Private Medical Education in Sri Lanka

Abstract

Medicine is one of the most sought after professions in the world. However, opportunities for students to realise this dream are few, particularly due to the competitive nature of university entrance examinations. This essay discusses the establishment of private medical schools in Sri Lanka and the expanded opportunities now available for medical students. There are differing perspectives on these developments, among medical professionals as well as the public. We give a background to the controversy followed by opposing views from the first and second author on the regulatory framework in Sri Lanka and providers’ commercial agenda. Background The Sri Lankan public education system consists of five years of primary school, a scholarship examination, five years of junior secondary school, the General Certificate of Education (GCE) Ordinary level examination, two years of senior secondary school, and the GCE Advanced Level Examination (GCE-A/L) (1), the university entrance examination. In 2009, 1,611 students who studied in the biology stream entered medical colleges in Sri Lanka. Students are selected for medical schools on scores based on merit and a district quota system (2). There are eight faculties of medicine functioning under the University Grants Commission (UGC) and one under the Ministry of Defence. The first private medical school was the North Colombo Medical College established in 1980. However, due to heavy opposition from the Marxist party People’s Liberation Front, medical professionals, university students and other professionals, the college was nationalised and renamed the Kelaniya Medical Faculty. After graduation, all medical graduates are offered employment at the Ministry of Health. The majority accept it and continue to work in the government sector even after their internship year. All the medical graduates passing out are in a single list based on a common multiple choice and clinical examination. Graduates who top the list can opt for internship in a hospital of their choice before those placed below them. The lists of all graduating medical students are also standardised after common MCQ. Undergraduate students who qualified abroad must pass a licensing examination and are placed at the bottom of this list. Sri Lanka has exemplary health indicators and is often referred to as a model for other developing countries (3). Sri Lankan medical professionals are considered to be skilled clinicians. These achievements are due to the high quality of training and standards maintained by Sri Lankan medical faculties. All medical schools and medical training are closely monitored by the Sri Lanka Medical Council (SLMC), an independent body benchmarking medical education.