Minimum standards of the medical education in Sri Lanka was at the centre of controversy recently with the historic judgment given by the Appeal Court directing the Sri Lanka Medical Council to give temporary registration for the graduates of the South Asian Institute of Technology and Medicine (SAITM) medical faculty students to do their internships.
This historic judgment initiated a wider dialogue in society about the minimum standards that have to be followed in the medical colleges in the country and there were many comparisons about the standards maintained at SAITM medical faculty and state medical faculties.
Bringing an apparent solution to the ongoing controversy about the minimum standards of medical education the Sri Lanka Medical Council (SLMC), the apex body in monitoring and supervision of medical education institution in the country last week came up with a document stipulating the minimum standards in the medical colleges in the country.
The document prepared after much discussions among the veterans in the medical field and in the medical education, has now been sent to the eight state medical faculties, the Dentistry Faculty and the Medical Faculty of the Kotelawala Defence University for their observation.
According to SLMC spokesman this is not the first time the SLMC came out with such document stipulating minimum standards for medical colleges. The SLMC had gazetted the minimum standards in 2006, 2007 and 2009 but the document did not become effective as it was not approved in Parliament.
Then after seeking legal opinion on the issue the SLMC in 2010 published guidelines stipulating minimum standards in medical education and it was the basis for the SLMC to monitor and evaluate the medical faculties in the country. But the Court of Appeal in its judgment on SAITM has not accepted these guidelines as a legal document.
As a result the SLMC continued with its effort to finalize a document on the minimum standards for medical education since the government also wanted them to formulate such document to be passed in Parliament to regularize the medical education in the country.
“Our guidelines were there since 2010 and it was a matter of conversion of the guideline documents into a gazette document.
In this document the format is a little different”, the SLMC spokesman added. Some changes were also made considering the many changes taking place in the world with regard to the medical education during the past few years, he said.
This document covers a vast area in medical education and can be used when the SLMC wants to approve a medical college.
“It mainly consists of how the curriculum should be, what is the student staff ratio, what are the areas that should be covered in the training programme, what are the subject areas and how much of the lectures and how much of practicals the students should have and what should be the qualification of the staff etc”, the spokesman added..
In addition it covers the entry criteria to the medical faculties as a component of students.
Since 2010 the minimum entry criteria for medical colleges was 2 Cs and one S pass in the bio science stream and it will be there in this new document too.
“But we have said, once in three years we can review the entry criteria and the SLMC can publish the entry criteria”, he added.
Entry criteria
He said the present entry criteria 2 Cs and one S have been decided after studying the entry criteria of medical students to state medical faculties for the past five to ten years.
“We have found in 2009 one student from Mullaitivu district entered the Jaffna Medical Faculty under the district quota system and now he has passed out from the faculty. That was the cut-off point we decided”, he added.
The current lower level goes around three Bs and what has been proposed in the minimum standards document is the UGC will decide on the state medical schools cut off line and for the private sector and for the foreign medical school the SLMC will decide taking into consideration the UGC levels.
“It might go up in the future but not soon. It will be studied and passed in the Council, and then published in the papers”, the spokesman added.
He said though there is much confusion about the minimum entry criteria it is only a small part of the minimum standard document, he added. It also discusses Teaching hospitals, and for 100 students it recommends a Teaching hospital with 700 beds with 70 per cent bed occupancy rate.
It also specifies how many obstetrician and gynecologists, pediatrician, medical doctors, surgical beds etc should be available at the teaching hospital.
The SLMC has also paid attention to the clinical aspect of the medical faculties as there is a lot of criticism about state medical faculties in remote parts of the country. The SLMC spokesman said the latest medical schools like Batticaloa and Rajarata also have more than adequate clinical exposure because, Anuradhapura and Batticaloa hospitals have all facilities.
Referring to the criticisms about the number of professors available in these medical faculties the SLMC spokesman said the SLMC did not consider the number of professors available in the faculty as an issue.
“If there is a qualified person as a non professor that is sufficient because for the private sector, it is an appointment given by the institution and in the government sector, professor is a big achievement. Therefore, we go by the number of qualified persons to teach the students. This standard is based on the World Federation of Medical Education Standards”, he added.
Teaching staff
He said the number of teaching staff should also be considered along with the staff available at the Teaching hospital to teach the medical students.
The SAITM university count their staff with the staff of the Neville Fernando Teaching hospital but the Rajarata University counts only the staff coming under the Higher Education Ministry.
“Actually the students are taught by the Health Department staff attached to the Anuradhapura hospital too. When we assess them we consider both together”, he added. He said the SLMC sent this minimum standard document to all the state medical faculties, Dentistry Faculty and to the KDU coming under the Ministry of Defence. “We have requested them to put the document to the Faculty boards and get their observations before 28th of this month.
At these medical faculties all the medical teachers will study this document and submit their observations to the Dean and they, in turn will submit the observations to the SLMC.
Then the Council will consider whether to incorporate their suggestions or to ignore them or whatever the decision taken after the documents is submitted to the Council”, he added .
The spokesman said there will be a few additions and deletion because this document has been thoroughly discussed at council meetings attended by the Deans of the medical faculties.
Finally, the document will be sent to the Minister of Health for his consideration to be submitted to Parliament for its approval. “In the past there were problems regarding getting the document passed in Parliament, as they have rejected it on various grounds and this time they have said they would grant approval”, the spokesman added.