Only one in 48 applicants get admission to study medicine

Only one in 48 applicants will get admission to study medicine in Nigerian universities in this year’s academic session due to limited vacancies, Daily Trust investigations have shown.

Joint Admission and Matriculation Board (JAMB) data shows that 156,213 students sat for the 2017 Unified Tertiary Matriculation Examinations (UTME) to read medicine whereas there are only 3,205 vacancies in 44 universities across the country.

There are 37 medical and nine dental colleges in the country, according to information on the official website of the Medical and Dental Council of Nigeria (MDCN).

Six medical and two dental colleges have partial accreditation, the MDCN website said.

The colleges are to produce 2,550 medical and 175 dental doctors annually, according to the council’s website.

MDCN is a federal body that regulates training in Medicine, Dentistry and Alternative Medicine as well as the regulation and control of Laboratory Medicine in Nigeria.

Fewer vacancies, mass applicants

JAMB data shows that 31 accredited medical colleges in the southern part of the country received 95,869 applications but they have a combined approved slots of 2,260 received

There are 12 accredited medical colleges in the north with 945 approved slots, but they received 57, 024 applications this year.

In the Federal Capital Territory, 3,227 applied to the University of Abuja and 93 to the Nigeria Turkish Nile University, Abuja.

Five accredited colleges in the Northcentral (Makurdi, Ilorin, Jos, Keffi, and Ayingba) have 400 approved total slots but 21,992 candidates applied.

In the North-east, three accredited medical colleges in Maiduguri, Bauchi, and Gombe have 265 approved slots even though 9,970 students have applied this year.

The North-west’s four accredited colleges in Kano, Kaduna, Sokoto, and Zaria with approved vacancies of 330 received 25,062 applications.

The South-east has nine accredited universities: Abia (2), Anambra (2), Enugu (2), Imo (2) and Ebonyi, with 590 approved slots, but got applications from 25,103.

In South-west, 34,938 students applied for 910 vacancies in the 12 universities with accreditation to train medical doctors.

The nine accredited medical colleges in the South-south received 35,828 applications that will vie for 760 slots.

Shortage of doctors

Nigeria falls below the “critical threshold” of 23 doctors, nurses and midwives per 10,000 population, according to the World Health Organisation (WHO) report on the density of doctors, nurses, and midwives in the 49 priority countries.

Attempts to speak to the officials of the MDCN on record for this story were not successful. The Nigerian Medical Association (NMA) couldn’t provide the number of registered doctors in the country.

But an official of the NMA who preferred not be named said there are currently 35, 000 doctors in Nigeria.

While the WHO stipulates 1:20 doctor-patient ratio, Nigeria has 1:5,200 based on its current unofficial population figure of 182 million.

But a medical doctor in the Federal Ministry of Health who spoke to this reporter on condition of anonymity because he’s not allowed to speak said Nigeria’s major problem is brain drain.

“The number of doctors graduated by medical schools is enough to take care of the population if not for internal and external brain drain,” he said. Other problems that bedevil the health sector, he said include “the dearth of facilities in medical schools, poor remuneration, shortage of tertiary institutions for housemanship and patients’ overloads.”

He said because of higher salaries, trained doctors abandoned local hospitals to take jobs with international non-governmental organizations working in the country.

Hundreds of other doctors troop abroad for better pay and conditions of service.

“It will take young doctors between one to three years after graduation searching for teaching hospitals for their housemanship.

“Another challenge is the concentration of doctors in urban areas. This is a huge problem because the majority of the population live in rural areas,” the doctor said.

What should be done

To address these challenges, the federal government should adopt the triple strategy of training, absorption and financing, Dr Obinna Ebirim, a consultant on Nigerian projects of Johns Hopkins International Vaccine Access Centre (JHU IVAC), told Daily Trust.

He said the federal government must fulfil its commitment of allocating 15 percent of its annual budget to health in line with the Abuja Declaration.

He said the absorption capacity of the existing medical colleges should be expanded by providing adequate infrastructure and manpower to enable them to train more doctors.

“Apart from that, the number of health tertiary institutions should be expanded, equipped and properly funded, so that the young doctors will be given placements to do their housemanship,” he said.

Dr Ebirim said aside from that, the health sector should adequately be financed to provide the good atmosphere for the doctors to work.

“Most of these young doctors travel abroad for greener pastures. That can only stop if there is an improvement in the remuneration packages and condition of service of doctors,” the public health advocate said.

“More interventions need to be implemented to train more, absorb more, and retain more doctors in Nigeria. We can learn from the health system in Cuba,” he said.

He said President Muhammadu Buhari’s administration’s focus on PHC revitalization, increased immunization coverage, tertiary health institution reform, automatic placement of graduate physicians, accountability and good governance in the health sector gives hope of a better for medicine in Nigeria.

“More money for health means we can pay doctors salaries commensurate with what their peers earn in those countries they run to, increase both the number and functionality of our health facilities such that practice of medicine is sweet and service delivery will improve, and cover more of our citizens with health insurance so that there is no financial demand on doctors by patients who can’t afford their bills,” he said.

Dr Ebirim, however, said beyond increased funding is the need to curb inefficiencies and corruption in the health sector. “In the past, there have been reports were doctors exit the medical residency in teaching hospitals and their names are still in the payroll system. There are also cases of how donor funding was misappropriated or stolen with the current administration made to pay. These have to stop,” he said.