SPECIALIST MEDICAL DOCTORS BECOMING AN ‘ENDANGERED SPECIES’?

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“The identified ‘mission’ of the Post Graduate Institute of Medicine (PGIM) is to plan,  develop, implement, monitor and evaluate postgraduate academic programmes required to produce specialists  of the highest quality, competence and dedication, in order to provide optimal humane healthcare to the people of Sri Lanka, the region and the world.”

The prevailing economic crisis however, may in the near future make ‘Specialist Medical Doctors an ‘endangered species.”

-Director General’s letter

The much publicised letter sent by Director General Health Service (DGHS)
Dr. Asela Gunawardena on 1 July 2022 underlined one of the many issues which would have a severe impact on Sri Lanka’s health service which may lead to a situation where the Government may have to consider importing specialists doctors among other goods and services to fill in the shortage that would emerge in the years to come.

Dr. Gunawardena in his letter to the Director of PGIM noted that due to the “Prevailing problem of limited foreign currency,” his Ministry was facing a challenge in arranging for medical officers who were already working in foreign countries in their mandatory foreign training.

Dr. Gunawardena in his letter further instructed that the Director of PGIM should “temporarily suspend offering further recommendations for foreign training especially for those who were planning to be completely dependent on monthly living allowance from the Ministry”.

Current Economic Crisis and Impact on Foreign Training                                      

Although the country has been facing a forex crisis since January 2022, the Health Ministry at the time had the money to support medical practitioners undergoing foreign training. But there was a delay when converting the money to dollars as the Central Bank lacked foreign currency, Media Committee Member of the Government Medical Officers’ Association (GMOA),
Dr. Chamil Wijesinghe explained. He said that the basic salaries were paid in ‘rupees’ to specialist trainees and was thoroughly insufficient to meet the cost of living in countries which they were receiving their training in. A total USD 36 million was allocated per month as living expenditure for medical doctors receiving foreign training.                                              

Specialist categories such as Community Physicians, Medical Administrators and Forensic Consultants, Pathologists and Haematologists, were among those whom the Health Ministry bore the cost as they did not receive job opportunities abroad. The GMOA, he said, had been against the move by the Health Ministry to even temporarily suspend mandatory foreign training.

Health Ministry sources said that while specialist foreign training had not been completely suspended, they had made a special request to trainee doctors heading overseas to check the availability of foreign currency before making preparations for their departure. “It’s a foreign currency issue that ails the programme,” he said. 

With the mounting opposition shown towards this move from the moment it was publicised, the Health Ministry proposed to reimburse the money spent by doctors who are able to afford the cost, while reimbursing the expenditure in due course.

But the truth of the matter is that most doctors cannot afford to study abroad, especially now, which only causes dissatisfaction and discrimination
– especially now when the dollar is well over Rs. 360.   

Sri Lanka sends her doctors for specialist training to India, US, UK, Canada, Germany, and Singapore.

Board Certification        

Board Certification of specialists once they completed their years of foreign training is awarded by the Sri Lanka Medical Council (SLMC) in collaboration with the PGIM following which relevant recommendations are made to the Public Service Commission.

But is Sri Lanka capable of catering to the needs of its specialist doctors, should the prevailing forex issue continue to plague the country’s health service much longer, crippling the foreign training procedure? According to the GMOA’s Media Committee Member, acting consultant specialists received training in Sri Lanka while waiting to go to study abroad. They were deployed to difficult areas. But, the comprehensive training given in foreign health service institutions complete the training programme.

Interim Budget

The GMOA’s Dr. Wijesinghe had urged the Government to allocate the necessary funds for foreign training from the Interim Budget that is to be tabled on 30 August 2022 to ensure that the island do not run out of medical specialists.

Should the ugly situation persist it would force senior specialist doctors to work past their retirement age to fill in the gaps.

The sad bad situation would also contribute towards a severe brain-drain with disillusioned doctors opting to leave the country. As mentioned earlier it’s up to the Government to provide the forex for foreign training as one cannot import Specialist Medical Practitioners in the way the Government imports essential commodities.

By Dilanthi Jayamanne