PMCs at the cost of free education

Medicine since the ancient Hippocrates era is not only mere book learning but also systematic accumulation of applied knowledge gained through years of practice. This hard earned wealth of knowledge in Medical science was reverently passed from generation to generation. In Sri Lanka we are fortunate to have inherited this well established system of medical education and free health care system which the vast majority of the country benefitted for decades. But sadly it is now at a risk of losing all its prestige in healing the physical, mental, social and spiritual maladies of our people. As we are aware, our country faced a severe traumatic and agonizing past of privatizing medical education on many occasions, especially the episode of Colombo North Medical College which thankfully came to a favorable conclusion but with the loss of many precious lives. When we review the history of privatizing medical education there were eight attempts of establishing Private Medical Colleges (PMCs) in Sri Lanka during the past three decades ending with the Malabe issue. Main Argument The main argument advocated by the proponents of PMC was, out of 210,000 students who sat the GCE Advance Level Examination in 2007, over 100,000 were qualified for university education. However, only 16.53% of those students were admitted to state universities, primarily due to the limited capacity available in universities. We would like to highlight, that according to the central bank data, out of the entire population of the country less than two percent can barely bear the expenditure of LKR 100,000 per month for one childs education in the PMC. According to the data available at the UGC (2007) 31.06 percent of biology stream students who are eligible for higher education were enrolled into state universities, and the above portion was out of 13.69 percent who opted for the biology stream. Only less than 2 percent of this percentage could afford a PMC degree. Therefore, it is apparent the state is wasting a colossal sum of money for the benefit of merely less than 0.188 percent of all university eligibles. Those advocating PMC argue that a considerable amount of foreign exchange which is expended for education abroad by local students to the detriment of the economy of Sri Lanka. Going by the UGC data, it is seen that the foreign exchange spent by the country on those who obtain foreign medical degrees is about LKR 1600 million, which is insignificant compared to the tremendous amount spent on some food items imported such as sugar and tined fish which is LKR 20,000 million and LKR 15,000 million respectively. Moreover, in the COPE report for 2006 it was highlighted that the amount lost due to bribery and corruption was LKR 150,000 million (one third of the countrys GDP). They emphasize that the educational standards and quality of some of the educational institutes abroad are not recognized by any regulatory authority of Sri Lanka and as such, there are greatly varying standards for the same qualification. Act 16 (ERPM) Though it may be true, the fact is that the current Malabe PMC is much more unacceptable and deficient in many aspects, than a whole lot of other foreign universities. We wonder how they can afford to produce a doctor with competence, compassion and care without ever seeing patients. This is really a laughing matter. A hospital is an essential requirement for a medical faculty. Sadly Malabe lacks such a facility. In our view, it is clear that the Malabe PMC has not recruited a qualified staff. A more shocking revelation is that the majority of the staff serving South Asian Institute of Technology and Medicine (SAITM) currently is

foreign medical graduates who could not get through the Act 16 examination (ERPM) even after many attempts. These tutors who have not passed Act 16 examination are, according to Sri Lankan standards cannot ever be considered as doctors. Moreover, it has to be stated that foreign graduates who sit the Act 16 examination suffer a failure rate of nearly 80 percent. The amusing point is through a special gazette the Ministry of Higher Education has decreed that the PMC students need not sit for the Act 16 examination. This means, the category of the 80 percent students who failed Act 16 in the past will now be awarded medical degrees. This means that Sri Lankans may be treated in the future by doctors who have not passed Act 16 examination or Sri Lankan standards. The PMC contends that though their teaching staff is not adequately qualified, it cannot be said that it is an institute producing substandard doctors. With total respect to their statement, I would like to point out that if the first statement is accepted how the second can be considered as true under any logical argument. Furthermore, if we consider the quality of the students who are now being enrolled and studying in the SAITM, it is surprising to find that some students who do not even have 3 simple (S) A/L passes are now studying in the SAITM. For instance, we have proof that two students who have failed A/L are enrolled by them. The first is a female student who has failed Chemistry in 2007 and she has not even sat for the next attempt. The other case is of a male student from a leading boys school in Negombo who failed Physics in A/L examination, 2009. Funds and Grants We also need to highlight the constraint of funds and grants for state universities in Sri Lanka. Over the years Sri Lanka has decreased the grants allocated to education significantly. Compared to countries such as Cuba, Norway and USA which are allocating 8.5%, 6.8% and 5.6% respectively of their GDP for education, Sri Lanka only allocates 1.87%. Grants for university education in Sri Lanka were 4.1% in 1978, 2.97% in 1990, 2.46% in 2000, 2.27% in 2008 and 1.87% in 2011. This clearly signifies the gradual choking of universities of their financial livelihood, while equipping PMC with millions of rupees. Even many other countries which are truly concerned about their educational systems such as Cuba and New Zealand have rejected the concept of PMCs. In the UK and Australia, countries which gain enormous amounts of foreign exchange through education market, have issued permits for only one and two PMCs respectively. They do not want to devalue their high educational standards; hence their eligibility criteria or qualifications for both Government and Private Medical Colleges remain the same. But here in Sri Lanka, our relevant authorities of education announced that they are to issue permits for 3 more PMCs in addition to the Malabe PMC. Reliable sources of information reveal that there are proposals for 15 more PMCs in the pipeline. This is the result of obnoxious efforts of an opportunistic businessman, no doubt encouraged by some political figures with avaricious mindsets. So, at least in this eleventh hour let us wake up to this irrational and catastrophic decision of opening PMCs. We should comprehend that the MBBS is not to laureate anybody but to serve our people. It is our courteous entreaty that the government retracts this unpatriotic and abhorrent venture of opening Malabe flood gate of PMCs which indeed devalues and endangers medical education and health care sector and instead strengthens the state universities pulling off with sticks and wire, with better grants and facilities. Samandika Saparamadu.