Solving the SAITM issue

President Maithripala Sirisena has pledged to put forward a solution to the long festering SAITM issue next week. The GMOA has regarded this latest announcement with skepticism as previous pledges given had not resulted in any significant change in the situation. The GMOA published a report on SAITM in 2010 and a five member committee appointed by the then Minister of Health (Maithripala Sirisena) put out a report on the matter in 2012. The most recent report on SAITM is the ‘Joint Statement on the SAITM Medical Degree’ by the deans of all the existing medical faculties in the state owned universities released in July 2016. The ‘Deans’ report’ as it is called, was signed by Prof. Jennifer Perera – University of Colombo, Prof. Vajira Weerasinghe – University of Peradeniya, Prof. Sarath Lekamwasam – University of Ruhuna, Dr. S Raviraj, University of Jaffna, Prof. Nilanthi de Silva – University of Kelaniya, Prof. Surangi Yasawardena – University of Sri Jayewardenepura, Dr. A. Arulpragasam – Eastern University, Prof. Sisira Siribaddana – Rajarata University.

This joint statement traced the history of the SAITM medical degree and the provisions of the existing law in relation to awarding medical degrees and made several recommendations. One might say that this ‘Deans’ report’ appears to have won general acceptance as offering a feasible solution to the problem. The Deans’ report is not ideologically opposed to private medical education as the majority of the anti-SAITM agitators appear to be. The deans have stressed that there must be opportunities for higher education (including medical education) in Sri Lanka, through both the public and private sectors due to the fact that large numbers of students go overseas in search of higher education because of the lack of opportunities at home. However they have stressed that Degree programmes offered by any Higher Educational Institute must comply with the requirements of the relevant professional body which in the case of medicine, is the SLMC.

Tracing the history of the SAITM medical degree, the deans report stated that in March 2008 the Board of Investment of Sri Lanka granted approval to the Dr Neville Fernando Investment Co (Pvt) Ltd to establish the South Asian Institute of Technology and Management (SAITM), offering degree programmes in IT, Management & Finance, Engineering, Vocational Studies, Nursing, Languages and Health Science. In 2011, the name was changed to South Asian Institute of Technology and Medicine. BOI approval had originally been granted to SAITM subject to the condition that the approval from the Ministry of Health and Nutrition be obtained prior to providing training in Health Sciences.

In September 2009, SAITM had registered its first intake of 40 students for its medical degree programme. The Sri Lanka Medical Council had promptly in October 2009, and intermittently thereafter, informed the public through newspaper advertisements of the fact that the SLMC has no legal provision to monitor or recognize the medical degree programme at SAITM. In April 2011, the University Grants Commission had conducted an institutional review of SAITM and made 13 recommendations to be ‘duly satisfied’ to consider SAITM for provisional recognition in six months. In April 2011 SAITM entered into a Memorandum of Understanding with the Provincial Director, Department of Health, Western Province (Dr Amal Harsha de Silva) to enable SAITM students to train in government hospitals coming under the supervision of the Western Province. However, this was never implemented.

In August 2011, the UGC by Gazette notice declared SAITM a degree-awarding institute with powers to award medical degrees. In January 2013, a four-member team appointed by the Secretary, Ministry of Higher Education and chaired by the Vice-Chairman of the UGC (Prof Ranjith Senaratne), conducted an institutional review focusing on the period from the establishment of SAITM up to August 2011 and recommended that conditional recognition be granted to the MBBS degree from the year of its commencement, provided that students enrolled in 2009 and 2010 are given additional training. In July 2015, a ten-member inspection team (chaired by Prof. Rezvi Sheriff) appointed by SLMC, carried out an inspection of SAITM and the Neville Fernando Teaching Hospital and arrived at the conclusion that the SLMC should not recognize graduates who have completed the SAITM medical degree.

The SLMC team headed by Prof. Sheriff observed that there were many irregularities, if not outright deception, in the manner in which the SAITM medical degree programme was established. Based on the above findings, the Deans report made several recommendations in relation to SAITM including the following: a) The recruitment of students to the MBBS degree programme of SAITM should be halted with immediate effect. Admissions should not be allowed to recommence until SAITM has obtained the compliance certificate from the SLMC. b) The SAITM medical degree programme may be permitted to continue to function after correcting the irregularities, as a governmental or semi-governmental, fee-levying, degree awarding institute, with provision for admission of some proportion of students on scholarships or student loans. c) The student admissions policy may be different to that adopted by the UGC, but the minimum admission requirements must comply with SLMC recommendations.

The Deans’ report had also made several recommendations to ensure that existing students of SAITM were not left out in the cold. Among those recommendations were the following: a) Students should be required to obtain intensive clinical exposure in Medicine, Surgery, Paediatrics and Obstetrics & Gynaecology, before their Final MBBS examination. Those who have already passed the MBBS examination conducted by SAITM should be required to undergo additional training and pass a licensing examination. b) All graduates from degree awarding institutes should be required to pass a licensing examination administered by the Sri Lanka Medical Council prior to registration. c) Internship appointments for SAITM graduates who pass this licensing examination and are given provisional registration, should be provided by the Ministry of Health, as for foreign graduates who have passed the Examination for Registration to Practice Medicine (ERPM). Those who complete the internship satisfactorily may be given full registration by the SLMC.

Above all else the Deans’ report had stressed that The Minister of Higher Education should ensure in the future, that all private higher education institutions which aspire to award medical degrees must provide a compliance certificate from the SLMC before being granted degree awarding status with the power to award medical degrees. This entire complication involving SAITM is due to the lack of coordination between the Ministry of Higher Education and the professional body relating to the medical profession – the SLMC. The whole nation is waiting with bated breath to see what solution President Sirisena has to offer to resolve this gargantuan mess.