By Hansika Hanthanapitiya –

Hansika Hanthanapitiya

We have a solution; only if you’re ready to listen; An Open Letter to the Government of Sri Lanka, the Local Medical Graduates and the SAITM

I will get to the solution strait away.

What if the government established a system where every medical graduate, local, local-private and foreign, has to go through THE SAME standard written and viva examinations so that;

1. Graduates from Colombo Medical Faculty can finally stop saying/thinking that they’re better than all the other local graduates from the rest of the government universities in the country put together,
2. All local graduates can finally stop pointing fingers at SAITM saying their educational standards are inferior to that of the local graduates’,
3. And all foreign graduates who want to practice medicine in Sri Lanka, who are from elite universities like Harvard or Cambridge or any other university which has better international recognition than the Colombo Medical Faculty can finally stop turning their noses up at the local graduates cause their medical education experience is far superior to theirs,

Because everyone will be facing THE SAME set of exams which will standardize the quality of medical graduates who will go on to become doctors in our country and they will all have the same level of knowledge and skills. This I believe will be the most effective solution to the problem, considering the current situation.

Now holding one final standard exam to issue the government medical license to medical graduates (much like the medical examination systems in America and most developed countries), along with one-one-one interviews to assess the mental stability and community mindedness of the examinees, will ensure that none of the doctors would get discriminated at the workplace for being not from the medical faculty of Colombo, or a local university- because this happens quite often, directly or indirectly, and I believe that this negativity affects the performance of the doctors in a hospital setting. Most graduates from Colombo Medical Faculty always regard themselves to be superior to others and consequently even the doctors who are better than Colombo Med graduates but are from other local universities feel inferior to them. I’m sure that everybody agrees that this has to stop.

If there was a single board examination for everybody, and only the medical graduates who passed that get to practice medicine regardless of where they went to medical school, then nobody will get to point fingers at somebody else saying that they aren’t as good as them, cause everyone will be equally skilled. This way only the best of the best will get to become doctors and serve the people. Ultimately, isn’t this what everyone wants?

Now for the local graduates who think that only the people who passed local A/Ls with district merits should become doctors, I’d say that if a person is really passionate about becoming a doctor, at any age, they should have an opportunity to at least give a shot at it. That’s what “free” education truly stands for. So if there was a single exam once every year or better yet, twice a year for all the medical graduates who want to practice medicine in Sri Lanka, including the local students (this wouldn’t be an extra exam for you- this could replace your fifth year finals), and only the people who got through this could go on to become doctors, you won’t have any suspicions about their abilities and knowledge, right? Because the people who will pass these exams along with you will be as good as you are?

And wouldn’t this be a better solution than abolishing private medical colleges altogether, and particularly, in this case, the SAITM, since there are already hundreds of students enrolled in it, hundreds of hopeful, scared students, of hundreds of innocent parents just like yours and mine? Wouldn’t it be more compassionate and humane to make sure that they are as good as you before letting them practice medicine, rather than just forcing them to throw away years of their lives?

And about the issue of local graduates getting less employment opportunities because of all the other graduates who will get to practice medicine when they pass the exams, for this I’d say the government can prioritize the placement of local gradates over all the other graduates who will pass the said standardized test. Frankly, these kinds of measures are rather detrimental to a country’s development, but this method would prevent a lot of future riots from the local graduates, so at the end of the day, this method will be better for the people of my country. So this ought to solve all the problems that the local graduates have. After all, this is a method biased towards your wellbeing just because you are a local graduate, even though all the other people who would have passed a standardized examination along with you should have got an equal eligibility for a job placement.

Also, about the local medical students wanting the future generations of students to have better access to local medical schools, yes of course this is a very valid point to rally for. But why should that abolish private medical colleges, in a scenario that a standardized examination system exists to screen doctors with the most exceptional knowledge and skills? Yes, I agree that the existence of a medical school that you can pay and enter alienates good students who couldn’t get into a local medical school or a private one because of financial issues, but at the same time if the government establishes a standardized examination system for all, sub-par students from private medical schools will never get to practice medicine anyway. And they can’t protest or rally about it either- because if you aren’t god enough to be a doctor, you just aren’t. It’s as simple as that. But yes, as for the rest of the good students who have the potential to get through a standardized medical examination, but couldn’t get into a local or private medical school, keep rallying for them. They need you. But the point you also need to understand here is that people who have the capacity to pay for a private medical school will somehow send their child to one, be it local or foreign. So wouldn’t it be better if our country could retain all those millions and billions of hard earned money of these people within this country itself, by establishing private medical schools? Wouldn’t it be better for our county’s development? Now again, don’t forget that these graduates would have to face the standardized exam along with you, so you need not fear that mindless people will go on to serve as doctors and endanger the lives of patients.

I know what you’re thinking right now. All of these opportunities to facilitate medical education would produce thousands of medical graduates each year wouldn’t it? Yes, it most certainly would. And then the government wouldn’t have job placements to offer them even if they pass the standardized exam? Most definitely yes. There’s only a limited number of opportunities available to become a doctor in a small developing country like Sri Lanka, and even if thousands of people had the knowledge and the skills to become a doctor, only hundreds would actually get the opportunity. But maybe, this way, two very important social changes could be finally brought about in the Sri Lankan society;

1. Being a doctor (or an engineer or a lawyer for that matter) is not the only kind of job that matters. If anything, the scientists who are engaged in medical research should be hailed well above the clinical doctors (they are hailed well above clinical doctors in developed countries- it’s just that most people in our country seem quite unable to look past the alleged glamour of certain professions) because they are the ones that enable the clinicians to perform the miracles that they do in hospitals every day. Now that’s the kind of work that’s reserved for the truly elite minds of the world, medical and other scientific research. So maybe, just maybe, this system will bring about collateral benefits like development in the areas of scientific and medical research.
2. People who are not truly and absolutely passionate about medicine would stop getting into medicine. There are people that I personally know who are doing medicine just because they got 3As and got selected to medical school, not because they are passionate about spending long hours tending to patients day and night. I believe that this is the root cause for the doctors’ dissatisfaction about their salaries and other privileges. The truth is, the doctors in our country don’t get paid as much as they should be paid, so unless only the people who are truly and unconditionally passionate about treating patients day and night become doctors (until the government is rich enough to pay the doctors a staggering monthly salary), we will never see the end of doctors going on strike compromising the lives of their patients in order to ask for more privileges.

When thinking about the whole SAITM predicament, it doesn’t make sense as to why any parent would spend their life’s savings to send their kid to a medical school, which is quite new and does not have the Sri Lankan Medical Council approval and also is rather expensive compared to some of the foreign universities that they could have sent their child to, which have better international recognition and facilities. If you were living under a rock about sending your child to study abroad, all I’ve got to say is that your conservative ideas and conformity and fear of change might have cost your child a future in the worst case scenario that the government is forced to shut down SAITM. Nothing is certain in a country like ours until it’s actually done; it was foolish to gamble away a child’s future on SAITM’s promise to get all the necessary approvals- which they still hadn’t delivered on, just because you were too conservative about your child getting a foreign education.
And to the management of SAITM, if you had any business acuity at all, you would have spent all the millions of rupees you spent on building the Neville Fernando Teaching Hospital to develop the infrastructure facilities of a few government hospitals which are not teaching hospitals, and asked for permission to let your students practice in those hospitals. That way;

1. You won’t be interfering with the education of local medical students by over populating their teaching hospitals
2. And local hospitals would get a contribution from the SAITM’s money, which is a win-win situation for both the government and the people of this country, plus your students could have received a well-rounded government university level clinical experience as well.

You should have had the foresight to know that no matter how many MRI machines you buy for your hospital, people are going to be wary of a new hospital attached to a new private medical school, and rightfully so. After all, it’s peoples’ lives and health we are talking about here, everyone is only going to trust the hospitals they already know of.

Lastly on the subject of vehicle permits that some of the recent strikes of the doctors were about, how exactly does one make up his/her mind to abandon human beings in need of their care for any material thing?

I study medicine too and I’m here not because of the things I can take, I’m here because of the things I can offer, to my people and my beautiful little country, and all other people from countries all over the world, because in the end, it doesn’t matter if somebody is the prime minister of England or a farmer in Vietnam or our next door neighbor in Sri Lanka, when they’re sick, they will be weak and vulnerable and needing all the care they can get, and we will be the ones providing it. Isn’t each of us as human as the rest of us? First, do no harm.

*Hansika Hanthanapitiya is a medical student at the Tianjin Medical University, China