Renowned Professor of Obstetrics & Gynecology and Medical Education Specialist, Prof. Uche Onwudiegwu has charged all medical schools to prioritize the adoption of standard medical education premised on curriculum development, pedagogy and assessment. The Bayelsa Medical University Dean of Science who specializes in the training, educational processes and methodologies deployed in the training of doctors in undergraduate and postgraduate levels so as to produce all-round qualified caregivers. Prof. Onwudiegwu spoke with Health Standard Journal at the 10th International Scientific Conference and 53rd Annual General Meeting of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) held in Abuja recently where he delivered the lecture titled ‘Medical Education in Nigeria: Situation Analysis’ in memory of Late Prof. Olusola Adewole Ojo.
Why the recent outcry for the revision of medical education in Nigeria?
The train is moving to medical education not only IVF, minimal x-ray surgery, neuro-gynecology. The way you train people determine. In what I do, I promote training medical teachers in medical schools, and examiners on how to train and teach their students and how to assess them. Emphasis needs to be laid because there is advancement in every area of life. Also, there is advancement in the training of doctors. The old methods when we did things anyhow are no longer working. We need to train the teachers even though they are Specialists, Surgeons, Obstetricians, but they are not trained in the educational theory and foundation on how to facilitate knowledge and deliver information. This lecture is about how to deal with fundamental things as teachers, trainers, and specialists. To sensitize them to see the need for training when they are asked to come for it.
What is the Situation Analysis of Medical Education in the country?
This thing cuts across every specialization in medicine, whether you are a surgeon, a Pediatrician, a Physician, a Cardiologist, because you have to train people. But I can tell you that the scenario is beginning to change. We have run a lot of workshops. I have done so many trainings in this country. I have gone to so many medical schools doing 2 to 5 days program and helping them to revise the way they are teaching. Some universities are doing it. A lot of people are catching up. In the past people didn’t understand, but now we are getting followership. There is an organization called ‘Doctors as Educators’. It is an agreement between the Royal College of Physicians in the Europe and the West African College of Physicians. They meet together and they train examiners on all these things am talking about and they certify them so that they can do better jobs. With time, we believe that everyone may not need to go outside to do masters, but because we are busy, we can run a two-week condensed program for you to grasp what it takes and then begin to do your job better because they are doing marvelous job. Not only are they experts in healthcare, they are training and training.
In this country, we have trained specialists, they go outside the world and they do so well but we want them to do better. You cannot say that where you are is the best. Every day, things are improving. So also in education, we need to go higher and higher. You never can say you have gotten to the zenith, you must continue to improve. God is the only one that doesn’t improve because HE is perfect.
Comparison of Nigerian medical education with other institutions in other parts of the world?
I can tell you that, among all professions, we are one profession that when we send our graduate outside, they don’t find them wanting whether it is in the United States, Canada, UK. Some of them are Chief Surgeons there. Our training is strong when it comes to medicine. People talk about Nigeria education is falling, yes, the present generation does not want to apply themselves the way we applied ourselves. We have a problem today with the young ones which is Attitude. They think that you just go in, get something out. Some of them feel that we are driving them too hard. Because you are looking after lives, you must apply yourself, you must work hard. We are not paying attention to attitude, behavior. If you are not disciplined and you don’t have the right attitude, you can’t learn. The students must realize that there is a time for everything. There is a time to listen to your master. If you cannot be disciplined, you won’t learn much. We are doing our best with what we have but we can do better. The major thing is that we must get the right attitude from our trainees and our students.
What approaches would you proffer for ideal medical education?
It’s Benjamin Bloom’s Taxonomy. It is a process designed by Benjamin Bloom in 1956 to categorize educational objectives and make it easy for teachers to train, access and evaluate. In the cognitive domain, he divided into six difficulties in learning. The lowest difficulty is called recall knowledge, understanding, application, analysis, synthesis, evaluation.
How can Nigerian reverse the current trend of brain drain in Nigeria?
I gave a lecture on this few years ago, they published it as a book with all the statistics. It is sad. You see Nigerian government does not know what it’s losing. It costs about 7 to 8,000 dollars to train a medical doctor from the beginning to the end in Nigeria. It is like nothing. In the US, for a doctor to graduate, they have a debt of 100 to 200,000 dollars to train a doctor. When we train doctors free, people don’t pay, those countries will just take them and we are watching. We are not thinking right. We should be crying that we are producing doctors for people free and they are happy because of the conditions we have painted. Some of us who are still practicing here, it is because we love what we are doing. I could have stayed back in the US years back. When I was coming back in 1994, they said ‘are you okay?’ They gave me forms to bring my papers, I said ‘No, we have work to do in Nigeria’ and I don’t regret it because what I have done here is worth a lot to the society than if I were there living in luxury. Brain drain is real. We don’t have enough doctors on ground but the ones we have cannot find employment. We have about 35,000 doctors working in Nigeria but by World Health Organization standard, we need about 280,000 doctors but even the 35,000 we have are not gainfully employed. Do you see the paradox?
So somebody is saying why are you producing more when they can’t stay in the country but you have to train people. Individuals have a right to develop themselves. When you are not developing them, they go away. We don’t know what we are losing. They value them, we don’t value them. Development is not just building skyscrapers in Abuja but building human beings, keeping them to run your society and improve the quality of lives.
How does Nigeria Government make rural practice attractive to medical practitioners?
I have been a scholar and Academic Educationist. I am 40 years qualified as a doctor this year. I became a specialist since 1987, that is 32 years ago. I have been a Professor for about 26 years working and training people. I am not in government. I have seen students under my professorship. I am doing my own beat. Everybody should do his or her own beats. Government should do their own beat. Go to Ife (Obafemi Awolowo University College of Medicine) and ask my students, I just retired. I am now at Bayelsa Medical University where I am the Dean of Science in the University. I have done my work, go and ask my students there, they know how I trained them day and night. Government should do its own work. Government is made of human beings. I turned 70 on the 26th of November. In this country, only 3% of the population is up to 70, who have seen everything. There is nothing people in government know that we don’t know. They don’t even know as much as we do. So nobody can bluff. The education I have received, some of them have not received it. Nobody can bluff that we don’t know because they are government. The fact that we are not in government doesn’t mean we are dullards. If we look at government, we will be discouraged. Those who are in government should sit down and do their work. Where they need to learn, they should go and learn and do the right thing and stop playing hanky-panky. If we played hanky-panky, we wouldn’t have developed the medical sector the way we developed it.