Private Medical College - a dIfferent point of view

October 23, 2011, 7:09 pm


By Dr. Sankalpa Marasinghe

I read with disbelief and dismay, the "point of view" of one Mr. Edward Gunawardena, on ‘The Island’ newspaper, 17th October 2011. I was even more astonished to see the same letter repeated in The Island on 18th October. Despite the rumors of SAITM allocating Rs 20 million as their "media budget", I truly believe it was an unintended mistake by the newspaper; my only hope is that this reply would also get repeated "by mistake" on two days.

Claiming himself to be an "Advisor" to the UGC during the dispute of NCMC (North Colombo Medical Faculty) he has repeatedly mislead the public. It would be in the best interest of the country to keep such advisors away from the current business of the UGC.

While it is required to respond to the allegations leveled against the GMOA by Mr Gunawardena it is pertinent to expose what he is trying to hide and how his writing deceive the average reader, helped by his entry to the subject with his own claims of being someone involved in the UGC and university matters.

1. Free education

"In fact Free education does not exist anymore"

Says Mr Gunawardena! On what evidence does he declare so? I quote His Excellency the president at a recent press discussion "I will not curtail the free education of the country’s children". http://www.adaderana.lk/news.php?nid=11792. If there is no "free education" in existence, what was his Excellency talking about? But according to Mr Gunawardena "As long as we have fools and opportunists in politics the abolition of free education will not be considered"

Declarations by individuals who do not understand even the basis of free education are not just deceiving but grossly damaging to the precious system of free education. While accusing GMOA of being "irrational" Mr Gunawardena attempts to hoodwink the public by baseless statements. Let me remind him what the word free education really means.

The government provides primary secondary and tertiary education free of charge to the public. How does government afford such a facility? Especially in a country like ours where the economy is still developing? This is the argument by many who think that the explanation appearing in their own small brain is in fact the reality. However, the answer is TAX. We pay taxes and that tax money is the government’s source of revenue. What if we did not have free education? Suppose the primary education costs Rs 10,000/= per month per child. A father who has two young kids schooling, should have at least Rs 20,000/= more in his pocket to give them education. A Grade II medical officer (doctor) whose basic salary is Rs 28095.00/= should have to be paid Rs 48,000.00/= !! (for the pay slip of a government medical officer annex1). Not only the government servants but also the private sector workers will have to be paid at least Rs 20,000/= extra.

It should be realized that the economics of services provided by the Government is not so simple as Mr Gunawardena says. It is a cycle and the Money of the country is cycled and "free education" is a name for a particular stage of the cycle. Contrary to the propagated "idea" that free education has fallen out of the skies, it should be appreciated that the concept of free education is a solid and deep economic strategy which even the developed countries are now returning to. It is an investment which has given Sri Lanka a long term benefit.

Another misconception which is doing the rounds these days is that "everything is being privatized and why not education"? Even in the mother land of capitalism, education is NOT privatized! Margaret Thatcher, the greatest ambassador of capitalism did NOT privatize higher education and especially NOT medical education. Free education is not a concept which necessarily belongs to either Capitalism or Socialism. It’s an advanced economic strategy with proven benefits over others. It is not outdated and it certainly is NOT useless!

Opposition to free education is not a new development. Even at the inception, C W W Kannangara had to face opponents within his own party who later became national leaders. The arguments were the same as now and only difference was that there was that those voices were not paid back then.

It should be emphasized that even the Medical faculty which the SAITM claims to have an "affiliation", with Nyshny Novgorod State Medical Academy is a state medical faculty in Russia!

However, it is due to such ignorant "advisors" in the past that the country has suffered immensely with losses of many young lives. Advising to award the Colombo medical faculties (CMF) degree, MBBS (Col) which was given to students who gets selected to CMF with the highest aggregates in GCE A/L to the Ragama private medical college (NCMC) which had selected students who had done even Home Science for their A/Ls was the blunder of the century !

It is worthwhile to recollect that there were two futile attempts to start PMCs, the North Lanka Medical faculty and the Vignan institute, after the collapse of NCMC and before SAITM.

So in reality, free education does exist and it is one of the most successful economic and educational strategies the world over.

2. Doctors and their conduct

"What a village midwife did some years ago is today performed by a FRCOG (London) assisted by a MBBS (Col) and a team of nurse in an Air conditioned, Sterilised theatre and what cost to the patient"

Ignorance is one thing but Mr Gunawardena has introduced a whole new meaning to the phrase "foot in his mouth"

If what the "Village midwife did" were to persist we would have had a maternal mortality rate to be displayed "deaths per 1000 live births". However, Sri Lankan maternal mortality rate is 39.6 deaths per 100000 live births (one lakh live births)!! A phenomenal figure comparable with developed countries in the world. Our Neonatal mortality rate is 11.2 per 1000 live births! It is the blabbering of those ignorant that spoil such an achievement. Further, it is the dedicated work of not only the doctors but the well trained midwives and the nursing staff together with all other auxiliary staff which helped to achieve this state.

It seems Mr Gunawardena is still living in the 1950s. Sri Lanka has long established the Post Graduate Institute of Medicine (PGIM). Doctors who only have FRCOG are NOT certified to be consultants in this country any more. We have surpassed the stage of dependency to the Royal College of Obstetrics and Gynaecology and our PGIM and the board of study is comparable to any other in the world. Sri Lankan specialists are qualified with Sri Lankan post graduate degrees. They complete a mandatory foreign training period after which they are evaluated and given the board certification. It is a very stringent procedure with equal status to any other foreign country. The consultants and their respective colleges in Sri Lanka overlook the training and the practice of the relevant field in the country.It is such a shame that individuals who are unqualified to appraise the subject are wasting an entire page of a National newspaper (twice in one week) to discuss matters they do not understand.

Mr Gunawardena asks "at what cost" the patients are treated in Air conditioned theatres? Well for Mr Gunawardena’s information almost all labor rooms of state hospitals in the country are now being air-conditioned. And the patients are not charged a cent!

"…….do these qualifications alone make one a specialist doctor?"

Yes they do !!

Because, unlike a qualification in any other field, in medicine the qualifications are not given for paper work. That’s why it takes 10 to 15 years for a doctor to become a specialist. It is a training and an

evaluation process. It is a process of continuous assessment. The training ends only when a panel of "judges" recommends that the competency is adequate. And the training is not necessarily confined

to clinical skills only. It should be emphasized that the "status" and the "competence" of Sri Lankan specialists should not be discredited because of Mr Gunawardena’s ignorance.

Mr Gunawardena’s wisdom could not be any better than a village damsel’s

as explained by his prediction that "Very soon the MBBS will be replaced by degrees such as Bachelor of Cardiology, Bachelor of Oncology, Bachelor of Nephrology, Bachelor of Urology etc".

It is such a shame that individuals who do not have even an ounce of knowledge of what a basic degree or what a post graduate degree is are making comments about subjects they do not comprehend. The University of Peradeniya would not be very proud of this son she has produced.

3. Honor and ethics

Mr Gunawardena seems to have developed a serious liking to the individuals who started the "malambe" institute. While questioning the morale and the ethics of GMOA and the doctors of state sector, he praises the individual who claim himself to be a "professor"!. May I ask, a professor in what? There is no practice of granting professorships to individuals similar to the doctorates given to every Tom and Dick. The chair of professor is a post given by a university after accomplishing a very high level of qualification. Prof A H Sheriffdeen, who had written an article to The Island on 20th September 2011 (http://pdfs.island.lk/2011/09/20/p9.pdf) explains how detrimental it is to open PMCs without standards. There are people waiting to cash in on the outcome of the current debate and like opening up "international schools" and " BOI approved Chinese hospitals" we may see a mushrooming of such institutions which even the judicial system may not be able to prevent. Unlike the infamous "professor" at "malambe", Prof Sheriffdeen is an emeritus professor in surgery and arguably the best product of Sri Lankan surgical teaching fraternity and many of us are simply fortunate enough just to have been his students. It is such a disgrace to see such a title being misused and Mr Gunawardena seems to have seen no evil in it.

However, he seems to be very concerned about the local graduates and their standards. He claims that "many of the MBBS graduates who pass out from the state medical faculties are themselves doubtful of the quality and standard of their own degrees". How many local graduates came to Mr Gunawardena and told so, may I ask? Rather than making unsubstantial comments, he should bring evidence to prove what he claims.

It is evident that somebody has given Mr Gunawardena the list of departments in the "malambe" PMC. He is "impressed" by the departments which are not found in any other medical faculty in the world such as "Latin", "Medical history" etc. However, the serious deficiency of permanent staff and the relevant departments has been conveniently omitted.

Mr Gunawardena has accused the Sri Lanka Medical Council (SLMC) on several accounts. Failing to stop "exploitation" of patients is one of them. This writer has been able to obtain a comment from Vidyajothi, Prof Lalitha Mendis, the president of SLMC.

"There are over 16000 doctors working in Sri Lanka at the moment. SLMC will investigate any formal complaint against any registrant with regard to unethical conduct. However, the Sri Lanka Medical Council is not only concerned about the exploitation of the patients by doctors but also exploitation of unsuspecting parents by bogus medical schools" she said.

Finally, why the Government Medical Officers’ Association opposes the "malambe" PMC?

The stated grievance of the GMOA is that no private institution can be allowed to function if it does not conform to standards according to Mr Edward Gunawardena.

Exactly ! However, GMOA is not the first and certainly not the only opposition the ill-conceived "malambe" campus has. The SLMC from its inception (2009) has made clear that the said institution does not have its recognition. Dr H H R Samarasinghe, who was the president of SLMC at the time and whom Mr Gunawardena claims to have had worked with has written to the management of the "malambe" PMC and informed that it is not recognized by the SLMC. Many paid advertisements were published by the SLMC instructing the public of the same. Yet, the "pioneers" have persisted and did not heed the call of the SLMC. Following are the facts in a nut shell.

1. "malambe" institution had NO BOI approval to start a medical faculty.

(BOI letter 2010.08.09)

2. No SLMC recognition, even though the institution repeatedly advertised that they have.

(SLMC letter 2009.05.28)

3. No affiliation with the Nyshny Novgorod State Medical Academy and the students of the faculty will NOT get MBBS (NNSMA)

Excerpts from the MOU between the two institutions; 1.4:- Upon obtaining the official recognition of the medical faculty in Sri Lanka, the duration of the course in SAITM is 5 years with student intake of about 100 students per year in accordance with the curriculum of NNSMA and on completion of the course graduates are awarded degree of SAITM.

NB: this MOU is not an agreement of affiliation. In fact it is a "contract agreement in providing services on Teaching in General Medicine"

4. No teaching hospital; which is a pre-requisite for any medical faculty.

NB: a functioning 300 bedded hospital is a mandatory requirement to even submit an application for a medical faculty in India.

The list of undelivered promises is as follows.

a. 2009:- A high-tech teaching hospital will be constructed (UGC report 19th November 2011)

b. 2009 at first intake:- Clinical training in Russia (SAITM brochure)

c. 2010:- Clinical training at an 800 bedded private hospital. (No private hospital in this country is equipped with 800 beds)

d. 2010/2011:- Clinical training at Homagama and Avissavella base hospital. (No health Ministry approval to acquire such a facility)

e. 2011:- 1004 bedded teaching hospital will be constructed ???

5. No permanent teaching staff; all the lecturers are either on sabbatical leave or on part time basis. However, a "promise" by the entrepreneur has gone in vain; I will get best professors and lecturers not only from Sri Lanka but also from UK and Australia" – letter to SLMC president

6. Entry criteria for students are at best questionable. According to a newspaper article on Divaina 20th October 2011 students who don’t even have 3 S passes at GCE A/L are enrolled. http://www.divaina.com/2011/10/20/news02.html



Editor’s Note:
Dr. Marasinghe levels a veiled allegation against us that the ‘media budget’ of the Malabe PMC had something to do with the article at issue. We would like to tell him with due respect that The Island cannot be swayed by moneybags unlike some unscrupulous doctors who have sold their souls to the Pharmaceutical Mafia for foreign trips, milk food for their offspring, tyres for their vehicles, television sets, refrigerators, hampers, sponsorships for their official and social functions etc.