Why do medical students need to emigrate to become doctors in 2017?

This article was exclusively written for the Sting by Mr. Ebong John Etietop, a medical student at the university of Uyo, Nigeria. He is also affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Many a doctor of Nigerian descent has found it lucrative and a first time option to emigrate to another country presumed to be better and more advanced than theirs. This ‘‘greener pasture” seems to be the dream of most doctors in Nigeria which fuels their drive to seek emigration. Same can be said of medical students and would-be medical doctors. In 2013, the Nigerian Medical Association estimated that about two-thirds of Nigerian doctors practice outside Nigeria. Worried by this trend, I approached 5 random colleagues of mine and inquired if they will follow the trend if given the opportunity, to this, they all responded in the affirmative. It is therefore obvious that major challenges exist in the health sector in Nigeria that brings dissatisfaction among its stakeholders leading to the desire to try somewhere different. These challenges are multifactorial and a proper dissection of the issues arising seems expedient.

The year 2017 in Nigeria began with a lot of challenges which made life almost unbearable. The health sector has not been left out as it has had its own fair share of burdens. Generally, recession ensued, frustration followed, and for most doctors, depression was inevitable and emigration became viable. Like most Nigerians, medical students began the year with enthusiasm and enormous hope of things getting better. Unfortunately, this hope began to wane as the year progressed. The cost of living has increased drastically, necessities have become luxuries and most medical students who were solely dependent on their guardians have found it extremely difficult to meet their basic needs as the economy has held a strangulating grip on the financial windpipe of these guardians as scholarships seem not to be forthcoming. The status quo for government workers (medical doctors inclusive) in 2017 has been to endure months of halved salaries and in some cases, no salaries at all. The morale of medical students has since decreased as there seems to be no reward for labor. Getting to see senior doctors complain of deprivation of their entitlements (which have made them embark on several industrial actions) sends a negative feedback signal to medical students thus decreasing their enthusiasm to practice under these same conditions and giving way for the alternative pathway (emigration).

It is assumed that medical students outside Nigeria have a better deal in terms of welfare and educational standards. Interactions with colleagues in other parts of the world on several occasions have shown that their system of learning is in sharp contrast with ours. While they reminisce on the friendly, gradual and productive nature of theirs, we complain of the propulsive nature of ours; they tell of the psychological and academic support they get when their grades get bad, we groan about our colleagues getting thrown out of medical school for same reason; they tell of the state of the art facilities they practice with while we keep up with our archaic few which in some cases are absent; while breakthrough in innovations are a plus to their developmental strides, we keep practicing therapeutic medicine relatively lacking in research for obvious reasons. These drives the average medical student to seek for a better deal elsewhere when the opportunity presents itself thus, Nigeria seems to lose a lot of capable hands.

The dream of any medical student is to someday become a doctor. On achieving this feat, excitement is intense and euphoria is immense. As a doctor, friends and family expect an acute change in your social and physical status, they place you at the top of their imaginary social strata and pressure is often high on you to live up to these expectations. This defines the extrinsic aspect of a young doctors’ existence. On the other hand, the young doctor is just introduced into a whole new world of struggles; he seeks for a house job which is seldom gotten immediately after graduation, he struggles to settle down after which he seeks an appointment for his residency which may end in futility, he gets to see casualties as a result of absence of necessary facilities, copes with delayed, halved and sometimes absent monthly benefits. This defines the intrinsic aspect of a young doctors’ existence. A synergistic relationship between the intrinsic and extrinsic aspects makes an average young doctors’ life in Nigeria almost unbearable. This leads to frustration whose end product could be emigration for some and depression for others. On the sidelines, medical students observe the trend while asking- Is the stress worth it?

The doctor to patient ratio in Nigeria as at 2016 was pegged at 1 medical doctor to 3500 patients. This figure poses an enormous burden to an average doctor who barely has time for anything asides attending to patients. In no time, a young doctor finds himself depressed worse still, the often strained relationship with seniors in the profession. In a typical Nigerian setting, senior colleagues in the medical profession are viewed as authoritarians; patients on the other hand are very demanding and seldom give any compliment to the physician rather sometimes choosing to pose a difficulty to the doctors in rendering their services. The young doctor is caught in between these two difficult situations and opts for practicing in a more favorable environment. Emigration has therefore become status quo.

About the author

Ebong John Etietop is a medical student of the University of Uyo, Nigeria. He had his childhood and primary educaton at Foundation Nursery and Primary school(1998-2006) at Kano state after which he proceeded to acquire his secondary education at Evangel International School(2006-2012) Kano state. He got admitted into the prestigous University of Uyo, Akwa Ibom state in the year 2014. He is a seasoned writer who boasts of several articles and publications. He takes deep interest in leadrship roles at different levels and is currently the assistant course representative of his class, the current assistant secretary general, Christian Medical and Dental Association, University of Uyo and is also the current program development and planning  secretary, Association of Niger Delta medical doctors- students’ arm. He is a pan-africanist and believes in the progress of the region through capacity building of the young.

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