scholarly journals Napoleon C. Ejercito, MD (1921 – 2007)

2007 ◽  
Vol 22 (1-2) ◽  
pp. 41
Author(s):  
Joselito C. Jamir
Keyword(s):  
Head And Neck ◽  
Training Program ◽  
Residency Training ◽  
Chief Resident ◽  
Residency Training Program ◽  
Neck Surgery ◽  
The United States ◽  
The Philippines ◽  
Head And Neck Surgery ◽  
Martial Law

  A Strong Pillar   After completing his residency training program in the United States, Dr. Napoleon Ejercito came back to join the faculty of the then combined Department of Eye Ear Nose and Throat (EENT) at the Philippine General Hospital. Unhappy with the fact that ORL in the Philippines was not yet a separate and distinct specialty with no existing standard and organized form of training, Dr. Ejercito and seven other optimistic and young ENT surgeons gathered together to form the Otolaryngology Society of the Philippines under the leadership of Dr. Tierry Garcia. These men became the historic pillars of the society.   With the birth of this society, the development and maturation of the specialty was simply a matter of time.   Fifteen years later, Dr. Ejercito spearheaded the founding of the Philippine Board of Otolaryngology and Bronchoesophagology in order to standardize and professionalize the practice of ORL. Initially composed of diplomates and candidates of the American Board of Otorhinolaryngology, the rigorous process of accreditation and qualification was patterned after the American Board. This organization was subsequently incorporated and evolved into what is now known as the Philippine Board of Otolaryngology Head and Neck Surgery. This board became his youngest child whose growth he fostered and whose interests he promoted and protected.   A Dedicated Leader   Dr. Ejercito was Chairman of the Department of ORL of the UP-PGH from 1970 to 1974, when Martial Law was declared. He was a staunch critic of the Marcos regime, but the repression did not deter him from leading the department in achieving its goals.   During his time as chair of the department, only a total of 12 residency slots were available. It was Dr. Ejercito who pioneered the restructuring of the residency training program into three ORL residents per year level. Furthermore, it was during Dr. Ejercito’s term that a post-residency graduate was chosen as the chief resident.   His integrity was beyond question. Rather than face the possibility of naming his eldest son as chief resident, he compelled his son to seek further fellowship abroad. A Trailblazer   Dr. Napoleon Ejercito can be called the father of head and neck surgery in the Philippines. While Dr. Tierry Garcia initiated the expansion of the specialty of Otorhinolaryngology to include head and neck surgery, it was Dr. Ejercito who nurtured and strengthened it to what it is today. As a testament to Dr. Ejercito’s legacy, the stipend of the fellow of the Head and Neck Program of the Department of ORL –PGH was made available by an alumnus of the department, and was named after him.   His dedication to the discipline was beyond comparison. Even when he was the Chair, Dr. Ejercito continued to operate on charity patients and demonstrated operative procedures to residents on a regular basis.   His retirement did not dampen his zeal to further the cause of ORL. He continued to support the different programs of the society and attended society conventions and departmental conferences whenever possible, which gained the admiration of younger generation of residents. Dr. Napoelon Ejercito: A strong pillar, a dedicated leader, a trailblazer. Such a man will truly be missed.

Implementation of duty hour standards in otolaryngology-head and neck surgery residency training

2005 ◽  
Vol 132 (6) ◽  
pp. 819-822 ◽  
Author(s):  
Todd A. Kupferman ◽  
Tim S. Lian
Keyword(s):  
Head And Neck ◽  
Residency Training ◽  
Training Programs ◽  
Neck Surgery ◽  
Program Directors ◽  
The United States ◽  
Head And Neck Surgery ◽  
Training Experience ◽  
Duty Hours ◽  
Resident Duty

OBJECTIVE: To determine what impact, if any, of the recently implemented duty hour standards have had on otolaryngology-head and neck surgery residency programs from the perspective of program directors. We hypothesized that the implementation of resident duty hour limitations have caused changes in otolaryngology training programs in the United States. STUDY DESIGN AND SETTING: Information was collected via survey in a prospective, blinded fashion from program directors of otolaryngology-head and neck residency training programs in the United States. RESULTS: Overall, limitation of resident duty hours is not an improvement in otolaryngology-head and neck residency training according to 77% of the respondents. The limitations on duty hours have caused changes in the resident work schedules in 71% of the programs responding. Approximately half of the residents have a favorable impression of the work hour changes. Thirty-two percent of the respondents indicate that changes to otolaryngology support staff were required, and of those many hired physician assistants. Eighty-four percent of the respondents did not believe that the limitations on resident duty hours improved patient care, and 81% believed that it has negatively impacted resident training experience. Forty-five percent of the program directors felt that otolaryngology-head and neck faculty were forced to increase their work loads to accommodate the decrease in the time that residents were allowed to be involved in clinical activities. Fifty-four percent of the programs changed from in-hospital to home call to accommodate the duty hour restrictions. CONCLUSIONS: According to the majority of otolaryngology-head and neck surgery program directors who responded to the survey, the limitations on resident duty hours imposed by the ACGME are not an improvement in residency training, do not improve patient care, and have decreased the training experience of residents. SIGNIFICANCE: This study demonstrates that multiple changes have been made to otolaryngology-head and neck surgery training programs because of work hour limitations set forth by the ACGME.

scholarly journals Carlos F. Dumlao, MD (1950-2018)

2018 ◽  
Vol 33 (2) ◽  
pp. 65
Author(s):  
Alfredo Q.Y. Pontejos
Keyword(s):  
High School ◽  
Head And Neck ◽  
Training Program ◽  
General Hospital ◽  
Neck Surgery ◽  
The Philippines ◽  
Head And Neck Surgery ◽  
One Year ◽  
The University ◽  
Good Number

Carlos F. Dumlao, ‘Caloy’ as he is fondly called by friends, was born in Bayombong, Nueva Vizcaya on November 4, 1950. He studied in the Bayombong Central School for elementary, then the Nueva Vizcaya High School, graduating valedictorian from both schools.  He took his B.S. Pre-Med in the University of the Philippines (U.P.) Diliman, finishing in 1970. He then entered the U.P. College of Medicine and graduated in 1975. He is a brod in the Mu Sigma Phi Fraternity where I got to know him. He was one-year senior and he would always have a helping hand to anyone in need. He looked fearsome because of his bulk and stance but deep inside he had a soft heart and was very humble, for a guy who happened to be a son of a governor.   Faith would have that we would be together again in the Department of Otolaryngology in the Philippine General Hospital. He was my immediate senior and helped and taught me the rudiments of surgery. He was one of the "fastest guns alive" that he could finish a laryngectomy in an hour.    Because of the prodding of Dr. Mariano B. Caparas, he took up the challenge of practicing in Baguio with the objective of establishing a training program there. The first few years were a challenge to him because he was not welcome there.  The senior surgeons frowned on the fact that he performed head and neck surgery, particularly thyroidectomy. But he persisted and even befriended them. He succeeded in forming a Department of Otolaryngology - Head and Neck Surgery in the Baguio General hospital. He gave much of his time and talent to that department and has produced a good number of diplomates and fellows.   He was unpretentious. What you see is what you get. He was also a true friend and a dedicated family man. He was faithful to Josie, his wife and his children Janie, Dessy, Biboy, Joboy and Popo.   One measure of success of a leader is the number of successors you have produced. He has done well in this. He has given much of himself to Baguio General Hospital, the Philippine Society of Otolaryngology – Head and Neck Surgery (PSO-HNS) Northern Luzon Chapter and to the PSO-HNS as a whole. His legacy will live on in his graduates in Baguio General Hospital and through his son Popo who just passed the Philippine Board of Otolaryngology – Head and Neck Surgery diplomate board examinations. Caloy, you have left you mark in Northern Luzon, particularly in Baguio City. May you rest in peace in God’s bosom.        

scholarly journals Self-Reported Assessment of Outcome-Based Education in Philippine Otolaryngology - Head and Neck Surgery Residency Training Programs by Consultants and Residents

2021 ◽  
Vol 36 (1) ◽  
pp. 15
Author(s):  
Maria Natividad Almazan
Keyword(s):  
Head And Neck ◽  
Residency Training ◽  
Training Programs ◽  
Neck Surgery ◽  
Multisource Feedback ◽  
The Philippines ◽  
Head And Neck Surgery ◽  
The Self ◽  
Outcome Based Education ◽  
Training Institutions

ABSTRACT Objective: To determine the self-reported assessment of initial implementation of the 3 domains of Outcome-Based Education in accredited Otolaryngology - Head and Neck Surgery residency training programs in the Philippines by consultants and residents and explore any associations between their demographic profiles and assessments. Methods: Design: Mixed Method Research Design Setting: Multicenter - 30 accredited ORL-HNS residency training institutions in the Philippines- National Capital Region (NCR) 19, Luzon 7, Visayas 2, and Mindanao 2. Participants: A total of 129 consultants and 82 second to fourth year residents in  training were included in the study by convenience sampling. First-year residents who started  their residency training in January 2020 were excluded. Respondents answered self-reported questionnaires to assess implementation of the 3 domains of OBE: intended learning outcomes (ILO), teaching and learning activities (TLA) and assessment tasks (AT) using the 4-point scale score from “fully implemented” (4) to “not implemented” (1). Results of questionnaires were confirmed using open-ended questions on the challenges of OBE with a focused group discussion among 4 consultants and 1 resident.   Results: The self-reported assessment of respondents on OBE implementation was “fully implemented” in the 3 domains. However, low numerical scores were seen for “managing community health and social need” in the ILO and “laboratory activities and workshops” in the TLA for both consultants and residents, in the assessment task (AT “multisource feedback by nurses and administrative staff” for the consultants, and “direct observation of performance skills for patient encounter” for residents. Among the 7 modules, “research methodology” had the lowest score for both consultants’ and residents’ self-perception. Challenges of OBE revealed included “mastery,” “time” and “data keeping.” Consultants younger than 60 years of age who had been in the department longer than 3 years and residents who attended an OBE workshop / lecture tended to give higher scores Conclusion: Two years after distribution of the manual on OBE to ORL-HNS residency training institutions, the consultants’ and residents’ self-reported assessment on implementation in all the 3 domains of OBE was “fully implemented.”

scholarly journals EDILBERTO M. JOSE, MD (1946 - 2019) Otorhinolaryngologist, Head & Neck Surgeon, Mentor, Friend

2020 ◽  
Vol 35 (1) ◽  
pp. 82
Author(s):  
Ruzanne Magiba-Caro
Keyword(s):  
Clinical Practice ◽  
Head And Neck ◽  
Role Model ◽  
Chief Resident ◽  
Neck Surgery ◽  
The Philippines ◽  
Head And Neck Surgery ◽  
Primary Concern ◽  
Senior Year ◽  
The Right

Dr. Ed Jose is (and will always be) my best friend --- my mentor, guidance counselor and the “kuya” that I never had. I would like to share with you his two constant reminders to me which will make us know, understand and appreciate him more Very few people can handle power. He was a prime example of “not seeking any position but rather the position seeking him.” He was Chairman of the Department of Otorhinolaryngology, University of the Philippines – Philippine General Hospital (UPPGH) and at the same time President of the Philippine Society of OtorhinolaryngologyHead and Neck Surgery. He also became Chairman of the Philippine Board of Otorhinolaryngology-Head and Neck Surgery. At one point, he was also Assistant Director for Health Operations of UP-PGH. Committed to his positions, Dr. Jose remained humble and unassuming. He may appear “suplado” but he was always willing to help in whatever way possible. He was quite flexible believing that “rules can be bent” if it was the right thing to do at the time. One of his favorite songs was “Both Sides Now” and indeed, he was always fair when very important decisions were made. Simplify…Simplify…Simplify… This explains why his dedication was unwavering. Dr. Ed focused on three important aspects of his life: family, clinical practice and ORL training. Married to a pathologist (Dr. Rebecca Tongco-Jose) who passed away three years ago, his primary concern up to the end were his sons Noel and Ian. His world revolved around his family. The University of the Philippines (UP) was his way of life where he obtained his secondary, college and medical education. He took his residency at UP-PGH and served as chief resident on his senior year. Upon his return from Fellowship in Head and Neck Surgery at the Royal Nose, Throat and Ear Hospital in England, he started teaching and training residents at UP-PGH … and never stopped even after retirement. Fortunately for all the residents and even young consultants in UP-PGH, his clinic was just across Taft Avenue — so he was forever ON CALL especially during difficult and complicated surgeries. Papa Ed’s presence in the OR was a “confidence booster” for all of us. A true head and neck surgeon who did sharp dissection with bravado, the “thyroid and parotid expert,” the “surgeon’s surgeon” — Daddy Joe was very decisive and pragmatic in the management of cases. He had numerous patients and surgeries, always ready with an alternate case, and was also known as the “extension king” of UP-PGH. He was a silent worker but a very witty colleague. He was abreast of all the developments in the field of ORL. In fact, it was during his term as PSO-HNS President that the First PSO-HNS Clinical Practice Guidelines were developed and disseminated. Proof of his dedication to ORL training was his serving as director of the PBO-HNS until his demise. He made it a point to attend all the meetings, workshops, accreditation visits and other related activities (actually missing out on some social obligations). He was also ON CALL when other directors were not available. Dr. Jose was very religious, a practicing Roman Catholic and a devotee of Our Lady of Manaoag. He never failed to pray before seeing a patient and commencing surgery. He may seem grumpy but having known him for 35 years, he can be very playful with a very good sense of humor. Recognized as the FPJ of ORL, he would occasionally boast of his female admirers. He declared to our family that our grandson was his “adopted apo” and he had a “pasalubong only for Teo” every time he went on an accreditation visit. He was a voracious reader and a lover of history. Dr. Ed Jose was a simple man. His only luxury was collecting cars and watches. The last time I saw DJ (that is how our family calls him) prior to his hospitalization was significant because my mentor came to my clinic in Quezon City to consult me regarding his ear problem. True to form, I ended up consulting him for my nasal complaint. It will not only be I who will miss Dr. Ed Jose and his signature laughter…the entire ORL community will miss their Papa Ed/Daddy Joe. He will forever remain as an inspiration and role model for any Otorhinolaryngologist - Head and Neck Surgeon.

A National Survey of Robotic Surgery Training Among Otolaryngology—Head and Neck Surgery Residents

2021 ◽  
pp. 000348942199696
Author(s):  
Hilary C. McCrary ◽  
Sierra R. McLean ◽  
Abigail Luman ◽  
Patricia O’Sullivan ◽  
Brigitte Smith ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Head And Neck ◽  
National Survey ◽  
Neck Surgery ◽  
The United States ◽  
Head And Neck Surgery ◽  
Residency Programs ◽  
Surgery Training ◽  
Robotic Surgery Training ◽  
Operative Experience

Objective: The aim of this study is to describe the current state of robotic surgery training among Otolaryngology—Head and Neck Surgery (OHNS) residency programs in the United States. Methods: This is a national survey study among OHNS residents. All OHNS residency programs were identified via the Accreditation Council for Graduate Medical Education website. A total of 64/127 (50.3%) of OHNS programs were selected based on a random number generator. The main outcome measure was the number of OHNS residents with access to robotic surgery training and assessment of operative experience in robotic surgery among those residents. Results: A total of 140 OHNS residents participated in the survey, of which 59.3% (n = 83) were male. Response rate was 40.2%. Respondents came from middle 50.0% (n = 70), southern 17.8% (n = 25), western 17.8% (n = 25), and eastern sections 14.3% (n = 20). Most respondents (94.3%, n = 132) reported that their institution utilized a robot for head and neck surgery. Resident experience at the bedside increased in the junior years of training and console experience increased across the years particularly for more senior residents. However, 63.4% of residents reported no operative experience at the console. Only 11.4% of programs have a structured robotics training program. Conclusion: This survey indicated that nearly all OHNS residencies utilize robotic surgery in their clinical practice with residents receiving little formal education in robotics or experience at the console. OHNS residencies should aim to increase access to training opportunities in order to increase resident competency. Level of Evidence: IV

scholarly journals Designing and Implementing a Competency-Based Training Program for Anesthesiology Residents at the University of Ottawa

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Emma J. Stodel ◽  
Anna Wyand ◽  
Simone Crooks ◽  
Stéphane Moffett ◽  
Michelle Chiu ◽  
...  
Keyword(s):  
Medical Education ◽  
Training Program ◽  
Residency Training ◽  
Residency Training Program ◽  
Neck Surgery ◽  
Current Time ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
Specialty Practice ◽  
The University

Competency-based medical education is gaining traction as a solution to address the challenges associated with the current time-based models of physician training. Competency-based medical education is an outcomes-based approach that involves identifying the abilities required of physicians and then designing the curriculum to support the achievement and assessment of these competencies. This paradigm defies the assumption that competence is achieved based on time spent on rotations and instead requires residents to demonstrate competence. The Royal College of Physicians and Surgeons of Canada (RCPSC) has launched Competence by Design (CBD), a competency-based approach for residency training and specialty practice. The first residents to be trained within this model will be those in medical oncology and otolaryngology-head and neck surgery in July, 2016. However, with approval from the RCPSC, the Department of Anesthesiology, University of Ottawa, launched an innovative competency-based residency training program July 1, 2015. The purpose of this paper is to provide an overview of the program and offer a blueprint for other programs planning similar curricular reform. The program is structured according to the RCPSC CBD stages and addresses all CanMEDS roles. While our program retains some aspects of the traditional design, we have made many transformational changes.

Commentary on “Otolaryngology–Head and Neck Surgery Physician Workforce Issues An Analysis for Future Specialty Planning” by Kim, Cooper, and Kennedy

2012 ◽  
Vol 146 (2) ◽  
pp. 203-205 ◽  
Author(s):  
Shannon P. Pryor ◽  
Linda Brodsky ◽  
Sujana S. Chandrasekhar ◽  
Lauren Zaretsky ◽  
Duane J. Taylor ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Surgery ◽  
The United States ◽  
Head And Neck Surgery ◽  
Physician Workforce ◽  
Modeling Methods ◽  
The Us ◽  
Workforce Issues ◽  
Time Work ◽  
Part Time

An impending physician shortage has been projected. The article by Kim, Cooper, and Kennedy, titled “Otolaryngology–Head and Neck Surgery Physician Workforce Issues: An Analysis for Future Specialty Planning,” is an attempt to evaluate and address this potential shortage as it applies to otolaryngology. The authors of this comment have concerns about the article’s assumptions, design, and recommendations. Kim et al attempt to extrapolate data from other specialties and other countries to the US otolaryngology workforce, use that data in modeling methods without demonstrated validity, and based on their analysis, they recommend drastic changes to otolaryngologic training and practice in the United States. Particularly troublesome are (1) the emphasis placed on gender and part-time work and (2) the measurement of productivity defined as hours worked per week. Before redefining our specialty, more thorough and systematic data acquisition and review are necessary to meet the needs of our patients now and in the future.

Otolaryngology–Head and Neck Surgery Physician Work Force Issues

2012 ◽  
Vol 146 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Jin Suk C. Kim ◽  
Richard A. Cooper ◽  
David W. Kennedy
Keyword(s):  
Head And Neck ◽  
Census Data ◽  
Supply And Demand ◽  
Insurance Coverage ◽  
Neck Surgery ◽  
The United States ◽  
Economic Modeling ◽  
Head And Neck Surgery ◽  
Population Census ◽  
Data Sets

Objective. To predict future trends in the otolaryngology workforce and propose solutions to correct the identified discrepancies between supply and demand. Study Design. Economic modeling and analysis. Setting. Data sets at national medical and economic organizations. Subjects and Methods. Based on current American Academy of Otolaryngology–Head and Neck Surgery, American Medical Association, and National Residency Matching Program data sets, population census data, and historical physician growth demand curves, the future otolaryngology workforce supply and demand were modeled. Adjustments were made for projected increases in mid-level providers, increased insurance coverage, and the potential effects of lifestyle preferences. Results. There are currently approximately 8600 otolaryngologists in the United States. Estimated demand by 2025 is 11,127 based on projected population growth and anticipated increase in insurance coverage. With an average retirement age of 65 years and no increase in PGY-1 positions for the specialty, the number of otolaryngologists in 2025 will be approximately 2500 short of projected demand. This shortfall will not be adequately compensated by mid-level providers performing less intensive services and may be increased by lifestyle preferences and changing demographics among medical students and residents. The current geographic maldistribution of otolaryngologists is likely to be exacerbated. Conclusion. The specialty needs to actively plan for the coming otolaryngologist shortage and train mid-level providers within the specialty. Failure to plan appropriately may result in a reduction in scope of practice of high-intensity services, which will likely remain a physician prerogative. Given the limited likelihood of a significant increase in residency slots, strong consideration should be given to shortening the base otolaryngology training program length.

scholarly journals Rizal, Renaissance and Reform: Reflections on Ophthalmology and Otorhinolaryngology in the Philippine General Hospital

2011 ◽  
Vol 26 (1) ◽  
pp. 4-5
Author(s):  
José Florencio F. Lapeña
Keyword(s):  
Health Care ◽  
Head And Neck ◽  
General Hospital ◽  
Neck Surgery ◽  
The Philippines ◽  
Health Care Facilities ◽  
Head And Neck Surgery ◽  
Department Head ◽  
National Hero ◽  
The Many

The nineteenth of June 2011 marks a century and fifty years since the birth of José Protasio Rizal in 1861.1 The ninth of November 2011 also marks the Golden Jubilee of the foundation of the Departments of Ophthalmology and Otorhinolaryngology of the Philippine General Hospital (PGH) in 1961, dividing the original Department of Eye, Ear, Nose and Throat that was established a century ago in May 1911. The national hero of the Philippines and Pride of the Malay Race2 is immortalized in countless ways, reflecting his multiple accomplishments that mark a true renaissance individual. The two departments of the national University of the Philippines (UP) have likewise made their mark in pace with the many achievements of their alumni. Rizal was a polyglot and polymath poet, painter, sculptor, sportsman, scientist and patriot, whose writings led to his execution and sparked the Philippine Revolution of 1898.1,3 He was also a physician and an ophthalmologist who insightfully dissected the ills of his patients and society.4 What have the departments and their hospital contributed to health and to humankind?   If precedence were the measure of significance, the pioneering “firsts” would have to include the first laryngo-fissure operation by founding department head Dr. Reinhard Rembe in 1913, the first intracapsular cataract lens extraction in the country using a suction erisophake after the technique of Barraquer by the next chair (and nephew of the national hero) Dr. Aristeo Rizal Ubaldo in 1920, the first laryngectomy by Drs. Ubaldo and founding president of the Philippine Academy of Ophthalmology Antonio S. Fernando in 1923 and the first labyrinthectomy by Drs. Ubaldo and Vicencio C. Alcantara in 1927.5 There was a time when the chairs and senior consultants of most departments of otorhinolaryngology - head and neck surgery in the Philippines were alumni of the UP-PGH, as was the leadership of the Philippine Society of Otolaryngology and Bronchoesophagology (later Philippine Society of Otolaryngology Head and Neck Surgery) which separated from the Philippine Ophthalmological and Otolaryngological Society (subsequently Philippine Academy of Ophthalmology and Otolaryngology) in 1956. But those are bygone days, and the folly of resting on one’s laurels becomes all too apparent, as these are quickly eclipsed by the capabilities of newer, better-equipped health care facilities that are manned by experts trained in their respective institutions. Thus the race to super-specialize and sub-specialize, perhaps to regain lost ground and primacy at the expense of tertiary general health care has become the battle cry for some, led by the present administration of the PGH.   And yet, the majority of Filipinos still do not have access to primary health care.6 They who do not even have the services of a basic physician much less can avail of special care of their sight, hearing and balance, smell and taste, breathing, swallowing or speaking, nor of the face with which they face the world. Witness the number of adults with unrepaired cleft lips and untreated head and neck tumors roaming the streets of the city.   The UP College of Medicine (UPCM) founded in 1905 aims “towards leadership and excellence in community-oriented medical education, research and service directed particularly to the underserved.”5 As the teaching hospital of the UPCM, with whom it shares such academic and clinical departments as Ophthalmology and Otorhinolaryngology, the hundred-year-old Philippine General Hospital and its leadership cannot and must not turn a blind eye or deaf ear to the underserved it is mandated to serve. Its true strength lies in relevance, which is quickly lost if it succumbs to the delusionary glitter of super specialization beyond the reach of most people. Of what benefit is it to be the “first,” if it does not redound to the good of the “many?” Of Rizal, it has been said “to his patients he gave sight; and to his country he gave vision.”7 As the Departments of Ophthalmology and Otorhinolaryngology pursue the arts and sciences of vision, hearing and balance, olfaction and gustation, respiration and deglutition, phonation and facial expression, may they sharpen the sensitivity of health providers in PGH and other loco-regional general hospitals to the real issues of health and humankind in the developing world and embolden us to overcome the apathy to “hear no evil, see no evil, speak no evil.”

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