Nigeria: The Quiet Erosion of Medical Authority Professional Jungle

Recently, the National Universities 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 fuel 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 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.

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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 last was the medical education reviewed? They're always finding shortcuts. When you go to our hospitals, you'll see nurses who did post-basic courses -- like ENT, ophthalmic, orthopaedics, and dermatology -- already kyphosing like consultants, 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. We can also integrate 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 specialities as an MO (Surgery, Medicine, O&G, Paediatrics). Nothing special is added. Yet you may find MOs sending consults to nurse specialists in Orthopaedics, ENT.

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

We are in a democracy, and inasmuch as we preach morality and discipline, there are things you can't stop!!! They will lobby, they will push, and bribe their way 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.

Let's unbundle the MBBS too, make the system easier while maintaining discipline!

Dr Shamsu Gujungu can be reached via [email protected]

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