By R.P. Gunawardane –
I was alarmed and deeply concerned after reading Mr. Sarath Bandara’s (typical) Pera story about his difficult path to become a doctor in Sri Lanka. He says typical probably because this is the normal path taken by most of the students in Sri Lanka. His article highlights general issues regarding getting a good school for secondary education, university admission process, and particularly the delays in each step from O/L exam through university admission, internship appointment and beyond. In my response, I will deal only with the delays in each of these stages. All these delays are avoidable if suitable action is taken by the Ministry of Education, the UGC, universities and the Ministry of Health.
Due to the current set up in Sri Lanka, bright students like Mr. Bandara would have wasted about 7-8 years of his prime time between O/L exam and beginning of his internship in the medical career. Even after that he has a long way ahead to become a medical consultant. In Mr. Bandara’s case, he will be 32 years old when he starts his internship. Then there will be another waiting period for his post internship appointment, followed by exams and foreign training. Even after foreign training component, he may still have to wait for a considerable period for his consultant appointment. By that time, he will be around 40 yrs. of age having only 20 years to serve the nation, after nearly 35 years of continuous school education, university education and professional training. This is a pathetic situation prevailing in Sri Lanka today.
In most of the other countries such delays do not exist. As such even our students with best A/L results tend to go abroad if their parents can afford it. For example, in USA most students enter universities when they reach about 17 years. In USA, most professional programs are conducted at graduate level. For instance, medicine, dentistry, veterinary science and even education are conducted as postgraduate courses. In the case of medicine, you need to follow an undergraduate program which includes pre-medical requirements prior to admission to medical school. Then, they should pass MCAT (Medical College Admission Test) to apply for a medical school. Total period of the first degree and MD program is 8 years. Thus, they will be about 25 years when they complete MD. Their internship is combined with specialized training to become consultants. This training lasts for 3-5 years depending on the specialty, except in highly specialized fields such as cardiac surgery, neuro surgery, plastic surgery etc. which may take 6-10 years. For example, one can become a consultant physician at the age of 28 years and a consultant dermatologist at the age of 29 yrs. The situation is similar regarding the average ages of the medical professionals in most of the other developed countries and even in some developing countries. This means that Mr. Bandara from Sri Lanka spends over one decade more than an average medical professional in any other country to become a medical consultant!
As mentioned earlier, such long delays do not exist in most other countries. As such there is a greater tendency now for our students with even the best A/L results try to gain admission to foreign universities for medical degrees provided their parents can afford it.
In most countries students apply for admission to universities in their final year in the high school so that they do not lose time. Similarly, medical students apply for internship and specialization programmes in their final year in the medical school so that they can start combined internship and specialization immediately after graduation. They have a highly organized and coordinated systems with a fixed calendar to administer these activities annually.
During the period 2000-2004 some concrete measures were taken to reduce waiting times of students at different stages (see this author’s article on “Why GCE A/L Exam should be held in April?, Colombo Telegraph & Island, October 28, 2016), and to minimize delays in release of exam results in Sri Lanka.. Action was also taken at the same time to expedite and synchronize university admissions. Since then this aspect has been completely ignored and no coordinated action has been taken regarding this matter during the last decade.
For medical graduates the delays occur in the following stages without considering delays arising due to strikes and other disruptions in the university system:
- After GCE O/L exam and before A/L classes begin (9 months)
- After A/L exam and before the selection to university (1-2 years)
- After selection and before actual admission to the faculty (1-2 years)
- After Final exam and before internship placement (1-2 years)
- After internship and before permanent appointments (6-9 months)
At least in No. 5 above the officers are paid their salaries during this period, but their professional advancement is delayed. As in Mr. Bandara’s case the total period of delay from numbers 1-4 listed above is about 7-8 years.
It is a national crime to waste many productive years and precious time of our most talented young generation due to inaction of our authorities. Thus, it is absolutely essential to implement an action programme to reduce this time lag to a minimum without any further delay. A dedicated and a highly coordinated effort is need in this direction with the active participation of Ministry of Education, Ministry of Health, UGC and the universities. Furthermore, it is also essential that all the medical faculties have the same fixed academic year so that internship appointments can be streamlined and expedited.
We have seen the rapid increase of waiting period and the delay at the different stages of medical training during the last decade. It has now become a very serious issue affecting our young generation and the whole nation. Many generations of our highly talented young medical students have gone through this painful process without much protest. Even a very active trade union like GMOA has not taken this matter seriously. Probably they have taken it for granted without realizing the gravity of the situation. Thus, it is high time for the civil society activists and particularly trade unions like GMOA and FUTA to take this matter up with the authorities and see that appropriate action is taken by the relevant authorities (Education Ministry, UGC and Health Ministry) without any further delay. Considering the plight of Mr. Bandara as a general situation, there is a strong case for extending the retirement age of medical consultants to 65 years as in the case of university academics. Although many generations of medical graduates are already seriously affected, immediate and effective remedial action coupled with a possible extension of retirement age will benefit many future generations of our medical profession.
*The author is a Professor Emeritus, University of Peradeniya, formerly Secretary, Ministry of Education and Higher Education and Chairman, National Education Commission, Sri Lanka