How Nigeria produces medical graduates for external markets

BY OLUSOLA OWONIKOKO

Nigeria, the world’s most populous black nation is in a quagmire. A nation where almost 70% of the population are aged below 30, a country full of potential and creativity, potentials many times left untapped.

The political, educational, security and economic situation in the country naturally stifles the opportunities of the average Nigerian Youth. Hence bright minds leave for other countries in search of greener pastures. In recent times, migration has been heavy on the side of medical practitioners.

In 2019 alone, over 12,000 Nigerians emigrated to Canada. Statistics show that about 15 million Nigerians in the diaspora.

Medical Education

Every year, medicine and surgery (MBBS) receive the highest number of applications in many Nigerian universities but only about 1 or 2% are offered admission. Having gained admission, they spend 6 years rigorously learning and training, then they acquire practical experience for 1 extra year at the university teaching hospitals or any government hospital across the nation.

These years of training, hard work and sacrifice earn them Bachelors in both Medicine and Surgery. They become licensed doctors. Another set of freshly baked and newly-drilled doctors become available to the Nigerian market…or not.

As per reports by Vanguard newspaper in 2019, Nigeria’s doctor to population ratio is 1:6000 (that is 1 doctor to 6000 Nigerians) against WHO’s 1:600 recommended ratio. This portends the poor health indices of the nation.

Over 1 billion dollars is spent annually by Nigerians (including the country’s president) seeking better healthcare abroad.

According to Nigeria HealthWatch, 80,000 doctors are registered with the Medical and Dental Council of Nigeria (MDCN), only about 35,000 are practising in Nigeria. The others are practising abroad while a few have switched professions.

The big question is, why are our doctors leaving the Nigerian market to external markets?

Here are three reasons the external market is a more attractive option for Nigerian Doctors:

• Facilities and work environment
• Career progression and professional advancement
• Salaries and remuneration
• Political climate

Facilities and work environment

When you ask doctors why they chose their profession, most times their answer is the same, “to save lives.” They took an oath to do everything they can to save the lives of their patients. This means so much to them.

Nevertheless, passion wanes when there are no favourable policies and adequate infrastructure to keep it aflame. This is one reason Nigerian doctors are leaving the country in droves. Fleeing doctors figure that “it is useless to practice in a country where the tools of your trade are non-existent”.

Other times, when they are barely making do with the poor infrastructure they are frustrated by unfavourable policies and hostile superiors. The system provides no solace from predatory superiors who bark at doctors, talk them down and make the work environment inhabitable.

Therefore, they seek saner climes and environments where they are respected and allowed to do their jobs with dignity and respect.

Career progression and professional advancement

Every serious-minded doctor wants to be better at what (s)he does and one day reach the peak of his career.

With hospitals outside Nigeria taking advantage of technology to improve their efficiency and ability to save lives, they become attractive destinations for young Nigerian Doctors. They become improved, knowledgeable and vast in their field making them an asset. They hardly find such an opportunity in Nigeria.

Salaries and remunerations

Resident Doctors in Nigerian hospitals embark on warning strikes over unpaid salaries almost every year.

For months, doctors who many times are unable to sleep due to the volume of work are left with nothing at the end of the month.

No salary. No allowance. No insurance covers.

Not everyone can bear to live like that. They want to save lives while living their best life possible. In Nigeria, Doctors are overworked, doing the jobs of 3-5 persons and are yet underpaid or not paid at all.

Hostile political climate

It is no longer news that many citizens consider the country unsafe to live in. The promise of a secure and better geographical terrain where the rule of law is sacred and upheld is enough motivation to send any young doctor packing.

The levels of insecurity in the country have not only grown at an alarming rate, but it is also showing no signs of stopping. This singular fear for their safety is enough to send them packing.

Only the living can save the living.

These are some reasons Nigeria produces so many skilled and promising doctors that leave the Nigerian market for more profitable markets.

Every Nigerian has a right to healthcare but there are not enough hands to do the job efficiently. Nigeria is in dire need of more doctors but until there’s the political will to change this narrative, the country will continue to produce the most promising medical talents for markets with the most promising work conditions.

Owonikoko is a serial-entrepreneur and a trained international development practitioner who has worked on projects by USAID, DfID, World Bank/IFC. He tweets @SolaOwonikoko.