As the crisis over private medical colleges intensified this week, Deans of the eight state medical faculties are considering seeking an urgent meeting with President Maithripala Sirisena next week to discuss the “consequences” of a court ruling on medical education in Sri Lanka. This was while the Sri Lanka Medical Council (SLMC) was moving in [...]


Medical Deans consider urgent talks with President on fallout

CA ruling on SAITM – SLMC ponders appealing to Supreme Court

State University medical students and other protestors took to the road soon after the court ruling. Pic by Amila Gamage

As the crisis over private medical colleges intensified this week, Deans of the eight state medical faculties are considering seeking an urgent meeting with President Maithripala Sirisena next week to discuss the “consequences” of a court ruling on medical education in Sri Lanka.

This was while the Sri Lanka Medical Council (SLMC) was moving in the direction of appealing to the Supreme Court against a Court of Appeal (CA) ruling with regard to provisional registration of students of the privately-run South Asian Institute of Technology and Medicine (SAITM). The ratification of the move to appeal to the Supreme Court is expected when the SLMC meets on Wednesday, with a 42-day window to file such an appeal.

There was also an outpouring of support and commitment not only by medical professional organizations but also by trade unions such as the Association of Medical Specialists (AMS) and the Government Medical Officers’ Association (GMOA) towards legally strengthening the role played by the SLMC.

For, the consensus among medical as well as other professionals is that the SLMC plays a ‘crucial, essential and indispensable’ role with regard to medical education and the practice of medicine.

“The SLMC acts as the watchdog of the public or patients, protecting the interests of these voiceless masses, even though many may not realize it,” was the view put in a nutshell by a senior doctor and echoed by numerous other doctors, academics and even non-medical professionals.

The AMS will meet this week to discuss and get-together with all relevant stakeholders to make a draft to strengthen the SLMC and then put it to the government to bring about legislation to implement it, an AMS spokesperson said.

GMOA President Dr. Anuruddha Padeniya said that in any country the monitoring mechanism for medical education and medical practice is the Medical Council. As such, in Sri Lanka the SLMC grants recognition for medical education institutes considering several criteria, while it also registers all those qualified to practise medicine and regulates medical practice. Therefore, the government has a fundamental obligation to uphold the principles on which the SLMC has been established as otherwise the rights of the public are at stake.

Higher Education Minister Lakshman Kiriella, meanwhile, is scheduled to meet the eight Deans next week, as they in turn are considering whether they should hold an in-depth discussion with the President on this issue.

“We feel that there is an urgent need to discuss what we should do in the context of this ruling and spell out not only to the decision-makers but also to the public what bearing this ruling would have on higher education in general and medical education in particular,” a source close to the Deans told the Sunday Times.  

The eight Deans, the Sunday Times understands, were meeting this weekend to discuss the “consequences” of the CA ruling on medical education per se in Sri Lanka. They are from the state medical faculties under the Colombo, Peradeniya, Jaffna, Kelaniya, Sri Jayewardenepura, Ruhuna, Raja Rata and Eastern Universities.

As a flurry of meetings are also being held in different quarters, SAITM published huge advertisements in newspapers about its victory and the state universities braced themselves for widespread protests by their students.

On Thursday, a large group of student protesters snaking towards President’s House were tear-gassed and dispersed with water-cannons, while the GMOA launched a day’s token strike on Friday against the violence perpetrated on the students by the authorities.

Pointing out that the CA has kept strictly to the letter of the law in giving its ruling, a source said that the SLMC should necessarily go to the Supreme Court which would look at this issue in a wider context along with its social repercussions.

Many sources in medical circles and other professionals were also “disturbed” by the turn of events that medical education could take in the country as well as a drop in international esteem for the medical profession in Sri Lanka. They were vociferous in their views that the SLMC should get its act together and make a strong appeal against the CA ruling to the Supreme Court.

With regard to the situation in seven of the eight state medical faculties, the Sunday Times learns that though they are not ‘officially’ closed, students are not attending lectures on the grounds that they have to make the public aware about the private medical education fiasco in the country.

“Students are refraining from attending lectures,” a source said, adding that only the Colombo Medical Faculty students were attending lectures after a one-day token strike. But they too were said to be considering a boycott of lectures from tomorrow.

Firm standards of training should be in place before venturing into private medical education

It is essential for policy-makers to have an open and transparent as well as a no-holds-barred discussion with the medical profession on how to expand educational opportunities for medicine to the private sector without compromising standards. The maintenance of standards is of paramount importance, a senior doctor said, with nods of agreement from many others.

For, the CA ruling has brought to the fore several important issues, they said. They are:

* Even though the SLMC made a recommendation to Health Minister Dr. Rajitha Senaratne that SAITM should not be granted recognition, non-recognition was in the hands of the Minister.

* The non-approval of the Prescribed Minimum Standards for Medical Education in Sri Lanka by Parliament, which has resulted in these Minimum Standards not having any legal binding.

* The Higher Education Ministry having the mandate to provide degree-awarding status to institutions. SAITM was given such status by two Gazettes in 2011 and 2013, under Section 70c of the Universities’ Act. There was also another Gazette issued in 2013 under Section 137 of the Universities’ Act which set out rules which are applicable for recognition of degree-awarding institutes. Under Rule 31 of this Gazette, there is reference to the requirement of a ‘compliance certificate’ from the relevant professional body, in the case of SAITM, it would be the SLMC.

* The SLMC, however, which functions under the Medical Ordinance has no mandate to issue such a ‘compliance certificate’.

* If a degree-awarding institute does not secure such a ‘compliance certificate’ (in the case of SAITM in medicine), how should such an institute be de-recognized.

* According to the court ruling, de-recognition should come from the Higher Education Ministry and that has also not been done in the case of SAITM despite the absence of a ‘compliance certificate’.

* Another factor is that the Higher Education Ministry is also waiting to grant five other private medical faculties permission to operate in Sri Lanka.

If the authorities and policy-makers are keen to expand medical education into the private sector, well-thought of legislation needs to be implemented first. The foundation should be laid for proper education including essential clinical training, an academic pointed out.

While the ‘compliance certificate’ should be made mandatory under the Universities’ Act which comes under the Higher Education Ministry, the Medical Ordinance which is under the Health Ministry should be strengthened to ensure that such institutes ensure the Prescribed Minimum Standards for Medical Education which should have a strong legal backing, the academic pointed out.

The SLMC should be given wide-ranging powers even to visit such private medical faculties and shut them down if standards are not met, similar to practices in other countries like Bangladesh where the Medical Council has such authority.

The other repercussions of private medical education which need to be closely examined, sources pointed out, are:

* Should there be a mandatory licensing examination for students who pass out of all private medical institutions in the country like the Examination for Registration to Practise Medicine (ERPM or Act 16) that all medical graduates who have studied abroad and wish to practice here have to sit compulsorily?

* Should the students of such private medical faculties within the country be provided internship in state hospitals?

* Should the students of such private medical faculties within the country be absorbed into the state health cadre, once they complete the internship?


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