Top 10 Important Things Nigerian Medical Schools Do Not Teach Our Future Doctors

Medical school is crazy! The expectations and demands placed on all admitted to medical school is daunting, and the path which must be thread by all who seek to be certified as medical doctors is arduous. The sacrifice demanded by the training is one untold and it could even be worse if you are in a developing country like Nigeria. Yet it is a system proven over the years to efficiently transform naive high school graduates into members of the noble profession of medicine. However, there are certain important things that this training system has consistently failed to prepare its new doctors for.

The medical training is so difficult many claim it is the most difficult course in the world to study yet with key deficiencies in the tools handed over to the new doctor. Let’s take a look at the 10 topmost important things Nigerian medical schools do not prepare their doctors for.

1.       Your health is important.

You might think this will be emphasized to your doctors but alas it is not so. The training lays emphasis on sacrifice in all forms especially self-sacrifice as long as it is for patient care. Many medical students over time learn to think of their patients first rather than themselves. They tell their patients to exercise regularly but are too busy taking care of patients to even exercise once a month. When they are ill, they are too busy to seek care from their colleagues as long as they still have enough energy in them to work even if with considerate pain.

Somewhere in the training, it gradually dawns on medical students that they are supermen; they can work for 72hrs at a stretch, they do not need to exercise to keep fit, they do not even need to adhere strictly to medications to get better when ill – Supernatural beings, those Doctors!

 

2.       Health care is also a business and it must make profit.

Now don’t get me wrong. Your doctors care about you but every hospital which does not make profit will eventually run down except it is externally financed. This is not hard to figure out. You would think that medical training in Nigeria includes some management courses to help prepare your doctors for this; it doesn’t. How do you price your hospital services? How do you obtain financing for your hospital? They do not teach them whether it is better to buy a Fresenius or Phillips equipment or whether getting it all from China is the best. Your average medical student has no idea about any of these questions. He/she will have to figure it out over the years. Many give up learning these as medical training doesn’t involve much of such non-academic thinking.

 

3.       Health laws.

Don’t be surprised. Medical training in Nigeria includes only occasional references to laws of the land that affect their practice. For example, ask the average new doctor what laws guide his roles as a passerby stopping to provide emergencies to victims of road traffic accidents and I bet you will not get an informed response.. Medical students are not taught or made fully aware of the laws of the land that relate to their practice until they graduate and they have to get used to the reality that there are laws that they must adhere to and so, they cannot take decisions based only on their professional or moral discretion.

 

4.       Don’t bury your talent.

I have met medical students/doctors who would do equally well or even better if they were music artists, actors/actresses, writers, footballers or business analysts but do you know what happened to them? Medical school. These talents got so unutilized that they became rusty old tales. Chimamanda Adichie, author of ‘Half a Yellow Sun’ and now arguably Nigeria’s most popular author in her generation, left medical schooI to focus on other passions. Dr. Sid, popular Nigerian hip-hop artist, graduated from medical school and Wale Okediran, author, politician and former member of the federal House of Representatives, remains a medical practitioner. I have heard doctors narrate how they were on the way to breakthrough with their talents only to get caught up in the demands of medical school. Medical school never told them talents need not be buried to survive medical school.

 

5.       You will not remember many of what you read or knew in medical school in years to come.

Medical school curriculum could be bewildering with courses ranging from the small details of organ-specific embryology and histology to the full clinical spectrum of organ-specific diseases with emphasis on certain rare diseases. Medical schools emphasize that you know everything but alas few years after, you are going to be left with only hazy memories of many things you could spontaneously recall back in medschool. I know some countries have realized this folly and are now making attempts to restructure the curriculum but this remains partly controversial. Thank goodness for the Medical and Dental Council of Nigeria (MDCN)’s now-mandatory attendance of medical update courses by practicing doctors in Nigeria as requirement for renewal of practicing licenses though. Doctors’ knowledge can now be regularly consolidated and updated.

 

6.       How not to marry a none-health worker.

Don’t get me wrong. There is nothing bad in a doctor getting married to a doctor or a nurse or pharmacist or lab scientist or any other health worker. All through medical school you are constantly reminded you are most likely going to add up to the statistics and end up marrying a fellow health worker. For those who do not desire this, don’t you think there should be some kind of elective course/coaching on how to go about this? You might not agree but this definitely makes my list of top 10.

 

7.       Getting into medical school was tough? Getting into residency placement is more difficult.

All through medical school, medical students in Nigeria day dream of themselves as specialists – a good dream. What they are not told is that there are so few training spots for specialists’ training that it makes entering medical school looks like ‘butter and bread’. They are not taught how to prepare for this bottle neck competition and many are dazed when they face the harsh realities of securing a training position especially in a society like ours where merit is relegated and most of the time ‘you have to have leg’.

 

8.       How do you deal with pharmaceutical representatives?

These are friends of all doctors but their unrelenting marketing could be tiring. Do you decline their ‘gifts’ and lunch offers and prescribe medications as you please or do you cut personal deals with them? Or do you just shut them out? Is there an established code of conduct in this regard? Many final year students are not even aware they ever have to make such decision. They learn that on the job.

 

9.       You are not normal.

You gist while dissecting cadavers; you certify a patient dead and move on straight to the next without even thinking about it; you see blood and don’t get nauseated; you reside in the hostel with your non-medical friend and wonder why he is shocked to see a human skull in your hands while you claim to be studying anatomy; and you don’t see anything abnormal about yourself! One other thing medical training fails to tell its students is that they are no longer normal like the general populace.

 

10.   ???

And lastly, I will leave number 10 open to you my reader; what important thing do you think medical school failed to teach its students that should make this list?