REVISED POLICIES AND GUIDELINES IN THE CONDUCT OF FOREIGN SURGICAL AND MEDICAL MISSIONS (FSMM) IN THE COUNTRY

I. Background/Rationale

Foreign Surgical and Medical Missions (FSMM) are activities where
surgical and medical care are provided by local and foreign
organizations upon the initiative/requests of various local government
units and groups. They are primarily undertaken in underserved
areas/communities with the goal of providing assistance to the needy or
as a professional humanitarian endeavor. They may also serve the purpose
of continuing medical education (CME), professional advancement and as a
venue for transfer of technology by the missioners to their local
counterparts.

II. Objectives

This Joint Administrative Order aims to provide policies/guidelines
to:

1. Integrate the efforts of various agencies overseeing the conduct
of FSMM.
2. Facilitate the issuance of Special Temporary Permit to Practice
for missioners.
3. Ensure proper supervision and monitoring of FSMM in the country.

III. Scope and Coverage

This order shall apply to all government and private institutions,
non-governmental organizations, people’s organizations and other
organizations undertaking or facilitating the conduct of FSMM in the
country.

IV. Definition of Terms/Acronyms

1. Foreign Surgical and Medical Missions (FSMM) – is
a project or an activity in which health care delivery is provided to
the poor segments of Filipino society where medicines, ancillary
procedures, medical/surgical interventions, and services are given at no
cost to the beneficiary. It also employs a team of
Filipino/non-Filipino health service providers, who are foreigners but
will need to practice their profession in this country.
2. Local counterpart – is a Philippine counterpart
organization sponsoring a medical mission. It may be a local medical
society of a specialty society or a civic organization or a local
government unit in coordination with the local component medical society
and/or specialty society of the Philippine Medical Association (PMA).
In all cases, it must be a juridical entity properly listed and
operating under the Corporation Code of the Philippines.
3. Local Component Medical Society – is a Philippine
medical component society of the PMA operating in a given geographical
area and is affiliated with the PMA.
4. Missioner – is someone sent on a foreign mission
especially a religious or charitable mission.
5. Specialty Society – is an association of
Philippine physicians accredited by the PMA as the recognized
association of a given specialty in medicine.
6. DOH – Department of Health
7. PRC – Professional Regulation Commission
8. DILG – Department of Interior and Local Government
9. PMA – Philippine Medical Association
10. PNA – Philippine Nurses Association
11. PDA – Philippine Dental Association
12. BIHC – Bureau of International Health Cooperation
13. BHDT – Bureau of Health Devices and Technology
14. FDA – Food and Drug Administration
15. CHD – Center for Health Management
16. CME – Continuing Medical Education

V. Guiding Principles

The guidelines on the conduct of FSMM were developed based on the
following principles:

1. Underserved communities shall be prioritized.
2. The sponsors shall establish linkages and networks with other
concerned stakeholders in the community.
3. All medicines, supplies, reagents as well as medical and surgical
services shall be provided at no cost to the beneficiaries.
4. Only qualified and competent medical and paramedical health workers
shall perform the appropriate medical and surgical procedures.

VI. General Guidelines

1. The Department of Health (DOH) shall be the lead agency in
overseeing the implementation of any FSMM in the country.
2. The conduct of any FSMM shall be guided by the following policies
and guidelines where applicable:

2.1 DOH Administrative Order Number 2007-0017 dated May 28, 2007
shall be the basis for acceptance and processing of foreign and local
donations during emergencies and disaster situation; and

2.2 DOH Administrative Order No. 54-A, s. 2003 dated June 6, 2003
shall be the basis for the processing and clearance of importation
through donations during normal situations by the Department of Health.

3. The PMA shall maintain a database containing the valid documents
of the foreign physicians given Special Temporary Permit to practice
medicine in the country. Only a valid license to practice medicine in
their country of origin will be required for subsequent application for
future missions.
4. Under no circumstances shall a foreigner physician and/or
health-related professional practice their profession in the Philippines
without a Special Temporary Permit from the PRC.
5. The actual supervision/monitoring of the conduct of the mission shall
be undertaken by the local government health unit and local component
medical society and/or specialty society of the PMA. Additionally, the
DOH CHDs shall oversee the conduct of the mission.

VII. Implementing Mechanism

1. A team composed of representatives from DOH, DILG, PRC and PMA
shall be organized to ensure the smooth implementation of the
provisions of this issuance.

2. All applications for FSMM shall be submitted to the PMA who shall
forward the same to the following professional groups copy furnished
DOH. (Application forms can be downloaded from the PMA website –
www.pma.com.ph)

2.1 PMA – medical doctors
2.2 PDA – dentists
2.3 PNA – nurses

3. Each member of the foreign medical team must submit the following
documents in applying for temporary license to practice during the
duration of the mission. All documents must be in English or with
English translation:

a. valid/current license from country of origin
b. board certification (specialty)
c. curriculum vitae

^*(letters a to c must be
authenticated by the Philippine Consulate Office in the country of
origin)

d. passport sized picture in four copies (taken within one year)
e. Application letter addressed to the President of PMA to contain
the following information:

1. type of mission (medical, surgical or both)
2. duration of the mission and inclusive dates
3.names and specialties of the mission team members
4. written consent from the host local government executive
(governor/mayor) and/or chief of the health facility where the mission
will be conducted.

f. The following are additional requirements if the foreign mission
team members intend to bring drugs, and/or medicines, medical supplies
and medical equipment to be donated or used during the mission:

1. itemized list of the items together with the quantity and the
expiration dates for drugs and medicines
2. flight details
3. deed of donation authenticated at the country of origin
4. deed of acceptance from the host hospital/LGU
5. drugs and medicines to be donated should have a shelf life of
at least 12 months upon arrival in the country and the said medicine
shall be used solely for the scheduled mission
6. application must be submitted 60 days before the date of
mission to facilitate clearance/s from DOH and other agencies.

g. Letter of certification from the sponsoring host organization
(LGU or NGO) certifying the need and type of mission to be conducted.
Cost of post-care mission of morbidities/mortalities arising from the
mission will be shouldered as well by the host organization.

h. Proof of juridical entity (certified true copy of the SEC
registration must be submitted).

i. Notarized letter of Guarantee from both the medical mission
group and the host organization assuming full responsibility for the
outcome of the missions.

4. The PMA, upon receipt of all requirements, will forward the
application to the concerned specialty societies for evaluation of
credentials. The DOH will be informed immediately of the presence of
drugs, medical supplies and medical equipment.

5. The DOH shall facilitate issuance of clearance by its FDA and BHDT
for the above mentioned goods.

6. After the evaluation of the missioner’s credentials by the
concerned Specialty Society, the PMA shall send a letter of endorsement
to DOH.

7. The DOH shall then endorse the documents to PRC.

8. The PRC after final review shall issue the Special Temporary
Permit to Practice to concerned foreign missioners.

9. The lead time for the processing of the application are as
follows:

a. PMA – 2 weeks before the mission date
b. DOH – 1 week before the mission date
c. PRC – 3 weeks before the mission date

10. Post-mission report shall be submitted by the head of the foreign
surgical and/ or medical missions, concurred/noted by the President of
the local component society of PMA, and/or specialty society and the LGU
concerned, to the oversight agencies (DOH, PMA, PRC) 15 days after the
completion of the mission. All records and audio-visual documents must
also be submitted in triplicate form. The post mission report should
contain the following minimum basic information:

a. no. and age of cases seen

b. diagnosis of patients
c. list of medicines distributed and surgical interventions done
d. endorsements to the necessary health facilities (follow-up,
further evaluation and management)
e. morbidities and mortalities if any

11. All materials submitted to the oversight agencies shall be the
property of the Philippine counterpart and may not be used for
advertisement, solicitation or medical publication without the written
and expressed approval of the local medical society and/or specialty
society of the PMA and the local counterpart. Any intellectual output as
journal or publication must include the local physicians as senior
authors.

12. Former Filipino Registered Health Professionals who are part of a
Medical/Surgical Mission Team may practice their profession in the
Philippines upon presentation of proof of valid and current PRC
licenses. Otherwise they have to renew their licenses upon submission of
the following requirements (Presidential Decree No. 541):

a. Photocopy of current/valid passport (Page 1 and the page showing
the date of arrival in the Philippines)
b. Photocopy of PRC license and valid certificate of registration
c. License/Certificate of Registration in the adopted country or
Certification of employment with letterhead indicating the job
description within the definition of the applicant’s profession
d. Four pieces of recent passport size pictures (taken within one
year)
e. Payment of prescribe fees at PRC
f. Certificate of training and board certification (for specialists)
g. Application for Temporary Special Permit (PRC form 103-A)

13. Foreign Religious groups/missionaries practicing medicine in the
country shall abide by the same requirements and adhere to the
guidelines. These missioners who serve for longer period of time shall
signify their intention to continue living in the Philippines to
pursue missionary works. They shall secure Special Temporary Permit
which is to be renewed annually. The following must be submitted:

a. Certification from their congregation that the medical works are
purely for charity purposes and with no remuneration involved
whatsoever.
b. A certification from the congregation assuming the responsibility
for any action of the said physician.
c. The missionary should submit to PMA an annual mission report
including a list of patients treated.
d. The missionary is required to attend PMA or component societies’
CME related activities once a year to update their medical knowledge
e. The missionary who conducted his missionary works in the province
must coordinate with the PMA component society for proper
identification and monitoring.

14. Foreign SMM conducted in the Philippines without proper
permits/licenses must be reported to PRC for investigation of possible
illegal practice of medicine and/or unauthorized conduct of FSMM for
appropriate sanction and disposition accordingly.

VIII. Sanction/Penalty Clause

Failure to comply with any provision of this Joint Policy will result
to the disapproval of the application and/or disqualification from
future application.

IX. Repealing Clause

DOH Administrative Order No. 179, s. 2001 and all other issuances
inconsistent with this are hereby repealed.

X. Effectivity

This order shall take effect immediately.

Adopted: 22 December 2009

DEPARTMENT OF HEALTH

BY:

(SGD.) HON. FRANCISCO T. DUQUE III, MD
Department Secretary

DEPARTMENT OF INTERIOR AND LOCAL GOVERNMENT

BY:

(SGD.) HON. RONALDO V. PUNO
Department Secretary

PROFESSIONAL REGULATION COMMISSION

BY:

(SGD.) HON. NICOLAS LAPEÑA
Chairperson