For three months, intern doctors (also called house officers) working at federal hospitals across the country have not been paid salaries and allowances despite working in tough conditions for days, a situation caused by the struggle between chief medical directors and the Medical and Dental Council of Nigeria (MDCN) to control resources.

Fatigued and penurious, one of such doctors, Okorie Ifeanyi Venatus, collapsed after a 72-hour shift at the University of Port Harcourt Teaching Hospital (UPTH).

This is Dr Okorie Ifeanyi Venatus,an intern Doctor in UPTH. He collapsed with his forehead to the ground after a 72 hour shift as the only House Officer in the unit.

He and other intern Doctors all over Nigeria have not been paid for 3 months now (Since December 2020). pic.twitter.com/46JnYhnwcE

— DR.PENKING™ (@drpenking) March 5, 2021

Graduates of medical schools proceed to medical institutions approved by the MDCN for a one-year supervised clinical training in all medical and surgical specialities. During the housemanship, house officers would work under the guidance and supervision of senior doctors and consultants.

Many house officers become resolute in their decision to travel to western countries to practice after undergoing harsh conditions during housemanship, a decision which continues to lead to the dearth of medical workers in Nigeria. According to a report, the MDCN has about 72,000 doctors in its register; more than half practise abroad.

I did my housejob in a crazy state university hospital in Ekiti State for 5 months and I wasn't paid a dime till I left. Some of my colleagues were practically begging for money from patients. That moment, I decided to write my exams and leave the country. No regrets now.

— Dr Ayeni (@Adamsayeni) March 5, 2021

Dr Okhuaihesuyi Uyilawa, the President of the National Association Resident Doctor (NARD), an umbrella body of house officers, attributed the challenges house officers go through to system failure.

“It is system failure when the MDCN and chief medical directors of hospitals are using house officers as pawns, not wanting to pay them for over three months while they have been working; it is system failure when you are making 24 house officers work in an establishment that sees thousands of patients without taking care of the welfare of the workers,” Dr Uyilawa told FIJ.

He noted that there should be at least 10 house officers in each unit of a medical institution, “but in Nigeria, you may have like two, running back-to-back calls… and when fatigue sets in, it leads to mistakes, pressure on mental health and they end up fainting and falling sick”.

 In most of the hospitals in Nigeria as we speak, the quota of house officers assigned to hospitals have not been reviewed. So they tend to overwork them,” he said.

According to reports, Dr Venatus was the only house officer in the unit on the day he collapsed.

In addition to working long hours in harsh conditions, the doctors are not sure of being paid at the end of the month. Earning about N173,000 every month, Dr Uyilawa confirmed that house officers have not been paid their salaries for three months.   

But the NARD has been accused of doing nothing to resolve the situation of house officers although it collects dues from them, an allegation the NARD President denied. He disclosed that he had been in Abuja for over a week, meeting with the ministers of health and finance and legislators.

“I have been attending meetings, changing clothes and washing them because of these house officers and they say I don’t do anything about them?” he wondered.

Dr Uyilawa noted that CMDs of federal hospitals should be held responsible for house officers subjected to working without pay. He told FIJ that since the payment platform hospitals use to pay house officers was taken from chief medical directors and a committee was set up by the Ministry of Finance to collate the names and salaries of house officers, only 19 out of 54 hospitals had sent their list.

The platform was removed to allow a central system of payment for house officers.  

“So, NARD is expected to go and arm-twist the chief medical directors to bring the list that is supposed to be submitted to the minister of finance?” he asked.

“They (chief medical directors) want the payment platform to be reversed to them being in charge of payment, not MDCN. It is like a chess game. This January, the payment platform for house officers was removed from the teaching hospitals and sent to be controlled by the Medical and Dental Council of Nigeria. That means the extra money that come into the hospital has been taken from the chief medical directors.

“So many of them are not happy about this new development and their plan is to make this platform fail, and force ARD/NARD to go on strike so that it will be reversed to them being in charge of payment.”