Now that we have examined this issue through the eyes of both parties, lets move onto the part 2 of the series. Under this section, we will analyze statements made by both parties, and identify compromises (if any) that can be made to find some middle ground.
State University Lecturers
Today a senior lecturer earns a figure close to LKR 200 000 per month. Also unlike any other state officials, the non-monetary benefits present are quite inviting. To name just one, academics have sabbatical leave. I can put in a block of research regarding these perks, however ultimately, all these benefits coupled with the job security of a State employee makes the battleground for academics quite difficult to compete in. Analyzing the situation at Rajarata and Eastern universities, it needs to be understood that for a completely new faculty to fully establish itself, time is of the essence. Most academics from Colombo prefer not to be stationed in other parts of the country. Once 8 -10 batches pass out from these specific universities, the academic staff will build up to form the structure present at other State universities. Coincidentally this issue is not local to medicine alone. The identical problem has been faced at the engineering faculty at the South-Eastern University. Hence the concern regarding State academics leaving the system seems to be a distant & unlikely possibility.
The reason the state university students are claiming this Armageddon will occur is due to the cost of the medical degree at SAITM. However, let’s look at the cost of a state university medical education. Despite the fact that students don’t pay out of their own pockets, the state bears the cost. Let’s look at how much the state spends per head. The recurrent cost alone is approximately Rs.3Million for the 5 year degree. Recurrent cost meaning only the costs which need to be paid within the year (eg. Salaries, Utility bills). This is leaving aside all capital costs involved in building the university, in building state teaching hospitals and so on. I can’t provide an accurate figure, however when we consider the overall cost in providing a state medical eduction the figure would reach well over Rs.8Million per head. In taking in students who can pay, private medical colleges are lessening the burden on the state to increase the number of med students they need to cater for. Also students who can afford it will have a larger propensity to choose SAITM over state universities. Hence the argument that private medical faculties are more expensive in comparison to state seems questionable.
The entry requirements at SAITM are currently 2 Cs and 1 S pass. Further into our research we were able to identify that the reason SAITM used this specific minimum result is due to an SLMC ruling stating that even those studying at foreign universities need to have a minimum Advanced Level pass of 2 Cs and 1 S pass. (So that students could use the SAITM alternative instead of traveling overseas for higher studies.) The logic behind this decision is sound, however, adjustments can be made. A doctor is one of the top-notch professionals in any country. Hence this entry requirement seems slightly mediocre. The proposed solution is to increase these entry requirements to a new minimum of 3 Bs. This, in my opinion completely eliminates the allegation of recruiting students with low results.
The Clinical Training Situation
Whatever the argument for or against providing these facilities for SAITM students, the judiciary is supreme. If the courts have decided that the students of SAITM should be provided clinical training at said State hospitals, that request needs to be heeded. Before the SAITM students were allowed to use the facilities, only State medical students had clinical training at State hospitals. This privilege was offered to the State medical students completely free of charge. With the private medical students in play, the court decision stated that these students have to make a payment of LKR 50 000 per subject. These students are provided clinical training for 3 subjects (Psychology, Community Medicine & Forensics), hence these students have to make an overall payment of LKR 150 000 to the state. The risk involved for the patient is identical, be it a State medical student or a SAITM medical student. They’re both amateurs when they start their clinical training in their 3rd year. The only difference is, the State earns a fee because of the SAITM students. If we look at the numbers, there are approximately 900 students studying medicine, hence with the existing students alone, the state would earn LKR 135 million by providing these facilities. That is an additional LKR 135 million that was not present in the State coffers before. This money could be utilized to further strengthen the State medical education. An additional laboratory or lecture hall could be built at a State Medical Faculty. This money could even be used to provide additional financial incentive for State academics to transfer to Rajarata & Eastern universities where Medical Faculties seem to be struggling without academics. From an analytical perspective this is a win-win situation for both parties.
At the Dr. Neville Fernando Teaching Hospital, relative to any other private or state hospital I have visited, the number of patients was significantly low. Many parties claim the reason for this is due to it being a private hospital where payment is required. Whilst this maybe a minor reason, I believe the more significant reason is it’s location (This hospital is located in the middle of nowhere) as there are a number of private hospitals bustling with patients similar to State hospitals. Now while it needs to be understood that Malabe is a rapidly developing city, it isn’t as developed as other cities in the country (For example, Maharagama). Over the next two decades when Malabe does develop I believe this issue will fix itself. A recent statement by it’s chairman Dr.Neville Fernando draws up a new hope for the SAITM students. Should NFTH be converted to a semi-government hospital where no payment is required, the number of patients would certainly boost. However another fact that was brought into light during our research is that these students receive clinical training at various other private hospitals including Nawaloka, Asiri, Oasis and Central hospitals.
Studying at a foreign university. A smarter choice? Read the next part of this series written by a former Sri Lankan foreign medical student to find stunning revelations;