Hi Stewart, As far as I'm able to work out you can renew a 59 day tourist for up to 16 months by just going to a local immigration office every 59 days without the need to leave and come back. Within that time you can apply for a 13a if you wish to stay and live with your Filipina wife. The Bureau of Immigration requirements for 13a "seem" to be different if you apply in the Phils, (so I have been told). The fact is that no one can seem to give a positive answer to the 13a requirements, the latest info I have from members on this site and others is that if you apply in the Phils a medical is not required.