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SAITM and private medical schools:

One bad start should not lead to


throwing away a good idea

Undergraduates in medical faculties of State sector


universities in Sri Lanka have been up in arms against
SAITM right from the very beginning Pic by
ShehanGunasekara
Offering a medical degree without approval by medical
authorities

Monday, 20 February 2017


Opposition to SAITM

SAITM, the abbreviation for Sri Lanka's newest private university,


South Asian Institute of Technology and Medicine (available at:
http://www.saitm.edu.lk/), has been denoting a derogatory
meaning in Sri Lankans' present local vocabulary.

It is a private initiative, done at private costs, to offer a solution to


one of Sri Lanka's chronic problems relating to medical education.
That problem is the failure of the Government to meet the
aspirations of all students seeking to continue for a medical
degree at a State university.

Normally, when the private sector offers a solution for such a


chronic issue, it should be appreciated, recognised and upheld.
Yet, a large section of society has chosen to reject it. Criticisms
have been levelled at it as a 'private sector degree shop' that
produces low quality graduates, specifically, in medicine.

Undergraduates in medical faculties of State sector universities in


Sri Lanka have been up in arms against SAITM right from the very
beginning. They have been supported, by word, deed and big
brotherly protection, by the powerful Government Medical
Officers' Association or GMOA, the trade union that holds
monopoly power over the professionals who provide healthcare
services to Sri Lankans through State sector healthcare facilities.
Its website contains reports after reports calling it a 'corrupt
institution' or 'illegal institution' making its stand on SAITM clear
to its membership as well as to fellow citizens (available at:
http://www.gmoa.lk/index.php/2016/01/issues-related-to-pmc-
malabe-saitm/).
A higher learning institution approved by BOI

According to GMOA, SAITM has cheated the Board of Investment


or BOI, the Government and the community at large. It had got
approval from BOI, says GMOA, to set up a higher learning outfit
called South Asian Institute of Technology and Management.

In the original application to BOI, there had not been mention


about its offering medical degrees in Sri Lanka. The only
indication in that application had been that it would offer training
courses in a number of areas including nursing and healthcare
services. But later, it had, alleges GMOA, surreptitiously
substituted Medicine for Management so that its abbreviation
could stand as it is and started to recruit students for its medical
degree programmes.

SAITM is silent on this allegation. But according to its website, it


had got itself affiliated to a medical degree awarding academy in
Russia called Nizhny Novgorod State Medical Academy or NNSMA,
a medical college that had existed since around 1920 and is
presently ranked at around seven among 46 odd Russian medical
colleges. However, it is not in the list of global top medical
schools. Thus, as far as the quality standards in Russia are
concerned, NNSMA does not appear to have any shortcoming as a
medical degree awarding higher learning institution in that
country.

According to the website of Sri Lanka Medical Council or SLMC, its


current list of recognised foreign universities does not include
NNSMA. But a letter purported to have been issued by its
Secretary in 2009 and reproduced in a report filed by GMOA has
confirmed that the six-year medical degree leading to the award
of Doctor of Medicine by NNSMA had been a recognised medical
qualification at that time.

It appears that this approval has now been withdrawn so that


itsmedical graduates cannot practice as medical professionals in
Sri Lanka. This applies to both the medical graduates proper from
NNSMA and those who would pass out through the hybrid facility
at SAITM.
Thus, the first mistake done by SAITM has been that it had got
itself affiliated to a foreign medical college which is yet to receive
the nod of SLMC. Hence, the students joining SAITM for medical
degrees were exposed to the risk of not being approved by SLMC
even if they would get their medical degree after following one
year's study programme in the final year at NNSMA.
SLMC has no power to recognise a local private medical
school

Apparently in order to overcome this problem and bypass SLMC,


SAITM has got the approval from the Ministry of Higher Education
at a later stage as an institution that can award medical degrees
in Sri Lanka. Accordingly, SAITM can now award its own medical
degree without having to get its students to follow a prescribed
course at NNSMA.

Though SAITM is a local approved university, SLMC has no


business of approving its medical degrees since it has not been
established under the Higher Education Act of 1966. But
according to statutes, all medical graduates have to sit for a
common eligibility examination and SLMC was required to allow
SAITM graduates too to sit for this examination along with State
university medical graduates and those passing out from the fee-
levying medical school run by Kothalawala Defence University or
KDU, a higher learning institution functioning under the Ministry of
Defence rather than under the Ministry of Higher Education.

SLMC, after examining the clinical training facilities available to


SAITM students, has refused to register those graduates as
qualified medical practitioners in Sri Lanka claiming that their
clinical training is below the required standards. It would be
interesting to see whether SLMC would apply the same yardstick
to medical graduates passing out from KDU since it is also not a
university established under the Higher Education Act of 1966.
GMOA is opposed to SAITM but not to KDU

There have been a lot of protests by medical students in State


universities against SAITM functioning as a medical college right
from the very beginning. GMOA says in its website referred to
above that at the time SAITM started its medical education, it did
not raise its voice loud enough to protest against what they have
termed as an 'illegal institution'. It has regretfully admitted that
not making its voice against SAITM at that initial stage was to its
'disadvantage'.

But this was to change, according to the website, after its current
President, Dr. Anuruddha Padeniya, returned to Sri Lanka after
overseas training to assume its leadership once again. According
to GMOA, it was Dr. Padeniya who had pressurised this otherwise
militant trade union 'to take a clear stand on the issue'. What it
means is that had it not been for Dr. Padeniya, GMOA would have
accepted SAITM as a recognised medical college just like it had
accepted the medical college run by KDU. Curiously, the website
of GMOA does not bear any evidence that it had protested against
that medical college at all.

Thus, allowing a single person to pressurise the membership to


protest against SAITM poses serious issues relating to the
governance structure of one of the prestigious associations made
up of top professionals in the country.
GMOAs inquiry into SAITM

However, GMOA had commissioned an inquiry in 2010 under the


chairmanship of its President, Dr. Padeniya, into the medical
degrees being awarded by what was known at that time as the
Private Medical College at Malabe. This report, which could be
called the Padeniya Report, is available in the website of GMOA
for reference by the public.

According to the correspondence between SAITM's founder Dr.


Neville Fernando and SLMC and between BOI and SLMC as
reproduced in the Padeniya Report, SAITM had been called at that
time in its original name, namely, South Asian Institute of
Technology and Management. Thus, its transformation into South
Asian Institute of Technology and Medicine would have taken
place much later as a marketing device.

SLMC has written to Dr. Neville Fernando in 2009 that though it


had recognised the six-year medical degree being awarded by
NNSMA for registration of practitioners in Sri Lanka, it has no
powers to recognise any degree being awarded by an institution
not set up under the Higher Education Act of 1966.

What this means is that, since the Private Medical College had not
been set up under this legislation, its degrees cannot be approved
by SLMC. Thus, the management of the Private Medical College at
Malabe had known as far back as 2009 that its graduates cannot
register themselves in Sri Lanka as medical practitioners under
the existing laws. Yet, this information had not been conveyed to
parents or students who had chosen it to pursue medical studies.
To the contrary, it had misinformed them that the particular
college is being supervised by SLMC, prompting the latter to issue
a public denial.
SAITM is not approved to run a medical school

The correspondence between BOI and SLMC in 2010 has revealed


that SAITM had been a BOI-approved private venture and allowed
to conduct training courses, and not degree courses, in
management, nursing, languages, vocational studies, health
science and technology areas. BOI had confirmed that the original
application had not asked for permission to run a medical school;
nor had it indicated that it was affiliated to NNSMA which is a later
development.

It further reveals that BOI had granted approval to SAITM in 2008


without referring it to any Sri Lankan authority involved in the
subject matter or verifying whether SAITM had got approval from
such authorities. Thus, it appears that as far as BOI had been
concerned it was another private business venture which should
seek out its market as well as its success through its business
operations.
Padeniya Report is critical of SAITM

The Padeniya Report had not been kind to the private medical
college at Malabe. It had criticised the college from many
viewpoints, some relevant and most others irrelevant.

The relevant criticisms had been based on the irregularities


surrounding the establishment of the Private Medical College at
Malabe. It was a training institution authorised to conduct training
programmes in management and not in medicine. Thus, its entry
into medical field had been an irregularity, according to Padeniya
Report.

It had not got approval from University Grants Commission or


UGC to run a medical school in 2010. Its claimed-affiliation with
NNSMA was suspicious since that had not been presented to BOI
for approval and nor had it been established that Russian
authorities had approved it. Thus, the Padeniya Report had
concluded that SAITM had misled both parents and students;
cheating them in this manner, the Padeniya Reportclaims,
amounts to a financial fraud.
Some criticisms are irrelevant
However, most of the other criticisms levelled against the private
medical college at Malabe in the Padeniya Report are irrelevant.

Based on the presumption that these graduates are of inferior


quality, the report had claimed that the medical graduates
passing out from this college would erode the reputation of Sri
Lanka's medical practitioners. It is indeed too much to say that a
few graduates could do such damage to a profession which,
according to the Padeniya Report, is of high standards and quality.

In a similar tone, the Padeniya Report had expressed the fear that
those medical graduates could cause Sri Lanka's high healthcare
indices to fall over time. That is also a presumptuous claim.

They could also do much harm, says the Padeniya Report, to Sri
Lanka's plan to set up a knowledge hub, an avowed goal of the
previous as well as the present Government. In fact, if SAITM is a
success, it would definitely help Sri Lanka to build its reputation
as a knowledge hub.

The Padeniya Report also charges SAITM for derailing Sri Lankas
attempt at promoting medical tourism in the country. That again
is too much to claim. The success of Sri Lanka as a medical
tourism destination will depend on the quality of services
provided by both the State and private healthcare facilities.

The issue was highlighted by this writer in a previous article in


this series that Sri Lankas private healthcare service providers
should benchmark their service to best global practices (available
at: http://www.ft.lk/article/189900/Private-healthcare-providers-in-
Sri-Lanka-should-benchmark-with-better-service-providers-
abroad). This proposition in this article applies to state sector
healthcare providers as well.
SAITMs other operations are also at stake

The opposition to SAITM by a section of university students,


GMOA and some political parties has been based exclusively on
its involvement in medical education. In addition, SAITM is
involved in offering both management and engineering degrees
with affiliation with two foreign universities.

Its management degrees are awarded by UKs Bucks New


University. This university has a long history dating back to 1891
when it was started as School of Science and Arts. But, it was
elevated to university status only in 2007 and therefore is yet to
establish its reputation. Being a new university, it is not ranked
very high among British universities today; in fact it is ranked
close to the last few British universities on the league table. It is
still not ranked globally by the Times Higher Education World
University Rankings but it could happen in the days to come.

Its engineering degrees are awarded by Thailand based Asian


Institute of Technology or AIT which is a reputed university in that
subject area; students in engineering complete the first two years
at SAITM and the last two years at AIT. About 200 SAITM students
graduate in engineering subjects from AIT per annum. Almost all
of them are immediately absorbed by many Thai and international
companies operating in Thailand, a fact that testifies to the
quality of these graduates. However, since AIT has stopped its
undergraduate courses from 2017, SAITM will have to affiliate
itself with another university to allow its engineering students to
complete their degrees in the future.

These are real issues which SAITM is facing as a private sector-


sponsored higher learning institution in the country.
One bad start should not lead to throwing away a good
idea

Private sector-sponsored universities are a must in Sri Lanka given


its current level of economic development and fiscal issues its
Government is facing. However, SAITM has given a bad start to
this initiative. It has been set up without proper planning, without
proper authority and without proper management at the top. Such
approval had been obtained after it had admitted students and
even then, that approval has not been complete.

It has funding for both capital and running expenditure and is


being supported by top politicians of the country. That alone is not
sufficient for it to make its mark as a prestigious private university
in the country. As a result, it is the private sector higher education
initiative which has now suffered. It is inevitable that this black
name would be adduced to other private initiatives that are
planningto enter the field today.
Absorption by the State is not the solution

Some are suggesting that SAITM should be taken over by the


State. That would complicate the problem since it would add an
additional burden to the already-constrained State coffers.

Instead, what the authorities should do now is to force SAITM to


upgrade its standards in collaboration with the Ministry of Higher
Education, Ministry of Health, SLMC and the warring trade union,
GMOA. As it is, the fate of the students presently following
medical degrees at SAITM is at stake. Resorting to legal channels
as had been done by present students is not an option since SLMC
is reported to have planned to appeal to Supreme Court against
the judgment delivered by the Court of Appeal recently directing
it to register SAITM graduates for medical practice in Sri Lanka.

SLMC does not have powers at present to recognise these


graduates, but Parliament could give it powers by approving the
Gazette already issued by SLMC long ago in this regard. An early
resolution is crucial in the interest of the students already
following its medical courses. It would be a national tragedy if
they are to lose both their money and hope.

One bad example does not mean Sri Lanka should throw away
private sector-based higher education. It has to go for that, but
before doing so, it is necessary to establish independent
authorities to assure the quality and standards of all universities
in the country, both State and private sector sponsored.

Hence, it is a time when wisdom, patience and understanding are


needed by all, specifically by those in the medical profession like
the GMOA.
(W.A. Wijewardena, a former Deputy Governor of the
Central Bank of Sri Lanka, can be reached at
waw1949@gmail.com.)
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