The Department of Obstetrics and Gynecology: Pushing through Changing Times.

At the turn of the 20 th century, the medicalization of obstetric care in the Philippines was linked to transnational shifts in medical knowledge that happened concurrently in Europe and the United States. 1 Wealthy Filipinos, the pensionados , were sent to Europe to study medicine and its specialties. Among them were Dr. Baldomero Roxas and Dr. Fernando Calderon who studied obstetrics and integrated European knowledge with local practice. 2 They would later be among the founding members of the Department of Obstetrics in the University of the Philippines College of Medicine. The Philippine Medical School was established on December 1, 1905 following a meeting of the Philippine Islands Medical Association. It was later integrated into the University of the Philippines (UP) and renamed the College of Medicine. The Department of Obstetrics was one of its eleven primary departments along with Chemistry, Anatomy, Pathology, Bacteriology, Medicine, Surgery, Pharmacology, Physiology, Hygiene, and Pediatrics. Dr. Calderon served as the first Chief of the Department of Obstetrics while Dr. Roxas was appointed as an Associate Professor. 3 , 4 In 1910, Dr. Honoria Acosta ( Figure 1 ) returned to the Philippines after receiving a scholarship to study medicine and obstetrics at the Women’s Medical College in Philadelphia. Regarded as the first female Filipino physician, she joined the faculty of Obstetrics as an Assistant Professor upon her return. Instructors of the Department included Dr. Mariano Tolentino, Dr. Guillermo Rustia, and Dr. Arsenio Morales. The first obstetric clinic was held in a small room at St. Paul’s Hospital. 5 Postal stamp in honor of Dr. Honoria Acosta Sison, the First Filipino Lady Physician. Source: Philippine Postal Stamp Catalogs, first issued December 15, 1978. The construction of the Philippine General Hospital was approved in August 17, 1907 through the Philippine Commission Act 1688. With its inauguration in 1910, the practice of obstetrics opened in the hospital. The members of the faculty promoted medicalization of childbirth during a time when women would rather give birth at home attended to by traditional birth attendants or hilots . This led to an unprecedented increase in the number of consults with obstetricians for pregnancy and delivery. Over the years, the faculty members conducted a substantial amount of research and published clinical materials on various topics. Gynecology was initially a section under the Department of Surgery until it became its own clinical department in 1922 on the motion of then Regent Calderon. 5 Dr. Calderon served as its first Chief with its staff taken from both surgery and obstetrics. The Department of Gynecology was inaugurated in the school year 1922-1923 offering six courses. The faculty helped improve the healthcare delivery over the next years. The faculty led by Dr. Calderon would give lectures to gatherings of women in poor districts to invite them to consult the hospital. They also volunteered as medics during the Japanese occupation and continued to help in nation building after the liberation. In 1952, following a mandate from the UP College of Medicine and PGH Director Dr. Agerico Sison, formal postgraduate trainings in obstetrics and gynecology were started. Dr. Honoria Acosta-Sison and Dr. Constantino Manahan were the chairs of the Department of Obstetrics and Department of Gynecology, respectively. Residents from the Department of Obstetrics ( Figure 2 ) began a formal rotation in the Department of Gynecology, and vice versa. The Department of Obstetrics Consultant and Resident Staff in 1957. Source: Archives of the Department of Obstetrics and Gynecology, credit to the original owner.

In 1961, Dr. Luciano Sotto established the Section of Gynecologic Oncology, marking a significant step in the capacity to treat complex women’s health issues. An outpatient gynecologic oncology clinic, radiation treatment protocols, and a surgical training program focused on gynecologic oncology were instituted. In Dean Benjamin Barrera’s letter dated March 6, 1964, he recommended the fusion of the Department of Obstetrics and Department of Gynecology to UP System President Carlos P. Romulo in line with universal practices of medical schools abroad citing the great degree of overlap between the two disciplines. The fusion of the Department of Obstetrics and Department of Gynecology ( Figure 3 ) was approved during the 720th Meeting of the Board of Regents on April 3, 1964. Dr. Constantino Manahan ( Figure 4 ) served as the first chair of the merged departments. The Department of Obstetrics and Gynecology in 1964. Source: From the collection of Dr. Erlinda F. Gonzales-Germar. (Photo courtesy of Dr. MJV Germar). Dr. Constantino P. Manahan served as the first Chair of the merged Department of Obstetrics and Gynecology. Source: Photo taken from POGS at 75: Our Story, Our Legacy. 2 Dr. Manahan initiated the Residency Training Program in Obstetrics and Gynecology during his term, which aimed to train future generations of obstetricians and gynecologists, ensuring a skilled workforce capable of delivering high-quality care in the field of reproductive health. By investing in residency training, the Department cemented its commitment to academic excellence and professional development. The Family Planning and Postpartum Clinic, was established in 1965, and this would later become the Reproductive Biology Center. Under the leadership of Dr. Gloria Aragon in 1967, the Department underwent major organizational restructuring, dividing it into three major units: Obstetric Service, Gynecologic Service, and Outpatient Service. This strategic division allowed for more specialized care delivery and improved operational efficiency. In 1969, the Department hosted its first postgraduate course for general practitioners. This initiative facilitated knowledge exchange and continued medical education, fostering collaboration among healthcare professionals and is still being conducted until now.

Dr. Julita Jalbuena established three main committees in 1973 which focused on Teaching and Training, Services, and Research. These committees played a crucial role in advancing the Department mission, facilitating educational initiatives, expanding services, and fostering research in obstetrics and gynecology. Under the leadership of Dr. Nora Silao, the Department underwent further restructuring, leading to the merging of its major units into three general services (Service A, B, and C) in 1977. In 1978, the first Fellowship Training Program in Gynecologic Oncology was created, driven by the collaborative efforts of Dr. Luciano Sotto, Dr. Augusto Manalo, and Dr. Genara Limson. This initiative aimed to cultivate expertise in the management of gynecologic cancers, further advancing the Department's capabilities in specialized care. Two years after, the Section of Trophoblastic Diseases was established under the leadership of Dr. Isidro B. Benitez, through the perseverance of Dr. Fe Palo-Garcia. Dr. Lourdes B. Capito was the first physician to be mentored as a trophoblastic disease specialist. Formal training in trophoblastic diseases came much later on in 1988 and remains the only one of its kind in the country and the world. The commitment to specialized training continued in 1981 with the establishment of Fellowship Training Program in Maternal and Fetal Medicine, launched under the leadership of Dr. Natividad Puertollano, Dr. Vicente Poblete Jr., and Dr. Fernando dela Rama Jr. This program focused on advancing the management of high-risk pregnancies and fetal conditions. In 1982, the Colposcopy Unit was established. Dr. Rosario Isidro-Gutierrez, Dr. Erlinda F. Gonzales-Germar, and Dr. Angeles Cruz conducted training courses in cytology and colposcopy. This initiative aimed to enhance the Department’s diagnostic capabilities, and improve the early detection of cervical abnormalities, contributing to the prevention and management of cervical cancer. The year 1985 saw the establishment of the Section of Reproductive Endocrinology and Infertility, followed shortly by its Fellowship Training Program in 1988, under the leadership of Dr. Florante Gonzaga and Dr. Rosalinda Arceo. This addition expanded the Department's scope to include specialized services for patients struggling with infertility and hormonal disorders, addressing previously unmet needs in women's healthcare. In the same year, the Menopause Clinic was opened. This clinic provided comprehensive services tailored to the unique needs of menopausal women. The Section of Obstetric and Gynecologic Infectious Diseases was established in 1989 under the leadership of Dr. Mildred Pareja. This initiative addressed the growing concerns surrounding infectious diseases in obstetrics and gynecology. Formal fellowship training in OBGYN Infectious Diseases was started in 1998. The year 1991 saw the birth of the ultrasound unit with Dr. Augusto Manalo as Chair and Dr. Felix Salgado as unit head. With sonography now emerging as a subspecialty in obstetrics and gynecology, the ultrasound unit was reorganized into the Section of Ultrasound with Dr. Filomena San Juan as its first Section Chief. In the same year, the section also started its formal fellowship training program.

At the turn of the new millennium, the Department of Obstetrics and Gynecology was readily poised to be at the forefront of maternal healthcare service delivery and expanding its subspecialty programs. The Department was keen on quickly adopting emerging fields in the realms of obstetrics and gynecology to advance the local healthcare landscape. The institution of the Master of Science in Clinical Medicine (Obstetrics and Gynecology) was approved during the 1127 th Meeting of the Board of Regents last December 18, 1998. It is a two-year program designed to provide a Master’s level training program in Obstetrics and Gynecology. The program is intended for graduates who have completed clinical training and aims to develop faculty members who are knowledgeable and skilled in teaching, research, and administration. In 2004, the Division of Urogynecology and Reconstructive Pelvic Surgery, pioneered by Dr. Lisa Prodigalidad-Jabson, was established during the term of Dr. Virginia R. de Jesus. It was followed later by the opening of its formal training program in 2006. In 2012, the Division of Family Planning was started under the leadership of Dr. Lourdes B. Capito. The Division of Family Planning offered a dual-track Fellowship Training Program, including Clinical Fellowship in Family Planning and a Master of Science in Clinical Medicine in Obstetrics and Gynecology. In 2014, under the supervision of Dr. Blanca De Guia, the UP Manila Primary Reproductive Health Care Center (formerly the Ortoll Primary Reproductive Health Care Center), previously operating under UP Manila, was transferred under the Department of Obstetrics and Gynecology. Currently, this site is being renovated to become a multi-specialty building which will house the Department’s assisted reproductive technology and family planning clinics. The clinical and administrative areas of the Department underwent major renovations in 2018, in line with the renovation of the emergency room complex of the hospital. The OB Admitting Section was transferred to Ward 15 and the labor and delivery rooms were transferred to the fourth floor LCB. The administrative areas were subsequently transferred to Ortoll Hall. Following the renovations, the Department also welcomed midwives into its staff complement whose functions are vital in the labor and delivery rooms.

On March 23, 2020, as the country officially declared a state of public health emergency due to the COVID-19 Pandemic, the Philippine General Hospital was designated as a COVID Referral Hospital. The Department became the referral center for severe and critical cases of COVID in pregnancy. The Department transformed its obstetric wards into the COVID Labor and Delivery room with strict protocols on patient flow, donning and doffing, and use of personal protective equipment ( Figure 5 ). The Philippine General Hospital became a referral center during the COVID-19 Pandemic. Consultants and trainees responded to the need and catered to COVID-positive obstetric and gynecologic cases. Though the Department was still reeling from the pandemic, the opening of the renovated OB Admitting Section ( Figure 6 ) last August 2021 served as a beacon of hope. The newly-renovated OB Admitting Section and Administration Complex showcased a 300 sqm. facility complete with modern operating theaters, an ultrasound room, an obstetric triage unit, labor and delivery rooms, and recovery rooms. The construction was supervised by then Chair, Dr. Efren Domingo. The newly renovated OB Admitting Section. The Division of Sexual Health, being the youngest addition to the roster of subspecialty divisions, was formally launched last November 2021 headed by Dr. Sherri Ann Suplido. Since then, it has served as an avenue for cis-gender women and sexual gender minorities to seek healthcare without fear of discrimination and disrespect in the clinical setting. Expanding its services even further, the Department established two multidisciplinary clinics in 2023. The Center for Endometriosis was formally opened on March 1, 2023. Together with the Department of Psychiatry, Division of Colorectal Surgery and the Pain clinic, the center offers a multi-disciplinary and holistic approach to the management of endometriosis. Dr. Maria Antonia E. Habana served as the founding head of the Center for Endometriosis. The Pediatric and Adolescent Gynecology Clinic was likewise opened in 2023, catering to the reproductive health and gynecological issues of infants, children, and adolescents. The clinic is led by Dr. Angela S. Aguilar with the consultants and fellows of the Division of Reproductive Endocrinology and Infertility. The clinic works collaboratively with other subspecialties such as Pediatric Surgery, Adolescent Medicine, and Pediatric Endocrinology. Upgrading of equipment and renovation plans are also underway to modernize key service areas like the Maternal Fetal Medicine Center, Chemotherapy Ward, and Lactation Rooms. In addition, the Department is focused on enhancing its training and graduate program offerings. The curriculum of the Master of Science in Clinical Medicine (Obstetrics and Gynecology) underwent review, and revisions are being proposed. The Department is also proposing the institution of a Master of Clinical Science in Obstetrics and Gynecology which will be offered during residency training. In the 1385 th meeting of the Board of Regents last November 30, 2023, the proposal for the creation of the Institute of Reproductive Health was approved. It was established to serve as a centralized resource of research on reproductive health issues and concerns, to guide policy and legislation, guideline development, training and educational needs, and research agenda setting. Dr. Mario R. Festin was appointed as the founding Director of the Institute. As the country braced from the aftermath of the pandemic, the Department ( Figure 7 ) continues to adapt to changing times and remains at the forefront in promoting reproductive healthcare in the country. The Department remains to be a national center of excellence in reproductive health science and professions, a globally recognized leader in training and education, research, and service in the field of Obstetrics and Gynecology, socially relevant and contributing to national health policy development in reproductive health. The Faculty of the Department of Obstetrics and Gynecology 2023. Past Chairs Past Chairs Past Chairs