• Docs groups including GMOA seek clarity 

A circular issued by the Postgraduate Institute of Medicine (PGIM) has raised concerns over the role of ‘acting consultant specialists’ in State-run hospitals, with doctors warning that the directive could disrupt specialist services at a time when the country is facing a shortage of consultant specialists.

President of the Medical and Civil Rights Professional Association of Doctors, Dr Chamal Sanjeewa told The Daily Morning yesterday (20) that according an extract of the minute number 2026.6.6 (II)(b), issued on 26 June by the Senior Assistant Registrar of the PGIM, ‘acting consultant specialists’ who have completed specialist training at the PGIM and overseas training but have yet to obtain Board Certification from the PGIM are barred from independently examining patients, making clinical decisions and issuing medical recommendations within their respective specialties. 

Dr Sanjeewa said that the circular had created a serious issue within the health service, as many State-run hospitals across the country currently rely on acting consultant specialists to provide specialist care. He noted that due to the shortage of consultant specialists, the Secretary to the Health Ministry has been appointing doctors who have completed their initial local postgraduate specialist training at the PGIM as acting consultant specialists to Base Hospitals and specialist units across the island. 

He said that the new PGIM instructions have now cast doubts on the deployment of these acting consultant specialists and their ability to independently manage patients and provide medical recommendations in the units to which they have been assigned. He urged the Secretary to urgently issue clear guidelines to consultant specialists and acting consultant specialists to clarify their responsibilities and ensure the uninterrupted delivery of specialist healthcare services. 

Dr Sanjeewa said the Secretary should urgently clarify the matter to the public in order to safeguard patient safety and maintain public confidence in the health service. Dr Sanjeewa further said that many specialist units in hospitals throughout the country are currently being managed by acting consultant specialists who have not yet completed overseas training and are providing an essential service in the face of the existing shortage of consultant specialists. 

Issuing such instructions under these circumstances, he said, is questionable. He also noted that many acting consultant specialists engage in private medical practice within the areas where they serve. He argued that if the circular prevents them from independently examining and treating patients in the public sector, it also raises questions over the legality of the services that they provide in private sector healthcare.

Meanwhile, the Government Medical Officers' Association (GMOA) too raised concerns regarding the PGIM Minute No. 2026.6.6 (II)(b), stating that doctors awaiting Board Certification are considered suitable only to practise under supervision until they obtained Board Certification. In a letter to the Health Minister Dr Nalinda Jayatissa, the Doctors' Union said that the minute contradicted the Ministry's decision to entrust these medical practitioners with independent specialist responsibilities while the PGIM considered them unsuitable to practise independently. They also urged Dr Jayatissa to appoint a high level committee with representatives from his Ministry, the PGIM, the Public Service Commission and the Medical Council to review the PGIM Minute No. 2026.6.6 (II)(b). 

GMOA Secretary Dr Ubaya Bandara Warakagoda, when contacted by The Daily Morning, said his outfit is "totally against” the service minute issued by the PGIM, noting that it "did not have provisions to take such a decision with regard to 'acting consultants.' That decision can only be taken by the Ministry," he stressed. “It is not a decision to be taken even by the University Grants Commission or the Medical Council," Dr Warakagoda pointed out.    

Efforts to contact the Deputy Health Minister and the Secretary for comment on the issue were unsuccessful at the time of publication.