• Moratuwa Uni. Med. Fac. founder Dean Prof. Fernando on the need for a nat’l medical edu. policy with criteria to follow in establishing a med. school 
• Notes that the challenge for medical educators/academies is to produce doctors who are humane, compassionate, & caring 

The latest addition to Sri Lankan medical education, the Moratuwa University Medical Faculty, is reaching several milestones this year, becoming deep rooted in the national medical education sector. Today, in the process of moving into an administrative building of the SAITM (The South Asian Institute of Technology and Medicine) the Moratuwa Medical Faculty is to be housed in a set up that can claim as their own. The Ministry of Health will be responsible for establishing the professorial unit for the Moratuwa Med Faculty at the Neville Fernando Hospital.

Conceptualised around 2017, gazetted in 2018, the Medical Faculty initiated its establishment in 2020.

On 1 December 2020 Prof. F.R. Fernando assumed duties as the Founder Dean of Faculty of Medicine, University of Moratuwa. Registered the first batch of students in March 2021.

Today the Faculty educates four batches, with 400 students – the first batch of the Faculty has now reached their final year. By 2027 the Moratuwa University Medical Faculty will be ready to introduce the first set of medical doctors it educated.

“Ours is the first faculty to be established after the publication of minimum standards of medical education gazette. Which means that this Faculty has to comply with the minimum standard requirements in medical education – which is a huge burden. But, unfortunately, this is a faculty that we had to start even without a brick,” said Prof. F.R. Fernando.

Celebrating these achievements, Moratuwa University Medical Faculty founder Dean Prof. F.R. Fernando joined The Daily Morning for an interview.

Following are excerpts from the interview:

The Faculty is reaching several milestones this year. How would you describe the progress?

Definitely not a cake walk. Ours is the first Faculty to be established after the publication of the minimum standards of medical education gazette. This means that this Faculty has to comply with the minimum standard requirements in medical education – which is a huge burden. But, unfortunately, this is a Faculty that we had to start without even a brick. But, we slowly progressed. Whatever the difficulties and challenges were, we didn’t allow the academic standards to drop. 

At present the preclinical block, with funding from Asian Development Bank, is nearing completion within the Moratuwa University premises. It would enable the medical students, in their first Two years in the faculty, to be educated within the mother university. Construction is being completed on time – phase by phase – and by the end of the year the construction of three floors will be completed, as the building contractors have assured. The Faculty expects the completed building to be available by April 2025. 

As of now, part of the clinical years is spent at the Kalutara Teaching Hospital. But with the transferring of property of Neville Fernando Hospital to the Government, a new professorial unit will be established in it for the students of the upcoming clinical years.

How did academic education get established?

Currently, there are 13 Departments in the Faculty. And, among them, we are the only Medical Faculty in the country with a Medical Technology Department. We have got a very committed set of academics. Despite all the challenges we faced during the process of establishing this Faculty, we managed to recruit the best professionals in the field. We have an integrated curriculum. Many other medical faculties are also following this. It's nothing new but very efficient and that needs a lot of dedication and coordination of the academic staff. 

The University has been a technical university for years. How does a Medical Faculty fit in this set up?

 We have faced this criticism since the beginning. But, such concepts come from a very narrow point of view. The medical profession of the future is always going to be linked to technology. We are able to create a graduate who is empowered to suit the future needs. This is definitely a plus point for the University. Added to that, medical technology is taught by engineers. Nowhere in Sri Lanka’s medical faculties do we find this. In this, I see huge potential. There is collaboration between two professions that is benefiting the country in creating empowered medical professionals. We are introducing the collaboration of different fields to students. This is broadening the horizons of medical education. The doctor of the future has to be technologically empowered. A doctor with knowledge in technology can be far better placed in the profession. It elevates the levels of diagnostic capabilities and the efficiency of the doctors. Well, none of the students are complaining about studying technology. I believe that they seem to understand the relevance of it. I don’t want to say that we are much better or much worse than the others. But, we have a different point of view in medical education.  

You are a veteran in the medical profession who has maintained quality and high standards in your practice. How does this Faculty ensure the quality and standard of the doctors it produces?

Ours is the first Faculty to be set up after the enactment of the minimum standards in medical education in Sri Lanka by the Sri Lanka Medical Council (SLMC), gazetted by the Government. First, you must have a good team and up to now, this is what we have been trying to establish. I’m very happy with the team – they are superb. Some eminent medical professionals have joined us. And, we had to maintain the standards in the clinical practice. Currently, our students in their clinical years are studying at the Kalutara TH in Nagoda – which is a fully-fledged government hospital – but does not include a professorial unit in its design. To maintain the standards we desperately needed a hospital with a professorial unit. Moving into the Dr. Neville Fernando TH enables our students to continue their clinical years in the professorial unit that will be built in it. If we don’t maintain the minimum standards criteria, our students will face a problem in their professional registrations at the SLMC, after graduation. At that stage, all these factors are reviewed by the SLMC. 

It is being discussed from time to time that within the medical education sector, the facilities for medical graduates to complete the internship, is insufficient. How do you see this?

I agree. This is going to be an emerging issue in the future, because at present, several medical schools are producing doctors. Two factors have contributed to this state. One is the increased number of medical graduates passing out and the latest factor being many consultants of the medical field leaving the country. Currently, over 600 consultants have left the country. Without consultants you cannot guide interns. Consultants leaving the country has created a huge vacuum for internship posts. The internship period is crucial since it is the first time that a medical graduate starts independently diagnosing conditions and prescribing drugs – which needs quality supervision. And, these interns are dealing with real human beings. The SLMC is giving due concern to this issue, accessing all the available slots in the country and planning to increase the number of training slots. I don’t know whether we can provide a complete solution, but the SLMC, with the help of the Government Medical Officers Association (GMOA), is attempting to address the situation. We need to have a national policy on medical education – criteria to follow in establishing a medical school. A medical school must first have the necessary infrastructure established – with professorial units for clinical training and a fully fledged faculty. 

The present-day challenges, be it the Covid-19 pandemic or the economic crisis, are equally affecting globally. Fresh medical graduates face a similar challenging environment in Sri Lanka. How do you evaluate the situation? Do you believe that the new doctors are getting enough support to adjust in these trying times?

The way I look at it is like this. As medical educators, we have a huge responsibility to produce doctors who view things humanely, simultaneously providing them with the technical know-how with its latest advances. But, most importantly, it is that compassionate, caring doctor that we need to produce. That is the challenge that I see. This is a challenge for every medical academy. You can give the students complete knowledge, and empower them with advanced technical know-how, but what they will actually practise is what they see and experience. 

The seniors and medical educators are the role models. All of us have this responsibility in this chaos. 

We need to emphasise on maintaining standards and our ethical behaviour – in the way that we treat patients. That is what you need to impart. Eventually, it is up to each individual to take up all the knowledge and proceed as a professional. We cannot change people easily as many factors apply to any individual’s behaviour. In a society like ours, these factors become far more important than subject knowledge. If you think from a humane angle, what does a patient expect genuinely? What they expect is somebody they can talk to and express their fears and worries. I always ask these medical students – ‘Now, you want to be a good doctor – who is a good doctor?’ A lot of them cannot define this. As I have learnt, a good doctor is a doctor who always comforts, who relieves pain and misery in patients. So therefore, always provide comfort, relief often and cure to the maximum possible. One can be the best knowledgeable doctor, but, if they are not caring, then, it is useless. Following this principle, doctors can withstand whatever the society throws at them. 

How do you see the evolution within the generations of doctors?

It is not a situation that can be taken in isolation. Attitudes of society have changed. Medical students reflect all that. It is easy to say that ‘we were not like this those days’, but I don’t take that view. Because these students come from the society, and if, in the society, the values have changed, and attitudes have altered, it reflects in them. In a society where technology has taken over people, everything is chaotic. We must use technology but by the time technology overtakes, the human becomes nothing. This needs to be handled in balance.

PHOTOS Venura Chandramalitha