By 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.