CHALLENGES AND SOLUTIONS TO THE CRISIS FACING THE PRACTICE OF MEDICINE BY DOCTORS IN NIGERIA.

The medical profession evolves, it grows and the doctor is the leader. This self-evident fact will not change. The profession did not start in Nigeria and will not end in Nigeria. It is universal. The Nigerian aberration of the universal norm in the healthcare industry, like other aberrations will only add to the reasons we are the world’s laughing stock.
The present challenges are a manifestation of failures of members of the profession starting especially from the 1980s .
We went against the grain of government policy in the mid-1970s designed to train doctors who at the end of medical
school would be mini specialists in the four broad fields of Medicine viz: medicine, surgery, paediatrics and obstetrics and gynaecology. He is meant to be able to hold his
ground in any of the four fields and provide primary and secondary expertise with ease.
Everyone who went to medical school in Nigeria will attest that the training is along this policy. However, as we as a people in Nigeria have done in all sectors, we put personal
ego and interest over and above the common interest and trivialized the MBBS
What we are using today as the basis for how medical doctors are trained in medical school’s in Nigeria, bore in mind the all import fact that once you graduate from medical school you are already a BASIC SPECIALIST in every field, this is the system that is employed in the UK and we simply carried it over in Nigeria,
Whereby your medical training is divided into two parts, the 1st part being the pre-clinical where you do anatomy, physiology, biochemistry and community health. Then, you now proceed to the clinical where you do medicine, surgery and community medicine.. the rotation is such that to go through all the different subspecialty‘s under these three including pharmacology and pathology.!
So once you leave medical school your degree isn’t the same thing as some-one who went to for example, school of nursing and midwifery, a diploma certificate or even a 1st degree(Bsc).
You become a General Practitioner with Basic specialist knowledge in every field and as you progress along the GP cadre also known as the medical officer cadre the expectation is on promotion to an SMO, PMO and finally CMO. You will have acquired commensurate surgical and medical skill to make you poly-efficient and self-sustaining to provide satisfactory health services to an average Nigerian who lives in the rural setting, without making it binding on him(the rural dweller) to mandatorily come to an urban centre before he can access such quality health care, and also serves as the basis for referrals from the rural/semi-urban centre’s to the cities when the services of a specialist in a particular field are required.
This is the reason and still remains the only reason why medical training as a student is so stressful and vigorous, because the founding fathers have seen that the medical and surgical needs of the Nigerian Nation will not be achieved adequately if the system that produced the doctors is not properly tailored in a direction that is sustainable.
And they also acknowledged the fact that producing unidirectional specialist in every field is not self-sustaining in meeting the multiple health needs of the nation. Since it is not realistic to have every specialist in all the fields, all in the same place, at the same time and in every health facility in the country.
But it is possible and very practicable to have a well experienced General Practioner in all the rural health facilities in every local government area of this country meeting the health needs of Nigerians.
98% of SR’s, Consultants, Profs and Medical Elders today as has being stratified by themselves will on no account want to work in a rural setting, so they have concentrated themselves in the Big cities/Urban centres and have with so much disdain and utter disrespect trivialized the MBBS that is the basis of medical practice in Nigeria.
We went against the grain of government policy and trivialized the MBBS. We carry on like being a Consultant is sine qua non for a "proper" doctor and Medical Officers/General Practioners are retards that managed to become doctors and should not be taken seriously. Everything was for and about the Consultant in this country whether or not he had the “Expected” skill, exposure and knowledge on how to handle the Job, it was principally about acquiring the title of consultant, not because they wanted to get their hands dirty by being more involved at the levels of healthcare where different cadre of medical officers are working to further boost on their job capacity building but because it was seen as a relaxation spot where you get more salary purely because of status.
A young doctor who is convinced from his observation of the treatment meted out to non consultants, that the fastest way to making the elusive" it" is by becoming a consultant. He seeks out the fastest and easiest path to becoming a consultant usually residency in laboratory medicine (less Histopathology) or public health. To worsen matters they leave all procedures to the JOHESU people while they just flaunt their doctorhood. Leadership that is not based on anything other than status can never be sustained, especially not in a knowledge and skill based environment.
The JOHESU people recognized the fact that there is nothing the doctor in the laboratory brings to the table which they don't have and probably even more. They set out to take over the laboratory via hard nosed politicking, lobbying and bare faced impunity. They have achieved this. Now they seek to take over the hospital because they misconstrue the other hospital doctors to be the same as their laboratory colleagues and all they need do is acquire the title" Dr." via genuine and phony PhDs and get appointed Consultants. By virtue of decree 10, that is what you must be to be appointed Chief Medical Director of a Federal Teaching Hospital. Next they will have the decree amended to accommodate consultants other than medical doctors.The JOHESU people took a cue from that. They don't just want to be equal to doctors ( they have achieved that through CONHESS) ; they want to be consultants. The medical officers also didn't help matters. They tacitly accepted that they're second rate and not good enough. Thus you see a doctor 15 years post registration, on the rank of PMO1 going "back to school" to commence residency. Subconsciously he is convinced that the decade and half he has practiced is useless because he didn't have the designation "Consultant", obviously because he has noticed that an average consultant feels he has sacrificed “too much” to become one so he believes he is entitled to special treatment and demands for it. He treats all who are not with disdain and utter disrespect.
Because as it stands today the is practically no financial difference between CONMESS and CONHESS, by the actions of our consultants and medical elders who have over trivialized the hard earned MBBS by making it look cheap in the eyes of other professionals.
The honest truth is that even our colleagues’ who assume the top positions of the medical profession as doctors have contributed significantly to where we are today, unfortunately the residency programme as it is designed today ends up producing timid doctors instead of giants.. Doctors who don't have the guts to standup for their fellow colleagues’ purely because they want to pass an exam or the want a certain favour from the so-called "oga at the top".Residents in my centre are totally un-aware of what is going on in the health sector, simply because they believe that once they become consultants they are on-top of the world..so they don't even know what is happening around them, an allied professional asked the question that how many even pass to become consultants and the answer is a staggering few..Has passing the exams become a tribal/religious affair? Where doctors from a certain part of the country pass while other from some other part fail, must a doctor turn another fellow doctor to a houseboy or a driver so that he can influence what happens when he goes for exams? Must i dress shabby to show that i am a resident doctor?during my houseman-ship my own consultant said that house officers shouldn't be paid salary, shouldn't have teaching allowance, should have their call duty allowance halved in two or better still removed.! The SR's under them agreed that we where "medical students+"..and this is the degrading and sadly unhealthy view of over 85% of residents, because they have become cowards instead of giants, and carrying over the myopic mentality of our senior colleagues’..2/3rds of NARD is composed of house-officers and medical officers.. And incidentally this unacceptable thinking of consultants has infiltrated afew members of this noble body to begin to act like the leadership of NARD belongs only to Resident doctors.. Undermining the real reason why NARD was setup..!It breaks my heart to see how low we have fallen in the general scheme of things..Our allied professionals are doing internship [nurses/pharmacist/physiotherapist/radiotherapist. etc..], receiving shift & call allowance, Specialist allowance, Offs[PH, Night Off, etc], going on career developing courses..yet my own doctor colleague who is my senior in this noble profession of medicine believes i should remain a slave under the guise of what i am doing is humanitarian? as such i don't need to be paid salary or receive any allowance? are we the only persons doing humanitarian service??It will never be well with these individuals, because i can name Doctors [SR's/consultants/profs] who are still advocating for other cadre of doctors to remain as beggars till today and who are still practicing in our hospitals.. and unfortunately want to be policy makers in the health sector.Every other sector is protecting their own except our highly protected and over-ratted "OGA's/Chiefs/Consultants/Medical Elders" when there is a salary increase. Theirs is 10times that of any other person.. Nobody is complaining about that.. we are simply saying protect us because we are one and the same body.? but this is to big a request to make and therefore our elders cannot accept.nurses moved from grade level 5 to 7, their own Oga's didn't say that the salary was to much for those young nurses..when our own Oga's where approached for us to move from grade level 9 to 11, they said that the salary will be too much for the young doctors, and instead of the move to 11, our salary should be halved and all allowances stripped off, some even advocated that we start paying school fees??for God's sakes...At-times i really regret why i even read medicine and why i am even a resident to begin with.?it has become a cause to be a doctor in this country..

Today all a nurse needs as qualification to become a CNO (Chief Nursing Officer) is RN&RM i.e Registered Nurse & Registered Midwife, which is not even equal to a diploma not even to mention a Bsc and yet they are on the same rank as a PMO or a Consultant and this has being the weather forecast in almost every sector of the hospital as it stands today.
The solution lies in reforming the system of remuneration of doctors. As it stands now doctors' remuneration is not geared to the complexity, the skills and training needed to carry out procedures . A neurosurgeon gets paid the same amount as a chemical pathologist if they both are on CONMESS 5. A Chief Medical officer who carries out surgeries like thyroidectomy and hip replacement gets paid less than a public health physician on CONMESS 7 because he doesn't get paid specialist allowance. Each procedure should be evaluated and costed by Actuaries and a doctor who performs them should get a percentage of the cost according to his rank , expertise and experience. What we have now CONMESS should be the base pay each doctor earns.
2. We must all skip 1 level and for those already on 7, CONMESS 8 must be created to accommodate them3. Retirement age for all doctors at 75ys
4. Specialist allowance for all doctors5. Excess workload allowance commensurate with the work we are doing6. Revert to call duty being a percentage of our basic salary7. All doctors on salary grades equivalent to that of assistant directors and above should get the things that come with such offices such as allowances for domestic servants, drivers, newspaper, vacation etc.
This I believe will finally put to rest all the agitation going on in the health sector as all their aspirations can be reduced to asking for a bigger portion of resources allocated to emolument of healthcare labour Provided.
DR. JIMMY IDAMA [FORMER ARD PRESIDENT KSSH LOKOJA-KOGI STATE].

Engineer!!!
Hmmm!! What will u say when laborers decide today and say they are closer to d building than d Engineers so they shld be regarded as d Engineer? Grant their demands? Fine! It is our nation! Next time when u go to hospital go and see a Nurse or Potter, don't border looking for a doctor!
This morning I went to work & met a patient gasping, I looked for oxygen to give her but there was none as nurses have locked them up. Tell me if u were that patient...!

on a good day:

My
brother,the strike is not really about money or salaries but mainly for
professionalism and separation of duties along the lines of professional
qualification,people are fighting to free themselves from the strangulating clutch
of medical doctors,people/workers feel that what we run in nigeria is the
ministry of doctors and not ministry of health,the medical doctors feels that a
lab scientist who through his duty comfirms diagnosis before a doctor could
commence treatment is not a professional after five years of education,the
ministry of health feels no other person is qualified to head an hospital (an
administrative post) except a medical doctor,the medical doctors feels that a
clinical pharmacist is not competent enough to prescribe a drug,advice him on
drug use etc,the minister of health is a medical doctor and he foolishly thinks a
medical doctor is a mr know it all,the disharmony in the health sector is
orchestrated by dr ransom kuti and sustained by NMA, The workers feels that as
a profesional,they should be allowed to do their job,and what is due to them
should be given to them,how can a medical doctor feel he/she can do without
the the nurse,if you see the way and manner they order nurses around,you will
feel for them, my dear when and anytime the president and the minister of
health ensure that everyone does their work according to their professional
inclination and compensated as such,then this sort of strike will be a thing of
the past.

Ur point exactly...??
Total rubbish.
Wen next u are in the hospital look for a nurse to attend to u or a lab technician.

I'm trying to put this in perspective. If the office of the presidency fasts for a little over 2 weeks(@ N3million per day) , THEY could have donated said equipment. Some else donates it and a product of institutionalized greed with parochi...al vision is frustrating something he himself may well need in the not to distant future?!?! I feel like praying he gets a severe debilitating lumbar spondylolisthesis with radiculopathy while he's in Abuja so that he can be referred to and hopefully land in the consulting room of the doctor he so mindlessly handicapped.
God help us all.

Atleast sumtin Good about Ohakim, i've bin reading alot of negative publicity abt him of late!!!
well! bring one Fine Omo-ge on ur way back

I know that the 1st match is by 03:00pm, but is the opening ceremony around that time to??

Nawa 4U@jackbauer.

Really!!!!!!!!!!!!

Agreed , my people! we are good to gooooo, ! one love.

I'm Afraid to say what's on my mind,  But i'm sure that God will be with us in the world Cup, !!!!

i just hope that our friendly match with Korea will be in our favour

Pervert, !

Really, ! how pathetic of you @jackbauer, always a baby in your thinkin. I'm really ashamed of the vomitus puking out of ur mouth it's pretty obvious that wat you need is moral rebirth!
i need to remind you, just incase ur memory has begun to fail that it was never a competition btw you and the nobel profession of putting smiles on the faces of sick people.!
Now that is something i honestly don't expect you to understand in that arrogrant and self-achieving Complex of yours! You are NO match for anyone in that profession, irrespective of your so-called un-holy millions, you can not give urself health once illness comes calling, ! we're God's messangers on earth to deliver the Gospel of Hope to those who need it, well, that is something i don't also expect you to fanthom again, !
You obviously have being watching to-many Jack Bauer series 24 films!%$&^!
Beware HIV/AIDS is Real.

convert to MsDoc and send to idamaoa@gmail.com

He that gives will never lack, And when you help others you are also opening the doors of your own blessing too, !
Lets be our brothers keeper.

@9ja-voices, i just cheaked up ur post and the email to which Cv's are to be sent is faulty, pls cheak it again and put up the one to which Cv's can be sent by. here is an extract of the page i was referred to;
To Apply-:
Qualified candidates should CV’s and applications to: Medservicesjobs@ghain.org within a week from the date of this publication. pls, The email isn't working.

Send ur Cv to Idamaoa@gmail.com,

Anyone with valuable information as regards a hospital, Clinic, of Other health care centres in or around Abuja, Lagos, Kaduna, etc. etc. That reguires the services of a Medical Doctor(Medical officer), Nurse, and Medical laborarory scientist Should kindly contact me through the following as soon as possible:
Email; idamaoa@gmail.com
idamaoa@yahoo.com
Phone number; +234(0)8036057330
Thanks House in Anticipation

@Jackbauer! So what is your Point, ? You haven't said anything yet, ! What you need is more selfesteem and stop comparing yourself with Others.
Inferiority Complex is a syndromic illness the earlier u get treatment for it the better

@deluxecad-Who controls the SSS? This account can't be true. Why would they ransack his office. Goodluck cannot resign. We'll go to war!

Who are you to say "who controls the SSS", Guy watch your mouth, !!! if i tell you that i know where you are now& what kind of thing you do. will you be surprised, !! you have no idea what is at work or who you are dealing with.

Goodluck is behaving like mrs Patricia Ete former speaker, advisers are dangerous he'll just have to learn it the hard way. resign or be removed.

The prophet on the sun newspaper had already predicted that Goodluck will not finish his tenure as VP, AND IT IS COMING TO PASS

I think i prefer Prof. Jerry Gana as minister instead of 'Angel of light Dora',
the current Director General of NAFDAC has done far more than all of dora's years as DG
put together,
his achievements now are the Gold standard for NAFDAC!
thanks to the latest technology brought in under his leadership,
we now know that we should be careful when buying LORNAT Antimal(Fake NAFDAC N0.04-99-22)
Pls, if you see this Number anywhere on LONART antimalaria know that it is fake.
And also Ampiclox, the fakes are in circulation. pls becareful.
Aondoakaa is right, Dora should stop parading herself as an angel of light.

Hallo, !! House, who will win Sunday's premier league match between world famous Gunners and the five times champions league winners Liverpool.

Polls will close tomorrow, Keep voting Guys.

At the end of the month long fifa U-17 world cup soccer championship last week,
vice president Goodluck Jonathan announced that the federal government was instituting an inquiry into the finances and conduct of officials of the game's Local Organizing Committee (LOC).
The tournament, hosted by nigeria, saw the emergence of the golden eaglets national team as second-place winners, with silver.
what was in Mr. Jonathan's mind, and the object of his concern was not the teams performance, which has being widely commended, but widespread allegation of corruption and abuse of funds by LOC officials in the disbursement of the 13 billion naira that the government provided to facilitate hosting the tournament
fielding reporters' questions at a briefing in Abuja, the vice president said that external auditors would be appointed to look into the LOC's books.
Mr. Jonathan pointedly noted that 'relevant anti-corruption agencies' would be involved in the investigations. He stressed that any of the LOC officials found to have embezzled tournament money would be made to face the law.
"we have stories of mismanagement of funds and that people are sharing the vehicles and and other items that were used for the tournament, If there are things that they have bought and used, we will know the number and we will sell them to nigerians at reduced rates, Anybody that mismanages government funds, definitely the law will catch up with him or her", the vice president assured the nation. indeed, anyone with a passing interest in organization of a football championship would not have failed to notice the slip-shod manner that officials of the LOC in question handled the procurement and deployment of facilities for the one that this country hosted.
what is puzzling, however, is that Mr. Jonathan, who is chairman of the LOC would fail to notice anything untoward in the conduct of his colleagues on the committee and call them to order before it got out of hand.
we hope that the investigators' terms of reference would be broad enough to inquire into how this failure occured, and why.
Beyond that however, we must take the vice president's word that a thorough work in determining the extent of fraud in the LOC would be conducted, and that the investigators would be given free and unfettered access to everyone they wish to question, and that their findings would be made public.
If any officials are found to have misused the trust reposed in them when the government appointed them, they should be held to account and prosecuted.
we have seen to much of this corruption in our sporting arena for far too long; an example of these should be made, if only to spare the nation further embarrassment and spare the taxpayer's money. in addition, it would assure us that government is serious about fighting corruption in whatever from, wherever and whosoever is involved.

The focus of the impending probe should not be limited in scope, as we can conclude from the vice president's statement, namely that whatever was purchased would have to be retrieved and sold to nigerians. it should go further to identify all officials of the main committee and those of it's subcommittees who were provided funds to do one business or the other pertaining to the championship.
each must convincingly account for the money that was given, what it was spent on, and evidence of such expenditure.
we observe that two subcommittees, in charge of print and electronic media for the LOC board, have sought to declaim any responsibility in the mismanagement of money, and to shift blame somewhere else.
we expect other subcommittees to seek to do the same. we call on the probe panel members not to be in anyway distracted by any antics to stonewall or divert it's attention. nigerian expect them to do a clean and professional Job


DAILY TRUST TUESDAY NOVEMBER 23rd,2009.

More shockers as the daily trust newspaper expressly stated with relevant references that the amount given for hosting the competition was N13 billion, and the vice-president has requested external auditors to comb through all the financial twists and turns that happened from when the money was released to the last kobo

unfortunately the is mounting pressure for the vice-president to resign as the fate of Mr. President hangs around uncertainty, this will pave way for the senate president to assume the office on acting capacity!

Do our leaders have to be selected on the basis of political zones or the credibility of the person.?

i pray that these large sums of money being stolen from the nation will be invested here on our soil and be a blessing to us instead of our undoing

How i wish all of you who are quick to Judge! will have all your hidden secrets EXPOSED,
Mind what concerns you.

Many sports lovers all over the country have being wondering what special package was put down for the U-17 hero's!
A few days following their exit, The minister of sports was interviewed on NTA, and when asked this same question, said 'the government will do something for them at the appropriate time',
but actually the government never did as they claimed.
It was TOM-TOM company that organized i dinner reception for the "football stars" with TOM-TOM outfits plus well Fitting face Caps and Off-course they will be licking TOM-TOM for the next one year for free!
I'm pretty Blown-away, because we should have won the finals, if not for the greed of our players, NFA and the over Glorified minister of sports.