‘MBBS at early age, an investment for the country’ | Daily News

‘MBBS at early age, an investment for the country’

GMOA brings proposal for an efficient medical education

According to Government Medical Officers’ Association (GMOA) President, Dr. Anuruddha Padeniya, during the last five decades, the GMOA has observed a gradual increase in the age limit of graduation of MBBS from 22 years up to 25–27 years, an unacceptable delay of four to five years.

This is a result of many complex challenges endured by the education system since Independence including youth unrests, political turmoils, terrorism, and poor economic growth.

This preventable delay has led to adverse consequences in the personal, economic, academic, professional, and social spheres. As a result, the country has suffered in many aspects including an incalculable economic loss.

The latest proposal presented by the GMOA aims to introduce a strategic plan for the optimisation of the age of graduation back to 22 years. The GMOA hopes that this proposal will benefit not only the students awaiting university entrance and undergraduates, but also the entire country and create many opportunities in Sri Lanka and internationally.

The GMOA would like to express their gratitude to everyone who helped to develop this conceptual proposal and welcome their suggestions for improvement.

The GMOA officials pointed out in their proposal that Sri Lanka offers school and university level undergraduate education funded by the Government. With the reforms in the health and Government education system, currently, there is an average five-year delay, which is neither experienced by the Sri Lankan private sector nor the international arena, leading to many negative impacts on Sri Lankan people, nationally, regionally and internationally, and to a huge loss of revenue and productivity. Thereby effective years in the lives of the maximum proficient and hardworking academics have long gone to waste incurring an incalculable loss to the Sri Lankan economy, and at the same time leading to further losses in personal, economic, academic, professional, and social development.

As such the GMOA wishes to govern the leadership to implement the following steps to rectify this unsatisfactory state in order to make the path for students to achieve MBBS by the age of 22 years.

1. GCE (O/L) Examination should be held in Grade 10 when the student is 15 years and in August – by the Education Ministry

2. GCE (O/L) Examination results should be released by October enabling students to decide their future stream of education by December. – by the Examinations Department

3. GCE (A/L) should commence in January and the examination should be held in Grade 12 when the student is 17 years old and in December. – by the Education Ministry

4. GCE (A/L) results should be released by February enabling students to decide their future stream of education by April. – by the Examinations Department

5. University admission should commence in April when the student is 18 years. – by the University Grants Commission

6. Immediately after graduation, internship should be commenced. – by the University Grants Commission and Health Ministry.

The GMOA suggests that the reform they recommend for MBBS should be applicable to other graduation streams based on their durations.

Sri Lanka is one of the few countries in the world that offers universal public-funded education for all schoolchildren and free undergraduate and postgraduate education for high achieving students and vocational training for the rest.

(1) This has contributed immensely to the emergence of a middle-class, social mobility

(2) and high social development indices achieved by Sri Lanka since Independence. Commitment to public education both at school and higher education sectors has contributed towards elevating the Sri Lankan workforce above those of regional countries and served as a model for the developing world.

During the colonial era and the immediate post-colonial period, it was the norm to complete school education by the age of 17 years and to graduate from the university by the age of 22 years for MBBS and 20 years for BA/BSc.

However, over the past five decades, the age of completion of school education in the public sector has increased to 19 years and the age of graduation has increased to 27–28 years for MBBS and 25–26 years for BSc/BA.

Sri Lankan private sector and the regional and international arena have not been deteriorated in a similar manner as of today, keeping the age at graduation largely unaffected over the years.

This highlights the fact that a focused leadership can resolve this discrepancy. This unattended ill-effect has created many detrimental outcomes affecting individual lives, the families of the most gifted citizens of the country and the country’s social and economic aspects as well. Highly valuable and productive years in the lives of the hardworking academics and professionals have gone to waste in this crisis incurring an incalculable loss to the Sri Lankan economy, while at the same time hampering further personal economic, academic, professional, and social development. This problem has been further exacerbated by the current COVID-19 pandemic.

Impact on the individual

The graduates who complete MBBS or another degree programme at around 27–28 years of age face many financial, professional, social, and personal challenges.

Professional and financial loss

Delays in graduation lead to a vicious cycle of further delays and losses. Increased duration of the undergraduate courses increases drop-out rates. Among those who complete education, a loss of four to five years of professional life is observed. Moreover, the analysis of the age at the post-intern appointment in Sri Lanka, shows, over the past 10 years, it has been varying from the age of 22 years to 33 years, of which the majority lie around the age of 28–30 years. The years lost are the most energetic and productive period of a graduate that can be best utilised for developing an academic background, professional development, learning new skills, and establishing a strong platform to be successful in life. Invariably this results in loss of high earning professional years from the back end of the career and delays all promotions and increments by nearly half a decade.

Most international academic/professional programmes and career positions give preference to younger graduates with less commitment and higher enthusiasm. Delays in graduation drastically reduce the likelihood of Sri Lankan graduates being selected for foreign careers and academic opportunities and put highly talented Sri Lankan graduates at a disadvantage when competing with international graduates. Economic losses in the form of direct losses and loss of opportunities accumulate into a large financial loss for the graduate and also the country. Delays in reaching academic and professional goals and personal economic stability are the main reasons for migration.

Family and social cost

State universities are public funded. However, undergraduates must still spend on their own expenses which goes unattended. Graduates are not financially self-reliant until the completion of graduation and in the case of medical graduates, until the completion of internship. Most degree programmes in public and private universities are full-time courses which require complete dedication of their time and energy. Therefore, undergraduates are financially reliant upon their aging parents up to their late twenties. Furthermore, this undue delay deducts valuable time that could be dedicated for family and social life.

Disproportionate impact on women

The lack of financial independence delays the age of marriage for university graduates. This leads to delays in family completion and disproportionately affects women graduates. Women graduates are often compelled to select between postgraduate studies and the completion of a family which forces many women graduates to not pursue further academic and professional development. Ones who follow postgraduate studies end up having to delay family completion and risks associated complications. They are also compelled to select career pathways which require less time commitment but also reward less financially.

Impact on the Economy

Delays in school education incur a loss of approximately 200,000 working years annually to the Sri Lankan economy. These delays accumulate approximately up to 100,000 highly skilled working years lost from public university graduates to the Sri Lankan economy annually in various academic, professional, and industrial sectors. Increased age of graduation eventually results in late entry into the workforce including the public service.

The losses are even more pronounced among medical graduates who amount to 1,500 annually and suffer a delay of approximately four years before entering the workforce. Above economic losses have been gradually worsening over the last five decades amounting to an incalculable loss to the country. Delays in school education and undergraduate education accumulate into postgraduate education, resulting in delays in producing specialists. This has contributed towards the deficiency of specialists in the Sri Lankan health sector. Furthermore, the advanced age of Sri Lankan doctors and other graduates curtail the competitiveness of Sri Lankans in the international job market and when applying for international academic positions.

Individual economic losses and delays deter graduates from entrepreneurship, research, and innovation. Sri Lanka is facing a crisis of not having adequate local entrepreneurs and researchers. Delays in graduation destabilise graduates financially, forcing them to follow safer career pathways compared to riskier but more rewarding avenues of entrepreneurship and innovation. Unfavourable economic and social implications of the above delays contribute to the brain drain which Sri Lanka is facing in many professional and academic sectors. The economic and social costs of the above delays have contributed towards historic, social and political unrests in the country.

Benefits to the Individual and Family

Once implemented, this concept is expected to reduce the financial burden on undergraduates and their families by minimising the period of dependence and early entry into the workforce. It will allow individuals to allocate a longer time for academic and professional development, gaining skills, exploring research and innovations, and experimenting with entrepreneurship. These will accumulate substantial economic benefits and early progression through professional milestones. The bove gains are expected to improve family and social environments as well.

Benefits to the country

A person who completes the basic degree by 22 years has the opportunity of serving the nation as a professional for a longer period with higher efficiency. Sri Lankan graduates will be more competitive when competing for international academic positions and employment opportunities. A younger and more updated workforce will help to transform Sri Lanka into a knowledge-based economic hub. This will minimise brain drain, improve the ability to retain skilled professionals for longer years and develop the economy.

Graduation at a predicted early age will boost the individual and social well-being. This will minimise social unrest among youth and guide them towards productive academic and economic activities freeing them from current state of frustration and confusion. Women graduates are expected to benefit the most as they will no longer have to compromise their academic and professional ambitions to balance family lives.

Benefits to healthcare system

Proposed measures are expected to reduce the unrest among the medical graduates, enabling them to build more conducive working environments to get the maximum outcome and improve patient care. Younger doctors can efficiently serve in difficult areas and ensure quality and equity of healthcare. Furthermore, early graduation will serve as an incentive for postgraduate education. Producing qualified young consultants will strengthen the healthcare system and provide expertise over a longer period. Younger medical graduates can also work abroad intermittently and earn through knowledge economy and improve the ability to retain doctors in Sri Lanka.

The proposed strategies and activities to reduce the time gap 

 Action Plan

Comparison of Primary, Secondary and Tertiary Education in Global Settings with that of Sri Lanka

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