Dr. Osahon Enabulele, a past President of the Nigerian Medical Association, NMA, has called for the urgent establishment of a Residency Training Programme (RTP) Budget Implementation, Monitoring and Evaluation Committee (RTP BIMEC), as well as the full implementation of the Medical Residency Training Act of 2017, signed into law on 26 June 2018 by President Muhammadu Buhari GCFR.
Dr. Enabulele who currently is an Executive Committee member of the World Medical Association made the calls while delivering a keynote address on ‘The Corollary of Government Policies on Residency Training” at the 39th Ordinary General Meeting and Scientific Conference of the National Association of Resident Doctors (NARD), recently held in Benin City.
In a critical analysis of the policy and legal frameworks on Residency Training in Nigeria, Dr. Enabulele informed the audience that some steps had been taken by the government to address some challenges, including the issuance of a uniform template to guide the appointment and admission into the RTP; issuance of a policy statement directing strict adherence to the established scheme of service; and the enactment of the Medical Residency Training Act, MRTA, 2017.
He stated that the policy and legal frameworks have attempted to cure some defects in the training programme, particularly as it concerns the determination of the career progression of Resident doctors; funding of the programme; the admission and entry requirements for the programme; and the standardization of the structure and classification of the programme.
Recounting the history and structure of RTP in Nigeria, Dr. Enabulele explained that though the Residency Training Programme in Nigeria is yet to meet national aspirations and the vision of its founding fathers
“The programme has made some significant contributions to Nigeria’s healthcare delivery system, particularly in terms of production of indigenous specialist medical and dental manpower and improved access to specialist medical and dental care,” he said.
“The challenges facing RTP in Nigeria include absence of specific budget lines, budgetary allocations and releases for the program at federal and state levels; differential, varied and arbitrary application of training guidelines, rules and duration of training period by training institutions; defective recruitment, admissions and replacement policies and processes plagued by federal character/quota system, administrative shenanigans and bureaucratic red-tapism; lack of slots for residency training; Inefficient and ineffective manpower development plans; poor state of health infrastructure and training facilities; poor funding of the postgraduate medical colleges, amongst others,” he explained.
In his strategic recommendations, Dr. Enabulele asserted that there is need for improved political will and commitment of the government and all stakeholders in the Nigerian health project to the sustenance and advancement of the Residency Training Program (RTP), in Nigeria.
He further called for the full implementation of the Medical Residency Training Act and the urgent establishment of a Residency Training Programme Budget Implementation, Monitoring and Evaluation Committee (RTP BIMEC).
He also recommended the need for “sustained advocacy efforts and strategic engagement with policy makers, public and political office holders at all levels of government, particularly the executive and legislative arms of government; greater collaboration between the leadership of the Nigerian Medical Association, National Association of Resident Doctors, the Medical and Dental Consultants Association of Nigeria, the Medical and Dental Council of Nigeria, the Postgraduate Medical Colleges, and all other players that initiated and facilitated the enactment of the Medical Residency Training Act of 2017.
He then called for regular dynamic and holistic reviews of the RTP, at least every 3-4 years, amongst other recommendations.