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Once upon a time in Sri Lanka youngsters aspired to become doctors because they wanted to help people. But today all this appears to have changed. It seems that a good many of them simply want to help themselves. And now a segment of them appears determined to stomp on anyone else hoping to enter the medical profession.

The chronicle of the opposition to a private medical school has gone on unabated for too long now. It is not as though the country’s medical sector has become an overcrowded profession. On the contrary, the country is experiencing a dearth of doctors. Medicine is different today and so are many of its practitioners.

Patients need competent doctors. High quality doctors make the care of their patients their first concern. It takes years of study and hard work before you are qualified to work as a medical practitioner and even then you will be continuously learning throughout your career. But in this neck of the woods it seems that however committed and qualified you are it’s a darn tough proposition to even enter a state medical university. That is because we have too few teaching hospitals to churn out potential medical professionals and no room to accommodate some of the brightest prospects among them.

In the case of Sri Lanka, university entrance is not selected entirely on merit but based on a district quota system which leads to discriminatory consequences. For instance, even if a student from a district considered ‘developed’ such as Colombo, Galle or Kandy achieves ‘A’ or ‘B’ passes he or she can be rejected from entering a government medical faculty. On the flip there have been cases of students sitting the ‘A’ Level exam from Nuwara Eliya, Badulla, Anuradhapura and Polonnaruwa Districts, with ‘C’ or ‘S’ passes entering State medical faculties. Some of them are currently working as doctors in the country simply because they sat the entrance exam from ‘underprivileged’ areas.

The upshot of it is that the authorities are unable to provide higher education to all the students who successfully complete their Advanced Level exam. While 3000 are entering the universities for a host of general degrees, there are a further some 70,000 unable to enter them and showing signs of growing frustration. From a practicable and fair perspective, the solution to this problem is quite simple. The opportunities for tertiary education in every field should be expanded in every possible way. But one supposes that would take an interminable time in coming, particularly because of the prospect of the colossal investment involved in infrastructure, equipment and competent training personnel.

So for now the best those aspiring to becoming medical professionals could do – including many with excellent grades – is to pursue their tertiary medical studies at private institutions overseas – at prohibitive expense to their parents as well as draining the nation’s coffers of valuable foreign exchange. The only slim chance for those students locked out of entering a state medical institution – instead of pursuing their dream overseas – is to enter the South Asian Institute of Technology and Medicine (SAITM), which at present is the only such fee-levying private institution authorised to award MBBS degrees.

But SAITM has been given a rough roller-coaster ride from several quarters since its inception to have its MBBS degrees validated by the Sri Lanka Medical Council (SLMC).  The SLMC is a statutory body established for the purpose of protecting healthcare-seekers by ensuring the maintenance of academic and professional standards, discipline and ethical practice by health professionals who are registered with it.

The SLMC contends that SAITM has not met the required standards to grant it the authority to award medical degrees. It asserts that SAITM lacks facilities for clinical training, but in the same breath objects to SAITM students obtaining their training from government hospitals.  Why?  The hostility was aggravated further after a recent Appeal Court ruling supporting the registration of its students. Two days later, on February 2 a protest was held by the Medical Faculty Student Activists Committee  in Colombo.
Police fired tear gas and water cannons to disperse the protesters who were opposing the court order issued on January 31. Students belonging to eight medical faculties then decided to boycott studies as a protest against the Court ruling which permits the SLMC to provisionally register SAITM’s MBBS graduates. Then on February 3 government doctors  across the country launched a trade union action opposing the efforts to disperse the protest.

The courts have also observed that the SLMC – supposedly an impartial body – used double standards in judging SAITM and the Kotelawela Defence Academy, the latter a state military school is authorized to confer MBBS degrees from its inception. From both a practical  and ethical perspective the SLMA could not be faulted on insisting that medical groves of learning must maintain the best traditions and foremost qualities of excellence in both their intake of students, as well as to providing them with adequate facilities for training.

No right-thinking person would disagree that the highest standards should be maintained in medical education because once they qualify, doctors deal with patients’ lives. But wouldn’t  it seem logical that not only SAITM but all state medical faculties too should be subjected to the same scrupulous scrutiny?

Why not establish an independent body such as a commission of inquiry to make a comprehensive probe into the quality of amenities and services not only of SAITM but also all other state medical faculties, particularly those at the more recently established ones such as Anuradhapura and Batticaloa? And pray, by what yardstick is the quality of tutelage and facilities of these institutions to be judged? Besides, as far as medical ethics are concerned, we hope they are not determined by the capricious and egoistic behaviour being displayed of late by the state medical officers’ trade union which appears to go against all the tenets of the sacred Hippocratic Oath.

Yes, it’s time to take the Government Medical Officers Association, (GMOA) to task for backing the protest to the hilt and going to the extent of staging a strike. Meanwhile, the recent four-hour doctors’ strike crippled hospital OPDs and clinics in country wide government medical hospitals. The GMOA has earned the dubious distinction of holding the nation to ransom on self-centred issues that affect the lifestyles of its members while leaving their patients to suffer in the process. There have been recent instances where they have left the suffering sick in the lurch for demands such as more elite schools for their children and also free vehicle permits.

The state university students who benefit from taxpayers’ money through free education are being egged on by all kinds of political opportunists to protest against the SAITM medical degree.  The Inter University Students’ Federation (IUSF) said this week the six months’ suspension on admitting students to SAITM would not make any difference and vowed to launch a countrywide protest campaign from Friday.

Its convener Lahiru Weerasekara told a media briefing that they would continue their struggle until SAITM is abolished completely. We quote him verbatim: “We oppose these proposals and will not let up in our struggle to safeguard free education. SAITM should be abolished immediately. Our fight is not against standards but against the privatisation of free education.” Strong and fighting words that obviously smack of more than a mere tinge of jealousy and fear that they would be upstaged by private university scholars.
But for some strange reason all these political orchestrated protests have totally ignored the scores of other degree conferring programmes offered by various private educational institutions. Again could someone enlighten us as to why only the private medical degree programme is seen as a threat to free education?

Besides, the SAITM  medical faculty is not the only discipline housed in its campus. It also has Engineering, Management, ICT and Media faculties. It is a composite of four faculties, where the main faculty is Medicine with more than 1,000 thousand students. SAITM has all the requisites a university needs to function well. In comparison to state universities, SAITM boasts of facilities of a very high standard. Recently, SAITM students shattered the false notion – espoused by its denouncers to create a sense of class envy – claiming that they all hailed from super-rich families. Not so, say the majority of students, who assert that they come from middle class families and their parents work hard to pay the cost of education. It is worth to point out SAITM also provided Rs.500 million worth of scholarship for deserving students.

Obviously we are shackled by a sick system of education particularly in the medical sphere. There is an entrenched medical mafia hellbent on keeping its privileged status quo intact. The entire issue could be resolved in a civilized manner if not, for the greed, envy and fear that their lucrative careers will be overshadowed by the students of private medical institutions.

No one denies the fact that not all members of the present medical fraternity are scalpel happy mercenaries whose main objective is ‘moolah’. Mercifully for this nation there are still several extraordinarily gifted medical personnel who attend to your medical needs with a captivating bedside manner in the best traditions of the noble profession.

As for the many clinical new specialists who exploit the sick and suffering and appear to know more about organic chemistry than human interaction while raking in the shekels we say: “Physician, heal thyself!