PROTOCOLS
I am deeply humbled and proud to stand before this esteemed gathering as the 23rd President of the National Postgraduate Medical College of Nigeria. I would like to begin by expressing my gratitude to the Almighty God, whose guidance I seek daily, for granting me this great priviledge and honour. I am reminded that true success and promotion come from God alone, and not from any worldly source.
I am extremely grateful to God for the great gift of exceptional individuals who have been a part of my life. Their unwavering guidance and support have played a vital role in shaping me into the person I am today. I confidently acknowledge that my achievements are largely attributable to the mentorship, teachings, and genuine friendships of countless remarkable individuals. Although their numbers are too vast to enumerate, I appreciate the presence of many of them here today. I am also grateful for the wonderful friendships and relationships that I have enjoyed with people from diverse backgrounds across tribal, religious, medical fellowship, geopolitical lines and walks of life. These relationships have enriched my life immeasurably, and I am forever indebted to those who have invested their faith and confidence in me. Over the next two years, I pledge to work tirelessly to repay that investment and make the most of these valuable relationships in the actualization of the vision of our dear College.
The National Postgraduate Medical College of Nigeria
The National Postgraduate Medical College of Nigeria (NPMCN) has a very rich history. It was established by the National Postgraduate Medical College Decree No. 67 of 24th September 1979, now Cap N59 Laws of the Federation 2004. The National Postgraduate Medical College of Nigeria was established in 1969 to produce specialists in all branches of Medicine and Dentistry. Before its establishment, the Medical and Dental Council of Nigeria (MDCN) was responsible for both regulating and training doctors in Nigeria. However, in 1969, the responsibility for training specialists was separated from the regulatory function of the MDCN and the National Postgraduate Medical College of Nigeria was created. It is the tertiary institution at the apex of postgraduate medical education in Nigeria following the British model which Nigeria adopted at independence.
The founding fathers of the College deserve much praise for their great vision and the strong principles on which the institution is built. The larger Nigerian nation could learn a lot from the College. I will highlight just two of these qualities. First, our founding fathers were mostly distinguished fellows of the Royal and American postgraduate medical colleges. They were committed to reproducing their high standards and values with no room for anything less, with the goal of creating a top-quality institution with the Vision:
“To produce medical and dental specialists of the highest standards who will provide world-class services in teaching, research and healthcare”.
They were not only committed to producing specialists but to producing the best of the best. I say this with utmost respect, knowing that if they had allowed for lower standards, we would most likely have more fellows today. However, this would have resulted in more mediocrity in the Nigerian medical space. Fellows of the National College stand out and are like precious metals, not measured by quantity but by quality. Gold is valued by its carats, not by its mass. A man who desires to build a house with precious metals would be foolish to compare himself to another, who, in a hurry to complete his building quickly, uses wood. Precious metals take time, effort, and perseverance to mine and refine, but those who commit to the process reap the benefits for a lifetime!
These great men and women deserve credit for their commitment to establishing a system of rigorous research training at the College from the outset. The programme culminates in the defence of a completed doctoral-level dissertation in all faculties, following external blinded peer review at the proposal stage by two senior academics. It is worth noting that this was a groundbreaking approach at the time, as it was not practised by either the Royal or American medical colleges. Similar standards were established to evaluate the achievement of world-class training goals in teaching and healthcare. However, some people believe that the standards were excessively strict and high, given the significant demand for specialized healthcare professionals in the country. They feel that the college should have lowered the standards to produce a greater number of specialists. There is always a risk in our lives, as individuals and organizations, of setting low standards for ourselves and attaining them. And the great Aristotle has something to say about this:
“Our problem is not that we aim too high and miss but that we aim too low and hit” And it was the great Albert Einstein who stated that “What is right is not always popular and what is popular is not always right”.
The founding fathers of the college also had a well-thought-out plan to ensure that none of the sixteen faculties were considered inferior. They established a rotatory presidency from the beginning which guarantees that each of the sixteen faculties has an equal chance of producing a president at least once in 32 years! This has ensured that the larger faculties have not dominated the College’s leadership. This is the reason why, even though the Faculty of Obstetrics and Gynaecology is the largest, I am only the second President from the faculty. We are proud of this arrangement which has ensured harmony and served the College well and gladly recommend it or a slight modification to the Nigerian nation. Not many people will argue against the fact that we are likely to be a better country the day a Nigerian who is nok, nupe or Isoko, and has distinguished him/herself, has an equal chance of leading this country as one that is Fulani or Yoruba.
Progress made in the recent past.
The College has made significant progress which has been speeded up in recent years, and we plan to continue building on this foundation over the next two years. The College now has an interactive enterprise website with an electronic portal system that captures all processes relating to interaction with resident doctors, assessors, and training institutions in real-time. This system allows users to upload documents, images, and videos seamlessly. The College has digitized and computerized all its administrative, training, accreditation, and assessment processes. It was the first to introduce Computer Based Tests for postgraduate medical examinations in sub-Saharan Africa. Presently, all Primary Examinations and Part 1 MCQ Screening Examinations are conducted through CBT at up to ten eligible centres across the country.
The College has created a database that contains information about all resident doctors in training which is continuously updated. This database includes the start date of training, important milestones of progress, and exit time. This database has been very helpful in the performance of the college’s function as the regulator of the residency training program in Nigeria.
The College is working in partnership with the National University Commission to achieve the goals of the Postgraduate Doctor of Medicine (MD) programme. The programme has been successful in attracting more resident doctors and young fellows to enrol in the MD by Coursework and Thesis, as well as the MD by Thesis only. This progress will be further enhanced over the next two years.
About four years ago, the College adopted use of the principles of Standard Setting in the determination of cut-off marks for screening examinations and pass marks for all components of its examinations. This is in line with current international best practices. This contrasts with the widespread practice of arbitrarily setting pass marks for examinations at 50, 60 or whatever marks, with little evidence base. This is not ideal since no two sets of test items have the same combined level of difficulty and no two cohorts of students are the same which opens the institution to legal challenges.
The focus of the College in the next two years
A. Enhancement of the efficiency of college processes
Over the next two years, our goal is to enhance the speed and efficiency of all our college processes. This includes reducing the time it takes to assess proposals and dissertations, increasing the speed at which we respond to inquiries from stakeholders, improving the turnaround time for processing transcripts and other certifications for alumni, and streamlining the accreditation process. We will continually train ourselves on the principles of effective execution of organization objectives and policies to minimize inefficiencies and bureaucracies. Excellence should be evident in all our processes, not just the outcome. We will set high standards for ourselves and strive hard to meet them.
B. Sustenance of the journey to becoming a digital-first organization:
We are committed to advancing the digitization efforts of the College and transforming it into a digital-first organization. Our priority will be to enhance the capacity of our website and digital systems to ensure easy access to information, training, and assessment services. We are also working on establishing an electronic library that will benefit our resident doctors and alumni in good financial standing with the Postgraduate Medical Fellows Association. I believe that access to comprehensive academic resources is mandatory for any genuine academic pursuit and training. Additionally, we will provide easy access to world-class plagiarism software for both trainers and trainees. Our focus will not only be on detecting academic misconduct but also on strengthening the processes that ensure all specialists receive comprehensive training in proper academic conduct and integrity.
C. Local and international engagements:
The College will work to maintain continuous engagement with all stakeholders involved in national postgraduate training processes, including policymakers, training institutions, trainers, trainees, alumni, and employers of specialist medical manpower. This will help facilitate sustained interaction and encourage input from all major stakeholders in decision-making processes and the implementation of college programmes.
This is the “Nigerian” postgraduate medical college, there cannot be two. I therefore invite all qualified Nigerian specialists irrespective of the fellowships they possess, who have proven themselves in training, research, and healthcare to come on board and let us continue to build a truly Nigerian brand that we can all be proud of. Generations of Nigerians have contributed to making the Royal, American, and other medical colleges what they are today, and we are very proud of them. The truth, however, is that no matter how high the number of Nigerians committed to any of these colleges, it would neither make the Nigerians primarily British or American nor make the colleges Nigerian! The colleges are testimony to the continuing dedication of the British and American people to excellence in the medical and dental fields, not of Nigeria or Nigerians.
We must learn from what the Japanese, Singaporeans and lately Indians have done in various sectors of their economy including healthcare. Great nations learn from others and build their own. The Nigerian people are not backward by any standards despite the current setbacks. We are a sovereign nation with some of the most intelligent and progressively minded peoples on earth! We do not need to perpetually associate ourselves with the “edifices” built by other nations to get a sense of pride and fulfilment in ourselves. We are old enough as a nation and have enough resources to build an organization that stands out. And that is exactly what we are doing as a college.
I want to use this opportunity to extend a warm invitation to all Nigerian medical and dental specialists, who are not fellows of our college, working in Nigeria or in the diaspora. Any Nigerian, who besides being involved in healthcare, can show objective and verifiable evidence of continuing commitment to excellence in research and training, shares in our vision is welcome to join us in this project. Please visit our website, www.npmcn.edu.ng and get the details of how you can become fellows of our college by election. Application is wholly online. I assure you that the process of assessment is transparent and does not require that you know anyone. All those who meet the very objective criteria can come on board. You may speak with the Faculty Chairman or Faculty Secretary in your specialty for more details. If you still encounter any difficulties, send me a mail at president@npmcn.edu.ng. The door is open, and we are waiting to give you a warm welcome with a huge Nigerian hug!
The College will keep engaging with our esteemed resident doctors, who we relate with as we do with our adult children, for whom we continue to “suffer labour pains” individually. All the faculties will provide expanded opportunities for continuous interaction and the gathering of input from resident doctors in all processes related to training and assessment. I had very productive discussions with “His Excellency” the National President of the Association of Resident Doctors (POTARD) in January, and we will continue to interact at every opportunity. I understand that we may not always agree because NARD, like any great association or trade union, usually pursues what it considers in the immediate best interest of its members. In contrast, as a college and a federal government parastatal, we must stand by our understanding of what we consider in the best long-term interest of the nation, guided by government policy. However, we will always be open to superior arguments in the national interest. My doors, as well as those of all the principal officers and faculty officials, will always remain open to all resident doctors. I assure everyone that making training and assessment friendly and objective in a conducive environment for all Nigerian resident doctors will be my top priority. Anyone with fresh ideas or suggestions on how we can improve on the processes of training and assessment is welcome to give me a call or preferably send me an email.
The College values its warm relationship with other postgraduate training organizations in the West African sub-region, such as the West African postgraduate medical colleges, the Ghana Medical College, the Liberian Medical College, and others. We will work to strengthen these relationships in a mutually beneficial manner. The College will actively engage with various national and international training organizations to improve the skills of trainers and trainees, particularly in areas where opportunities for such are not widely available nationally. This will include collaborating with specialty and subspecialty organizations, as well as health institutions in both low, middle, and high-income countries. Additionally, the College will seek partnerships with medical and dental faculties of universities in Europe and America, as well as international medical specialty and subspecialty organizations, if deemed beneficial.
D. Grow and strengthen a mutually beneficial relationship with all College Alumni
The College will work to improve its relationship with all alumni across its sixteen faculties. It plans to achieve this by keeping open channels of communication to seek and obtain the views and inputs of college alumni in the policies and plans of the College. The College intends to work more closely with its alumni based in Nigeria and the diaspora, allowing them to have a stronger say in what the College does and how it does it.
E. Establishment of Clinical Skill Laboratories
The College is currently working towards establishing clinical skill laboratories in the six geopolitical zones. Unfortunately, the decrease in the value of the naira in recent months has significantly hindered progress in the attainment of this objective. The drop in the value of the Naira has made many mannequins unaffordable. We are grateful to the immediate past River State Government, led by Senator Nyesom Wike, for providing us with land in Port Harcourt for this purpose. Additionally, we extend our gratitude to the CMD of the UNTH, Enugu, Professor Obinna Onodugo and the immediate past CMD of AKTH, Kano, Professor Abdulrahman Abba Sheshe for providing the College with accommodation for this. We will work aggressively at actualising this vision in the next two years and call on governments at all levels, the organized private sector, and well-meaning Nigerians to partner with us.
The Challenges: The poor economic conditions, the brain drain and the worsening plight of those who currently remain.
As a medical student, I experienced the medical brain drain during the government of General Mohammed Buhari. A core department in the institution was depleted from eight lecturers to only one. One of my teachers, who travelled to the Middle East and came back after many years, explained things to me stating that a Nigerian medical professor’s annual earnings, gradually dwindled until it was less than the equivalent of 700 dollars. The Saudis and other Middle Eastern governments offered these consultants between $2,500 and $4500 monthly and two to-and-fro tickets for all their family members or the cash equivalent if they preferred. We know the rest of the story. It was an insightful “economic” intervention by the Federal Government, the enactment of the Medical Salary Scale, which resulted in better pay for doctors, that put an end to the medical brain drain. Although the earning of consultants was still not equal to what they were offered in the Middle East, when their earnings reached the equivalent of $1,000 to $1,500, nobody was interested in travelling to earn $4,500 under conditions that often amounted to modern slavery.
There has been a lot of talk about the reasons behind the current brain drain of doctors and other skilled workers that started in Nigeria when the value of the Naira was less than 400 naira to a dollar. The root cause of the brain drain is economic and economic interventions are urgently needed to stem the worsening cascade and prevent a collapse of the health system. As a person who relates closely, daily, with Nigerian resident doctors and trainers, I must inform the Honourable Minister of State for Health and Social Welfare about the severity of the situation. The number of candidates registering for our examinations has crashed due to the large number of resident doctors leaving the country. Trainers are leaving too. This has led to a severe shortage of health manpower in most tertiary hospitals in Nigeria.
I am not going to bore this audience with the sickening data of the brain drain that we all know. However, I would like to shed light on the plight of those of us who currently remain in the country. Due to the decrease in the value of the naira to the dollar, the most senior Nigerian Consultant earns the equivalent of 300 dollars monthly outside any earnings for extra work. This is a decrease from the equivalent of around 1450 dollars as at January last year. This amounts to an annual salary of about 3600 dollars. Meanwhile, his colleague who has travelled to the middle east earns up to 10,000 to 12,000 dollars in a month equivalent to his/her three years earnings. It will not be considered strange if any rational healthy human being asks him/herself why he/she is still here.
I must join all well-meaning Nigerians in applauding two recent major interventions of the Federal government. The first is the directive to MDCN to increase the quota of all Medical Schools to increase the number of doctors produced by the country. What I commend even more is the expressed willingness of the Federal government to help meet the extra personnel and equipment needed to attain the new quotas. In addition, the planned upgrade of over 12 tertiary teaching institutions nationwide is the right step in the right direction. It is glaring that for both objectives to be achieved, the country needs to have a critical minimal number of medical teachers and specialists in the upgraded and non-upgraded teaching hospitals. These interventions must therefore be implemented together with an economic intervention to ensure that medical teachers and specialists and resident doctors stay back in the country via an urgent review of salaries and provision of other incentives.
I have interacted with the Honourable Minister of State for Health and Social Welfare. The first impression you get on meeting him is that you are dealing with a very knowledgeable and experienced official that means well for this nation. Honourable Minister, Sir, we want you and this government to succeed in improving the plight of all citizens in every way. I have no doubt that the top officials of the Federal Ministry of Health and Social Welfare, and indeed the President, have a good grasp of the urgency of the intervention that I speak of. I urge the Federal Government to urgently intervene with deliberate measures that will keep the necessary personnel back home so that the massive investment of resources into actualising the two interventions do not end up being a waste of limited public resources.
Acknowledgements
I must thank all the members of the Governing Board who overwhelmingly elected me as the 23rd President of the College for their confidence in me. I thank the immediate Past President of the College, Professor Akin Osibogun and all the past Presidents and principal officers of the college present at this ceremony for being such wonderful examples to follow.
I am most grateful to His Excellency Rt.Hon. Sheriff Francis Orohwedor Oborevwori, the Executive Governor of the best state in Nigeria, Delta State, for the wonderful support I have enjoyed since he learnt of my election as College President. I am also grateful to Dr Festus Okubor, former Commissioner of Health in Delta State and Chief Strategist to the Delta State Governor for his love and support.
I am grateful to the Honourable Minister of State for Health and Social Welfare, Dr Tunji Alausa, for the wonderful discussions we have had on various aspects of training and healthcare in Nigeria. I appreciate Dr Yusuf Sununu, the Minister of State for Education, a wonderful colleague, friend, and great leader.
I thank the Honourable Commissioner of Health, Delta State, Dr Joseph Onojaeme, the Permanent Secretary, HMB, Ministry of Health, Dr Paul Okubor and all other officials of the Delta State Ministry of Health.
I thank the amiable Chairman of the Faculty of Obstetrics and Gynaecology, NPMCN, Dr Ayodeji Oluwole, Faculty Board, examiners and all the amazing fellows of the Faculty of Obstetrics and Gynaecology of all generations, worldwide, for the massive support I have received over the years and in preparation for this investiture. I thank all my teachers and the elders of the Faculty of Obstetrics including Professor Olalekan Abudu, Professor OO Fakeye, Professor Bomi Ogedengbe, Professor CT John, Professor AO Ojengbede, Dr Habib Sadauki, Professor Okechukwu Ikpeze, Professor Ayo Arowojolu, Professor Akinyinka Omigbodun, Professor Isaac Adewole, Professor AO Ilesanmi, Professor AD Ekanem, Professor Eric Achibong and Professor Ibrahim Yakasai and others.
I thank the leadership and fellows of the sixteen faculties of our great college and all heads of units and staff of the National Postgraduate Medical College for the wonderful work that they all continue to do and for attending this ceremony.
I thank my trainers including the two professors who have played the role of Father to me in so many way: Professors Eugene E Okpere and Professor Augustine AE Orhue. Professor Eugene Okpere, “the perfect blend of the old and the new”, supervised my Dissertation and has been available for me at every stage of my career, Professor AAE Orhue taught me how to manage labour and has shown me love over the years. I acknowledge the contributions of the late Professor Augustine Oronsaye, who was a gentleman per excellence and a great teacher, Professor Friday Okonofua, who was a great inspiration for academic excellence and research, Professor AO Aisien, the mother of the department, Professor Michael Aziken, who continues to be a teacher, great friend and guide, Professor ABA Ande, who was a constant encouragement and from whom I learnt most of the basic surgical skills I have. I must also thank Professor Alfred Ehigiegba, whose speed during surgery is not surpassed by many and the late Professor Etedafe Gharoro, who guided me through some of my first scientific publications. I must thank all the wonderful alumni of the Department of Obstetrics and Gynaecology for their love and support over the years. I thank Professor OUJ Umeora, Professor Jude Okohue and Dr Paul Okubor for their great effort at mobilization for this investiture without my prompting.
I must thank my amiable Vice Chancellor, Professor Andy Egwuyenga, a renown Parasitologist who has contributed immensely to Public Health, a man with a good heart and a great administrator and inspiration, for being present at this occasion. I acknowledge the presence of the Provost of the College of Health Sciences, Professor Emmanuel Odokuma, Deans and academic staff of the college and university at this occasion.
I must also appreciate the current Chairman of the Committee of Nigerian Vice Chancellors, Professor Lilian Salami, the Vice Chancellor of my Alma mater, the great University of Benin, for her very kind words and support since she learnt of my election as College President. In the same line, I am grateful to Professor Wilson Sadoh, Provost, College of Health Sciences, University of Benin, Professor Wilson Osarogiagbon, Dean, School of Medicine and staff and alumni of “Great Uniben” for their love and support. The support of my good friend, Professor Bala Audu, Vice Chancellor, Federal University of Health Sciences, Azare is acknowledged.
I thank my Chief Medical Director, Professor Neku Okolugbo, for being present at this occasion. I am also grateful to the Chairman of the Medical Advisory Committee, Dr Cletus Otene, the DELSUTH MDCAN Chairman, Dr NS Awunor and the wonderful team of consultants and other staff of Delta State University and Delta State University Teaching Hospital, Oghara, who “crossed seven rivers” to attend this ceremony to honour their own.
Let me also thank the Chief Medical Director of UBTH, Benin, where I did my residency training, Professor Darlington Obaseki and the CMAC, Professor Stanley Okugbo, the Medical Director of Federal Medical Centre Asaba, Dr Victor Osiatuma and the Chief Medical Director of Asaba Specialist Hospital, Dr Peace Ighosewe for attending this programme.
I am most grateful to the following for their love and support: Professor Adetokunbo O Fabanwo, CMD of LASUTH,Ikeja, Professor Wasiu Adeyemo, CMD, LUTH, Idi-Araba, Profesor Ahmed Ahidjo, CMD, UMTH, Maiduguri, Professor Adamu Abdullahi Atterwahmie, MD, Federal Medical Centre, Birnin Kudu, Professor Hadiza Usman, MD, Federal Medical Centre, Nguru, Professor Obinna Onodugo, CMD, University of Nigeria Teaching Hospital, Enugu, Professor Onyebuchi Azubuike, MD, Federal Medical Centre, Umuahia and Professor Hyacinth Onah, Immediate Past CMD, Enugu State University Teaching Hospital, Enugu.
I thank Professor Okechukwu Ikpeze, the President of SOGON, Dr Olajuwon Alabi, President, Association of Gynaecological Endoscopists of Nigeria and Professor Bosede Afolabi, President, AFEMSON for their support.
I thank my Head of Department, Dr William Odunvbum and all the professors, consultants, and staff of the department. I appreciate the love and support I continue to receive from Professor Gabriel Igberase and Professor Patrick Okonta, who though in diaspora, are still an integral part of the department. I thank the resident doctors that I have had the privilege of supervising their Dissertations, for honouring me: Dr Henry Ebo, Dr Ejiro Aramabi, Dr Emeke Mofon, Dr Pedro Diken, Dr Ayotunde Adeyinka, Dr Nwabunor Osifo, Dr Wale Iyiola, Dr Amos Ekoh, Dr Chukwuemeke Nzekwue, Dr Cousin Kesiena, Dr Destiny Agadaga, Dr Jerry Isogun, Dr Samuel Ilikannu, Dr Victory Chukwuneku Oje and Dr Ese Adigba among others. Thanks for tolerating “my academic stress” during the supervision process.
I thank the heads of department and staff of the departments of obstetrics and Gynaecology at the Federal Medical Centre, Asaba and Asaba Specialist Hospital, Asaba for attending this ceremony.
I thank my classmates at Ika Grammer School, Agbor led by our President, Dr Cletus Otene, a Plastic Surgeon, for attending this ceremony. I also am grateful to my classmates at the University of Benin Medical school led by our captain, Professor Stanley Okugbo for honouring me.
I am grateful to my wonderful late parents: Emmanuel Agwanewem Ebeigbe and Theresa Kweme Ebeigbe for setting me on the path of excellence very early in life.
I am grateful to my siblings Dr Nicholas Ebeigbe, Mrs. Nneka Chiemeke and Dr Kate Okofoh and their wonderful spouses Nancy, James and Jerry for their support and presence at this ceremony.
I am grateful to my lovely wife, Professor Jennifer Ebeigbe for standing by me and children, Brian, Amanda and Noel for their love and support.
Finally, I thank everyone who attended this ceremony. May God bless you all and grant you safe journey back to your homes.
Dr.PN Ebeigbe MD, FMCOG, PNMC
College President, 01/03/2024
