By Tissa Jayaweera
Education was taken over by the State with the privatisation of schools in the name of free education – a political decision, considered a good move to make free education available to all citizens.
A grievous mistake was made by making the medium of education Sinhala only. Dropping English converted the country into a third world state within a few years. The country is still struggling to get over the backlash.
We as Ceylon were economically ahead of all countries in Asia other than Japan at that time. Our neighbour India continued English education and now it has overtaken Sri Lanka in IT and many fields.
Our English in the past was better than that of English-speaking countries. We have now gone to the extent of suggesting importing teachers of English from India. Some time ago we had a program funded by England/Australia to teach teachers to teach English when the current Prime Minister was Minister of Education.
After the mistake was realised, the same Government that took over private schools was compelled to allow private schools, with the restriction being placed that GCE examinations be conducted as London General Certification of Education, subjects in English.
Many private schools in the English Medium sprung up all over the country. Some with high quality, some below quality but students sat a common London GCE. No private schools in Sinhala medium have started. Parents and investors realised the value of English education.
All these schools educated students to sit for the London GCE Examination. GCE standards were set by the University of London International Examinations Department. The GCE Sri Lanka Standard is set by the Department of Examinations.
Now opportunity is given to students to sit for Sri Lanka GCE examinations in English. Private schools as well as State schools are gradually starting classes for Sri Lanka GCE English medium. The obstacle is the lack of teachers who are able to teach in English as they have been educated in Sinhala.
This is the one country in which State education is considered superior to private education as the demand to enter State schools and State universities is far greater than available capacity.
For the good fortune of the students of the country private schools as well as degree awarding private colleges affiliated to numerous colleges/universities overseas were allowed to be operated in the country. Yet approximately three to four thousand students of affluent parents leave the country each year for higher education to overseas universities of G7 countries and some to less developed countries who offer recognised degrees affiliated to G7 universities in high profile professions. Very few of these students come back to paradise – a brain drain of affluent students encouraged by Governments in power since 1960.
Now we come to the debate of private medical education. Should the State be the only educator and graduator in medicine in Sri Lanka? Then all doctors who have obtained their medical degrees oversees should be disqualified from practicing in Sri Lanka although they have passed the eligibility requirement to practice medicine, the ERPM Examination conducted by Government of Sri Lanka, as the degree has not been awarded by Government of Sri Lanka Medical Colleges.
Approximately 1,000 foreign qualified graduates from universities outside of Sri Lanka sit ERPM conducted by the Government. The pass rate is 25-30%. The quality of these foreign universities is so poor although the Government has recognised these universities as suitable for medical degrees.
Male graduates who attend medical colleges in countries where Islam is practiced are not given opportunity to treat females or touch a female during clinicals but they have graduated as MBBS, passed ERPM and practice medicine in Sri Lanka. There are many who call themselves doctors in business and other professions as they could not pass ERPM.
The Kotelawala Defence Academy Medical Faculty although fee-levying does not fall into a private degree awarding medical college as it is owned by the State and the number of students are 25 to 30 per batch. This gives them better opportunity to interact with faculty.
A quick fix for the current crisis at the Malabe Private Medical College as well as medical colleges to be set up in future would be for medical students of all faculties to sit for the same examination conducted by State medical colleges as done for Sri Lanka GCE O/L and A/L.
Immediate action must be taken to adjust the curriculum of the Malabe Medical Faculty to be compatible with the Defence Academy Medical College as the teaching faculty of both colleges are retired State university practitioners and lecturers.
A cut-off mark must be set by Government as done for entrance to State Colleges for entrance to private colleges according to the number of seats available in private medical colleges to ensure that students with high marks follow the degree and that duds with money are not allowed to follow the degree.
As per GMOA and student unions they object to the medical degree being awarded by Malabe Medical College stating the degree is not on par with standards. Or is there jealousy that some of the students in private medical education are from international schools who have had their education in English and sat for London GCE Advanced Level?
Has GMOA or student unions specified the standard or offered a solution other than objecting to the functioning of the private medical college and award of degree?
Once the standard is specified by the Government, all doctors in practice who do not meet this standard must be compelled to meet the specified standard or resign from service. As per GMOA and student unions, we cannot have two standards and rules in the same playing field.
By this method a common MBBS degree can be awarded by Malabe/Kotelawala and any other private medical colleges to be set up.
Does Sri Lanka need this many doctors?
Another big question is, does Sri Lanka need this many doctors?
Approximately 1,200 doctors pass out of the medical system each year. If the per capita doctor/population ratio is studied, Sri Lanka compares well with the developed world but doctors are not available in the required rural areas.
Most of the MBBS Doctors have not obtained post graduate qualifications and specialised. Those who have specialised try to concentrate in the big cities where private practice is rampant and educational facilities for their children are available. The poor farmer or those living in rural areas do not have a doctor for many, many kms or population ratio.
It must be made mandatory for a doctor qualifying from a rural area to serve the said area for a minimum of five years before being eligible to serve in another area. There should be a good appointment and transfer scheme to ensure doctors serve at least 10 years in rural areas.
The Government must ensure the facilities in rural hospitals be improved and family accommodation provided in all rural hospitals for doctors and secondary staff. ‘Kolambata kiri gamata kakiri’ is rampant in the medical service. The not-so-well-to-do have to travel all the way to Colombo and other big cities in the early hours of the morning to receive treatment in general/base hospitals. This is highlighted by media whenever there is a work stoppage by doctors.
The wise move would be to improve the facilities of the existing medical colleges. Colombo Medical College was ranked amongst the World’s Best up to about 1970. Set up research facilities in medical facilities. We have many diseases endemic to Sri Lanka. Research could be done to find solutions for these.
News says we are to import anti dengue products from Australia. Our scientists are doing great in developed countries. Why can’t we do it here?
No difference between doctors and bus conductors
It is the quality of the medical service that matters, not quantity. There were no work stoppages by the medical profession and medical students when they were of quality. Medicine was a profession. Now there is no difference between doctors and bus conductors.
At the rate Sri Lanka is producing doctors, there won’t be capacity to offer internship in State hospitals. There won’t be vacancies in the Government medical service to offer jobs for doctors. In the near future we will have unemployed doctors protesting on streets asking for jobs in State service. They will have to form an Unemployed Doctors Association to have protest marches or half-baked doctors will be offered employment in the many private hospitals, thereby bringing the quality of clinical medicine down
If protests vs. loss to the economy is calculated, the Government could have improved the health services tenfold. Eventually it is the people who suffer, not Malabe Medical College, GMOA or the student unions. Students who boycott lectures and their parents need to realise that it is they who suffer the loss and not those who incite boycotts and protests.
If a serious calculation is done on loss to State, public life, disruption of services to the public and damage to property, it will run into billions. Can this loss to economy be recovered from those who encourage disruption of services, incite work stoppage and damage property? 99% of the population is paying for the loss caused by less than 1% of the population.
It is very strange to see Buddhist priests in the protest march of medical students. These are the persons who should be arrested, charges filed and put in jail. The Most Venerable Mahanayakas will stand by justice. Our Judicial system is so slow, it will be another burden on the public.
Those who are against private medical education will have to give serious thoughts with respect to loss to the economy, given this low quality mentality of the educated and to-be-educated.