By Dr. Umunnakwe
Aspiring to become a physician (Medical Doctor) is most times conceived within one’s inner self. This is borne out of a determined interest in choosing a life career and future life fulfillment. Even though, most times, individuals choose career based on peer group, family and largely environmental influence, the bottom line is that the choice and pursuit of future dreams lie in your hands.
Pursuing a medical career in life may be easy by abilities but tasking along the way to successful attainment of the goal. It is one of the most prestigious professions in the world yet demanding even after qualification. This you shall get to realize as you read on. The bedrock of any profession still intimately lies on the foundation, sequential growth and eventual solid grooming to become a fully backed career person.
As a medical doctor or aspiring physician, the basic foundation from the basic (primary education) cannot be over emphasized. As it is known, medicine is an interactive profession that requires communication skills, good grasp of language (particularly the linqua franca), visual skills and utmost power of observation. So, the basis is starting from primary Igbo, Hausa, Yoruba, French and off course English Language as the best master. This is so because certain countries have ways of studying with their common language (lingua franca) and understanding of the subject matter. Also, for the basics which include Elementary Science which takes you through to the further to acquiring some knowledge of physics, biology, chemistry, mathematics and further mathematics.
Having gotten into a secondary/High school education, a pupil is set to under study at the junior secondary school level where general subjects for all students include integrated science (that consists of basics in animal biology, chemistry, physics, agricultural science, etc.). It is also important to stress the fact that other subjects include introductory technology, history, rudiments of government etc. This prepares the students for choice of career with the help of the guidance counselor attached to each class or group of students.
As soon as students get through the junior secondary school (JSS) level, the stage is set for students to approach the next step which is the senior secondary school (SSS) level. This stage now stratifies students into science, commercial and Arts classes according to the choice of students and of course most times influence of parents, with the inputs of the counselors. To get straight to the meat of this write up that involves medicine as a career, a science student interested in medical profession has task of understanding the basic science courses viz: physics, chemistry, biology with English language and mathematics. This is studied for a period of 3 years vigorously in preparation for a general/globally organized senior school certificate examination (SSCE).
West African Examination Council (WAEC) and National Examination Council (NECO) are the known bodies overseeing the conduct and certification of these exams for candidates that are deemed fit for such.
At least, a credit is required from the basic science subjects listed above including English Language and Mathematics. It is imperative to note here that the Joint Admission and Matriculation Board (JAMB) of Nigeria conducts the ultimate Unified Tertiary Matriculation Examination (UTME) and of course with the present grading system of candidates since the abolition of the statutory Post UTME which was controlled by various Universities in Nigeria, each candidate must have good graded results both at the WAEC or/and NECO level and JAMB level before such candidate could be thinking of merit admission. Different universities have their different cut off points for intake of student willing to study medicine and surgery in any of the universities. So it is important for all candidates to have a good grasp of the above listed basic subjects.
Then the journey begins as the student gets into Medical school of various Universities offering the course of Medicine and Surgery. These various institutions have different but similar Medical curriculum of which allows all medical students and Doctors to understand, and invariably speak the same language of medicine. Apart from the first-year rudimentary general study of English language, Mathematics, Computer Science, advanced basic Physics, Chemistry and Biology, (different universities may introduce some other courses), the journey into the real Medical training starts from the 2nd to 6th year of deep study into the basics of Medicine. The courses offered at the Pre-Clinical phase (1st half of training) are listed below:
Human Anatomy
Physiology
Medical Biochemistry
Medical Psychology
Basic Pharmacology
Note: The last depends on the curriculum of the institution.
Having gone through the listed above in both theory and practical, the student are hereby set for a professional examination conducted by the university with the help of external body, the Medical and Dental Council of Nigeria as the regulatory organization.
The students having fulfilled the examiners demands both in knowledge and character are then bid to proceed to the clinical (second) phase of their training which takes about another 3 years. This phase exposes the students to live patients in order to learn the rudiments of history taking, signs and symptoms recognition, clinical examinations (both general and systemic physical examination), interpretation together with laboratory investigations and ultimately correct treatment options as regards a particular disease.
The subjects at this stage include;
Pathology which is the understanding of the basics of disease and ailments. This part has four components viz: Anatomic Pathology, Chemical Pathology, Medical Microbiology and Haematology.
Clinical Pharmacology which is the understanding of drugs, their use and adverse effects.
Surgery
Internal Medicine
Obstetrics and Gynaecology – that deals with Pregnancy and pregnancy related ailments. This actually does not exclude males. Male folks can also visit them in cases of infertility, the male factor.
Paediatrics
I will like to bring out the fact that as examinations are taken at the end of the courses by the universities, general professional examination also takes place. At the end of the 5th year, Obstetrics and Gynaecology with Paediatrics examination is taken while at end of the 6th and the final year, Medicine and Surgery examination is taken. All the examinations are conducted both by the schools and sometime by external professional bodies. The candidates are deemed fit to be certified and licensed as Medical Doctors having had overall 75% attendance during study and 50% total score in the examination which comprises 3 parts (Written, Practical/Clinical and Viva Voce which means oral exams/tests) all candidates must have been seen to be good in learning, knowledge and character.
All these steps would ultimately prepare these students to plunge into the Medical field with great enthusiasm but with a greater and tasking medical career ahead. They acquire Bachelor of Medicine and Bachelor of Surgery (MB; BS or MB; ChB) altogether traditionally.
The beginning of the sojourn into the career after induction into Medial Council starts with practice as a Physician under supervision by a senior Doctor for a year. This is called internship (Housemanship). This period offers the young Doctor to practise and sharpen up the skills acquired while in Medical school. At the completion of this important and compulsory one year, the doctor then acquires a full registration and proceeds to serve the nation through National Youth Service Corp as a Medical officer for another one year. At this level of the profession the young Doctor begins to think of ways forward in his/her career. Which either that he/she decides to venture into private practice, Career Medical Officer with government Hospital or decide to be a specialist in the branches of Medicine.
A Medical officer is a doctor who has an NYSC Certificate and can practice as a doctor as licensed by the Medical and Dental Council of Nigeria (MDCN). He or she can however decide to proceed into Residency programme (specialization) in any field of medicine of choice. The fields are listed below:
Internal Medicine
Community Medicine
Family Medicine
Radiology
Pathology
- Anatomic Pathology and Forensic Medicine
- Haematology and Immunology
- Chemical Pathology
- Medical Microbiology
Obsterics and Gynaecology
Paediatrics
Anaesthesia
Surgery
- Paediatric Surgery
- General Surgery
- Orthopaedic Surgery
- Plastic Surgery
- Neurosurgery
- Ear, Nose and Throat Surgery
- Ophthalmology (Eye)
Psychiatry (Mental Health).
Note that many of this specialization has further subspecialist training as the programme advances. The rankings in Medical profession is not totally stereotyped but there is a general progression upward the ladder as highlighted below:
House Officer/Intern – a fresh graduate practicing under the supervision by a more senior Doctor.
Medical Officer – Starting from the time of graduation as a doctor during NYSC till any point in the career without specialization. This group of doctors could rise to the post of Principal Medical Officer (PMO), Permanent Secretary etc. in public service.
Registrar/Junior Resident – This is a doctor (Medical Officer) who have written and passed primary examination in colleges or faculties offering specialist training programme in accredited hospitals.
Senior Registrar – Is a registrar who has written and passed Part 1 fellowship examination in a chosen field and preparing to take a Part 2 fellowship examination.
Consultant – is a Senior Registrar who has written and passed the Part 2 fellowship examination in a chosen field.
These fellowship examinations at all stages of training are regulated by two (2) main colleges in Nigeria viz: West African College of Physicians/and her Surgeon Counterpart and National Postgraduate Medical College of Nigeria. These bodies are similar to other regulatory bodies around the world. For example, Royal College of Surgeon and Physicians in the United Kingdom etc.
At this level the specialist Doctor is referred to as a Consultant who upon several researches can attain the post of a Professor in his/her field.
In conclusion, the Medical career is enviable, honourable and prestigious but above all, tasking. This doesn’t make it hard to be practitioner as several people have ventured into it and have progressed, practised and excelled in all parts of the world. Therefore, core mind determination and diligence is the key word to success in this profession and in life generally.
Finally, my advice is that you just think it, dream it, and sure, you will live it!