11 December, 2017

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What Is The Real Problem Of Private Medical School?

By Bruce Tamilson

Bruce Tamilson

The court has instructed to Sri Lankan medical council to recognize the private medical school. There is ambiguous opinion among public but all the Sri Lankan doctors vigorously oppose this move. No one has the absolute ability to predict how it will affect and whom it will affect. We need to wait and see.

Medical profession is no more a service or charity oriented. It is almost business-oriented. Most of the doctors do private practice and are money oriented. I am not going to deny that there is handful of doctors who are service minded. The main fear for doctors already in practice is increased competition in private practice. In Addition, in Sri Lanka, to become a doctor you need to be super talented in memorizing and, accordingly well respected. If there is easy way to become doctor within the country, the respect towards the doctors may fade. Only outsiders and public can feel the selfishness and jealous of doctors who refuse alternative entry into SLMC register.

Will the quality of care be affected? I do not think that will be the case. The role of SLMC is to maintain the standard of doctors. Therefore, SLMC can introduce common exam for all the candidates. The similar system is operated in USA and now UK is adopting that system. There are plenty of ways that SLMC can ensure standard of Doctors is maintained. If someone experience or witness malpractice, they need to notify SLMC and it can investigate, resolve and prevent the incidents. Therefore, Private medical studies will downgrade the quality of care is not a convincing argument.

In UK, only consultants or GP [independent practitioner] can do private practice. The juniors who are in training are not allowed to practice independently. This phenomenon makes sure the patients are safe. In contrast, in SL, any junior doctor who has full SLMC registration can open his or her own private practice. Obviously, juniors do not have enough training and therefore not safe to practice independently.

In Sri Lanka, some Doctors use the private practice to charge the patient for treatment in government hospital. This is ridiculous. They use all the facilities of government hospital and charge the patient out side the hospital. They find a hole in the law and ingeniously earn money. “If you pay money, I will do the surgery otherwise, my junior will do it.” This is how materialized in private practice. This is why doctors ruined the public support and respect.

How many doctors who are trained for free in Sri Lanka escaping to overseas? Well, a significant numbers of doctors go to UK, USA and Australia. I am not going to state this is wrong. Everyone should have the right to work wherever they want but Sri Lankan government can put some restriction such as mandatory service for certain numbers of years to the country before leaving. It is easy to implement because arrival country always request document from SLMC, thus this can be used as tool of controlling.

We do not want anyone to become a doctor by paying Money. This could be quite right but not completely if the doctors march against private tuitions and private schools. Those who enter into medical studies are studied in well famous schools and had lots of private tuition. There are students who cannot afford tuitions. So the money plays a role in selecting medical candidates in conventional system. Definitely, the money play roles for certain extend.

Other argument of doctors is People who have low grades in Advance level are allowed to study medicine in private universities. Anyone passed relevant subjects and if the university board allows that he or she is fit for further education, they can study any subject in University. This is norm but Medicine is competitive field therefore, usually people who get higher grade get seats. Also, you may have noticed, people who get low grades from deprived areas can enter medicine and some one with higher grade from another district may not enter into medicine. In nutshell, higher results are not vital for medicine; you just need results that meet the eligibility criteria.

Do you think the Education system of Sri Lanka is fair? Not at all, it makes the students bound to books. It only assesses the memorizing ability. It completely ignores rest of the entities. For instance, if you want to enter into medicine in UK, they look for overall qualities including academic, non-academic, aspiration and commitment. A person who shine in 5th standard not necessarily excels in ordinary level and a person who does not excel in ordinary level may shine in advance level. So these examinations do not reflect the person abilities in real. It only reflects the level of training for that particular exam. Similarly, a person with ordinary pass could perform well in Universities with better training. Numerous medical specialties are available. Not all the specialties require identical skill of memorizing. Surgeon requires hand eye coordination skill where radiologist or psychiatrist will involve different skills. How can the GCSE advance level exam identify those skills and find a suitable candidate for medical specialties? Fundamentally, it is not fair selection.

Because of the opposition to private universities in Sri Lanka, it does not have vast numbers of private institutions. This causes major impact on Sri Lankan economy. There are substantial number of students who go abroad for higher education and facilitate the economy of Russia, China, Bangladesh and India. For example, Philippines create excess quantity of nurses every year and they go to each corner of the world and do a respectful staff grade of job and support the home economy. In Sri Lanka, no such planning, so all the people who does not get University entrance go to Middle east and get abused for low pays. A famous proverb in Tamil “ A Frog in the well” it does not know the world. A person goes to university from village and not used anything other than book and university less likely to think broad mindedly.

It is very selfishness to oppose private education. Why can’t someone become a doctor with the money? No other reason apart from selfishness. Please do not talk about standard, SLMC Can talk about standard and if standard is not met, can take action. As long as the doctor is safe and maintains the standard, none of your business is to talk how he or she became a doctor. How will it affect the poor student? I could not think an answer. Poor student will still get a place in Government University as usual. In fact, there will be more vacancy for poor students in Government University when rich people choose to study in private. The extreme form of jealous is to restrict others to spend the money on education. How silly if I tell the doctors, do not drive cars because poor people do not have car? Similarly, How silly it is to tell to a successful businessman to don’t spend money on your son or daughter’s education.

In the world, if you compare the performance and achievement of private and state educated students, the one who privately educated are more successful individual. The state educated can only score high in exams but that is not only the life. The private education creates a personality not only the exam results. I am sure; the private education will provide quality training to those who pay for it. How may doctors in Sri Lanka send their child to private school? How many doctors in Sri Lanka send their child or siblings abroad for private medical education? Medicine is not a Family business for Doctors. Rich or poor, anyone can become a doctor. Free Education should be based on the merits and need of country, not the private education. Do not scrutinize how someone becomes a doctor. Please do challenge whether the standards are met or not.

Doctors who studied privately do compete with government graduates in postgraduate examinations. They do progress and prosper well in their career. So it is meaningless to stereotypically assume the standard will be compromised without any evidence. There is shortage for doctors in Sri Lanka; The Sri Lankan doctors should welcome the new doctors to share their workload.

SLMC’s performance is inadequate in comparison with foreign countries such as GMC of UK. GMC give proper guideline for doctors and maintain the standard in many ways. GMC protect the patient from harm and abuse. In Sri Lanka, There are incidents where Doctor slapped, banged patient or bullied juniors. In UK, these types of incidences will lead to suspension of license to practice. The SLMC should also imply new guideline and policies for doctors. SLMC should investigate misconduct, malpractice and patient complaints. SLMC should not allow non-fully trained doctors [non –consultants] to practice independently in private. SLMC should put the patient first. Have you ever heard of a doctor was sacked by SLMC because of misconduct or malpractice or for anyone claimed for medical negligence? There are cases every year in USA and UK where doctors are sacked for misconduct and malpractice or sued for medical negligence. Should I believe that no doctors make mistake in Sri Lanka? Or the SLMC does not play the role well?

There are number of doctors in Sri Lanka act like dictators in government hospital and in society. A lot of incidents occurred in Sri Lanka where doctors harass patients and nurses. This situation must change. Doctors need to respect patients in government hospitals. Soon, the Sri Lanka will get the world standard where patient become boss of their health and doctor become performer of patient’s choice.

Undeniable truth, there are many inadequacy in government hospital where patient’s life are put at risk. In Sri Lankan history, doctors never marched for patients. How the doctors will expect the public to support them. Some predicts, following private medical school, there will be more private hospital, which leads to end of free national health services. Why on earth these folks do not march against private practice and hospitals first? Of course, if a family member of doctor gets ill, they will go to private hospital. The Single fact is enough to judge the standard of government hospital presently. Fair enough, private hospital has the better quality of care. I should be a communist to oppose private hospitals. Because I am poor, it does not give me the rights to restrict the rich people choosing better care. I need to fight for my free care rather than stopping rich to pay for better.

I should call them clever astrologer, because only astrologers can predict without evidence or logic. They say there will be reduction in medical seats in government universities in the future. There are other subjects, which can be studied privately. This is the case for many years in Sri Lanka. Does it mean those seats are cut from the government universities? What made you to think that there will be drop in government medical seats? People have the mind set to say anything to secure their benefits. They Express Complex mind set of assuming they are the genius in the world and other professions are second-class. This mindset of superiority will change with private medical education.

What actually the SLMC and doctors of Sri Lanka should do is, instead of blindly opposing, should agree for piloting any new notions as western nations do. Then weigh the pros and cons to make a conclusion. Without a trial, merely opposing shows the vindictive nature of the act.

I do not support any particular organization. I do support the private education sector including medical education. I wish more and more private universities would be in Sri Lanka. In the future, double the number of students should have higher education. I believe Universities should create job-oriented studies than plain BSc or BA. There should be degree programmes for skills such as cooking, photography, carpenter work, cloth design, hair styling and etc.

Appropriate authorities should ensure the quality of educations and standard of universities are maintained. We can learn the positives and negatives of private education from Bangladesh and we could structure our future better.

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Latest comments

  • 12
    1

    Justice has truly arrived. Most doctors don’t spend time protesting as they are too busy. Few TU dictators only make decisions. The writer identifies jealousy but I would say its deeper. These protesters are now shame based in the verdict of illegal stand of SLMC violation of the Medical Ordinance (ultra vires). The false accusatory shame they tried to put on SAITM has returned on their own heads. Its a small area and issue that the courts put right for SLMC. They can function as usual. But good if they appeal as the SC can solidify SAITM position at an even higher and wider level. Hope they prove the Mala Fides( malicious intent) lies of SLMC and its deceiving god, the GMOA as well. Writer said their mentality is A/L. They sit 3 times to improve that goal, but no mindset of patient care, and MBBS is the tool for money making. Sad for profession. Hope privates do good.

  • 7
    2

    As Tamilson indicates let the SLMC maintain the standard and quality of doctors. The government must venture and break the closed shop that allows the doctors to dictate who can register with SLMC.

    Many Sri Lankan doctors are mediocre and are book worms who enter university at their last chance. They go abroad and try to maintain their superior position as they are used to in our country of poor peasants and are told off by the nurses who, in most cases, know more than these doctors. The expatriate GPs seldom refer to any medical journal and are unaware of new drugs or advance in medicine.

  • 2
    5

    Bruce Tamilson

    RE: What Is The Real Problem Of Private Medical School?

    “The court has instructed to Sri Lankan medical council to recognize the private medical school. There is ambiguous opinion among public but all the Sri Lankan doctors vigorously oppose this move. No one has the absolute ability to predict how it will affect and whom it will affect. We need to wait and see.”

    Q. What is the real underlying issue? It is the “caste” system of the SL Medical Council, most of whom are graduates from the Sri Lankan Public Medical Schools.

    Are they protesting the dilution of the medical ‘caste” system, or are they really pretesting the quality and training of the graduates from the Private Medical schools, and thereby putting the public at large at risk. We know that there are quack doctors out there. Every medical graduate must be subjected to acceptable testing to make sure they have the knowledge to practice medicine and treat or service the patients.

    One issue Amarasii has is that the general intelligence of the Private Medical School graduates may be lees than those from the Public Medical Schools, because of the competitive selection criteria.

    While the Sri Lankan public almost exclusively served by the Sri Lankan Public Medical Schools graduates, the percentage of the diabetics in the population had increased and so has obesity.

    Rising diabetes in Sri Lanka

    One in five adults has either diabetes or pre-diabetes and one-third of those with diabetes are undiagnosed, reveals one of the first nation-wide studies to be conducted in Sri Lanka. This has startling implications for the spread of the disease here.

    http://www.sundaytimes.lk/090621/MediScene/mediscene_7.html

  • 6
    1

    I think Doctors are also pushing too much because simply they are greedy and selfish. They should understand how doctors are unemployed in Britain. Because of new technology, simple prescription writing can be done even with software. In Sri lanka, former Apothecaries (AMPS) and Nurses can fulfill some of the doctor duties. Besides, India has 1.3 billion people. Indian Iniversities are rolling out graduate like out from manufacturing plants. Many are willing to work in Sri lanka as they do right now. It is the same in China.

  • 3
    1

    IF they think Prvate Medicall college is below par. evaluate it and increase. IF APothecaries (AMPS) are allowed to practice, why SAITM graduates are not allowed. Increase the standards.

    Are there any statistics to show the performance of other medical graduates, their misbahaviours, negligence, arrogance, mal-practice etc ?
    I think Sri lanka is prescribing pain killers and anti-biotics without any hesitation.

    • 4
      0

      jim softy

      “I think Sri lanka is prescribing pain killers and anti-biotics without any hesitation.”

      Are they prescribing antibiotics for viral infections as well?

  • 6
    2

    Bruce Tamilson,
    You put out your points very well. These hypocritical GMOA parasites should be exposed. As you say, just having 3 A levels is no indication of your performance as a doctor (or engineer, electrician, plumber or accountant).
    Let even O-level qualified students be allowed entry (with an appropriate foundation course) into SAITM or any future medical colleges

  • 4
    14

    its obvious some idiot who failed advanced level has written this with full jealous on doctors. Some of the same kind of idiots are appreciating him.

    • 9
      3

      Munasinge! you are one of the perfect example of Sri Lankan doctor’s mentality. You do not have the knowledge or professionalism to discuss. So just under estimate others. Soon things will change dear.

    • 2
      0

      munasinghe

      “its obvious some idiot who failed advanced level has written this with full jealous on doctors. Some of the same kind of idiots are appreciating him “

      Interesting comment. There should be a general intelligence test as well, for admission to medical schools and the universities, besides the subject tests.

      That way, the admission is not fully tilted towards those who memorize, and crammers, and levels the admissions for thinkers, problem solvers and those with sufficient IQs as well. The “Processing Capacity” of the students also should be tested.

      Many years ago, the IQ of students at Peradeniya University was measured. The IQ’s from the Hughes to the lowest are given below. It is high time, every student who is selected to highers education be tested for IQ, so that they can be directed appropriately based on their IQ’s.

      Sciences-Physical Sciences, Physics, Chemistry, Mathematics

      Engineering Faculty

      Medical, Dental, Agricultural, and Biological Sciences and Faculties

      Arts Faculty

  • 11
    2

    My Munasighe, from your tone it’s loud and clear you are from the GMOA
    medical terrorists mafia.

    Man, we read readers’ comments in every news outlets in Sri Lanka, 99% of them were highly critical and abusive of your mafia outfit, the despicable GMOA medical mafia. The entire public of the country are terribly against your GMOA medical mafia’s heartless ways. In facts one comment said – ” if things go like this, the public would soon pellet the GMOA doctors”. See to where and which level the GMOA medical mafia brought down this noble profession. GMOA medical mafia has created the condition so that all doctors, including the good ones lost the trust and respect of the public. Nowadays people wouldn’t give a damn shit for our doctors owing to GMOA mafia’s greed, jealousy, arrogance and meanness.

    The medical profession should be marchent of mercy but in Sri Lanka the GMOA medical mafia has made it a merchant of pain, death, and miseries.

    Now they say, they going to go international, this abundantly exposes their callous stupidities. This would be like, cutting their own throats, when our qualifications are downgraded, the adverse affects of which would affect not only the country but including them, their kids and their generations to come, if all of them choose medical profession, and want to go abroad to practice.

    They are sadly mistaken that international organizations would behave like the SLMC. They wouldn’t act like a fools, they would thoroughly go through all the facts and figures in all areas and angles, do a fine and meticulous investigation before coming to conclusions. If they get to know the motives behind this move that would throw back stinking shit on the faces of the GMOA medical mafia.

  • 7
    0

    Very valid and logical points. Of course the majority of the doctors, mostly consultants have created the “Medical Mafia”. Forget about private medical colleges and the absolutely corrupt private hospitals which are patronized by consultants working in both the public and private sectors, creating a very obvious double standard with absolutely no respect or regard to patients. Even if a top specialist (consultant) from another country (ie USA or UK) were to try and practice free of charge in our beloved country, the local doctors mafia will make sure that all avenues are shut. These consultants have deeply tarnished the image of the noble profession. How ever skilled and intelligent they may be, they have forgotten the fundamental point in treating patients; the Hippocratic oath!

  • 3
    7

    SAITM students are those who can afford Rs. Six Million for a medical degree, and who scored very low marks – which do not enable entry to ANY medical school – in the A Level.

    The course has been found to be not up to the standard of other medical schools by Teams appointed by the SLMC.

    SAITM is actually a financial enterprise of Neville Fernando to sell a much wanted commodity – a Medical Degree – in the open market, for those who can afford it.

    • 4
      0

      Let SAITM students sit for the government exams to qualify and practice locally.

  • 5
    0

    One thing that came to light in the SAITAM judgement is that among other things the applicants to register with SLMC should have a good character. Not only at the time of registration but they should continue to be of good character. I do not know how many of the present Doctors will qualify under this criteria if adopted.

  • 3
    0

    Very good points and need to be taken seriously. However i hardly think writer understands the SAITM issue.

  • 1
    1

    “One issue Amarasii has is that the general intelligence of the Private Medical School graduates may be lees than those from the Public Medical Schools, because of the competitive selection criteria.”

    Do you really believe that IQ scores, exam success and the character qualities, wisdom and knowledge needed to be a good physician or surgeon are directly related?

  • 5
    0

    I am a doctor by profession with almost 20 years of experience, I will just stop with that because it is not about me, but I want to share the three of the patients experience in Colombo Srilanka, first is my father who was being seen for 10years and was diagnosed with AGE RELATED PROBLEMS(this is commonly being given in SL) later turns out to have completly reversible brain cause which could have easily been detected if the examining neurologist and other doctors bothered to talk, test and order a scan in the early stage called obstructive hydrocephalus which was later found in an advanced stage in Singapore.Second is my cousins husband who recently died due to the negligence and EGO of the consultant who refused to listen to others suuggestions, Patient after 5days of a surgery was readmitted with bleeding and was put on normal saline and left for more than 24 hours, when he had already lost 50% of blood over days.I know firsthand of few others who have suffered in the same manner.Is this the care we want???

    • 1
      0

      What you say is serious. Please share the information in social media and raise awareness. This should not be done to target Sri Lankan doctors but only to develop our health sector and avoid such incidents in the future.

  • 2
    0

    It is said that Doctors bury their sins. We have no culture of taking Doctors to courts in cases of medical negligence like in western countries. There Doctors are not allowed to practice without insurance cover for negligence. Michael Jacksons Doctor Conrad Murray was jailed for prescribing excessive sleep aid Anesthetic PROPOFOL which killed Michael Jackson. Here we simply bury our kith and kin subjects of medical negligence.

    • 0
      0

      Upali,

      Doctors have to conform to the Hippocratic Oath.

      http://guides.library.jhu.edu/c.php?g=202502&p=1335759

      Those who deviate are punished – even struck off the list of medical practitioners – to varying degrees, by medical councils of various countries.

  • 3
    0

    Dear friends don’t waste your valuable time In spending to justifyig the private medical education to those idiots shameless jelousy nuts.this is not something to talk because people who studied with help of public’s money protesting against to those who paid for their studies and made them a medical officers.
    Only thing we have to do is that if those doctors not doing their job for what they are paid for. Gather the public for massive protest against them and demand them to pay back all the expenses that public bares to make them a doctor.

  • 1
    0

    SLMC, Should be a government body!
    Few doctors cannot hijack the policy making in SLMC!

    University students who waste time protesting too much must be removed from the universities. These idiots have no value of the free education and they think it is their right to protest on every stupid thing happenning in the Bananaland!
    Don’t they have any idea how much tax payers spend on them?

    If they strike, GMOA heads must be brought to courts on the charge of contempt of court!

  • 0
    0

    Justice, its sounds, you too in the pay of the GMOA medical mafia.

    If Neville Fernando, and SAITM are breaking the laws of the land, there are many peaceful ways and method to nail them, rather than taking the innocent poor patients, and the country into ransom.

    For doing all these third rates and despicable things all of you even wouldn’t get an easy death. Sure all the curses in the universe would befall on all of you.

  • 0
    0

    Determining the quality of a medical college should lie with medical council. They may not correct always in a system like this. Real danger here is determining that quality goes to the hands of politicians.I could really imagine the irreversible severe repercussions due to such a decision On the other hand all other decisions would go to the hands of politicians thereafter freely.

  • 3
    0

    Selling Degrees? We have been doing this for years. Let me give two examples. Student A produced a totally unsatisfactory dissertationfor MA. She was failed by the first set of examiners. But she had friends among the professors. They manipulated the faculty to appoint examiners who would pass her. The Head of Department refused to agree and resigned. A temporary head was appointed from outside the subject to do the needful. Once the girl passed, he resigned. No appeal to the UGC or Minister or Council of the Univerity worked and today this girl is on the teaching staff of the same University! Second example. Ask any independent academic to read the dissertations for PhD in the Humanities/Arts/Social Sciences and at least 80% would fail. Who strikes for these things… who is interested? The Medical Mafia has power over life and death (of the sick). Power corrupts and absolute power corrupts absolutely. Already in the second and third year of Medical Studies, students are discussing how much money they can make and the vehicles they could purchase!!!
    Why repeat the story of the lion and the straw. The lion will neither eat the straw nor allow the cow to eat it. But he remains the king of the jungle… So will doctors because patients need them!!

  • 0
    0

    We do not want too many mediocre Medical schools in Sri Lanka. We do not want those students who do not do well in their Advanced level exams to enter Medical Colleges. The private Medical colleges are there to make money by getting the rich peoples children to do medicine. There should be a common final examination for all Medical Colleges be it private or not.

  • 0
    0

    Giving registration to SAITM graduates without assessing their knowledge is not a good decision, on thd other hand if you ask them to sit for act 16 we all know what will happen to them, the exam is conducted by SLMC without being transparent about the exam and they will faill all the SAITM students even if they do well. So IMO the best way is to give them mandatory training in a government hospital (not in a teaching hospital since the local graduates will strike for that as well) for each subject (of course ask them to pay fot the training) and then make them sit for an exam simillar to ERPM but with more transparency. If they hae the sufficient knowledge they would get through

  • 0
    0

    I am worried about how these private graduates are going to be bullied at work.

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