NUC vs. MDCAN - AN IMPENDING IMPLOSION

(The Reason Doctors are on Strike in Nigerian Hospitals)

When you hear of strike actions from medical doctors in Nigerian hospitals, the union that readily comes to mind is the Association of Resident Doctors (the body overseeing the welfare of resident doctors). However, there is another body that oversees the welfare of senior doctors or Consultants in our various hospitals called Medical and Dental Consultants Association of Nigeria (MDCAN) that has almost never embarked on any strike action in the annals of the profession. Unfortunately, as at the time of this writing, this body of professionals have embarked on a strike action beginning from Monday, 25th of February 2020 and the duration of the strike is indefinite because MDCAN had previously undergone a warning strike after several pleas to avert the strike, yet the authorities still refused to bulge.

At this point, many questions would be rising in the minds of readers: why have these senior doctors chosen to go on strike and who are these “authorities” MDCAN is protesting against? This article intends to supply answers to all of such questions.

MDCAN has embarked on an indefinite strike to protest a recent directive by the National University Commission (NUC) which is asking senior medical doctors who already possess Fellowships in the field of medicine, to henceforth enrolled into PhD. programs as an additional prerequisite for their career advancement in the Universities where they teach. The said directive was published in a communique to all medical postgraduate schools in Nigeria. It reads in part:

“…after exhaustive deliberations at series of meetings held between the Commission (NUC) and the management of National Post Graduate Medical College of Nigeria (NPMCN), stakeholders unanimously agreed to introduce PhD. programmes in the Clinical Sciences in the Nigerian University System, for the postgraduate training of interested medical practitioners and for their career progression, especially for those in the academia.” This communique was sent out on the 24th of December, 2019.

This directive follows an earlier publication by the NUC which had provided guidelines for appointment of academic staffs in the Universities in Nigeria. In stating the minimum academic qualification for anyone who will teach in the Universities, they wrote:

“All academic staffs are expected to have the terminal degree of PhD. For academic staffs in the Clinical departments of Faculties/Schools/Colleges of Medicine, the Fellowship of the National Post Graduate Medical College of Nigeria and/or the West African College of Surgeons/Physicians is currently accepted as the terminal qualifications, instead of PhD. However, no promotion shall be made to the level of senior lecturer and above even for those in the clinical departments of Faculties/Schools/Colleges of Medicine without PhD from 2025.”

The aforementioned and particularly italized and bolded words are the grouses that MDCAN has with NUC. They are worth examining on close quarters:

First, MDCAN is indeed a stakeholder in NPMCN and they readily agree that they had joined the NUC in series of meetings where the matter of PhD in the academia were extensively deliberated upon. But MDCAN never, at anytime, “unanimously agree” with any of the stakeholders, let alone NUC, that the PhD. programs be introduced into Clinical Sciences in Nigerian as their highest qualification. The position of MDCAN, throughout the deliberations, was that the Fellowships that doctors obtain, which brings them to the position of Specialists and Consultants, exceeds the regular PhD. obtained by anyone in Nigerian Universities because the curriculum which an average Consultant must have passed through before acquiring the Fellowship also encompasses research. Thus it is superfluous to again begin to ask doctors with Fellowships to obtain PhDs before they can be promoted in the Universities.

Secondly, the communique had initially stated correctly that the Fellowship was a terminal qualification for doctors, not PhDs. But, inline with its published guidelines, it went further to state that doctors with such Fellowships will no longer be promoted in the Universities by 2025 except they obtain PhD.

This position calls into question the age old wisdom and practice that had limited doctors highest qualification to Fellowships and it also disregards the unique style of training medical doctors undergo as against other professionals in the academia. Doctors are primarily professionals that attend to patients. The nature of their job is hands-on, and not so much research based. Doctors cannot reach the epitome of their career until they have undergone extensive training in an aspect of their field in hands-on practical works with patients. This is the reason why the Fellowship, which demands five to seven years (depending on the speciality) in residency training in the teaching hospitals is their highest qualification. Residency training is also accompanied with the writing of two rigorous examinations (a part one and part two exams), and the submission of a final thesis. These standard not only equate in demands with PhD training but even exceeds them.

The NUC communique had rightly stated that PhD. programmes in Nigerian universities require a minimum 52 credit unit of course work. They however disregard the fact that the Fellowship training come with a minimum of 204 credit units. This is almost four times the credit units required to obtain PhDs.

Besides, the records show clearly that doctors with Fellowships produce more academic research works than other professionals with PhDs in the Universities. A list of most published scholars in Nigerian universities reveal that doctors with Fellowships and without PhDs are the leading published scholars in Nigeria. Prof. Adesola O. Ogunniyi of the University of Ibadan is a doctor without a PhD but with fellowship. He is the third highest publisher of researches in Nigeria. Prof. Emmanuel Adoyi Ameh is the seventh and he also does not have a PhD. Out of the 28 researchers listed in that paper almost 70% have only Fellowships and no PhD.

The current position of the NUC to impose PhD. as the highest qualification on all academic staffs in the Universities in Nigeria, including doctors, is not a well thought out one because it is a well known fact that medical graduates from Nigeria are in high demand in countries like Canada, United State of American and United Kingdom leading to an alarming brain drain of young doctors in the health sector. This new guideline is a sure way to further deplete our health sector of her best brains because our senior doctors would also be forced to exit the country in droves and it is hoped that NUC will heed the cry of MDCAN and withdraw those guidelines placed against doctors practicing and particularly teaching their profession in our Universities.

At the moment, the strike action is limited to universities, meaning MDCAN members have withdrawn their services by not teaching medical students and other ancillary students in the teaching hospitals. However, if NUC refuses to withdraw this unsavoury directive, MDCAN would be forced to extend its strike action on hospital services. This would bring a total collapse of services in Nigerian teaching hospitals and innocent patients would be at the receiving end because by extension, their mentees resident doctors will not be taught or supervised. This will lead to total collapse of the health sector and with the threat of Coronavirus and Lassa Fever epidemic breathing down our necks in Nigeria at this time, the country faces an avoidable implosion.

This is the reason MDCAN is using all available channels to air their grouses and it is hoped that those who have ears to hear will listen.

© Deji Yesufu (Yesufu is a Public Analyst. He can be reached on newdejix@gmail.com)