Africa: 15,000 doctors dump Nigeria for overseas
No fewer than 15,000 medical doctors have left Nigeria for overseas in search of greener pastures. A reliable source at the Medical and Dental Council of Nigeria (MDCN) told New Telegraph that “over 15,000 doctors have travelled out of Nigeria to developed countries where they are now practising medicine.”
President of the Nigerian Medical Association (NMA), Dr. Mike Ogirima, confirmed that between 10,000 and 15,000 Nigerian doctors are working outside the country. Ogirima told New Telegraph that about 90 per cent of those working outside the country are trained in Nigeria where they acquired their capacity.
The NMA President noted that between 40,000 and 60,000 doctors are working in the country. Ogirima said: “Nigeria has trained these doctors while other countries are making use of them. That is a sad thing. Of course in a country where the working environment is not conducive, what do you expect? “So, we expect the government to improve the working environment, provide the necessary tools for the doctors to work with and give them needed welfare to encourage them to stay in the country.” Just last month, over 500 doctors took examination for possible recruitment placement abroad.
For Nigerian doctors looking for employment in the United States, they write the United States Medical Licensing Examination, while those seeking employment opportunities in the United Kingdom write examination with the Professional and Linguistic Assessments Board (PLAB). Unfortunately, the conditions driving the migration have worsened with more doctors working for several months in the country without salaries. While providing an insight into the trend, a top member of the NMA told New Telegraph that in 2015, a total number of 715 doctors departed the shores of Nigeria, seeking greener pastures in foreign countries.
“Annually, the number of Nigerian doctors departing the country to work abroad ranges between 500 to 700,” a top NMA official told our correspondent. Giving details of the doctor’s migration, a medical doctor who spoke on the condition of anonymity, said more Nigerian doctors move to the UK while a fewer number go to Canada. “Their final destination is, however, the United States (U.S.), which offers them better remuneration and welfare package. “For these Nigerian doctors, working in the UK, Canada and other countries, including the Caribbean, working in these foreign nations is a stepping stone,” he said. The source added that foreign doctors, including the ones from Nigeria, don’t enter the U.S. directly.
According to the source, “Migrating doctors have to go through UK, Canada and later enter the U.S. It’s easier to go to the UK, but the population of Nigerian doctors in the U.S. is more. “The final destination of majority of doctors leaving Nigeria for greener pastures is the U.S., because that is the country that pays more.” Explaining the migration, the member of NMA said going to the Caribbean to practice has been on with Nigerian doctors for a long time, but usually, that is not their final destination.
When these doctors want to settle down, they usually move further to the U.S. and Canada. The source noted that not all the doctors in the country, an estimated 40,000, practice medicine. Some have since left the medical field to venture into other areas, some don’t renew their registration while some are dead.
The doctors’ migration to overseas countries has, however resulted in huge workload for the medical practitioners that are left behind. Presently, the doctor-patient ratio in Nigeria is one doctor to 4,250 patients, which is far below the World Health Organisation (WHO), recommended one doctor to not more than 600 patients. On the contrary, Dr. Adeyeye Arigbabuwo, immediate past chairman, Association of General Private Medical Practitioners of Nigeria (AGPMPN), Lagos State Chapter said some countries have achieved better doctor-patient ratio. “Cuba has the best doctor patient ratio – one to 170; that of the United States (U.S.) is one doctor to 390 patients; while in Australia, the ratio is one doctor to 400 patients,” he asserted.
According to Arigbabuwo, Africa especially south of the Sahara, is mainly vulnerable to poor doctor patient ratio. “It is where we have bad doctor-patient ratio,” he added. Stakeholders have raised the alarm over the continued mass exodus of Nigerian medical doctors from the country for greener pastures abroad. The stakeholders are also calling for a better welfare and improved working conditions to check the dangerous trend. Prof. Mosto Onuoha, the president of the Nigerian Academy of Science (NAS), described the migration of medical doctors abroad as “a real problem.”
Highlighting the enormity of the challenge, he related the experience of a young frustrated Nigerian doctor, who decided to go for an examination, a prerequisite for Nigerian doctors to practice medicine in the United Kingdom. “This doctor went for this examination last month and the first surprise he had was that there were over 500 Nigerian doctors that came for it. “So, it is a serious problem and it is one that we at the NAS, and even me as the President of NAS, are concerned about,” Onuoha told New Telegraph. Speaking on the menace, the president of the NAS lamented that the medical doctors that are leaving Nigeria to practice abroad are the young ones, especially those that are very intelligent. “They are the ones that are capable of passing the prerequisite examinations. We are losing most of the brightest doctors that we have,” he said.
The other group that Nigeria is losing, according to him, is the affluent doctors whose parents are wealthy, because they can afford to send their doctor sons and daughters for educational programmes in developed countries. Highlighting other factors driving this migration, Onuoha stated that many doctors who graduated for the past three to four years cannot get health facilities as placement for Residency training. “Most of the state hospitals available are not accredited for Residency Programmes,” he lamented. Residency is a stage of graduate medical training. A resident is one who holds the degree of MBBS, who practices medicine usually in a hospital or clinic under the direct or indirect supervision of an attending physician.
During the six-year period of the Residency training, the Residents specialise in a particular field of medicine such as orthopaedics, cardiology, ophthalmology, etc. Another category of doctors the nation is losing are consultants, most of whom get frustrated because they just watch their patients die as a result of poor working environment and dilapidated working tools. Furthermore, Onuoha blamed the problem on limited hospitals that employ doctors. Federal Government is their major employer, he said, adding that although private hospitals are thriving, many of them in Abuja and Lagos are not employing many doctors.
He lamented that some of the few facilities that employ doctors in Nigeria owe salaries for several months. Onuoha said: “As I speak with you, I know teaching hospitals that are paying employed doctors fractions of their salary, ranging from 70 per cent to 80 per cent. Many doctors in Nigeria work for several months without salaries.” Highlighting factors driving the migration, Dr. Arigbabuwo attributed the trend mainly to economic interest, saying those working in Nigeria do not have good incentives.
“There are no incentives for the doctors to go to the rural areas and practice,” Arigbabuwo told New Telegraph. A Consultant Paediatric Haematologic Oncologist and former Chairman of Lagos NMA, Prof. Edamisan Temiye, blamed the migration of Nigerian doctors abroad on the hostile working environment in Nigeria. He said: “There are no amenities to work with. It starts with electricity, water supply to the provision of equipment to carry out treatment on patients.”
What is happening, according to the former Chairman of Lagos NMA, is that the Nigerian doctors are well trained, but not given equipment to work with. Temiye noted that another reason for the migration is that everybody in Nigeria “wants to be the doctor,” adding that the competition is unhealthy and it is only in Nigeria that such competition is seen. On measures to halt this trend, the president of NAS called for the harmonisation of Residency training in Nigeria.
According to Onuoha, most of the time, some Resident Doctors in Nigeria write the examinations to qualify them as consultants four to five times without passing and end up getting frustrated.“You find them leaving the country to go and practice abroad. Something needs to be done about their training. That is why often times, the resident doctors are on strike,” he said. He urged the government to pay doctors salaries as and when due as well as look into the various agreements it signed with different professional associations in the health sector with a view to addressing their problems.
“We cannot continue to have the Nigerian doctors’ exodus that is on now; it is not healthy for any country,” the NAS President stated. Speaking in similar vein, the immediate former 2nd Vice Chairman of the NMA in Lagos State, Dr. Olusegun Akinwotu, urged government and stakeholders to ensure the provision of adequate remuneration for doctors in the country. “This (remuneration) is the most attractive factor driving Nigerian doctors to emigrate abroad,” he said. Akinwotu called for improved training for Nigerian doctors so that they can work with their contemporaries anywhere in the world.