Dearth of medical manpower amid redundant institutions

Apart from being globally-recognised as a football nation, Nigeria is also known for producing outstanding medical doctors.

From Saudi Arabia to United Kingdom, and United States, Nigerians are very visible in hospital wards around the world, delivering outstanding medical feats.

These experts are ‘truly’ Nigerians because most of them were born, bred, and trained here in Nigeria as medical doctors before proceeding abroad for practice.

Yet, this is a country whose health indices point southwards. Nigeria ranks among the first five worst countries in maternal mortality, under-five deaths, tuberculosis, polio, and HIV/AIDS prevalence amid other health challenges.

Recently, the Minister of Labour and Employment, Dr Chris Ngige, was quoted to have said that Nigeria had enough medical doctors, and those wishing to leave for greener pastures were free to do so.
The comment generated a lot of outrage, as stakeholders decried such declaration from a Minister, who should know better.

But Ngige is unrepentant, saying he spoke from the point of knowledge. “I speak from the vintage position of being a medical doctor, and member of the Nigerian Medical Association since June, 1979, and enriched by my vast knowledge on health administration, having retired as a Deputy Director, Medical Services and Training from the Federal Ministry of Health in 1998, member of Vision 2010 Committee on Health as well as senior member, Senate Committee on Health 2011-2015,” he reeled out.

But he admitted that Nigeria is far away from the desired position in terms of healthcare delivery, and as such, does not currently have enough facilities to accommodate all the doctors seeking to do tertiary specialist training (residency) in the teaching hospitals, Federal Medical Centres (FMCs), and some accredited state and private specialist centres in the country.

This situation, he hinted, has led to roughly 20 per cent of the yearly applicants being absorbed, while the remaining 80 per cent try their luck elsewhere.

A former Chairman, Medical and Dental Consultants of Nigeria (MDCAN), Dr Chris Agboghoroma, had criticised that the country has medical facilities that are not put into use, saying if properly deployed, Nigeria can train all its required doctors and even train for export.

His words: “I agree that we may not have enough space, but what are we doing to put the ones we have to maximum use? Are we expanding the current space we have to our advantage? We have medical facilities and space we can use to train medical doctors in this country that are not being used. As I speak, I can point to a few hospitals that are well-equipped to train between 150 to 200 doctors every year that are redundant. The National Hospital in Abuja, for example, is one of the best hospitals in Nigeria. This medical facility is not training medical doctors; and that is unbelievable. All that is needed is for the hospital to be attached to universities to train medical doctors. Can anyone explain why the national hospital is not training medical doctors in spite of the huge investment government is committing to the facility every year? Not only that, there are many other hospitals that are big enough to train medical personnel, I think that the time has come to look inward and use what we have to train our medical doctors and stop this so-called overseas training. The doctors that are trained in this country are still the best we have around. These are the doctors that are accepted in every parts of the world. We have shown over the years that Nigerian doctors are among the best trained worldwide. What are we using this comparative advantage for?”

Agboghoroma, who is also the Chief Consultant Obstetrician and Gynaecologist at the National Hospital, Abuja, also decried the proliferation of ill-equipped medical schools popping up in some parts of the world that are specially built to meet the need of desperate parents that want their wards to study medicine at all cost.
“I am really concerned about the young Nigerians going abroad to study medicine. I am concerned not only because I am a medical doctor, but also because I am aware that most of the students that go outside of this country go to train in mushroom institutions compared to what we have in the country. Many of the institutions are not standard universities, but colleges that are owed by the individuals or organisations that are not equipped to run standard training, and lack standard curriculum,” he explained.

Apart from the cost to the country, Agboghoroma further noted that most foreign training institutions do not train Nigerian doctors on prevailing ailment in the country, adding that what they do is to churn out half-baked medical doctors that cannot pass basic tests by even the Dental Council to qualify to practice in Nigeria.

“The young adults that go out to train as doctors do not most of the time have access to clinical training. They do not touch patients and are most times not allowed into the main hospitals and do not have access to hands-on training they are expected to have. At the end of the day, when they complete these trainings, they are half-baked individuals. The MDCN report validates this position. The MDCN said last year that most of those that were trained abroad did not qualify to do housemanship. The simple test they are required to pass, most of them could not pass it. Indeed, about 80 per cent of them failed. Most of them have to do the test for about five times before they could pass eventually. They eventually passed after going through another round of training here,” he said.

Though there is a general notion that the standard of education is falling in Nigeria, Dr Agboghoroma does not share this view, and insisted that the standard of medical training locally meets international standard.
He argued, “As I speak, there are many organisations that are shopping for doctors in Nigeria. This happens almost on daily basis. Of course, some of our colleagues are leaving for these countries because of poor pay.

But that is an irony because poor pay has actually thrown up the best doctors. Most of our doctors that leave turn out to be the best wherever they find themselves. Most of the hospitals in the United Kingdom, United States, India, and other places have Nigerian medical doctors in their hundreds. What does that show? It shows that the standard of our training is good enough and can compete favourably with the global standards.”
He added that he is at a loss as to why government is not expanding the teaching facilities in the country to widen the space.

“We have the opportunity to do more than what we are doing right now. Is it that government is afraid that we are going to train too many doctors? I don’t think so; because we still do not have enough if one looks at the doctor-patient ratio as specified by the World Health Organisation (WHO). Is there anything wrong in exporting medical doctors? There is no reason we should not develop our system to the level of exporting medical doctors, and earn foreign exchange that can compete with what we earn from oil and gas,” he stated.