SAITM and issue of access to

professional education in SL

The first batch of MBBS graduates from SAITM is expected to be announced in

2016. However, the Sri Lanka Medical Council had informed the Minster for Health
by a letter dated 25 September 2015 that The degree awarded by SAITM should
not be recognised for the purpose of registration under the
Medical Ordinance

Wednesday, 2 December 2015

The SAITM founder was clearly upset when he recently
said that those against SAITM would go to hell and burn.
His choice of words is unfortunate, but his frustration is
understandable.
South Asian Institute of Technology and Medicine Ltd. or
SAITM has been established under Companies Act No. 07
of 2007 and recognised with the authority to award
Bachelor of Medicine and Bachelor of Surgery (MBBS)
degree as of 30 August 2011 by the University Grants
Commission.
The first batch of MBBS graduates from SAITM is expected
to be announced in 2016. However, the Sri Lanka Medical

Council had informed the Minster for Health by a letter dated 25 September
2015 that The degree awarded by SAITM should not be recognised for the
purpose of registration under the Medical Ordinance. This decision is based
on an inspection of the Malabe premises by SLMC earlier this year.
According to the information posted on the Sri Lanka Medical Council
website, it recognises 210 colleges of medicine; 78% of these institutions or
166 are from the Eastern Europe (54), UK, Europe, Australia, New Zealand
and other developed countries (45), India (40) and China (13) and Middle
East including Libya (5). The remaining 24% or the 44 institutions are from
the developing world.
The Asian countries in the developing country list account for 33
institutions, namely, Bangladesh 3, Malaysia 5, Nepal 9; Pakistan 14 and
Philippines 2. The other developing countries account for 11 institutions as
Cuba 1, Nigeria 4, South Africa 2, Tanzania 1, Jamaica 2, Grenada 1 and
Zimbabwe 1.
As I argue here, the fact of the SAITM case points to a lack of vision by the
SLMC. It endorses 210 or more institutions, 24% of them from other
developing countries, for the 400 or more students seeking medical
education, but, does not seem to do the right thing and go the extra mile to
develop local capacity.
Recognition of credentials
The UGC recognises degrees granted by
any foreign university which is
recognised either by the Commonwealth
Association of Universities or
International Association of Universities.
To my knowledge no such international
organisation takes responsibility for the
quality of the colleges of medicine from
across the world.
In a list published by World Health
Organization in 2003 they simply
reported that: WHO received the
following information on medical schools
from the governments of its Member
States for updates to the World directory
of medical schools, base year 2000. This
information covers the period through 30
June 2003.
Even that limited reporting function is not
carried out by WHO anymore. The new
World Directory of Medical Schools, a

joint venture of the World Federation for Medical Education (WFME) and the
Foundation for Advancement of International Medical Education and
Research (FAIMER), merely provides a listing. They very clearly state that
they merely provide the data, but not a certificate of approval.
The basis for the listing posted by the SLMC is not explicit, but it seems
likely that the SLMC acts on the recommendation of their counterparts in
each country. Presumably, when a graduate from foreign college of
medicine applies to sit for Examination for Registration to Practice Medicine
(or ERPM) in Sri Lanka, SLMC would check with their counterpart in that
country.
Essentially, Government approved councils such as SLMC serve as the
ultimate gateways for medical profession in each country. This kind of
monopoly power behooves SLMC to exercise it with responsibility but with
vison, wisdom and empathy. Whether the SLMC is doing that in the SAITM
issue is matter that should receive the attention of all concerned.
According to SLMC, their inspection team examined SAITM premises in
earlier this year and concluded that: Clinical facilities, an essential
requirement for potential doctors, are unsatisfactory at the Malabe medical
faculty and thus the degrees should not be recognised.
Actually, the SLMC team did not have to visit the Malabe facility to make
that conclusion. The GMOA, the medical trade union, has prevented private
medical students from completing their internships at Government-owned
hospitals. This is ironic considering that they would be hard-pressed to find
many from among its membership who can say they have not or do not
engage in private medical practice services through channeling or directly.
But, there have been a few positives in the SLMC report. For example, the
SLMC team had noted that one must acknowledge and appreciate some of
the rather innovative and novel teaching utilities that have been
encompassed into the pediatrics training programme that tries to mitigate
the shortcomings that have been present as a result of the low patient
numbers.
In fact, with more dialogue, SAITM could have achieved the required
standards, one would think and more thought should be given to the larger
context of relationships between of higher education providers and
professional associations in Sri Lanka
From guilds to professional associations
Guilds were active in medieval times. They are associations of craftsmen or
merchants formed to help each other and make regulation and standards
for the craft or the trade, but, as the term connotes, this guilds often acted
as barriers to entry to the profession. As higher education emerged in
Europe and the Americas in the 14th century, they mainly served
professional functions in divinity and medicine and by the 19th century

universities had become places from broader learning.

With the massification of higher education after World War II and the more
recent call more relevance in higher education, professional education has
been increasingly embraced by universities. In fact in developing countries
private initiatives are often dedicated to professional degree programs in IT,
business and engineering and those only.
Universities and professional associations
In this context, guilds have essentially reinvented them as professional
associations working in parallel with universities, but, focusing on the
practice of a profession.
Membership in a recognised professional association is a goal pursued by
any professional. Chartered associations are those given a mandate by
government to represent a particular profession. Other associations derive
their legitimacy from their track record serving the profession. A charter
signifies that an individual has the knowledge and the experience to
practice as a full-fledged professional. To become a Chartered professional,
a degree or a degree equivalent qualification plus specified level of
experience is required.
In accountancy, architecture, and law, the linkage between professional
associations and the emerging public/private mix of university education
institutions in Sri Lanka has proceeded more or less smoothly. In all these
fields, the professionals associations have facilitated the transition from
academic to the professional domain or have provided paths parallel to and
independent from universities.
Chartered accountant
The story of the accountancy profession in Sri Lanka is a story of success
driven by adversity. Until the late 1980s there were no private options for
pursuing degrees outside of the public university system in any field of
study. Even those who gained admission to public universities were forced
to find alternatives to keep themselves occupied since student unrest and
disturbances due to civil war kept universities closed for periods of time.
Thanks to professional associations such as ACCA, CIMA and ICASL, a large
number of school leavers, irrespective of their prior categorization into Arts
or Science streams, embraced management accounting or financial
accounting as fields of study. Today there are many more paths of
progression from entry at GCE O/L, GCE A/L to qualifications in accountancy.
Today, certification by the Institute of chartered Accountants of Sri Lanka
(ICASL) is required to practice as a public accountant with the authority to
audit and certify financial documents in Sri Lanka. In 2011, ICASL reported
an enrolment of 37,000.

Chartered architect
Until recently the only way to become an architect in Sri Lanka was to
follow the Bachelor of Architecture or B.Arch. degree program at the
University of Moratuwa and then join the Sri Lanka Institute of Architects to
complete the requirements for the charter. Today the City School of
Architecture which offers diploma and a higher diploma in architecture
offers a second entry point with an annual intake of 50 or more. The City
School of Architecture (CSA) is a result of an initiative by the Sri Lanka
Institute of Architects itself. CSA was begun in 1989 to meet the unmet
demand for higher education in architecture. The new architecture program
was also intended to be more practice-based.
Chartered engineer
Today, school leavers who are interested in a career in engineering have
multiple options. Even those who would not have offered Math at GCE A/L
can now theoretically progress from Technician to Technologist to
Chartered Engineer thanks to multiple opportunities provided by public or
private institutions. The Graduate Diploma and the Post-Graduate Diploma
offered by City & Guilds, Bachelor of Technology degree offered by the
University of Vocational Technology (UNIVOTEC) and the Graduateship in
Engineering offered by the Institution of Engineers of Sri Lanka are some of
these higher qualifications in engineering that provide additional pathways
to a charter, but, it should be noted that these arduous paths. Much more
needs to be done.
Admission to the bar in the legal profession
Admission to the legal profession, or admission to the bar as it is popularly
known, requires success at the final examination of the Sri Lanka Law
College followed by admission as an Attorney-at-Law by the Supreme Court
of Sri Lanka.
The Sri Lanka Law College was established in 1874 by the Council of Legal
Education. Although the intake to the Law College is limited to a batch of
250 or so, almost twice as many others with LLB qualifications sit for the
final exam as external candidates. For example, in 2009, seven hundred
and fifty three candidates sat for the law final conducted by Sri Lanka Law
College. Only one third of those candidates were internal students of Sri
Lanka Law College. The other two third consisted of LLB graduates. The
pass rate in 2009 as whole for the examination was 78%.
Those with LLB degrees from the public universities in Sri Lanka including
the University of Colombo, Jaffna and Peradeniya and Open University of Sri
Lanka are eligible to sit for the Final Examination at the Law College.

Graduates of all other institutions, local or foreign, are required to sit for full
series of examinations from Year 1 to Year 3 at the Sri Lanka Law College.
These examinations constitute 20+ written papers. In 2012, for example,
Sri Lanka Law College had received applications from graduates who have
foreign degree programs offered by APIIT, British college of Applied Studies
(BCAS) and Royal Institute.
License to practice medicine
Clinical practice is more crucial in medicine than in any other profession
and SLMC is correct in its focus on the lack of facilities for clinical training at
SAITM. However, as the Council responsible for the overall quality of
medical practice in Sri Lanka, SLMC should consider whether a monopoly by
the State sector is the best for the profession. For example, the current
practice of intake to medical colleges based on the Z-score and that score
only may open doors for individuals who are not suitable or even dangerous
for dealing with patients. While acting as guardian of quality they have a
responsibility or create more competition and room for innovation in the
professional training of doctors in this country.
Chambers, BOI and others should act as honest brokers
Professional education in this country will not progress if professional
associations limit themselves to being gatekeepers. They have to act with
vision and forethought in regard to both quality and access. In this article I
have addressed only the access issue saving the quality issue for later.
We cannot increase access without investments and the Government
clearly should not be burdened with investments in professional education.
The SAITM founder says he has to pay Rs. 30 million as interest per month
in addition to a salary bill of Rs. 100 million and a former Russian
Ambassador has told him that he wouldnt have faced all these problems if
he had opened a casino with his money.
If the BOI, chambers and OPA and others do not intervene in the present
case to bring peace between the SLMC and SAITM, they would be failing in
their civic responsibility.
(Some of the data in this article are from the 2012 LIRNEasia
Career Guide survey posted on
http://www.educationforum.lk/careerguide/.)
Posted by Thavam