve the country was formulated and signed by the student and the College, but full compliance to the contract is yet to be achieved. In 2005, the Regionalization Program Committee (RPC) deemed it necessary to bind the students in the Program through a legal contract to serve his/her region for an equal number of years of his/her medical education. The Acceptance to Serve and Assumption of Liability Agreement (ASAL), a legally binding contract to serve the country was implemented beginning academic school year 2005-2006. Members of the Regionalization Program of the graduating Class 2010 are the first UPM-CM graduates under ASAL
The SCHEME
Regionalization is a ter m used in reference to a scheme that
would involve the acceptance of candidates from the various
regions of the country deemed to be in need of doctors . These
candidates will be the future leaders, experts and educators upon
their return to these areas.
Candidates for admission to the UP Manila College of Medicine
should signify their intention to be considered for the
Regionalization Program upon submission of their application
form. The candidates will then be oriented with regard to the
essence, goals and requirements of the program.
Before acceptance to the Program, the applicant is required to sign
a legally binding contract, signifying service to the Philippines,
after graduation, with his/her parent(s)/guardian(s) as
co-signatories.
WHO MAY APPLY TO THE REGIONALIZATION
PROGRAM (RP)
1.
She/He must fulfill the minimum requirements of the
College of Medicine for admission
2.
She/He must show proof of residency in the community by
submitting the following:
a)
ITR of parents
b)
Barangay Certification,
c)
Certification of Membership of Indigenous People
3.
She/He must speak the dialect of her/his region.
4.
Preferably a graduate of the local elementary, high school
and/or college (Form 137 as proof, preferred but NOT
required)
5.
Preferably has participated in projects in her/his community
of origin certified by representatives of the organizations
involved (preferred but not required)
6.
She/He must be willing to sign a binding contract upon
application, signifying that she/he is willing to serve in her/
his community after graduation. The candidate's
parent(s)/guardian(s) must be co-signatories in the contract.
Once a candidate has signified her/his intention to be considered
under the UPCM-RP and is accepted to the College of Medicine,
she/he will have to meet all the obligations for all candidates to the
Regionalization Program and she/he will be given all the benefits
for being a part of the Regionalization Program.
APPLICATION PROCEDURES
1. Secure Forms from the Admissions Office of the UPCM
up-on payment of applicatiup-on fees:
a. Regionalization Program (RP) application form
(this will be given to the applicant together with the
Regular application Form)
b. Directory of the Community Liaison Officer (CLO) of
your region.
2. Contact the regional CLO for your interview appointment.
Submit Application Form together with the complete
requirements to the CLO & to the UPCM Admissions Office.
3. List of requirements to be submitted to:
3.1. CLO
a. RP Application Form
b. NSO Birth Certificate
c. RP Form # 3 (to be provided by the Admissions
Office)
d. True copies of Income Tax Return (ITR) of
parents for the last three (3) years
e. Voter's/Comelec ID of parent(s) and applicant
f. Letter of Intention addressed to the RPC Chair to
be considered under the Regionalization Program
and to serve the region (specific province) or
underserved regions of the Philippines after
graduation from medical school.
3.2. UPCM
a. Photocopies of all requirements submitted to CLO
b. Regular Application Form
c. Transcript of Records
d. NMAT Result
e. 4 copies 2 x 2 pictures
f. 3 copies of Acceptance to Serve and Assumption of
Liability (ASAL) & Suretyship Agreements
g. For Members of Indigenous People Group (IP):
A certification obtained from the National Commission
on Indigenous People
h. Certificate of participation in community projects
from representative of local organization (if any)
i. Reply Slip (page 23 of this primer)
4. Pass and qualify under the NMAT and GWAG Cut-off.
5. Be interviewed and evaluated by the members of the
Regionalization Program Committee (RPC) and the UPCM
Admissions Committee.
6. Await notification to see the Chairman of the RPC
Please also refer to Admissions Brochure “ ENTRANCE
REQUIREMENTS, GUIDELINES AND POLICIES ON
ADMISSION” leading to the Degr ee of Doctor of Medicine
which is available at the Admissions Office.
PART II
The Implementing Rules and
Regulations (IRR)
and the
Acceptance to Serve
and Assumption of Liability (ASAL)
Agreement
RULE I
INCLUSION CRITERIA
Section 1: All candidates for admission to the UPCM-RP have 3 absolute admission requirements:
1. General Weighted Average Grade (GWAG) of at least 2.5000
2. National Admission Test (NMAT) score of 90th percentile or better
3. Signed Acceptance to Serve and Assumption of Liability (ASAL) Agreement
Section 2: All candidates for admission to the UPCM who signified their intention to be considered for the Regionalization Program (RP) written on their Application Form and who, upon application, have been oriented with regard to the essence, goals, and requirements of the program, are required to sign a legally binding contract. The ASAL (Acceptance to Serve and Assumption of Liability) Agreement binds the student to render service in an identified underserved locality in the Philippines, after graduation. Parent(s)/guardian(s) are made co-signatories to the ASAL. The affixing of the parents & students signatures is the last step towards acceptance to the UPCM .
Said candidates are considered RP applicants even if they also signified their additional intention of being considered in the other entrance categories.
Section 3: To be considered for and later included in the RP, the applicant shall:
1. Tick the RP box in the application form, regardless of their having signified any additional intention to be considered in the other entrance categories;
2. Sign the ASAL and Suretyship Agreement forms that are later notarized, prior to official admission to the University
Section 4: The student shall thereafter execute/sign the ASAL Agreement as a prerequisite for his/her inclusion in the official class list for the semester. Official admission to the University occurs at the time of issuance of the class list for each semester.
RULE II
OBLIGATIONS OF MEDICAL RP STUDENTS Section 1: The UPCM RP student shall fully comply with the following obligations:
Prior to graduation, by his/her faithfully adhering to the Vision- Mission of the UPCM by:
1. Participating in UPCM RP activities;
2. Participating in UPCM summer immersion activities.
Community Immersion in the Philippines is a prerequisite for Off-campus elective;
3. Finishing the full prescribed years of medical college education; and,
4. Obtaining a certification of satisfactory completion of the RP
from the Chair of the UPCM RP Committee (UPCM RPC) and of an Exit Interview given by the UPCM RPC.
Failure to obtain a Certificate of Completion of the Regionalization Program is not a disqualifying criteria for graduation but shall be merely considered a breach of the ASAL Agreement subject to the prescribed penalties imposed on said Agreement.
RULE III RETURN SERVICE
Section 1: Immediately after graduation, the UPCM RP student shall: 1. Obtain a Philippine medical license
2. Practice full time in the underserved health
sector in any capacity as a physician for a
minimum of five (5) years; and
3. Undergo residency or post-graduate training in his/ her own region or other underserved areas in the Philippines:
Provided, that, if residency or Postgraduate training is done in Metro Manila or the National Capital Region (NCR), such period spent shall not be count-ed as part of the return service;
Provided, further, that the RP student must render service to the Philippines, before taking any residency or post-graduate training in countries outside the Philippines; and,
Provided, finally, that eligible postgraduate training shall not include other undergraduate degrees such as nursing.
Section 2: The UPCM RP student shall submit to the PGIM Coordinating and Placement Office (CPO) on or before 31 December
of every year until completion of five (5) year return service beginning the year he/she graduated from UPCM, a report of his/her health care activities and proof of such services for that year, specifying the follow-ing minimum required information:
1. Exact location and address where he/she is
currently working
2. Nature of his/her work
3. The community served
4. Career plans/ goals for the succeeding year
Section 3: The return service shall be completed within 10 years from date of graduation after which a cer tification of completion of r etur n ser -vice is issued.
Section 4: The failure of the UPCM RP graduate to inform the UPCM PGIM office of his/her whereabouts and the completion of his/her return service contract shall be considered a breach of the ASAL agreement and is subject to the prescribed sanctions hereinafter provided.
RULE IV
COORDINATING, MONITORING, EVALUATION AND PLACEMENT
A Coordinating and Placement Office (CPO) under the Post Graduate Insti-tute of Medicine (PGIM) shall be established. This will ensure incorpora-tion of updates/enhancements or addiincorpora-tional recommendaincorpora-tions from stake-holders and lessons from local and international examples into the ACCEPTANCE TO SERVE AND ASSUMPTION OF LIABILITY (ASAL) AGREEMENT.
This shall ensure choice of placement of UPCM RP graduates.
This will guarantee monitoring of the return service obligation collation of the yearly written reports of the RP graduates to commence a year after offi-cial close of internship and validate the reports which include activities of the previous year e.g. by employer or Local Government Unit (LGU). (DTI forms if in private practice).
RULE V
PRE-TERMINATION AND PENALTIES FOR BREACH OF OBLIGATIONS
Section I: Pre-termination of this Agreement may be allowed under certain conditions, but in other/different conditions the same may be sub-ject to prescribed penalties, as follows:
1. Physical and mental incapacity of a permanent nature which
exceeds the Maximum Residency Rule (MRR) period and or leads to release from the University, shall release the student from any legal and financial liability.
Pre-termination due to physical or mental incapaci-ty of permanent
nature entails no penalty.
2. Physical and mental incapacity of a temporary nature which does
not exceed the MRR period and or does not lead to release from
the University upon decision/request by the Arbitration Committee of the UPCM RP student, shall entail a payback scheme equivalent
to the number of years that the student took his/her medical course. (Physical or mental incapacity of a temporary nature that resolves prior to the lapse of the MRR period shall entail an extension of the period to complete medical education and/or satisfy ASAL Agreement requirements.) Section 2: Pre-termination due to non-completion of medical education due to academic deficiencies shall entail a payback equivalent to the number of years that the student was enrolled.
Section 3: Pre-termination due to dismissal of the student for disciplinary action shall entail a payback equivalent to five (5) years of medical education regardless of number of years completed.
Section 4: Pre-termination for any reason other than the ones above enumerated shall entail a payback equivalent to five (5) years of medical education regardless of number of years completed.
If the UPCM RP student fails to comply with his/her obligations under the ASAL Agreement, upon the student’s request from UPCM for required original transcripts of grades and/or diploma for out of the country education/ job placement, the student may not be given a letter of recommendation by the Dean. The transcript of records and/or diploma shall contain a statement about the student having been admitted under RP, and his/her having reneged the corresponding obligation of a return service.
RULE VI
STUDENT RECORDS PRIOR TO COMPLETION OF RETURN SERVICE
1. Transcript of Records requested before the completion of return
service shall bear the statement “Subject to compliance with the Return Service Agreement. Valid for employment within the Philippines only”.
2. Request for authentication of medical education records from
hospitals/institutions abroad shall be denied.
3. Request for Dean’s Letter of Recommendation for out of the
country education/training shall be denied.
4. Request for UPCM Faculty to give letters of recommendation for
training abroad shall likewise be denied.
12 RULE VII
ARBITRATION COMMITTEE/PROCEEDINGS
Section I: There shall be an Arbitration Committee whose functions shall be to determine whether a UPCM RP recipient:
1. Has successfully completed his/ her obligations according to the ASAL agreement, or
·2. Has valid or non-valid reason not to be able to serve the Philippines after graduation.
3. Committee decisions will be submitted to the Dean for approval, and recommendation to the Chancellor.
Section 2: The Arbitration Committee shall be composed of the UP Manila Legal Counsel and the following:
1. UPCM Assoc. Dean for Faculty & Students or his/her representative
2. The UPCM Regionalization Program Committee Chair 3. The UPCM College Secretary
4. The UPCM RSO Student representative
The Chair shall be appointed by the Dean.
Section 3: Penalties due to breach of the ASAL Agreement and/or Suretyship Agreement shall be settled through the Arbitration Committee for any dispute in the implementation thereof. The Dean shall report to the College Council, the names of the UPCM RP students who satisfactorily fulfilled their ASAL Agreement obligations, those who reneged, and the status of arbitration proceedings as well as the arbitration agreements reached.
RULE VIII
DISPUTE SETTLEMENT
Section 1: In case of a dispute between the Parties arising from the breach by the UPCM RP Student of his/ her obligations under ASAL Agreement, the Parties agree to freely and voluntarily submit themselves to the necessary consultation and negotiation for purposes of amicably settling the dispute.
Section 2: Should the Parties fail to reach an amicable settlement, any dispute or controversy arising from this Agreement shall be submitted to arbitration in accordance with Law (RA 9285). The competent courts of Manila shall have jurisdiction over these cases if legal action is resorted to.
RULE IX
TERMS OF PAYMENT
Section 1: In the event that the UPCM RP student shall not be able to hon-or his/her ASAL Agreement and is then subjected to monetary penalties, payment as determined by the Arbitration Committee and as confirmed by the UP Manila Chancellor shall be payable in cash or check in favor of the University of the Philippines Manila College of Medicine.
Section 2: The terms of payment if not paid in full can be negotiated with the Arbitration Committee subject to the imposition of the official year on inflation rate, during the period of payment and shall be reflected in a promissory agreement to be entered into by UP Manila and the UPCM RP student.
RULE X EFFECTIVITY
Section 1: This IRR for the ASAL Agreement is effective for RP students entering UPCM starting Academic Year 2005-2006.
RULE XI AMENDMENTS
Amendments to this IRR shall be subject to approval by the UP Manila Chancellor upon the recommendation by the UPCM Dean.
Part III
ACCEPTANCE TO SERVE AND ASSUMPTION OF LIABILITY (ASAL) AGREEMENT
This Acceptance to Serve and Assumption of Liability Agreement (“ASAL Agreement”) made and executed this ______ day of ____________________ in ______________________, Philippines by and between:
(name of student), Filipino, of legal age ,single/married to _________________________, with residence and postal address at ________(address)__________________________ , hereinafter referred to as “Student”;
- and -
University of the Philippines Manila College of Medicine, with prin-cipal office at Pedro Gil St., Ermita, Manila, herein represented by its Chancellor, ________________________________, hereinafter referred to as “UPCM”;
WITNESSETH: That
WHEREAS, the Regionalization Program of the UPCM hereinafter referred to as (the “Program”) strives to ensure excellence and leadership in community-oriented medical education, research and service, using the primary health care approach, intended especially for the underserved;
WHEREAS, the Student has applied to the Program and is aware of the requirements of the said program, and for this purpose, the Primer on the Regionalization Program is hereto attached as Annex “A” the same to form an integral part hereof;
WHEREAS, the ASAL agreement becomes effective only upon acceptance of the student to the College of Medicine;
WHEREAS, in consideration of his/her admission to the Program and his/her being covered/under the abovementioned Agreement and considering his/her availment of state subsidy for his/her tuition fees, the student is required by UPCM to render health care services in his/her region (specific province) or other underserved regions of the Philippines, immediately after his/her graduation;
NOW, THEREFORE, in consider ation of the for egoing premises, the Parties agree as follows:
Article I. Obligations of the Student
The Student, having been accepted into the Regionalization Program (the “Program”) of the UPCM and covered by/under the ASAL Agreement shall:
1. Faithfully adhere to the Vision-Mission of the UPCM specifically the ideals and requirements of the Program;
2. Abide by the prescribed course or instruction unless sooner separated or dismissed by competent authority for failure to cope with the academic and/or disciplinary standards, rules and regulations;
3. Render health care services in his/her region (specific province) or other underserved regions of the Philippines, immediately after graduation, for a minimum of five (5) years unless unable to do so due to physical and/or mental incapacitations as determined by UPCM authority;
4. Submit on or before December 31 of every year for five (5) years, beginning the year he/she graduated from UPCM, a report of his/ her health care activities and services for that year, specifying the following minimum required information: (1) exact location and address where he/she is currently working; (2) nature of his/ her work; (3) the community served; and (4) career plans/goals for the succeeding year.
Article II. Penalty for Breach
1. The student acknowledges and agrees that before the completion of his/her obligations under Article I of this Agreement and
such other obligations as may from time to time be imposed by concerned University officials in the implementation of said Agreement, his/her transcripts of grades and/or diploma shall bear the statement “Subject to compliance with the Return Service agreement. Valid for employment within the Philippines only”.
2. In addition, the Student shall be held liable for breach of contract jointly and severally with his/her parents or guardians, and guarantor/surety as provided for in the Suretyship Agreement hereto attached as Annex “C”, and reimburse to UPCM twice the full amount of his/her tuition, government subsidy and scholarship, and all other expenses incurred by UPCM during his/her entire period of schooling as a student of the Program, with interest at the prevailing legal rate at the time of the breach of the aforesaid ASAL Agreement, in the event that he/she shall fail to fulfill the above mentioned obligation in paragraphs 3 and 4 of Article I, for no justi-fiable reason as determined solely by UPCM authority.
3. The College of Medicine, UP Manila reserves the right to determine the amount to be paid back based on the fair financial liability of a student who reneged on the Agreement subject to the estimated amount of subsidy consumed plus other relevant costs and inflation from the perspective of the government.
Article III. Free and Hold Harmless Clause
Any loss and/or damage caused by the Student to any person as a result of his/her performance of health care services as required under this ASAL Agreement shall be the sole and exclusive liability and responsibility of the student. In this connection, the Student holds UPCM free and harmless from all claims, liabilities, proceedings, damages, costs, charges and expenses whatsoever arising out of or as a result of such loss and/or damage.
Article IV. Alternative Dispute Resolution
In case of a dispute between the Parties, arising from the breach by the Student of his/her obligations under this ASAL Agreement, they here-by agree to freely and voluntarily submit themselves to the necessary con-sultation and negotiation for purposes of amicably settling their dispute. Should the Parties fail to reach an amicable settlement, any dispute or controversy arising from this Agreement shall be submitted to arbitration, in accordance with law (RA 9285). Finally, the Parties agree that should their
dispute reach the courts of law, the competent courts of Manila shall have exclusive jurisdiction over the same.
IN WITNESS WHEREOF, the Par ties her eto her eby sign this ASAL Agreement together with the parent(s)/guardian(s) of the Student, this ____ day of ________________ at __________________, Philippines.
_________________________ _____________________________ Name and Signature of Student Chancellor, UP Manila
_________________________ _____________________________ Name and Signature of Mother Name and Signature of Father
Signed in the presence of:
_________________________ _____________________________ Signature over printed name Dean, UPCM
of witness
ACKNOWLEDGMENT Republic of the Philippines)
________ , Metro Manila) s.s.
BEFORE ME, this ___ day of _______ in __________ personally appeared:
Name GOVT. ISSUED ID ISSUANCE DETAILS
_________________________ ______________ __________________ _________________________ ______________ __________________ known to me and to me known to be the same persons who executed the foregoing instrument and they acknowledged to me that the same is their free and voluntary act and deed as well as that of the institution represented.
This instrument refers to an Acceptance to Serve and Assumption of Liability (ASAL) agreement that consists of four (4) pages, including the page whereon the acknowledgment is written.
WITNESS MY HAND AND NOTARIAL SEAL, on the date and place above written. Doc. No. _____________ Page No. _____________ Book No. _____________ Series of _____________ 20
Part IV
SURETYSHIP AGREEMENT
FOR UPCM REGIONALIZATION PROGRAM ASAL
This Agreement executed at ____________________ (place), on ______________ (date) by _________________________ (name of surety), Filipino, of legal age, single/married to _____________________
with residence and postal address at ______________________________ hereinafter referred to as “Surety”, in favor of the University of the Philippines Manila College of Medicine, with principal office at Pedr o
Gil St., Ermita, Manila, hereinafter referred to as “UPCM”;
WHEREAS, _________________________ (name of student)
(hereinafter referred to as “Principal”) a student of the UPCM Regionalization Program, executed the attached Acceptance to Serve and
Assumption of Liability Agreement (“ASAL Agr eement”) with UPCM on _______________ (date of ASAL) to which this Surety Agreement is attached to as Annex “C”
WHEREAS, UPCM requir es that the due and faithful performance of the provisions of the said ASAL Agreement be underwritten by a Surety;
NOW, THEREFORE, for and in consider ation of the forego-ing, the undersigned Surety, jointly and severally with the Principal, hereby guarantee and warrant to UPCM that the Principal shall comply with and perform all the stipulations contained in the ASAL Agreement, and that if for any reason the Principal fails to comply therewith, the Surety binds him-self jointly and severally with the Principal:
To reimburse the UPCM twice the full of such amount/s as may have been defrayed for the Principal’s tuition, government subsidy and scholarship, and all other expenses incurred by the UPCM, with interest at the prevailing legal rate at the time of the breach of the aforesaid ASAL Agreement.
The liability of the Surety under this Agreement shall be solidary, direct and immediate and not contingent upon the enforcement by UPCM of whatever remedies it may have against the Principal, and the Surety shall at anytime on demand, pay to the UPCM whatever amount is owing from the Principal to the UPCM to the extent stated above.
This instrument is intended to be a complete and free indemnity to UPCM for any indebtedness or liability of the Principal arising from the ASAL Agreement. It shall be valid and binding without further notice to the Surety, until the Principal has complied with all his/her obligations under the said ASAL Agreement.
IN WITNESS WHEREOF, the Surety has caused its authorized
representative to set his/her hand this ___ day of _________, 200__, in ___________________._______________________
___________________________ ______________________________
SURETY SPOUSE (if married)
Signed in the presence of:
_________________________ _____________________________ Signature over printed name Signature over printed name
ACKNOWLEDGEMENT
Republic of the Philippines)
__________ Metro Manila) s.s.
BEFORE ME, this ______day of _______ in _________ personally
appeared:
Name Govt. Issued ID Issuance Details
_________________________ __________________ ________________
_________________________ __________________ ________________
known to me and to me known to be the same persons who executed the foregoing instrument and they acknowledged to me that the same is their free and voluntary act and deed as well as that of the corporation herein represented.
This instrument refers to as Suretyship Agreement for UPCM Regionalization Program consists of two (2) pages, including the page whereon the acknowledgement is written.
WITNESS MY HAND SEAL on the date and at the place first written above.
P lea se sub m it t og et her w it h y our Appl ica tio n F or m a nd o ther ad m is sio n s re qu ire m ents. Inco m plet e app lica tio n f or m s w ill no t be acc ept ed. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - RE P L Y SL IP I ce rtify th at I hav e rea d an d un der sto od th e po licies an d th e Im ple m en tin g R ules an d R eg ula tio ns ( IR R ) go ver ni ng th e Acc ept ance T o Serv e and Ass u m ptio n of L ia bil it y (ASAL ) Ag re em ent a nd f or t his p ur po se, h er eb y m an if es t m y ac -ce ptan ce an d/o r fait hf ul a dh er en ce th er eto . Sig nat ur e ov er p rin ted n am e: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ A pp lican t Gu ar dian (s ) Date : _ __ __ __ __ __ __ __ __ __ __ _ 23
GLOSSARY
ASAL Acceptance to Serve and Assumption of Liability
CM College of Medicine
CLO Community Liaison Officer
CPO Coordinating and Placement Office DOH Department of Health
IRR Implementing Rules and Regulations
IP Indigenous People
LGU Local Government Unit
MRR Maximum Residency Rule NMAT National Medical Admission Test PGIM Post Graduate Institute of Medicine PRC Professional Regulatory Commission
RP Regionalization Program
RPC Regionalization Program Committee
RPAO Regionalization Program Alumni Organization RPAA Regionalization Program Alumni Association
RSO Regionalization Students Organization
UP University the Philippines
UPCM University of the Philippines College of Medicine UPM University of the Philippines Manila
UPMAS University of the Philippines Medical Alumni Society
UPMASA University of the Philippines Medical Alumni Society in America
OFFICERS OF ADMINISTRATION MANUEL B. AGULTO, MD
Chancellor, UP Manila
AGNES D. MEJIA, MD
Dean, College of Medicine
MARIA SALOME NICDAO-VIOS, MD FRANCISCO P. TRANQUILINO, MD
College Secretary Special Assistant to the Dean and
College Secretary
CORALIE THERESE D. DIMACALI, MD LEILANI S. APOSTOL-NICODEMUS,MD, MScFM
Associate Dean for Academic Development Assistant to the Associate Dean for Academic
Development
ARMANDO C. CRISOSTOMO, MD,MHPEd RICARDO D.T. QUINTOS, MD, MSc, PhD
Associate Dean for Planning & Research Assistant to the Associate Dean for Planning
& Research
MADELEINE W. SUMPAICO, MD LYNN CRISANTA D.R. PANGANIBAN,MD
Associate Dean for Faculty & Students Assistant to the Associate Dean for
Faculty & Students
LENORA C. FERNANDEZ, MD TERESA LUISA GLORIA-CRUZ, MD,MHPEd
Director, Postgraduate Institute of Assistant to the PGIM Director
Medicine (PGIM)
RAFAEL C. BUNDOC, MD RODY G. SY, MD
Assistant to the Dean for Alumni Affairs MELFRED L. HERNANDEZ, MD
Resource Generation Office
ANTHONY GERONIMO H. CORDERO, MD LUCIA L. JUGUAN
ABDEL JEFFRI A. ABDULLA, MD Supervising Administrative Officer
Return Service Obligation
REGIONALIZATION PROGRAM COMMITTEE
ABDEL JEFFRI A. ABDULLA, Chair & Regional Adviser, Region IX & ARMM EDELINA P. DELA PAZ, MD, Vice-Chair & Regional Adviser, Region V
Members/Regional Advisers
CORAZON A. NGELANGEL, MD JOAN TRILDE F. OCUBILLO, MD
Region I & CAR Region VII & VIII
ROWENA F. GENUINO, MD LEO D.P. CUBILLAN, ,MD
ARLENE A. SAMANIEGO, MD Region X & CARAGA
Region II
JOSEFINA ISIDRO-LAPEÑA, MD, MFM
ISIDRO C. SIA, MD Region XI
Region III & IV
JOSE C. GONZALES, MD
CLEOTILDE H. HOW, MD Region XII
Region V
CHRISTIAN BONDOC Class 2017
EDUARDO R. BAUTISTA, MD Chair , Regionalization Students Organization (RSO)
MIRIAM JOY C. CALAGUAS, MD SALVADOR BENJAMIN D. VISTA, MD
