I wish to write in solidarity with the medical profession in Nigeria because I understand the importance of professionalism as a Registered Engineer with The Council for the Regulation of Engineering in Nigeria (COREN), a Member of Nigerian Society of Engineers (MNSE), a PhD holder and a Senior Fellow, Higher Education Academy (SFHEA), United Kingdom. I have copied the public servants at the relevant ministries because I believe that a crisis in the healthcare sector, at this time in Nigeria, is of the highest public interest and should be nipped on the bud. While I sincerely empathise with the medical profession, I do believe that a discussion on “professionalism and career progression”, which I believe is fundamental to sustainable development, is of public interest as it influences the choices the future generations will make regarding discipline of study, professional pathway and career choices.
Contextually, apart from Engineering and Medicine, there are other professions such as Law, Accounting, Nursing, etc that undertake rigorous and extensive training regimes. Within the same professions, career choices may influence the professional pathway one may choose to progress along. These career choices may be influenced by many factors including additional academic or professional requirements. For instance, for Law, after Law School, a graduate of Law may choose to grow in the profession to become a Senior Advocate of Nigeria (SAN) but those in Academia will still require growing through acquiring a PhD, conducting legal research, publishing, practice and mentoring younger researchers and so on. They ultimately achieve a position of a professor. For Accounting, a graduate of accounting may eventually grow to become a Chartered Accountant, after a rigorous examination regime by The Institute of Chartered Accountants of Nigeria (ICAN) but those in academics can grow through acquiring a PhD, conducting research, publishing, practice and mentoring. They ultimately achieve a position of a professor. This is the same with engineering, nursing, architecture and so on. I think that your organisation should pay attention to the changing landscape and the shrinking opportunities in the society and adapt fast. Medicine is a prestigious profession because they save human life, but your organisation should recognise that politics and governance in Nigeria lacks support for professionalism. Meanwhile, promoting professionalism underpins how Nigerians can cognitively evolve to solve domain-based complex societal problems for Nigeria, Africa and the world.
I therefore wish to recommend as follows, as a professional in solidarity with the medical professionals in academia in Nigeria.
Let the NPMCN honestly accept that a Fellowship, however rigorous they perceive it to be, cannot be equal or equivalent to a PhD. A PhD is a training in research in a field, it can be in any field not mentioned in this text. It has nothing to do with professional practice but having a practice background should be an advantage. This is why a graduate of Mathematics can obtain a PhD in Engineering because a PhD is a contribution to human knowledge in a field of study. Dialogically, if Fellowships are accepted as being equal to a PhD, it will open a Pandora box because professions like Law, Nursing, Engineering, etc can institute equivalences of PhD but not a PhD. This is a recipe for reverse professionalism as it opens the system for all sorts of unregulated practices.
Apart from a PhD, there is a pedagogy aspect of the teaching practice relevant for all academics. The design of the medical programme may be unique but the “theories and practice of teaching and learning” by students undergoing medical professional training is a skill that needs to be learned by teachers of modules in Medicine. In other words, not all medical practitioners can teach and manage learning of medicine and medical science modules. Learning how to teach contents in a field can be acquired through a Postgraduate Diploma in Education (PGDE) but this can be included as a module (say Medical Science Pedagogy) within the training of academic medical professionals.
Based on the two points above, I recommend that NPMCN should consider working with all stakeholders including National Universities Commission (NUC), Federal Ministry of Education (FMoE), Nigerian Medical Association (NMA), Federal Ministry of Health, etc to innovatively design an academic and career pathway for teachers of medicine so that their PhD can be creatively integrated into their professional training. There could be novelty in realising this. The description of the processes of acquiring a Medical Fellowship status appears to have met a significant threshold to contribute towards earning a PhD. However, because a PhD, as in other fields, should be a training in research and a defence of a “significant contribution and/or a discovery of novel knowledge” in medicine, there should be the elements of writing a thesis, defending the thesis through a viva, publishing the new knowledge in articles, creating patents and intellectual properties, disseminating the knowledge through conferences, seminar and symposiums, including the new knowledge in training of students, etc. This means that not all Fellows may wish to earn a PhD as a matter of career choice, but those who wish to grow to the level of a Professor in Medicine should achieve the elements of a PhD since contribution to knowledge is globally universal.
I therefore urge the President of Nigeria, HE Bola A. Tinubu, who is an accountant and understands the importance of professionalism to nudge all the necessary ministries, departments and agencies to support the MPMCN to solve the problem of Fellowship vs PhD through Medical Science Curriculum design so that the requirements for different professional pathways can be a matter of choice.
I read that NPMCN has threatened a strike. This does not solve the problem, if I am to be honest. I pray them to shelf the strike, stay away from playing to the gallery but think, collaborate with the necessary stakeholders and solve the issue of PhD vs Fellowship through a “CURRICULUM DESIGN” approach.
I hope that the Federal Government of Nigeria will act proactively to support NPMCN with the necessary institutional policies, working condition and other resources that will enable those who wish to go extra mile to get a PhD, in order to teach future generations of medical doctors as well as contributor to human knowledge in medical sciences, to do so. This matter is an issue of public interests and should not be looked from the lens of being or not being a medical doctor.
Finally, this crisis can translate into a constructive improvement in the medical profession as it is an opportunity to constructively align the Fellowship programme to create a pathway for career progressions for medical doctors that may wish to pursue a career in teaching and practice.
Dr Chukwuma Ogbonnaya, PhD, MSc, BEng, PGDE, R.Engr, MIET, MNSE, SFHEA, FIMC
