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Don’t recognise SAITM degree – SLMC
The Sri Lanka Medical Council (SLMC) has urged the Health Ministry not to recognise medical degrees awarded by the South Asian Institute of Technology & Medicine (SAITM), facing accusations of a faulty approval process, saying the private medical faculty has insufficient clinical facilities.
The council in a September 4, 2015 letter to Health Minister Dr. Rajitha Senaratne, said a report by its Inspection Team 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. This is the very first time that the SLMC has visited the Malabe medical faculty.
“Based on the evaluation, the consensus of the council is that the number of cases students are exposed to is far from satisfactory and that the case numbers must go up by at least five times and should comprise a ‘mix of patients’ representative of all the major problems commonly encountered in practice,” said the letter and report to the Minister. It added: “The SLMC evaluated the findings of the Inspection Team and recommends to the Minister of Heath that the degree awarded by SAITM should not be recognised for the purpose of registration under the Medical Ordinance.”
In the SLMC’s first-ever inspection of the facility, the team reported that the lack of clinical facilities was being compensated by: (a) use of clinical skills lab; (b) use of role play and simulated cases; and (c) clinical rotations in other private hospitals – students being assigned to identified consultants in other private hospitals, among others. “However, none of these methods can compensate for insufficient patient turnover,” it said.
The recommendation once again blocks SAITM’s efforts to formalise its teaching and clinical programme in line with local regulatory rules. Clinical training, where medical undergraduates get real-life experiences in all forms of patient care and operations, is a pre-requisite for medical practice in State hospitals. The SLMC, by law, is the regulatory authority on medical education in Sri Lanka.
Ever since SAITM secured Board of Investment approval first as a technical college and later added a medical faculty, it has encountered problems with the authorities and the SLMC which has faulted the institute for not following a proper registration process.
A recognised one-year’s internship, after obtaining a recognised medical degree, is mandatory to register with the SLMC as a doctor. The desk-evaluation of SAITM by the SLMC was handled by a team of three professors representing pre-clinical, para-clinical and clinical disciplines and the 10-member SLMC Inspection Team comprising academics as well as clinicians visited SAITM and its Neville Fernando Teaching Hospital (NFTH) on July 13-15, 2015, at the request of SAITM Chairman Dr. Neville Fernando.
The report said the NFTH has 850 beds, of which only 200 have been commissioned, another reason why there is inadequate clinical training for students. “According to information supplied by SAITM, since admissions in 2009, the first seven batches (363 students) are undergoing clinical training in the NFTH wards. Clearly so many students having access to so few patients cannot be expected to receive adequate clinical training. This is in startling contrast to what obtains in the State medical faculties where there is a large number and variety of patients in our hospitals for students to learn the techniques of medical diagnosis and treatment,” it said.
The main deficiencies observed by the SLMC Inspection Team were — general inadequacy of clinical exposure in all areas in terms of numbers and case mix, which were of grave concern. In particular, exposure to trauma in surgery, common surgical emergencies and obstetrics and gynaecology, as well as exposure to emergencies in adult medicine and paediatric care is lacking. The faculty is making an attempt to overcome these deficiencies but it is still insufficient at present, the report said.
It added that there “is a lack of facilities for training in practical clinical Forensic Medicine e.g. to examine and report on clinical medico-legal post-mortem examinations,” in addition to a deficiency in exposure to preventive care services in the State sector e.g. MOH (Medical Officer of Health) office activities and field services.
While physical facilities including lecture halls seem adequate, the Inspection Team report to the SLMC said that the number of non-academic staff was “surprisingly few”. “The Anatomy Department and the Biochemistry Department have a few technical officers and lab assistants but in all other departments all technical and clerical functions appear to be carried out by junior academic staff. This is not satisfactory and needs improvement,” the report said. The student-staff ratio was 7.7:1 (856 students and 110 full-time academic staff). “However, one must acknowledge and appreciate some of the rather innovative and novel teaching utilities that have been encompassed into the paediatrics training programme that tries to mitigate the shortcomings that have been present as a result of the low patient numbers,” the report said.
It said internship is not addressed in the SAITM MBBS programme and recommended that a one-year internship programme needs to be negotiated with the Ministry of Health as per order or merit status. The NFTH, it said, has no intern house officers.