Are doctors’ unions making threats again? - EDITORIAL

The doctors in our country seem to be girding up their loin cloths for a possible fight with the government in the aftermath of a government decision to set up a medical faculty at the ‘National School of Business Management (NSBM) and at the General Sir John Kotelawala Defence University (KDU). 
A study by ‘The National Library of Medicine’ shows currently around 1,450 doctors enter the health system annually and the national doctor-to-patient ratio is 1:671 to 1,000 patients. Not surprisingly there is a shortage of doctors in the country.

According to the 2019 GCE (A/L) Examinations Analysis Book 20,287 students sat for the biology science (medical stream). In 2023, 40,329 students took the Bio Science stream. Of this number only 23,178 were able to gain entry to the available facilities in the country.

In other words we have a huge gap between the number of candidates attempting to enter the medical faculties of the university in the country and the numbers they are able to absorb.
To make matters worse in March 2024, Dr. Ananda Wijewickrama, President of the Sri Lanka Medical Association (SLMA) said that about 700 medical officers, including consultants, migrated overseas in 2022.

He added as per statistics, a total of close to 450 specialists have migrated since the latter part of 2022, while another 785 specialists are set to go overseas for training. He said, of the 450 specialists who left the country only five had returned by 2024.
It is therefore extremely clear that the number of doctors in the country is drastically reducing. 

It was obviously in an effort to bridge this shortage, government recently proposed establishing a medical faculty at the NSBM and at the KDU.  
Despite the very visibly posed dangers to our health sector due to the dwindling number of doctors in the country, the Association of Medical Specialists (AMS) has raised concerns regarding proposed changes to the entry criteria for fee-levying medical undergraduate programmes at the state-owned medical school of Kotelawala Defense University. 
Mama mia, it seems strange the doctors of the AMS have still not realised the sons and daughters of the more well-to-do in the country go abroad to complete their studies as our country cannot cope with the need.

UNESCO estimates that 29,000 Sri Lankans are studying abroad in higher education institutions in 2020, mostly in Australia (roughly 10,500), Japan (5,500), US (3,100), Malaysia (2,400), and UK (1,300). Today medical students who are unable to enter the medical faculties in our country even go to Bangladesh to obtain a medical degree. 
 They return to this country, take up the local exam conducted by the local body here and are absorbed into the medical system.
 In the meantime the study abroad fees for Sri Lankan students varies depending on the university, country and course. But an average annual tuition fee ranges from an annual fee of LKR 600,000 - LKR 3,000000 to study abroad. According to UNESCO at least 29,000 Sri Lankans are today studying abroad .

This in turn means a huge flight of badly needed foreign exchange leaving our bankrupt-ridden country. Looked at in another way opening private foreign universities in the country is a means of bringing the much-needed foreign exchange into the country as well as preventing the flight of exchange out of the country.
The AMS main fear probably lies in ‘a fear of potential unemployment of medical graduates’.
At this moment doctors are able to dictate terms from governments to the ordinary beggar on the street as their numbers are few. The AMS seems to be intent on keeping up this status quo, rather than look to afford their patients an affordable medical system. 

Doctors have also reminded us of the ‘unpleasant incidents’ leading to the closing of the SAITM institute in Malabe. Are they threatening more of the same?
Increasing the number of doctors in the public medical systems could negate the need for private medical practice. 
Is this what scares to good doctors who demand we limit the number of medical universities in the country?