There is an ongoing crisis in the Nigerian Medical Internship/Housemanship placement which has plagued its prospective interns/house officers for years. The mandatory internship/housemanship program is an extention of our training, where we acquire more comprehensive clinical training as we are dealing with the most sacred form of life, human life and as such there is the very need for us in the health sector to be efficient and competent in all ramification. Having said that, this mandatory one year program has virtually become a stumbling block to prospective interns/house officers as there are no well structured and organised modalities put in place for securing placement. You can imagine a situation where a graduate from Medicine, Pharmarcy, Medical Laboratory Science, Radiography, Physiotherapy, Nutrition and Dietitrics, Optometry will graduate from the University after five or six years, will then stay back at home for additional two to three years or more pending when him/her secure placement in any of the acreditted hospitals.
This unneccessary delay caused by the irregularities in the process is uncalled for and grossly unacceptable. To worsen the situation, most hospitals are now in the habit of selecting just a few from the thousands of the crowd that put in for the application. In addition, most of them sell their forms for as high as N5000, N3000, and N2000, to all candidates only to take less than 30 applicants from the thousands that bought the form leaving the others helpless after the release of the interview results. Prospective interns/house officers risk their life nation wide in the bid to attend interview in various parts of the nation and at the end of the day, they are disappointed, and it is not a question of they not passing the interview exams but most often, this can be attributed to multiple factors such as not having the connection, not having the funds to probably pay for a slot, the politics that is inherent in the hospital management board, the small size capacity of the laboratory, for instance which may not be able to cater for or contain all the intern Med lab scientist, and so many other unforeseen factors.
The most grievous of all is the the sales of forms to thousands of candidates and end up taking less than thirty (30) from the crowd, together with the politics been played in the entire process, which in most hospitals, the process is far from transparent and merit. From our own perspective, this appear to be tantamount to exploiting and taking undue advantage of the helpless candidates financially, who are in dire need of securing placement for the mandately one year internsship/housemanship program which precedes the National Youth Service Corps (NYSC). Because of this delay in the process of securing placement, prospective interns/house officers are going through hard times, wasting at home, getting weary and are seen like people who never actually graduated from school since they are not going to service immediately as this is what is obtainable among fresh university graduates.
Again, the cumbersome predicament will always results in a situation where by a 200level or 300level student in other discipline outside medical field in the university will graduate and go for service while a medical graduate who must have graduated some two to three years back will still be wasting at home, no internship/housemanship, no service. This is grossly unacceptable. Prospective interns/house officers are therefore requesting for the Federal government, National University Commission and the various governing bodies to urgently step into the situation and resolve this crisis by regulating internaship/housemanship for the entire Medical graduates.
Having pointed out the enormous challenges been faced by prospective interns/house officers, below are some few recommndations to aid in the regulation of the entire process and bring to a permanent halt the worrysome challenges.
1. There is the the need for the one year internship/housemanship placement to be regulated just like the National Youth Service Corps, which therefore warrant a body to b set up and charged with the duty of posting medical graduates for the mandatory internship/housemanship program.
2. The said body above will work closely with the various governing council bodies/universities to ensure the universities adhere strictly to the regulation of the council bodies as regards intake into the various disciplines, so as to control the output which will b a function of the number and available acredited hospitals.
3. All hospital form for internship/housemanship should be made free of charge as obtainable in some few hospitals, since as fresh graduates, we are not occupationally engaged yet. Financially the cost of purchasing a form for say for as high as N5000 may be difficult for some individuals judging by the status quo of our economy.
4. As a matter of urgency, Federal government need to upgrade and properly equip our hospitals to facilitate and enhance further training of medical graduates as this is one of the major setback in the entire process.
5. The examination is not neccessary when a medical graduate is qualified and provisionally licensed by their council body. However, should it be, it has to be for only the few candidates posted to the particular hospital. And should a candidate fail, a resit exam may be considered since the hospital capacity is still not filled up yet. All this modalities will go a long way curbing the unneccessary delay been experienced by prospective interns/house officers.
6. The maximum capacity of each acreditted hospital will have to be on record so as to avoid overflooding of a particular hospital.
7. Final exam in medical schools nationwide should be administered quarterly and within a certain period in a bid to synchronize the graduation of new doctors and appropriate placement within that period.
8. The medical council, NMA and the federal government should come up with a structured approach to implement the placement of newly inducted doctors through matching of candidates to various hospitals for internship.
9. If number seven above cannot be achieved, the all teaching hospitals should be made to absorb their doctors who pass at first sitting and resit candidates should be matched to various federal medical centers nationwide including private hospitals.
10. The salary scheme and package for interns in all hospitals should be synchronized to reduce the monopoly of interest in certain hospitals.
11. The governing council can also increase the number of hospitals accredited for internship placements so as to cater for the increasing populace of graduating doctors.