Picture this: a young Nigerian who has spent a minimum of seven years in medical school, putting himself through endless strikes, sleepless nights, and excruciating exams, finally graduates. But instead of moving forward in his career, he is told he must spend not one, but two more years in “compulsory service”—first in the hospital for housemanship, then in an often-worthless NYSC posting. This is the frustrating destiny of Nigeria’s medical graduates. The system is unfair and outdated. It is time we scrap NYSC for doctors or recognise housemanship as their service year.
Let us crunch numbers. A medical degree is supposed to run for six years. But thanks to ASUU strikes and institutional inefficiencies, most students spend at least seven or eight years in school. Some spend even nine or 10 years before graduating. If they had gone overseas to study, they would have returned and spent months preparing and taking the MDCN licensing exams. And then housemanship: a whole year of rotating through different hospital departments, working tedious shifts, and learning the practicalities of patient management. By this point, they have already spent years of service working for Nigeria’s healthcare sector.
Then there is another hurdle—NYSC. After all that training, they are supposed to serve yet another year before they can practice fully. That is, on average, a Nigerian doctor cannot enter the workforce fully until he or she is nearing 30. While their peers who read engineering, accounting, or law graduated in four years, did NYSC at 22 or 23, and have established their careers already. How is this fair?
The NYSC programme was created to deploy young graduates to where they will be of value to national development. But medical doctors are already doing that during their housemanship. Young doctors are deployed to hospitals across Nigeria each year to provide crucial healthcare services. They work long hours, in most instances in understaffed and ill-equipped hospitals, saving lives daily.
What is the rationale in asking them to do another year of “national service” if they have done one already? What will NYSC do that housemanship will not? The reality is, in most NYSC postings, doctors are underutilised or simply ignored. They sit in clinics doing nothing or very little, while hospitals that are desperately in need of doctors are left short-staffed. Not only is this a waste of time—it is a waste of human resources.
No serious country puts its doctors through the kind of bureaucratic red tape Nigeria does. In most nations, the minute a doctor graduates from medical school, he or she automatically falls into a well-structured system where they start to work, earn, and advance their careers. Nigeria, on the other hand, forces medical graduates into a gratuitous and career-stalling extra year of NYSC following housemanship.
Take South Africa, for example. The medical graduates serve two years of internship, which is highly remunerated and directly linked to their medical training. Then they enter a one-year mandatory community service scheme before being given a full medical licence. However, for Nigeria’s NYSC, the scheme is specially designed for doctors—such that they are posted to state hospitals where their services are most needed. They continue treating patients, acquiring valuable experience, and practice under proper medical supervision. It is a phase in their professional development, not an arbitrary service year. Medical students in Ukraine too are following the same pattern. Following six years of study in medicine, they have an organised internatura (internship) of 1-3 years, depending on the specialty. This is a compensated internship and an active participation in their professional development, allowing them to either start practicing or move on to specialisation.
Just around the corner in Ghana, medical graduates do one year of housemanship, which is remunerated, organised, and considered national service. Following this, they are at liberty to start practicing independently or subspecialising. It is the same case in Hungary, where medical graduates move straight into gyakornoki idő (hospital jobs or postgraduate training programmes) without going through an additional obligatory year of service. At the same time, in the UK and the US, medical school graduates proceed straight to their Foundation Programme (UK) or Residency (US), both of which are salaried positions that contribute to paying for their medical training and professional development.
Nigeria is the rule, not the exception. It is one of the few countries that still mandates that physicians, after graduating from years of medical school and another year of housemanship, waste an additional year in a programme that has no contribution to their professional growth, nor is it a requirement to obtain their full medical license. Compared to South Africa’s community service that is incorporated into a doctor’s training curriculum, NYSC lacks any inherent career value.
The worst? Quite a number of NYSC postings for doctors are random and disorganised. While some are posted to government hospitals, others are posted to health centres with little or no equipment, and some are even posted to non-medical postings, doing administrative work that has absolutely no connection to what they were trained to do—losing an entire year of precious hands-on experience.
Meanwhile, their counterparts abroad—who also graduated around the same period—are already getting ahead in life. By the time the Nigerian doctor finally completes NYSC, their counterparts in Ukraine, Hungary, Ghana, South Africa, the UK, or the US are already employed, advancing in postgraduate studies, or even considering specialisation. The Nigerian doctor, however, is only just getting their very first real job, during which time they are years behind their foreign counterparts.
Though established as a national integration programme, the NYSC programme, as it is currently, is of no use to doctors. This unnecessary delay is, in fact, stoking the brain drain issue. Our doctors see a system that is deliberately holding them back while their counterparts worldwide are making progress. Instead of wasting another year of their lives earning peanuts, many choose to leave as soon as housemanship is over, moving to countries where their careers can start without needless bureaucratic hindrances.
We must rethink the way we train and utilise our doctors. Nigeria cannot afford to lose its brightest medical minds to obsolete policies anymore.
I see only one reasonable option and that is:
If we truly care about our healthcare system, we need to stop making life harder for the very people we need to save it. It is time for our policymakers to do something.