The West Africa College of Physicians concluded the
second diet of exams recently. The faculty of psychiatry
declared a pass rate of 13.8% at its part one membership
exams (8 of 58 candidates). The faculty of public and
community health recorded a 32% pass rate (23 of 70
candidates)

Twice every year, candidates from all over the country
converge in Ibadan and Lagos for the West Africa College
of Physician and National Post Graduate Medical College
exams respectively, each diet of examinations consisting
of written, objective structured clinical exams, picture tests
and oral/long case exams as the case may be. It is usually
a very grueling and trying time for any candidate with
psychological, emotional, financial and sometimes
physical consequences.

A minimum of N60,000 is paid for each exam attended
without consideration of transportation, feeding, and other
ancillary expenses incurred. It is funded by the candidate
after an initial one time sponsorship by the training
hospital.

A candidate may repeat the exams as many as seven (7)
times. There are records of up to 10 times and over at one
stage. Usually, candidates do not scale the first stage, and
even then, meeting hurdles in each subsequent stages of
the OSCE, Picture test and long case stages. Each must be
passed independently, usually under stifling time
constraints.

It is pertinent to shed some light on the long case
examination, already phased out by certain faculties of the
college owing to its largely subjective nature. A candidate
is assigned a patient for the purposes of the exam, and is
to conduct an interview, physical examination and
prescribe a course of management under harrowing time
conditions. The candidate is to make an oral submission
of his findings to two or more examiners who are usually
less than dispassionate in their assessments. Mark you,
less than 10% of these examiners have any degree in
education, evaluation, assessing or any pedagogic training
for that matter.

It is under this long case that a lot of examiners excise
their “pound of flesh” as a candidate may be faulted in
practically any and everything! Thus, a candidate who
manages to scale through the first, second and third
stages, is truncated at the last stage by an examiner who
chooses to sleep during proceedings!

A lot of candidates have been maimed as a result of the
activities of these colleges with the active connivance of
some training hospitals. Failing to pass these exams, a
doctor is unable to make any professional advancement;
he is stuck and sooner or later shown the way out of the
residency program with no lifeline. He is unemployable as
a specialist, and cannot proceed as a general practitioner.
Medicine is touted to be an apprenticeship; so, if a
candidate has to repeat a particular exam so many times,
has he been properly mentored? Small wonder the high
morbidity and mortality rates; the capital flight in medical
tourism and the total loss of faith in the healthcare system.
Such candidates who are frustrated out of the system for
their inability to scales these exams, where do they go?
Where do they start from with families and other
dependants? What about the psychological toll on him?
Something to which he has committed a lifetime of effort
and suffered untold deprivation?

A number of questions beg for answers;
Does this “high” standard that candidates are held up to
translate to favorable health indices for the country-
reduced morbidity, mortality and medical tourism to India
and other nations? Capital flight? Is the nation any better
off from the efforts of the Postgraduate medical college?
What does a failure rate of 87% connote? The trainers are
not doing their jobs? The trainers do not understand what
is required of them? That candidates are so dull? Or is it
simply a case of unregulated and misguided leadership?
What role does national interest play in the determination
of proceedings, procedures, modus operandi and outcomes of the college? The national postgraduate medical college of Nigeria prides itself in having produced 4,000 plus specialists in over 30 years of existence and in a country of about 160 million people. Whose interest do they really serve?

What is the role of international best practice in the
regulation of the colleges? Any peer review mechanism?
Any validity and reliability studies on the mechanisms of
these colleges? Should each region or state not regulate its own postgraduate education, require and needs? Who oversees the activities of these colleges?

It is high time the House committee on health, the federal
ministry of health, policy makers and other interest groups
gave some scrutiny into the workings of these colleges in
the interest of all stake holders, and the nation as a whole
bearing in mind the various ramifications, dimensions and
implications of the activity of these colleges on all and
sundry.

It is no longer acceptable that things remain the
way they’ve always been. Indeed, the mark of humanity is
the ability to adapt; to evolve; to meet challenges and
peculiarities of the day, a peculiarity that once again
challenges our resourcefulness.
• Timi Babatunde MD
Lagos.

http://thenationonlineng.net/true-face-of-postgraduate-medical-training/

How this never reached front page baffles me. lalasticlala and others na wa for you. You populate front page with snakes and tiwa savage stories and ignore important ones like this.

Rssidency programme is usually very difficult in Nigeria. The good news is that with patience over 95% of doctors who enrol eventually pass out as specialist. After the Part one, accepting your proposal is another challenge which would be followed with the dissertation defence
They should try to standardise entry into the programme so that everybody has a fair chance of entering. It will be fair if people are posted straight after the Primary Exams without a "post UTME". The topics for dissertation should not be recycled. There is need to introduce newer studies yearly