Being a doctor in Nigeria: Challenges and opportunities for change
This week, a Twitter user who has chosen to remain anonymous, , in a series of tweets told the story of her brother, who is a doctor. Her tweets caught the attention of Nigerian Twitter, and of Nigeria Health Watch as well. In the process of her candid outburst, she highlighted several pertinent issues that we believe merit further attention. Read the full blog piece here.
We have collated her tweets below:
· Medical practice in Nigeria is in shambles and the way it is right now, nobody is here for it. Figuratively and literally.
· My older brother is also a doctor and he was one of the lucky ones to finish his residency programme at the age of 30. Young, vibrant, ready
· Being a Consultant at 30 is no easy feat considering the pathway required to reach this milestone. I’ll explain.
· The usual pattern in Nigeria. Get into uni at 16/17, struggle and persevere (hurdles are infinite) through med school for 7 plus X years.
· Where X = extra months/years lost to ASUU/Doctors strikes, riots, hospital shut down, insecurity-related interruption, Repeat year etc
· After this, you emerge out of school and take the hippocratic oath and you’re handed a Temporary Certificate of registration with MDCN.
· The council will only give you a permanent registration when you have completed another 12 months of hellish Housemanship.
· NB: Housemanship placements are not handed out to new doctors neither is there an organised nor central scheme for recruitment. Na per head.
· So it involves alot of applying and interviewing and having “long leg” and grace and prayer and some people grease hands and maybe juju.
· Whatever works. So you can get into a training hospital, finish and acquire that full registration before 2 Years elapses(from graduation).
· Note that this placement search may take a few months or years in some extreme cases. Well, you get in, push through and giving. Then NYSC
· NYSC is another thing entirely. Let me not begin. I won’t finish. But that takes out another year. So you have, 16 + 7 + X + 2 (at best)
· You’re a 25+x year-old post NYSC doctor who is thrown into the labour market. Contrary to popular belief, there is a market for doctors too
· And My God, is it a nightmare!!!
· But say you get a temp job somewhere and then begin to map out your career. To be a specialist, you take exams and wait for residency.
· Exams are hosted by the two colleges. West African or National college of physicians/surgeons as the case may be.
· As at last exams, exam fees for West Africa was 150,000 plus other miscellaneous for study material, post, transportation to exam venue
· These exams are known for mass failure by the way. Pass rates are usually 10–30% at best. Its really about being in the percentile they want
· Console yourself and say “Its not that I failed, I just didn’t pass well” Whatever works for you. Because No re-marking, no arguments
· You can only wipe your tears and start saving up more money for the next stream of exams and burning all the candles while still working.
· In the amazing event that your name is up there above the failure line, celebrate for a second. Then begin to hustle for a placement
· See placement procedure for Housemanship and multiply rigors by 10 to find one for residency.
· You scale this hurdle and begin residency. The challenges in that program can’t be exhausted in this thread. ‘Budget’ 5 or more years here
· You have strikes from all sorts of associations interrupting the programme and all kinds of internal health sector crisis, and then some.
· Then, you finish. You’re a fellow of the college of physicians or surgeons. You add FWACP/FWACS to your name. You have arrived. Psyche
· You haven’t even taken off. You’re really just starting out in this terrible terrible country with no direction and misplaced priorities.
· So, back to my brother. This is where he is. Young vibrant consultant radiologist with all the cards in his hands, yeah? But this is chess.
· All my life, I’ve known him to be someone who loves Nigeria to a fault and has refused countless opportunities to leave the country.
· So imagine my surprise when on Saturday while we were talking about our careers, he told me he was making plans to leave.
· Leave the country. Write membership exams for royal colleges in the UK. Try for Arab countries. Move his family and everything OUT.
· And he is serious. Because as a consultant radiologist, few as they are in the entire country, he still has to search for a suitable job.
· A consultant radiologist in Nigeria has no offer of employment in any Government establishment and has to work in private facilities.
· Private facilities who are manipulative users with no respect or sense of value for a professional that rare and seasoned.
· It is sad and appalling. And my brother is only one of thousands of doctors, from every cadre, who are exiting this darned country.
· And those of us staying are finding alternatives in every sector. The flow is away from the hospitals. Far far away.
· Poor and unpaid salaries. Terrible work environment. No infrastructure. No pension. No training scheme. Doctors doing the impossible.
· Improvising. Sacrificing. Working impossible hours with heaviest patient load. Still no incentive, no progress, no prestige. Nothing.
· The brain drain is here. It is live. Doctors are leaving, to other sectors and mostly away from Africa and its decay.
· Funfact: Nigerian doctors leave the country and excel everywhere they go. There’s hardly ever any doubt as to your success abroad.
· You will work and be rewarded: renumeration and fulfilment-wise. You will make impact. You will thrive and be your best self.
· (((I forgot to mention that those entry exams to residency expire after 5 years with no placement. If it does, you’ll rewrite the exam)))