In the seventies, the disturbing picture of the country’s health and health manpower situation placed the UP College of Medicine in a dilemma regarding its role in nation building. Its high standards of admission, performance, and commitment to academic excellence made its graduates leaders in Philippine medicine and its curriculum the model for other medical schools to copy. However, these gave rise to overspecialization, brain drain, maldistribution of health manpower (which were disproportionately concentrated in urban areas), and neglect of the rural areas.
In 1971, Dr. Francisco Nemezo, the Dean of the UP College of Arts and Sciences at UP Diliman, expressed that the fierce competition for admission to the College of Medicine was breeding a generation of individualistic, self-centered, grade-conscious arts and sciences students who cared not for knowledge and how it could help serve their people, but only to have good grades that would allow them to enter the College of Medicine.
Dean Herrera, thereafter, convened an “Extraordinary Curriculum Committee of the College of Medicine” to design a medical curriculum that would develop graduates who were not only scientifically disciplined and medically competent but, more importantly, socially conscious, community-oriented. and firmly committed to the service of the people. The result is the Step-ladder Curriculum and to the Institute of Health Sciences (IHS).
The UP Institute of Health Sciences (UP-IHS) was established on the 28 June 1976 in Tacloban City, Leyte, as a joint endeavor of the Ministry of Health, Ministry of Local Government and Community Development, and the UP System. The Step-Ladder Curriculum was approved by the UP Board of Regents during its 871t meeting on 19 April 1976. With the support of the governor’s staff, IHS opened its doors to a select group of 96 students whose NCEE scores ranged from a high of 90% to a low of 9%. They started with the Certificate in Community Health Work (CHW), with the option to work their way up to until they reach the degree of BS Rural Medicine.
In 1981, the IHS campus moved to its present location in the town of Palo on a 4,083 square-meter lot donated by the municipality, through the facilitation of Don Pio Pedrosa. The donation was made possible by the virtue of Resolution 82-71 on October 20, 1982.
On May 3, 1989, after 13 years of operation and being referred to as the “Tacloban Experiment,” the IHS was renamed as the School of Health Sciences unit by virtue of the "Reorganization Act of UP Manila."
Certificate in Community Health Work (Midwifery)
How does the SHS Step-Ladder Curriculum work?
The innovative step-ladder curriculum, the first of its kind in Asia, is the main feature of the school’s academic program. It is known to be very effective in addressing health manpower problems in the country. It is a competency-based and community-based curriculum which integrates the training of a broad range of health manpower from the midwife, nurse, nurse practitioner, and Doctor of Medicine in a single, sequential, and continuous curriculum. This strategy has been used as a model by several community-based health training programs worldwide.
After seven quarters (11 weeks/quarter) of training, the student shall have acquired the knowledge and skills of a midwife and earns the certificate in Community Health Work (CHW) which qualifies him/her to practice midwifery after passing the Midwifery Licensure Examination. A student who goes on for another five quarters of study graduates with the degree of Bachelor of Science in Nursing (BSN) which qualifies him/her to practice nursing after passing the Nurse Licensure Examination. Two more quarters of study will qualify the student asa local counterpart of the nurse practitioner in other countries. This level of the curriculum however is under study. The final level of the curriculum is the Doctor of Medicine (MD) program. It consists of a yearly interval of didactics, clinica,l and community experiences over a period of five years. After completing the prescribed period of study, the student is now qualified to take the Physicians Licensure Examination and subsequently practice medicine after passing the examinations. (Please check latest curricular revisions in attached document.)
In between program levels, the student is required to undertake service leaves in his/her home community for an indefinite duration or a minimum of three months. The concept of service leave is derived from the need to integrate the instructional content and processes learned in school into a unified and understandable whole in the community he/she serves. The service leave offers the following opportunities:
For the student
- To enrich his/her educational experience with actual service at several levels of the curricular ladder;
- To be continuously oriented with the dynamic interplay of forces that affect the development of his/her community;
- To reflect on the institutional goals and instructional objectives of the School and on the different academic, psychological, and situational demands on the capabilities and competencies of a health professional; and,
- To strengthen commitment and renew the bond generated between the scholar and the community begun during the recruitment.
For the School
- To assess the relevance of its philosophy, objectives, program content, methods, and strategies of the curriculum;
- To strengthen its linkages with the DOH, DILG, and various Local Government Units;
- To strengthen partnership with communities in the training of their scholars;
- To provide opportunities for the faculty to keep in touch with the realities in the communities and strengthen their commitment to the concept of the school.
For the Community
- To strengthen support for their scholar and enhance its own commitment by jointly working with and availing of the services of the scholar.
- To augment the delivery of health services in the community.
Multiple Levels of Exit and the Mechanism for Lateral Entry
- A student may exit from any level of the curriculum and return to the community as a functional health worker. Thus, a graduate could exit as a Community Health Worker (Midwife), a Nurse or Nurse Practitioner, or a Medical practitioner.
- After a period of serving the community, a graduate can be readmitted to the next level of the curriculum subject to community need and endorsement, and the student’s performance in the previous level.
- Should there be a need for a health worker with advance skills in his/her community, the graduate who has been serving as a health worker for quite sometime already, may be readmitted to the next level of the curriculum, subject to re-endorsement of the community or its sending agency.
Partnership with Linked Agencies and Communities in the Development of Health Human Resources
- Involvement of DOH, DILG, and LGUs in the recruitment of scholars;
- Endorsement is required for the scholar’s admission and progress to higher levels;
- University, linked agencies, and LGUs share the responsibility of providing financial support for scholars.
- Shared supervision of the students during service leave between the school, linked agencies and local community leaders.
- The school’s part-time lecturers come mainly from the DOH. Service people as mentors are envisioned to broaden the student’s theoretical and academic perspectives with their realistic “first hand” experiences.
- The service facilities of the Department of Health and the Local Health Unit’s health centers serve as the main training facilities for the students’ field experiences.
- Policies on recruitment and admissions de-emphasize past academic performance and passing the UPCAT. Instead, admission is based on community need and the scholar’s willingness and commitment for community service.
- The school has adopted the qualitative grading system of “Passed” (P) and “Needs Tutorials” to ensure the development of required competencies rather than competing for grades.
Return Service Requirement
- Sponsoring communities are committed to employ their scholars after graduation,
- Scholars are required a Return Service obligation of 2 years of service for every year of study which ensures the availability of health workers specially in underserved areas.