₦airaland Forum

Joenz: Phantomm Phantomm,presumably one of the all-knowing drs we have around,well-done o!So tell me,what do you have to say abt a dr requested for FBS @ 2.30 am.the request was sent back to him and he insisted till he appropriately schooled.so how is he gonna make a better consultant than this very Nurse?I dey laff o,try again bro.

A "fast" is usually regarded as 8 hours or more of no meal intake. If a patient had not eaten say since 6pm of the previous day, it is justifiable to tag the blood sugar requested @ 2.30 am as fasting. Instead of condemning d doctor, u should have requested to know why he requested the test as "FBS" and not jump to conclusions. The hospitals usually take fasting blood sugar samples in the morning because it's assumed that the patient's slept over the night and thus went for at least 8 hrs without food. Barring the somogyi/dawn phenomenon

zeezahbee: If you are sure it is tuberculosis ,the recommended dosage for standard unsupervised 6-month treatment is. adult dose rifampicin 1caps daily,isoniazid 1tab daily,pyrazinamide 1tab daily,ethambutol 1tab daily for 2months followed by a 2nd stage continuation phase of rifampicin 1caps daily and isoniazid 1tab daily for 4months. It is important 2 note that it may be harmful if u re nt sure of been an infected TB patient

Pls this is totally wrong on a lot of levels. You shouldn't prescribe drugs online most especially anti-TB drugs. Not with the increase in multi-drug resistant TB and extreme drug-resistant TB cases which mostly developed due to poor drug adherence. I'm even sure your regulatory body will be against this. Do u realise that in hospitals a patient is counselled extensively on drug adherence, amongst others, before any attempt on starting the treatment is commenced? What about possible co-infections that are commonplace with TB patients (as a pharmacist u will know d particular one I'm talking about). Doing this trivialises the Health profession, in addition to being totally wrong. What you should tell the person is to go to a hospital for proper evaluation, counselling and treatment

thewarrior72: The should rather implement the ban W.H.O put on the treatment of malaria cases with artemether

W.H.O banned arthemeter used alone. The current treatment of malaria is ACT (artemisinin-based combination therapy) which includes arthemeter/artesunate/dihydroartemisin PLUS A SECOND DRUG. I'm pointing this out cos arthemeter is still being used but in combination with another drug like lumefantrine, etc.

Danhumprey: I wonder o! But wetin the rest of them turned into?

Withdraw or change programme

YourHealthlabs: It happened, it's on record that FMC ARDs owerri docs are the most notorious physicians. Go find out why Soldiers invaded that hospital and beat up everybody in wardcoat and lab coats.

The only photocopy center there(they call it Doctors photocopy center) in that hospital does not offer services to non-doctors including patients. Only doctors are allowed to do photocopy there.

Infact Patients' relatives have to enter Keke napep to warehouse bus stop about 20mins(with go-slow) from there to go do photocopy and documentations before they can be attended to.
This is a first hand experience. Not 'dem say'.

I 'm sorry i don't empathize with FMC-owerri docs whenever they complain about salaries, Docs there are dreadful.

Some teaching hospitals or FMCs usually have a policy that no commercial/business center be in the hospital environment except a canteen. if the resident doctors in their own lounge decided to establish a computer centre to make things easy for it members, u should not begrudge them.
And FMC Owerri isn't the only hospital that does that. In NAUTH, Nnewi there is no single business center inside the hospital premises except the canteen. The only "luck" there is that just outside the hospital gate, there r a lot of business centers

sigmundfreud: Now that's barbaric and inhumane! When did doctors become touts?!

Don't be taken with the over-sensationalised statement. What usually happens during doctors' strikes is this : the doctors will inform the patients about the coming strike so that the patients would be aware that they will not be seen by doctors during the strike. The patients r given the option of staying or leaving during this period. Most patients opt to leave to private hospitals. The doctor then discharges the patient. Note- a patient can only leave the hospital when discharged formally by the doctor, so even when the patient opts to leave the hospital, the doctor will have to formally discharge him. The patient is told to make this decision because since only doctors can formally discharge a patient, a patient who decides to stay back can't change his mind during the strike because then there will be no doctor to discharge him and an attempt to leave the hospital would be stopped by the security. The JOHESU members would then sensationalise that act to mean that the doctors "chased" away patients. All this in a bid to score cheap points and garner public sympathy. I hope this explanation is ok.
P.s- patients can also leave the hospital without a doctors's discharge by DAMA (discharge against medical advice) but this has some adverse consequences with the patient and the hospital

Hopez456: I am one if those eagerly awaiting the call off of this strike, I am seriously sick. I am scared of self medication.

Pls don't joke with your health. U can visit a good private hospital before things get out of hand

YourHealthlabs: Nobody feels threatened, you are the one who keeps showing anger, i put people like you in your place.

"Residency positions
If Questa had been trained in the United States, he likely would have been accepted for a residency position. Among doctors who went to medical school in the US, nearly 95 percent of those who apply for residencies get one". source--->

http://www.pri.org/stories/2011-04-14/foreign-trained-doctors-kept-out-practice-us

Now where does that leave the remaining "5%"?

It seems u have some difficulty understanding standing statistics. 95% of U.S- trained medical doctors can get a residency slot but there may still be enough residency slots left (after taking the 95 percent US doctors) to accommodate say 80 percent of IMGS. The remaining 5 percent US doctors that couldn't get a residency slot have nothing to do with the actual total number of residency slots available. They are mutually exclusive.
Also, remember that a higher number of US doctors getting residency slots may be purely a policy thing giving a particular quota to citizens to avoid immigrants taking over such a sensitive profession

Omonoba1: you seem to misunderstand me..i have never and will never support consultancy position for nurses et others cos i too wud be a consultant in the nearest future and wouldn't want competition from JOHESU..infact if you go through my post, i tagged it overambitiousness..my post was directed towards that guy who was using this thread as an avenue to show off his arrogancy and rubbish other's profession...in any case, i have gone through the link and it was a good read..thanks!

U re welcome
Sori for the misunderstanding

Omonoba1: well done,, now among the outline, can you point at one part that the doctors have indepth knowledge of?? anatomy, physiology and Medical bch are borrowed courses..path and pharm is also borrowed..or wud you say d doctor has as much knowledge as those who spent yrs studying these courses?? obstr and gyn et others that you listed are also not indepth cos if they were, then the concept of residency becomes fallacy..it readily brings to mind the saying; jack of all trade...what do you think?
.
P.s--just wanna learn from you, so lets do it in a mature way..

P.s- I'm just quoting the original post for continuity.

From the above links I put in my previous posts, the following deductions can be made:
1) USA, the country we seek to copy from' is a capitalist nation that tries to get the highest profit/productivity at the lowest cost.
2) the Nurse practitioners/ consultants were created in the USA because of non-availabilty of medical doctors in some areas and also the apparently "cheaper" cost of using the Nurse practitioners/consultants compared with medical doctors.
3) these consulting nurses ONLY work in primary care settings/ areas where there is no medical doctor. Should they work with doctors in the same hospital, they are usually under supervision by the doctor. It can be inferred from here that a medical consultant and an INDEPENDENT consulting nurse CANNOT be found in the same hospital.
4) come back to Nigeria, the health professionals agitating for consultant positions are found in teaching hospitals, federal medical centres, government hospitals,etc. These hospital already have enough medical doctors and consultants.
5) if we are to transfer what is being practised in USA to Nigeria, it should be done properly and not just the parts that are favourable to other health professionals.
As such, other health professionals should be consultants only in health institutions where no doctors are available. We have a lot of these in Nigeria ranging from primary health centres, motherless babies homes, secondary schools, old people's homes..etc. On priciple, they should not be made consultants and remain in teaching hospitals with medical doctors and consulatnts but no, They want to be made consultants in teaching hospitals.
What would be the effect of these? The patients would be exposed to conflicting management. The pharm consultant or nurse consultant may just oppose the management protocol of a medical doctor simply as a show of power just to impress on the medical doctor that he has authority over the patient also. Is this what you want to happen to our already staggering health system?

Omonoba1: well done,, now among the outline, can you point at one part that the doctors have indepth knowledge of?? anatomy, physiology and Medical bch are borrowed courses..path and pharm is also borrowed..or wud you say d doctor has as much knowledge as those who spent yrs studying these courses?? obstr and gyn et others that you listed are also not indepth cos if they were, then the concept of residency becomes fallacy..it readily brings to mind the saying; jack of all trade...what do you think?
.
P.s--just wanna learn from you, so lets do it in a mature way..

Additional links on the subject matter:


http://mobile.nytimes.com/2014/04/30/opinion/nurses-are-not-doctors.html?referrer=

Sorry this is the correct link:

http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=all&_r=0

Omonoba1: well done,, now among the outline, can you point at one part that the doctors have indepth knowledge of?? anatomy, physiology and Medical bch are borrowed courses..path and pharm is also borrowed..or wud you say d doctor has as much knowledge as those who spent yrs studying these courses?? obstr and gyn et others that you listed are also not indepth cos if they were, then the concept of residency becomes fallacy..it readily brings to mind the saying; jack of all trade...what do you think?
.
P.s--just wanna learn from you, so lets do it in a mature way..

For the anatomy, physiology, biochemistry; I earlier said they learn everything needed in years 2 and 3. Even in some schools, to make it easier for the school mgt, they r required to join the students of these respective courses during their lectures so that there won't be need to duplicate these courses for only medical students. U may want to know how possible this is; a biochem student may have 2 courses on a particular day and the rest of the day is free period. On the free period of the biochem sudent, the anatomy students have their own course and were free during the biochem lectures and so on. The medical student would have no free period cos he/she would have to sit through all the courses. At the end of the day, he has learnt what the biochem, anatomy and physiology student did.
Next- pharmacology is just an aspect of pharmacy. In pharmacology, each drug/class of drugs is learnt under the following headings (disease; class; pharmacodynamics; pharmacokinetics; dosing; side effects; interactions; uses..etc(this is not exhaustive). What is learnt in pharmacology is actually enough for clinical practice in a hospital setting. There are other aspects of pharmacy involving drug compounding/production, monitoring..etc. These aspects do not concern the doctor in direct care of his patient so they don't learn about it. If they did, there will be no need for pharmacists. Same goes for lab medicine.
In the remaining courses (obs/gynae, paeds, medicine, surgery, etc) these courses are so broad and vast that if the medical student was to learn every single thing about it, then med school would extend close to 12 yrs or more. They are taught what is necessary to make them a fully rounded general practitioner. But there is still more to these courses which cannot be handled in its full depth by just one "head". So after MBBS, they then choose one specific field/specialty and spend 5-8 yrs post graduate period(residency) studying this specific area after which they become specialists/consultants. That is why a general practitioner/primary care physician can treat some ailments but if the ailment requires more, he then refers the patient to a specialist/consultant of the field in which that disease falls into. A general prac. Will treat hypertension but if he see a hypertensive patient who has developed a complication of renal failure and needs a kidney transplant, then the patient is referred to a urology/nephrology consultant(whose specialty is the kidneys and urinary system). At this point, I want to point out that it's the consultants mostly that are against the other health professionals being named consultants. Note that some of these health professional just rose through the ranks through normal civil service 3 yearly promotion without any further postgraduate learning/training. When @ level 15, these health professionals ask to be made consultants. Now ask yourself, how you wud react if you were a med doctor who went thru vigorous undergrad and even more cut-throat post graduate residency to become a consultant. That is what is happening. And this resistance by med doctors is not happening in Nigeria alone. This is also a problem happening in the USA from which other health professionals claim they want to copy these practices from. The link is below:


http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=all&_r=0

Omonoba1: umm! calm down before you develop myocardial infarction..can you pls write out the course outline for a medical student from yr 2 to 6 for me??

Yes I can do that.
Year 1- A-level science courses +general studies courses (these courses are offered by everyone)
Year 2 and 3 - (a)anatomy (gross anatomy, histology, embryology of all body systems); (b)physiology (all body systems); (c)biochemistry (topics are many so won't bother listing them here)
Year 4- (a)pharmacology and (b)laboratory medicine/histopathology/morbid anatomy (comprised of pathology, haematology, microbiology, chemical pathology)
Year 5 - a) obstetrics and gynaecology
(b) paediatrics.
Year 6- (a) internal Medicine (b) surgery. (c) community medicine (d) family medicine.
Note- the year 5 and 6 courses are done ONLY by medical Doctors. Also note that from year 4 (beginning of clinical classes) they start bits of medicine and surgery (final year courses) in addition to the normal courses offered in those years. The reason is that medicine and surgery are so broad that it cannot be handled in final year alone so it's started earlier even though it's actually a final year course.

Omonoba1: seriously, i have been following your post and they all depict arrogancy...from the previous thread till now, you tend to stress the superiority of doctors.. people like you end up spending abnormal years in medical school because you are freaky too proud...if every one should write jamb again for MBBS/BDS, who will you work with?? dont forget that a Doctor simply have little knowledge of everything in the body but does not have full comprehensive knowledge about anything in the body..

Your statement is a complete show of ignorance. Doctors learn about the human body in-depth and extensively. In addition, they learn bits of the other health professionals' courses. Why do u think Doctors' claim that they are indispensable in the health sector? That "pride" must have been backed with a firm standing and not just empty noise. FYI, it's the other health professionals that learn only bits about the human body (bits just necessary for them to understand their course). In years 2 and 3 in university, medical students attend ALL the courses offered by anatomy, biochemistry and physiology before their 1st professional exams. Other health professionals usually offer only selected topics in the above courses in 1st semester year 2 and at most an additional few topics in 2nd semester year 2.
A medical doctor, after learning that extensively about the human body, will after graduation go into a post graduate residency program. Here, the medical Doctor now chooses a particular specialty(body system) and learns even more in-depth on that particular system in the body, so that by the time the med Doctor is through with residency, he/she knows EVERYTHING in every knowledge bank about the system he specialised in.

When JOHESU thinks that NMA is selfish and bossy..read the following article below. The Medical Doctors vs other health professionals fight is also happening even in d USA and the Doctors there are fighting back as bitterly as is happening in Nigeria. Link below

http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=all&_r=0

aztruth: I had a privilege of knowing two nurses who own big hospitals (medicare centres) and I also met the Doctors who worked for them.
Initially I was taken aback and wondered why. I for one don't think I can do that if i were a Doctor but that is the reality.

secondly it may amaze you to know that majority of patients in nigeria don't get treated by medical doctors
the number of patients that are treated by nurses in their homes are even moře than the ones that visit Hospitals. That's why pharmaceutical companies have special promotion programmes for nurses. I can tell you that pharmaceutical companies make more sales in nurses meetings than Doctors meeting. A friend who was selling for one of those companies once said Doctors are poor they do not have money to buy drugs. Little wonder , they want government to end their poverty

Only a medical Doctor/ group of medical Doctors or a Government can open and register a hospital legitimately anywhere in the world. If u ever find a hospital "owned" by a nurse or any other person apart from a medical Doctor, it could be one of the following possibilities:
1) the hospital is actually registered in the name of a medical Doctor who happened to place a trusted person (nurse/ other persons) in administrative charge because he, the medical Doctor, cannot be around to head the hospital. In this case, any legal proceedings involving the hospital is directed at the medical Doctor in whose name the hospital is registered and not the administrator (nurse, etc)
2) the hospital may actually be an illegal "quack house" operating surreptitiously without the knowledge of regulating bodies. This is usually found in rural areas/ remote areas because it would be more unlikely for the regulating bodies to discover them.

The Pharm D proponents claim that it's an undergraduate programme in the USA but it isn't. In USA, Pharm D is a postgraduate programme. Here's the link:
http://en.m.wikipedia.org/wiki/Doctor_of_Pharmacy

There it is clearly stated that Pharm D is a postgraduate program. The few US universities offering an undergraduate Pharm D program are querried about the adequacy of training of undergrads to be accorded the Pharm D. I think the Pharm D program should be a postgraduate one if it's to be relevant in Nigeria. The more I research about this, the more I see that stakeholders trying to force an undergrad Pharm D program in Nigeria are more concerned about acquiring "bragging" rights than actually gaining the knowledge and experience required for holding the Pharm D title

zeezahbee: Get your info right, we do pharmaceutical microbiology so pathology comes in.

Medical students do a course called pathology/ lab medicine. This course includes: haematology, medical microbiology, chemical pathology and pathology
Microbiology is not Pathology and vice versa

ACM10: The catchword there is NITTY-GRITTY. Even Physiotherapists/Nurses/Radiographers do study these courses too, but not in details. Does pharmacy students do practicals with cadaver? I mean dissecting cadaver region by region. It is only Anatomy/MedSurg students that does it.

Moreover, how can you treat a patient without the knowledge of the PATHOLOGY behind the disease. Don't you think that this defiency in knowledge can make a difference between life and death?

I wish I could give this post 1000 likes

A clinical residency programme (as is to be found in the last year of Pharm D programme) usually involves a close contact with patients with a sense of responsibility. IMO that cannot be found in a student. Will students take night calls to care for the patients? Would students be available for patient care 24hrs a day (even in shifts)? I think not. Even medical students can't have adequate contact with patients during their training because they have lectures, studying/ reading to attend to. That is why the residency programme of medical Doctors is a postgraduate programme involving working (both supervised and unsupervised) and training/ learning before a medical Doctor can call himself/herself a specialist/consultant. I would like to ask the Pharmacists and even the general public what their reaction would be if medical Doctors decided to increase Medicine and Surgery undergraduate programme from 6yrs to 9/10yrs claiming that the additional 3 or 4yrs is clinical residency after which the fresh graduate would be regarded as a specialist/consultant? Won't there be indignation and fear at being treated by such "specialists"? The Pharm D programme should be a postgraduate clinical residency done in hospitals under the College of Pharmacy certification. There, the Pharmacist is in close working relationship with patients alongside learning. It should not be crashed into the undergraduate programme where students don't have a binding responsibility to patients.
I would also like to note that when u compare what is being done in developed countries like USA, it would be good to read about what the professional medical associations in those countries say about whatever programme they run. One statement that the medical bodies in most countries usually say is paraphrased " any programme should be directed by the needs and situation in that particular country." on that note I would state that "transplanting" degrees/programmes to Nigeria on the basis that it is what obtains in developed countries should not be encouraged because the situation in Nigeria isn't the same with those other countries. Anything done in Nigeria should be relevant to the contry's situation and not just because it is done in developed countries.