7 February 2009

Nigeria: University of Abuja Teaching Hospital - Tug-of-War, Confusion Over New Site

After gaining approval to train medical doctors, the University of Abuja Teaching Hospital is rocked by controversy as medical students are at a loss as to where they should go for their clinical training.

Medical students of the University of Abuja heaved a sigh of relief when the Federal Government in 2006 approved Gwagwalada Specialist Hospital (GSH) as the institution's teaching hospital, but almost three years after the approval was granted to run a teaching hospital, the trainee doctors are in the dark as to where they will have their clinical, which is the basic training they must undergo before they qualify to practice medicine anywhere.

But the grim prospect faced by the medical students is connected to the emergence of two schools of thought on the best structure that is most fitting for the teaching hospital to adopt. While one supports a single teaching hospital, the other insists on multi-teaching hospitals. This divergence of view nonetheless seems set to tear the institution apart.

The gate of the former Gwagwalada Specialist Hospital now carries the new inscription of the University of Abuja Teaching Hospital. A walk into the hospital's premises reveals some renovation work going on. Documents of the hospital now carry its new name but the staff said there was nothing more tangible to show that the status of the hospital has changed, while the medical students of the university do not know their fate.

Mrs Kande John, a staff of the hospital, said, "We thought that as a teaching hospital, we would have many medical students but nothing seems to have changed. The presence of consultants from the university that once gave this hospital hope is also lost because the consultants have resigned."

For the medical students, their fate hangs in the balance. While they read in the pages of newspapers that GSH is their learning hospital, some of their lecturers have told them "GSH is not". During a visit to the hospital, the Chief Medical Director (CMD) of the hospital, Dr Peter Alabi, told Weekly Trust that their doors are open to the medical students. "We might not be the best or biggest hospital but we have the space and manpower to support a teaching hospital," said Dr Alabi

But while he sounds optimistic, the Provost of the College of Health Sciences of the University of Abuja, Prof. J.A.M. Otubu on the other hand, said the hospital is not fit for the purpose of a teaching hospital. "How does it become our teaching hospital when nobody from the College of Health Sciences is consulting for the hospital?" he posed.

Prof. Otubu's resignation as honorary consultant of the hospital on 11th April, 2008 is also generating another debate. Prof. Hussein Akande Abdul-Kareem in a petition to the university's Senate argued that "no one can be the Provost of a College of Medicine of a university in Nigeria unless he is also a staff-member (consultant) in the Teaching Hospital that serves the university... by resigning, he (Prof. Otubu) is therefore not qualified to continue as the Provost."

Otubu stated that he was not consulted before a new CMD of the hospital was appointed yet it bears the name of the university. This, Abdul-Kareem countered, quoting a letter from the Federal Government to the university which reads in part: "That GSH should serve as the University Teaching Hospital (but not acquired) by the university."

Abdul-Kareem also faulted the appointment Prof. Otubu as Head of the Biochemistry Department, saying "The appointment of Dr Maxwell Nwegbu, a non-Biochemist as Lecturer 1 and Prof. J.A.M. Otubu also a non-Biochemist as Head of the same department is an error of judgment." Otubu countered that he is an "overseer".

In an interview with Weekly Trust, Abdul-Kareem argued that universities in Nigeria that attempted multi-teaching hospitals failed. "University of Ibadan tried government hospitals, Adeoye Hospital, Jericho General Hospital and Jericho Annex as Teaching Hospitals but they failed; so also Ife." GSH, he said, has highly experienced medical and dental specialists who have been training postgraduate Residency Programmers; the hospital has room for expansion and the proximity of the hospital to the university is parts of the merits of a single teaching hospital. He added that a multi-teaching hospital is only obtainable in cities with good communication and transport network.

But Otubu disagrees. "Universities of Ife and Ibadan did not try it in the full complex system we are trying to do. It has worked all over the world." he said.

"We want to maximally use consultants in the FCT," said Otubu who argued that having their consultants in one hospital will be a disservice to other parts of the FCT.

"GSH does not have the standard of a teaching hospital but the National Hospital is excellent for that," he said. "The National Hospital has first-class equipment, why should we deny our medical students the opportunity to train in the hospital?" said Otubu. According to him, the College of Health Sciences is already working with other hospitals to serve as their teaching hospitals.

The stand of the two Professors seems to take another shape with accusations from each other. Prof. Otubu in a letter asked that Prof. Abdul-Kareem returns the sum of N18, 000 loaned to him, but Abdul-Kareem said the money was used for an official assignment.

The Medical and Dental Council of Nigeria in a letter to the VC of the university noted that the College of Health Sciences' curriculum on community medicine is satisfactory but that the college needed more staffing and upgrading for accreditation. It also endorsed GSH as the university's teaching hospital while "other hospitals will be ancillary".

As the politics of the University Teaching Hospital continues, there are fears that the university might as well be on the verge of graduating its first medical students without good clinical experience. Otubu, however, said the most senior medical students are in their third year and they will come to some amicable terms before then.

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