How to become a Medical Doctor in Nigeria: requirements and details

The details and requirements to becoming a Medical Doctor in Nigeria

Most times, we may want to starta career but we are left with little or no information about the field. We may blindly follow our goals without knowing the consequences that we may face, the challenges, the benefits and many unforeseen things. If you are reading this and you do not know how to become a doctor in Nigeria, then you have come to the right place. I am in the field and so would explain to you what it takes to be a doctor in Nigeria from the first year to the final year (600 level).

Before I proceed, I would list out the steps you need to follow to actually read medicine and surgery in Nigeria which is the course you will be study in the university while "Doctor" is the Title attached to someone that studied Medicine and Surgery.

Steps to take in order to become a doctor in Nigeria

Here are the steps to becoming a medical doctor in Nigeria.

You must have passion for the Course:

Most times, children are forced by parents to studya course even whena child dislike it, this may be as a result of the fact that the course is lucrative or that it commands respect or that the parents are in competition with other friends or relatives whose children are studying that particular course. Medicine and Surgery is one of those courses that people value much in Nigeria and is envied by most; other professional courses such as Law, Pharmacy, Engineering etc have the same competition just as medicine does. The best you can do for your children is to guide them and explain the advantages and disadvantages of every field they want to study. This will enable the child to choose based on what he or she likes and therefore help the child and the society to become fulfilled in life and happy.
Most people push their children into medicine because they think it has the following benefits:
- Job security,
- Pays well
- There is prestige and respect in it since it is a noble profession
Using the above reasons to study Medicine and Surgery in Nigeria will lead to frustration because the child may not have passion for the course. This is because the challenges a child would face would make the child lost the zeal and love for the profession. If you want to study medicine, then you must have passion for it because if it is money, there are various ways to make money more than medicine and the richest man on earth is not a medical doctor, the richest in Africa is not a doctor and the richest in Nigeria is not a doctor either. If you go into medicine because of money, you will be disappointed because your friends that study different courses could make money more than you. This is one of the contributory factors to doctors, nurses, medical lab scientist, pharmacist and other health professionals complaining about low pay and would keep going on one strike to another because of unpaid salaries and allowances. I have not seen strike that was embarked by medical professionals that does not have salary or allowance as one of the factor; sometimes, they masked it with some issues to gain the love of the public but their inner primary issue would be salary, benefits and allowances. In fact if the government provides for the salary issue or allowances, the strikes are observed to be called off immediately even when other needs have not been made. Therefore, zeal for medicine is what should make you study it and not the money.

Minimum of credits in all the six subjects required for admission into the university

Your first step to becoming a medical doctor starts from the types of subjects you choose while in secondary school. If you do not choose the right subjects, then you have to go back and re-write the WAEC again for thethe correct subjects needed to study medicine. Such subjects include:

1. Mathematics: this is required in order to gain admission into any university in Nigeria. It is important you have a minimum grade of "C" - Credit, in your WAEC or NECO or GCE in order to be given admission. In University of Jos, you need to pass Maths 101 and maths 103 before you are allowed to be promoted to 200 level in Medicine.
   Again, you will need mathematics in your Community Medicine while doing statistics and also you need maths to calculate volumes and concentrations of drugs needed to give to your patients, especially in Paediatrics (aspect of medicine that deals with children alone). Mathematics is therefore important for your study, hence it is included as a "MUST".
2. English:This is another subject you must pass with a minimum of credit too. English is important because you need to communicate well with your Patients, your colleagues and other people, since it is the widely used language in the country.
3. Biology:a minimum of Credit in Biology is also required to gain admission and it is important in medicine because Biology deals with humans too. When you understand biology well, it gives you a little glimpse of what the human body is and how it works; with your knowledge of biology, you would find learning Physiology, HistoPathology, and Haematology easier, hence it is vital for studying medicine.
4. Chemistry:You need a minimum of C too in Chemistry for admission. Chemistry is important in medicine because it helps you understand drugs and how they interact in the body of humans. You need to understand chemistry in order to be able to understand other courses you will take while studying Medicine and surgery such as Biochemistry, Pharmacology, and Chemical pathology.
5. Physics:You also need to score a minimum of "C" in Physics in order to be given admission to study medicine. Physics is needed in Medicine because the use of diagnostic tools and machines such as Magnetic Resonance Imaging, MRI; Ultrasound Scanning machine, X-Ray machine, Computed Tomographic Scan, CT-scan and many other tools depend on your knowledge of Physics to understand how they work. In fact, when you have a good knowledge of Physics, you may be the next person to invent a new or better diagnostic tool that could help save people's lives.
6. Any other science related subject of your choice such as Agriculture, Geography, Further mathematics, Economics, etc.

You need to write UTME or IJMB or their equivalents and score high marks

There are two types of examinations you can write to gain admissions into Nigerian Universities: UTME or IJMB.

Using UTME to gain admission

After your secondary school, you need to write the Unified Tertiary Matriculation Examination, UTME. This is the exam that allows you gain entry into any approved university in Nigeria. The Total score is 400 marks and you need to have a minimum of 180 marks to become eligible to write Post-UTME examination in Nigeria. Some universities require the cut off mark for eligibility to sit for the Post-UTME to be more than 200 marks. The more the marks, the better your chances of gaining admission. For University of Jos, the cut off mark in UTME at the time of this writing is 180 for all courses.

When your score is above 200 marks, you stand a better chance of getting admission to study medicine better than someone with a lower score but that is not entirely the case in Nigeria as some factors could affect you gaining admission in Nigeria,I have experienced this.

Using Direct entry to gain admission to study Medicine.

If you were not able to write Jamb or could not get the required points and you do not want to stay at home, you could first of all go through a Polytechnic first before applying for medicine through Direct entry. Your course of study at the Polytechnic must be medically related such as biological science.

Sometimes, some people do finish their degree program in any related medical course before applying through direct entry to study Medicine. The related medical courses include: BSc in Biochemistry, Physiology, or Anatomy. If you have a degree in any of these courses, then you can apply for direct entry and you will start from 200 level instead of 100 level. This means that all direct entry candidates will no more go through 100 level but will begin at 200 level.

The competition for studying medicine and surgery is very very high. Whatever method you are using to gain admission, always score as high as you can so that you could be among the few that would be selected because thousands of people apply for a course that only 200 are needed. During our Post-UTME examination, we were more than 5,000 that applied in University of Jos of which only about 350 students were selected and given admission. We had another unusual exam in our 200 level that reduced our number to 128 students. So you need to score a very high mark in order to stand out and have the chance of studying medicine.

Using Remedial Sciences to gain admission

Another way you can gain entry to study medicine is by going through remedial sciences.Here in University of Jos, you can apply for remedial sciences by buying the form from the department at the university. If your application is granted, you will be given intensive lectures in Biology, Chemistry, Physics, English and Maths for only one session (approximately 1 year which are 2 semesters). If you score high, University of Jos then gives you admission. You can learn in details about the nature of remedial sciences in Unijos.

Post-UTME for MedicineApplicants

After writing your Entry examination either through UTME or Direct entry, the University would have to test your knowledge as a form of confirmation that the score you had is genuine; this is due to the fact that some candidates malpractice and could score high in UTME or Direct entry, hence the University would confirm that by setting another exam known as Post-UTME which is one of the considerations for gaining admission too. For Medical students, the exam in University of Jos will test your knowledge on Basic Science subjects such as Biology, Chemistry, Physics. You need to pass the Post-UTME with high marksbecause the score will be added with that of UTME/Direct entry to get the final score used for grading applicants for admission.

At the time of this writing, University of Jos uses computers for writing of Post-UTME. Each student is given a computer with the questions and they are required to answer the questions within a specified time, mostly about 30 minutes, after which the screen of the computer becomes locked. The answers would be made available on Unijos website within a few days. If you apply for medicine or any other course in Unijos, then you need to learn how to use the mouse for clicking the answers, you must not learn how to type with a computer because all the questions are objectives in which you are required to click one answer from the options A,B,C,D, or E.

Starting the Medical Degree after getting admission

If you finally gain admission to study Medicine and Surgery, then you need to know the nature of the courses that you will studying and the activities involved in order to become a medical doctor in Nigeria.

100 level courses for Medical students

Welcome to your journey of starting the Medical school, the journey that will transform you in terms of time management, your mode of dressing, your social activities and your future.

If you have gained admission for studying Medicine and Surgery, then you are on your way to becoming a Medical Doctor.

In your 100 level, you will be having your lectures of Natural science coursessuch as Chemistry, Biology, Physics, Zoology and some general courses such as Mathematics and General Studies (GST).

Chemistry:You will have a practical chemistry course different from the theory. This means that there will be different lecturers teaching theory and practical, and the results would be considered differently. You need to pass with a "C" after adding the practical and theory.

Physics:This is just like the chemistry, you have both theory lectures different from Practical sessions.

Biology:This is just like the other two mentioned above.

Zoology:This is the study of animals. It is somehow the same with biology but you will still do it.

General Studies:This is shortened as GST. It involves a little of History, Peace and Conflict resolution, Logic etc. This is not really a criteria for promotion to 200 level but you still need to pass with at least a "D".

Mathematics:This is an important criteria together with the three basic science courses mentioned above. You need to pass maths with a minimum of "C".

You will be taking all the courses mentioned above in your first and second semester and you will write exams at the end of each semester in 100 level alone. ( A semester is like a " Term - used in secondary school"; a semester lasts for about 3 or 4 months; There are 2 semesters in one Academic Session).

At the end of your 1st and 2nd semesters, the scores you have in all the courses will be added and an average is taken; You need to Pass each of the courses in order to move to 200 level.

If you fail to pass any of the courses, you have to repeat the year, your mates will move to 200 level while you will stay in 100 level. If the course you fail is in the 2nd semester, you will come back and write just that particular course, the same goes if the course were in the first semester. If you pass, you can then proceed to 200 level. Please know that in most other courses at the University, you may carry over but in Medicine, there is nothing as such. If you fail in 100 level, you have to repeat the year.

Pre-Clinical Activities in Medical School

The Pre-Clinical period refers to your 200 level and 300 level. It is a time during which you need to learn all the normal functions of the body. When you know the normal aspect of the human body, then you can proceed to learn the Abnormal conditions in the Clinical aspect which is from 400 level to 600 level.

200 level courses and activities in medicine and surgery

This is the level that introduces you to thebasicmedical courses different from natural science courses. In 100 level, you were attending lectures with Natural science students as well as other students from different courses, but in 200 level, you will get your own class and start medical school proper.

The courses you will be studying include: Anatomy, Biochemistry, Physiology and Community Medicine.

Anatomy:This is the study of human body parts and their functions; It is an interesting course you will like so much and may cherish it more than others, because whatever you see in the books, you will see it while in the dissection room.

While doing your anatomy, you will have lectures on the theory in class while you proceed to the Dissection room ( Cadaver room) for the practical sessions. In this room, you have the bodies of condemned criminals to dissect and see the muscles, bones, veins, arteries, intestines, heart, lungs and other parts. Through out your 200 and 300 level, you will be dissecting in anatomy. This aspect is known as Gross Anatomy. There are books that will guide you on how to go about with the dissection, you can check a list of the medical textbooks you need.

Histology:Another aspect of Anatomy that youwilldo isHistology. Histology involves the study of structures and functions of Cells and Tissues of the body.It involves using the Microscope to view the different cells and tissues of the body. Whereas Gross Anatomy involves using the eye without the microscope, Histology requires using the Microscope.

Embryology:This is the study of an embryo. An embryo is what forms a Foetus and foetus forms a baby. Embryology therefore studies the formation of a child in the womb. It is also a branch of Anatomy.

Anatomy therefore encompasses Gross Anatomy, Histology and Embryology.

Biochemistry:This is the study of Molecules and chemical compounds in the body and how they interact. It deals with how cells break down fats, proteins, carbohydrates, mineral salts, vitamins and water. It tells you the structures of compounds and how they are affected by heat, enzymes, etc. In general, biochemistry helps you understand how chemicals interact within cells.

It has both theory and practical aspects and you will do all. The practical involves using reagents and compounds to test for various other chemical compounds such as testing for glucose, fat etc; You will also learn how to measure the concentration of chemical compounds and many more.

Physiology:This is the study of normal functions of cells. This course helps you to know how cells are activated, how they divide, how food is eaten and broken down. This tells you the normal functions of the body. It is the opposite of pathology which deals with abnormal function of the body, but pathology is taken at the clinical aspect.

Community Medicine:This is the study of the health of people and their environment. It is just like the aspect of medicine that has to do with environmental health. It studies diseases, outbreaks and their patterns, their season, treatment and prevention. Community health is concerned more but not restricted to prevention of diseases. You will learn about the history of medicine and the fathers of the different aspects of medicine and their inventions. You will also learn Statistics to help you in taking information about disease outbreaks or research. You will start your community health in Pre-clinical and continue it even to the clinical.

In all the courses mentioned above, you will be writing continuous assessments in each of them. You can learn more about the nature of the medical examinations in Nigeria.

Throughout your 200 level, you will only write tests without writing exams. Your first professional examination comes in your 300 level. For the fact thatyou are not writing exam in 200 level does not mean you have free time, you will be engaged and the work load is much. All you have been doing in 200 and 300 levels will be combined in your first professional exam in 300 level.

300 level courses and activities in medicine and surgery

Your 300 level will be the year that you will write your first professional examination in Medicine and Surgery. This exam is called the Second (2nd) M.B.B.S professional examination. This exam combines all you have been doing in 200 level and 300 level. It requires consistent reading and attendance of lectures in order to pass this exam at just one sitting. You can learn more about the Examinations in Medical School here.

The courses you will betaking inyour 300 level are the same as the 200 level mentioned above. Other things such as practical and lectures are also the same.

Using the Goldmann Applanation Tonometer in our Ophthalmology Posting in Jos University Teaching Hospital

Clinical Activities in Medical School

After your 3rd year in medical school, you will then move to 400 level. But the 400 level is entirely a new environment, new form of learning, and many. From your 400 level to your final year (600 level), you will be engaged with clinical activities mostly withlectures at these activities take place at the Teaching Hospital of the University. Remember that in your Pre-clinical period, you were learning the normal functions of the human body, but in this clinical period, you will be dealing with the abnormal conditions and how to treat or restore them to normal.

You may pass exams easily in your pre-clinical if you read well, but in your clinical, you must continually make yourself present for clinical activities in order to understand the art and science of saving lives and also to be able to pass your exam. You are required to know more, and more is demanded from you. You therefore need to be more serious to pass the clinical exams and become a doctor.

400 level courses and activities in medical school

In your 400 level, you will be having lectures in Pathology, Pharmacology, Medicine and Surgery. These courses can vary according to variousuniversities but here in University of Jos, this is how it is done; some universities may take pharmacology in 300 level while others may take medicine in final year. But it all depends on what your universitydecides. But you must do all the courses at the end of the 6 years. I am giving you what we do in University of Jos.

1. Pathology:

   This is the study of the abnormal function of the body. It studies how diseases come about and how it affects cells and how it manifests in physical form.
   Pathology is divided into four subdivisions. These divisions are taken as individual courses and in University of Jos, they are departments, standing on their own with each having its own Head Of Department, HOD.
   The subdivisions of Pathology include:
   Histopathology:This is the study of cells, their structures and how they are affected with diseases. This form of pathology studies diseases at the cellular level and how it manifest in the physical form. It requires the use of microscopes.
   When a surgical operation is done and a part of a tissue is removed in order to confirm whether the tissue has become cancerous or not (testing whether a cell is a cancer cell or normal cell), then the tissue being removed is taken to the Histopathology laboratory and it is viewed under microscope so as to understand whether it is normal or cancerous.
   Haematology:This is basically the study of blood and its related diseases. All the malignancies (cancers) of the Blood such as lymphomas, Leukamias and also some disorders such as Sickle Cell Anaemia, Thallasemias etc are all studied under haematology.
   Chemical Pathology: This isthe study of the disorders of electrolytes of the body and how they affect health. It explains how excess glucose and low insulin could cause diabetes; it also shows how potassium, calcium, sodium, water and many other chemicals interact in the body and how disease could occur if their equilibrium is distorted.
   Microbiology:This refers to the study of microorganisms such as Bacteria, Viruses, Fungi etc and how they could cause diseases. It shows how infections can be contracted, their mode ofaction, their life cycle, their classification and also how our immune system works to fight these infections.
   Pathology is a vast course and the examination seems to be the hardest in medical school.

2. Pharmacology:

   This is simply the study of drugs and how they interact with the body such as drug absorption, metabolism, excretion and side effects (adverse effects).
   In University of Jos, your third (3rd) M.B.B.S examination will only be Pathology and Pharmacology. This means you will write 5 courses comprising of the 4 courses of pathology and pharmacology. You will still have to do Medicine and Surgery in your 400 level together with Pathology and Pharmacology but you will only write Pathology and Pharmacology in the 3rd MBBS. You will only get to write Medicine and Surgery examination in the Final year.

3. Medicine:

   In your 400 level, you will be introduced into Medicine as a course. You will learn the ethics of the medical profession. You will also learn how to take the history of a disease in order to arrive at a diagnosis; taking the history is also referred to as clerking. You will learn the various types of diseases and their symptoms and signs and how to diagnose them. You will be shown how to perform examinations of patients coming with various diseases, infections, tumours, pains etc. You will learn both in class as lectures and also the practical aspect in the hospital. You will be given patients to ask them questions in order to knowwhat broughtthem to the hospital. After you take their history, you will be required to present the patient, that is, you will stand before a senior doctor and you will narrate everything you asked the patients and you will also say what you think is the problem of the patient and how to treat the patient.
   In the clinical period, you have to learn how to speak and communicate well.

4. Surgery:

   Surgery is also another course you will do as an introduction in 400 level. Here, you will learn the ethics of surgery and you will only watch how operations are done. You will enter the surgical theater and see how surgeons remove tumours, repair broken bones, and many others. You will have both surgery lectures and clinical aspects such as clerking of patients and presenting them.

All the clinical activities such as clerking and attending of theatres form part of your eligibility to sit for the examinations and also part of your assessment because you will be given log books to sign everything you do. After every procedure you watch or after every clinic, clerking, operation etc, the most senior doctor will sign in your log book and before writing examinations, an eligibility list containing the names of students qualified to write the exams is pasted. If your name is not eligible, you cannot write the exam. Eligibility is formed from your attendance of lectures, clinical activities and surgical theatres.

After being eligible, you will then sit for the 3rd M.B.B.S professional examination for promotion to 500 level.

500 level Courses and Activities of Medical School

In 5oo level, you will study Obstetrics and Gynaecology, Community Health, and Paediatrics.

Obstetrics and Gynaecology:This is a course that studies pregnancies (Obstetrics) and Women (Gynaecology). Therefore it is the study of pregnancy and women. All the infections related to just women alone, or the diseases affecting women alone and also taking care of pregnancies such as regular Antenatal visits are done under "Obs and Gynae".Your knowledge of learning how to take a good medical history that you learned while in 400 level would be required. Hence, learning how to clerk patients is vital in becoming a good medical doctor.

Paediatrics:This is the branch of medicine and surgery that deals with treating Children. It studies the disease that affects children, how the child grows and what could cause the delay in development.

Community Medicine:This is the branch of medicine that is concerned with disease prevention, outbreaks, statistics and some parts of treatments. It is concerned more about environmental health as it relates to or affect human health.
It is in community medicine that you will write your Medical project on a topic of choice. You will also go for another field project (Community diagnostic) in Gindiri where you will spend two weeks in the JUTH hostel. Everyone must go and it forms a major part of your assessment.

If you are eligible, you will then write the 4th M.B.B.S examination in Obstetrics and Gynaecology, Paediatrics and Community Medicine. The community health exams will include all that you have been doing from 200 level to 500 level. Even though you had done another community health exam in 300 level (2nd MBBS), you will still writeanother one again in 500 level (fourth MBBS) and your project must be submitted before the exam.

600 level Courses and Activities of Medical School

600 level is the final class in medical school. In University of Jos, the courses you need to do are just Medicine and Surgery. Remember that it was started as an introduction in 400 level. In 600 level, you will go into details, and you are now required to clerk a patient, perform an examination on the patient, and also know the laboratory investigations you need to order and the treatment modalities to take.

You are required to have known how to save a life because after the final examination (5th MBBS) you will be given a license to practice as a Medical doctor anywhere in the world and not just in Nigeria. It is therefore required of you that at 600 level, you should have known the basic skills to saving a life.

After your final examination in 600 level, you will be inducted as a medical doctor in Nigeria and the final certificate(license) to practice will be given to you. The certificate carries the award of the degree:M.B.B.Swhich stands for "Bachelor ofMedicine,Bachelor ofSurgery". This degree is the same as a Masters degree in Nigeria and can be used outside the shores of Nigeria.

The induction ceremony is just like convocation ceremony. It is during induction that the certificates are given after every graduating student must have taken an oath referred to as theHippocratic Oath.This oath binds the doctor to his patients and that of his practice; the doctor must abide by the oath and if found guilty in anyway contrary to what he sworn an oath to, his/her licensed could be revoked.

The Hippocratic oath has undergone so many changes, but the one accepted by the General Assembly of World Medical Association in 1964 is now called thePhysicians Oathwhich is written below:

PHYSICIANS OATH

"I solemnly pledge to consecrate my life to the service of humanity;

I will give to my teachers the respect and gratitude that is their due;

I will practice my profession with conscience and dignity;

The health of my patient will be my first consideration;

I will respect the secrets that are confided in me, even after the patient has died;

I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;

My colleagues will be my sisters and brothers;

I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I will maintain the utmost respect for human life;

I will not use my medical knowledge to violate human rights and civil liberties, even under threat;

I make these promises solemnly, freely and upon my honour."

One thing you have to know is that the Medical certificate in Nigeria has nothing like 1st class or second class degree. It is always Pass for everyone because medical schools in Nigeria do not make use of Grade Points. If you are able to graduate, the minimum point you could get would be equivalent to that of second class upper degree. But in reality, GP is not used in Medicine and Surgery in Nigeria, hence, there is no First class or second class or third class.

Congratulations!!, if God has helps you and yougothrough all these for the years it might take you, then finally you will emerge a medical doctor and you could use the title before or after your names minding the fact that it is not about the title but for the saving of lives!.

After your Induction, you will then start your housemanship or internship in any hospital of your choice that has a vacant space and is approved by the Medical and Dental Council of Nigeria, MDCN for internship. The MDCN is the organisation that have the sole power to issue license to any Medical practice in Nigeria.

Wishing you the best of luck in your quest to becoming a medical doctor, either in Nigeria or anywhere in the world.

You can also study Medicine and Surgery in other countries such as United Kingdom (London), United States of America, Ukraine and other African countries depending on how you can get Visa and your finance for funding the Education.