Nigerian medical students' dreams dashed amid Ukraine's ongoing war
By Iliya KureHer medical degree did not matter.
It was devastating news for Jummai, 22, a graduate of a Ukrainian university when the Medical and Dental Council of Nigeria (MDCN) said it would not recognize medical credentials that were issued in 2022 by universities in Ukraine.
The Council made the first announcement in June 2022 when the students returned home. The MDCN action left students like Jummai confused. “Why would they say that because of two months of online school, everything I've done for six years is useless? … It doesn't make sense to me because [two months], it's not too much out of 6 years,” said Jummai, who does not want her real name used for concerns raised by her family.
Her greatest frustration was the denial of the opportunity to practice something she had been dreaming of since childhood, “I studied to practice my dream profession. I really am scared that I won't be able to practice as a doctor after studying in school for that long,” she said.
Jummai returned to Nigeria in March 2022 soon after the war broke out in Ukraine and concluded her last two months of classes and exams online. She was already preparing to take the mandatory qualifying exams required of medical graduates who want to practice as medical doctors in Nigeria when the news came.
Nigerian students in Ukraine who were studying to become medical doctors suddenly found themselves displaced from their studies when the war broke out.
“I was already downloading the past exam, and scores, to start reading for the MDCN assessment exam, so I can read and pass and start my housemanship,” she said.
Jummai who recalled the first day of the attacks on Ukraine by Russia described it as an ordinary day, “it came less than three months before my final medical exams” she said. They ran and took refuge at the designated bunker where everyone was told to go for safety.
When the attack on Ukraine continued unabated, she and her friends escaped to neighboring Hungary, facing racial discrimination while boarding trains en route to the border.
In Hungary, they were evacuated back home by the Nigerian government alongside over 1,000 others schooling in Ukraine.
To address students’ concerns about graduation, her school rolled out a plan for online lectures and exams for the graduating class. She took the online classes and the exams, which she passed and was qualified to practice as a medical doctor.
But the MDCN announcement which came soon after graduation threw into confusion hundreds of Nigerian students who graduated from Ukrainian universities in 2022 – they were barred from taking the exams.
“There are people who want to write the exams and work in the country [Nigeria] and they're not allowing them to,” she said.
Parents of the graduated medical students were equally unhappy with the development. In September 2022, they came under the auspices of Concerned Parents of Ukraine Medical Graduates of 2022, an organization the parents formed to advocate for their children’s rights.
The group issued a statement, criticizing MDCN for misinformation in an “advertorial in a national daily” in June 2022, and for denying their children the right to write the exams.
In their statement, the parents said they confirmed to be untrue a claim by MDCN that the Indian government also, did not recognize certificates of the 2022 medical graduates from Ukraine – the parents said their findings “can be confirmed from either the Indian Embassy in Nigeria or the Nigerian Embassy in India.”
The group also criticized the MDCN for misinforming the public that the Ukrainian government took their citizens to the UK to complete their medical training, which they said they have confirmed to be untrue.
House of Reps intervene
Sensing the implications of steps taken by MDCN, Nigeria’s House of Representatives set up a committee to look into the matter. In March 2023, the House of Reps resolved that the MDCN, “in the spirit of nation building” review its position and tow the path of India and Ghana and allow the ‘Ukrainian Medical Graduates of 2022 in the 6th and final year’ to write the assessment examination.
But instead of addressing the issue of “Ukrainian Medical Graduates of 2022 in the 6th and final year” raised by the House of Representatives, the MDCN went to its Twitter handle @MDCNOfficial, on April 11, 2023, to re-issue the statement of June 2022, that it will “not honoring the certificates of 2022 graduates from Ukrainian universities,” a broad statement that suggests the whole six years were spent studying medicine online.
The MDCN position attracted wide criticism from many quarters including medical practitioners like, Dr. Muhammad Okaba, who told Sahara Reporters, an online news media that, “the only time classes were conducted online was during the COVID-19 pandemic… and “when the war was declared on Ukraine in February 2022.”
Is it just about online school?
It appears beyond online schooling, the MDCN has another issue with those who go to Ukraine and other countries for medical training.
Nigerian students who were studying medicine in Ukraine before the war erupted with Russia suddenly found themselves studying online, then fleeing the nation.
In an interview with a Nigerian newspaper in June 2022, the Registrar of MDCN, Dr. Tajudeen Sanusi said foreign-trained doctors from China, Ukraine, and Venezuela are “half-baked” and need a minimum of six months of remedial training to re-orientate them before they can take the exams.
This position was criticized in early 2022 by a group of parents called the Coalition of Parents of Foreign-trained Doctors in Nigeria, who also accused MDCN of extortion and compelling their children to write an “assessment exam” charging N135,000 for registration, N200,000 for hospital attachment, and N100,000 for a tutorial.
The group called for transparency in the administration of the MDCN assessment exams.
The issue of six months of training turned out to be contentious when it became clear that the MDCN planned to charge all foreign-trained doctors a non-refundable fee of N900,000, and non-citizens, N1,400,000.
Following cries that excessive costs would be charged, the House of Reps set up a committee to investigate the matter. The plan was later shelved, as a result of the House of Reps findings.
Speaking with journalists on the issue of non-rigorous training by Ukrainian medical schools, Fred Thomas, a Ukraine-trained doctor dismissed the claims by MDCN Registrar and urged him to “stop spreading such false narrative aimed at tarnishing the image of institutions in Ukraine.
“I trained in Ukraine and I want to debunk the lies that those trained in Ukraine are half-baked. I trained at Kharkiv National Medical University and their system is better and organized than Nigeria,” Thomas said.
Yet again, reacting to the student’s choice of schooling in Ukraine and not Nigeria, the MDCN Registrar was quoted by Premium Times, a Nigerian online news media, saying, “When the students were going, did they tell anybody? … Did they tell me they were going anywhere? Do I have their record that they are anywhere?” This reaction was interpreted by many as a “personal vendetta” against students who studied overseas rather than professional requirements.
Brain drains, inadequate health workers
Nigerians like Isah Gidado of Kauna Human Capital Development Initiative, an NGO that advocates for a skilled workforce in the health sector, are wondering about the decision by MDCN when the country has grossly inadequate medical workers. He lamented that Nigeria’s health sector was already suffering due to a brain drain that sees professionals leaving in droves to other countries for greener pastures.
“If these graduates spent only two months of their last days in school online, then I don’t think the MDCN has any excuse not to allow them to write the exams,” Gidado said. “The MDCN will end up sending these young doctors away to other countries as a workforce, and Nigeria will end up at a loss,” he said.
Recently commenting on brain drain at a press conference in Uyo, the President of the Nigerian Association of Resident Doctors (NARD), Dr. Innocent Orji, said, Nigeria has lost about 2,800 resident doctors in two years.
He said the association conducted a study in September 2022, covering a two-year period, “we lost 2000 resident doctors. From January to August of 2022, we lost 800 doctors; that is to say, we lose 100 doctors every month,” he said.
According to him, between December 2021 and May 2022, a total of 727 Nigerian-trained medical doctors relocated to the UK.
Nigerian officials state that the dearth of medical professionals in the country poses a challenge to provide adequate care — especially in the face of medical school graduates who are unable to return with degrees.
Speaking on the inadequate number of doctors in Nigeria last October, the President of the Nigeria Medical Association (NMA), Uche Rowland Ojinmah, lamented that the ratio of doctors to patients is approximately 1:10,000.
“Only one doctor is incredibly available to treat 30,000 patients in some states in the south, while states in the North are as worse as one doctor to 45,000 patients,” he said.
Addressing a gathering at the induction of 63 doctors at Babcock University, Ogun State, in 2021, the Registrar of the MDCN, Dr. Sanusi, urged the federal and state governments to do all within their power to retain the services of young doctors in Nigeria.
“Some things may have to be done to encourage young doctors to practice in the country. If we go by the recommendation of the World Health Organisation, there must be one doctor to 600 patients. But by the record we have, it is one doctor to over 4,000 patients…. Despite that, it is like we don’t value what we have,” he said.
The Registrar’s statement at Babcock is seen by Mr. Gidado as a double standard, “he knows there is a shortage of doctors in Nigeria, yet he is leading the rejection of academically qualified medical doctors to practice in the country? This is pathetic,” he said.
Ukraine has remained an attractive destination for the study of medicine for many students from India, Morocco, Egypt, and Nigeria among others. This is mainly for its affordability compared to other European universities, and its position as an entry point to Europe.
For Nigerians, it affords them the opportunity to graduate as scheduled, escaping the incessant strike actions in their nation’s public universities that keep students for additional years in school before graduation.
According to Times Higher Education, the world universities ranking body, Ukraine has 45 medical schools that are all accredited by the World Health Organisation and UNESCO, and Ukraine is one of the world’s most popular destinations for medical training. It ranks fourth in Europe for the number of graduate and postgraduate specializations in the field of medicine.
Having stayed in Nigeria for more than a year without her certificate being recognized, Jummai, like other Ukrainian Medical Graduates of 2022 from Nigeria, is considering moving to another country to pursue her dream of becoming a medical doctor.
Iliya Kure is the inaugural Charlotta Bass Research Fellow. The Bass Lab funded his master’s thesis fieldwork, which led him to report in Nigeria on the #AfricansinUkraine movement.