Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit. - Aristotle
Every young Nigerian doctor's dream is to get well trained. This training is carried out by two nationally recognized postgraduate medical colleges namely: National Postgraduate Medical College of Nigeria (NPMCN) and West African College of Physicians/Surgeons (WACP/WACS). Their operations for many decades have produced seasoned medical specialists in different specialties and sub-specialties who have driven medical practice and training from rudimentary stages to where it is today. Albeit, the whole process has not been without certain burgeoning factors.
FACTORS
Three major factors among others have been identified to be militating against the central rationale of Residency Training in Nigeria. These factors include
1. Trainer's factor
2. Trainee's factor
3. Training Institutions’ Management
1. Trainer's factor
The Residency Trainer (Consultants/Professors), are specialists who are universally recognized as those having the requisite knowledge, skills and professional demeanor required to successfully pass on the ideals/baton of quality and evidence-based practice from one dispensation to another. Astonishingly, it has been observed and held by most stakeholders that majority of these trainers have lost the noble enthusiasm that had driven the whole process of development of medical manpower from time immemorial. It is now very glaring that impartation of knowledge and skills to the younger generation of doctors has become impaired. If left unabated it will negatively impact on the utter future of medical practice.
It is now very glaring that impartation of knowledge and skills to the younger generation of doctors has become impaired. If left unabated it will negatively impact on the utter future of medical practice.
The bitter truth about this situation is that when a ‘future’ of poor specialist manpower eventually arrives, these same trainers could become patients in the hands of their haphazardly trained junior colleagues. This could be due to the fact that they are more focused on their private clinics and hospitals which keep them out of their duty posts for training. It has been noticed that instead of physically being present to train, they consult and direct their junior colleagues/residents on the phone even they are officially on call. How can a resident be properly trained without the consultants being available?Most of these trainers have been known to be incredibly selfish in sharing their specialist knowledge/expertise in order to maintain the monopoly of such capacity in the index locality. And when they seldom do, it's mixed with a lot of demeaning tendencies that are toxic to effective learning. Severally this occurs in most training centers in Nigeria and its effect is lethal to the residents’ self-confidence.
2. Trainee’s factor
Resident doctors have their fair share are the whole blame. Many of them approach the specialist training with so much impropriety. The trainees’ impropriety hinges on baseless pride and an inordinate quest for money. A situation where a resident doctor gets distracted by the frenzy of the feeling of having arrived, little privileges and develops a mindset of the misdemeanour is very inimical to the acquisition of knowledge and skills. The unbridled quest for money affects the development of good ethical practices and erodes professionalism and respect for higher authorities connected to their training. The foregoing worsens the trainer’s factors.
Many of them approach the specialist training with so much impropriety. The trainees’ impropriety hinges on baseless pride and an inordinate quest for money.
3. Training Institutions’ Management
Institutions and nations fall, stand or thrive on the platform of leadership. Poor leadership or total lack of it bedevils Residency Training in Nigeria.
Poor leadership or total lack of it bedevils Residency Training in Nigeria.
It is impossible to explain away the unacceptable trends of:
- Using poor equipment or running residency training institutions improvising virtually every equipment due to stack lack,
- Running Accident/emergencies unit at day/night without power/water supply,
- Operating in theater during surgical emergencies with mobile phone light
- Running emergency pediatric and neonatal units without assistive instruments
- Poor remuneration of resident doctors and times none at all for several months
- Handling of agreed stances in labor matters with poor integrity (always reneging on agreements with resident doctors) leading to incessant strike actions and shut down of hospitals with an attendant collateral loss of innocent lives.
One may argue that management teams of institutions don’t mean Government itself but it is a no-brainer that they represent Government, period! Most of them are either bereft of good managerial competencies or are enmeshed in the dirty political milieu of partisanship.
The time to act is now!!!!!!!!!!!!!!!!!!!!!!!!
Problems of Nigeria’s Resident Doctors was written Dr. Okeaba U.K.
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