2 July, 2020

Blog

The SAITM

By Godwin Constantine

Dr. Godwin Constantine

The SAITM issue has become a national issue. This has become an issue for politicking for various politically motivated groups. Various groups and individuals have raised their voices for and against SAITM creating much heat and less light.

The SAITM issue has brought out some important questions regarding state funded/private higher education in this country. SAITM assumes importance since it is an institution providing private medical degree. In this regard the following questions needs to be addressed:

1. Do we need private medical degree warding institutions?

2. Is it possible to provide adequate training for private medical students in the private sector?

3. What are the entry criteria for private medical colleges?

4. What are the important issues with SAITM

5. Will private medical colleges affect the state medical faculties?

Do we need private medical degree warding institutions?

The simple answer for this question is yes. We have private education from kindergarten to university level except for medical profession. There are two important factors that make private medical degree contentious issue compared to other professional courses:

    1. Inadequate patient turnover in the private sector hospitals 

    2. Immediate government employment at completion of the degree course.

At present not a single private sector hospital in Sri Lanka could provide the number and the variety of patients needed for training medical graduates. This can only be resolved by giving private medical students access to government hospitals and other health care facilities for training purposes. This will benefit the private sector as well as the government sector in the long run.

Immediate government employment at the completion of the degree course is a privilege enjoyed by medical graduates in this country. State medical graduates and foreign medical graduates enjoy this benefit at present. This ensured state employment has given rise to the argument about the number of doctors produced vs number needed to serve the country. However, the number of graduates / professionals produced in the country and the need of the country has not been raised in any other profession. All the doctors produced in this country are not going to stay in this country and are not going to be confined to state sector alone. We need not assume that the kinetics/ dynamics will remain the same when there is high demand and when there is surplus production. 

The popular argument against private medical education is that it will affect the free education. Is that applicable only for medical education? Is it acceptable to prevent a tax payer’s child obtaining a private medical degree in spite of the tax payer providing money for the ‘free education’ of a state medical faculty graduate? However those who have money are sending their children to other countries to obtain medical degree at a loss to the country’s foreign exchange.

What are the entry criteria for private medical colleges?

Medical students are admitted to the state medical faculties once a year depending on the National Advanced Level examination results. However, the SAITM and the Kotelawala Defence University (KDU) admits students more than once a year depending on National or London Advanced Level examination results. There are three important issues regarding student entry into private medical faculties:

1 Minimum results at the Advanced Level examination 

2. Students entering at a younger age into private medical faculties 

3 more than one batch being admitted per year

The minimum results required to enter the university in Sri Lanka has remained as simple pass in all subjects probably since the time the A/L examinations started. That was so when 4As were hard to find and it remains same when 3As are in abundance. This needs to be revised.

The students who are entering through London A/L have an undue advantage of being at least one year younger to their peers who enter state universities through the National A/L. The state university students will waste one more year to enter state medical faculties whereas the students entering the non-state institutions will be able to start their medical education soon after the A/L results are released. This anomaly will affect the career of medical graduates from state medical faculties as they will be older than their parallels from the private medical college. This will become one of the major disadvantages of being a medical student in a state medical faculty in the future. 

What are the important issues with SAITM?

The main complaint against SAITM is that it had not complied with the recommendations made by the SLMC. The pertinent question we need to ask is whether the KDU and all the state medical faculties have the essential facilities to conduct a medical degree course? The answer is no. However SAITM needs to be singled out in this issue as it is totally a private enterprise. If one private institution is allowed to offer medical degree without adequate facilities it will result in mushrooming of medical colleges without adequate facilities, like in some other countries. 

The SAITM administration has failed to satisfy the expectations of the medical community. There had been some shady issues relating to the SAITM from the beginning. All these facts need to be considered in deciding on the future of SAITM. There needs to be a drastic change in the administrative structure of the SAITM if it is to continue. On the other hand if SAITM is nationalised the establishment of private medical degree awarding institutions in this country will be pushed back by several decades and we will continue to lose foreign exchange. 

Will private medical colleges affect the state medical faculties?

There is a fear that the private medical colleges will lead to deterioration of the state faculties as in the case of Sri Lanka Transport Board. Higher education cannot be simply compared to the other enterprises. The Law College, Institute of Chemistry and various other organisations are conducting higher degree programs for a long time. There are offshore campuses of high ranking international universities in Sri Lanka. None of them have so far been a threat to the Sri Lankan universities.

The government has to take measures to improve the state universities. The well established medical faculties should be promoted to Schools of Medicine with more independence. The facilities in the state faculties can be improved and the possibility of admitting paying students to state faculties could also be explored.

The current trend to promote foreign universities and non state higher education institutions by the government, even by providing infrastructure facilities needs to be questioned.  The recent move by the SAITM owner to ‘gift’ the Neville Fernando Hospital to the government, need to be considered as a serious issue. This is obviously an attempt to resuscitate a private education facility which is in a debt trap. What transactions go on behind this ‘gift’ is unknown.  SAITM medical faculty is a bad start of an acceptable initiative to introduce private medical education in this country.

In addition to SAITM issue further bigger issues have emerged recently. One such issue is the creation of a quality assurance unit to ensure quality of higher education both state and non-state institutions. Though this appears to be founded on a sound principle, this institution may undermine the importance of the Sri Lanka Medical Council in determining the standard of medical education in this country. Which of these two institutions will be the final authority to accredit/approve non-state medical education institutions will be a pertinent question in this regard?

And the pending appointment of the chair person for the SLMC is also an immediate challenge facing the medical community at present. The SLMC chair person will be able to give the necessary green light to fast track the approval of SAITM.  Apart from the issues created by SAITM, the important question of the role of non-state medical education in Sri Lanka has fallen by the wayside. Various professional bodies in the medical field need to address this question, they should not shy away from addressing this pertinent question at this moment in time.

In conclusion, private medical education is a necessary evil. If it is to be accepted in Sri Lanka it needs to be monitored and regulated by the government and the Sri Lanka Medical Association. The number of private institutions and the student admission needs to be monitored and regulated. Remedial measures needs to be taken to ensure that the time of entry of students to the private or the state medical faculties from affecting their career in the long run. All private medical college students should be placed at the bottom of the merit list, as in the case of foreign students, for the purpose of internship appointments. And more importantly there should not be any political interference in the process of establishing a private medical education facility.

Dr. Godwin Constantine – Senior lecturer in Medicine, University of Colombo and Cardiologist
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Latest comments

  • 14
    3

    Dr. Godwin Constantine:
    Even though I might not be supportive of every point you’ve made, thank you for the sincere attempt at a balanced appraisal of the SAITM issue.
    As you say, there has been a lot of heat and little (if any) light around this issue and yours was a welcome addition to the debate.

    • 5
      0

      This is not because what you ay, but because your name is Constantine, one of OUR kind!

  • 7
    0

    Dear Dr Constantine,

    Far too much fuss is being made over SAITM, by people who know nothing of the issues. And most of that fuss is mindless demonstrations on the streets, with SAITM now having acquired the status of a hate word.

    It is voices such as yours that ought to be heard, since you know some complexities that we don’t. For me the issues seem to be simple enough. Human knowledge has galloped apace and all those who are interested in studying have aright to do so. At the end of that process, before a licence to practice is issued the competence of the new graduates has to be assessed. This is not a matter for laymen, and it is good to have persons of your stature making your views known.

  • 3
    0

    I personally believe, if government going to establish private medical institutions , there should be some standards, for example, before entering the Uni need to check MCAT score, which may be a higher standard government medical uni doesn’t want. but people cannot blame for private universities then. Now many sri lankans doing london a/l, some student cannot enter government schools for various reasons , i think which is a good think, they want a chance to do their education freely.

    • 1
      2

      We don’t need alien MCAT. The Common paper MCQ is the one used by all state and part of it is incorporated into ERPM/Act 16 for foreign medical graduates. You have no idea of the destruction done by insane and weird Medical Council by cancelling ERPM for fmg hoping to cancel SAITM, refusing to register SAITM after they completed their requirements for MBBS, prez. still hanging on to power he tasted with TU, not willing to let go and allow a fresh breath enter into the cycle of chaos he created violating medical ordinance as per court verdict. There can be no logical reasoning in vindictive terrorism, focused on erasing SAITM. The comedy is that SAITM is still alive and well

  • 2
    9

    I don’t think this is an unbiased article but another article against SAITM.
    Most of these lecturers from the government unis are brain washing the students too. This is what we have heard from the students it self.

  • 2
    2

    Corrupt regimes have provided shortcuts for the children of the elite at the expense of public good.
    *
    University and technical education in Europe is state controlled and admission is based on proven ability.
    What we have seen in Sri Lanka has been state attempts to offer easier routes for the rich and influential.
    *
    Public protest killed one such move in the 1980’s. But private education including tutoriels thrived at school level thanks to state neglect of general education.
    Neglect of higher education led to the prolifrtation of degrees for cash in corner shops in Colombo plus foreign business ventures that offer second and third rate degrees.
    *
    It is not just SAITM, but the entire system of private institutions awarding sub-standard degrees needs serious remedial action.
    The state must invest heavily in QUALITY EDUCATION and not make education a venture for profiteering by the unscrupulous.

    • 2
      0

      If the education is sub standard demand will drop and they will close down. This is clearly evident in the MBAs awarded by state sector universities. There is a world of a difference between the top two MBAs and the rest of the state sector MBAS.

      What is required is minimum standards for private and state sector university education and ensue strict compliance by both.

      Don’t kill private enterprise please.

      In the Carribbean there are 70 private medical schools catering to the spill over from the American students. Our own students are studying medicine in Grenada. Please understand that it is not only the state that can provide education and health services.

      Imagine if we did not have private education, health, banking, telecom, insurance, etc and the state of this country!!!

      This is what these tax payer funded doctors from GMOA are asking for.

  • 3
    0

    The marks for assessments associated with how much can be accommodated in the university
    If the number enrolling for the first time is more than the capacity of space available at the university student will be removed, even if the marks is 1 point less.

    Therefore with the same results student obtained in university can be approach the private school.

    A panel of experts in the subjects shall assess justify the Pass marks theory
    entries to private schools

  • 4
    1

    2 0
    Any trade Union has the right to strike and let them do that.

    Hambantota port has so far lost Rs 45 billion and no Hope other than working with private sector. Let the petrol sheds run dry for a few days !! We have to put it to operational use and hence fully supportive of the proposed joint venture.

    SAITM has to be there and let the doctors strike because they will want to protect their profession from competition. We have to allow private medical education and let all medical schools both govt and private be subject to minimum rules.

    Yahapalanaya govt is two years late but congrats for pushing through these tough reforms.
    Happy to suffer a few days without petrol and due to traffic congestion and queues at govt hospitals because these reforms are a must.

  • 2
    2

    Yesterday’s news said that “Thirteen medical faculty undergraduates arrested for allegedly engaged in a Satyagraha campaign at Lipton Circus against the SAITM in violation of a Court order were yesterday ordered to be released on cash bail of Rs.500,000 each”
    . Think about that. We have future ‘doctors’ who are violent and have no respect for court orders or the law. And then, hey presto, a shadowy entity with a lot of cash pays their bail. Rs 500,000 in cash for cash bail multiplied by 13 persons = Rs 6,500,000 which is about US $42,000. Which destabilizing fund is paying for this? Any guesses anyone? And is the government smart enough to check the source of the money? Anywhere else the world people coming up with this kind of cash would be questioned as to the source of funds. Even a bank transfer of $2,000 needs to backed up by legitimate source in this day and age of terrorism and money laundering. How does this secret funding happen in Sri Lanka?

    • 1
      1

      Funding is from many sources. It is clearly obvious that politics plays its cards. Less known ones include the job agencies who could have sent SAITM students to foreign uni for a good price, some being on duplication road. Many inroads. Well known is GMOA AS to USSR. Limitless possibilities. The destabilizing fund has to supply students to buy their souls. Govt. must wake up and expose frauds fast.

  • 3
    2

    Writings about SAITM should be done with. In fact there is no issue here to discuss. The problem is people who have no idea about medical education try to put their two cents. Let me describe things briefly.
    1. SLMC as the authority in accreditation and issuing medical licencing, SLMC should be consulted and worked with to develop medical curriculum of any new medical school either private or state.
    2. SLMC should clearly spell out requirements for admission to these schools and minimum academic achievement levels they expect.
    3. In a personal note, admission to a private medical school should be from the same merit list used by the state schools which will ultimately maintain a student body of higher standards.

    That is all about it. I am flabbergasted why the gov. does not agree with this. If the gov. don’t agree they should pass legislation for the gov. to take over what the duties of SLMC and let the politicians carryout medical education, registration and licencing according to their wishes.

    • 0
      1

      Suggestion to stop writing about SAITM is again followed by 3 more points. Why? The idea is to give those excluded from state merit list like London and Cambridge A/L an opportunity as they too have citizen rights to education though outside that uniquely weird and crazy Z score merit list found nowhere in world education. That high standard of ethics, honesty, integrity and morality required for medicine obviously does not come from Z scores has been proved beyond doubt these last few months by the terrorist behavior of these ‘Z’ on the streets. Do we need ‘Z’ in the private sector too after wasting parents money and not state funding. Imagine ‘Z’ wanting to sit exams. in English. Useless talking about the biased dead SLMC

      • 4
        0

        Mr. citizen,
        I am not writing articles on SAITM. Do you consider my post as an article?

        Many academics and myself have many times shown that London and Cambridge A/Ls are inferior in academic standards compared to the SL A/Ls. Almost every kid who sit for these exams obtain As. That is the reason why SLMC does not accept foreign A/Ls for registration. Why should a medical school accept low quality students when we have many students with local A/Ls who just missed medical school, sometimes by one mark? How about mediocre kids from poor families who are unable to prepare or sit for these foreign exams? You want them to rot in poverty for ever? Don’t they also have the citizens rights you talk about?

        The way you describe Z scores and its attributions is funny. You seem to have a poor knowledge of how medical profession, the GMOA and the SLMC operate.
        SLMC is the ultimate body that issue licenses to practice medicine not the UGC
        SLMC is the ultimate authority for accreditation of medical schools and medical degrees not the UGC, the President, the health minister or the legal system which have no capability of assessing medical education.
        GMOA and medical students (future physicians) will always look after the interest of their profession, which among many aspects, quality of future physicians who join them. If you call their activities (against a gov. which appear to ignore their concerns) terrorism it shows your ignorance.

        • 0
          1

          You are right. SLMC is the ultimate body. Cancelled exams. of foreign med. grads., the ERPM/Act 16 vindictively. Violated Med. Ordinance for SAITM as per verdict. All these years, had no minimum standards or conformity even to KDU which forced SLMC double standards. Try trusting this ultimate body and your arrogant judgment of London and Cambridge A/L compared to corrupt ‘Z’

  • 3
    1

    Godwin Constantine in “The SAITM” seems to support the concept of private education in medicine.
    This may open a floodgate to private universities in law, accountancy, banking & finance, police, army, foreign service and you name it and we will have it!
    Remember the case of a young politician who scored 98% in a law paper. This genius was never heard of before or after this success. The man was received with bulath and escorted to the AC exam room. A fellow student who protested was dealt with in the usual way.
    Short answers to Goodwin’s questions are
    1. Do we need private medical degree warding institutions?
    Answer: No
    2. Is it possible to provide adequate training for private medical students in the private sector?
    Answer: No
    3. What are the entry criteria for private medical colleges?
    Answer: Three examples Wealth, wealth and wealth
    4. What are the important issues with SAITM
    Answer: The standardization was introduced in 1970 (or there about) to “correct” discrepancies in availability of education between rural schools and “elite” urban schools. Does this ring a bell Godwin? SAITM will cater for the elite in elitist Colombo.
    5. Will private medical colleges affect the state medical faculties?
    Answer: Yes. In due course the private medical colleges will get state support.
    Some general comments:
    (a) We can try increasing intakes into university medical schools.
    (b) Except for Colombo and possibly Kandy, others find it difficult to retain staff. Why?
    (c) KDU is for all purposes is a state funded private university. What contribution has KDU made to medical field in the past six years?

  • 2
    2

    The SAITM issue in reality is a non-issue. It has been turned into an issue only for political opportunity at the expense of students and the future of the country.

    SATIM was technically approved to operate under MR- So it is a JO inspired project.

    Get the Army to intervene to sort out the GMOA like the CPC issue. The GMOA has lost its stature as a respected and noble community of professionals. They are the ugly face of this country and goons of the previous regime.

    • 0
      0

      Tragic that GMOA goons are deceived by JO project which stops at nothing to regain power, promising gold to those who do not know boundaries where to stop. When mind controlled and drugged, money laundering and murders take place. Must think about who will pay the ultimate price for injustice. The Tzars? Watch the leaders in courts tell their own stories

  • 0
    0

    Padeniya = Asgiriya joker= Gnanasara the thug= the dogs that dirty the Road

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