The Medical profession is a noble
profession that ought to be treated with great dignity and respect.
Unfortunately, a malignant mutation has emerged giving rise to a myriad of
crises and disorders.
It is quite incredible that the
medical graduates after passing through the rigorous training in the medical
schools are denied of the opportunity to undergo their internship within the
time of graduation.
In accordance with the code of medical ethics in Nigeria,
section 9.1a, every registered new medical graduate is entitled to
internship during which he/she is meant to practice under a close supervision
of the senior colleagues (consultant/specialist)
before heading to the society as an independent practitioner or in pursuit of
specialization.
The current administration in the
various teaching hospitals in Nigeria, especially in the south-east geopolitical zone has made things extremely difficult
for the new medical graduates.
Some teaching hospitals in Nigeria
have graduated a lot of medical doctors who were thrown into the society to
wallow in joblessness. Many doctors have overstayed the period of validity of
their licences in idleness without any hope of placement for house job.
The medical profession among other
professions takes the longest period of training. In spite of this, the medical
graduates are compelled to spend extra: one, two, three or even four years
looking for placement for house job. It takes a minimum of six (6) years to
become a medical doctor and some due to one setback or the other spend up to
eight (8) to ten (10) years in the medical school. If this is added to three/
four years of awaiting internship, this would amount to ten (10) to fourteen
(14) years of undergraduate training. Almost half a generation; what a
tremendous squander of time?
It is quite disheartening that parents
who with fortitude had sponsored their children through the medical school in
the hope of experiencing relief after their graduation still behold their
children languishing in joblessness after all the suffering. Some parents have
begun to doubt the authenticity of their children having passed through the
medical school owing to the untoward delayed house job placement.
Some medical graduates who cannot
withstand the stigma of being tied to their parents apron string after one, two
or more years of graduation resort to private practices in the remote parts of
the country. They become private practitioners without having undergone
internship contrary to the code of the
medical ethics, section 9.1.
Some teaching hospitals in Nigeria
like the University of Nigeria Teaching
Hospital (UNTH), Ituku-Ozalla, for no justifiable reason have been
graduating doctors without placing them for house job. They graduate a good
number of doctors and take only a small proportion of them. Many doctors from
UNTH have been wandering about like sheep without shepherd searching for house
job. In every house job interview conducted across the country, the UNTH
medical graduates constitute the greatest proportion of the house job seekers.
Considering the number of the UNTH medical graduates that always attend house
job interview, one would think it is another round of UNN Doctors Alumni Home
Coming. This is a damning indictment of the health administration therein.
Some teaching hospitals in Nigeria
like UNTH conduct substandard internship interviews just for formality sake
after which they manipulate the scores of the candidates in accordance with
those they had wanted to take. They
deceitfully keep the spurious result sheet as a concrete evidence in pretext of
having conducted a genuine interview in case they are investigated. This is one
of the reasons why the results of the UNTH interviews usually take a long period
of time (months) before they are released.
Some teaching hospitals in Nigeria now
derive pleasure in exploiting the poor medical graduates in the name of fees
for house job interview. This has been
the practice of the University of Benin
Teaching Hospital (2014), University of Ilorin Teaching Hospital (UITH) and
University of Port-Harcourt Teaching Hospital (UPTH) who charge the sum of
five thousand naira (#5000) yearly as a prerequisite for house job interview.
The system of allowing the new medical
graduates to search for house job has constituted a great stress to them. Apart
from the risk of travelling from one hospital to another, many have exhausted
their resources without success.
This system has also given room for a
lot of egregious practices by some Chief Medical Directors. They now take house
job positions as personal possession and can decide whom to give it or not. The
house job positions meant for the medical graduates has become an article of
trade for some CMD's who sell them for a huge amount of money. However, they
don't collect the money by themselves rather they set up some agents who
covertly and diplomatically reach out to the medical graduates in need of house
job. Payment of money for house job is an open secret in UNTH. In fact, it has
become a sacred cow.
Again, this system tends to subject
the fate of the new medical graduates under the whims and caprices of the Chief
Medical Directors even when they have a streak of sadism in their personality.
The present administration in some
teaching hospitals in Nigerian like UNTH has succeeded in creating two
unhealthy criteria for house job placement namely:
(i)
Personal
knowledge of the CMD or any person who can influence him.
(ii)
Payment
of astronomical fee as a quid pro quo.
Any new medical graduate who fails to
meet up with the above criteria has no hope of securing house job in UNTH. Some
medical graduates who for some moral reasons had resolved not to yield to these
unwarranted demands had begun to compromise their faith after waiting for two
to three years beyond the limit of their endurance. The University of Nigeria
Teaching Hospital has been turned into a microcosm of a politically corrupt
society unleashing professional torture and inhumanity to the young medical
graduates. What a great tragedy!
The collection of exorbitant fees for
house job placement has further worsened the situation for the new medical
graduates. Some of the house officers who paid a huge sum of money to secure
house job are provoked to do a second and even a third internship (second or third missionary journey) in
order to make up for the paid money; causing a further increase in the number
of house job seekers and leading to a vicious cycle of apparent house job
scarcity
The health administration could easily
detect this insalubrious practice if they had wished but they have deliberately
feigned ignorance of that since it does not militate against their monetary
gain but rather enhances it .
The health administration in UNTH does
not have in mind the welfare of her medical graduates. It is only hell-bent on
making money even if it means stepping on someone's toes. How can a health
institution fail to consider her own medical graduates whose licences were
about to expire and some of whose licences had expired only to take newer
medical graduates from other institutions who are willing to respond to their
cash demand?
University of Nigeria Teaching
Hospital, (UNTH) is in quagmire. The present administration has nothing to
write home about. The cost of medical service has been hiked ranging from the
consultation fee and the cost of surgery. Patients are now mandated to pay for
oxygen whether it would be used on them or not. Yet, the quality of service
rendered therein amidst this high cost is continually depreciating due to mismanagement. For goodness sake, the
incumbent administrators should be called to order. UNTH is not a private
hospital where a single individual should dominate over its affairs almost to
the level of a tyrant. Over the years, the affairs of the hospital has been
kept under the selfish interest of the so called administrators. It is time for
radical positive changes.
Moreover, the apparent house job
inflation in the country is not due to the aforementioned second and third
missionary journeys because only very few rapacious ones indulge in it. It is
mainly due to the periodic increase in the number of "ghost interns". A considerable proportion of the house job
positions due for the new medical graduates have been unfairly allocated to “ghost
house officers” to the egocentric aggrandizement of the CMD. Many
medical graduates are languishing in stagnation and joblessness while some
CMD's are busy amassing wealth to the detriment of the new medical graduates. This
is an apogee of callousness and sadism. The truth about ghost interns is
evident in the scarcity of house job considering the number/capacity of all the
accredited hospitals and the number of doctors produced yearly in the country.
It is high time the Federal Government re-evaluated this.
Some teaching hospitals in Nigeria
deliberately delay the yearly intake of new interns for some months even when
the preceding house officers had completed their internship and vacated the
hospital. This they do in order to divert the salaries paid within this period
to their personal pockets thereby creating artificial house job scarcity for
the new medical graduates. This has been happening in UNTH. For instance, in
the 2016 house job intake, the preceding house officers at UNTH completed their
internship on July, 2016. House job interview was delayed till 5th of
September, 2016. The result of the interview was further delayed till the month
of November. Now, one would logically ask; who received the housemanship
salaries paid for the months of August, September and October? Worse still, it
has become a norm in the hospital not to release at once the list of the
admitted interns. Instead, they are released bit by bit so as create another
delay tactics for further embezzlement.
Nevertheless, not all CMD's are
involved in the perpetration of these anomalies. A handful of them are above
board regarding the housemanship affair. For instance, it is apt to recognise
and commend the uprightness of the incumbent CMD of the Federal Medical Centre (FMC), Owerri, Mrs. Agnes Uwakwem who for
the past few years had sanitized and has continued to sanitize the hospital.
FMC, Owerri is one of the hospitals
in Nigeria where housemanship interview is conducted without any whiff of
jiggery-pokery. She has left much examples for other CMD's to emulate.
The compulsory nature of internship in
the midst of these corrupt practices has worsened the whole condition for the
law-abiding new medical graduates. Being unable to proceed with their youth
service and legally unqualified to commence a private practice they become
entangled in a state of stagnation like a rat entrapped in a cage.
Some teaching hospitals like the UNTH for no justifiable reason have
been withholding the salaries of their house officers for the first three months of recruitment. They
claim to use this period to ascertain the loyalty of the employees; but how do
they expect them to survive within those period of “nil per oral”? Even the
scripture says that a labourer deserves his wage when due.
It is quite appalling that those at
the helm of affairs who aid and abet these crises were once new medical
graduates who enjoyed an un-delayed and hitch-free house job placement during
their time but have failed to maintain a similar status quo for the present
generation. Haplessly, some of the senior colleagues in the profession have
remained apparently nonchalant to these obnoxious developments. Probably, they
are not directly affected. However, it is pertinent to note that darkness can
only dominate in the absence of light. Evil can only perpetuate in the society
when the righteous ones fail to challenge it. And the righteous has a share in
the recompense of the wicked for any evil he fails to reprimand either in this
world or in the world to come.
The medical profession by the virtue
of its humanitarian service, remains the prime of professions where unalloyed
order and discipline should thrive but unfortunately, the reverse has become
the case in our country today.The prestige that accrues to the medical
profession has begun to wane as many young medical graduates who ought to be
looked up to are seen as frustrated jobless young men and women. Many medical
graduates for lack of house jobs are untimely and illegally resorting to
private practices just to keep body and soul together. This is a seed of
potential disaster which if allowed to grow will eventually cause an
unmitigated devastation in the fabric of our national health.
A glimse into the prospect of medical
profession in the country reveals a colossal migration of Nigerian doctors to
other countries in search of greener pastures (brain drain) unless these
anomalies are nipped in the bud.
Since the health of a nation is the
wealth of the nation, it is time we all faught tooth and nail to restore the
dignity of medical profession which is at the verge of decadence
Therefore, this is a solemn appeal to
the incumbent patriotic Nigerian leaders, the office of the President, the House of Senate, the House
of Representatives, the Ministry of
Health and all at the helm of affairs to look into this matter with justice
and fairness and come to the rescue of the beleaguered medical graduates.
THE WAY FORWARD
In search of remedy to the above
problems, the following suggestions have been made:
1. Since
internship is mandatory for all the new medical graduates and no new medical
graduate is legally qualified to indulge in any private practice or proceed
with youth service without the completion of internship, then internship should
be integrated as a part and parcel of undergraduate training.
2. The
country should adopt a new system of house job placement similar to the system
of posting of youth corpers in the country. Biannually, the teaching hospitals
should submit the list of her medical graduates who would then be posted by the
Federal Government to any competent hospital across the federation regardless
of where they had been trained. This will help to create orderliness in house
job placement, prevent the problem of “second and third missionary journeys”
and avert the corrupt practices of the Chief Medical Directors.
3. The
Federal government should ascertain the number
of interns each competent hospital in the country can absorb and post
the same number of medical graduates therein. This would help to prevent the
daily multiplication of ghost interns
and save the country from wasteful spending on the aforementioned ghost workers. A clear knowledge of the
number/capacity of all the accredited hospitals for housemanship in the country
will also help the federal government to strike a balance between the number of
doctors produced yearly and the number of spaces available for housemanship.
4. The
obtainment of medical degree (MBBS) and the acquisition of the provisional
licence as issued by the MDCN should automatically qualify the new medical
graduates for house job placement in any teaching hospitals across the country.
Sequel
to this, no licenced new medical graduate who has passed his/her final MBBS
should be subjected to any further examination in the name of house job
interview. This will help to eliminate the chance of exploiting the poor
medical graduates in the name of house job fees and unnecessary delay in house
job placement as some hospitals spend several months before calling for
interview and thereafter spend another several months before releasing the
result of the interview.
If these measures are adopted, the
problems of delayed internship training, selling of house job positions for a
huge sum, second missionary journey, artificial house job scarcity,
embezzlement of public fund, private medical practice without internship and multiplication
of ghost workers will surely become things of the past. Hence, this article is a
clarion call for all to join hand in restoring the dignity of the medical profession
SON OF THE KINGDOM...
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