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SAITM gives its side of story, Kiriella says suspension of new intake only a ‘discussion’
Ten days after a high-powered delegation of medical professors issued a strong report on the South Asian Institute of Technology and Medicine (SAITM) including a call to immediately suspend new intakes of students, the future of the controversy-ridden institution remained in the balance.
The SAITM Panel at the media briefing on Thursday: Prof. Deepthi Samarage; Prof. Kolitha Sellahewa; Vice Chancellor Prof. Ananda Samarasekera; Registrar Husni Hussain; CEO of SAITM and NFTH Sameera Senaratne; Prof. Neville Perera; Director of Medicine, Prof. Deepal Weerasekara; and SAITM MBBS holder Tharindu Ruwanpathiranage and a current student Prageeth Wimalachandra.
As to-and-fro arguments were dished out by defenders of SAITM (mainly its management, students and parents), others urged the SAITM authorities and the Government to separate the two main nagging issues – the legal status (including recognition as an institution to send out graduates who should be registered to practise medicine) and the humane factor (that students should not be made to suffer for the SAITM management’s shortcomings).
Deans of the eight state medical faculties, who submitted their report and discussed the matter with Prime Minister Ranil Wickremesinghe and Higher Education Minister Lakshman Kiriella last week, this week, followed this up with a fax on Monday July 25 to the Higher Education Ministry Secretary to implement, as promised, at least the first recommendation “immediately halt new admissions” to SAITM, until issues are resolved, the Sunday Times reliably understands.
Their report, among other matters, lists out clearly that the due process was not followed by SAITM, a similar position taken by the Sunday Times which has campaigned since 2011 for a proper legal process to be followed particularly in the field of medical education which – unlike any other profession – deals with the births, lives and deaths of the men, women and children of Sri Lanka. Joining other experts in the field, the paper has consistently maintained that students should not suffer for the alleged faults of SAITM which is now using the humane-situation-of-students-card, to formalise a so-called private medical faculty that has not allegedly followed due processes.
The Sunday Times has maintained that private medical education, if and when, established in the country should be done the right way and in keeping with the right norms and laws.
The Sri Lanka Medical Council (SLMC) and the Government Medical Officers’ Association (GMOA), individually also maintain that the main issue with regard to SAITM has been the non-compliance to standards of medical education as prescribed by the SLMC.
GMOA’s Dr. Nalinda Herath alleged that as SAITM is an illegal institute, the fraud that it has perpetrated on the public needs to be investigated and the culprits punished under the laws of the land.
However, a question on whether the due process including recognition from the SLMC– as medicine impacts on people’s life –was followed was dealt with ‘lightly’ with the SAITM Registrar saying, “It doesn’t make a difference whether it is a doctor, engineer or account, everything affects the life of people”. This was at a media briefing on Thursday by SAITM management, elaborately organized at the Malabe-based Neville Fernando Teaching Hospital (NFTH) by a public relations outfit which appears to have been hired for a damage-control exercise (the same unit was hired by the Colombo Port city when protests rose during the latter stages of the Rajapaksa administration). To the Sunday Times query on the issue of an SLMC ‘compliance certificate’, counter-questions were raised whether Rajarata and Eastern Medical Faculties had also got this SLMC compliance certificate.
In the meantime, the Deans in their July 25 letter urged Higher Education Ministry Secretary D.C. Dissanayake “to take immediate steps to implement this recommendation (halt new intake)”, pointing out that “the Minister himself was of the view that this recommendation is very reasonable, given the controversy surrounding the MBBS degree programme offered by SAITM at present”.
However, Minister Kiriella, when asked by the Sunday Times on his ‘agreement’ with the Deans at last week’s meeting to suspend the new intake of students, was quick to say, “There was only a discussion (with the Deans). There was no such agreement”. He added, “Seven Deans came and met with me and they proposed that SAITM should be converted into a private public partnership and so many other matters were discussed”. It is reliably learnt, and also confirmed by the fax, that the Minister had endorsed the Deans’ view that new student intakes should be suspended forthwith.
In the July 25 fax, the Deans cite the rules made under Section 137 of the Universities Act (published in Gazette No 1824/21 on 2013.08.22 and subsequently amended in Gazette No 1847/56 published on 2014.01.31 and amended again in Gazette No 1891/9 or 2014.12.02) that require all non-state institutes, recognized as degree-awarding institutes which offer study programmes leading to degrees in Medicine, to obtain compliance certification from the SLMC and to submit such certification to the Specified Authority.
“Our first recommendation is 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,” the Deans state clearly, going back to the meetings they had on July 21 with the Prime Minister and Minister Kiriella both of who, “were of the view that our recommendations could pave the way for resolution of the current impasse regarding the medical degree programme offered by SAITM”.
The Minister, though, asked by the Sunday Times whether he had agreed to stop new admissions, retorted, “We had a discussion. You don’t know the difference between a discussion and an agreement – we had a discussion on so many things.”
“They requested that admissions be stopped but there was no agreement – they also proposed that SAITM should be converted to a public private partnership that they will support it — but that was a discussion,” he insisted, adding that there was only a discussion and “I will have to report to other members of the Cabinet for approval but what we really discussed was the conversion of SAITM into a public private partnership”.
The Sunday Times understands that the Minister said that it (the stoppage of new admissions) can be done until the problem is sorted out, even though one UGC official present at the meeting showed some reluctance to do so.
The Deans’ statement, meanwhile, has stirred another controversy. The SLMC which met on Friday for its monthly meeting discussed whether the Deans’ Joint Statement which had been circulated on request was issued in an “official” or “private” capacity. Another set of observations by a group of SLMC members “correcting” several sections of the Joint Statement had also been put up at the meeting.
The Sunday Times understands that there was some discussion among members over a comment by an SLMC member who is also a Dean that this person had posted the Joint Statement to judges across the country. Matters such as conflict of interest and whether that Dean should have taken such action even in a private capacity had generated some debate.
Meanwhile, the lengthy media conference at SAITM on Thursday was followed by a tour of the NFTH, after journalists had been ferried by bus from Colombo to Malabe.
When asked where its founder Dr. Neville Fernando was, the answer was that he was unable to attend the briefing as he was at a meeting. About a week ago Dr. Fernando was seen on local TV visiting the Dalada Maligawa.
The SAITM Panel which held the briefing, going into detail about the teaching, facilities and standards of the 19 students who have graduated with the SAITM MBBS, comprised Prof. Deepthi Samarage (Paediatrics), Prof. Kolitha Sellahewa (Medicine), Vice Chancellor Prof. Ananda Samarasekera (Forensic Medicine), Registrar Husni Hussain, CEO of both SAITM and NFTH Sameera Senaratne, Prof. Neville Perera (Surgery), Director of Medicine Prof. Deepal Weerasekara (Obstetrics and Gynaecology), SAITM MBBS holder Tharindu Ruwanpathiranage and a current student Prageeth Wimalachandra.
With regard to obtaining degree-awarding status, a slide presentation at the briefing stated that such status was awarded after many institutional, programme and financial reviews by committees comprising eminent personnel.
The slides stated:
n By Gazette No: 1721/19 dated 30.08.2011 and Gazette Notification No: 1829/36 dated 26.09.2013 SAITM has been granted degree-awarding status to award the MBBS degree.
n According to the Gazettes there were stipulations which SAITM had to fulfil within a specified time frame.
n All stipulations were fulfilled by SAITM within the said period and the ‘specified authority’ has issued two letters confirming that SAITM has fulfilled all conditions therein.
With regard to maintaining quality in medical education, Prof. Samarage said all aspects such as curriculum, assessments/clinical examinations, staff, teaching-learning methods, quality of students and infrastructure facilities had been reviewed by the SLMC which said it has no issues.
Prof. Samarage explained that there are 21 Professors, 76 Senior Lecturers/Consultants, 59 Lecturers and 38 other academic staff, while going into detail about the infrastructure facilities as well as the state-of-the-art teaching hospital.
With regard to assessments/examinations, she said that different tools of assessment methods were used, with the final-year theory examination having the same format as in state medical schools. The final-year clinical examinations also have a similar format as in the state medical schools and were held with the participation of external examiners. Students were given ‘a consensus mark’ considering both sets of marks given by internal and external examiners with the latter being Professors from the Colombo, Peradeniya and Ruhuna Medical Faculties, Senior Lecturers from Peradeniya and Senior Consultants from the National Hospital, the Lady Ridgeway Hospital for Children and the Kandy Hospital who are examiners for the Colombo and Peradeniya Medical Faculties.
Regarding deficiencies in the practical experience cited by the SLMC, Prof. Samarage said that the deficiency in exposure to preventative care services in an MOH (Medical Officer of Health) area and lack of facilities for training in practical clinical Forensic Medicine are no longer valid as students have this training at the Avisawella Hospital and the Kaduwela MOH.
She reiterated that the SAITM academics “do not agree” with the third deficiency cited by SLMC which is “General inadequacy of clinical exposure in all areas in terms of numbers and case mix is of grave concern. In particular, exposure to trauma in Surgery, common surgical emergencies and obstetric care is lacking. The Faculty is making an attempt to overcome these deficiencies, but is still insufficient at present”.
Prof. Samarage questioned why the SLMC has no grave concerns to register graduates from foreign medical schools with inferior quality proven beyond doubt; the SLMC provides assistance through the Health Ministry for further training to improve the quality of graduates from these medical schools utilising state facilities; the SLMC has tabled a separate adverse report submitted by one member of the review team who did not participate in the review process; the SLMC had made the nine-member review panel change their initial recommendation of SAITM graduates as being registrable; the GMOA and student unions are silent about the functioning of the fee-levying KDU (Kotelawela Defence University) medical school and it obtaining state facilities; the GMOA and student unions do not object to students going abroad to obtain private medical education.
What’s a Certificate of Compliance, asks SAITM VC  Prof. Ananda Samarasekera When asked specifically by the Sunday Times at Thursday’s media briefing whether SAITM has got Compliance Certification from the SLMC, SAITM Vice Chancellor (VC) Prof. Ananda Samarasekera said: “Point is this, to answer your question I should know what is a compliance certificate means, from whom should we get it. In the gazette notification we saw about a compliance certificate and we wanted to verify what this compliance certificate means, compliance with what and who is the relevant ‘professional body’ that the compliance certificate if at all (should) obtained from? And we wrote a letter asking for clarification.” To the question to whom they wrote, the reply was that it was to the ‘specified authority’ which is the Higher Education Ministry. “Yes. About one and half years back. We had a delegation and met him and there was no answer,” said the VC. Here are some questions that the Sunday Times asked the SAITM management not only at the media briefing but also at a separate meeting on Wednesday with Vice Chancellor Samarasekera and Director – Laboratory Services and Senior Lecturer, Department of Biochemistry, Dr. Keerthi Attanayake and on e-mail. What is the justification against allegations that SAITM is illegal? Please describe the process of setting up the ‘Medical Faculty’ briefly and how, when and from whom authorizations were achieved, with dates and documentary proof. SAITM is a legally established higher education institution according to the current legislations applicable to set-up such institutions in Sri Lanka. SAITM has fulfilled the legal requirements set out in section 70 and section 25 of the Universities Act of 1978 and the procedure relating to recognizing as a degree awarding institute has been duly followed and the Minister of Higher Education in accidence (accordance?) with the powers vested on him has declared in the Government Gazette in 30th August 2011 as a degree awarding institute to award the MBBS (SAITM) degree subject to certain conditions. All these conditions have been fulfilled and was (were) reviewed by a panel of exports (experts?) appointed by UGC at the time and the Specified Authority (Secretary, Ministry of Higher Education) has issued a letter confirming that. Subsequently this gazette notification was amended by another Gazette in September 2013 have re-evaluated the institution and the academic programme and included the first four batches of students taken to follow the MD programme of the NNSMA (Nizhny Novgorodof State Medical Academy) Russia subject to some conditions. Those conditions were also fulfilled and were revived by another panel of experts appointed by the specified authority. The NFTH which is the main hospital for clinical training with professorial units is an approved private hospital by the health regulatory authority. The curricula are on par with the curriculums of state medical faculties and the benchmark statement of medicine of the UGC. In terms of the section 29 of the Medical Ordinance Medical degree awarded by University of Ceylon or corresponding University or from a degree awarding Institute or KDU must be accepted for registration as a medical practitioner and there is no provision in Medical Ordinance to ask or give prior recognition for those degrees. Furthermore SLMC does not have minimum standards prescribed by regulation (approved by Parliament) to evaluate medical school within Sri Lanka. SLMC is not vested with powers in terms of Medical Ordinance to issue a certificate of compliance. What is the role of the SLMC with regard to SAITM (the private medical college)? Is there no role at all? If not, why has the SAITM Management invited the SLMC by letter to visit SAITM? SLMC has a role to play in SAITM like for any other degree awarding institution in Medicine, state or non state, to ensure maintaining of minimum standards which have been recognized by law. However to do this SLMC should have Minimum standards prescribed by regulations and approved by Parliament as stipulated in the Medical Ordinance. The guidelines for accreditation published by SLMC are not the prescribed standards published by regulation. As such even though SLMC could acc (ask?) for information and even carry out a visit under section 19 of the Ordinance they cannot make any comment or further recommendation to the Minister of Health to initiate de-recognition of the degree for registration. In any event SLMC is not vested with the powers to recognize or derecognize or refuse registration of the MBBS degree by SAITM under current laws. SLMC was invited by SAITM only to inspect the study program and the facilities with a view of obtaining its advice for any further improvements. Is there a difference between ‘specified authority’ and ‘specified body’ in the Universities Act? Yes there is a clear difference between ‘specified authority’ and ‘Specified professional body’ Specified authority is appointed by the Minister of Higher Education by regulations approved in the Parliament to perform specific activities laid down in the Universities Act. Specified professional body is not defined in Universities Act. Once the Specified Authority is appointed (currently the Secretary of Minister of Higher Education and earlier UGC), such authority may publish rules in the Government Gazette under his signature for the administrative and academic purposes. These rules cannot supersede the laws or regulations made under provisions of law. Furthermore by these rules the powers vested on the Minister, or specified authority cannot be delegated to another person or a body such as SLMC. Has SAITM obtained a ‘Compliance Certificate’ from the SLMC? We have not been informed as to the specific professional body relevant to degree awarding institutes in Medicine who is legally empowered to issue such a certificate. A letter requesting clarification regarding this was sent to specify (specified?) authority more than year ago and also discussed with the then specified authority but no response yet. Furthermore the rules were published after SAITM was given degree awarding status whether these rules have retrospective effect also not stated. As far as SAITM is aware there is no degree awarding institute (Medicine or other) who has fulfilled this requirement.
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