THIS IS A DECLARATION OF THE POSITION OF THE MEDICINE STUDENT COUNCIL, REPRESENTING THE STUDENTS OF THE COLLEGE OF MEDICINE, ON THE MATTER OF THE PROPOSED TUITION AND OTHER FEES

ADJUSTMENT IN THE UP COLLEGE OF MEDICINE.

SEPTEMBER 28, 2005

Based on consultations, analyses and discussions by the members of the Medicine Student Council (MSC), we unconditionally oppose the Tuition and other Fees Adjustment (TFA) proposed by the

Administration of the UP College of Medicine and any modification thereof.

I. The College Committee (Task Force on Cost of Medical Education) the Past Year

The Administration of the UP College of Medicine (UPCM) has created a special Committee, the Task Force Tuition Fee Increase on October 2004. It later changed its name to Task Force on Cost of Medical Education last January 2005. From the minutes of the November 3, 2004 meeting, its objective was “to recommend appropriate tuition fee increase including laboratory fees for medical students of the College and to recommend mechanics of implementation. Study prospect of financial status for the year to come, for operation alone.” From the very start, the task force was set to recommend an increase, before reviewing the financial status of the College and its subordinate units, and before the consultation with students and parents. Thus with its original committee name and objective, it is not improbable that subsequent meetings and actions of the committee were biased to endorsing an increase in tuition and other fees. Subsequent activities carried out by the Committee included review of records, meetings, and consultations with students, parents and faculty.

1. On the review of records for expenditures, the Committee computed that the cost of UPCM education is Php186, 508.75 per year per student. This was apparently based on current operational costs, personnel salaries and additional “Departmental expenses”. For “Departmental expenses”, it can be argued that there is no clear distinction for expenses where students benefit, since expenses by the department also covers other personnel (residents, fellows, and staff), and equipments / supplies for the patients. For example, some departments included utilities (electricity, water, etc) as part of their expenditure for students. This would only be accurate if the department somehow developed a formula where they extracted the usage of students apart from the use by patients, doctors and other personnel. In addition, the Philippine General Hospital (PGH) has a separate budget where the Departments also receive subsidy particularly for personnel salaries. Because of this, some departments may have inadvertently submitted a much increased expenditure which certainly does not reflect their expenses for medical education. A specific example is the Department of Neurosciences where they declared that in AY2004-05 they apparently spent Php57,444,050.97 for medical education, most of which came from personnel expenses (Php42,005,467.50). This certainly does not reflect the cost of medical education among the students who spend a relatively short time in the department. Thus, the cost of UPCM education as Php186, 508.75 per year per student is erroneous.

2. The Committee’s student consultations included one survey and one forum. Two items in the student survey (by the administration) were either misinterpreted or misrepresented.

Figure 1Part of the Student survey form(made by the Administration)

Item number 5 clearly asked the maximum amount affordable per semester. However, in the Committee report, the results indicated “maximum amount increase” affordable. There is a big difference between the

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amount affordable and the additional amount affordable. On item number 6, it asked comments on a possible tuition increase. However, this was reported as a “Yes-No” to a tuition increase. The validity of such Yes-No interpretation is questionable since comments by the respondents may not be directly Yes-No and the checking of this item is very subjective.

3. The Committee’s parent consultations included one survey and one forum. The respondents in the survey are 129 out of the more than 800 parents. The survey showed that 74% of the respondents were amenable to an increase, most of which suggested a 20-25% increase. Note that on the proposed TFA, there will be an overall ~37% increase on the first year, and a ~82% increase on full implementation. An 82% increase is unprecedented in any university – a State University at that. Meanwhile, 14 parents attended the TFA forum. It is safe to say that most of them live in or around Metro Manila.

In general, consultation with students and parents is unsatisfactory especially for those who are in the provinces and there are noted inconsistencies in the Committee report regarding the student survey.

II. The Medicine Student Council (MSC) the Past Year

The MSC has had different activities regarding the TFA issue foremost of which is information dissemination, consultations with the students and attendance to meetings and fora.

Information dissemination for the proposed TFA included presentations to the different classes, Bulletin board announcements, and the release of a TFA primer to all students of the College. [See attached TFA Primer]

The MSC and the respective Class Presidents / Representatives, have represented the studentry on all meetings of the Committee on TFA. The usual extent of participation in those meetings is to give inputs, ideas or suggestions. Final decisions rest on the faculties and Chairperson of the Committee.

MSC student consultation-discussions included two major consultations and informal small group discussions undertaken by class representatives of the MSC. From the February consultation-discussion with different Year Levels, the MSC found that majority of the students are opposed to any TFA.

On the August consultation-survey, proposed amounts for TFA were already available. This time, we have consulted 527 students (73%) from Year Level 1 to Year Level 6 (Classes 2012 – 2007). We have found that majority of the students (52%) are not in favor of the proposed TFA. Most respondents cited that the increase was too high or too fast, that the College is a State institution and that many students would not be able to cope with an increase. Majority (54%) also believe that a TFA is not the best solution for the current financial problems of the College. Alternatives suggested by the respondents include increased government support, income generation schemes, strengthening of alumni support, proper budget allocation & prioritization, and linkages with the private sector. We also found that 60% of the students acknowledged that they are capable to pay more than the current tuition. However, a significant percentage remains who believe they can only pay up to the current tuition rate. In addition, only around 6% of the respondents avail of scholarships. The current estimated need for financial aid is at 8%. If the proposal is fully implemented the need for financial support would increase to greater than 60% of the student population. [See attached consultation-survey results]

III. Reasons for Opposing the Proposed TFA

1. Majority of the Students Are Not in Favor of a TFA

Apart from the above MSC consultations, as of this writing, the following classes and organizations have declared to “unconditionally oppose” the proposed TFA: Class 2008, Class 2011, Class 2012, Lingkod ER – UP Manila, MediCine, Mu Sigma Phi Sorority Inc., Pangkalusugang Samahan ng Mag-aaral (PAGSAMA), Phi Kappa Mu Fraternity, Phi Lambda Delta Sorority, Regionalization Students Organization (RSO), UP KASANAG, UP Medical Student’s Society (MSS), UP Medics, UP Medrhythmics, and UP Meridian. [Please see attached resolution] Note that other classes and organizations not included in the resolution are not necessarily supporting the proposal. The class or organization is either divided on the issue or have not decided yet.

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2. There are Problems in the Process of Making the TFA ProposalAs stated above, the Committee created by the Administration was biased from the start to recommend an increase. In addition, student members of the Committee were sometimes misquoted or misinterpreted in the minutes. For example, on the November 10, 2004 minutes, Mr. Joseph Lachica was quoted as saying that he was amenable to an increase in tuition. He however, denies that he uttered such a statement. Furthermore, the computed cost of UPCM education is erroneous and certainly does not reflect the actual cost. A more extensive review of the College’s and departments’ balance sheets, statement of income and expenses etc. (if they exist) would give a more accurate figure. Misinterpretations in the student survey should also be noted. We also believe that the student and parent consultations done (one forum and one survey) are inadequate in quantity and quality.

3. The Bases of the Increase Are Not Justifieda. Problematic Figures and Computations

The proposed TFA was derived by dividing the total estimated operational expenses for 2005 to the estimated number of students who pay a full tuition (70% of Year level 3 to 6). Additional and supplemental fees were then added to give a total of Php20,969.78 per semester. The proposed additional charges for tuition (Instructional Materials Development, Facilities Upgrading and Improvement and Program Evaluation and Monitoring) and the supplemental fees were all estimates.

We acknowledge that there are bases for some of the estimates; however, supporting documents for these (like balance sheets, cash flow statements etc) should be present in the Committee report. As repeatedly suggested and insisted by the MSC, concrete data should have been presented and outlined. For example, the laboratory fee is proposed to increase two-fold but the basis for such an increase is a mere estimate. A list of laboratory expenses and subsequent computations should reflect a more accurate laboratory fee. In addition, the proposed increase of Student Council fund from Php0.50 to Php50.00 should be disregarded. Increases in Student Fund follows a process of a referendum with the students, and it is initiated by the Student Council concerned.

Proper accounting and fund management in the College is another issue that needs to be reviewed. To quote a statement from the minutes of the March 11, 2005 meeting, Dr. Caballes said, “a lot of expenses aren’t here (indicates to a graph). Hindi lang ito ang dapat ayusin ng College, and even if we increase tuition fee every year, if we don’t have a good accounting…” We understand that the Administrators are not accountants and the staff are probably overworked, but in proposing a financial viability plan for the College, in this case a TFA, the accounting books are indispensable, not only from the College but also from the different subordinate departments or units.

Going back to the computation, the divisor used was only 70% of the student population. This would mean that a student who pays full tuition would be subsidizing his / her scholar classmate since both of them receive the same medical education. Subsidy for scholars is the responsibility of the Administration and Government, not classmates. This also holds true for the UP dependents. The University gave the scholars privileges, and those scholars should not be blamed if they receive certain discounts in their tuition and other fees.

b. Reasons Cited on the Committee Report are either Inaccurate or Unsatisfactory As stated previously, departmental expenses were increased since there is no clear distinction for

educational expenses and service (patient) expenses. Donors’ fatigue as the Committee report acknowledged, is a perception. It may or may not be the actual

situation and it is based wholly on anecdotal interpretations. The slow return / contribution for the Centennial Endowment Fund may have been due to other factors. The extravagant Centennial celebrations also show that there are donors willing to contribute to the College. The Centennial Committee has a large budget enough to spend ~Php300,000 for an alumni show, ~Php700,000 for a new statue, and ~Php2,000,000 for the December 1 Celebrations. The challenge is to encourage willing donors to channel future contributions for areas in medical education where it is needed most.

Patients’ paying certain fees for their hospital stay is not directly related to the tuition of the medical students. Subsidy to hospital service expenses are and should not be part of the tuition. This also reflects the lack of budget in PGH, not in the College.

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It is also invalid to compare the College’s tuition with other private medical schools because the College is a State Institution receiving Government subsidy. Also not all State Universities with a Medicine degree has a higher tuition than the College e.g. Mindanao State University.

4. Funds from an Increased Tuition Will Not Necessarily Go to the CollegeTuition and other fees are paid to the University and it becomes part of the University budget. The administrative officer admits that the College does not receive 100% of the paid fees by Medicine students. Thus, not all earnings from an increased tuition will necessarily benefit UPCM students.In addition to this, a TFA in the College would have a domino effect among the other colleges of the UP system.

5. Safeguards for Students Needing Financial Aid Are Significantly LackingThe proposal essentially lacks safeguards for those who will not be able to cope with the proposed increases. As stated above, current scholarships are not sufficient to cover those who need them. A TFA would certainly increase the number of students needing financial aid. Without safeguards and changes in the University and College’s scholarship system, some of the current students may stop studying, and more importantly, prospective students would opt not to apply in the College. In addition, it would be harder for the College to enlist more private scholarships because of the higher fees.

6. Alternatives to a TFA Have Not Been ExhaustedThe MSC understands the economic problems that beset the College and the whole University; however, we believe that adjustments of any fees from students must only be done as a last and final option after exhausting other means. We believe that other means such as continuous lobbying for an increased budget and UP Charter change from Congress, further strengthening the network with the alumni and the private sector, and income generation schemes have not been exhausted. The Committee report has stated that the Administration has instituted several fund raisings. However, we remain to see any of the supposed fund raisings that are not related to the Centennial celebrations.The Committee report also stated that the only stakeholders left untapped are the students and their families. This statement is inaccurate. One, the primary role of the students in the university is to learn and study, not become the source of income. And two, the students and their families have already been tapped for College income. Currently, students’ tuition and other fees compose a significant majority of the budget for MOOE.

7. The College is a State InstitutionWe believe at the primacy of the UP College of Medicine as a State Institution where the financial burden of the College must not be the students’ responsibility but the Government’s. Being a State Institution has a greater and more significant bearing than the apparent capacity of students to pay.

8. A TFA in the College has Significant Negative Effects in the Philippine Healthcare SystemBeing the primary State Institution for Medicine in the country, the College has a great stake in Philippine Healthcare system. Significant changes in the College would ultimately affect the healthcare system. For example, the College is one of the primary chances of an individual from the middle to lower socioeconomic class to pursue a medical career. A TFA would certainly affect that individual’s decision – he/she may just opt to go to work. This may contribute to the shortage of healthcare professionals thereby contributing to the current healthcare crisis. In addition, a TFA is not compatible with the current medical crisis where we are experiencing an exodus of doctors and a declining interest in Medicine as a career. As cited by the Philippine Medical Association (PMA) Pre-summit, one of the reasons for this declining interest is the very high cost of medical education. The College would certainly be contributing to this by raising its tuition and other fees.

IV. Alternatives to a TFA and What Can Be Done with the Limited Funds Continued lobbying for an increased budget and continued support for a UP Charter change that

will strengthen the fiscal viability of the College and University should be consistently carried out. A more extensive study of the College’s fiscal viability is warranted. An independent accounting,

economic and business administration professionals may be employed to look into the College’s finances. Collaborations with the UP College of Business Administration and School of Economics can be done. The possibility of this endeavour should be acted upon immediately.

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The College should increase its financial efficiency by streamlining expenses and thru continued austerity measures. Efficiency can also be achieved by proper prioritization of budget and donation allocation. Donors should be encouraged to give their contributions to areas where it is needed most.

Networking with the alumni, local / international academic institutions, and the private sector should be strengthened. A strong network of alumni would certainly be beneficial for the future of the College. Networking with corporate and private individuals involves not only soliciting for donations but also encouraging investments e.g. in research.

Related to the above is the implementation of innovative income generation schemes in the College. One such income-generating scheme which does not sacrifice the academic nature of the institution is to aggressively market clinical (or even basic) elective programs abroad. Foreign students would pay a higher tuition and other fees for a rotation in the hospital without additional costs from the College. The College can certainly profit from this. We pray that the Administration be open-minded and creative in coming up with innovative income-generating endeavours.

Discussions on the issue of Return of Service can be started with the purpose ascertaining the College’s and its graduates’ service to the Filipinos. This is also in relation to the alleged reasoning of Government and Congress that they cannot increase subsidy because UPCM graduates do not practice in the country.

Finally, to quote a comment from a student, “Hindi ang mga makabagong kagamitan ang nagpapaganda sa reputasyon ng UP kundi ang mga estudyante pa rin nito.” Indeed, an adjustment in Tuition and other Fees

may augment the College’s finances, but at the same time, a TFA would also lead to adjustments in the population of the students – only those who can afford to pay the increased tuition (and the increasing cost of daily living in Manila) would be able to study in the College. With the foregoing consultations, analyses and discussions of the TFA and the issues surrounding it, the Medicine Student Council, representing the students of the College, hereby declare our position to unconditionally oppose the Administration’s

proposal of Tuition and other Fees Adjustment and any modification thereof.

Prepared by:

_________________________________________ Alvin Rae F. Cenina

Secretary-General / OIC, MSC TFA Ad Hoc Comm

Noted by:

__________________________ _________________________

Benjo A. Delarmente Vanessa L. Yap Chairperson Vice-Chairperson

References to the “Committee report” (minutes of meetings, lacking documents, etc) in this position paper are based on the documents provided by the Administration regarding the proposed TFA. The document was given to the MSC on the 2nd week of September 2005. Inconsistencies to the final

Committee report submitted to the UP Manila Chancellor, UP President and UP Board of Regents should be duly noted.

APPENDIX:

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Results of the MSC Consultation on TFA last August 2005

2. Sumasang-ayon ka ba sa Tuition and other Fees Adjustment na ito (TFA proposal)? Bakit?OO 47%

HINDI52%

Category Examples # Category Examples #General improvement / maintenance of quality education

For quality educationTo improve facilitiesTo raise salariesTo improve equipmentsPrevent deterioration

72 TFA proposal is too high or too fast 72

There is a need by the UPCM 38 Financial reasons

Some students or families will not be able to cope with the increase

33

Administration made a good case for the TFA

Parents convinced / approvedFair / valid / justified increase

11 UPCM as a State institution

UP is a State universityTFA inconsistent with UPCM objectivesGovernment should fulfil roleGreater state subsidy

33

Right time for increase

“Panahon na” Due to current economic crisis

10 Bases for TFA not justified

Not convinced of basisProposal not justifiedUnnecessary additions / changesNo evidence for MOOE withdrawal by gov’tHindi ito ung napagkasunduan ng parents

10

Students are capable

Students can affordHelp collegeStudents’ contributionburden not on govt alone

7 No proper consultation

Students not consulted properlyHow about Parents from provinces?

6

Government support not enough 7 College finances not students’ burden 5

Current tuition is really low especially if compared to other schools

5 Exhaust other means first

There are other waysExhaust other ways

5

Other answers No need for increase

Current spending does not reflect need for increaseCollege has enough money

3

Easiest way to solve deficit 2 Other answers“We” are not affected 2 Since budget is centralized, All of UP units should

increase 1st 2

For the good of many 1 Bad for many 2Since there are scholarships 1 Not enough safety nets 2

Increase can be a reason for students to go abroad more

1

UPCM Survived before without TFA 1*Conditional increase

As long as not too high or too fast 11 TFA not the solution 1

Increase according to socioeconomic status

2

Makikinabang DAPAT students 1

APPENDIX:

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Results of the MSC Consultation on TFA last August 2005

3. a. i. Nakatatanggap ka ba ng tulong mula sa mga ito (scholarships)?OO. Scholarships received: HINDI. Reasons:

UP Dependent (3) UP Presidential (3) UPMASA Scholarship (2) Oblation scholar (2)UP Government scholarship Dr. _______ ScholarshipPMA-GSL J. MorenoJose Perez

Problems with qualifications or criteriaGrade requirements too high[7]Not qualified [5]hard to have slots[3]too many requirements[3]Strict qualificationsCriteria not updatedProblems with release of stipends (matagal magrelease; di maaasahan) Limited offerings or limited slots availableLimited information regarding the process of availing scholarships

4. Sa iyong palagay, Tuition Fee Adjustment na ba ang pinakamabuting paraan para matulungan ang ating Kolehiyo sa mga gastusin?

HINDIIBANG PARAAN / Suggestions:

Category #Government support(Lobby for higher budget, ask government support, write to Congress…)

80

Income generation(raise funds, generate funds…)

22

Alumni support 22Proper budget allocation and expenditure(proper spending, proper budget allocations, cost cutting, austerity measures, avoid extravagance…)

17

Linkages with private sector(use or liquidate assets, networking with private sector, utilize research, lobby for donations from institutions / individuals, strengthen Public Relations…)

17

Socialized tuition within the college (base tuition according to socioeconomic status, charge dependents…)

13

Return of service 5Divert funds from Centennial celebrations(use centennial funds, make a trust fund…)

5

Lobby for UP Charter change 3Hire professional team (accounting / financial expert team to study, evaluate and propose measures)

1

Separate budget from UP system 1Improve tax collection 1

APPENDIX:

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Results of the MSC Consultation on TFA last August 2005

Other CommentsComments Supporting the TFA Proposal

Cooperation / Contribution:With the current economic state… tayo-tayo na ang magtulungan Tulungan na lang, wag na pag-awayanWe should help out, government can’t do it on its ownUP dependents can pay miscellaneous:UP dependents: payag magbayad ng miscellaneousDependents should pay too especially that sila naman ang may peraOthers: TFI is necessary

Neutral comments

The “fair” increase:A fair increase (defined) should give opportunity to the financially needy and a clear allocation is givenSana mapag-usuapan ng mabuti para fair sa mga studentsOn Scholarships:Ensure fairness and just process in admissions and scholarships (3)UPCM should also increase the number of scholarshipsAyusin STFAPStrengthen scholarshipsEnsure availability to those in needConditional increase: Ensure safety netsModerate increase lang sanaTFA is ok, but the increase should be gradual (3) UPCM and Service:Students / graduates should prove that were worth the money: serve here for two yearsUPCM serves communityLobby still for a higher budget… but we should show that our graduates are staying in the country…Need for other measures:TFA will help… short-term… more far-reaching plans must be implementedThere is also a need for other measures not just TFA Option for merchandising to raise funds If not TFA, There is a need for concrete alternativesPrudent / wise appropriations and spending:Hope they appropriate and use the funds wiselyTransparency is important (regarding fund appropriations / allocations / spending) [2]Others:All the TFA issue came too fast, as if instant and unplanned. I will agree with the TFA but know that I’ve judged the admin as lazy yet demanding

APPENDIX:

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Results of the MSC Consultation on TFA last August 2005

Comments Against the TFA Proposal

UP as a State University:The primacy of UP as a State University must still have a greater weight than the apparent capacity of students to pay…UP will lose its essence of being a State University… students will be competent and compassionate but EXPENSIVE Student capacity to pay is beside the point… (UP is a state University)Focus for funds should still come from government, not the parentsTuition should only supplement funds not be the bulk of itUP is a public schoolGovernment’s responsibility huwag ipasa sa sa studentsUP becomes semi-privateFinancial state of students / families:Not everyone who needs scholarships get themSad, baka marami na ang di tumuloy sa MedPuro mayayaman lang ang papaaralin ng collegeMany students would not be able to affordUPCM students entered the college because of the low cost of Med Education (3)Paano na magiging doctor ang mahihirapDapat alamin din nila kung ilang tao yung naghahati sa “family income”… an income of P500T annually is different from a family of 3 to a family of 7…Problems with Bases of increase:Need for a clear basis for increaseClarify the P14M for maintenanceIs there really a directive from the government re: MOOE?Check on student fund… questionable Inconsiderate proposalTFI should be reasonableProposal is too much (2)Hindi makabuluhan… lalo na sa miscellaneous…Socialized Tuition:TFA should only be imposed on those who can afford itBase tuition on parents’ income (2)Dependents should not be affected (2) Lifestyle check scholars… give to those deservingDapat rationalized ang scheme… hindi across the boardImplement to incoming or OSI classes only:TFA should be imposed only on incoming class 2013 and lateral 2011… at least they have a choice not to enter UPCM… If tuition is adjusted, incoming direct entrants would be most affected since we (2011) do not have a degree…Implement to future freshmenOSI students lang dapat magbayad ng certain add’l fees Problems with consultation:Parents from provinces not consulted Ayusin ang consultationImplications of an increase:Has the admin studied the implications of TFA (i.e. change in UP culture, in student population…)?Hindi ang mga makabagong kagamitan ang nagpapaganda sa reputasyon ng UP kundi ang mga estudyante pa rin nito.Others:Baka mawalan na ng regulation ang TFA… baka maging yearly TFA should be studied / evaluated / reviewed further (3)Why hurry TFI should be last resort Unfair for taxpayers Nakakabigla / nakakagulat ang proposal

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APPENDIX: Results of the MSC Consultation on TFA last August 2005

    % TOTAL 2007 2008 2009 2010 2011 2012           

Population     721 160 163 159 160 40 39Respondents     527 56 137 145 122 30 37

% Respondents     73% 35% 84% 91% 76% 75% 95%           1. Baseline Knowledge OO 98% 518 56 137 137 122 30 36  HINDI 2% 9 0 0 8 0 0 1           1.a. Source of Knowledege MSC 83% 437 44 125 129 98 29 12  Admin 21% 112 16 30 49 0 1 16  Faculty 22% 115 15 39 43 0 5 13  Classmate / friend 30% 156 33 69 9 0 23 22  Other Colleges 1% 4 0 1 1 0 2 0  Others 2% 12 2 3 5 0 0 2           1.b. Knowledge 82% increase 53% 281 20 91 78 48 29 15

 does not know % inc 43% 224 30 42 57 73 1 21

  Other answers 1% 4 0 4 0 0 0 0           2. TFA proposal Agree 47% 247 36 49 84 59 6 13  Disagree 52% 273 20 84 59 63 24 23  Other answers 1% 6 0 4 2 0 0 0

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APPENDIX: Results of the MSC Consultation on TFA last August 2005

           3. Capability to pay >11529.50 60% 315 35 72 101 74 14 19  =11529.50 30% 158 15 49 35 37 13 9  <11529.50 8% 41 2 14 9 10 3 3           

For >11529.50, Capable upto… < 15, 001 25% 130 12 33 31 35 10 9

  < 20, 001 12% 61 15 6 14 18 4 4  < 25, 001 2% 13 0 1 9 3 0 0  > 25, 001 0% 1 0 0 0 0 0 1  Proposed TFA 0% 1 0 1 0 0 0 0

*For <11529.50:          3.a. Knowledge on Scholarships OO 20% 105 4 24 42 29 3 3  HINDI 4% 20 0 2 12 6 0 03.b. Avails of Scholarships OO 6% 30 3 13 10 1 2 1  HINDI 9% 48 1 10 27 7 1 2           4. TFA the Best Solution OO 43% 228 26 37 82 54 9 20  HINDI 54% 282 30 99 58 60 21 14  Other answers 1% 6 0 1 5 0 0 0

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