Fate of Nigerian Medical Graduates from Ukrainian Universities Hangs in the Balance

The fate of some returnee Nigerian medical graduates from Ukrainian universities hangs in the balance following the refusal of the Medical and Dental Council of Nigeria to allow them sit its exams.

Their education in the European country came to a halt following the February 24, 2022, invasion by Russian soldiers, leading to deaths and destruction of buildings, bridges, and public infrastructure. Over 1500 Nigerian students were displaced with the majority being final-year medical students preparing to graduate in June before the war outbreak.

One of the graduates, Ben Ezuro, had become troubled despite his plan to return to Nigeria and practice. Ezuro disclosed that he and other colleagues had their hearts in their mouths before leaving Ukraine as they scampered for safety but were unhappy with the situation in the country.

He added, “I was hopeful that after nearly losing my life to the war, I would sit the licensing exams and commence residency. I believed so much in Nigeria but the current reality shattered my dreams. I was devastated at this point after surviving the war and losing my dad. This year has been cruel to me and life has lost meaning to me.’’

He stated that a medical licence was only granted after a one-year compulsory internship, wondering why the medical and dental council took the decision.

He said, “I guess this decision was born out of the resentment they had for foreign-trained graduates. Over the years, some of my senior colleagues told us of their experiences with the council, especially when they discovered their plan was to travel abroad after obtaining their licence. They abuse them in a zestful way. I guess they took the opportunity of this unfortunate incident to get back at us.”

He noted that he did a one-year study in Nigeria prior to obtaining admission to study medicine in Ukraine, stating that a senior colleague told him how toxic the Nigerian medical system was and how it made him feel incapable.

He stated, “We have been labelled online doctors and that we do not have the technical skills/know-how to handle real-life patients. We should be allowed to take the exams and let the results determine if we are competent or not. Other countries are accepting people but it’s a complete rejection here.

“We understand their concerns and that the council is making sure to absorb qualified doctors but the time this issue came up was insensitive. It’s really a sad and painful situation but most of us are beginning to move on. Some of us have to raise a ridiculous amount of about 10,000 pounds to get into the foundation which is like an internship in the United Kingdom.”

The issue

The MDCN is the regulatory and licensing body for all medical and dental experts. The council organizes the exams twice in a year to determine qualified candidates to be grafted into the Nigerian health care system. The exam dictates if a graduate of medicine or dentistry will be licensed in Nigeria or not.

This indicates that any graduate of medicine or dentistry who desires to practice in Nigeria must first take the MDCN exams and undergo a rigorous compulsory one-year houseman ship before such a person can be recognized as a qualified medical practitioner. Also, with the licence, such medical practitioners can practice anywhere in the world.

On June 18, 2022, medical and dental council noted in a statement that it would not honour medical and dental degree certificates issued by medical schools in Ukraine from 2022 until when normal academic activities resumed.

The council advised students currently studying medicine or dentistry in Ukrainian medical schools to seek transfer to other accredited medical or dental schools in other countries to complete their programmes. Previous reports showed that the Nigerian Medical Association backed the MDCN’s decision. The NMA said the reported online teaching of the medical students was not acceptable anywhere in the world.

Frustrating narrations 

A baker and  medical graduate of Kharkiv National Medical University, Ukraine, Mary Etteh, was among those whose studies were disrupted by the war. She returned to Nigeria optimistic after six years of rigorous study in Ukraine. Upon returning home, she was broken by the reality that her certificate was null and void.

Etteh told Sunday PUNCH that the recent development came as a shock to her and her colleagues. She stated that the majority of their classes were in person, expressing surprise that the council held on to the fact that they held classes online for a few months to deny them taking the exams. “Do I throw away the certificate I laboured for six years to get? Where do we start from?” she said.

She stated, “Our scores are more class-based. We are graded 60 per cent for class participation and 40 per cent for exams. With the online exams we did, one can’t be a student doing badly previously in classes and pass well in the final exams.”

She noted that countries such as Hungary, Amsterdam, and The Netherlands that were more advanced than Nigeria accepted those who took online classes and allowed them to engage in practical sessions and learn on the job.

Etteh told our correspondent, “These countries understood that it wasn’t the fault of the students but due to the war. Why make us pay for what isn’t our doing? They are pained because we left the country to study abroad. I believe the licensing board should be different from the exam council. It’s different in the United States of America.

“There is no sympathy or empathy. If their children were a part of us, I’m sure they would not take the decision. At least the council should tell us what to do if it’s to take some training before the exam. They should let us take the exams and that will determine who is competent to be grafted or not. Let us take the exam and prove ourselves.’’

She added that the body claimed that they didn’t have practical experience but an average Nigerian medical graduate depended on houseman ship to get hands-on experience, noting that medicine was a job where one continually learnt on the job and if one didn’t practice, one would forget certain things.

She said, “Most of the Nigerian-trained medical students don’t know how to set a line. They learnt that during houseman ship and that’s what the training is meant for.”

Exodus of Nigerian doctors

The General Medical Council which licenses and maintains the official register of medical practitioners in the United Kingdom licensed at least 266 Nigerian doctors between June and July 2022.

The report stated that at least three Nigerian doctors were licensed per day in June and July 2022 despite the moves by the Federal Government to stop the exodus of doctors and health workers in the country amidst the worsening brain drain of the professionals in the country.

“Council should allow us take exams”

A music artiste, Ben Krezt, told Sunday PUNCH that he returned to the country to practise medicine after over seven years overseas and was denied the opportunity.

Krezt

The artiste-cum medical graduate said that many of his colleagues were idle at home while others had devised other means to survive. He added that some had to move to other countries for means of livelihood and to start life afresh.

He said, “People feel they can wake up and make rash decisions. We cannot blame this sector only, other sectors are not functioning properly either. Many doctors are leaving the country for greener pastures.”

He expressed shock over the council’s refusal to accept fresh graduates who he said were willing to contribute their quota to the country’s health care system despite the current shortage of doctors in the country.

“After graduating, one’s certificate is rendered invalid in one’s own country but valid in other countries. It is devastating. I called my landlord in Ukraine and he told me my apartment was bombed and could barely pick up anything from there. Our dear motherland doesn’t care about how we are trying to stay sane in the situation and then we return home to meet a bigger disappointment,” he said in a devastated tone.

Krezt told our correspondent that he couldn’t wait to pick up his certificate because of the war but a friend had to help me out, stating that he currently sought a means to transfer it to Nigeria with the high naira to dollar exchange rate impeding his opportunity.

He stated that salaries of medical doctors in Nigeria were meagre yet they had to register for the MDCN exams after paying through their noses to graduate from medical school.

“While in Ukraine, a comfortable place costs about $400 not calculating our feeding and transportation expenses. They have killed the zeal for going to medical school and returning to contribute to the economy. Most of us have ventured into other professions.

“If they were a bit empathetic about how we survived the war and returned to Nigeria, then they will consider us. If the Academic Staff Union of Universities is still on strike after several months, then I’m not surprised this is happening.

“The council should let us take the exams and then with the results they can determine if we are competent or not. It shouldn’t be a blanket,” he told our correspondent.

In his account, another medical graduate of Kharkiv National Medical University, Ukraine,  Emeka Chidube, narrated how he travelled to another European country for survival, hoping for a review of the ban on their certificates soon. He stated that he was bitter that the exams were cancelled for his set due to the war, noting that classes were taken online during COVID-19-induced lockdown and nobody faulted it.

Chidube

He said, “I had plans to return to Nigeria, take the MDCN exams and start residency but the council’s position has truncated my plans.’’

Chidube claimed that there was bias against medical students who studied abroad, stating that generally some medical practitioners felt they should have stayed back in Nigeria to study.

He claimed that he once trained in a Nigerian hospital during summer where the health workers in the hospital stigmatized foreign-trained doctors especially those who graduated from Cyprus, Ukraine, and China.

Chidube noted that he had to do menial jobs to earn a living while waiting to get his certificate from his school.

He said, “I feel the council had been looking for a means to get back at us, so the war was a big opportunity. It’s not just about the war or online classes but the way they perceive foreign students. I spent six years in medical school. I fled for my life during the war and I can’t abandon my certificate. I believe it’s ideal to be licensed in one’s home country. I’m holding on and believing that the council might reconsider its decision. But if not, I’ll push through with other plans although it’ll take me a long time and more money.”

Medical, dental experts weigh in

Commenting on the issue, the foundational dean of dentistry, Bayero University Kano, Kano State, Adebola Adetokumbo, opined that the case of the students was an unfortunate one, adding that sentiments cannot be attached to issues that bothered on life. He stated that the medical council was a regulatory body and saddled with the responsibility of certifying those qualified to practice in Nigeria.

He said, “The council certifies those who will not jeopardize the lives of Nigerians. We cannot use passion or emotion to truncate the standard because life is involved. We must be objective and appreciate the unfortunate circumstance and those affected but the lives of Nigerians are paramount. Anyone can fall victim to quackery so we must be careful.”

He stated however that the body only organized exams for foreign-trained doctors and was the final authority to certify medical practitioners who can practice in Nigeria. He advised those affected to use the channel of the ministry of health or national assembly to seek help from the Nigerian Universities Commission to fix them into medical schools in the country considering the level they were with the admission requirements of those universities.

He noted, “They cannot be absorbed into the council robotically. We cannot endanger the lives of Nigerians and that is why the MDCN is taking the stance. But there must be a balance. We shouldn’t look at it from an emotional perspective and conclude that MDCN is cruel. The MDCN can identify one or two schools where a special programme can be organised for the candidates and then the assessment can be done. Those qualified ones should be granted access to take the MDCN exams.”

Similarly, a professor of orthodontics at the University of Port Harcourt, Rivers State, Chukwudi Onyeaso, stated that the situation in Ukraine wasn’t the making of the students, noting however that there was no excuse for quackery as the profession involved saving lives and once a mistake was made, lives might be lost.

Onyeaso said that the council was only doing its job and wasn’t to blame for the decision taken. He stated that it was protecting the lives of Nigerians and those in other countries because these students could choose to practice anywhere in the world.

He said, “It will not be justifiable for the council to graft them based on sentiments as they didn’t meet required standards. It is painful but sometimes one has to take painful decisions to save lives. I would advise us to pray that the war in Ukraine is short-lived so that the students, especially those who were finalists when the war broke out, can return to complete their studies and qualify for the council exams.”

He advised those in their third year and below to wait for the war to end or obtain transcripts from their schools to Nigeria universities so the schools could know the right level to fix them to continue their studies.

He, however, said that on a larger scale, learning from the issue, every Nigerian should be constructive and make the government realize that they needed to put the universities in good shape so that there would be a reduction in the exodus of promising Nigerian students to other countries.

“Why should Ukraine be better than Nigeria? The exchange rate is even alarming and people pay through their noses to train the children abroad. We have all the facilities, lecturers, and money to run the system well. If we do so, we’ll be able to produce our doctors. From testimonies, those trained in Nigeria and go abroad to practice are well sought after which shows that the lecturers are doing their jobs to take the students through rigorous training,” Onyeaso said.

He expressed bitterness over the ongoing ASUU strike as would-be-doctors were also affected and they cannot be rushed as those studying other courses. He urged the media and individuals to call on the government in order to pay attention to the university system.

The orthodontist stated that the situation in Ukraine was almost like that of Nigeria as schools had been on strike for about six months, urging the lecturers to properly teach the students upon calling off the strike for resumption of academic session.

He said, “We are not looking for shortcuts. The MDCN has not taken a wrong decision. Universities can take them but they have to give details of what they did in their previous years to guide in assigning them to the right levels. Nigeria is losing on all ends. The government should do the needful. You cannot develop a nation when the university education is faulty because that’s where the manpower lies. Let’s put more pressure on the government to do the needful so we don’t start cutting corners, thereby endangering the lives of Nigerians by employing those who aren’t properly trained.”

On his part, a medical doctor and professor of obstetrics and gynaecology at the University of Nigeria, Nsukka, Enugu State, Okezie Obioma, said it was impossible to take final MBBS exams online because it was a clinical exam.

Obioma stated, “It is not possible to take professional exams online and claim to be a doctor. Why are they complaining? Why didn’t they say they cannot do medicine online? They should go and plead with the council to help fix them in medical schools in Nigeria where they can take clinical examinations before they can qualify to become doctors. Otherwise, if the war is over they can return to finish up properly. They know what to do. There are more pressing issues. The strike is still persistent for six months and nothing has been done about it.”

Also, a professor of pathology/forensic medicine at the University of Benin, Edo State, Aligbe Umezuluike, stated that training was usually organised for foreign-trained medical students and after passing the exams they would be registered and licensed as medical doctors in Nigeria.

He stated, “It’s just like the IELTS exams done overseas. Anyone who doesn’t pass is not licensed.’’

MDCN, Ministry of Education’s responses

Contacted for its comment on the issue, the acting Head, Planning, Registration and Statistics, and assistant registrar, MDCN, Dr Henry Okwuokenye, said that he wasn’t authorised to comment on the issue as he was on vacation. He referred our correspondent to the council’s registrar.

The council’s Registrar, Dr. Tajudeen Sanusi, told our correspondent that the students could train wherever they desired and present themselves for exams, stating that if they passed they would be grafted, else they would have to keep trying.

Doctors

“We will not organize any crash course. These students with their parents petitioned the national assembly to cancel the programme. So no one should say the council is not mindful of these people.

“The prerequisite for being qualified to sit the MDCN exams is if they have graduated from a recognised university anywhere in the world. Those who learnt for a few months and took final exams online are not recognised. Will you allow a doctor who studied online to treat you? That should not come up. The global practice doesn’t train doctors online. Leave those ones out. Let them go to where they will acquire hands-on skills after they have completed their medical programme onsite not online,” he stated.

He added that the online classes organised during the war were a fraudulent practice, stating that the Ukrainian government sent their citizens to the United Kingdom to complete their training programme. He added that during the war in Nigeria, the University of Nigeria closed down for three years and the same thing happened in Liberia and Sierra Leone.

Sanusi stated that the council would not allow Nigerians to be used as guinea pigs.

He said, “If they are not fraudulent, why didn’t the schools send them to neighbouring countries to complete their programme? They have taken their money and are looking for shortcuts. We have told them, anyone who brings a 2022 certificate from Ukraine will not be honoured because the war broke out in February 2022.”

The registrar further said that provisions had been made for those affected to be transferred to universities in Nigeria and they must meet the minimum requirements for admission, adding that the schools were the determinants of the levels the students would be fixed. According to him, the NUC, ministries of education and health including the Joint Admissions and Matriculation Board were aware of the development.

He said, “The fact that you were in 300 level there doesn’t mean you’ll automatically be in 300 level here. We only made sure that the Joint Admissions and Matriculation Board will give a waiver for them to get into higher institutions without taking the Unified Tertiary Matriculation Examination required for admission into the university. Those people are full of mischief and deceit. There is no shortcut.”

He advised those affected to get their transcripts and transfer to any university of their choice or wait till the end of the war to return to Ukraine and complete their studies. He added that training medical students wasn’t the job of the council.

In his view, the public relations officer, Federal Ministry of Education, Benjamin Bem-Goong, noted that if the council decided that concluding training onsite was their standard requirement, then there was nothing the ministry could do about it.

Goong said, “Transfer is an individual matter between the students, the releasing and receiving university. These students ran away from Nigeria because of the strike. Has the strike finished? They went there and met war, that’s to show that it is not only Nigeria that has problems. Let them choose which is better, war or strike. I wish them good luck and leave them to their judgement.”

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