Features

Sri Lanka Medical Council
Past, Present and the Future

By Dr. Ananda Samarasekera
(ND, MBBS, DLM, DMJ (Lond.), Dip.F.M (Glasgow), Vice President, Sri Lanka Medical Council)
The Colombo Medical College (CMC) was the first medical academy declared open by Sir Henry Robinson, Governor of Ceylon in June 1870. There were 25 male students in the first batch and the institute came under the purview of Principal Civil Medical Officer (PCMO) equivalent to present Director General of Health Services. The Diploma of Licentiate of Medicine and Surgery (L.M.S) was conducted by the C.M.C. In 1890 the school was raised to the dignified level of Ceylon Medical College. The L.M.S became registrable with the General Medical Council of Britain without further examination in 1887 and this recognition continued until 1970 even with the MBBS (Ceylon), which was the successor to LMS after Ceylon Medical College was affiliated to University of Ceylon in 1942. Thereafter the Medical College Council became a separated body and continued to award certificates of efficiency for all other registrable categories including AMPP. The University started degree course for medical and dental students.

There was no Medical Council or an equivalent body until Medical Registration Ordinance was passed in 1905 incorporating the Council of the CMC. This empowered the Ceylon Medical College Council to register certain categories of persons including holders of LMS (Ceylon) to practice medicine and surgery in Ceylon.

Thereafter the Medical Registration (Amendment) Ordinance No. 36 of 1908 made legislative provision to practice medicine and surgery by Apothecaries and Estate Dispensers with the approval of the PCMO in the government sector. In 1915, Dentist Registration Ordinance was passed to register Dentists to practice dentistry.

Until 1924 provision of medical education as well as registration of medical practitioners and dentists was vested with the Ceylon Medical College Council. The Medical Council Ordinance No 24 of 1924 made legislative provision to constitute a separate Council to govern the medical profession. This was the forerunner of the current ordinance and the Medical Council. The first meeting of the Medical Council was held at the Colombo Medical Library on 22nd June 1925 at 3 pm chaired by its founder President Dr. N. Duncan Walker. The other members of the first Council were Drs. J. S. R Gunawardana, R. Pestonjee, E. A. Cooray, V. Van Lanberg, Lucian de Zilva, H. M. Pieris, P. J. Chissll, Frank Gunasekera and G. Thornton. At this meeting Dr. Lucian de Zilva was elected uncontested as its Vice President and Prof. F. O. B. Ellison was appointed as the Registrar. Since then meetings of the Council were held in the Colombo Medical Library at Ceylon Medical College until the venue was changed to Board Room of the Medical College in January, 1930.

At that time the Council did not have a permanent staff or an office but the clerical staff of the CMC assisted in secretarial work to the Registrar. Prof. Milroy Paul being the Professor of Surgery as well as the Registrar SLMC was able to get the assistance of the members of his staff in the department of surgery to do the clerical work for the Council. The Council depended on a grant of Rs. 1000/= per annum from the government since 1925 but later legal provisions were made for the Council to charge fees for services and functions rendered to Practitioners. Council carried on without a permanent staff and an office for many years. In 1964 a subcommittee was appointed by the Council to reorganize the office of the Medical Council. This committee proposed to obtain 25 perches of land from the General Hospital premises, Colombo and also explore the possibility of obtaining a room from the Ceylon Medical Association (present SLMA) building until such time the Council has its own building. This committee also proposed to have a part time Registrar (Medically qualified person), full time office assistant, accounts clerk, a clerk and a labourer as council staff.

Director of Health Services declined to give a plot of land from General Hospital premises but CMA agreed to provide a room. In the meantime Vice-Chancellor of University of Ceylon agreed to provide a separate room from the administrative block of the Colombo Medical Faculty, the Council started its office in 1968 and appointed an office assistant and a part time clerk. Mr. S. A. Wilbert was recruited as the peon in 1967 and is still serving the Council.

Few years later the authority of the Colombo Medical Faculty wrote to the Medical Council requesting it to hand over the room in the administrative block in the faculty but later considered the request made by the Medical Council and permitted it to stay on for further period.

In 1967 a subcommittee was appointed by the Medical Council to look for a crown land in a suitable location for a building but all its attempts were unsuccessful.

Consequent to the expansion of the library of the Medical Faculty in 1971 the Medical Council had to vacate the room in the administrative block of the Colombo Medical Faculty. The Council shifted its office to a room in the first floor of the CMA building on a payment of monthly rent of Rs. 300/=. Thereafter the Council recruited a full time office assistant and two clerks. Since then venue of the Medical Council meetings was the council room of the Medical Association until the SLMC office was shifted to its new building.

After some time the office of the Medical Council was shifted to a bigger room in the ground floor of the SLMA building and paid Rs. 10,000/- per month as the rent. Thereafter the staff was increased to four. Subsequently monthly rent was increased to Rs. 25,000/= by the SLMA.

The Medical Councilís request to HE President in late 80ís for a plot of crown land was also unsuccessful.

To facilitate the building expansion project of the SLMA in 1996, the Medical Council was offered a bigger space in the new building. The Medical Council agreed to pay the proposed rent of Rs. 55,000/= per month for a period of 5 yrs in advance and obtained two rooms in the new building and shifted its office in February 1998.

On the initiative of its new President, Dr. H. H. R. Samarasinghe, in 1999 the Council appointed a subcommittee to find a suitable building site. Dr. A. M. L. Beligaswatta, Director General of Health Service offered a block of crown land to the Medical Council in Model Farm Road, Borella, behind the Health Ministryís sports ground. The building committee inspected the land and obtained technical advice from its architect. The opinion of the architect was that large amount of money will have to be spent for preparation of the land and for construction of a building in this site. On their advice the committee looked for a better land. Prof. P. S. S. Panditharatne, the Registrar of the SLMC was able to find the land where the building has now been constructed, from an advertisement in a newspaper. The Council decided to buy 17 perches of land and to construct its new office building. Foundation stone was laid in December 2001 and building was completed within a year. The office was shifted to the new building in February, 2003.

At present the Council staff consists of six clerks, one computer operator and two peons. All the data in the office was computerized in June 1995. There had been 430 routine Council meetings from its inception and several special meetings. Minutes of all these meetings are well maintained in the council office.

About the registration, Dr. Allan Perry was the first person to obtain registration with Ceylon Medical College Council, on 15th August l906. At the time of establishment of a separate Council for registration in 1925 there were 848 persons already registered as Medical Practitioners with the Ceylon Medical College Council. Since then total of 18,258 persons have obtained full registration as Medical Practitioners up to July 2003 and 15,829 persons have been given provisional registration to do their internship training since 1952.

Furthermore 1028 have been given temporary registration to practice as Government Medical Officers on the recommendation of the Director General of Health Services and 726 non-citizens have been given temporary registration to practice as Medical Practitioners in various institutions and Nursing Homes in Sri Lanka on the recommendation of the Director General of Health Services or Secretary of Health or a Dean of a Medical Faculty.

Up to July 2003, 1877 persons have obtained registration as Dentists and 2708 persons as Registered Medical Practitioners (RMPP). Total number registered as Pharmacists (including AMPP) is 5272.

Total of 19540 female nurses have been registered whereas only 2617 have been registered as male nurses up to July 2003. Since 1920 total of 12,418 females have obtained registration as Midwives. There are 57 registered Para Medical Assistants and 611 Professional Supplements to Medicine (PSM Group).

Since it is a legal requirement to obtain registration by ophthalmic auxiliaries, Dieticians, Occupational Therapists, Chiropodists and Nutritionists to practice in their respective fields in Sri Lanka many of them are also registered with the Council.

In addition to licensing Medical Practitioners, Dentists and other health care providers mentioned herein, the Council should monitor the undergraduate and postgraduate medical education in Sri Lanka. It is the sole responsibility of the Council to ensure that those who qualify outside Sri Lanka possess at least the minimum skill and knowledge stipulated by the Council before they are given license to practice. The council conducts the Act 16 examination to evaluate medical and dental graduates qualified overseas for this purpose.

The Council is empowered by the Medical Ordinance to conduct disciplinary inquiries for the registered medical practitioners and all other registered categories for alleged Serious Professional Misconduct. Their license to practice may be cancelled or suspended if any one is found guilty at a quasi-judicial inquiry conducted by the disciplinary committees.

Over the past decade, the workload and responsibilities of the Council has increased tremendously. To achieve its tasks adequate infrastructure facility and manpower are essential requirements for the Council. In this context adequately staffed and well-equipped office complex is nothing but a basic need.

The Council has already identified some activities for the future. This includes accreditation of medical schools in Sri Lanka and abroad, establishment of examination unit to conduct the Act-16 examination regularly for all eligible candidates, preparation and publishing of ethical guidelines for practitioners, guidelines for Assisted Reproduction Technologies for Sri Lanka, introduction of a scheme for revalidation of license to practice medicine, surgery and dentistry in Sri Lanka and establish and maintenance of a specialist register.

In conclusion it must be emphasized that the general duty of the Council is to protect the public and to uphold the reputation of the profession. The Council does this by keeping and publishing registers of qualified persons in different categories to practice each discipline, by fixing the standard of education and experience required for entry to each register and by promoting high standard of medical education, by giving advice on standards of the professional conduct and on medical ethics, and by taking action against those who are registered with the council if it appears that they have become unfit to practice and to continue to exercise the privileges of registration.


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