The mortal debate has been that the office of the Chief Medical Director in the Teaching Hospitals across Nigeria is an exclusive preserve of the medical consultants.
This debate has been on for a long time. While the non doctors have maintained that the office is not exclusively created to be operated in and occupied by medical doctors, they could not cite valid enactments to support their argument.
The generality of the arguments has refused to go beyond the issue of who is medically qualified. In the past and in the present times, the offices of the Chief Medical Directors in our Teaching Hospitals have been allocated to medical consultants who have been medically qualified for twelve years and who have also been consultants for five years.
This mode of appointments, and the persons appointed, did not only exclude the non medical practitioners, but also relegated and debarred other cadre of Medical practitioners like house officers, residents and medical officers, from being appointed Chief Medical Directors.
The highpoint of this piece is to ascertain the legal position on who can be appointed Chief Medical Director. This highpoint might also be pertinent as it regards the appointment of the Chairman Medical Advisory Committee (CMAC) and the appointment of the Director of Administration (DA) in our Teaching Hospitals. For instance, which professional practitioners are eligible to be appointed CMAC or DA in our Teaching Hospitals. The scope of this discussion shall be limited to the office of the Chief Medical Director.
The relevant sections of the Hospital Management Board Act will fall for interpretation at this moment.
Section 5 of the Hospital Management Board Act states :
Appointment of Chief Medical Director, Director of Administration and other staff
(1) There shall be for each hospital a Chief Medical Director who shall be appointed by the President on such terms and conditions as may be specified in his letter of appointment or as may be determined from time to time by the Federal Government.
(2) The Chief Medical Director shall—
(a) be a person who is medically qualified and registered as such for a period of not less than twelve years, and has had considerable administrative experience in matters of health and holds a post-graduate medical qualification obtained not less than five years prior to the appointment as Chief Medical Director; and
(b) be charged with the responsibility for the execution of the policies and matters affecting the day-to-day management of the affairs of the Hospital.
The specific requirements from this section are "medically qualified" for twelve years, holds "postgraduate medical" qualification for five years, and considerable "administrative experience" in matters of health. While "medically qualified" has been adjudicated to mean "medical practitioners", and postgraduate medical qualification can either be "academic or professional" postgraduate qualification, the third limb of the requisite qualification of "considerable administrative experience" is neither here nor there. It is vague and fluidy, and only crystallizes in the mind of the authority with the power of disposal of action. This is because, having considerable administrative experience in matters of health, does not import anything to mean that such a person must have been an administrative officer in matters of health. Such administrative experience can be considerable in a person even as a recipient of administrative directives and orders.
This brings us to the crux of the matter. With the forgoing analysis, it is now obvious that the office of the Chief Medical Director in the Teaching Hospitals is not meant for medical consultants alone. That office can be occupied by a post horsemanship doctor, a resident doctor, or a Medical Officer, who has been so qualified and fully registered as a medical practitioner for twelve years prior, and who has obtained Masters Degree certificate or PhD in medical areas of Paediatrics, medicine etc, or Membership or Fellowship qualification, and who has so obtained any of those mentioned postgraduate medical qualifications of five years duration.
The provision in the Act for considerable administrative experience is rather a surplusage as no such medical practitioners would have been left out of this considerable administrative experience in matters of health, either as the administrator or a recipient of administrative orders, after seventeen years of medical qualification and postgraduate medical qualification.
©Awkadigwe Fredrick Ikenna (MBBS, LLB, MWACS, DSC)
awkadigweikenna@yahoo.com
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ReplyDeleteI enjoy the above debate the legal luminary, but I have a problem with your definition of postgraduate medical qualifications. You implied that certification from the university could be used in place of residency training certification for the position of CMD. I am worried because the spirit behind such postgraduate qualifications meant that the certificate should be used in the teaching hospital. We know that university medical qualification beyond first degree is not recognized in clinical setting, hence how would such a candidate emerge as a CMD when his certification is not recognized in the hospital?
Again I think the NPMCN act stipulates as follows.
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Functions of the College
*The College shall have responsibility for the conduct of professional post-graduate examination of candidates in the various specialised branches of medicine, surgery, obstetrics and gynaecology and dental surgery and making awards in relation thereto accordingly*.
Hence does the above say who can award such postgraduate medical qualifications?
Once again Dalu for the write up.
The Act only provided for postgraduate medical qualification as I cited. There are two postgraduate medical qualifications viz masters/phd (in medical academic qualification ) and membership/fellowship (professional medical qualification).
ReplyDeleteThe masters/phd qualifications referred to here is not in anatomy or biochemistry as those are not medical qualifications but rather qualifications in basic sciences. The masters/phd relevant is in medical areas like Paediatrics, medicine etc. These are done in different countries that offer them.
I just repeated things I have already written in the article. But as you only understood few and not all, I repeat myself in the spirit of brotherly gratuitousness.
You appear persistently fixed on this NPMCN. What has NPMCN got to do with how a teaching hospital should be organized? The Hospital Management Board Act , and Teaching Hospital Act are the main relevant Acts, not Medical College Act that created NPMCN as an appendage.
Teaching hospitals have associate Universities. Teaching Hospitals have medical students to cater for. Teaching Hospitals have researches to be conducted etc.
CMDs must have postgraduate medical qualification, not professional postgraduate medical qualification alone. The word "professional " is not in the Act my brother.
Legislature does not care how we get skewed. They put their intentions down in black and white. That is the law.