Dear reader, please do not develop a health condition requiring a doctor’s examination in Nigeria because you would have to compete with 3,500 other patients for his or her attention. This is clearly bad news, enough to not wish for any hospital needs in Nigeria any time soon.
Or ever, as this reality is probably going to get worse. It is becoming easier for Nigerian doctors to seek and attain whiter lab coats overseas. Where examination conditions were an inconvenience, foreign medical councils are making it more comfortable for doctors to sit their exams and apply for licenses to practice in their country. No wonder about 12 Nigerian medical doctors have been registered in the United Kingdom every week so far this year, according to Africa Check. The rate has been accelerating for a decade.
In 2006, there were 2,692 Nigerian doctors registered as practitioners in the UK; that number has risen 95% to 5,250 as at 25th April 2018. Between January and April this year, 190 Nigerian doctors have gained licenses to work in the UK. This should raise eyebrows on a rate of exodus that has become very aggressive over the past three years, where 998 doctors moved between 2010 and 2015 at an average of 200 per year, 245 doctors moved in 2016 alone, going much higher to 439 in 2017.
And thanks to new provisions by the UK’s General Medical Council (GMC), more Nigerian doctors should be on the march in the coming months. The GMC’s Professional and Linguistic Assessment Board (PLAB) Part 1 exams will now be available in two other locations – Enugu and Abuja – in addition to Lagos. The part 1 exams is a written multiple choice exam, with 180 single best answer questions, after which a set of 18 practical questions in form of a structured clinical exam follows. Candidates who pass both parts can apply for registration with a license to practice medicine in the UK, according to information on the GMC’s website.
More Nigerian doctors will write and apply because there is a record of Nigerians applying and doing well in these exams over the years. What more, the general pass rate of PLABs has risen for five successive years meaning there will be more encouragement for more doctors to try even as working conditions in the country seem not to be improving significantly. In the 2015/16 PLAB exams season, only Pakistan (566) had more applicants than Nigeria’s 328 doctors. More Nigerian doctors are applying to go to the UK than from India (288). That is some feat; the GMC receives entries from doctors from 95 nationalities. That year, 328 Nigerians took the PLAB part 1 for the first time with a pass rate of 77.1%. Their mean score was 67.8%, just a few points below the 69% general average for that year. For the part 2, the pass rate was lower at 66% for the 247 who wrote the tests.
Though not as good as the 100% pass rate of candidates from Myanmar (for the 15/16 year), these are impressive numbers that highlight how good Nigerians can be when desperate to embrace better working conditions. They are numbers that should scare us, and make us fear an imminent crisis of chronic doctor shortages. But according to Chris Bode, the CMD of Lagos University Teaching Hospital, it is not a lose-lose situation for the Nigerian medical environment as the departing doctors can be a source of experience.
“It is not as if Nigerian medicine is dead,” Mr Bode said earlier this year. “I had to spend a lot, $14,000, some years back on going to Israel to learn new skills. That has distinguished me and Nigerians are benefitting. By the time the medical doctors come back, we will be better for it. It is not a hopeless situation. There is a lot we can do to harness the opportunity”.
That won’t calm the wave of concern around the deterioration of healthcare delivery in Nigeria. It is reasonable to suggest that even well paid and sufficiently skilled doctors are leaving the country for broader issues on peace and security in Nigeria. Doctors, as other Nigerians, deserve to raise their children within a society that they can be assured is peaceful and safe, not one where going through traffic portends life and death danger from a potentially tumbling truck or container falling off a bridge.
For the years of study they devote to become qualified, the Nigerian working and living condition could arouse brain drain and frustration. Nobody can authoritatively say why Dr Allwell Orji died by suicide in March of 2017 but it did bring into question the need to review the state of mind of Nigeria’s medical practitioners and the socio-economic circumstances that trigger them towards depressing poles. Without any definite policy measures from the government (instead we have more strikes), it should not be surprising for doctors to look more to PLAB as the perfect escape.