The attention of the Management of the National Postgraduate Medical College of Nigeria has been drawn to unnecessary altercations that have recently evolved with regard to the issue of the relativity of Postgraduate Fellowships in Medicine and Dentistry vis-à-vis Ph.D in the Nigerian University System. It has therefore become imperative for the College to make some clarification as the organ of the Federal Government of Nigeria that awards the Fellowships in Clinical Medicine and Dentistry in line with international best practices.
The National Postgraduate Medical College was established by Law, (Decree 67 of 1979), now Cap. N59 Laws of the Federation of Nigeria 2004, as a body corporate with perpetual succession and a common seal. The Law gave the College the responsibility to conduct postgraduate examinations of “candidates in the various specialized branches of medicine, surgery, obstetrics and gynaecology and dental surgery and making awards in relation thereto accordingly”. Section 7 of the Law gave the Senate of the College the responsibility for running the academic affairs of the College including “(b) the Award of degrees, diplomas and such other qualifications as may be prescribed in connection with examinations held as aforesaid”
Based on this Law, as the body at the Apex of Medical Education in Nigeria, the College has been functioning over the last 36 years to produce specialists in all branches of Medicine and Dentistry. This has been done through the organization of the curricula for professional postgraduate education in the various specialized branches of medicine and dentistry; and the conduct of professional postgraduate examination of candidates leading to the Award of the FELLOWSHIP as the terminal Academic and Professional qualification.
It is a trite knowledge that Medicine is as much of Science as an Art. Medicine is the discipline of using science-based skills to solve human health problems. All over the world, Medical schools are divided into at least 2 components: basic medical sciences and clinical sciences. In Nigeria, as in other parts of the world, the topmost postgraduate qualification recognised for clinical sciences is the Fellowship while for the Core Basic Medical Sciences (Anatomy, Biochemistry and Physiology), it is the Ph.D. that is recognized to get to the peak of their careers. The uniqueness of the Fellowship training of the College is the fact that it combines the full academic and research content as obtainable in any sound doctoral degree with structured clinical (professional) postgraduate training. This accounts for why it takes a long time to produce a single Fellow in any of the specialized branches of Medicine and Dentistry. It is to be noted that the competency-based curriculum for the Fellowship Residency programme has been designed to train postgraduate specialists and clinical lecturers over a minimum of 6 years with definite competencies in the four areas of professional practice: clinical problem solving, research, teaching and Health Resources Management.
Towards the FELLOWSHIP certification, there are 3 layers of the evaluation process viz: PRIMARY, PART I FELLOWSHIP and PART II (FINAL) FELLOWSHIP. The basic medical degree (MB, BS) and dental degree (BDS) after 600 Level courses in the University are equivalent to special Masters Degrees and holders are often appointed as Assistant lecturers in the basic medical sciences. Such registered medical and dental practitioners are eligible to sit for the PRIMARY FELLOWSHIP which is the Postgraduate Examination after Internship. Only those who have been successful can enroll in an accredited Tertiary Institution for the Residency Training Programme. The Junior Residency programme spans a period of a minimum of between 24 to 36 Months (depending on discipline) for rotations consisting of at least 100 Course credit Units of Lectures/Seminars and over 180 credit Units of practical/clinical skills acquisitions. Eligible candidates can then proceed to sit for the PART I FELLOWSHIP examinations. Those who are successful can enroll for the Senior Residency programme which is a full time endeavor for 30 to 48 Months after Part I.
The Senior Resident is expected to register the research topic for his Dissertation and submit a detailed proposal on the justification for the research topic and the methodology to be used. Formative assessment is carried out and if successful he would continue with the research. Concurrently, he will continue with academic programmes consisting of Lectures/Seminars of over 120 Course Credit Units and 200 Credit Units of Clinical/Practical skills acquisition for which Log-books must be signed per event. After a minimum of 36 months, eligible candidate can now apply for the PART II (FELLOWSHIP) examinations which are divided into TWO components. The successful defence of dissertation as adjudged by external examiners (in the absence of the supervisors) earns the candidate a PASS in this part which is equivalent to a successful defence of Ph. D Theses. Thereafter the candidate will be examined through written, clinical and oral evaluation to be adjudged by at least TWO External Examiners (who are not his trainers) as being fit to be a Specialist. The Fellowship is thereafter awarded to successful candidates. The evaluation process is carried out objectively, mostly by Professors in the Universities, and devoid of interference by the supervisors/trainers. It follows therefore that the FELLOWSHIP is like a post-doctoral degree as it has satisfied more than all essential requirements for the award of a Doctor of Philosophy (Ph. D) in any discipline apart from the accompanying professional training.
It must be on this basis that the National Universities Commission (NUC) itself had, since 1989 when it issued its first Benchmark Minimum Academic Standards (BMAS) for Medicine and Dentistry, been stipulating that persons with Fellowships are appointable as Lecturer I in Clinical Sciences while those with Ph. D are appointable only as Lecturer II in the Basic Sciences. Holders of Ph.D can only become Lecturer I after 3 Years Teaching experience in a University or similar Institution. Any Clinician that has only a Ph. D as his only postgraduate attainment is not appointable as a Consultant and cannot have patients under his care. The possession of a Fellowship is thus a sine qua non for the appointment of anyone as a Consultant and Clinical Lecturer. The National Postgraduate Medical College of Nigeria is therefore the only Federal Government Agency that has the capacity and the capability to certify specialists that will train other medical and dental doctors to Professorial level.
It is hoped that those who have been perpetuating the unnecessary controversy will be better educated by these clarifications according to the Law and international best practices.
Professor O. A. Atoyebi, FMCS
30th September 2015