Reflection note on two year pause 1/12/2017-16/09/2019

It appears a long pause in life is coming to an end. At the same time, much puzzled and worried about the days ahead and the need of making choices in contrast to the last two years where there was no choice than doing what ever was on the plate.

It all began on 30^th November 2017, following the allocation of the wards, started internship at the professorial surgical ward. Unexpected beginning though, to get the ward handed over just after the first visit and to be in charge of all the patients with out any clue as to what has to be done. I guess it is the same with anyone on the first day of internship.

In fact, my start was much better with all due respect to Dr. Pradeep ( Pradeep aia), who happened to be the first registrar among the many registrars I met over the last two years, and one among the best too. Time at Professorial unit was a bit homely, to be working under the same teachers that taught at medical school, but also was challenging as the dynamics of medical student vs teacher and HO vs consultant was  bit different. However, the time at Prof unit was the ideal start for a career as an intern.

The joy did not last longer, until the vascular surgical 6 weeks commenced. It was being HO to 2 different wards situated so many meters apart and also catering the needs of the merchant ward and class one. To be honest, the 6 weeks at the Vascular surgical unit was the most challenging time of the 2 years. It wasn’t because the senior team was challenging, in fact the senior team was very encouraging. We were working under senior registrars mainly and for most of the time it was under Dr. Buddhima. What I’d learnt most during these 6 weeks is how energetic and enthusiastic one could be if they find the passion for their lives. The lengths they go, and the hours they spent trying to save limbs that are about to die or failed livers were unbelievable to perceive as an intern. To be honest, there were many times I was wondering “is this effort worth it”, and I do still wonder.

I can still recall the first 4pm off day in my internship, which was after 3 months in to internship, doing male ward with Sadiranga; first co-HO. I was clueless as what to do with the extra time I had when the work was done by 4pm. Tried to call few other interns whom I knew to see if any celebration plans could be arranged, yet failed. However, the next 3 months at male ward was relatively easier, because there was a co-HO to share the experience was and more importantly, the partner was supportive.

When 6 months of surgery was over, and when Jayanth came to male ward to take over the patients, and I happened to go to Professorial medical ward (female) was a day life crashed altogether. It was where I met the co-HO / co-RHO for the most period over the years, Dr. Avanthi. I do not want to recall the first few days in the medical ward, because it is too painful to tolerate. The ward rounds with over whelming floor patients, endless patients with renal disease, never ending admissions, in depth evaluations with many tests requested and after all that is dealt with, the pile of discharges to write drained me off whatever interest I had for clinical medicine. On top of all these, answering the microbiology calls and recalling the investigations to a person who is having all relevant reports in hand, sorting all issues related to delay in sending patients due to lack of minor staff, begging radiology department for an ultrasound scan or CT scan as if i was trying to get myself scanned and catering to frequent patient inquiries were too much to deal with.  Evenings considering quitting clinicals were pretty common during those days as Avanthi may recall. However, thanks to the best of the registrars and the support form the co Ho, we somehow adjusted to the life in medical ward and since then it was somewhat tolerable. I should also recall, just like Pradeep aia helped with surgery in early days, there were life saviors in medicine as well. The gods for medical interns will be ones who will appear when the repeated peritoneal tap fail or the lumbar puncture fails or pleural fluid aspirate fails. Considering so, gods were in abundance at Prof. Unit. Of them, the supreme god being Dr. Ishan (Ishan aia), who would always lend a supportive hand when ever we fall in trouble. There were goddesses too, who would keep everyone together and made the entire unit very pleasing. Chathurika akka’s presence really made the professorial medical unit very motherly I would say. Not to forget Shiran aia, who worked with such a great level of professionalism and I am glad I witnessed his patient clerking as a trainee (just witnessed, adopting is impossible). 

I would be doing an injustice to the legendary Praveen aia, if I don’t add a comment about his presence in the internship. Being taught and motivated by him since 1^st year, specially in the final year, and having him as the senior registrar in the internship was challenging, mainly sorting to call him sir or ayya. His presence was such a relief, for the registrars, and hence kept the entire environment so calm. He also made sure all the multi barrels, bombs coming our way were neutralized, so that what we had on the plates never exploded.

Internship at medical ward continued to be a challenge however, we adopted with time and like Pradeep aia told at the very beginning of my internship, the real team effort was experienced. With time, medical internship became our entire life and having lunch together was a much-awaited time of the day. Eventually, the universe started to revolve only around ward 41 and 48  B.

Time passed much faster than expected, and 31^st November 2018 was reached. The official “internship” ended and an era of conflicts started. The expected reality of not having a new batch became a reality. Frustration, anger, sadness, acceptance evolved in the respective order during that time. However, we continued to work as HOs in medicine for 4 extra months and altogether 10 months. The understanding, respect shown by “most” registrars and the SRs during this period is extremely grate as I recall. In fact, that was the only motivation that kept us rolling through the days. This period was a good experience in understanding how the decision makers in medicine work, and to witness the gap between what is preached and what is done. During this was when the great co HO/co RHO decides to take the two weeks of wedding leave, I wasn’t adversely affected by that anyways.

After 10 longs exhausting months of medicine, was the victorious RHO switch to Surgery. This time in ward 6B and 19; mainly managing breast related issues. This was the most relaxed period of the entire 2 years of intern’s work. We enjoyed our lives, Gyming, travelling around, going out etc. We were also busy doing research during this period. The co RHOs for these 4 months were Ramesh (who also was the roommate for the 2 years), and Dileema.

After 4 months, again the re switch to Medicine happened, this time to ward 55 and 56 B with Ramesh and Amanee as co RHOs. Challenging period as Amanee was on her wedding leave, but thanks to,

1. Our mental adaptation for being forever HOs and were thinking nothing much worse could have happened ,

2. supportive registrars, particulary Buddhika akka, who virtually functioned as another mini intern ,

.....the period was manageable.

Time at this moment is point of writing is 00.47 am on 16/09/2019; a hopeful day to see a new batch of interns coming and taking over the baton, a dream we expected since August 2019.

The past 2 years were a pause in life. Everything around life; family, friends, college, relatives were moving away and it was just a life doing a job. I guess that is what a clinicians’ life anyway is. The enormous stress of loads of work, the life and death decisions to make, physicals exhaustion of work were too much to deal with. But the prolonged period was a good experience too. I have seen the superb caring surgeons, wonderful teachers, elegant clinicians during this period. At least reflected on what to do and what not to do, particularly with regard to juniors if I’d ever become a senior. The experience over the past 2 years would hopefully be very useful in the time to come.

Perks of being a HO in prof units was having a bunch of medical students around us all the time, sometimes easing our work ; may be with a procedure or so. But for the most part, it was to have some entertainment ,a chat, may be to share something we knew. The occasional end of appointment parties, Padura, Brithday celebrations cannot be forgotten, and were mini celebrations of the period.

Time at 6B/19 was also special as I met some non-professorial medical students for the first time and sharing knowledge with them was something I really enjoyed , because the final years already knew more than what we knew (the superb 2011 batch was doing professorial).

This self reflection placed to remind the 2 years of hard work would be incomplete if I fail to add the following account to it. I have mentioned all my co HOs and some registrars. I need to recall Dilip and Krishna, who were HOs at surgery, Seyon and Rushdha at medicine. There is a long list of registrars, senior registrars and consultants. I was so lucky that I did not meet any reg, SR, consultant who made my life miserable when listening to stories from my friends all around the country. Of all consultants, some of them taught great lessons and made an impact such as, Sivaganesh sir’s patients care, Chang sir’s brilliant teaching, Saroj sir’s encouraging atmosphere, Ajith sir’s life guidance, Jayanaga sir’s brilliant teaching rounds and Hareendra sir’s most energetic and evidence based rounds. 

There were few celebrations and few memorable tokens during this 2 year period too. Few of the most memorable ones would be,

1.       Udari akka’s birth day gift despite our reg vs RHO conflicts 

2.       Meidical sudents tokens

3.       Chathurika akka’s farewell gift

Life of pure medicine was never a possibility for me. At times of extreme exhaustion, it was mainly music that added some flavour. For the last 2 years, it was the same music and the same play list that kept on playing and I am grateful to all of musicians for their creativity for helping me relax mostly at the late hours of exhaustion. Particularly Charitha Attalage’s music helped in relaxation. Of all song’s listened to over the 2 years, Ridhma Weerawardhana’s Kuweni must be the mostly played and would be an all-time favorite.

Just like the music did, meeting good people, chatting and eating out had been a great way of relaxation. Unfortunately, meeting people had been difficult due to distance and time constraints. I’d be extremely grateful for those who could spend time eating out and chatting, which added some flavour to the busy times over the 2 years. This guy from the Rajans could join me most of the time when requested and the time spent was great.   

While thanking everyone who helped during the battling period, let’s be open minded and hopefull about what awaits and wish the choices to be made end up in happiness and success!

Victory

SAITM is abolished. Hence the fight against fraud has succeeded, however the culprits will not be punished as it appears; which is the Sri Lankan style anyway. But let’s leave the punishment to the nature and celebrate the victory against fraud.

SAITM fight had two slogans, “Abolish SAITM” and “NO PMC”. During this fight, it was agreed that the implementation of the deans’ proposals would be considered the end point or the success. The points were,

1.       Admission of students to SAITM to be terminated permanently.

2.       SAITM students enrolled before 2016, with minimum entry criteria (2Cs 1S), to be allowed to complete MBBS with additional training and licencing examination.

3.       The details to implement 2 above to be decided by an Interim Independent Authority (IIA) under purview of SLMC and the IIA to be dissolved when the SAITM students passed out.

4.       Above 1-3 to be approved in parliament and to be published in gazette notification.

What did Dr. Harsha De Silva’s solutions that we agreed ,

1.       Admission of students to SAITM to be terminated permanently.

2.       All assets, students etc of SAITM to be transferred to a non governmental (PMC), not of profit entity, that will have a sun set clause after the SAITM students passed out (The way this is worded in FB creates some confusion, however FFMTA confirms this stance was approved in the latest committee meeting too).

3.       A presidential committee to arrange 1 & 2 and to complete everything by 31^st December 2017.

4.       Government policy is non governmental not for profit medical education but is not related to Abolishing SAITM. ie, what ever that is to come is not an outcome of this process.

Except the gazette in the deans’ proposals, all other aspects are covered in the agreed proposals. However, the stance of NO PMC is at threat, but we need not panic YET, because whatever comes off in abolishing SAITM is ONLY for SAITM students. PMCs to come are different entities as told. If the government policy is PMC and we are against that, the way would be to topple the government and get a new one whose policy is NO PMC, which I think should be a good debate in the 2 years to come before the next general elections. Considering the mess this government is in already, if I was in it, would not bother to create a new mess with more PMCs sooner, but considering the mindset of the politicians, they may still attempt it.

The issue is, ideally, I would have loved to celebrate a victory, like in NCMC, where we win a state medical faculty, so that the so called “just missed the z score cut off” can jolly well be doctors irrespective of their financial capacity. But it has not happened yet. With the allocation of funds to establish 3 more state medical faculties in the recent budget 2018, there is a high chance of this entity to the SAITM graduates to end as one of them, but that is only if the SAITM graduates are fortunate enough. I feel pretty sorry of these SAITM students. They are being used by the government to ensure their policy of PMC. Now SAITM is abolished. The graduates of MBBS(SAITM) are lost. They have graduated from a place that is to be abolished. Even the other lot, will be taken to an entity which is beyond my imagination. Non state , non profit, and only for 5 years and then get dissolved. Unless a big donor is willing, this process will be dragging. And the medical students and the other parties will be closely monitoring the process which is to happen, and the SAITM students might again get trapped in a new entity like SAITM itself. I am hopeful for these SAITM students that they would be lucky enough to find this non Nevil Fernando related donor, who would invest for these disadvantaged students expecting no profit and to close down the investment in 5 years. To me this is bit impossible, unless a betrayal like the continuation of the new entity after SAITM students complete the degree happen, which is again a breach of trust of the student movement, that the government would not be happy with the elections to come, from Provincial elections in January. None of such issues shall arise if this is a state medical faculty. In such case, no sun set clause would be demanded, and since the hospitals, locations etc all are planned, as to UGC chairman, the structure can easily be set with no resistance. That ensures quick progression. At the same time, as a sunset clause may not be demanded, whatever the MBBS to be given will have a place with in brackets that would last for long time. Eg: MBBS(Moratuwa)/MBBS(Wayamba)/MBBS(Sabaragamuwa). In fact, just like NCMC graduates demanded MBBS (Colombo), it is time the SAITM graduates demand one of MBBS(Moratuwa)/MBBS(Wayamba)/MBBS(Sabaragamuwa), which the state students are also willing to agree. However, it is not the duty of state medical students. Considering the intelligence displayed by applying to this outright fraud; to be abolished SAITM, I do not expect SAITM students to fight for a MBBS (known place) over MBBS(previously abolished and offered by an institute that is to be ceased in 5 years).

I personally love this intermediate victory of the medical students and the student movement. Because, SAITM was not a fight they should have done by them in first place. It was a fight to be done by the academics to ensure proper standards of medical education from fraudulent businessman. But what happened was, academics were inert or less active initially hence the student movement had to step in as protecting free education is their top priority. What some academics actually did was help to defend this outright fraud. Some earned black money from this fraudulent place, by employing there on sabbatical leave or by permanently leaving the state faculties. They let SAITM become a menace, and in the process, did not forget to criticize the student actions. It was only the SLMC that had the backbone to stand on it’s prime target of maintaining standards, which cost them the resignation of 2 presidents, bombing, appointment of political presidents for advantage etc. But when all other measures against fraud failed, the students unfortunately had to start the boycott of lectures, and suddenly everyone became so compassionate and considerate about the future of the students with motherly love; not because their administrative positions were threatened. At this point of time, when the medical students had to boycott lectures over 10 months to abolish this fraud business, now those who were so compassionate and considerate have got the ideal opportunity to ensure this devastation will not happen to the students in future, by ensuring that the agreed solutions are implemented as it is agreed. We shall await to see if the outcome of them would be of pure motherly love to the students or with pure love to the administrative positions by pleasing politicians. Hence, I love the temporary end of the battle chosen by students.

SAITM dragged over 7 years of my life 2011-2018, to win in this level, and to ensure victory, the sun set mechanism shall end in 5-6 years, hence will be on the watch over the time. It was a period that taught many lessons.

Most importantly, however big and powerful the opponent is, the unity and determination with dedication and commitment can take you close to the victory. Also, it was a lesson that, however big and reputed some are claimed to be, or some think they are; their actions are the best reflection of their character. Hence, the validity of an idea shall not be based on the number of letters at the end of a name. For example, a surgeon shall be very good at the sub speciality trained, but can have very poor logic and understanding of matters other than surgery, because those are not the fields of their expertise. We need not worry much of them, as long as we genuinely know, what we are doing is right. I also learnt that although you focus on topics of your interest, for eg. Say gender equity – you fail to realize the word equity is not limited to gender. Unless the root causes like poverty, inequity in education, social imbalance etc are solved, gender inequity cannot be reduced. Hence ensuring equity in education would be an essential component in combating gender inequity and hopefully the women’s activists will ensure equity in education at least in that regard. As far as I am aware, gender equity is not forcefully invading the habitats of the opposite gender and such action is exploitation of the concept of gender equity.

When it comes to pre-interns, who were considered a lot that never can be organized for an effective action, even the top guns in profession; consultants, failed to stop them from joining together and showing the brotherhood by taking the best level of action possible at the right time towards a social cause irrespective of the bad outcome to their own careers. This brotherhood was a huge achievement and a proof that as long as we are together, even the pre-interns, or interns can do many things. This lesson would be much important for future.

At a personal level, it was evident to me, with this development of social media, the news of our lives is not in our control. People can make stories of your life and they can spread so fast and you will never have a control in such rumours and news in your life.

The young medicos, would have sat, slept in almost every pavement in Colombo and I am sure the social understanding that they obtained through this adventurous journey will help them be more compassionate doctors in near future.

 The student movement achieved what they wanted, and they would be on the watch that the agreed solutions are implemented. NO PMC is a fight that is there to fight, and will happen when a PMC starts again. As for me, a PMC that,

1.       Recruits students who disadvantaged by z score ONLY

2.       With better quality

3.       Doesn’t consider financial status at recruitment; ie, students can study without paying and later pay once they have passed out

4.       Doesn’t affect the health care system and the other existing state medical faculties – ie, equal salary scales for academic and other facilities, doesn’t recruit those on sabbatical leave or those occupied in a state medical faculty. The PMC should be set as per needs of the health care, ie, location shall not be just in the towns like Colombo, Kandy, Galle etc.

5.       Doesn’t use state property for private usage: ie, a separate private hospital to be maintained. No state hospitals for PMCs.

Would be accepted if the government is desperate for a PMC. But SAITM proved the level to which things can go when PMCs start in Sri Lanka and how chaotic and impossible to maintain standards due to this political madness in the country. Hence for a country like Sri Lanka, which is to set up 3 more state medical faculties as to the budget 2018, would not need a PMC, considering the need of doctors in future and the impossibility of providing training to undergraduates by the private sector to meet the required standards. Anyway, those are battles to face, and I am sure since those who are so much concerned of the lives of medical students are now in the authority, they would ensure that medical students will not have to get to streets again to ensure standards and fight against fraud. So, let’s keep watch.

And for the brave medicos, let’s keep in mind this selfless sacrifice you made towards the general public; although they may not be aware. With the same spirit, make sure that in the careers to come, we would selflessly strive towards improvement of healthcare in the individual and the community in future. So, let’s resume the mammoth but rewarding task of completing MBBS, and we are awaiting to see those long queues in the canteen and the fully crowded sofas during lunch hour at the faculty soon.

Best Wishes !!!

පසු විපරම

දැන් ලංකාවට අධ්‍යාපනයේ නිදහස ලැබී ඇත . මෙච්චරකල් මේ රටේ අධ්‍යාපනයට තිබුනේ මාර බාධකය . සරසවි වලට සිසුන් තෝරා ගත්තේ අන්තරේ විසින් මිස විභාග ක්‍රමයකින් නොවේ . විභාග ක්‍රමයේ Z අගය තරම් අවුලක් තවත් තිබුනේ නැත . මේ රටේ දේශප්‍රේමී දේශපාලකයන් කල සංවර්ධනයට පින්සිද්ද වෙන්නට ලංකාවේ දිස්ත්‍රික්ක වල සම්පත් විෂමතාවක් නැත . Z අගය 100% සාධාරණද ? නැත . 100% සාධාරණ ඇතුල්වීමේ ක්‍රමයක් සකස්කළ හැකිද ? මම දන්නා තරමින් නම් බැරිය  . Z අගය නිසා අසාධාරණ වන අයට යන්නට තවත් විශ්වවිද්‍යාල තිබිය යුතුය . PMC මේ ප්‍රශ්ණයට විසඳුමද ? මට නම් එහෙම පෙන්නේ නැත . මොකද ඔය කියන Z අගය දශමෙන් miss වුනු අපේ යාළුවන්ට සිදු වුණ දේ අපි හොඳින් දනිමු . ඔවුන්ට PMC වලින් පිහිටක් වේද ? නැත . ඒ අයටත් වෛද්‍ය වරයෙක් වීමේ සිහිනය තිබුණි . ඔය කියන්නේ 10%ක් ඒ අයට ශිෂ්‍යත්ව කියාය . ඒ වෙනුවෙන් ඉතා අඩු ප්‍රථිපල සහිත 90%ක් මුදල් මත පමණක් පදනම් ව වෛද්‍ය වරු කිරීම z අගයට වඩා පට්ට සාධාරණය . අධ්‍යාපනයේ නිදහස ලැබෙන්නේ එවිටය . තමන් කැමති විෂය , තමන්ට වඩා සුදුසුකම් සහිත පිරිසක් පසෙකලා , මුදල් තිබීම යන සාධකය මත පදනම්ව , ඉගෙනීමට ලැබීම අධ්‍යාපනයේ නිදහසය . මේ රට ආසියාවේ ආශ්චර්ය කියන්නේ මේවා නිසාය .

මේ කියන PMC නිසා , දැන් වෛද්‍ය සභාව ට දෙවි පිහිටය . රටේ සෞඛ්‍ය ඇමති සාමාන්‍යයෙන් කරන්නේ ඒ රටේ සෞඛ්‍ය සේවාව ශක්තිමත් කිරීමය . දැන් ලංකාවේ සෞඛ්‍ය ඇමති , දන්ත වෛද්‍ය වරයෙකි . ඔහු සෞඛ්‍ය ගැන දන්නා අයෙකි . මීට කලින් සිටි සෞඛ්‍ය ඇමති වරු රැකියාව කලේ ග්‍රාම නිලධාරී , නීතිඥයන් ආදී වශයෙනි . මේ නඩු තීන්දුව අනුව , ආචාර්ය , මහාචාර්ය වරු , වෛද්‍ය සභාව හරහා ඉදිරිපත් කල නිර්දේශ , සෞඛ්‍ය ඇමති ක්‍රියාත්මක නොකළ නිසා , වෛද්‍ය සභාව ඔය කියන කවුරුත් , කොහොම ආවත් පිළිගත යුතුව . මෙය ලංකාවේ නීතියය . වඩාත් පුදුම සහගත කරුණ , ලංකාවේ මිනිස්සු මේ තීන්දුවෙන් ලැබුවේ පට්ට ජයග්‍රහණයකි . "පාර්ලිමේන්තු මන්ත්‍රී වරු මෙච්චර සා . පෙළ , උ .පෙළ අසමත් , ඉතින් අපි දියුණු වෙයිද ?" අසන fb වීරයන් දැන් ලැබුවේ විජයග්‍රහණයකි .මීට කලින් සිටි සෞඛ්‍ය ඇමති බඳවා ගන්නට එපා , ශික්ෂණ රෝහලක් ලෙස පිළිගත නොහැකි යයි කීව තැන , මේ ඇමති යටතේ වෛද්‍ය සභාව ලියාපදිංචි කල යුතුය.
 වත්මන් ඇමති තුමා පවුල් පාලනය අවසන් කිරීමට නායකත්වය දුන් කෙනෙකි . අද එතුමාගේ පුතා වකුගඩු රෝග වැළැක්වීම සම්බන්ධ ව්‍යාපෘතියේ අධ්‍යක්ෂ ජෙනරාල්ය , බිරිඳ සෞඛ්‍ය පරිපාලනයේ ඉහලම තනතුරක් දරයි . ඔවුන්ට ඒවාට සුදුසුකම් ඇතිද නැතිද යන්න මම හරියටම නොදනිමි . මේ රටේ එම තනතුරු වලට ඊට වඩා සුදුසුකම් ඇති අය අනන්තවත් සිටින බව නම් දනී .  තම ලේලි ඉගෙන ගන්න තැන අපක්ෂපාතිව තීන්දු ගන්නේ මෙවන් පසුභිමක් යුත්  සෞඛ්‍ය ඇමතිය . රටක ජනාධිපති , අගමැති , රට හැර ගිය බුද්ධිමතුන්ට ආයෙත් එන්න කියන්නේ මෙවන් රටකටය . ඉන්න කීප දෙනාටත් යන්න හිතෙන වැඩ සිද්ද වෙන රටකට , ගියපු අය ආයෙත් ඒවි යැවී සිතීම විහිළුවක් යයි මගේ බුද්ධි මට්ටමට මට තේරෙන තරමය .

දැන් රටටම සතුටුය . වෛද්‍ය සංගමය , වෛද්‍ය සභාව , පිටාධිපතිවරුන් , වෛද්‍ය සිසුන් , අන්තරේ , හැමෝම පාඩමක් ඉගෙන ගත්තේය . ජනතාවට full marvelous ය . සිංගප්පූරුවෙන් බෙහෙත් ගන්න සෞඛ්‍ය ඇමති , ජනතාවට සුදුසුම තීරණය ගනු ඇත . මීට කලින් ඖෂධ මාෆියාවට එරෙහි නැගී සිටි මහාචාර්ය වරු ඉවත් වෙන විට  , මේ සෞඛ්‍ය ඇමති හිස් මුදුනෙන් ඔවුන්ව ආරක්ෂා කළේය .  ඇමතිතුමාට ස්තුති කර  පෝස්ටර් ගහන රෝගීන් කියන පරිදි දැන් බෙහෙත් පට්ට ලාභය . ඇමති කියන පරිදි , clinical trial වල විස්තර නැතත් , ඇමති ගෙන්නන බෙහෙත පිලිකා  රෝග සම්බන්ධ වෛද්‍ය වරු රෝගීන්ට ලබා දිය යුතුය . දැන් නීතියට අනුව , ඇමති කැමති විදිහට වෛද්‍ය වරු පිළිගැනීම , ඉවත්කිරීම කල හැක . වෛද්‍ය සභාව දේවල් කියනු ඇත . අහන , නොඅහන එක ඇමතිගේ වැඩක්ය . ඇමති මොකුත් කලේ නැත්තම් , වෛද්‍ය සභාව කියන දේ පිළිගන්නේ නෑ යැයි නිගමනය වේ . ඉතා කාර්යක්ෂම අමාත්‍යංශ පිරි රටකට මෙම ක්‍රමය විශිෂ්ටය .

ඔය කියන විදිහට , හෙට අනිද්දා තවත් PMC කීපයක් ආරම්භ කිරීමට නියමිතය . ලංකාවේ නීතියට , සෞඛ්‍ය ඇමතිට අනුව වෛද්‍ය වරයෙක් වීමට හදිසි අනතුරු , මාතෘ /ළමා රෝග ඇති රෝගීන් පරීක්ෂා කිරීම අනිවාර්ය නොවේ . සියලු අංශවල සමස්ත රෝගී සංඛ්‍යාවේ අඩුව - වෛද්‍ය උපාධියේ ප්‍රමිතියේ ඉතා සුළු සාධකයකි .(ඇමති උත්තරීතර පාර්ලිමේන්තුවට වාර්තා කලේ මෙහෙමය ). හදිසි අනතුරු , මාතෘ /ළමා රෝග පෞද්ගලික අංශයට අඩුවෙන් වාර්තා වෙන බව සැබෑය  . ඒ මගින් මට ගම්‍ය වෙන එක කරුණක් ඇත . ජීවිතය මරණය අතර අවස්ථාවල , ගොඩක් සැලකිලිමත් ළමයින් ගැන හිතද්දී , තවමත් රාජ්‍ය අංශය ගැන මිනිසුන්ට ෂුවර්ය . හෙට අනිද්දට එන තර්කය , PMC වලට රජයේ ඉස්පිරිතාල ලබාදිය යුතුය යන්නය . ඒවටත් මේ හුරේ දමන අය හුරේ දමා උඩ පනිනු ඇත . ඒ අයම ,අනතුරක් වෙලා හදිස්සියට හොස්පිටල් ගිය වෙලාවට බිලක් එන දවසට පාලකයන්ට ශාප කරනු ඇත . මේ typical ලංකාවය . මුලින් දේශපාලකයන් පෙන්නන දිරච්ච ලණු ගිලියි . ඇත්ත තේරෙන දවසට දේශපාලකයන්ට පලු යන්ඩ බණි . එසේ බණින දවසට දේශපාලකයෝ  ජනතාවට කොකා පේන්නති . පස්සේ හැමෝම , හැම දේටම දේශපාලකයෙක් පස්සේ දුවයි .

ඉතිං උඩපනින්න . සතුටු වන්න . රාජ්‍ය වෛද්‍ය පීඨ බිඳ වැටී(දාන PMC වල උගන්නන්නේ මේ රටේ ආචාර්ය වරුමය . දැනට තියෙන රජයේ ටිකටත් ආචර්යවරු හිඟ බව කියන්නේ මේ රටේ උසස් අධ්‍යාපන ඇමතිය ) , රජයේ රෝහල් ටික බිඳ වැටෙන විට , වෛද්‍ය වරුන්ට ගොඩාක් රිදෙනු ඇත . මොකද පෞද්ගලික රෝහල් වල සේවයට පිටරටවල් වලින් වෛද්‍ය වරු ගේන නිසා වෛද්‍ය වරුන්ගේ බමුණු කුලය බිඳවැටී , ජනතාවට මනෝරම්‍ය සෞඛ්‍ය සේවයක් ලැබෙනු ඇත . ඉතින් සමරන්න . උසස් ප්‍රතිඵල අරන් උසස් අධ්‍යාපනය ලබන ක්‍රමයේ වැරදි වැසීමට , වඩා හොඳ ප්‍රතිඵල අභිබවා මුදල් ඇතිනම් ඉගෙන ගැනීමේ නිදහස දැන් ඔබට උදා වුයේය . ඉතින් සමරන්න . ඔබට හා රටට ජය !

අඳුරු දවසක්

මේ  ලඟදි faculty එකේ ළමයෙක් මම blog ලියනවද ඇහුව . ඉඳල හිටලා ලියන එකක් තියෙනවා කිවා .සිංහලෙන් ලියනවද ඇහුව .තාම ලිවේ නෑ කියල තමයි එදා කීවෙ . අද මුලින්ම ලියන්න හිතුණා . අදත් නොලියන blog කවද ලියන්නද  ?
අද ජනවාරි 31. අවුරුද්දේ දවස් වලින් ගොඩක් කැමති දවසක් , හේතු ගොඩක් නිසා . වෙනදා වගේ අද උදෙත් කැමැත්තෙන් පටන් ගත්ත . උදේ වැඩ ටික කරලා අලුත් කඩේ උසාවිය ලඟට ගියා , තීන්දුව කලින්ම දැනන් හිටියත් , පොඩ්ඩක් හරි අධිකරණය කියන එක ගැන කොහේදෝ කොනක තිබ්බ බලාපොරොත්තුවකුත් එක්ක . හිතුවටත් වඩා බරපතල තීන්දුවක් . වෛද්‍ය සභාවට , ලංකාවේ වෛද්‍ය අධ්‍යාපනයට , ප්‍රමිතිය කියල එකක් තියෙනවනම් ඒකට, ආයේ කවදාවත් ගොඩගන්න බැරි විනාශයක් . මොකද ඔය නීතිය හෙට ඉඳන් අහන හැම නඩුවෙම බලන්නේ කලින් නඩුවේ කොහොමද කිවේ කියලනේ .( දන්න තරමට ). SAITM  වගේ ඒවත් පිළිගත්තා නම් , ආයෙ දාන PMC එකක තව මොන ප්‍රමිතියක්ද .
මම දන්න තරමට අධිකරණ වුනත්  තමන් දන්නැති විෂයය  (අධිකරණ වෛද්‍ය විද්‍යාව වගේ  ) ගැන expert witness ගෙන්නලා මතය අහනවා . අද තීන්දුවේ හැටියට මේ expert witness කොහෙන් කොහොම ආවත් ඇමතිලා දෙන්නෙක් "හා" කියනවනම් නිත්‍යනුකූලයි  . වෛද්‍ය සභාව ඔය කවුරු කොහෙන් ආවත් ලියාපදිංචි කරන්ඩ ඕනෙ . මම හරියට නීතිය දන් නෑ . මට තේරුණ විදිහ තමයි ඔය.
උද්ඝෝෂණය ඉවර වෙලා hostel ගියාම facebook ගිණි අරන් . අපි යුද්ධයක් පැරදුනා වගේ කට්ටිය හූ කියනවා , හුරේ දානවා , "ඔබට සතුටුයි ද " අහනවා. තවත් සමහරු අපිට රස්සාවක් නැතුව පාරෙ ඉන්ඩ වෙන්නෙත් කියනවා. ඔය අස්සේ දැන් රස්සාවක් හොයාගන්ඩ Somalia යන්ඩ වෙයි කියපු ප්‍රාථමික බුද්ධි මට්ටම් වල කීපදෙනෙකුත්  හිටිය . මම දන්න තරම මෙච්චරයි . නඩු තීන්දුව ගැන සෑහෙන්ඩ දුකයි . මගේ බුද්ධි මට්ටමේ තරමට ඒ තීන්දුව මේ රටේ වෛද්‍ය ක්ෂේත්‍රයටම ලොකු බලපෑමක් . හැබැයි ඒ තීන්දුව ගැන සෑහෙන ප්‍රීතියෙන් උඩ පනින අයගේ විනෝදජනක අදහස් ගැන නම් සෑහෙන්ඩ සතුටුයි , විභාගේ ඉවරවෙලා නිකං ඉන්න එකේ කරන්ඩ දෙයක් තියෙන්ඩ එපැයි . අපේ රස්සාව ගැන අපිට වඩා හිතන ගොඩක් අය ගැන අද තමයි දැනගත්තේ . හැබැයි , SAITM නිසා රස්සා නැතුව අපි පාරේ දකින්ඩ කැමති අයට නම් පොඩි නරක ආරංචියක් තියෙනවා . අන්තිම විභාගේ ඉවර වෙලා ප්‍රථිපල එන්ඩත් කලින් මාත්  එක්ක ඉගෙනගත්ත ගොඩක් අය දැනටමත් රස්සා කරනවා . අනික් එක ඔය කියන විදිහට , අපේ රස්සාව හෙට ඉඳන් හරිම තරඟකාරී වෙනවා . අපි ඒ තරඟ උඩින්ම පරදිනවා . (හරියට අපි තරඟ කරලා පැරදිලා හොර පාරෙන් ආව වගේ ) ලංකාවේ විභාග බොහොමයක් හරි විදිහට තරඟ කරලා ආපු අයට , තරගේ පැරදුන අයට භය වෙලා තමයි දැන් ඉන්න වෙන්නේ . මීට‍ කලින් පුද්ගලික ඉංජිනේරුවෝ ඔය විදිහට ආව නිසා අපේ ඉංජිනේරුවෝ දැන් රස්සා නැතුව ගෙදරනේ ඉන්නේ . :D

සරළව කීවොත් මටවත් , මම දැනට කරන රස්සාවටවත් , ඉස්සරහට කරන්න ඉන්න රස්සාවටවත් ඔය කියන ඍජු බලපෑමක් මට නම් පෙන් නෑ . හැබැයි මේ තීන්දුව නිසා මුළු රටටම ගොඩක් ලොකු අහිතකර බලපෑම් වෙයි ඉස්සරහට . මගේ අත්දැකීම අනුව ,ශිෂ්‍යත්වෙ pass වෙලා , නුවර ඉස්කෝලෙකට ගිහින් , O /L , A /L  pass වෙලා කොළඹ වෛද්‍ය පීඨයට ඇවිත්  , වැඩ ඔක්කොම අස්සේ තමන් ඉගෙනගත්ත ක්‍රමයට පින්සිද්දවෙන්න සතයක් වත් නැතුව උගන්නපු වෛද්‍ය වරුන් ගෙන් (Consultants , Senior registrars , registrars , SHO ,RHO , MO , HO ) ඉගෙන ගන්න අපිට තිබ්බ වාසනාව , තව අවුරුදු කීපයකින් නැතිවෙයි කියන භයයි , දුකයි තියෙනවා . මොකද ඔය කියන ඉතිරි PMC ටිකත් දාල ගත්තම , සල්ලි මත්තෙම වෛද්‍ය අධ්‍යාපනය තීරණය වෙන්න ගියාම , මේ system එක අවුල් වෙන එක විශ්වාසයි  . ඒකෙ ලක්ෂණ අපි පුහුණු වෙද්දිත් දැක්කා .

වෛද්‍ය සභාවට නඩුවෙන් වුණදේ ඔය කෝකටත් වඩා භයානකයි . ඒ ගැන දැන්වත් අපේ මහාචාර්ය , ආචාර්යවරු , Professional Colleges - තමන්ගේ දරුවා SAITM වුණත් නැතත් , ආයෙත් හිතයි කියල පොඩි බලාපොරොත්තුවක් තියෙනවා . ඒකත් ඉතින් අද අධිකරණෙ ගැන තිබ්බ බලාපොරොත්තුව වගේම වෙන්ඩත් පුළුවන් බොහෝදුරට .

ජීවිතේ අයෙත් ජනවාරි 31 , වෙනද වගේම බලන් ඉන්න දවසක් වෙන්ඩත් පුළුවන් නැති වෙන්ඩත් පුළුවන් . හැබැයි 2017 ජනවාරි 31, ජීවිතේ කවර දාවත් අමතක වෙන් නැති අඳුරු දවසක් වෙනවා සත්තයි !

Last Night

As an undergraduate of MBBS degree, there are many events happenening around us these days. Yesterday was an important day as for the first time a court case was filed requesting SLMC recognition to a degree the SLMC has denied recognition over the last 7 years. I simply did not understand the logic how someone can be a doctor throught the law, when the governing body of the profession denies it's recognition. But i am also aware that my knowledge on law was so poor, and the law can make murderes innocent and the innocent murderers, as the history says. With all these events happening, yesterday night was a TV debate between two Trade Union leaders and the President and Secretary of SAITM parents' association; both were lawyers. It was a pretty interesting debate. I was anyway biased as I am opposing SAITM, but this blog is titled My Opinion, so it would not affect anyway I guess.

The whole argument the two parents had throughout the debate was the Gazzate issued by Minister S.B. Dissanayake in 2011 which the entire doctor community, university students community, the university teachers community said to be off the procedure. But, they were lawyers, so were talking on that word by word as any lawyer would do. Infact I remebered an incident in 2015, at the Law Med, the Law College students virtually won a tennis match with Colombo Medical faculty by WORDS; when they purposefully hid one of their players and later claimed he was unavailable and requested victory based on the unfinished matches. That story is long, (infact it can be a seperate blog itself);which however ended with a fair solution from the party of Law College, but it was the day I realized , how a lawyer will be able to convince that the obvious fraud is correct, just by the words he/she may utter. But, that is their profession, and I still do respect it.
The two parents were also of the same profession. When the host asked the parent 1(President), why he chose SAITM for his child when the SLMC was against it, He answered , " I studied the Gazzate very well. If UGC has approved, who else should I worry etc etc". In the latter part of the discussion he said, "My child is passed out, fully qualified", which reminded me that to pass out, the child must have been of the 1st batch(as only a single batch has passed out), which was recruited in 2009; by the time the so called Gazzate(which is the only thing SAITM claims they got recognition) was not there. Then I realized, "Oh yes, he must be a lawyer". And this father also overwhelmingly challenged the Gvt. Medical students for an open competition with SAITM students. This same comment came off a Past president of the Parents's association, Mr. Gamunu Wijerathne( popular as Bus Gamunu). These parents have forgotten the fact that, the whole issue why their kids are in this difficulty is because unfortunately they were able to perform enough at the so called competitive exam A/Ls. A/L is a tricky exam. But as to the law the lawyers are protecting, we will have to settle with it. If A/L is wrong, we need to change A/Ls, but not develop fraud shops of SAITM nature.That argument Coming from Mr. Gamunu was obvious considering how he commented to media over the years, but from a lawyer was never expected. But realized he was also a father representing the Parents' association.
And then was the other lawyer, who claimed of Students at SAITM has "Just missed A/Ls". In argument, the opposit party stated names of two students who failed A/L Biology and had just 2 S passes who are registered at SAITM. While agreeing that both of them were registered, he so proudly claimed ,ONE has already left. I was puzzeled. If someone build an institute to those who just missed A/Ls, why would someone recruit at least one student who failed A/Ls? Leave aside Physics and Chemistry, if they failed Biology- the Most important subject of A/L subjects for a Doctor? And as he said, if ONE has left the course, does he admit that One is still studying?? Probably passed out as well?; from this marvelous place SAITM?  And the parent said his son got 4As in London A/Ls and he admitted his child in 2013 after the Gazzate(sigh). Wait, London A/Ls? So he was anyway not expecting to enter a Gvt. Uni by A/Ls in first place as he chose London A/Ls. And anyone who did A/L would know, provided if your English is average, London A/L is way too easy than Lankan A/L and not competitive too. So, I was wondering how can someone who chose London A/L fall under the category of "just missed A/L students in Sri Lanka" which SAITM claims they cater to? The president and the secretary of the parents association proved that reality of SAITM is not what they represent at all.
A word must also be placed about this tricky parents association. When the SAITM administration tried to get their needs by disgracing people etc( as of Mr. S.B. Dissanayake era), the President was Mr. Gamunu Wijerathne. Once they need to get sympathy of doctors, the president was a famous surgeon. And when the court case is filed, the President and Secretary both are Lawyers. The parents of this association are genius that to cater the needs of it's administration, they choose the president; but not to cater to the needs of the students.But I am yet to see a Farmer, Fisherman coming as the president of parents' association, as SAITM advertises in news papers throughout the week saying SAITM is for the children of Farmers, Fishermen who JUST MISSED A/L.
During the discussion, the two doctors pointed facts that SAITM is farud since it's inception , and the response of two parents was that " If you need to ask about it's inception, ask from the administration. We are talkng from 2011 onwards".  I was perplexed. Now they came to defend an institute, and they say to ask the administration. Why did the so called learned members failed to do so for over 7 years where there kids learn? And if the start is wrong, how can it be right from the mid way? I simply did not understand the logic, but they were lawyers.
After all, due to the involvement of so many lawyers during recent times, I called one of my friends who graduated from Law Faculty, and asked "how can one be a lawyer in SL?" He said, If you enter a Gvt. Uni and get LLB, you need to sit for final year exam in Sri Lanka Law College to be a lawyer.Anywhere else you learn LLB, you need to complete all 3 years exams in Sri Lanka Law College to be a practicing Lawyer. If you are not going for a degree, you can sit for the Entrance exam in Sri Lanka Law College and then be an Attorney and practice law, but can't do posgraduate then. And when I asked who regulates he said, "Council on Sri Lanka Law education " or something similar. Well I said Thanks. It appears complicated, but for a prestigeous profession like a Lawyer, a proper regulation and standard pathway must be there. But the two lawyers who must have followed the same procedure, now blames the Process of Being A Doctor in this country in Dictatorship. Whose dictatorship? If all lawyers need Sri Lanka Law College recognition to practice and what is wrong when Sri Lanka Medical Council recognition needed for all doctors. And , if the exams are regulated by A Council, what is wrong when SLMC regulated medical training? It's important to realize, A Lawyer must be well trained and regulated and so should a doctor. If two children of doctors who failed Law Entrance exam or so claims they want to be Lawyers and to award them the Sri Lanka Law College recognition, will those two parents agree to it? And similarly how professional it is for the two lawyers to disgrace another profession which is equally/even more regulated like their own profession?
While formulating all arguments in my mind of the discussion held recently, I remembered some incidents happened in the recent Wassana Diyawara ( An annual project done by Medical Faculty Buddhist Association to help a rural village). I was able to chat with a few students studying in Garde 8 of that school. One said, he wants to be a doctor? So i asked if they got A/L science in their school ? They said no. All the childrens' parents were chena cultivators. They had no lab facilities. But, there were few great kids to chat and were enthusiastic as to what Medical faculty looks like, what do we do in there , whether i got a stethescope etc.. As it always does, Wassana Diyawara is an event I personally like a lot as it helps me reflect on life. Personnaly, me too started from Aralaganvila in Polonnaruwa , from Grade 5 scholarship came to Kandy, and from A/L, was able to come to Colombo Faculty. I had a process for me to believe and I was certain that if I succeed the exams, I can get to Med school. And the system helped me as well. In a country where resources are so poorly distributed as it was evident in Wassana Diyawara project, the Minister of Higher Education is more worried of leagalizing institues which produce doctors(for the sake of few children of the powerful people) while the entire medical profession rejects them as it challenges the already existing proper system of medical training which is available for every citizen if they excell in studies.
And in response to the SAITM issue, current minister says, " It was done by previous government". If I am not mistaken, this goverment requested the people's vote saying they'll change the system , corruption, punish ministers who made mistakes etc.., Mr. S.B. Dissanayake was well punished by people for mistakes he did by not re electing him, but the current administration re chose him. As shouted, it's high time the current minister Mr. Lakshman Kiriella to change the mitakes done by previous regime as they say it. If the solution for fraud is punishment, it's time to, ABOLISH SAITM and PUNISH the relevant authorities. And as said by Dr. Neville himself, the "SAITM thawalama( cart)", has already gone too long than what the bulls can tolerate.