PIP: The Institute of Health Sciences was established on the island of Leyte in the Philippines in 1976 for the specific purpose of training health personnel for work in the depressed and underserviced areas on the islands of Leyte and Samar. The Institute differs markedly from other medical institutions in terms of recruitment policies, training procedures, and goals. The key elements in the program include 1) the recruitment of students from the depressed areas ultimately to be served by the program; 2) a ladder type of training program which permits students to pogress through various levels of medical service certification from health worker to physician; and 3) the punctuation of academic training with periods of in-service work back in the student's community of origin. The Institute is designed to offer 5 progressive levels of training including 1) a health worker program; 2) a community health worker program; 3) a nursing program; 4) a bachelor of science program in community medicine; and 5) a doctor of medicine program. The 5th level of training has not been fully implemented as yet. The students at the Institute are recent high school graduates who have been nominated by their local communities to participate in the program. All the students begin the program at the 1st level and progress up the ladder as far as possible taking into account individual trainee desires and aptitudes, community needs, and evaluation by Institute personnel. Participants in the program are not legally bound to work in their communities of origin after the completion of their training. It is expected that most of these individuals will elect to return to the depressed areas because 1) the trainees grew up in low income, rural families unlike their counterparts at other institutions; 2) the trainee's ties with his village of origin are constantly reinforced by the in-service training built into the program; 3) the students are accorded high prestige in their communities; and 4) the Institute instills in the students a sense of social responsibility.