A rightful fight for education

By Harsha Subhashana

As an administrative professional working for South Asian Institute of Technology and Medicine (SAITM) and even before joining SAITM, I have been observing the SAITM saga going on for the last five to six years. I was trying my best to find some logic behind the varying arguments against SAITM but utterly failed. The following points need consideration.

Is SAITM enrolling lower grade students for the medical degree?

SAITM enrols only 75 students per batch out of approximately 500 applicants. Therefore even though the cut off mark for university entrance is 3Ss (for SAITM it is even higher, 2Cs and 1S), those who get selected to SAITM are with much better results than the minimum required. 

Even if it is with 3Ss, all A/L students with 3Ss are qualified for university entrance and they have the right to study what they like. It is just Government universities cannot facilitate it due to resource limitations. Otherwise they are eligible to do medicine even in Government universities.

Even though SAITM hardly recruits students with minimum qualifications, many of them get their degrees from the so-called SLMC approved foreign universities and return to the country for practice.

SAITM has also enrolled many London A/L qualified students with 3As and they have no other choice as they cannot enter Government universities.

Government sector teaching hospitals

Medicine is a profession and there is very a little relationship between A/L and medicine. So in the same way, there is a very little relationship between how you perform at A/L and as a medical doctor.

Do SAITM students lack clinical exposure?

It is not easy to compare the Government sector teaching hospitals and a private sector teaching hospital. In the Government sector, there are patients on the bed, on the side of the bed and even on chairs. This is not the same in the private sector and there are standards when a private teaching hospital allows students to examine patients. As this is the same even in the developed world, there are different teaching techniques used in the private sector to provide necessary training to students.

But when SAITM wanted to use few a Government hospitals that are not used by Government universities as their teaching hospitals, the pressure groups went against this. This shows their hypocritical nature. From one end, they argue on the quality of clinical exposure, from the other end they block SAITM students having access to Government hospitals for clinical exposure.

Is it ethical to limit Government hospitals to Government medical students?

Whether they are private medical students or Government medical students, they are citizens of Sri Lanka. Government hospitals are not maintained by Government medical faculties but by the taxpayers’ money. So whether they are Government or private, they should have equal access to Government hospitals.

As the parents of private medical students pay more taxes, they should have better access to Government hospitals. If Government medical students say private medical students should not come to Government hospitals, how about Government qualified medical officers not coming to private hospitals but sticking to Government hospitals?

Pressure groups are on silly arguments such as “If a tuition class does not have a lab, should the Government provide a lab?” If the policy is free education to all, the Government should provide the free labs and free education to all. But if the Government does not have funds to provide both labs and education free, if there is a set of students who can afford private education but not labs, what is the problem in the Government providing labs for them? It is win-win for both parties.

Private teaching hospital

In fact SAITM needs a Government hospital for subjects that cannot be taught only in the private sector such as community medicine and judiciary medicine. 

If not they have their own private teaching hospital, which is the largest among the private hospitals in the country. 

Community medicine is a subject that needs exposure to a cross section of the society, so that cannot be learnt only by studding patients at a private hospital. Judiciary medicine is about post mortems, etc. that is not legal to be practised in a private hospital environment.

Will nationalising SAITM be a solution to free education?

Shortage of free education is due to poverty. The solution to poverty is not to nationalise private institutions. This was proven over and over again during communism. 

A simple e.g.: The worst issue in the world is not medical education but shortage of food. If nationalisation is the solution, the easy solution to food shortage should be nationalising all the food manufacturing organisations and giving it free!

Is free education a myth?

There is nothing call free education. It is an illusion. Someone is paying for any service we consume. Just because we do not pay for it that does not mean it falls from the sky. Private medical students pay for themselves and we all pay for Government medical students’ education. 

That means private medical students in fact pay for Government medical students’ education as well. So why cannot private medical students study what they want by paying their own money? Real free education is freedom for education. That is what a group of people is trying to block for another group of people.

How come only medical education cannot be offered private?

Medicine is another profession, just like engineering, architecture, finance, admin, etc. Currently education opportunities for all the other professions are offered in the private sector and they are in fact equally competitive or sometimes better than what is offered in the Government sector. Another argument in this regard is, medical professionals deal with human lives, so their education needs to be perfect but others’ not! What about engineers then? Aren’t they dealing with human lives? If an aeronautical engineer makes a small mistake, it could be hundreds of people dying at once. What about civil engineers? If they make a mistake, it could be thousands of people dying at once. Even if a bus driver makes a mistake, it could be many people dying and they all deal with human lives. 

If a doctor does a mistake, luckily it won’t be hundreds or thousands dying at once, it is mostly just one or two people and he/she will lose his/her licence. So the answer is not to keep education to Government sector but to provide right education to whatever the profession.

Quality of healthcare

Are these pressure groups really fighting to give a better care to public?

We can understand this when we go to a Government hospital. Not all but the majority is not even in the hospitals, but at their private practices. The moment they get out of Government universities, their prime objective is not to serve public at Government hospitals, but to earn money in the private sector. 

Even the little time they are in hospitals, they do not treat patients humanly. It is rarely that a doctor would have some sympathy towards patients’ queries. 

If a patient tries to talk to a doctor regarding his/her illness, they would jump at him/her, as if it is the biggest crime the patient has done.

If they are so worried about the quality of healthcare offered to public, there are bigger issues they should fight on, such as mushrooming low quality nursing homes, labs and clinics, drug companies selling low quality drugs at very high prices, one-minute appointments of consultation at exorbitant rates and doctors unethical in their practice such as prescribing brands. 

How come they do not ask to nationalise private hospitals and give free healthcare to public? Healthcare is more of a primary need to people than medical education. So it is more important to give free healthcare than free medical education.

Isn’t it funny that we still do not have a single private medical school but import medical education from countries such as Nepal, Pakistan, Bangladesh, Belarus and Ukraine?

Sri Lanka has an excellent track record of healthcare for a longer period thanks to Government and private healthcare institutions. But we keep importing medical education from countries that are not even closer to us where healthcare standards are concerned.

Isn’t it a shame for the whole country?

The Sri Lanka Medical Council could find many private medical schools in those countries to accredit, but it is a pity that there is not a single yet in Sri Lanka. If there is a private university in Sri Lanka, our students will not look for foreign universities and SLMC will have better access to monitor quality of their education.

Foreign medical education

The much-needed foreign currency drain is due to foreign medical education. Due to the petty mindedness of pressure groups, a large number of students go to other countries for a long period of medical education. It affects foreign currency reserves used for their education abroad. 

If we have started private medical education sometime back, by now we would be attracting a huge number of medical students from abroad. Countries like USA, Australia, Russia and even India make big money out of selling education to the whole world.

By having a private med uni in Sri Lanka, the teaching hospital of the faculty will serve the locals at a more affordable price than the other private hospitals as it is funded by the medical students’ funds. This is how Dr. Neville Fernando Teaching Hospital, the teaching hospital of SAITM, is providing superior services at an affordable price. 

This is a more visible benefit to the public of Sri Lanka than the benefit of foreign currency saving. All this time this benefit has been enjoyed by the citizens of some other country as our students were funding med unis of other countries.  

Is Government qualification that great?

If the Government qualification is that great, how could they commit mistakes such as amputating the wrong limb? Why do patients die owing to negligence of the medical practitioners?

Is education a commodity?

Education is a major commodity in the open economy. Countries such as Australia, USA and UK are in the forefront of this and education is already making a major contribution to their economy. 

The world is going forward by making changes to their cultures, geographies, economies and many other factors to meet the new challenges in the 21st century. In the current contest, Sri Lanka is an insignificant in the world’s arena. By lagging behind holding on to the outdated principals in the communist world, we are further becoming insignificant. 

We are already late but not too late to change and update ourselves for the competition. But it is a call of the day and now or never!