How many Medical specialists do Ministry of Health- Sri Lanka need by 2025: Use of system dynamics modelling for policy decisions

Introduction: The Ministry of Health is the largest health care provider in Sri Lanka in terms of funding, coverage and human resources. Long duration and high training cost of a medical specialist highlights the importance of health human resource planning. Ministry of Health, Sri Lanka has no scientific cadre planning for medical specialists.

Methods: System dynamics, an analytical modelling approach and a methodology for studying complex feedback systems was used. Two sub models of “need” and “supply” were developed and simulated over a period of 10 years from 2016 to 2025.

Results: By December 2015 there were 1860 clinician medical specialists with an average age of 46.8 years, in the government hospitals in Sri Lanka. In the surgical group of specialties the Proposed Training Rate is more than Current Training Rate while in Medical and Paediatric groups and in Radiology, Anaesthesiology, Psychiatry, Dermatology and Hematology Proposed Training Rate is less than the Current Training Rate.

Conclusions: In Surgical specilities the number of trainees enrolled in the Pre-MD programme should be increased from 55 to 71 and while in Medical specilaities the number of trainees enrolled in Pre- MD programmes should be reduced from 107 to 68 and in the Paediatric specialities from 47 to 39. During the 2016-2025 period, 765 specialists will be lost to the Ministry of Health costing nearly Rs 7.6 billion and there will be 4050 consultants by 2025, which is a 120% increase.