By Professor Friday E. Okonofua

Of all the areas of strength of the hospital, one of the most critical is the quality and quantum of its residency training program.

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The training of resident doctors is an important strategy for building the next generation of clinicians, without which the country will continue to fall short of human resource requirements in health.

With the increasing wave of out-migration of specialist doctors for greener pastures, it is only through the improvement of the residency training programs of lead hospitals such as the National Hospital that the country will be able to replace the human resources depletion in health.

To date, the hospital has achieved accreditation for postgraduate residency training programs in most of its clinical departments with the National Postgraduate Medical College of Nigeria (NPMCN) and the West African Colleges of Physicians and Surgery (WACP/S).

The first female neurosurgeon trained in Nigeria is from the National Hospital, while some of the best graduating students in haematology and general surgery from examinations conducted by the NPMCN and the WACS emerged from the hospital. Additionally, the National Hospital currently runs one of the first postgraduate training programs in critical care and trauma in the country.

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The National Hospital also runs internship training programs in various disciplines. These include medicine and dentistry, pharmacy, medical laboratory science, radiography, dental therapy and technology, and nursing. There are also post-basic schools in nephrology, nursing oncology and radiotherapy.

However, research activities in the hospital are still nascent. Most of the ongoing research activities in the hospital include those initiated by international donor agencies such as the Institute for Human Virology and the Cincinnati Children Hospital.

Areas of excellence

The National Hospital is now recognized throughout the country in specific areas of clinical excellence. One of the best known areas is in the high-profile treatment of cancer. With the increasing prevalence of cancer, the demand for high fidelity treatment has become more urgent. This will reduce the propensity for Nigerians to seek very expensive treatment for cancer in other parts of the world with great economic loss to the country.

The National Hospital is one of a very few tertiary hospitals in Nigeria providing sophisticated machines for the radiological treatment of various types of cancer. Apart from having sophisticated radiology machines for the diagnosis of cancer including MRI and CT scanner, the hospital also has high profile cancer treatment machines including a Linear Accelerator (LINAC) with simulator and therapy. Surely this is one of the most sophisticated machines for cancer treatment known throughout the world, but its continued functionality and expertise use also needs to be guaranteed.

Another area where the National Hospital has distinguished itself is in the provision of facilities for the treatment of infertility by in-vitro fertilization and embryo transfer (IVF-ET). The hospital was the first public health institution in Nigeria to initiate clinical services for IVF-ET, and still has one of the cheapest and most accessible services for poor couples. This is an area of service delivery that stands the hospital tall among its peers in the country.

The hospital also has psychiatry and nuclear physics facilities that can compete with those in other parts of the world. The hospital has facilities for diagnostic arthroscopy, gamma camera for nuclear medicine, and facilities for cardiothoracic surgery, including pacemaker insertion and open heart surgery.

The National Hospital has also done well in the provision of high level laboratory diagnostic services that meet international standards. The hospital has automated laboratory services, including those for chemical pathology, haematology, immunology and microbiology. Its histopathology and mortuary services are standard and represent some of the best in the country. Specifically, the hospital has a Polymerase Chain Reaction (PCR) machine that enables the diagnosis of infections at bio-molecular level, especially in children with HIV/AIDS and other infections.

It also has equipment for immunohistochemistry, which allows for improved cancer diagnosis, as well as tumor markers, immunological, serological and hormonal assay.

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• Okonofua, Vice-Chancellor, University of Medical Sciences, Ondo, delivered this paper at the 20th anniversary of the National Hospital, Abuja

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