On the occasion of Nigeria’s 64th anniversary of independence, the Nigerian Association of Resident Doctors has voiced concerns over the ongoing struggles within the country’s healthcare system.
They have highlighted issues such as challenging working conditions, insufficient training opportunities, and inadequate remuneration for medical professionals.
Dr. Tope Osundara, the president of NARD, emphasized that despite some initiatives by the government to enhance the working environment for healthcare workers, many resident doctors continue to face difficult circumstances.
Specifically, he mentioned the burdensome work hours without corresponding compensation or rewards, a situation that differs from practices observed in other nations where extra work is duly acknowledged and remunerated.
Dr. Osundara cited examples from healthcare institutions like the Obafemi Awolowo University Teaching Hospitals Complex, where he alleged that basic amenities such as meals for doctors on prolonged shifts were reportedly lacking. This inadequacy, he pointed out, has led to many doctors leaving their positions, further disrupting an already demanding schedule.
While acknowledging certain advancements made over the past 64 years, the NARD president criticized the government’s response to the challenges confronted by resident doctors.
He highlighted the importance of actionable plans with well-defined timelines, rather than just policy drafts, from the Ministry of Health to effectively address these critical issues and translate improvements into reality.
He stated, “The current state of the health care system is suboptimal. Resident doctors still work under harsh conditions. Though the government is trying to improve the working conditions, Resident doctors work long hours and are not rewarded for it. No incentive whatsoever. Unlike what we have in other climes where extra work hours are duly paid for.
“In some hospitals, the welfare of doctors is not prioritised like OAUTHC and some other hospitals where call meals are not provided for doctors which invariably means that a resident doctor on 24-hour call will have to go home to find what to eat during his/her call duty.
“The government’s effort to mitigate against some of these challenges is seen with the drafted policy from the Ministry of Health to address the gamut of issues that have plagued our health system. Beyond policy, however, there should be a workable action plan with a timeline else some of these policies will only remain as random attempts at dress to impress.”
The Nigerian Association of Resident Doctors (NARD) President, Osundare, highlighted several major challenges facing resident doctors in the country.
A significant shortage of healthcare personnel tops the list, exacerbated by the mass migration of skilled professionals seeking better opportunities abroad ¹. This brain drain is further complicated by inadequate training resources and facilities, hindering doctors’ development to meet global standards.
Some hospitals are in dire conditions, lacking essential medical equipment like functional CT scan machines for critical diagnoses. In many areas, patients have no choice but to rely on outdated equipment or, worse still, go without necessary medical technology.
“We still have several hospitals with obsolete medical equipment in the theatre. Some don’t have equipment at all. CT machine is a medical gadget every hospital should have but in some states in Nigeria, you will find just one serving the whole population of the state. Some states don’t have functioning CT scans.
“Unfortunately, our roads are bad which has increased the rate of accidents. There is the issue of poor attention to health and other lifestyle factors that have contributed to the prevalence of medical conditions like hypertension. Accident victims from road traffic and those with cerebrovascular accidents suffer the most from the lack of a functioning CT Scan machine.
“Resident doctors in Nigeria don’t have specific working hours. When they resume by 8 am, for instance, they can end up going home by 8 pm. Thus, increasing burnout for most residents. Some do back-to-back call duty that spans into weeks.
“Poor remuneration for doctors is a major factor. Nigerian doctors are among the least paid globally. The Nigerian doctor’s pay is terrible irrespective of the calculating index,” he noted.
The Nigerian Association of Resident Doctors (NARD) President, Osundare, is calling for urgent improvements to healthcare workers’ conditions, including set working hours.
To address the ongoing challenges, Osundare recommends that the government implement policies to retain skilled doctors and boost workforce capabilities.
This includes fair compensation, regular working condition reviews, and robust security measures to protect healthcare workers, who are increasingly vulnerable .
He added, “A conducive work environment is also equally important. During long hours of call, doctors in some hospitals don’t have call rooms. Some have call rooms with squalid conditions due to neglect by hospital management.
“Policies seeking to retain our best hands should be prioritised. There should be a policy that is targeted at improving the workforce which should be aimed at meeting the healthcare needs of Nigerians and there should be adequate compensation.
“There should be a policy on regular review of working conditions. The policy of security for all health workers is essentially important as most health workers, especially doctors, are now endangered species.”
To improve residency training in Nigeria, the NARD president advocates for allocating sufficient resources to a comprehensive development framework. This framework should prioritize modern medical methodologies and innovative practices.
He recommends in-service training opportunities, international exposure to best practices, and a robust certification process to validate resident doctors’ skills.
The president emphasizes adopting international best practices, focusing on continuous training and research in a supportive environment. Mentorship, government support, and incentives are crucial for healthcare professionals’ success in Nigeria.
“Quality training during residency has a multifactor component. A robust structure for training, research and service delivery in a conducive environment with good and effective mentorship, incentive and government support is critical for success,” he summarized.
