Letters to the Editor
I agree with Dr. Kommalage and Dr. Ponnamperuma that medical education reform in Sri Lanka in recent years has resulted in the region's best health indicators, with high life expectancy, low infant mortality, and low maternal mortality. The emphasis of community-based medical education in Sri Lanka aiming to meet the health care needs of the community is now largely fulfilled.
Regarding South Asia itself, Amin et al1 pointed out some important education issues facing that region. An explosion of private medical education there (with Sri Lanka being a notable exception) and the lack of proper quality assurance are of serious concern. It is an issue with implication beyond the region because of the large number of medical graduates emigrating from South Asia to other parts of the world.
Even Sri Lanka, whose medical schools, as Dr. Kommalage and Dr. Ponnamperuma stated, are free and government funded, now has a private medical college in Colombo.2 The Sri Lankan minister of higher education, a strong supporter of private universities, had promised that the students of this private institution would be granted the opportunity to carry out their education, despite opposition to the school and claims that it is illegal. It will be interesting to observe the quality of education of this private school and the impact of its graduates on the overall quality of medical graduates from Sri Lanka.
The proliferation of unregulated private medical schools in 19th-century America and the production of physicians of uncertain quality led to the Flexner Report and subsequent closure of these substandard institutions. Many of the private medical schools in the South Asian region have been established for profit and are not well regulated. Is history repeating itself, although at different geographical locations?
Tai Pong Lam, MFM, PhD, MD
Professor and chief of postgraduate education, Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, China; email@example.com.