A historical perspective of North Colombo Medical College

A historical perspective of North Colombo Medical College

At the outset I must thank my good friend of several decades Prof. Carlo Fonseka for having invited me to be a Guest of Honour at this convocation.

I am happy to say that he has accorded me the same privilege that he granted Dr. Stanley Kalpage. He told me I could say whatever I wanted to say at this historic and last convocation of the NCMC. After all he added, ‘inspite of the few differences we may have had, we must recognise that all of you helped to produce 800 excellent doctors’. To strike a personal note, I must say that over the years, that Carlo and I have agreed on several issues and we have also disagreed on some, but we have continued to be friends over the long period of time. I might add that in the early days when we were creating the NCMC, I sought Carlo’s advice on several occasions. To stimulate his memory one of the first questions I put to him was, what should be the annual student intake of the NCMC. At that time, the Colombo Faculty was admitting 150, Peradeniya, Ruhuna and Jaffna, 90 each. We realised that in order to be viable and create a stable insitution, we should have an annual intake of 120 students. Carlo’s answer was very clear. “There is nothing magical about the numbers 90 or 120 or 150. If you can provide adequate and competent staff, hospital teaching facilities in the clinical years, the equipment and buildings – you could admit 90 or 120 or 150 or even more” I can state that it was because of what Carlo said that day that the NCMC became the second biggest medical school in our country admitting 120 students, each year.

Ladies and gentlmen, for me, today is a day of memories. As I stand here before you, I recall the early days of the NCMC a truly magnificient institution which as Dr. Stanley Kalpage said was sadly destroyed. Prof. Carlo Fonseka has requested me to give a short review of the early history of the NCMC and this is what I propose to do, while being aware of the time constraints.

In the beginning there was Dr. G M Heennilame — ladies and gentlemen I pause to recognise that without Dr. Heennilame there would have been no NCMC and no convocation today. I request you to show your appreciation by giving him a round of applause. To repeat, in the beginning there was Dr. G M Heennilame with an idea which he was advocating since 1975. At first no one took him seriously, as he was striving towards the unattainable. In 1979 Dr. Walter Gooneratne and I joined him, being convinced of the feasibility and necessity for a private undergraduate medical college in Sri Lanka. Dr. Gooneratne and I began to share with Dr. Heennilame, the cynical comments and barbs of our colleagues. No one seemed to take us serious ly, as it appeared that we had an unrealistic objective and most importantly after all, we were only general practitioners.

In November 1979 as Dr. Stanley Kalpage stated, the College of General Practitioners of Sri Lanka appointed a 3 member project implemention committee, to take steps to create a private medical undergraduate institution. I somehow feel that this was done in order to keep Dr. Heennilame, Walter Gooneratne and me quiet at Council meetings, as it was probably thought that the Council had more important business to get on with. Between April and July 1980 Drs. Sathis Jayasinghe, Willie Ratnavale and Shelton Cabraal joined us. This small team of 6 persons created history by daring mighty things, working part time and creating an institution that has produced over 800 doctors – namely the North Colombo Medical College. As Dr. Stanley Kalpage said, it was a truly a miracle. Having unbiased minds was an asset we brought to bear on this project when we embarked on it. We were not put off by the revelation of the magnitude of the task we had set ourselves. In the evaluation of our data, as well as in our actions, we were not hampered by past experiences, precedents and frozen ideas. We did not hesitate to challenge established dogma and we raced along paths on which experts would have feared to tread.

I must place as record those who helped to make the NCMC a reality, with their encouragment and assistance; President J R Jayewardene who from the beginning till the end of his term of office supported us. Dr. Stanley Kaplage as Chairman of the Univesity Grants Commision and Secretary of Higher Education, played a similar role. So did Prof. Stanley Wijesundara, L H R Peiris and Gamini Jayasuriya. Mr. Edward Arambawela gave us support from the media and helped considerably to improve our credibility. There were several other persons who helped selflessly to make the NCMC the success it was — but if I were to mention all their names and the roles they played, the graduands will have to wait till midnight to be awarded their degrees.

In July 1980, when the first Board of Governors was appointed and Dr. Willie Ratnavale took office as Director, we had no funds, no office, no staff and little credibility. But in less than one year 3 months, we opened the North Colombo Medical College, with the first intake of 120 students 20 of whom had foreign eligibility qualifications.

I must state that had it not been for the quota of foreign students we admitted each year, paying enhanced fees in foreign exchange, we would not have been able to charge the low fees we did from the local students and also we would not have had the funds to embark on the massive capital development programme – the hospital, library, pathology block, canteen block etc. In less than 2 years we had created 13 departments for the NCMC, a truly stupendous achievement. We must record that the staff of the Faculty of Medicine, Colombo was of great assistance to us in this exercise.

A fair amount of controversy accompanied the creation of the NCMC, But, there was also a tremendous fund of goodwill and support. We had to face some destructive criticism from a few. But the verbalisation of their arguments, the tone of their criticism and the nature of the debate revealed to everyone that their case was based on ideological and not educational grounds. It was the first time that the private sector had entered the field of medical education in modern Sri Lanka and this was very difficult for some to accept.

There was another group of vitriolic critics, whose antics I recall with amusment and some measure of contempt because from the moment their children were admitted to the NCMC as students, these sworn enemies became our strongest supporters. There were however several who had useful and constructive criticisms to make. To them we were very grateful.

I remember, at the beginning I quoted Victor Hugo who said “No army can withstand an idea whose time has come” but I made a mistake, we were actually ahead of our time by over 1 1/2 decades. Today “private sector” and “privatisation” are no longer dirty words in the vocabulary of nearly every political party. I wonder sometimes what would be the attitude of those who criticised us, if some group decides to start another private medical educational establishment in our country today. It will certainly make an interesting scenario.

Some of the our actions illustrate the attitude of the Board of Governors and the Director towards our institution and its objectives. We organised a well structured orientation course lasting nearly 2 months prior to admission of each batch of students. This we did because we found that the majority of the students who obtained high marks in the advanced level examination had poor general knowledge. We cannot blame these students, for after all they had been exposed to a purely examination oriented environment. The blame falls squarely on the shoulders of those who designed the sadistic A/L examination format and also those who made this examination the criterion for measure of merit for entry into the University. The orientation course has been hailed by many educationists as a very fruitful exercise. We were extremely happy to note that subsequently the faculties of medicine in our country made attempts to organise similar courses for their students.

We also had an interview before selection of students. Whatever the merits and demerits this exercise had, we obtained some valuable results.

We found that fair number of applicants were not motivated to study medicine or become doctors. They told us in no uncertain terms, at the interview that they had been compelled by their parents to follow a prestigious course in a medical school. These individuals were weeded out and from the feedback received subsequently, they were successful, satisfied and happy in the disciplines of their choice and not that of their parents.

Another feature was that we detected a few psychotic individuals at the 15 minute interview. After all there were 3 to 4 experienced family physicians on the interview board and this facilitated this task. Interestingly enough, these psychotic individuals whom we rejected did have relatively high marks in the A/L examination. May be the A/L examination could be used to screen or detect psychosis.

It was however sad to note that out of the 20 to 30 applicants we interviewed each day, only one or two could be chosen, merely because of the limitation on the numbers, we could admit. This resulted in a large number of applications being rejected and several influential persons whose children could not be admitted becoming bitter enemies of the NCMC.

The students we chose were wonderful group of individuals, so were their parents. The first batch of students I recall, swept the floors help to repair the buildings and colourwash them, landscape the gardens etc. One thing comes to my mind is that the parents also took an active part in this. They even converted an old hospital kitchen into a canteen in less then two months. To do this they scraped several inches of soot off the walls and floors.

The Board of Governors and its Director were proud of the fact that in the 8 years we were in administrative control of the College, that there was no incident of ragging. Ragging had become a cruel and sadistic practice in our universities. Unprotected new entrants were harassed, tormented and forced to perform some sub¬human, degrading and obscene acts. We created an environment that did not condone ragging and so there was no ragging in the NCMC.

There are two matters I would like to speak on, Dr. Stanley Kalpage has already addressed these in some detail.

1. Takeover of the NCMC

The Board of Governors and all those concerned with the NCMC were deeply perturbed and hurt with the manner the NCMC was taken over. The takeover was bad enough but the manner in which it was done was inexcusable. We were lawabiding citizens and it was totally unfair of the government of that time to send the military to occupy our premises. After all we had not violated any law of the land nor had we any intention of ever doing so.

2. The second matter is the compensation issue. The College of General Practitioners which owned the NCMC and all its assets was entitled to compensation according to the law that was framed and passed, to enable the takeover. The College of General Practitioners is planning a vocational training programme. This will help the vast majority of doctors who will qualify in the future. Most of them will not be employed by the state as the cadre will be full. We welcome these doctors to the ranks of general practitioners. However, if they are to be professional and competent in their job as family physicians, they will need further training. This is what the College of General Practitioners plans to provide, using the funds obtained from the compensation. We are not asking for the full value of the assets, we are not asking for even 25% of the value. What we have requested s less than 10% of what is due to us. Our sincere hope is that those who will make the decision, will also ensure that some measure of justice is done and the country will benefit from the training programme.

Ladies and gentlemen, I end by paraphrasing what Dr. Willie Ratnavale said about the early days the NCMC. “Everything fell into place. I think it was a lot of luck. It was chance – the chance that brought Drs. Heennilame, Dennis Aloysius, Walter Gooneratne, Sathis Jayasinghe, Shelton Cabraal and Willie Ratnavale together. No other combination would have worked”.

For me, it was a privilege to have been involved in this gigantic project. It was an enjoyable and memorable experience.

Do we have any regrets? I answer that question with mixed feelings, at this, the swan song of the NCMC. We are proud of the achieve¬ments, the whole exercise was a worthwhile one and as the NCMC ends, we see that we have helped the state to create a new faculty of medicine namely the Faculty of Medicine, University of Kelaniya. We are grateful to the two competent authorities Profs. T Visvanathan and Carlo Fonseka and also their staff who after the state takeover, took over the responsibility to complete what we had started.

I recall with a nostalgia that hurts, numerous events and episodes. I also recall the several hours we members of the Board of Governors and the Director, spent organising, creating and administering this remarkable institution. The magnificent efforts of our academic staff, the sacrifices they made, especially the clinical professors – namely Profs. Stella de Silva, Thanabalasundaram, Wilfred Perera and Cris-topher CanagaRetra. I sincerely hope that one of those involved will write the history of the NCMC. Sadly two of our pioneers, Drs. Shelton Cabraal and Willie Ratnavale died last year.

Whatever has been the outcome the 800 doctors we helped to produce have brought credit to the NCMC. Their discipline, dedication and decorum have been widely commented upon and commended. Consultants in all disciplines have a special word of praise for the NCMC qualified doctors. Some of our students have become consultants both in Sri Lanka and abroad. Our NCMC graduates have fanned out across the country and across the world and they have left the stamp of tb.2 NCMC on our soil and the soil of foreign lands.

As this the final batch leave the portals of the NCMC for the last time and as the doors the NCMC close today for all time. We thank everyone of those who helped to make it a reality and a success.

We are sure that historians and the graduates of the NCMC will keep the North Colombo Medical College alive for a long, long time.