Monday, May 8, 2017

A SAITM Solution: Take Over Medical & Allow Other Faculties To Continue

Colombo Telegraph
By Laksiri Fernando –May 6, 2017
Dr. Laksiri Fernando
There is no point in allowing the SAITM issue to continue for so long without a solution. The government or the country should be able to resolve such problems within a reasonable time, let us say two months. The failure to do so, not good for the country and its normal functioning, and much desired development. This is not to say that resolving such a problem is easy. But most difficulties are related to (1) the reluctance to give-in (2) unwillingness to face the reality (3) hesitation to change previously held views and (4) acrimonious political confrontations.
At present, the confrontation seems to be mainly between the government, or certain sections of the government, and the GMOA (General Medical Officers Association), although there are several other stake holders. SAITM (South Asian Institute of Technology and Medicine) seems to have taken a back seat, tactfully or not, and their medical students have become the main victims of the situation.
Various Views
I have seen over 50 articles on the subject in various newspapers and websites, the authors mostly expressing their views ‘for’ or ‘against’ SAITM based on their ideological/political views and/or self-interests. On both counts, the reasoning could be considered ‘subjective,’ which is something not easy to avoid even in my case. Dr Ruwan Weerasinghe commendably analysed most of these views (“To SAITM or Not to SAITM – Is that the Question?” – Colombo Telegraph, 11 April), listing them into 12 issues, for the discerning readers to make their own judgement/s. Unfortunately, even the present controversy seems to be broadly – ‘To SAITM or Not to SAITM.’ In Weerasinghe’s view, which I largely agree, the rational question instead should be: “Can the medical education be provided by the private sector?
There have been various other articles, some addressing the professional or economic/business aspects of the issue/s, nevertheless finally expressing personal/ideological preferences. Two of the important ones were by Professor R. P. Gunewardene and Dr W. A. Wijewardena. These are my selections.
Whatever his personal views on the matter of private medical education, Gunewardene (“SAITM Issue: A Rational Approach Needed,” – CT, 24 February) has frankly noted the following, in respect of negligence or breach on the part of SAITM and also correctly blaming the other authorities, for the present crisis.
“It is regrettable to note that SAITM on their part has continuously disregarded the guidelines issued by the regulatory bodies in their development process. Their gross negligence towards the stipulated guidelines is clearly evident as reported by Professor Carlo Fonseka. In addition, SAITM authorities have not explained the current status of their degree program to the students at the time of admission. It is rather unfortunate that no action has been taken by the appropriate authorities well in advance to avoid the present situation.”
Wijewardena, on the other hand, was highlighting the economic/business aspects of the matter in fact even endorsing private medical education emphasising the “failure of the government to meet the aspirations of all students seeking to continue for a medical degree at a state university.” Writing after the Court of Appeal decision, favouring the request of students (31 January), nevertheless he was not completely dismissing the institutional criticisms of SAITM by the GMOA or the Padeniya Report. That is why he was talking about “SAITM and Private Medical Schools: One Bad Start should not lead to Throwing Away a Good Idea” – (CT, 20 February). One instance of his acceptance of institutional criticisms is the following:
“According to the correspondence between SAITM’s founder Dr. Neville Fernando and SLMC and between BOI and SLMC as reproduced in the Padeniya Report, SAITM had been called at that time in its original name, namely, South Asian Institute of Technology and Management. Thus, its transformation into South Asian Institute of Technology and Medicine would have taken place much later as a marketing device.”
Controversial Issues
SAITM initially has been a BOI approved private venture in 2008 to conduct training (and not degrees) in management, nursing, languages, vocational studies, health science and technology. It has been the Ministry of Higher Education and the UGC which have given SAITM, the degree awarding status (August 2011). By that time SAITM had already started recruiting students for medicine. It is important to note that this was Rajapaksa time, while some key decision makers are with the present government.
However, the Sri Lanka Medical Council (SLMC) has clearly written to SAITM in 2009, among other matters, that it cannot “recognise any degree being awarded by an institution not set up under the Higher Education Act.” This cannot be just a technical matter, which even the UGC has overlooked. The present controversy is much on the substance, for instance, whether the SAITM students have sufficient clinical experience to qualify for national and international standards, whatever the facilities they have in superior to even some of the state run medical facilities.
On the part of the university student unions and other trade unions in the country, they question the recruitment procedure of SAITM, based on the capacity to pay high fees, leaving out many more qualified students out of the possibility of entering the lucrative medical profession. If you have, for instance, two Cs (with one S) in bio-sciences, you can enter as a medical student at SAITM but not to a state university, because of the higher Z-score required. Here has a strong equity problem. Even then, enrolment of SAITM students for a batch is not more than 30, because of the financial factor. This cannot even be considered ‘freedom of education’ by any means, they argue. However, the protests should not be at all against the SAITM students or even SAITM, but against the prevailing injustice.
Medical graduates are the only graduates who are assured of secure employment in the country. Therefore, all those who are qualified, should have the opportunity to enter medical education, whatever the determined minimum qualification. There are more and more good doctors needed in the country. They also have the opportunity to go abroad an earn a good living, whether they contribute back to the country or not. On the other hand, there is nothing wrong, under the circumstances, in having fees for medical students either on the direct payment basis (like at SAITM) or on an interest free loan basis like HELP (Higher Education Loan Program) in Australia in the long run. However, this is not an issue that should be settled now. Much more discussions are necessary.