• 30 NOV 18
    • 1
    MDCN and the Practice of Medicine Limitations and Way Forward

    MDCN and the Practice of Medicine Limitations and Way Forward

    Dr. T. A. B. Sanusi,
    BDS, M.Bioethics, LL.M
    Medical & Dental Council of Nigeria

    Introduction/Historical Perspectives
    Regulation of Physicians and Dental Surgeons in Nigeria preceded the statutory provisions
    Portuguese were the first set of allopathic doctors recorded in Nigeria, came in 1472
    In the year 1504, the Roman Catholic Mission opened a hospital at St. Thomas Island off the Bight of Benin
    About same period the Trans Atlantic slave traders came with ship doctors and surgeons that attended to the healthcare needs of the slavers and slaves

    During the year 1865, the Roman Catholic Mission established another hospital, the Sacred Heart Hospital at Abeokuta whilst St. Margaret’s Hospital Calabar also came into being in 1898
    Before the establishment of these hospitals, a medical examining board in 1789 recorded doctors’ names mainly Dutch, followed by Danish and British names on its register

    Notably most of the explorers that came to Nigeria were medical men such as Mungo Park, David Livingstone, Schnister, John Kirk
    Some of the doctors of Dutch West Indies Company went to Benin and treated the local people
    West African Medical Service originated from the West African Frontier Force with the Medical Departments of the various British Colonies( Nigeria, Ghana(Gold Coast), Sierra Leone and the Gambia) established in1902

    It was in that era that the regulation of the conduct of medical and dental practitioners started in Nigeria
    Thus establishing the Medical Practitioners Disciplinary Board in the Colonial Dept of Health for the doctors whose names were in the register of GMC in England with the Director of Medical Services being the Chairman
    This position of statutory regulation of the professions of Medicine and Dentistry was maintained till independence in 1960

    The indigenous statutory regulation came into being through the effort of the then and first Nigerian Inspector of Medical Services, Sir(Dr) Samuel Manuwa
    This effort culminated into promulgation by the Federal Parliament of the Medical and Dental Practitioners Act that became operational from 18th December 1963

    This law created Nigeria Medical Council, the first regulatory body for the professions of Medicine and Dentistry in Nigeria
    Had its Inaugural Meeting on Saturday 24 October 1964 at the Boardroom of the Federal Ministry of Health
    Dr.S.O.Awoliyi was the first President with memberships drawn from;

    University of Ibadan
    University of Lagos
    Ministry of Health,Kaduna
    Ministry of Health,Ibadan
    Ministry of Health,Enugu
    Ministry of Health,Port Harcourt
    Royal Orthopaedic Hospital,Igbobi,Lagos
    Vom Hospital,Vom,Northern Nigeria
    Private Practice
    Dr.M.S.Graham-Douglas was the first Registrar of Council

    Mandates of Council
    Determining the standards of knowledge and skill to be attained by persons seeking to become members of the medical or dental profession and reviewing those standards from time to time as circumstances may permit
    Securing in accordance with the provisions of this Act the establishment and maintenance of registers of persons entitled to practise as members of the medical or dental profession and the publication from time to time of lists of those persons

    Reviewing and preparing from time to time, a statement as to the Code of Conduct which the Council considers desirable for the practice of the professions in Nigeria
    Performing the other functions conferred on the Council by the Act
    Following the amendment by Decree 78 of 1992, the functions of MDCN were expanded to include;

    Supervising and Controlling the practice of Homeopathy and other forms of Alternative Medicine i.e. Naturopathy, Acupuncture and Osteopathy
    Making regulations for the operation of Clinical Laboratory Practice in the fields of Pathology, which include Histopathology, Forensic Pathology, Autopsy and Cytology, Clinical Cytogenetics, Haematology, Medical Microbiology and Medical Parasitology, Chemical Pathology, Clinical Chemistry, Immunology and Medical Virology.

    Provisional: This is granted on graduation from accredited medical school or passing the Assessment Exam i.e. foreign trained graduates as this will enable newly qualified to the mandatory one year housemanship
    Full: Granted immediately on successful completion of housejob
    Limited/Temporary: Granted to foreigners wishing to practise in Nigeria. Here there are two types, those with recognised additional qualification(s) may not need to sit for assessment exam while those without recognised additional qualification will sit and pass assessment exam before registration.

    Challenges of Registration
    Foreign trained graduates now come with unverifiable certificates
    Some foreign trained graduates don’t have our minimum entry requirements into local medical schools
    Non payment of practising fees as at when due
    Universities not releasing the degree certificates on time especially for those seeking for full registration
    Internship training centres releasing these doctors and signing them off before completion of housemanship
    Teaching Hospitals reluctance in engaging the house officers to fill up the quota granted by MDCN
    Impersonation/Falsification/ “Quackery”

    Non Payment of Practising Fees
    Section 14(5) MDP Act states “Any medical practitioner or dental surgeon who in respect of any year and without paying the prescribed practising fees practices as such shall be guilty of an offence and shall be liable on conviction:
    In the case of a first offender, to a fine of twice the prescribed practising fee; and
    In the case of a second or subsequent offence, to a fine of not less than ten times the prescribed fee, and if the medical practitioner or dental surgeon is in the employment of any person, that person shall also be guilty of an offence and punished in like
    manner as the medical practitioner or dental surgeon unless he proves that
    the failure to pay the practising fee was without his knowledge, consent or

    Due to various challenges in the practice, Council at its December 2007 meeting at Ado Ekiti created this department with the following functions;
    -Inspection of Accredited Medical/Dental Schools
    -Inspection of Internship Training Institutions

    Prior to Decree 67 of 1979 MDCN had jurisdiction over both undergraduate and postgraduate trainings.
    The only postgraduate training under MDCN now is the housemanship
    Essentially MDCN prepares the Minimum Guidelines for Medical and Dental Education at the undergraduate level
    Section 9 of MDPA is instructive with subsection 3 conferring the legitimacy of instituting the Assessment Exam on the holders of foreign medical or dental qualifications recognised by the government of the countries from where such qualifications are obtained.

    Professional Discipline
    Section 15 of MDP Act Subsection 1 established Disciplinary Tribunal which is our domestic court that technically has a status of the High Court
    Subsection 2 is about the composition of the DT, stipulates that the Chairman of Council is the Chairman of the DT with other ten members that shall include not less than two persons who are fully registered dental surgeons.

    Subsection 3 established the Investigating Panel whose function includes
    Conducting a preliminary investigation into an alleged professional misconduct
    Compelling any person by subpoena to give evidence before it
    Make order for interim suspension of registered practitioners for the protection of the members of the public

    Subsection 4 provides that Council shall appoint fifteen members of the Panel with not less than three dental surgeons as members

    Please note the difference between memberships of both Disciplinary Organs of Council.

    Penalties For Professional Misconducts
    Striking off the name from the relevant register
    Suspension from practice for a period not more than six months
    Admonishing the registered practitioners

    Limitations of MDCN
    Lack of funding despite adequate budgetary proposal
    Frequent dissolution of Council
    Disciplinary organs of Council can not function anytime it is in abeyance
    Council can not prosecute quacks caught.

    Ways Forward
    Allowing the perpetuity of Council via constitutional amendment so that when boards of parastatals are dissolved regulatory bodies are exempted
    Another constitutional amendment that will not tie the membership of the disciplinary organs to members of Council alone esp. DT
    Good Funding
    Allowing the doctors to take its statutory positions on the boards of other professions allied to Medicine and Dentistry esp. on their Education Committees

    Leave a reply →
  • Posted by Dr Abubakar Usman Ibrahim on December 30, 2018, 12:39 am

    How much is payment for additional qualification and how can I pay.

    Reply →

Leave a reply

Cancel reply