High powered committee in joint statement slams process and sequence of events since March 2008 in which SAITM was approved to undertake medical education Points out among other things compliance certificate from SLMC a must before admissions begin By Kumudini Hettiarachchi The Government has agreed to immediately suspend new admissions at the medical faculty of [...]

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SAITM: Govt. agrees to immediately halt admission of new students to Medical Faculty

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  • High powered committee in joint statement slams process and sequence of events since March 2008 in which SAITM was approved to undertake medical education
  • Points out among other things compliance certificate from SLMC a must before admissions begin

By Kumudini Hettiarachchi
The Government has agreed to immediately suspend new admissions at the medical faculty of the controversial South Asian Institute of Technology & Medicine (SAITM), based on a series of proposals by a high-powered committee of professors.
The group, Deans of the Medical Faculties of Sri Lanka’s eight state universities, had recommended that “… recruitment of students to the MBBS degree programme and admission of new students should be halted with immediate effect. Admissions should not be allowed to recommence until SAITM has obtained the compliance certificate from the SLMC (Sri Lanka Medical Council)”.
The decision, the Sunday Times learns, came during meetings the Deans had with Prime Minister (PM) Ranil Wickremesinghe, Higher Education and Highways Minister Lakshman Kiriella and officials this week.

In an in-depth look at the SAITM issue on which they have issued a Joint Statement, the Deans slammed the process and sequence of events since March 2008 in which SAITM was approved to undertake medical education, stating: “The sequence of events makes it clear that there were many irregularities, if not outright deception of the public, in the manner in which the SAITM medical degree programme was established.”

At meetings with the PM and the Minister at which University Grants Commission (UGC) Chairman Prof. Mohan de Silva and his deputy Prof. P.S.M. Gunaratne were also present, the other key decision was for the Government to work out a new structure at SAITM with major state representation for the decision-making process with regard to the admission of students and the conduct of the degree programme and examinations, while changing the Neville Fernando “Teaching” Hospital (owned by SAITM) to a governmental or semi-governmental hospital.

The group in its recommendations, a copy of which was exclusively obtained by the Sunday Times in addition to the paper reporting last week that the Deans were studying this issue, had a very significant paragraph titled ‘Declarations of conflict of interest’. It said: “We declare that none of us have taught or examined medical students at SAITM, nor do we have a spouse, son or daughter, who has taught or is teaching or has been a medical student at SAITM.”

It was an obvious reference to accusations in the past that the campaign to formalise SAITM, which received government approvals under an irregular and controversial process, was largely by powerful politicians and also medical specialists who were either teaching at SAITM on retirement and/or whose children were students there.

The group comprised Prof. Jennifer Perera, Dean, Faculty of Medicine, University of Colombo; Prof. Vajira Weerasinghe, Dean, Faculty of Medicine, University of Peradeniya; Prof. Sarath Lekamwasan, Dean, Faculty of Medicine, University of Ruhuna; Dr. S. Raviraj, Dean, Faculty of Medicine, University of Jaffna; Prof. Nilanthi de Silva, Dean, Faculty of Medicine, University of Kelaniya; Prof. Surangi Yasawardena, Dean, Faculty of Medical Sciences, University of Sri Jayewardenepura; Dr. A. Arulpragasam, acting Dean, Faculty of Healthcare Sciences, Eastern University of Sri Lanka; and Prof Sisira Siribaddana, Dean, Faculty of Medicine, Rajarata University of Sri Lanka.

The Deans said in their statement that they undertook the exercise of examining long-term solutions due to ‘grave concern’ over protests by medical students across the country over SAITM and to prevent the development of a situation similar to the 1980s when the crisis over another private medical faculty, the North Colombo Medical College, led to the closure of all universities at the time.

The 13-page report detailed the sequence of events from March 2008 when 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, and the name-change to ‘South Asian Institute of Technology and Medicine’ in 2011.
It said “As of now, SAITM has not obtained the compliance certification from the specified professional body, which is the SLMC in the case of degrees in Medicine.”

The Deans said their recommendations and observations were based on four ‘cardinal principles’: That all degree programmes offered by any higher education institute must comply with the requirements of the relevant professional body, particularly so in the case of medical degree programmes; expansion of medical education opportunities in Sri Lanka must be based on national health policies; strong regulations must be enacted assuring the quality of these higher education programmes offered both in the public and private sectors; and the need for expansion in opportunities for higher education (including medical education) in Sri Lanka, through both public and private sectors.

The report said: “A just and equitable solution to the SAITM issue must provide answers to the following questions while abiding by the principles enunciated above:

1) Should the SAITM Medical Faculty be permitted to continue functioning in the long term, and if so, on what basis?
2) If it is different to the current basis, what relief can be given to students currently registered for the SAITM MBBS degree?
3) What is the best means of ensuring patient rights and safety in the context of private medical education?

Some of the other recommendations were that though the establishment of the SAITM medical degree had many serious irregularities, it 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; that the student admissions policy may be different to that adopted by the UGC, but the minimum admission requirements must comply with SLMC recommendations; that the SAITM medical programme should be subjected to another inspection visit by the SLMC, to consider if their hospital and other clinical training arrangements meet the required minimum standards.

With regard to the current students and graduates, the report said that the students should be required to obtain intensive clinical exposure in Medicine, Surgery, Paediatrics and Obstetrics & Gynaecology, and appointments in a Medical Officer of Health (MOH) office and an office of a Judicial Medical Officer (JMO), before their Final MBBS examination.

The Deans recommended that Section 29 of the Medical Ordinance should be amended so that all graduates from degree-awarding institutes are required to pass a licensing examination administered by the SLMC prior to provisional registration. It said that those who have already passed the MBBS examination conducted by SAITM should be required to undergo additional training and then pass this licensing examination.

It said placements for 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 ERPM (Examination for Registration to Practise Medicine — a special examination for graduates from foreign medical schools) prior to internship.

(Visit the Joint Statement on Medical Degree Programme offered by SAITM)

Joint statement: Key points

  • The ‘summary of key events’ in the Joint Statement issued by the Deans who also state: “The sequence of events makes it clear that there were many irregularities, if not outright deception of the public, in the manner in which the SAITM medical degree programme was established”.
  • 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 the South Asian Institute of Technology and Medicine. BOI approval was granted subject to the condition that the approval from the Ministry of Health and Nutrition be obtained prior to providing training in Health Sciences. 
  • May 2009: President SLMC (Dr. H.H.R. Samarasinghe) informed Dr. Neville Fernando in writing that the SLMC (Sri Lanka Medical Council) has no legal provision for recognition of a medical degree awarded jointly by a private degree-awarding institute in Sri Lanka and a foreign medical school, even if the foreign medical school has a medical degree programme that is recognized by the SLMC. 
  • Sept 2009: SAITM registered its 1st intake of 40 students for its medical degree programme, followed by subsequent intakes in February and September of every year since then. The intake reached a peak of 127 students in February 2014, and has declined since then to about 70 students per intake. 
  • October 2009- March 2010: SLMC informed the public through several newspaper advertisements of the fact that the SLMC has no legal provision to monitor or recognize the medical degree programme at SAITM. 
  • Mid-2010: SAITM advertised vacancies for academic staff to teach on an MD programme conducted jointly with the Nizhny Novgorod State Medical Academy (NNMSA) of the Russian Federation. The MoU with NNSMA has been terminated before October 2015 (exact time unknown). 
  • November 2010: According to the Ministry of Health Report signed on 28 February 2012, a team from the UGC has visited SAITM to review governance structure, medical academic programme and facilities and common amenities available. Recommendations were made to the Ministry of Higher Education, the University Grants Commission and the Ministry of Health and to SAITM. 
  • February 2011: According to the Ministry of Health Report signed on 28 February 2012, QAAC of UGC has conducted a SAITM MBBS Programme Review. 
  • April 2011: According to the Ministry of Health Report signed on 28 February 2012, QAAC of UGC has conducted a SAITM Institutional Review. The review report contained 13 recommendations to be ‘duly satisfied’ to consider SAITM for provisional recognition in 6 months. 
  • April 2011: SAITM entered into a Memorandum of Understanding with Provincial Director (PD), Dept of Health, Western Province (Dr Amal Harsha de Silva) to enable SAITM students to train in government hospitals coming under the supervision/management of the PD/Western Province. However, this was never implemented. 
  • August 2011: Gazette notice declared SAITM as a degree-awarding institute with powers to award medical degrees. 
  • February 2012: A 5-member committee appointed by the Minister of Health and chaired by the Secretary/Health (Dr Ravindra Ruberu) to look into matters related to the SAITM medical degree, made several recommendations, including one that “the UGC and SLMC should advise the management of SAITM that only one batch is admitted each year for training, as being done for admissions to the state medical schools”. 
  • January 2013: A 4-member team appointed by the Secretary/Higher Education and chaired by the Vice-Chairman UGC (Prof. Ranjith Senaratne), conducted an Institutional Review focusing on the period from the establishment of SAITM up to 29.08.2011. The team 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…” along with several other recommendations to ensure continued development and sustainability of the Institute. 
  • February 2013: A 6-member committee appointed by the Secretary/Higher Education and chaired by Prof. Mohan de Silva conducted a review (including a site visit) of SAITM to ascertain the suitability of backdating the recognition of the degree-awarding status to SAITM and award of the MBBS degree from 15 September 2009 to 29 August 2011. The committee recommended back dating of degree-awarding status to the date of inception (i.e. 15 Sept 2009). 
  • April 2013: Dr Neville Fernando Teaching Hospital (NFTH) started functioning in Malabe. 
  • August 2013: Gazette notice backdated degree-awarding status of SAITM to its inception in 2009. 
  • May – June 2014: SAITM requested SLMC to visit SAITM and its new teaching hospital. SLMC requested SAITM to complete application for recognition of a medical faculty/school in Sri Lanka. 
  • August 2014: SAITM submitted the completed application form for recognition of a medical school by the SLMC. SLMC appointed a 3-member team (all members of the SLMC) to carry out a desk review of the application. 
  • September 2014: F/R case no 208/2014 filed in Supreme Court by SAITM students against the Minister of Health, was settled out of courts in September 2014, on grounds that “in principle, Hon Minister (of Health) is agreeable to cooperate with the SAITM in order to facilitate the required clinical training at designated state hospital in respect of the petitioners and the batches registrable under the Medical Ordinance. However, SAITM remains responsible to adhere to all laws and regulations, specification and guidelines and to fulfil all the requisite standards applicable in respect of registration and recognition by the Sri Lanka Medical Council and/or other relevant authority”. 
  • December 2014: SLMC requested SAITM to provide clarifications requested by the desk review team; SAITM responded to this by letter dated 16 March 2015. 
  • July 2015: A 10-member inspection team (chaired by Prof. Rezvi Sheriff) appointed by the SLMC, carried out an inspection of SAITM and NFTH, and submitted a report recommending that the SLMC should not recognize graduates who have completed the study programme currently provided by the Faculty of Medicine, SAITM, as suitable for provisional registration under the Medical Ordinance. 
  • August 2015: The SLMC inspection report and recommendation were submitted to Minister of Health (Hon Rajitha Senaratne). 
  • November 2015: SLMC notified the public that a report has been submitted to the Minister of Health recommending that the degree awarded by SAITM should not be recognized for the purpose of registration under the Medical Ordinance 
  • May 2016: SAITM conducted the final MBBS examinations for the first intake of students. 
  • June 2016: SAITM graduates filed action in the Court of Appeal asking for SLMC registration and in the Supreme Court asking for an amendment to Medical Service Minute.

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