Caring Doctors or Cussed Ones we need?

Why this fuss over SAITM?

Leo Fernando, Pitipana (Island)

(Theme cartoons added by TW from internet)

If the question of recognition of the medical degree granted by SAITM is related to the standards in medical education, the issues raised below would have some relevance on the matter.

In the mid 1960s, I happened to be a boarder in a house in Kalutara where the landlady used to constantly sing praises about the skills of the Surgeon of the hospital for saving the life of her son who was in a coma after falling off his bicycle. The Surgeon, though (without the FRCS-UK)) had performed brain surgery on him and did the needful. The son concerned later became an Advocate and a Deputy Minister of Health but was killed by the JVP in 1988 or thereabout. Not only was the Surgeon unqualified to practice according to Ceylon Medical Council (CMC) standards then, but he had been appointed by the Health Department as Surgeon and allowed private practice. About the same time, the Gynecologist-Obstetrician appointed by the department too was unqualified being without the MRCOG. But they had been appointed to these specialist positions by the government, with or without the approval of the CMC. It appears these unqualified specialists did their job well from all accounts, as there were no fatalities reported in the media as far as I can remember.

Standards in medical practice may have risen since the 1960s, although we are aware that standards in the general education levels have declined, for the simple reason that it is so easy to obtain 8 distinctions at the O/Level today than in the sixties.Image result for doctors cartoonsImage result for doctors cartoons

Even though standards in medical education/practice have risen, there are still fatalities, misadventures and acquittals of the guilty at inquiries/inquests into deaths of patients. In a letter of mine published in The Island on 12/12/15 about the rate of fatalities and surgical misadventures in the UK as reported against the NHS in UK, and in the light of the facts surrounding the death of Rev. Sobitha Thero, one gets the impression that the scenario in our country, which considers the UK standards as the gold standard has much to be desired. If such surgical errors could occur among qualified surgeons in a highly developed country, will this fixation on standards and compliance certificates be worth the damage caused to the spirit of private enterprise, and the loss of man days affecting the lives of poor patients when the problem can be solved by holding an examination?Image result for doctors cartoons

The refusal by the SLMC to permit the SAITM graduates to practice medicine seems unreasonable considering the fact that the criterion of standards is a variable factor and is based on individual and group judgments and biases. I don’t understand why the usual yardstick of an examination is not used to test standards of these graduates. I might add that in former times the Institute of Chartered Accountants used to get qualified fellow accountants to answer questions under examination conditions, in order to confirm the adequacy of standards in accountancy examinations. The SLMC, which may be an older professional body, might do well to follow this method of examination to ensure high standards.

It seems pretty obvious that the GMOA members do not like to see more doctors entering their field as competitors. When they voice their protest against the SAITM doctors on the score that the entry qualifications to this private medical College were lower, they should realize that 40% of the doctors passing out of the state medical faculties have entered state universities with lower entry qualifications under the district quota system. Those entering the Military Medical faculty would have gained entry more for their brawn than brain.

The street protests launched by both students and politicians bode ill for foreign direct investment capital, as foreign investors would not like to face ugly unruly protests and breaches of the peace. Besides, as averred by other writers, our debt burdened country will be saved foreign exchange haemorrhages by allowing private investors to provide medical education here.

There is a line from a much sung song of yesteryear which bears quoting “money is the root of all evil…”. The protest against SAITM and against the verdict of the Appeal Court is possibly a case of triumph of money over good medicine. I hasten to add that I do not intend to cast any aspersions/accusation against members of the SLMC, and these comments are meant only for the misguided members of the GMOA. I wish that they are more concerned with the health and welfare of the sick without wasting time in staging protests and strikes, following the good example of their predecessors whose concern was cure and care of the poor patients, when the then UK qualified local doctors did not raise a protest nor resort to strike action against unqualified doctors doing operations.

I remember in those good old days witnessing a Burgher Regional Director of Health (RDHS) taking along with him in his car patients waiting at the Nagoda bus stop to go to the Kalutara hospital. Are there such doctors among the GMOA medics now? I believe there are such caring doctors, but the general impression created in the public mind unfortunately, is that our doctors are more after the pot of gold by creating a monopoly for government doctors. When the opportunity was made available for the SAITM undergrads to gain clinical experience at the Avissawella hospital, the GMOA members resisted the move and staged street protests. Why did this happen? It is obvious that they did not like competitors entering their gold field.

There is a Latin legal maxim “..ut res valeat quam pereat”-meaning that the matter should be promoted rather than be allowed to perish- that might be relevant here and the SLMC can be the midwife in promoting the matter by simply persuading the Medical Faculties to jointly hold a common examination.