Dear Nigerian Doctor

Dear Young Doctor,

I write to you not as a doctor but as a friend. I know a lot is going through your mind in recent times. You recently finished your youth service and suddenly you were jeered to the reality of a profession you started getting acquainted with just over a year ago. You had feared during your medical training that you might not practise. You were either coerced to study medicine by your parents or, if you were like me, for fantasy and social prestige.

You had barely entered clinical years than your resentment towards taking up the stethoscope after graduation began. At the first sight of blood in the theatre, you almost fainted. The feeling didn’t go away during your rotations in the emergency room. You dreaded it and did not look forward to it. You knew you were very swift in solving Physics and Mathematics. In fact Mat 102 and PHS 102 were straight As for you. But this medicine looks boring to you, like garbage in garbage out. You think better in spatial terms, you like the flexibility and creativity of architecture and design. At some point you have even written and tweaked around computer programs. In short, this medicine isn’t what you like.

On the other hand, you saw countless patients that should not have died were there necessary facilities and infrastructures in place that were either not available at all or were grossly dysfunctional. You could not bear to imagine that some essential drugs, blood products, imaging equipment were not available at the most dire times (or even at all). This was in sharp contrast to what you watched on Grey’s Anatomy and House where basic things were not luxury. You cried quietly in your hostel on the day that child with cancer died because you knew she could have lived longer had there been funding to care for innocent toddlers with such debilitating illness. You have read many stories of children in the western world who beat that same type of cancer or at least didn’t go down so fast. In fact you heard there is a Cancer fund in the U.K. Same feeling you had when you heard that that man with incurable kidney disease died so soon because he couldn’t get an urgent dialysis. He had sold his properties since last year when he began maintenance dialysis. And you wondered what public health and governance is all about. “Where is humanity in the government?” You asked. You cringed.

You have been taught medicine in this 21st century in oven-hot lecture halls where you and your lecturers dabbed sweat away like flood from your brows. You saw doctors and nurses helplessly but dutifully doing procedures in low-lit condition and, sometimes, in utter darkness. You were taught in the process that you have to “improvise”. Your professional examination was done inside a hall where you wrote your answers with one hand, and used the other to fan yourself with your question paper. But you made it through. You were told that regardless of the condition, you are bound by your oath to treat. You wondered if you were ready for that.

Housemanship was not any better. You were not disappointed. You have seen an operation, which your unit superiors harassed you to a sleepless night just to ensure complete pre-op work up and cross-matched blood, cancelled for lack of power supply or theatre space. You’ve seen a case that your teacher told you that should not stay for more than 24 hours still awaiting your teacher-turned-boss’s intervention on the fourth day for absolutely no fault of his. You wrote a drug for your patient and she couldn’t get it in your hospital’s big pharmacy. Or at other times an emergency drug was just not available. Your one year training was interrupted many times by industrial strikes for no reasons other than improved pay. You only spent 9 months doing house job if you honestly think about it. You wondered if you’ve gotten the all-round skills you need going out there. Is it going to be better in NYSC?

Yes, it was. You had the hands-on you desired. More liberty to learn on the job. But you were introduced to something new. The Nigerian governments and the civil service. Salary and allowances. Delays, denials and broken promises. You are still being owed 6 months’ salary four months after your service year. Now you are looking for job. Locum at least. You have had ridiculously bizarre offers; N60,000 per month. You were embarrassed, shocked, depressed. “After 8 years of my life!” You yelled in your room. Divinity heard and smiled on you and you landed a good paying job on the Island for N160k. Now you think you should go for your residency. But you don’t want endless strikes. You don’t want to work your career in grossly inadequate and frustrating conditions. You don’t want peanuts at the end of the month because you have thought of how much you can possibly get in your first two years of residency. Your girlfriend of three years subtly pesters you for marriage. You are going to leave your one-room apartment for a decent flat. You want a good car that competes with your established friends in the IT and Oil and Gas sectors. You will write primaries with a month’s salary. But you remember your senior registrar-turned-consultant asking you to link him up with a VIP to get a job after one year being jobless. You marveled that there was job scarcity for fellows too.

Then you look up to overseas. Three of your classmates have gone abroad, one in U.K already practising, another in U.S waiting to match, the last just joined the train to Saudi Arabia.  They told you of better remuneration, better commitment to health policies and better training, practice and service delivery. Yes, that’s it! You exclaimed. I’m leaving the country. Or you thought, let me drop the stethoscope. I’d face my photography business squarely. You know some senior colleagues who are now into Fashion Designing, Church ministry, Arts and Oil& Gas and are doing exceedingly well. Yet again you have a mentor who constantly persuades you to be optimistic, that it’s not that bad here, that there are lots of opportunities in medicine all around that she is enjoying and she is not regretting a bit practicing in Nigeria. She encourages you to write Primaries that she will follow up and help your progress. Hmmn.

Dear young doctor, your present predicament is not peculiar to you. Such is the internal conflict found in many members of this noble profession. I understand your plight, uncertainty, and fears. You are not alone. The future is here and it is in your hands. Make no mistake. Nigeria is rich. A very fertile ground for great ROI. There is abundance of opportunities when you are pulled up or you push. If this career has become your passion, follow it. If you believe you need greener pastures abroad to fulfil your ambitions, please find it. Choose with your eyes open. If this is really not your thing, then explore your gifts and abilities in other sectors. Go with your heart. Shut out the voices of emotional sentiments or family’s familiarity. You owe nobody any apology. Because no one will share your regrets. Choose which way you wish my friend. Your current profession is noble but it is not you. Look yourself in the mirror. Feel free my friend. You are not caged in yet. Until you do that yourself. Take the risks with the future in mind. Don’t live people’s expectation or dreams. Live your dream.

With love,

@bamsky007