Sunday Island Editorial

Way forward for SAITM

12 February 2017

We are glad that the deans of the medical faculties of eight state universities have infused a voice of sanity into the prevailing madness over the SAITM controversy. It was reported yesterday that they had a brief meeting with Higher Education Minister Lakshman Kiriella at the parliamentary complex where they handed a letter which stressed, among other matters, that the Sri Lanka Medical Council (SLMC) must remain the authorized institution for regulating the standards of doctors practicing in this country, its independence safeguarded and students who had qualified at SAITM be justly treated. They have anslo suggested that SAITM students are afforded an opportunity of a few months of proper clinical training followed by an examination by the SLMC in order to determine their competence and that enrolment of new medical students be suspended until outstanding issues are resolved.

As far as we can see, only the dean of the Kotelawela Defence University (KDU) medical school has not signed. There have been allegations, how correct we do not know, that the standards demanded of SAITM have not been applied to KDU. That university is also a fee-levying institution.

What is disgraceful about the controversy that has been swirling around SAITM these recent weeks, where even patients seeking treatment at government hospitals had to pay a price due to a GMOA token strike on that issue, is the double tongued approach of the Joint Opposition. During the previous regime, government scholarships were awarded to SAITM students, according to Prof. G.L. Pieris "on the expectation that SAITM would measure up to required standards". These standards were not met, he now says, but even if the claim were true it’s a essentially a case where the cart was put before the horse. The JO’s present stance has been determined for political advantage and nothing else.

It will also be useful to remember that there probably would not have been a medical faculty at the Kelaniya University (Ragama) but for the fact that the Sri Lanka College of General Practioners, at great cost and energy, set up the private, fee-levying North Colombo Medical College (NCMC). The founders may have had the influence to win the support of then President J.R. Jayewardene, but they got nothing free from the government. Standards of entry were highly competitive and just 100 of over 1000 applicants were admitted in the first year. The late Prof. Stanley Kalpage, the then Secretary to the Ministry of Higher Education and Chairman of the University Grants Commission, told the final convocation of NCMC over two decades ago that many practicing GPs whose children could not win admission to the NCMC were unhappy. One doctor who got his daughter in but whose son failed to make it became an implacable enemy of the NCMC, he said. Following much agitation, with arguments very similar to what we are hearing now, the NCMC was taken over and attached to the Kelaniya University. Many doctors in practice today would not have had that opportunity had the NCMC not been set up. Given the cash-strapped status of succeeding governments, it is an open question whether the Kelaniya University would have had a medical school at all; even if it finally achieved one, it would have been realized much later but for the NCMC core.

It would be relevant to find out how much foreign exchange flows out of this country to pay for Lankans studying medicine abroad. The collective figure over a period of years would run into the billions. The reality is that Sri Lanka lacks the resources to offer university places to all those students qualified for tertiary education especially for entry to the medical and engineering professions and perhaps law. This gap has been met by private fee-levying institutions, often linked to universities abroad. Except in the field of medicine, there has been no protest about the offering of these courses by the private sector.

Dr. Neville Fernando set up SAITM as a commercial venture; but a large number of scholarships are on offer there. Providing a quality education in a discipline such as medicine will not come cheap. But not all students of SAITM come from affluent families with some parents mortgaging homes and property to invest in their children’s education. It wasn’t different during the NCSC controversy, but as Prof. Kalpage observed in his convocation address of long ago, most students there were children of teachers.

Two eminent retired medical teachers, Emeritus Professor Herbert Aponso who taught pediatrics and Prof. Upali Ilangasekera, a former professor of medicine at Peradeniya, also made pertinent observations in Friday’s issue of The Island. They said that when they were examiners for the Act 16 examinations which Lankans who had acquired medical degrees abroad mainly in Russia and China (and some other countries) had to sit to qualify for registration as doctors here, they had found that the training, curriculum etc. in the countries where they studied was tailored to suit those conditions. The candidates were "awfully ignorant" of health problems and medical needs here. Sometimes they had to relearn and re-sit the exam several times but they had subsequently passed and proved to be efficient medical doctors.

Thus though their initial training had not been adequate by SLMC standards, they were given an opportunity to come up to the acceptable requirements for Sri Lanka, they said. The former professors say that as far as they were aware, SAITM has a curriculum acceptable to Sri Lanka and the institution has been able to attract capable teachers. Perhaps the students have been handicapped by lack of exposure to sufficient clinical training – a matter that could be corrected. They have made the further point that the training that SAITM offers is in no way less (in fact much better) than what they have experienced in the training offered in some foreign countries. Professors Aponso and Ilangasekera suggested that SAITM graduates be offered provisional registration until they pass the ACT 16 exam – the same yardstick applied to foreign medical graduates. Thus a way forward has been clearly identified; it should be applied without caving into various pressures and vested interests as the JRJ government did in the case of the NCMC.