Reducing brain drain in medical practice

It is no longer news that the bill to ensure medical professionals practice for five years before being issued a license has scaled through second reading at the national assembly in an effort to curb brain drain in the country.

Despite the good intention behind such a bill to ensure there are enough medical practitioners in the country to meet international best practices for medical practitioner-to-patient ratios, it is worrisome how such a bill targets only the practitioners emigrating without due consideration of the reasons behind such movement.

As wonderful as it could be to have so many medical professionals in the country to attend to patients, the bill does not address it in the context that would encourage it. This is because various issues compound and frustrate medical professionals, some of whom leave the country for the duration of their study in the country. Becoming a medical doctor in Nigeria requires six years of rigorous academic training and a mandatory one-year house job and the NYSC, while other health care professions like medical laboratory science, radiography, pharmacy, nursing, and others require five years of intensive academic and clinical training with a mandatory one-year internship and the NYSC, which may have been prolonged than necessary due to some Nigerian factors like the ASUU strike or a health worker strike. That being the case, what is the certainty that such a person would secure a job immediately? When would the five years start to count? Would the government make a 5-year job provision for all of them after their mandatory service? Would an individual who stayed for five years before securing a job work another five years to have freedom of emigration? How about the elongated years of study? At what age would such a fellow retire from a government job? All of these are factors of time that are crucial to any serious-minded fellow.

Aside from that, it is worth noting that without a license, an individual is yet unqualified to practice such a profession, and as such, it might not be wrong to say that only trained quacks would be practicing within a 5-year period post-graduation without a license, which will also do more harm than good for the health sector. In addition, what happens to the “freedom of movement” (Sec. 41) and “the right to freedom from discrimination” under (Sec. 42) as assured by the 1999 Constitution of the Federal Republic of Nigeria (CFRN), as amended? All of these may pose more danger than good as it would scare away fresh minds who intend to practice in the health care sector considering the length of time to actualize such a goal and the infringement of their right to practice at will in any region of their choice.

However, it would also be crucial not to turn a blind eye to issues and circumstances surrounding the emigration of such professionals in the country, such as the inadequate basic infrastructural facility in the health sector, a lack of proper motivation for the health professionals, and pay parity amongst the professionals, amongst other vital circumstances surrounding such. Till this moment, there are lingering issues with the implementation of an increase in the Consolidated Medical Salary Structure (CONMESS) and Consolidated Health Salary Structure (CONHESS) and the payment of Hazard allowances to some health professional interns across the nation. These are some of the worrisome issues that are responsible for such professionals seeking emigration to other places. More so, immigration fosters unity and diversity, confers international collaboration on offering solutions to health care challenges, and ensures research collaboration as well.

Beyond forceful retention of healthcare workers that would even frustrate the patient and quality of care due to a lack of motivation and willingness to practice in such an environment, it is necessary to put in place quality measures that would enable the health care professionals to stay at will and joyfully carry out their duty to improve health care practices. It is important to emphasize that such can only be achieved if a holistic approach to funding and resource allocation to healthcare is guaranteed, subsidized medical education for all medical students in the health sector, a smooth and hitch-free academic journey, adequate compensation and motivation of health workers, employment opportunities for health workers and not selected few professionals, scholarship and funding opportunities for exceptional medical students, and improvement in healthcare infrastructural facilities. All of these would make our home greener than looking the other way, which in turn would joyfully ensure health care workers stay and allow them to practice in satisfaction that would improve quality of care. I therefore implore the policymakers to have a redress of the bill and appeal to relevant stakeholders to ensure that the bill addresses what it intends to address in real time.

Abdulbasit, a Medical Laboratory Scientist writes from Lagos.