18th ASCAF Treasure Base 2024 Communique

Communique of the 18^th Annual Scientific Conference and All Fellows’ Congress (ASCAF Treasure Base 2024) Held from September 15^th to 21^st 2024 at the Obi Wali International Conference Center, Port Harcourt, Rivers State, Nigeria.

BACKGROUND
The National Postgraduate Medical College of Nigeria (NPMCN) was established by CAP No. 59 LFN, to provide postgraduate medical education in Nigeria. It has since inception produced over 8,408 Medical and Dental Specialists, thus saving the country billions of dollars on postgraduate medical training abroad.
The fellows of NPMCN hold strategic positions in Nigeria and abroad, in public and private sectors, as Medical and Dental Consultants in hospitals and Health Maintenance Organizations, as lecturers in medical schools, and as research scientists in health research institutions.
The 18^th Annual Scientific Conference and All Fellows Congress (ASCAF) tagged Treasure Base 2024, organized by the National Postgraduate Medical College of Nigeria (NPMCN) in conjunction with the Postgraduate Medical College Fellows Association (PMCFA) took place at the Obi Wali International Conference Center, Port Harcourt, Rivers State from Sunday 15^th to Saturday 21^st September, 2024.
The theme of the conference was “Medical Education, Research and Practice: Pushing the Frontiers Amidst Brain Drain, while the sub-themes included Advances in Medical Specialties and Sub-specialties: learning from experience; and Leadership and healthcare: Politics, Policies and Practice. The conference is a unique one because the 42^nd convocation ceremony of the College was incorporated into it.
The Conference started with a courtesy visit to the ASCAF 2024 Elder and Former Governor of Rivers State Sir (Dr). Peter Odili, GSSRS, CON, and the Chief Medical Director of the Rivers State University Teaching Hospital, Prof. Chizindu Alikor on Monday 16^th September 2024 by the principal officers of the College led by the College President, Dr Peter Ebeigbe, MD, FMCOG, PNMC.
The Opening Ceremony of the Conference held on Tuesday 17^th September 2024, with the Prof. Theophilus Oladipo Ogunlesi Annual lecture, instituted in honor of the pioneer President of the College, delivered by Dr. Alani Sulaimon Akanmu, MD, FMCPath of the Faculty of Pathology of the College. The lecture explored the different possibilities of achieving a cure and epidemiological control of HIV, an infection that has infected over eighty million and killed over forty million persons since its emergence in 1981.
A total of five plenary sessions on the theme and sub-themes of the Conference were held, including a special symposium hosted by the College President on pushing the frontiers in sub-specialization in Nigeria; while 103 peer-reviewed abstracts and 27 posters were presented at the Conference, and published as Proceedings of the Conference.
The Conference was preceded by preconference workshops held on Monday, 16^th September 2024 by the various Faculties of the College on issues relevant to training, practice, research and advocacy.

The convocation was done on Thursday the 19^th of September 2024, a total of 338 doctors were awarded the fellowship degree, 24 doctors were awarded the Fellowship-by Election, 11 were awarded post Fellowship diplomas, 6 doctors were awarded the diploma, 14 awarded doctor of Medicine degree, and 5 deserving individuals were awarded the distinguished Fellowship award.

OBSERVATIONS

1. Congress commiserated with the government and people of Bornu State over the recent flood disaster that resulted in the loss of lives and properties, and volunteered its services in the rehabilitation effort

2. The current harsh economic situation in the country, the poor remuneration of doctors and insecurity are important push factors in the current mass migration of young doctors and fellows of the College to Europe, North America and the Middle East.

3. The mass migration of young doctors outside the country has significantly reduced enrollment into the training programs of the College, thus compromising the ability of Nigeria to meet its future needs of medical and dental specialists that are specially adapted to its health systems and health care needs.

4. Sub-specialization and super-specialization of specialists are necessary in meeting the needs of Nigerians for sophisticated medical care, and in stemming the tide of medical tourism abroad. Some level of sub-specialty practice is currently available in both public and private hospitals in Nigeria, despite the challenging economic situation.

5. Provision of sub-specialty care, and establishment of sub-specialty training programs are expensive, and therefore require the massive injection of funds from the government, the private sector and philanthropic organizations.

6. Critical care is an important support service for sub-specialty practice, and traditionally the practice area of Anaesthetic specialists. Other medical specialists can also train to provide the critical care required for specific sub-specialty.

7. Subspecialty medical and dental associations with international affiliations play active role in the practice and Continuous Professional Development of sub-specialists in Nigeria.

8. Medical practice and postgraduate medical education are currently faced with cross-cutting problems like incessant strike actions that affect the various stakeholders in the medical profession.

9. Medical ethics, especially as set out by the Medical and Dental Council of Nigeria (MDCN) set the standard of what is right or wrong in medical practice in Nigeria. However, there are several conundrums in the course of the practice of the different specialties and sub-specialties of medicine, sometimes resulting in legal cases.

Recommendations
Following fruitful deliberations at the plenary sessions, scientific presentations and the All Fellows Congress, the following recommendations were made:

1. More proactive actions in the management of climate change related disasters by all stakeholders, by ensuring community-based, vulnerability assessment and emergency preparedness and response. The government can play a key role in this.

2. There is a need to expedite the payment of the recently approved minimal wage and carry out the consequential adjustment as they affect medical doctors in the CONMESS Salary structure and expand the social safety net.

3. There is a need to set timelines for achieving universal health coverage (UHC) in Nigeria by all stakeholders, including the Basic Health Care Provision Fund and the National Health Insurance Authority Act. Government should drive this process

4. The renumeration and working condition of medical and dental doctors should be increased and improved by all employers, to reduce the push to emigrate abroad for greener pasture.

5. Government should increase the residency training positions, and remove the bureaucratic bottlenecks associated with the replacement of emigrated doctors, to ensure that public postgraduate training facilities are able to effectively discharge their training and service delivery responsibilities.

6. Huge human and material resources are needed for the establishment of sub-specialty care and training centers, government should therefore in the interim establish and properly fund zonal centers that will serve as referral centers, and training facilities for trainees from all over the country.

7. Medical Directors and Chief Medical Directors should prioritize the establishment of sub-specialties in their hospitals, as they increase the profile of the hospitals and increase the Internally Generated Revenue that is needed to sustain the services in the sub-specialty.

8. The management of public tertiary hospitals should explore the option of intra-mural practice as a way of attracting and retaining the services of sub-specialists and super-specialists in the hospitals

9. National Postgraduate Medical College of Nigeria should accelerate the process for the accreditation of deserving private health care facilities as sub-specialty training centers.

10. National Postgraduate Medical College of Nigeria should establish communication channels with key stakeholders in medical practice and postgraduate medical education in Nigeria, in the conceptualization and implementation of its policies and programs.

11. Proper training of doctors and fellows on medical ethics and medical jurisprudence should be incorporated in undergraduate and postgraduate training. The MDCN, medical schools and the College should be actively involved in the training, which should be amply illustrated with case studies.

12. Hospitals should set up Clinical Ethics Committees, in addition to the well-established Health Research Ethics Committees, to help in resolving ethical conundrums that crop up in course of clinical practice

APPRECIATION
The College is deeply grateful to the President of the Federal Republic of Nigeria, His Excellency Bola Ahmed Tinubu GCFR, the Executive Governor of Rivers State, Sir Siminalayi Fubara GSSRS, the Honourable Minister of Health and Social Welfare, Prof. Ali Pate, the Honourable Minister of State for Health, Dr. Tunji Alausa, the ASCAF 2024 Elder and former Governor of Rivers State, Sir (Dr) Peter Odili GSSRS, CON, President and Past Presidents of the National Postgraduate Medical College, our distinguished Fellows, Chairman and Members of Local Organizing Committee, security agents, partners and supporters, gentlemen and ladies of the press, distinguished guests and participants.

Dr. Christie N. Mato, FMCA
Chairman, LOC ASCAF 2024
Dr. Fatiu A. Arogundade, MD, FMCP
College Registrar, NPMCN
Dr. Peter Ebeigbe, MD., FMCOG, PNMC
College President, NPMCN