Features

Private medical schools: Next assault on Free Education?

Published

3 years ago

2023/07/18

Thilina Walpola

A protest against SAITM

By Ramya Kumar

Interest-free loans of LKR 1.1 million are to be offered for students to follow degree programmes at private higher educational institutions. An amendment to the Universities Act has been proposed to establish a Quality Assurance Council under the University Grants Commission (UGC) to maintain the quality of academic programmes offered by state and non-state higher educational institutions.

According to the government, these policies are designed to increase access to higher education and standardize the quality of academic programmes. However, the relentless attacks on the student movement, arbitrary arrests of Inter-University Students’ Federation (IUSF) leaders and the media campaigns against free education signal a different agenda: privatisation. As the government sets the stage for a ‘radical’ revamping of higher education, this article looks at what might be in store for medical education.

Minimum standards

Private medical education is a sensitive topic in Sri Lanka, so much so that the government has kept mum about its plans. The foundation for the establishment of private medical schools has already been laid through the setting up of an Accreditation Unit under the Sri Lanka Medical Council (SLMC). The medical fraternity may oppose private medical schools of questionable standards, but does not, in principle, object to private medical education. Indeed, there is much complacency on this front since the gazetting of the Minimum Standards of Medical Education in 2018, after the SAITM debacle. Even the Government Medical Officers’ Association (GMOA), which opposed SAITM based on ‘quality’ concerns, now simply demands that they be consulted in matters pertaining to private medical education.

It is believed that the quality of MBBS degree programmes can be assured by the requirements set out in the Minimum Standards, for instance, minimum qualifications for student admission, staff requirements, hospital bed numbers, bed occupancy rates, etc. To be sure, the Minimum Standards do set much-needed ‘benchmarks’ to check the proliferation of low-quality private medical schools.

However, by considering state and non-state medical schools on an equal footing, neither the Minimum Standards nor accreditation processes give due consideration to the impact private medical schools will have on state medical faculties. In particular, they overlook equity and justice in access to medical education.

An unhealthy symbiosis

Take, for instance, the staff requirements laid out in the Minimum Standards. In terms of academic staff, the Standards specify that MBBS degree-awarding institutions should “conform to teacher-student ratios… not less than one teacher for every 14 medical students, taking into account the permanent academic staff and the extended faculty of specialists in affiliated teaching hospitals and other healthcare settings.” They include provisions for a balance between full-time and part-time academic staff, and ask that “all medically qualified staff engaged in patient care are registered with the designated body responsible for registration of medical professions in the relevant country” (Note: the Minimum Standards apply to overseas medical schools that produce MBBS graduates who intend to work in Sri Lanka).

In the event that private medical schools set foot in the country, it is unlikely that these institutions will be able to attract diaspora medical professionals who could renew their SLMC registration, given the economic situation in the country. Therefore, these institutions would need to rely on retired medical professionals or current teaching faculty at state medical faculties. As the Standards do not place limits on teaching hours, university teachers will be able to divide their time between public and private medical schools (akin to ‘dual practice’ by clinicians) or, if the benefits are appealing, a wholesale movement from state to private medical schools may occur.

If teaching faculty engage in ‘dual practice’ in state and private medical schools, there is no guarantee that their primary commitments will remain with state medical faculties. Given the required hospital beds and occupancy rates specified in the Minimum Standards, private medical schools may need to rely on public hospitals for clinical training. For this reason, they may be located adjacent to tertiary hospitals in peripheral districts that do not serve as clinical training centres for students of state medical faculties.

Winners and losers

Student intake to state universities, including medical faculties, has steeply risen in recent years (see table). Even so, the Colombo Medical Faculty has been able to maintain its student to permanent academic staff ratio at 7:1. Owing to its location, the Colombo Medical Faculty would be able to attract medical professionals to full-time teaching positions despite the higher salaries offered by the Ministry of Health.

However, the student to permanent academic staff ratio at the Jaffna Medical Faculty has risen over the years, climbing to 19:1 in 2021. The availability of vacant cadre positions at Ministry of Health institutions in and around Jaffna gives medical professionals no reason to resign from the Ministry to take up teaching positions that pay substantially less. (See table)

The requirement of 14:1 is fulfilled by state medical faculties in peripheral districts when temporary staff and extended faculty at teaching hospitals are considered. Yet, curriculum development, ‘quality assurance,’ student welfare and other time-consuming activities are undertaken primarily by permanent academic staff. If private medical schools are established in such districts, state medical faculties will need to compete not only with the Ministry of Health, but also with private medical schools that can offer much higher salaries, causing a dearth in teaching staff at state medical faculties.

Equity of access

The government will gloss over equity concerns by promising loans, voucher schemes and other carrots to study at private medical schools. Even as the state university system as a whole is seeing declines in state investment (see table), and even more so after the economic crisis, it is unclear how these loans will be financed. Accumulating student debt has shown to influence the career choices of medical students in other settings.

As the country struggles to retain medical professionals, it is unlikely that medical graduates burdened by student debt will serve in the public health sector under the present salary structure. It is even less likely that fee-levying international students, the government’s primary target for forex, will serve in Sri Lanka’s health sector. In other words, whether private medical schools will produce medical professionals to service the healthcare needs of ordinary citizens is uncertain.

The entry of private medical schools will change the demographic makeup of medical students by creating a two-tiered system of medical education. Given the emphasis on student resumes and ‘soft skills’, not to mention the hefty fees that will be levied, those who enter private medical schools will mostly represent the middle/upper-middle classes. According to UGC statistics, in 2020/2021, about 63% of enrollment in state medical faculties was through the district quote system. While the Colombo elite suggest that this is a form of reverse discrimination, such arguments overlook the tremendous disadvantages experienced by students from rural districts.

A closer look at the UGC’s admission statistics of 2020/2021 shows that the majority of students who entered medicine from the Vanni districts, Polonnaruwa, Anuradhapura, Moneragala and Nuwara Eliya, did so through the district quotas. With the entrenchment of private medical education, and weakening of state medical faculties, the opportunities for students from rural and plantation districts to access medical education will contract. It must be remembered that it is also these students who tend to populate peripherally located state medical faculties.

Ideology in the making

As health professionals leave en masse from the country, it is argued that private medical schools might present a solution for physician brain drain. The entry of private medical schools will surely create a two-tiered system with lasting impacts on who has access to medical education and on the healthcare system more broadly. Until now, state medical faculties have furnished the public health sector with its medical cadre. While there is certainly room for improvement, at this point, the focus should be on supporting state medical faculties to ensure the survival of the public health sector.

As welfare is steadily chipped away in the name of the economic crisis, the government, supported by sections of the elite, suggest that it is a ‘welfare mindset’ that has brought the country to this state of crisis. The media is drumming up support for the government’s short-sighted policies, including the dismantling of free education. Images of student protests are being deployed to further delegitimize state universities, detracting attention from the ongoing mass-scale dispossession that is taking place in this country, whether through ‘domestic debt optimisation’, labour reforms or the proposals on restructuring higher education and public health. In this context, opposing private medical education is portrayed as ‘ideological’ or impractical, concealing the ideological work that has been undertaken over the years to convince many to believe that fee-levying university education is the way forward.

(The author is attached to the Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna)

Kuppi is a politics and pedagogy happening on the margins of the lecture hall that parodies, subverts, and simultaneously reaffirms social hierarchies.

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Features

Political violence stalking Trump administration

Published

5 hours ago

2026/04/30

Sahan Weerasooriya

A scene that unfolded during the shooting incident at the recent White House Correspondents’ Dinner in Washington. (BBC)

It would not be particularly revelatory to say that the US is plagued by ‘gun violence’. It is a deeply entrenched and widespread malaise that has come in tandem with the relative ease with which firearms could be acquired and owned by sections of the US public, besides other causes.

However, a third apparent attempt on the life of US President Donald Trump in around two and a half years is both thought-provoking and unsettling for the defenders of democracy. After all, whatever its short comings the US remains the world’s most vibrant democracy and in fact the ‘mightiest’ one. And the US must remain a foremost democracy for the purpose of balancing and offsetting the growing power of authoritarian states in the global power system, who are no friends of genuine representational governance.

Therefore, the recent breaching of the security cordon surrounding the White House Correspondents’ Dinner in Washington at which President Trump and his inner Cabinet were present, by an apparently ‘Lone Wolf’ gunman, besides raising issues relating to the reliability of the security measures deployed for the President, indicates a notable spike in anti-VVIP political violence in particular in the US. It is a pointer to a strong and widespread emergence of anti-democratic forces which seem to be gaining in virulence and destructiveness.

The issues raised by the attack are in the main for the US’ political Right and its supporters. They have smugly and complacently stood by while the extremists in their midst have taken centre stage and begun to dictate the course of Right wing politics. It is the political culture bred by them that leads to ‘Lone Wolf’ gunmen, for instance, who see themselves as being repressed or victimized, taking the law into their own hands, so to speak, and perpetrating ‘revenge attacks’ on the state and society.

A disproportionate degree of attention has been paid particularly internationally to Donald Trump’s personality and his eccentricities but such political persons cannot be divorced from the political culture in which they originate and have their being. That is, “structural” questions matter. Put simply, Donald Trump is a ‘true son’ of the Far Right, his principal support base. The issues raised are therefore for the President as well as his supporters of the Right.

We are obliged to respect the choices of the voting public but in the case of Trump’s election to the highest public position in the US, this columnist is inclined to see in those sections that voted for Trump blind followers of the latter who cared not for their candidate’s suitability, in every relevant respect, and therefore acted irrationally. It would seem that the Right in the US wanted their candidate to win by ‘hook or by crook’ and exercise power on their behalf.

By making the above observations this columnist does not intend to imply that voting publics everywhere in the world of democracy cast their vote sensibly. In the case of Sri Lanka, for example, the question could be raised whether the voters of the country used their vote sensibly when voting into office the majority of Executive Presidents and other persons holding high public office. The obvious answer is ‘no’ and this should lead to a wider public discussion on the dire need for thoroughgoing voter education. The issue is a ‘huge’ one that needs to be addressed in the appropriate forums and is beyond the scope of this column.

Looking back it could be said that the actions of Trump and his die-hard support base led to the Rule of Law in the US being undermined as perhaps never before in modern times. A shaming moment in this connection was the protest march, virtually motivated by Trump, of his supporters to the US Capitol on January 6th, 2021, with the aim of scuttling the presidential poll result of that year. Much violence and unruly behaviour, as known, was let loose. This amounted to denigrating the democratic process and encouraging the violent take over of the state.

In a public address, prior to the unruly conduct of his supporters, Trump is on record as blaring forth the following: ‘We won this election and we won by a landslide’, ‘We will stop the steal’, ‘We will never give up. We will never concede. It doesn’t happen’, ‘If you don’t fight like hell, you’re not going to have a country anymore.’

It is plain to see that such inflammatory utterances could lead impressionable minds in particular to revolt violently. Besides, they should have led the more rationally inclined to wonder whether their candidate was the most suitable person to hold the office of President.

Unfortunately, the latter process was not to be and the question could be raised whether the US is in the ‘safest pair of hands’. Needless to say, as events have revealed, Donald Trump is proving to be one of the most erratic heads of state the US has ever had.

However, the latest attempt on the life of President Trump suggests that considerable damage has been done to the democratic integrity of the US and none other than the President himself has to take on himself a considerable proportion of the blame for such degeneration, besides the US’ Far Right. They could be said to be ‘reaping the whirlwind.’

It is a time for soul-searching by the US Right. The political Right has the right to exist, so the speak, in a functional democracy but it needs to take cognizance of how its political culture is affecting the democratic integrity or health of the US. Ironically, the repressive and chauvinistic politics advocated by it is having the effect of activating counter-violence of the most murderous kind, as was witnessed at the White House Correspondents’ Dinner. Continued repressive politics could only produce more such incidents that could be self-defeating for the US.

Some past US Presidents were assassinated but the present political violence in the country brings into focus as perhaps never before the role that an anti-democratic political culture could play in unraveling the gains that the US has made over the decades. A duty is cast on pro-democracy forces to work collectively towards protecting the democratic integrity and strength of the US.

Features

22nd Anniversary Gala …action-packed event

Published

5 hours ago

2026/04/30

Sahan Weerasooriya

The Skyliners: Shanaka Viswakula (bass), Mario Ranasuriya (lead guitar), Daryl D'Souza (keyboards) and Kushmin Balasuriya (drums)

The Editor-in-Chief of The Sri Lankan Anchorman, a Toronto-based monthly, celebrating Sri Lankan community life in Canada, is none other than veteran Sri Lankan journalist Dirk Tissera, who moved to Canada in 1997. His wife, Michelle, whom he calls his “tower of strength”, is the Design Editor.

According to reports coming my way, the paper has turned out to be extremely popular in Toronto.

In fact, The Sri Lankan Anchorman won a press award in Toronto for excellence in editorial content and visual presentation.

However, the buzz in the air in Canada, right now, is The Sri Lankan Anchorman’s 22nd Anniversary Gala, to be held on Friday, 12 June, 2026, at the J&J Swagat Banquet Convention Centre, in Toronto.

An action-packed programme has been put together for the night, featuring some of the very best artistes in the Toronto scene.

The Skylines, who are classified as ‘the local musical band in Toronto’, will headline the event.

Dirk Tissera and wife Michelle: Supporting Sri Lanka-Canada community events, in Toronto, since launching The Anchorman
in 2002

They have performed and backed many legendary Sri Lanka singers.

According to Dirk, The Skylines can belt out a rhythm with gusto … be it Western, Sinhala or Tamil hits.

Also adding sparkle to the evening will be the legendary Fahmy Nazick, who, with his smooth and velvety vocals, will have the crowd on the floor.

Fahmy who was a household name, back in Sri Lanka, will be flying down from Virginia, USA.

He has captivated audiences in Sri Lanka, the Middle East and North America, and this will be his fourth visit to Toronto – back by popular demand,

Cherry DeLuna, who is described by Dirk as a powerhouse, also makes her appearance on stage and is all set to stir up the tempo with her cool and easy delivery.

“She’s got a great voice and vocal range that has captivated audiences out here”, says Dirk.

Chamil Welikala, said to be one of the hottest DJs in town, will be spinning his magic … in English, Sinhala, Tamil and Latin.

Both Jive and Baila competitions are on the cards among many other surprises on the night of 12 June.

This is The Anchorman’s fifth annual dance in a row – starting from 2022, 2023, 2024 and 2025 – and both Dirk and Michelle, and The Anchorman, have always produced elegant social events in Toronto.

“We intend to knock this one out of the park,” the duo says, adding that Western music and Sinhala and Tamil songs is something they’ve always delivered and the crowd loves it.

“We have always supported Sri Lanka-Canada community events, in Toronto, since launching The Anchorman, in 2002, and we intend to keep it that way.”

No doubt, there will be a large crowd of Sri Lankans, from all communities, turning up, on 12 June, to support Dirk, Michelle and The Anchorman.

Features

Face Pack for Radiant Skin

Published

5 hours ago

2026/04/30

Sahan Weerasooriya

* Apple and Orange:

Blend a few apple and orange pieces together. Add to it a pinch of turmeric and one tablespoon of honey. Apply it to the face and neck and rinse off after 30 minutes. This face pack is suitable for all skin types.

According to experts, apple is one of the best fruits for your skin health with Vitamin A, B complex and Vitamin C and minerals, while, with the orange peel, excessive oil secretion can be easily balanced.

* Mango and Curd:

Ripe mango pulp, mixed with curd, can be rubbed directly onto the skin to remove dirt and cleanse clogged pores. Rinse off after a few minutes.

Yes, of course, mango is a tasty and delicious fruit and this is the mango season in our part of the world, and it has extra-ordinary benefits to skin health. Vitamins C and E in mangoes protect the skin from the UV rays of the sun and promotes cell regeneration. It also promotes skin elasticity and fights skin dullness and acne, while curd, in combination, further adds to it.

* Grapes and Kiwi:

Take a handful of grapes and make a pulp of it. Simultaneously, take one kiwi fruit and mash it after peeling its skin. Now mix them and add some yoghurt to it. Apply it on your face for few minutes and wash it off.

Here again experts say that kiwi is the best nutrient-rich fruit with high vitamin C, minerals, Omega-3 fatty acids and vitamin E, while grapes contain flavonoids, which is an antioxidant that protects the skin from free radical damage. This homemade face pack acts as a natural cleanser and slows down the ageing process.