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MEDICAL INTERNSHIP IN NIGERIA: EXPECTATIONS, CHALLENGES AND RECOMMENDATIONS

The educational system in Nigeria is riddled with unnecessary challenges which every scholar seeks many ways to avoid when avoiding them is not possible they wait to hurry out in search of greener pastures as soon as they get the opportunity.  

The curriculums are out of date , instructional materials aren't there or are very poor, incessant industrial actions or strikes, uninhabitable accommodations, hostile environment and poor teacher student relationship. Graduating from the harrows of educational institutions in Nigeria is like an escape  from the many problems in the system. After graduation comes another problem of getting internship or housemanship placement for those who studied medicine or related courses.

Different courses graduates require the mandatory one year internship prescribed by the country before they can proceed for the compulsory one year of National youth Service scheme (NYSC).  At least you need to fulfil this requirements before you can either go the PLAB route, USMLE or run off to Saudi Arabia. Even the person writing this article also undertook the compulsory one year internship in one of the hospitals in Nigeria some years ago. The graduates that require internship are:

1. Medicine and Surgery Graduates
This are the fresh doctors, they require compulsory one year internship which they call housemanship or house job and this doctors are called house officers. The young doctor is supposed to live in the hospital premises or close by and work under supervision in 4 major departments each consisting of a 12 weeks rotations. The rotations will cut across Medicine, Surgery, Pediatrics and obstetrics and Gynaecology. At the end of each posting the doctor is signed off as part of the requirement to be issued Permanent practicing license by medical and Dental council of Nigeria MDCN, which is renewable every year.
medical internship in nigeria

This internship is paid and these doctors earn for the services rendered. 
The intent of this program is nice but as with any sector in the country the aim of this program has been long gone as this doctors are subjected to all forms of hardship. Some are turned into glorified errand boys and girls and made jest of even before the patients they are supposed to look after. There are days superiors will so talk down on you before patients that you lose confidence to even ask the patient for permission to cannulate them. But like they say, every doctor went through this situation even the superiors, so enjoy it while the time last. But take appropriate measures to protect yourself as many house officers became victims of the scourge of the pandemic and many transmissible diseases because the seniors abandon such roles for lowest in the cadre.
The situation for the house officers is a bit milder now, previously young graduates travel round the country in search of hospital to accept them for this mandatory one year of internship and have to pay to enrol for exams in these centers until recently MDCN started central placing of doctors to the federal owned facilities and this is good. No matter the challenges you face as a young doctor, do it with all joy because certainly there will be light at the end of the tunnel.

2. Nurses are also required to go through the paid internship just like doctors before they can be signed off to go for NYSC. During this period the Bsc. Nursing graduate or BNSC will learn basic and advanced nursing practices and also nursing management of patients in a hospital setting. This internship period is paid.
3. Dental Graduates are also required to go through the internship just like there medical counterparts, Dentists or Dental surgeons as they love to call themselves are doctors and similar things apply as its obtainable for medical doctors. Dentists have better opportunities and working experience as they are fewer and have more facilities to accept them. They are paid as well as their MBBS counterparts. They are issued BDS at graduation and require this one year internship to be registered permanently by MDCN.
4. Pharmacists are also enrolled in this one year paid internship, the work under supervision with the registered pharmacists manning the hospital pharmacy department and required to acquire basic skills related to their discipline during this period.
5. Dental Technologists are not left out. Don't get it twisted these technologists are graduates of technology schools and also required by law to do one year internship. They are not equal to their BDS counterparts who are doctors. They are paid lower than the dental surgeons. This period is also a time to acquire basic skills.

6. Medical Laboratory Science graduates go through the same internship. they rotate through hematology, chemical pathology, anatomical pathology and microbiology.  They are paid during this period and their work is usually more flexible. Most centers accept them in numbers so most of the times they have less work to do. But please take this period serious. Don't be the type that will release questionable PCV results of 70% ...lol.

 Physiotherapy Graduates are also part of the program and are fully paid. Sometimes you can hardly tell them apart from those Ajebo doctors. They work very hard in bone setting and massage therapy.

Salaries of Medical Interns in Nigeria
Medical graduates/ House officers Salary is between N150,000- 250,000 monthly depending on center.
Dental Surgeons Interns Salary is same as House officers.
Nurses interns salary is around N120,000-150,000
Pharmacy Intern Salary is between N140,000-170,000
Medical Laboratory Science Interns are paid between N100,000-150,000k
Physiotherapists and Dental Technology interns are paid N100,000-120,000k
 

Challenges of Medical Internship in Nigeria
One year compulsory internship for medical graduates, pharmacists,dental surgeons, dental therapists, dental technologists,radiographers, prosthesis and orthopaedic technologists, optometrists,   medical laboratory scientists, physiotherapists nurses, and dieticians is saddled with so many challenges. 

The proponents of this one year internship scheme designed it as a continuation and a practical approach to what is learnt during undergraduate training.

 The system previously where prospective interns are left on their own to get placement has ridiculed medical training in the country until recently when central posting of interns started. In the past graduates wait for years before they can get an attachment. My fear is that the corruption in the country can eat up the current system whereby a certain group of people will be sent to juicy areas and their likes to war prone areas.

Previously Intending Interns travels round the country for interviews: Then prospective  interns attend upto ten interviews in different parts of Nigeria before securing a placement. This can take up to 1-3 years. Each of this journies has it's  risk from road traffic accident to kidnapping, armed robbery or even death. In my time I traveled to Umuahia, Sokoto, Yenagoa and finally got lucky with a facility in Rivers state.

2. It used to be an organised extortion: Many centres approved for internship act in gross defiance of Convention No. 181  International Labour Organization which prohibits recruitment fees imposed on workers. The  heads of these hospitals are left unchecked but thank God the federal institutions have changed their body language, we await the state facilities to follow suit.