Yes, it is necessary. In the Philippines, the education system isn't like India. There, a student has to go to school till class 10th, then do the BS course of 4 years and then MD if he/she wants to study medicine. The rule is same for international students too, just the difference is that if they've already done their 10+2, some credits are given on +2 and the rest on the 3 semesters of the BS course. After the degree, the student will be eligible for the MD.