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Medical specialists attached to the Provincial General (Teaching) Hospital in Ratnapura, who are currently providing the relevant Professorial Unit based training (a temporary arrangement) to the first batch of students of the Sabaragamuwa University had recently decided not to provide the related training to the medical students of the second, third, and fourth batches of the said university. Their decision has been caused by the continuous criticism by some parties including certain medical students regarding the quality of their teaching.

In response to the medical specialists' decision, the Medical Faculty Students' Action Committee (MFSAC), which has been making critical remarks about the current arrangement, proposed the allocation of the said batches of medical students to other medical faculties to undergo the relevant training. However, medical students and their parents, and medical specialists involved in the programme have said that if the ongoing programme is not implemented, students would have to face many issues and that there would be more problems related to medical education.

A temporary arrangement

When the first batch of medical students of the said university was to commence their Professorial Unit based training, there were no dedicated Professorial Wards at the Ratnapura Teaching Hospital, and while there were plans to construct such wards at the hospital, to date, the relevant construction activities have not commenced. Since the construction of such wards will take a minimum of four to five years, the relevant parties such as the Ministries of Education and Health, the University Grants Commission (UGC), the Sabaragamuwa University, and the Ratnapura Hospital signed a memorandum of understanding (MoU) to allow the existing wards at the hospital to be used as Professorial Wards.

Although the Professorial Unit based training is usually provided by medical specialists attached to the Ministry of Education, the training is provided to medical students of the Sabaragamuwa University with the support of medical specialists working in the hospital (under the Ministry of Health) until the wards and other facilities are permanently installed under this arrangement. The provision of the training commenced in December of last year (2023), and it was earlier reported that a total of 70 students were receiving the relevant training in general medicine, 25 others in paediatric medicine, and several others in the other respective medical specialties.

Criticisms

Since its inception, the current arrangement has attracted criticism from certain deans of the medical faculties of other universities and the MFSAC. It is learnt that both those parties are of the view that this arrangement would have a negative impact on other medical faculties for which there are Professorial Unit based trainings conducted by medical specialists attached to the universities themselves. They had also taken steps to inform the Sri Lanka Medical Council (SLMC) of their concerns in both formal and informal ways. In a letter dated 24 January of this year (2024), the MFSAC had informed the SLMC that there was the probability that the programme would undoubtedly create problematic situations for the future of medical education. Hence, they had urged the necessity of a broader approach in the relevant accreditation process, considering the smooth functioning of the other medical faculties and the future of medical education.

Medical specialists' response

In face of continuous criticism over the arrangement, the medical specialists at the hospital have now decided not to provide the relevant training to the second, third, and fourth batches of medical students at the said university. They have informed the university administration to arrange an alternative programme for them. Speaking to The Daily Morning recently, a consultant at the hospital said that the programme of providing the Professorial Unit based training to the first batch of students is progressive, with positive feedback from both the academic and clinical staff as well as the students. He said that the students from the second, third, and fourth batches have however been vehemently opposing the related MoU and demanding its annulment. Following their decision, the MFSAC had proposed that medical specialists at the Ratnapura Teaching Hospital associated with this programme should either join the Education Ministry or that the medical students of the said university should be referred for Professorial Unit based training to other medical faculties.

More issues?

With their decision, an uncertain situation has arisen regarding the provision of Professorial Unit based training to the second, third, and fourth batches of students. Although the option of transferring them to other medical faculties has been proposed, experts have warned that many practical difficulties may arise in its implementation. A professor who has worked at the medical faculties of several leading universities told The Daily Morning that never in the past were students of two medical faculties permitted to undergo professorial training in the same ward and/or hospital. "Such an arrangement (the transferring of medical students to other medical faculties) will increase the number of students in a clinical group, compromise clinical training, and do an injustice to students admitted to universities with a high ‘Z’ score. Following such an allocation, from which university will the students of the Sabaragamuwa University receive their degree is another issue. The students have been told that it may be possible for them to receive the degree from a well-established university such as the University of Colombo. It is something that has never happened in the past." If the students are to be transferred to other medical faculties, he queried what would be the role of academics attached to the Clinical Departments of the Sabaragamuwa University's Medical Faculty, and said that such a move would tarnish the image of the university and delay the proposed construction of a permanent Professorial Unit at the Ratnapura Teaching Hospital for many years. He concluded that such an arrangement would definitely result in certain medical students or parents filing lawsuits naming the UGC and the SLMC as respondents, which he claimed would affect the students of all medical faculties.

A matter of recognition

A student belonging to the second batch of students at the Sabaragamuwa University's Medical Faculty, who wished to remain anonymous, told The Daily Morning that it is best to continue the current programme until the Professorial Unit is established permanently. "The medical specialists of the Ratnapura Teaching Hospital have decided to withdraw from this programme on the basis that we (the second, third, and fourth batches) underestimate their teachings, but that is a misunderstanding. While we never underestimate their teachings, what we say is that the relevant authorities should make a firm declaration that students who are trained under this programme will receive a degree with the same recognition that those of other medical faculties receive." He said that the Accreditation Unit of the SLMC should work to ensure the quality of the programme and inform the relevant parties if it requires any improvement. "If this programme is stopped at this time, the students will have to be assigned to other medical faculties. Students who have studied in this university for several years may find it difficult to adjust to a medical faculty in another area. When those who are currently working in groups are separated, the students may also be affected mentally." He also elaborated that the SLMC's Accreditation Unit would have to comply with the criteria set out by the World Federation for Medical Education (WFME) in recognising the arrangement in question. "The WFME is assessing the SLMC's said unit once every five years. In case the ongoing arrangement is recognised without rectifying its shortcomings, if any, the WFME may not recognise the SLMC's unit next time. Such a move will affect all other medical faculties and that is why certain students of those faculties oppose this arrangement."

A parent's view

"We the parents do not have much of an understanding of the problems that have arisen, but, we request that a programme be prepared in such a way that our children can complete their education without any hindrance and become a doctor," the father of a student belonging to the third batch of students said. He said that the relevant authorities should work to facilitate the students to complete their education in due time and to start their professional life. "Starting a medical faculty at a state university is a very important matter. Before such an initiative, a study must be done on the availability of the other facilities. However, after the students are enrolled, they should be facilitated to undergo the relevant training instead of transferring them from one place to another. We believe that the authorities will work to provide a solution to this problem in a way that does not cause injustice to any party."

Health Minister, Dr. Ramesh Pathirana was not available for comment.

When contacted by The Daily Morning on an earlier occasion however, the SLMC's Registrar, Dr. Hemantha Herath said that the SLMC’s Accreditation Unit, which is an independent body, has observed that this programme lacks some required standards, and added that the Unit had informed it to the relevant authorities. Noting that the accreditation would be granted when the identified shortcomings are rectified, he also said that the students would become 'very helpless' if the issue is not addressed properly.