August 2017
Why Medical Students Emigrate to Become Doctors? Nigeria as a Case Study John Ebong
NiMSA - Nigeria eejohnn@gmail.com
Many a doctor of Nigerian descent has found it lucrative to emigrate to another country with a medical system that is presumed to be better and more advanced. This ‘‘greener pasture” seems to be the dream of most doctors in Nigeria, and the same can be said for medical students and would-be medical doctors. In 2013, the Nigerian Medical Association estimated that about two-thirds of Nigerian doctors practice outside Nigeria. Worried by this trend, I approached 5 random colleagues and asked whether they would, if given the opportunity, move abroad to practice medicine, all of whom suggested that they would. Obviously, major challenges exist in the Nigerian health sector that breed dissatisfaction among stakeholders, leading to a desire to practice elsewhere. These challenges are multifactorial in nature, and a proper discussion of the issues precipitating such an environment is important to ensure stability and growth in the Nigerian health sector. Nigeria has faced many challenges this year, which together have made life almost unbearable. The health sector is not immune to such challenges, and has had its own fair share of burdens. The combination of recession and consequent frustration has made many medical staff disenchanted with the medical system, and has highlighted the viability and attraction of emigration. Like most Nigerians, medical students began the year with enthusiasm and enormous hope for improvement. Unfortunately, this hope began to wane as the year progressed. The cost of living has increased drastically, necessities have become luxuries and most medical students who were solely dependent on their guardians have found it extremely difficult to meet their basic needs. In particular, growing economic pressure on students and their families has been exacerbated by a lack of scholarship opportunities. The status quo for government workers (medical doctors inclusive) in 2017 has been to endure months of halved salaries and, in some cases, no salary whatsoever. The morale of medical students has since decreased, as there seems to be no reward for labor. Seeing senior doctors complain of entitlement deprivation (which has precipitated several cases of industrial /ifmsa
@ifmsa
action) sends negative feedback to medical students, thus decreasing their enthusiasm to practice under the same conditions and making emigration and practice abroad a considerably more attractive prospect. It is assumed that medical students outside Nigeria have a better deal with respect to welfare and educational standards. Interactions with colleagues in other parts of the world have highlighted the significant contrasts between Nigeria and the rest of the world when it comes to medical education. While students abroad describe a friendly, gradual and productive medical education, Nigerian students complain of a rushed and stressed learning environment. The same international colleagues tell of the excellent psychological and academic support they receive in times of hardship, while such instances in Nigeria often result in immediate expulsion from medical school. Similarly, they tell of state of the art facilities and breakthrough innovations, while Nigerian medical students must practice without the same degree of innovation or research. These factors, among many more, regularly result in the average medical student seeking a better deal elsewhere when the opportunity presents itself, thus starving the Nigerian health system of capable and much-needed medical support. The dream of any medical student is to someday become a doctor. On achieving this feat, the excitement is unparalleled, and a rapid social change ensues. As a doctor, friends and family place you at the top of the social strata, and pressure to maintain these expectations is high. Such an environment defines the extrinsic aspect of a young doctor’s existence. On the other hand, the young doctor is introduced to a whole new world of struggles; seeking a house job, for example, which is seldom acquired immediately
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