The exodus of Nigerian doctors to the UK and other developed countries has become a matter of international concern. Last year, it was estimated that an average of 12 doctors emigrate from Nigeria to practise in the UK every week. Worse still, according to the General Medical Council, UK, 750 doctors in Nigeria enrolled to take the PLAB 1 exam which held on 14th March 2019. PLAB is the 2-part entrance exam into UK medical practice for international medical graduates. Among the many reasons doctors leave for the UK, here are a few statements I've heard from doctors.
I needed to feed my family.
Who no like better tin? (here for the goodies)
I wasn't getting into Residency.
Everything is wrong with Nigeria.
People have different motivations in life. Some want to be rich. Some want to be influential. Some are driven by passion. Some want to serve. Some pursue happiness. Some are driven by a sense of purpose or calling. Still some have no drive - they will take whatever life offers. From the statements above you can guess each person’s motivation.
While I am not advocating for doctors to leave Nigeria, here are some arguable benefits to consider the option of practising medicine in the UK.
1. Better practice
Here in UK, you get to practise Medicine by the book. There are national guidelines for every condition. The practice of Medicine is easier here in the UK because of technology. Money is not a hindering factor as most people have access to universal healthcare by the tax-funded national health service. If someone needs a CT scan, you go ahead and organise one without checking their pocket. We do proper investigations to identify the root cause of ailments. Also regular research and audits mean that recommendations get updated based on best evidence. Better practice leads to better results which leads to more fulfilment and less frustration.
2. Proper training
In Nigeria, a post-NYSC (one year compulsory national youth service) doctor working in a private hospital is expected to function at the level of a general practitioner (GP) without any further training aside from medical school and housemanship or probably, his trial and error exploits during NYSC. Here a GP trainee goes through at least 3 years of post-housemanship training rotating between hospital departments and the health centre, being supervised by seniors, taking 2 exams before emerging as a GP. Roles are clearly spelt out. Even those not in training posts know their limits. You are not allowed to attempt procedures you have not been properly trained for. And you are never alone. There is always a more experienced person to call on. If not physically available, their advice can be sought over the phone. Proper training leads to more confidence and less guilty conscience from causing harm.
3. Comfortable remuneration
This is one of the major reasons many Nigerian doctors leave. We anticipated a comfortable lifestyle when signing up for this career. However, the reality is that there are many struggling doctors living in Nigeria who work very long tedious hours to keep body and soul together. While the UK is not the most lucrative country for doctors to work in, it still affords you a fairly comfortable lifestyle. There is a high demand for doctors in the UK. I have not seen anyone who failed to find a job after passing PLAB.
Let’s talk about my experience
When I was in Nigeria I hated Medicine. The practice was crude. We lacked quality control. Many illnesses were treated blindly as many investigation results were unreliable and patients were unwilling to spend money on investigations. Finance for healthcare was and still is mainly out of patients' pockets. Even health insurance, for the few that had it, was a scam. After NYSC, I searched for jobs for months. Most private hospitals were looking for someone with both medical and advanced surgical skills like hernia repair or Caesarean Section. I couldn't perform those at my level. One interviewer asked if I knew how to operate an ultrasound scan machine. There was not much support or training opportunity in the private sector where I worked. Residency/training posts for doctors were so few. I applied for 4 training jobs, took their exams but never got listed. I wasn’t complaining about my pay. It was just enough for a single girl's basic needs. I didn't need a car as I lived in the hospital. But I was unhappy as a doctor because I wasn't improving my knowledge or skills.
Frustrated, I sought a way out of clinical medicine. By God's grace, I got a full tuition scholarship into a Masters programme in Public Health at the University of Nottingham in 2016. During my study I applied for Public Health jobs in Nigeria but got no response from any. I saw an opportunity here to face my fears and build my confidence as a doctor while reforming my thinking about clinical medicine. So I jumped on it.
For me, my biggest motivation to practise in the UK was the opportunity to learn the proper way of doing things and build my confidence as a doctor. How can we improve the system when we are so used to improvising that at times we forget things could be done better? Also, I considered that I would stand a greater chance in future of making a change in the Nigerian Public Health sector having gone through both systems. Since I started working in the UK, I have become much more confident because I have more knowledge and experience. I love what I do now which is training to be a general practitioner.
I am by no means calling on Nigerian doctors to evacuate Nigeria. I am only pointing out some reasons you might want to consider when weighing your pros. At the end of the day it boils down to what drives you as an individual. It is unfortunate that Nigeria is haemorrhaging on doctors at a critical rate. But I cannot blame people seeking more knowledge and experience of Medicine. The questions needing answers are: What are the people in power doing to improve the health service, retain doctors and attract those abroad? And how many overseas Nigerian doctors are willing to return to make impact after gaining superior knowledge and skills from developed countries?
Have you left or are considering leaving Nigeria or have rejected the idea, please tell us your experience in the comment section below. Thanks.
Very interesting write-up. You're one of the medical students I respect then in UNEC,even though we were not close.
You're just on point here. To be honest I try not to be too emotional about our naija laggings because it's even most unhealthy now I see how things work close to perfection here.
I could understand your frustrations then back home,not just you as a Dr,other health practitioners too.
Incidentally you guys (doctors),as wrosre it may still be, are even better looked after.
I recall in your point above on how quality diagnoses (citing CT scan) is ensured here,among numerous others. I can as well with experience here attest to it.
But you and I know know that back home,other health pracyinoers at not relevant to our Ministry, a pathetic situation that have kept us forever behind.here, as you must have seen yourself,other health practitioners get to the level of consultants, working peacefully with doctors..., ours is just fight and fight...One wonders what's really wrong with us
Nice piece though
Kà ómésiá nwanne mmadu
My dear, Nigeria is a trying place, but by His Grace we make the most of what we got. Doctors should not be blamed or made to feel guilty for emigrating overseas. E go better!
Nice write-up Chidiogo. Nigeria's situation is just pathetic. Even if you want to be patriotic at expense of your comfort by staying back to practice here, the system will simply frustrate you and your impact would hardly be felt. Many well-trained consultants are leaving in droves because the system is designed to frustrate their efforts. But you know what, nobody cares. They said we could actually go into farming and tailoring!
@Chris, awww. Thank you.
That’s another brilliant piece Chidiogo.The common theme usually seems to be that most Nigerian trained doctors graduate to find that the returns on their investment of time and effort and the fulfillment in clinical practice are simply non-existent for the reasons you mentioned above.Then then see a few colleagues with an MPH working in the NGOs and the UN organisations like WHO,UNICEF etc which seem to have a more efficient work environment and culture.Then they find themselves MPH programs in the UK and US hoping to do same.(Ironically,most doctors practicing in these countries tend to have an MPH First in most cases)If for any reason they find themselves in a clinical/hospital setting in the UK,then they find that the practice of medicine can indeed be better and they abandon the MPH plans and return to their first love.
Very interesting article. Thumbs up.
@Mexy, that's the case for many my dear.
Hmmm...I think about this every now and then, the number of doctors both young and experienced that have left is serious and the consequence better left unimagined. My consolation is that in delivering Israel, God sent a Joseph ahead perhaps in this situation also, God has also sent doctors like yourself ahead in order to become deliverers for the nation at a later time. God help us.
Lovely article.Especially this part that you said,'I now love my job'.
@Bro Tomi. Amen!!!
@Solu, thanks sis.
Excellent writeup here Chidiogo. I like the honest thoughts you have shared.
I have a different perspective though. Having an episode of Malaria delirium in 2013 changed my perspective about this. I will write more about it in a blog post soon. Can I tag and backlink to this post on my blog?
Thank you for sharing your thoughts dear.
Hey Chidogo this is the truth as you have mentioned. The Nigeria health system is a failed system. It is a hopeless situation. Keep the good work up dear.
@Bimbo pls feel free to tag and backlink. Will love to read your post
@Unknown, it may be failing but it is not hopeless. This a Clarion call to get both those in power to begin thinking about how to change it and us in diaspora to think of how we can make impact when we can. It is definitely not hopeless.
I think some senior colleagues who have travelled and practised abroad actually have tried to make an improvement back in Nigeria but then the backwardness of the system will just swallow their efforts. I can cite quite number of examples in UNTH those days.
Again am thinking, if everybody goes back home in order to give back to their countries after they have been improved and trained by the UK, I wonder if they would want any immigrants in training jobs any longer, in fact, you would have to sign a bond that you will remain and work in the UK after your training.
Naija Govt. should find a way to keep back their hard earned doctors before we become 'doctorless'
Hmmm... Who will fix us?? Before there is brain drain!!
Meeeennnn....it's only in Nigeria that you hear that theory (as written in books) is different from practical.
Well, you just proved that something is actually wrong with our system here.
You don't have to turn into a training director, yet you have to realize your training admirably. Figure out how to understand reports and get information. Dispense time to instructing yourself. Talk with your training chief, your bookkeeper, or different experts. when I joined Caribbean Medical University of St. Vincent I realized that selecting your college is much important because most of the universities, not providing the best facilities for practicing medicine but our university provides us best facilities overall.
Nice educational blog for students. Thanks for sharing and keep it up. Markcon
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