PSN is 50 in 2022: Bigger and Better

PSN is 50 in 2022:  Bigger and Better

By Reina Lynn G. Antonio, MD, FPCP, FPSN

 

As advances in the field of Nephrology took place in the Philippines in the 1980s, so did the demand for specialists in this field. Kidney transplantation, utilization of cyclosporine before its availability in the United States for clinical use, invention of dialysis machine adaptor for older models so they may be continuously used, and development of dialyzer reprocessing method that allowed its reuse and therefore, provision of more affordable dialysis sessions—these innovations flourished and so the demand for renal specialists was augmented.

As recalled by Drs. Claver Ramos and Ophelia Completo Buot, training to become a nephrologist during those times was more of apprenticeship or mentoring. It was informal and unstructured. A trainee would just usually go on rounds with the Consultant Nephrologist.  Dr. Filotelo Alano also recalled that most programs were mainly in the medical schools, with other medical centers and hospitals developing their own since not everyone could afford to go abroad for training.

So the need to standardize the quality of training in the subspecialty of Nephrology was emphasized. Hence by 1986, the formation of the PSN training program accreditation board (PSN TPAB) was included in the PSN Constitution.

While the Philippine Society of Nephrology Specialty board (PSN-SB) set the standards for the board examination that would test the qualifications of the locally trained nephrologists for Diplomate certification, and their subsequent evaluation to Fellow with peer acceptance, it was the responsibility of the PSN TPAB to accredit hospitals and ensure that the training programs in fellowship in Nephrology they offered would follow the standards determined by the PSN TPAB and be approved by the board.

UP-PGH, UERMMMC, the National Kidney Institute (formerly National Kidney Foundation of the Philippines on NKFP), UST Hospital, Makati Medical Center and AFP Medical Center were the first hospitals or medical centers accredited by the PSN TPAB to produce new generations of nephrologists in the country. These training institutions took turns in hosting continuing medical education (CME) sessions on emerging issues in the science and practice of Nephrology. Dr. Adriano Dela Paz often cited CME as vital for membership development, and emphasized the PSN’s role in keeping its members up-to-date on trends and concerns in their subspecialty.

Aside from establishing a standardized fellowship training in Nephrology and providing regular CMEs, the PSN also published the first issue of the Philippine Journal of Nephrology in 1986. This is the PSN’s official scientific and research publication, which also served as a vehicle for members to share their work and ideas in the field of renal disease and hypertension. Every quarter, the journal published original articles in basic research and clinical studies pertinent to both adult and pediatric nephrology. Contributors included members who were required to have research for membership qualification and foreign experts as well.

Conventions were held annually to add to the members’ learning exposure. Pediatric Nephrologists began to take a higher profile within the PSN, and in 1988, resource speakers included were from this subspecialty.

In the same year, the creation of regional chapters began and for the first time since its inception, the 9^th PSN National Convention was held outside Metro Manila, this one in Cebu City. This was part of the area covered by the first PSN chapter, the Visayas-Mindanao Chapter, led by the President, Dr. Ophelia Completo Buot and assisted by Dr. Vivina Chiu, as vice president for the Visayas, and Dr. Josefino Ramos, as the vice president for Mindanao. Drs. James Tam, Ruben Maguad, Nathan Amante, and Gil Octaviano comprised the rest of the board.

To keep the members updated of the activities of the society, BroadCast, PSN’s very own newsletter, was officially launched in 1990.

Aside from this, the 1990s also opened the opportunity to integrate the pediatric side of nephrology in the bigger picture when Dr. Carmelo Alfiler, a pediatric nephrologist, took the helm as PSN president. Later on in 1994, he and 11 other colleagues founded the Pediatric Nephrology Society of the Philippines (PNSP) as a component society of the PSN and hosted the 6^th Asian Congress of Pediatric Nephrology. They also organized to have their own Specialty and Training Program Accreditation Boards.

Under Dr. Alfiler’s leadership, the PSN was reconfigured to boost its health as an organization. It became a self-sustaining society. PSN conventions became 2-3 day events of not only scientific updates and fellowship among members but also a venue for promotion of medical products and technologies through booth exhibits and industry-sponsored scientific sessions.

He also set into motion the creation of relevant committees as part of the restructuring of the PSN constitution and bylaws.  To date, PSN already has 2 councils, 8 regional PSN chapters, 6 clusters, and 18 committees. It has accredited 18 Adult Nephrology and 5 Pediatric Nephrology fellowship training programs.

Numerous amendments were crafted, implemented and continued during the term of Dr. Vicente Tanseco, one of the first locally trained nephrologists who took the first PSN Diplomate Examination. Fellows in Training were also accepted as members in the Society; updates through conventions and symposia were made available to these trainees as well. This was a reflection of the Society’s focus on enhancing the training of nephrology fellows.

PSN also supported local research and set aside funds to encourage members and trainees to submit relevant research proposals and completed papers. From research output, the Preventive Nephrology Project was launched, with screening public school children for early signs of kidney disease a primary activity. Drs. Filoteo Alano and Imingarda Gueco led this ambitious nationwide effort.

June was later declared as National Kidney Month in the country. PSN set out to give lectures to lay people, advocating early detection and aggressive control of blood sugar and blood pressure among these individuals to prevent renal complications, as historical data pointed to diabetes and hypertension as major factors that heighten the risk of renal disease.

It was also during this time that freestanding dialysis centers began to mushroom in Metro Manila. Then PSN president Dr. Antonio Paraiso proposed to the Department of Health (DOH) about licensing requirements in operation of a dialysis unit so as to have consistency in the quality of care and service to the renal patients. He also conceived the Renal Disease Registry, envisaging this office to gather data on the major renal diseases and the status of dialysis and renal transplantation in the country.

PSN also collaborated with other medical subspecialties to formulate guidelines. The first was the Clinical Practice Guideline on Urinary tract Infection, when PSN tasked Drs. Oscar Naidas and Benita Padilla to partner with the Philippine Society of Microbiology and Infectious Disease (PSMID). It was disseminated in 1998. Later on, PSN also took part in the task force that created the Clinical Practice Guidelines for Leptospirosis and for the Management of Dyslipidemia in the Philippines.

During this same period, the society initiated an awarding process, recognizing members and their contributions. The first awards were given to the most outstanding fellow-in-training and to the nephrologists who were deemed distinguished in the field of Medical Education and Research.

Gender equality in the leadership of PSN was demonstrated as Dr. Irmingarda Gueco became the second female president after Dr. Aurora Padolina Perez, who held the position in 1974-1976. It was during Dr. Gueco’s term that PSN was formally inducted into the International Society of Nephrology, thereby bringing PSN to the global front. Foreign speakers were then invited regularly to the society’s scientific meetings. This was in line with the Vision and Mission of the Society, crafted that time by a team led by Dr. Lynn Gomez.

But as mentioned before, conventions were not only for scientific updates. As the number of members grew, these annual meetings also became venues that would foster camaraderie among Filipino nephrologists. Annual inter-hospital competitions were held to help everyone unwind and show their different and creative sides as members got to showcase their talents while celebrating in each another’s company.

So as the PSN gained more membership, it had become a more organized and goal oriented community… a family.

From just being recognized as a society of renal experts, PSN’s objectives had shifted to achieving improvement not only in the society and its members, but more importantly for the renal care of the Filipino people.

PSN has become bigger and better and yet still evolving as it also faced challenges and changes through the years.

 

(lifted from Beyond Measure: 40 years of the PSN)

RLGA2021