Date Posted: June 10, 2026

Author/s: Polly T. Chua-Chan, MD, FPAFP and Razel L. Kawano, DrPH

Doctor of Medicine graduates shall commit to the improvement of society’s well-being and public service. In the Philippines, 70% of physicians are hospital-based, only 30% are in the field or community where the need is greatest. One strategy stated in the Philippine Health Agenda 2016-2022 is to harness the power of strategic human resource for health development through curricular revision of health professions directed towards primary care to make it locally and globally responsive. Pedagogically, service-learning (SL) connects academic experience with community service with reflective practice. This paper aimed to determine the outcome of integrating service-learning as the innovation being diffused in the Medical curriculum of Far Eastern University-Nicanor Reyes Medical Foundation (FEU-NRMF) towards the development of community-oriented physicians. Convergent parallel mixed method design was used to describe the design and implementation of SL integration narrated as Institutionalization, Structural Framework and Support, and Campus-Community Partnership.

The crafting of the new Philosophy of FEU-NRMF Education paved the way for integrating SL as a method of teaching for all program offerings of FEU-NRMF. This is “institutionalizing” SL as a means for sustainability. To provide structural framework and support for SL program, the following were done: Orientation and awareness of SL, capacity building, logistic/technical and financial support, Committee on Community Engagement commissioned to be the permanent system for SL program. The Committee on Community Engagement likewise was tasked to partner with communities for Campus-Community partnership.

The SL process was also assessed through faculty’s curriculum linking service to the learning goals in at least one course per year level with service-learning project either partly or as a whole of the course. Higher year levels tend to use higher intensity community activities as assessed using the InstructorCentric Taxonomy of SL. Based on National Youth Leadership Council (NYLC) 2008 standards, projects were evaluated with lower level for projects for basic courses and higher levels for clinical courses commensurate with the length of time of the SL projects. Generally, students attained their course learning goals. Learning is by applying theory in actual practice and/or through reflection and making sense of what was experienced. Retention in the course and passing percentage cannot be attributed solely from SL but believed that community engagement creates and sustains interests that can contribute to retention and passing of the course.

As to the outcome of SL, in general, the impact of SL for faculty is positive since teaching the course reaffirmed the importance of SL to service oriented profession. Faculty had become community engaged to plan and implement a SL course. A total of eighty-eight (88) SL projects were conducted for the whole semester constituting health education, health promotion programs on personal hygiene, prevention of parasitism, financial allocation for health, health system management, community health and the like. For the students, around 84.54% of them across all year levels expressed their intention to practice Community Medicine or Public Health. Comparing influence of SL between the Basic and Clinical courses with their intention for Community Medicine or Public Health practice in the future showed no statistical difference.

That means, it was the exposure to the community per se, regardless of the timing that influenced them to have the intention. Possible explanation is the role modeling of community-engaged faculty somehow affects their intention (Social Cognitive Theory). Based on the theories of reasoned action and planned behavior, it is seeing the reality or the need in the community that can influence the students to have the intention, likewise, exposure to the community will increase their self-efficacy (Theory of Planned Behavior) that further intensify the intention. Around 85% of community participants said that they were helped a great deal by the services rendered to them. Help included additional knowledge, consultations, health screening, etc. None claimed that their rights were violated. Follow up study among the cohort of students who experienced SL is recommended to determine whether the intention of community practice was actually translated to community or public health practice, hence documenting the success of the intervention of curricular reform in medical education addressing the inequitable distribution of health human resources especially in the community where the need is greatest.

Keywords:
Service-learning (SL), medical curriculum, community-oriented