Opinion
Going places: Postgraduate paediatric education in Sri Lanka
It is not very often that one witnesses the occurrence of a seminal event that could vividly transform the very fabric of postgraduate pathways in medicine. This account is about such an event that took place on the 27th and 28th of May 2025 in Sri Lanka.
That occasion was the inaugural commencement of conducting the Final Part II Examination for the Membership of the Royal College of Paediatrics and Child Health (RCPCH) of the United Kingdom, in Sri Lanka. It was the final hurdle before the bestowment of the much-acclaimed MRCPCH (UK) academic qualification in Paediatric Medicine; a well-recognised qualification all over the world. This initiative was commenced for the first time this year by the RCPCH of the UK, in collaboration with the Sri Lanka College of Paediatricians (SLCP). These two academic colleges have had formal academic alliances for over 25 years, virtually from their inception in 1996. The SLCP was inaugurated on the 7th of June 1996, and the Charter that granted Royal Status was bestowed on the RCPCH, becoming operational in October 1996.
The Final Part II MRCPCH Examination of 2025 was conducted at the Academic Centre of the Postgraduate Institute of Medicine of the University of Colombo. The examination was handled by a team of 8 examiners from the United Kingdom, 6 examiners from India and Nepal, as well as examiners from Sri Lanka. All these examiners worked in tandem and were committed to the collaboration. The Sri Lankan examiners were Professor Shaman Rajindrajith, Dr Kumudu Weerasekera, Dr Anoma Abeygunawardena, Professor Sachith Mettananda, Professor Heshan Jayaweera, Dr Wathsala Hathagoda and Dr Tharindi Suriapperuma. The entire examination process was ably supported in the necessary logistical details by a capable squad of Senior Registrars, Registrars and Pre-Intern Medical Graduates from Sri Lanka.
The entire examination was a clinically oriented exercise designed to evaluate the scientific and patient assessment skills of the candidates. A total of 48 candidates from several countries, namely Bangladesh, Canada, India, the Maldives, Pakistan, Sri Lanka and the United Arab Emirates, took the examination in Colombo this year. We have no information on the pass rate, as it is governed by the privacy clauses of the RCPCH. The final MRCPCH examination is held only in a select few countries, and it is a sublime honour for Sri Lanka to be chosen and accommodated as one of them. It is very definitely an accolade presented to our island in recognition of the finest standards of paediatric care provided for our children and the variety of clinical material that is freely available for clinical assessments of budding Consultant Paediatricians. The RCPCH has indicated that they were extremely happy with the facilities provided and that they will conduct the examination every year from now onwards.
Of course, we have our own Doctorate in Medicine (Paediatrics); MD(Paediatrics) postgraduate qualification, which is a mandatory requirement for a Specialist Consultant Paediatrician in Sri Lanka. That examination is held in two parts by the Postgraduate Institute of Medicine (PGIM) of the University of Colombo. It is a qualification that is rated very highly by the RCPCH. The entire training programme in Paediatrics of the PGIM includes a mandatory period of overseas training after securing the full MD(Paediatrics) qualification. Many of our postgraduates elect to go to England for that component. It is essential to note that to be able to work in England, one needs to get registered with the General Medical Council (GMC) of England. It will be a feather in the cap of our postgraduates to have the MRCPCH(UK) qualification, to not only get registered with the GMC but also to secure a higher-quality position for their training. In that context, the holding of the MRCPCH Final Clinical Examination is an initiative that would facilitate adequate and proper training of our own future Specialist Consultant Paediatricians.
Finally, this author is inclined to go back in time to his own postgraduate training period following success at the MBBS(Ceylon) qualification in 1970 at the age of 23 years. He was extremely lucky that Part I of the Membership of the Royal College of Physicians of London (MRCP-London) Examination was held in Sri Lanka from 1971. He sat for that examination in June 1972, just nine months after completing the internship and was lucky enough to be successful. That set up a career which culminated in securing other necessary qualifications, then going to England to complete the MRCP degree and returning to Sri Lanka in 1979 at the age of 31 years as a Specialist Consultant Paediatrician. Then, although it was not essential for him, when the PGIM started around 1980, he sat for the MD (Paediatrics) Examination, passed, and was Board Certified in March 1983.
This author believes that it was success at that original MRCP Part I Examination held in June 1972 that was the initial impetus and the catalyst that set up his career and enabled him to serve his Motherland as a Child Specialist right up to the present time. He is ever so pleased to note that similar opportunities will now be available to younger colleagues, with the commencement of the MRCPCH(UK) Part II Examination in Sri Lanka. It is even better than what we had in the early 1970s, as then it was only the Part 1 of the MRCP, but from 2025 onwards it will be the complete MRCPCH qualification. All in all, it may be just the initial step, but in the course of progress of a professional paediatric career, it has the potential to be a giant leap for future Sri Lankan paediatricians.
by Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paediatrics), MRCP(UK), FRCP(Edin), FRCP(Lond), FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Joint Editor, Sri Lanka Journal of Child Health
Section Editor, Ceylon Medical Journal
Past President, Colombo Medical School Alumni Association (CoMSAA) – 2015
Past President, Sri Lanka Medical Association (2013).
Founder President, Sri Lanka College of Paediatricians (1996-97)
Opinion
We do not want to be press-ganged
Reference ,the Indian High Commissioner’s recent comments ( The Island, 9th Jan. ) on strong India-Sri Lanka relationship and the assistance granted on recovering from the financial collapse of Sri Lanka and yet again for cyclone recovery., Sri Lankans should express their thanks to India for standing up as a friendly neighbour.
On the Defence Cooperation agreement, the Indian High Commissioner’s assertion was that there was nothing beyond that which had been included in the text. But, dear High Commissioner, we Sri Lankans have burnt our fingers when we signed agreements with the European nations who invaded our country; they took our leaders around the Mulberry bush and made our nation pay a very high price by controlling our destiny for hundreds of years. When the Opposition parties in the Parliament requested the Sri Lankan government to reveal the contents of the Defence agreements signed with India as per the prevalent common practice, the government’s strange response was that India did not want them disclosed.
Even the terms of the one-sided infamous Indo-Sri Lanka agreement, signed in 1987, were disclosed to the public.
Mr. High Commissioner, we are not satisfied with your reply as we are weak, economically, and unable to clearly understand your “India’s Neighbourhood First and Mahasagar policies” . We need the details of the defence agreements signed with our government, early.
RANJITH SOYSA
Opinion
When will we learn?
At every election—general or presidential—we do not truly vote, we simply outvote. We push out the incumbent and bring in another, whether recycled from the past or presented as “fresh.” The last time, we chose a newcomer who had spent years criticising others, conveniently ignoring the centuries of damage they inflicted during successive governments. Only now do we realise that governing is far more difficult than criticising.
There is a saying: “Even with elephants, you cannot bring back the wisdom that has passed.” But are we learning? Among our legislators, there have been individuals accused of murder, fraud, and countless illegal acts. True, the courts did not punish them—but are we so blind as to remain naive in the face of such allegations? These fraudsters and criminals, and any sane citizen living in this decade, cannot deny those realities.
Meanwhile, many of our compatriots abroad, living comfortably with their families, ignore these past crimes with blind devotion and campaign for different parties. For most of us, the wish during an election is not the welfare of the country, but simply to send our personal favourite to the council. The clearest example was the election of a teledrama actress—someone who did not even understand the Constitution—over experienced and honest politicians.
It is time to stop this bogus hero worship. Vote not for personalities, but for the country. Vote for integrity, for competence, and for the future we deserve.
Deshapriya Rajapaksha
Opinion
Chlorophyll –The Life-giver is in peril
Chlorophyll is the green pigment found in plants, algae, and cyanobacteria. It is essential for photosynthesis, the process by which light energy is converted into chemical energy to sustain life on Earth. As it is green it reflects Green of the sunlight spectrum and absorbs its Red and Blue ranges. The energy in these rays are used to produce carbohydrates utilising water and carbon dioxide and releasing oxygen in the process. Thus, it performs, in this reaction, three functions essential for life on earth; it produces food and oxygen and removes carbon dioxide from the atmosphere to maintain equilibrium in our environment. It is one of the wonders of nature that are in peril today. It is essential for life on earth, at least for the present, as there are no suitable alternatives. While chlorophyll can be produced in a lab, it cannot be produced using simple, everyday chemicals in a straightforward process. The total synthesis of chlorophyll is an extremely complex multi-step organic chemistry process that requires specialized knowledge, advanced laboratory equipment, and numerous complex intermediary compounds and catalysts.
Chlorophyll probably evolved inside bacteria in water and migrated to land with plants that preceded animals who also evolved in water. Plants had to come on land first to oxygenate the atmosphere and make it possible for animals to follow. There was very little oxygen in the ocean or on the surface before chlorophyll carrying bacteria and algae started photosynthesis. Now 70% of our atmospheric oxygen is produced by sea phytoplankton and algae, hence the importance of the sea as a source of oxygen.
Chemically, chlorophyll is a porphyrin compound with a central magnesium (Mg²⁺) ion. Factors that affect its production and function are light intensity, availability of nutrients, especially nitrogen and magnesium, water supply and temperature. Availability of nutrients and temperature could be adversely affected due to sea pollution and global warming respectively.
Temperature range for optimum chlorophyll function is 25 – 35 C depending on the types of plants. Plants in temperate climates are adopted to function at lower temperatures and those in tropical regions prefer higher temperatures. Chlorophyll in most plants work most efficiently at 30 C. At lower temperatures it could slow down and become dormant. At temperatures above 40 C chlorophyll enzymes begin to denature and protein complexes can be damaged. Photosynthesis would decline sharply at these high temperatures.
Global warming therefore could affect chlorophyll function and threaten its very existence. Already there is a qualitative as well as quantitative decline of chlorophyll particularly in the sea. The last decade has been the hottest ten years and 2024 the hottest year since recording had started. The ocean absorbs 90% of the excess heat that reaches the Earth due to the greenhouse effect. Global warming has caused sea surface temperatures to rise significantly, leading to record-breaking temperatures in recent years (like 2023-2024), a faster warming rate (four times faster than 40 years ago), and more frequent, intense marine heatwaves, disrupting marine life and weather patterns. The ocean’s surface is heating up much faster, about four times quicker than in the late 1980s, with the last decade being the warmest on record. 2023 and 2024 saw unprecedented high sea surface temperatures, with some periods exceeding previous records by large margins, potentially becoming the new normal.
Half of the global sea surface has gradually changed in colour indicating chlorophyll decline (Frankie Adkins, 2024, Z Hong, 2025). Sea is blue in colour due to the absorption of Red of the sunlight spectrum by water and reflecting Blue. When the green chlorophyll of the phytoplankton is decreased the sea becomes bluer. Researchers from MIT and Georgia Tech found these color changes are global, affecting over half the ocean’s surface in the last two decades, and are consistent with climate model predictions. Sea phytoplankton and algae produce more than 70% of the atmospheric oxygen, replenishing what is consumed by animals. Danger to the life of these animals including humans due to decline of sea chlorophyll is obvious. Unless this trend is reversed there would be irreparable damage and irreversible changes in the ecosystems that involve chlorophyll function as a vital component.
The balance 30% of oxygen is supplied mainly by terrestrial plants which are lost due mainly to human action, either by felling and clearing or due to global warming. Since 2000, approximately 100 million hectares of forest area was lost globally by 2018 due to permanent deforestation. More recent estimates from the UN’s Food and Agriculture Organization (FAO) indicate that an estimated 420 million hectares of forest have been lost through deforestation since 1990, with a net loss of approximately 4.7 million hectares per year between 2010 and 2020 (accounting for forest gains by reforestation). From 2001 to 2024, there had been a total of 520 million hectares of tree cover loss globally. This figure includes both temporary loss (e.g., due to fires or logging where forests regrow) and permanent deforestation. Roughly 37% of tree cover loss since 2000 was likely permanent deforestation, resulting in conversion to non-forest land uses such as agriculture, mining, or urban development. Tropical forests account for the vast majority (nearly 94%) of permanent deforestation, largely driven by agricultural expansion. Limiting warming to 1.5°C significantly reduces risks, but without strong action, widespread plant loss and biodiversity decline are projected, making climate change a dominant threat to nature, notes the World Economic Forum. Tropical trees are Earth’s climate regulators—they cool the planet, store massive amounts of carbon, control rainfall, and stabilize global climate systems. Losing them would make climate change faster, hotter, and harder to reverse.
Another vital function of chlorophyll is carbon fixing. Carbon fixation by plants is crucial because it converts atmospheric carbon dioxide into organic compounds, forming the base of the food web, providing energy/building blocks for life, regulating Earth’s climate by removing greenhouse gases, and driving the global carbon cycle, making life as we know it possible. Plants use carbon fixation (photosynthesis) to create their own food (sugars), providing energy and organic matter that sustains all other life forms. By absorbing vast amounts of CO2 (a greenhouse gas) from the atmosphere, plants help control its concentration, mitigating global warming. Chlorophyll drives the Carbon Cycle, it’s the primary natural mechanism for moving inorganic carbon into the biosphere, making it available for all living organisms.
In essence, carbon fixation turns the air we breathe out (carbon dioxide) into the food we eat and the air we breathe in (oxygen), sustaining ecosystems and regulating our planet’s climate.
While land plants store much more total carbon in their biomass, marine plants (like phytoplankton) and algae fix nearly the same amount of carbon annually as all terrestrial plants combined, making the ocean a massive and highly efficient carbon sink, especially coastal ecosystems that sequester carbon far faster than forests. Coastal marine plants (mangroves, salt marshes, seagrasses) are extremely efficient carbon sequesters, absorbing carbon at rates up to 50 times faster than terrestrial forests.
If Chlorophyll decline, which is mainly due to human action driven by uncontrolled greed, is not arrested as soon as possible life on Earth would not be possible.
(Some information was obtained from Wikipedia)
by N. A. de S. Amaratunga ✍️
-
News3 days agoSajith: Ashoka Chakra replaces Dharmachakra in Buddhism textbook
-
Business3 days agoDialog and UnionPay International Join Forces to Elevate Sri Lanka’s Digital Payment Landscape
-
Features3 days agoThe Paradox of Trump Power: Contested Authoritarian at Home, Uncontested Bully Abroad
-
Features3 days agoSubject:Whatever happened to (my) three million dollars?
-
News3 days agoLevel I landslide early warnings issued to the Districts of Badulla, Kandy, Matale and Nuwara-Eliya extended
-
News3 days agoNational Communication Programme for Child Health Promotion (SBCC) has been launched. – PM
-
News3 days ago65 withdrawn cases re-filed by Govt, PM tells Parliament
-
Opinion5 days agoThe minstrel monk and Rafiki, the old mandrill in The Lion King – II
