* British Medical Council exposes falling standard of training in Nigeria* MDCN restores accreditation of eight medical schoolsIT is not all gloom for Nigerian medical graduates who were barred by the General Medical Council (GMC) from practising in the United Kingdom (UK).The cheery news is that the deficiency in eight out of the nine Nigerian institutions that led to their graduates being barred in the UK has been rectified.The Medical and Dental Council of Nigeria (MDCN) actually restored the accreditation of eight out of the nine institutions. The only medical college that has not been re-accredited is Ladoke Akintola University of Technology (LAUTECH).But the GMC apparently took its decision without being aware of the re-accreditation of the eight institutions.The affected universities includeAmbrose Ali University, Ekpoma; University of Benin, University of Jos, University of Nigeria, Nsukka; University of Port Harcourt, Ebonyi State University, Igbinedion University College of Health Sciences, LAUTECH and the Nnamdi Azikiwe University, Awka.The decision affects only those who graduated after December 10, 2010. In the case of the University of Benin and the Igbinedion University College of Health Sciences, it only applies to those who graduated on or after April 1, 2010.According to the GMC, the affected graduates cannot sit for the Professional and Linguistic Assessments Board (PLAB) examination, which enables non-UK medical graduates to undertake post-graduate medical training in the country.The decision of the GMC is generating a lot of reactions from Nigerian medical doctors, both at home and in the Diaspora.To some, the development may be a reflection of fallen standards of medical education in the country, poor information management, the vacuum created by the frequent dissolution of the Board of the Medical and Dental Council of Nigeria (MDCN), and the Nigeria University Commission (NUC), which approves the admission of students into the medical colleges against MDCN's advice.The stakeholders recommended increasing interaction of Nigerian medical schools with Nigerian graduates in the Diaspora and welcomed suggestions on how Nigerian physicians in the Diaspora could help raise standards of medical training in the country.Also, the GMC has given more reasons why it cannot allow some graduates of medicine from Nigeria to practise in the UK.The Registrar of MDCN, Dr. Abdulmumini Ibrahim, disclosed to The Guardian that the decision of the GMC was based on information on accreditation status of these institutions. The MDCN last year clamped down on the erring institutions for not meeting the prescribed minimum standards.Ibrahim told The Guardian that these institutions had rectified all the anomalies identified by the accrediting visitation panel and their accreditation restored. 'We have updated this information on our website and we are going to write officially to the GMC to enable them restore the affected institutions,' he said.President, Nigeria Medical Association (NMA), Dr. Omede Idris, and member, MDCN, told The Guardian: 'I would not say the standard has fallen in the real sense. It is over admission, which overwhelmed the facilities available at the medical schools and the trainers. The Council has been talking about it but the NUC will go and admit despite caution. All this happens because they dissolve the council and it is not reconstituted immediately. And when this happens, the institution, under pressure, goes ahead and admits students.'One of the main reasons is that there is a vacuum when you dissolve council for a long time and you don't reconstitute. So, unless the MDCN and the GMC wield a big stick, this will continue to happen.'Omede said the decision of the UK's GMC was not unconnected with the recent sanction of some of the medical schools by the MDCN. 'Not too long ago, the MDCN had to sanction these medical colleges because they were over-admitting students. Naturally, when you are over-admitting, it is going to affect the quality of education. Imagine when you use a facility meant to train 10 doctors for 50 doctors!' he said.On the suggestion of poor communication by the MDCN, the medical schools, the GMC and the public, the NMA President said: 'Council made it public and formally informed associate countries. But most of the institutions have actually defied the council. But some of the institutions were doing the right thing.'If you want to run a system well, there should be continuity. The MDCN is to ensure discipline in the medical practice and training. But when you have this kind of break because of dissolution of the board, you cannot do it because the other people involved in the council do not have the mandate. So, you have a backlog of problems to be solved. So, there is a major systemic problem here.'But according to the University of Port Harcourt, the GMC guidelines do not question the quality of its medicalgraduates and intellectual integrity of its teachers.The Vice Chancellor, Prof. Joseph Ajienka, told The Guardian that the GMC action was predicated on issues the university once had with the MDCN concerning the over-admission of medical students.According to him, the MDCN permits the admission of only 100 medical students into the university's college of medicine per year. Due to admission pressure, the institution at a point exceeded its quota but has reached an agreement with the council to cut down its intake to conform to its quota.Ajienka said: 'The quality of our teachers and students are not in doubt. The GMC was merely reacting to issues we had with MDCN, which have been resolved. We did not admit medical students this year just to conform to our quota. In the past, we admitted more than 100 medical students, which MDCN allows us. Our academic standard is not in question here.'According to him, scores of medical graduates from the university are practising in the UK and their intellectual integrity has not been questioned. He said that a medical graduate from the university, Sandra Ofili, was ranked the best in the just-concluded West African Fellowship Exams.Ajienka said the university would apply to MDCN to increase its quota to enable it admit more students seeking admission.A Nigerian and Associate Professor of Paediatrics, University of Nevada, United States (U.S.), Echezona Ezeanolue, asked whether the UK's ban could be a reflection of the falling standard of medical education in Nigeria.Ezeanolue, a graduate of the College of Medicine at the University of Nigeria, Nsukka (UNN), said: 'Like a significant number of my classmates, I moved to the United States after graduating from University of Nigeria. I never felt unprepared during both my residency and fellowship training. I felt I had a good clinical experience while acknowledging my deficiencies in medical related technology like Magnetic Resonance Imaging (MRI), Computed Tomography (CT), etc. I felt it would be easy to acquire those skills, which I did. Since I left medical school, most schools in Nigeria now have many of these technologies. So, I kept wondering if Nigerian medical schools are getting better or worse. Are they getting better technologies but losing the basic concept of medicine''I know the UK made this decision after the accreditation of these institutions was suspended by the Nigerian Medical and Dental Council. There appears to have been various reasons for each institution being added to the list, including admitting more students than the institution was accredited for (as the case with UNN). In some cases, it was the inability of the institution to respond in a timely manner to request from the accrediting bodies to address the identified shortfall that landed them on the list.'The GMC in its formal reply to enquiries by the Nigeria Health Watch said: 'The decision to add a number of Nigerian qualifications to our list of qualifications that we do not accept for the purpose of registration was made in the light of information we received from the MDCN. We were advised that the MDCN had suspended the accreditation of those schools.'The decision to add the Nigerian qualifications to our list of those that we do not accept took effect on February 14, 2011. The decision only applies to students who graduated from those medical schools after the MDCN suspended their accreditation.'The GMC is currently considering information from the MDCN, indicating that the medical schools' accreditation has been reinstated. We hope to be in a position to make a further decision regarding the acceptability of these qualifications shortly and subject to receiving responses to any relevant enquiries that we may need to make.'Today, it is estimated that no fewer than 10,000 Nigerian doctors are working in various hospitals across UK, and another over 21,000 in the United States (U.S.). Thousands of Nigerian doctors fill the campuses of U.S. and British medical schools; engaged in clinical work, teaching, and research. The vast majority are highly respected for their intellect and hard work.It all began in the 1950s when University College Hospital (UCH), Ibadan, began training doctors, as a campus of the University of London. Nigeria has been known for producing very knowledgeable and highly competent doctors.
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