Have you noticed, American doctor's append only MD as their titles? Indeed, to practice in the United States require that a doctor specialize in at least one of the many areas of medicine after the basic qualification. Therefore, as a specialist, the only insignia is the MD, though a description as a fellow may follow to show the specialty. Other appendages may include PhD, MPH and a few others. The reason is simple. A medical doctor (MD) is a medical doctor. The difference lies in the area of practice and expertise- psychiatry, surgery, Obstetrics and gynecology etc.
To become a specialist therefore is a right, a necessity expected of every doctor. It is because of this that a national matching system for residential program exists in the USA. It is also because of this that a system of knowledge acquisition and career progression through postgraduate years one through five exist, specific milestones. It is equally because of this that the emphasis is on the quality and standard of each residential program and its director rather than examinations. Finally, it is basically because of this that the speciality board examinations at the end of the residency program is optional, or voluntary, taken only to satisfy members of the public or if the individual is desirous of practice across state lines(a different state from which he trained).
Specialization in medicine must never therefore be a privilege, for what is the aim of specialization? To break down medical knowledge into discrete and manageable entities and enable an increasing depth of learning and skill acquisition therein. A division of labor of sorts.
In contrast however, specialists in Nigeria readily flout their titles, FWACP, FWACS, FMCP etc. These are well earned /deserved titles no doubt. Problem is, however, the attempt to make specialization an elitist enclave. All medical doctors are equal, but some doctors are more equal than others. How?
Elitism seems to be native to Nigeria. It is almost a cultural thing. Everyone wants to show the other how much worthier he is above his fellow. "Rankadede" you hear. The smallest size of generator is named 'i better pass my neigbour'....
There is a subtle but fierce battle to be the first always, primus inter pares! The best, the richest, the most brilliant etc. Competition, whilst not necessarily bad, but competition for her own sake, and in an unbridled manner is a death march! It breeds an excessive of rivalry and a penchant for ruthless despicable acts in order to suppress.... This at the expense of what is needful and necessary.
It is therefore of little wonder that even within medical circles this culture festers.
As alluded to earlier, to specialize in an area of medicine has become an elitist venture. The sheer process is brutal. It is dehumanizing and deliberately so.
The Specialists who are also meant to train others are the ones who make it so by not been held responsible or accountable in any guise for the resident doctors under them, by the desire for elitism and exclusivity, and through the proliferation of multiple landmines called examinations at every corner and stage.
The more vexatious of these issues is tying career advancement and promotions of the resident doctor to these centralized examinations without recourse to the sensitivities and peculiarities of the individual residential programs! And as alluded to earlier, these exams are landmines designed to frustrate and eliminate anyone but the best of the best-hubris!
Candidates are pitted against candidates and you have results like only 7 out almost 300 hundred candidates passed and exam nationwide( family medicine).
Since knowledge in Medicine is so deep and wide, there has to be, of necessity, specialization where a doctor further undergoes a residency program. A residential program affords the doctor the opportunity to focus on an area of medicine, work with specialists in their day to day care of patients, witness, participate and ultimately become a specialist himself. That is the concept of specialization and this should be our minimum requirement too.
Some of our people are wont us to believe it is the preserve of some special of privileged few.
Why is elitism and hubris so rife?
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