Our frustration with Nigeria’s system made us abandon residency programme for other opportunities –Resident doctors

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Amarachi Okeh

Amidst the ongoing strike action by the National Association of Resident Doctors and reports of more doctors leaving the country for greener pastures, some resident doctors are also abandoning the medical residency programme out of frustration with the health system.

Some of the resident doctors who spoke with PUNCH HealthWise said the current health system is not only pushing more doctors out of the country, but also making some young doctors abandon the residency programme.

The physicians, Dr. Oyinlola Abitoye and Dr. Obinna Ibemere, said they dropped out of the medical residency programme in the country because of the abysmal conditions of service they were contending with, noting that many of their colleagues also quit the residency due to similar frustrations.

Speaking with PUNCH HealthWise, Dr. Oyinlola Abitoye said she was in the third year of her medical residency when she decided she had had enough of the poor working conditions she was enduring at the University of Medical Science Teaching Hospital, Ondo.

The issues, she said, were many and included irregular payment of salaries, poor welfare and absence of required medical equipment to work.

Abitoye said she had woken up in June this year, counted her losses and gains within the three years of her five-year residency and concluded that it was not worth it, disclosing that she thus decided to quit her residency with the state-owned teaching hospital.

“I quit the residency programme midway and I am currently practising with a private organisation that I am happy with,” she said.

Abitoye said she has no regret for that decision, even though she knows that she has to start afresh if she wishes to continue her residency.

She said she is not bothered about that, saying, “There is no point staying where you are not moving.

“There was the irregular payment of salaries; the doctors were not taken care of. The hospital itself was not operating at a good standard. Everything was not working fine; so I just had to leave. The payment majorly was an issue; it wasn’t regular.

“We have been owed since February this year but last year and the last two years they’d owe us for like three months. I just had to find a better means of living,” Abitoye told PUNCH HealthWise.

She further said she doesn’t plan to continue her residency in Nigeria, noting that if not for financial considerations, she would have left the country.

“For now, I don’t think I want to ever continue my residency in a state like this. Maybe later I will continue with the residency,” she said.

Asked if she would like to leave the country, she answered, “I am thinking of moving.

“One of the reasons I cannot move easily is because of funds. Now if I can gather funds I will move as soon as possible. So, I am planning to move.

“I don’t regret resigning from the medical residency at all. I feel good resigning because where I work now, there is regular payment.You have value for what you do.You are appreciated; not threatened. I am having a good time where I work.”

Also speaking with our correspondent, Dr.Ibemere said he had considered himself a patriotic Nigeria, noting that he had thought he’d finish all his medical training in the country but his faith began to wane from the time he started seeking a residency placement.

He said that things got worse when he started practicing and while it was a difficult decision, he eventually abandoned his residency midway to move to Saudi Arabia.

He said, “It was a very complex decision. It wasn’t easy because I had always believed in Nigeria. I had always been patriotic.  I had always believed that I would finish my specialist training in Nigeria and contribute my quota to the country.

“But as things kept on unfolding, I noticed that it was not as easy as we imagined because after youth service, the first stress involved getting residency training and then so many uncertainties follow.

“I was even been duped a few times by some people who promised to help me get residency. So, with all those things, there was no clear-cut certainty that when I finished that step, I could go to the next.

“But I still persevered. So many of my classmates who were travelling kept on asking me what I was doing but I still believed in doing my residency in Nigeria.

“When I started my residency, I noticed that the whole programme was messed up, the facilities were not working.

“Most times you’d find out that in a teaching hospital, an ordinary X-ray machine is not functional. Simple laboratory tests – like kidney function tests – you’d find out that the machine can be faulty for one whole month in a teaching hospital and this increases the burden on the patients, many of whom are already facing financial difficulty and struggling to pay their medical bills.

“So, all those things weren’t motivating at all. I just decided that I wouldn’t continue with this for my own mental health,” Ibemere said.

He also added that the financial reward was not motivating at all for the work done. In addition to this, he said, “The issue of the health workers’ dichotomy, the unhealthy working environment, the poor relationship between doctors and other health workers, coupled with the incessant strikes.

“There is an unhealthy interface between the senior and junior doctors and when you interact with your colleagues abroad, you’d find out that it’s not like that but in Nigeria, the senior ones behave as if they are gods.

“They don’t even have time to teach you some simple procedures; instead they dish out insults to you most of the time.

“I don’t know – sometimes they expect that you should learn something from the moon when they are not always committed to teaching. This is also an issue; it makes the younger people want to leave the system for them.”

Speaking about his work experience now in Saudi Arabia, Ibemere said the difference between working in Nigeria and Saudi Arabia is “like the distance between Aba and Sokoto. It is so wide,” he said.

“When I came in and saw the difference, I concluded that the lives of Nigerian patients are in the hands of God because we are not doing anything.

“We are struggling with simple interventions in Nigeria. The bureaucracies involved in getting some simple procedures done, like treating road traffic accident patients with a head injury, are crazy.

“The logistics involved in booking a theatre can be crazy sometimes. Before you know it, you would have increased the time wasted before the patient gets the final care and it increases the fatality rate of all those care.

“When I came in here, I noticed that everything is swift. They have a rapid response team that attends promptly to emergencies. It gives a sort of fulfilment.

“The inter-professional rivalry we experience in Nigeria is not here. Here, everybody knows their duty. The system here is such a way that at every point in time everybody understands that we are working together for the patient and there is no room for all those unnecessary rivalries.

“I am happy working here. The financial benefit is also very good. At least, I can take care of my family,” Abimere said.

Recall that resident doctors in Nigeria have been on an indefinite strike action since August 2, to press home their demands.

Some of the issues raised by the doctors include the inconsistent payment of salaries, hazard allowances, non-payment of death benefits, and issues surrounding the registration of members on the Integrated Payroll and Personnel Information System.

The strike was also to demand the immediate withdrawal of the circular removing House Officers from the scheme of service and the hasty implementation of the circular by the Lagos State Government.

However, in response to the strike action, the Federal Government had taken the NARD to the National Industrial Court and followed up with the implementation of the no-work-no-pay rule.

The resident doctors are, however, adamant that the strike action will continue until all their demands are met.

Aside from the general demands of the NARD national body, resident doctors in different states of the country are also battling different issues relating to unfavourable working conditions, including non-payment of salaries.

In states like Ondo, Imo, Abia, Kaduna and Ekiti, resident doctors are owed five to 19 months’ salaries.

Speaking on the current situation, the president of the Association of Resident Doctors at the University of Medical Science Teaching Hospital, Ondo, Dr.OriyomiSanni described the current situation of the Nigerian health system as unfortunate.

“The way it is now, some of us who have a passion to stay in the country are beginning to have a rethink.

“For example, in my state, the last salary we received was February salary.We are not asking for an increment; we are not asking for extra, but the salary we worked for.

“I can count how many days I sleep in my house in a month. If I am on a weekend call, I leave my wife and children on Friday and I don’t return until Monday evening and I do that like two weekends in a month; and the other days too I still do calls.

“At the end of the day, the salary is not forthcoming.Not just the salary – talking about the environment and the equipment to work with, all of it is dilapidated.Some are not even working at all.

“When patients come, we have to run helter-skelter to get what we will use for them.We are short-staffed. Those who are leaving are not being replaced.

“At the end of the day, what do you expect people to do?” he asked.

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