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Playing Russian roulette with medical degrees By
Apsara Kapukotuwa However, the sheer number of "quacks" numbering about 40,000 as opposed to the 8000 qualified doctors in the country stand testimony to the fact that medical qualifications today are not as sacred as they used to be and that a "degree" is an open ended matter, sometimes depending only on the availability of funds and the right connections. With the large number of specialists qualified abroad -especially from Russian Universities- vying for recognition in the country, questions have arisen about who is responsible for the standards of healthcare in the country. When 50 Assistant Medical Practitioners and Registered Medical Practitioners left for Russia's St. Petersburg Medical Academy, they never dreamed that they would open a Pandora's box of repercussions on their return. Investigations have revealed that they left for this course on paid official leave. This 'accelerated course' which took one year to complete, was meant to put them on par with qualified medical practitioners of this country. The entry requirement for this, "only for Sri Lanka" course was a certificate showing their AMO or RMO qualifications, which exempted them from the first 3 years of the degree. No one knows where the rest of the necessary course work was completed even though reports suggest that it was conducted in Colombo, Kandy and Kurunegala. However, a medical degree takes at least six years to complete, so were those requirements met is the question? A spokesperson for The Sri Lanka Assistant Medical Officers and Registered Medical Officers Association defended the course saying that since they had difficulty in obtaining several years of leave for the course, they had requested the university to send down lecturers to conduct it here in Sri Lanka and that they had to complete the final year in Russia. He further said that the courses were conducted in English. "We reject all the allegations that are made against this course. The Russian institute in question did a survey of the curriculum here and determined that the Assistant Medical Officers Certificate was equal to the first 3 years of their 6-year course. In fact, what they equated was that the AMO certificate was enough to gain admission to the final year of their 6-year degree," he said. In their defence, the Registered Medical Officers point out that they are taught all the subjects that are in an MBBS course except for, two dealing with Forensic Medicine during their 21/2 year AMO course. Upon its conclusion, they have to complete a 6-month course. To be selected for the AMO course, you need just 4 passes with 2 credits in the Bioscience stream at the local A Levels. However, a spokesman for the Sri Lanka Medical Council says since it is not clear where and how the course was conducted, it is unable to recognize it as a valid qualification. He further said that the AMO's and RMO's have taken measures to consider their period of practice in lieu of qualifications towards shortening the length of time of the degree course. " The situation is grave because it is the public who will have to face the consequences. It is certainly unfair by those who have completed a full-term course. The AMP's and the RMP's would have probably accounted their period of service of medical experience (for some it is as much as 20 years) which in itself is unfair since a normal undergraduate has just a minimum of 5 years (and a maximum of 10 years) to complete the necessary course work". The SLMC says it found two curriculuma within the University only after initial recognition was given to the St. Petersburg Medical Academy. Once the SLMC realized a short-term course was being given a similar certificate they had requested clarification, but got no response. According to the Registered Medical Officers, they have written to several World Health Organization recognized universities abroad, after repeated requests to permit them to sit for the local MBBS qualification fell on deaf ears at the Health Ministry, and among the universities that responded was the St. Petersburg State Medical Mechnikov Academy. They say that senior officials of the Academy came to Sri Lanka for discussions with members of medical faculties here and the Sri Lanka Medical Council and after a thorough evaluation, they were given the go ahead. Sri Lanka has 3 medical councils, which fall under the purview of the Health Minister. They are the Ayurvedic, Western and the Homoeopathy medical councils. Unlike those who have completed the MBBS degree who can seek registration with the medical council once their internship is over (a provisional registration can be obtained beforehand), a person with an AMO certificate needs to complete 8 years of service before being recognized and registered as a Registered Medical Officer with the Sri Lanka Medical Council. Upon registration, RMO's have the same legal rights as the Medical Practitioners including the right to dispense prescriptions and perform surgery. Even though earlier reports said that the Health Minister was unable to intervene in this matter, the Government Medical Officers Association says that after it held discussions with him he has said that it is within his purview and that the matter can be settled in consultation with the relevant bodies. "If standards are compromised, who is going to accept responsibility for the quality of the medical care that is given to the public? If recognition is given for this 6-month course, we will resort to trade union action," a GMOA spokesman said. The GMOA stresses that a correct interpretation of the court ruling is the need of the hour. The original Court of Appeal judgment states that measures should be taken in "terms of the law to duly recognize the M.D. awarded". According to the GMOA, if due procedure is followed there is no way the short-term course could be recognised by the Sri Lanka Medical Council. Interestingly, a letter written by the Registrar of the Sri Lanka Medical Council in January 1999, refuses to further recognise the new programme leading upto the MD degree as well as the original course. The Supreme Court on September 23, this year, dismissed the two appeals filed by the Sri Lanka Medical Council seeking to set aside the Court of Appeal judgment directing the Council to recognize the MD degree awarded to RMO's and AMO's by the St. Petersburg State Medical Academy of Russia. About
St. Petersburg State Medical Academy The Saint-Petersburg State Medical Academy named after I.I Mechnikov (SPSMA) is the oldest institution of higher medical education in Russia. In December 1995 it was given the name of the outstanding scientist and winner of the Nobel Prize, I.I. Mechnikov. The Academy trains specialists in general and preventive medicine for more than 30 specialities, including specialists in economics and management of public health services, laboratory research, medical psychiatry and management in the field of nursing and ecology. Criteria for SLMC recognition
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