The quiet erosion of medical authority in Nigeria’s professional jungle

BY SHAMSU GUJUNGU

Recently, the Nigerian University Commission (NUC) went on a spree of approving first-degree allied health courses with “Doctor” titles — from the Pharm D to Doctor of Optometry, Doctor of Physiotherapy, and even discussions around Doctor of Medical Laboratory Science, as well as Doctor of Nursing Science.

This reckless elevation of titles without clarity on clinical roles is beginning to dangerously dilute the medical space. It confuses patients, creates false equivalence in multidisciplinary care, and contributes to an identity crisis in the healthcare workforce. These shortcuts are being institutionalised under the guise of academic reform — but with real consequences for clinical governance and health outcomes in an already fragile system.

Sadly, instead of turning inward and reforming our medical structure, many medical bodies— including respected bodies like the Nigerian Medical Association (NMA), MDCAN, and NARD — resort to their usual pulsatile, knee-jerk reactions that only appear like and fuels professional jealousy. Rather than pushing to redefine the MBBS, restructure training, and reposition the profession in policy circles, we whine. That won’t save us. What will is bold reform. Let’s rethink our structure, modernise our degree, add value to every stage of our training, and stop being passive in a system that rewards the loud and the lobbying.

For me, I blame doctors’ docility. Instead of aiming higher and seeking better opportunities, we often sit back and bemoan what others are getting. We should be initiating moves and targeting a better share. Remember, this is Nigeria — do you think they will stop? By the time they equalise, they aim even higher.

When was medical education last reviewed? They’re always finding shortcuts. When you go to our hospitals, you’ll see nurses who did post-basic courses — like ENT, Ophthalmic, Orthopedics, Dermatology — already kyphosing like consultant, feeling superior to MOs, with lighter work schedules, running clinics, and even getting improved payments.

We should aim higher too — like pushing for diplomas or post-MBBS certifications in specific fields before becoming fellows, adding value to our qualifications and pay. Or integrating postgraduate components into the MBBS, like awarding a BSc in basic medical sciences after finishing pre-clinicals.

As it stands today, a nurse who does a post-basic course gets improved allowances. But for doctors, unless you become a fellow, you get nothing extra — despite taking calls across all specialties as an MO (Surgery, Medicine, O&G, Paediatrics). Nothing special is added. Yet you may find MOs sending consults to nurse specialists in Orthopedics, ENT.

Let’s make the MBBS degree richer too. We shouldn’t carry the whole hospital on our neck and still feel depressed and underpaid compared to our work.

We are in a democracy, and in as much as we preach morality and discipline, there are things you can’t stop. They will lobby, they will push, bribe their ways until they get everything. You can’t stop politicians, and it will always seem like doctors are constantly jealous in nature. Whatever we push for, we can get it too. Two years basic nursing + one year post-basic and you’re acting like a consultant?

Let’s unbundle the MBBS too, make the system easier while maintaining discipline. Let’s consider removing the 100 level year for science classes (biology, physics and chemistry), introduce opportunities after finishing pre-clinicals, provide opportunities when you are working as MO doing all specialists’ work, improve consultant package or create a cadre for ‘super consultant’; SR will be the new consultant, while the consultant who passed Part I becomes ‘super’.

Let’s dominate too.

Sounds funny, right? That’s the only way to survive Nigerian shenanigans and this is what professional bodies like NMA, MDCAN, MDCN, NARD and all other medical professionals associations should be engaged in rather than jealousy.

To survive Nigeria, one must professionally play Nigerian.

Dr Shamsu Gujungu can be contacted via [email protected]