THE POSTGRADUATE MEDICAL COLLEGES ARE NOT EMPOWERED BY LAW TO CONDUCT COMPULSORY UPDATE AND SUNDRY COURSES FOR RESIDENTS.

This article was borne out of the legal and social incongruities of our time in Nigeria. The routine practice over the years is that the postgraduate medical colleges regularly organize courses for residents who are preparing for primaries, Part 1 and Part 2 exams. These courses are usually compulsory courses which the residents must attach evidence of attendance before they would be eligible to write the exams. The question this article seeks to answer is that there is no legal basis for this practice. In fact, the postgraduate medical colleges are not empowered by any law in Nigeria to train residents. They are only empowered to regulate the training of residents and conduct examinations for the already trained residents. The organization of update courses and other compulsory courses by the colleges is thus not backed by laws. This position is clearly provided in the regulatory laws of residency training program.

The undergraduate medical training is regulated by the Medical and Dental Council of Nigeria. This body approves institutions for the training of undergraduate medical students. The body also approves standards of knowledge required to be imparted into the trainee undergraduate medical students. These functions are clearly captured in Section 1 to 3 of the Medical and Dental Practioners Act of Nigeria. In the same manner, the Postgraduate Medical Colleges are empowered by the National Medical College Act and the Residency Training Act to approve institutions for the training of resident doctors in Nigeria. All the powers of training rest with the training institutions. The colleges only prescribe standards of training without being involved in the training itself. The colleges also approve the institutions for the training and conduct exams for candidates trained by the approved institutions.

Section 13 of the National Medical College Act, which mimicked Section 1 (2) of the Medical and Dental Practitioners Act states:

13. The College shall, from time to time, publish in the Federal Gazette and elsewhere as it may think fit-(a) particulars of the standards which are to be treated as sufficient for the purposes of examinations conducted by the College pursuant to this Act; and (b) the list of institutions recognised for the purposes of section 10 of this Act.

The descent of the colleges into the arena of training of resident doctors by conducting compulsory update courses and other sundry compulsory courses by themselves is akin to the Medical and Dental Council of Nigeria conducting update courses and other sundry compulsory courses for undergraduate jmedical students in Nigeria before the medical students are allowed to sit for any MBBS examination. This is not the spirit of the statutes establishing those bodies. The bodies are not supposed to be directly involved in the training. They only prescribe what the training institutions shall carry out. Only the training institutions are empowered to organize any form of training for the residents.

A candidate for residency training program examination is only required to fulfill the provisions of Section 10 of the National Medical College Act which states thus:

10. Where a candidate offers himself for examination under this Act he shall satisfy the appropriate Faculty Board- (a) that he is a registered medical practitioner or dental surgeon, as the case may be, so however that if the candidate is on the temporary register he may be examined only by leave of the Senate given either generally or as a special case; and (b) that he is in possession of and is therein named as the holder of a certificate from an institution recognised by the College showing that he has satisfactorily attended the prescribed course of training in the particular speciatised branch and for the prescribed period of the course.

The import of this provision is that the postgraduate medical colleges are exempted from the conduct of courses for the purposes of examinations of residents. Only the approved institutions can do that. The colleges can only regulate the institutions by ensuring that those update courses and the other sundry compulsory courses as prescribed by the colleges (like manuscript writing and medical ethics) are administered to the residents.

The beauty of this intendments of the Legislature is that residents across Nigeria are not made to risk their lives traveling all the way to attend update and other sundry courses in Abuja, Ibadan and Lagos, when their training institutions did not request for the extra-institutional training as required by law, and when their training institutions did not throw their hands in the air and affirmed that they could not organise the courses for those residents. The issues of cost, road traffic accidents and highway kidnappings will have been significantly obliterated. The issue of residents applying for sponsorship for the now-college courses will be a thing of the past, as the training institutions are required by law to conduct or organize the conduct of the courses of training for the residents, either in the institution of their training or in another institutions approved by the National Medical College.

See also Sections 2, 5 and 7 of the National Medical College Act for more on the functions of the Medical Colleges. The doctrine of ultra vires posits that statutory bodies have functions circumscribed by the statute creating them.  The apex Court had warned and stated unequivocally that any function not expressly or impliedly given to the statutory body is prohibited.

The residency laws of each training institution made it abundantly clear that any training institution which does not offer a particular course of training to the residents shall liaise with other institutions of repute to train their residents. These institutions of repute include teaching hospitals in foreign countries. Thus, where the director of residency training of an institution fails to organize update courses for his residents, he shall liaise with a nearby institution, or even collaborate with nearby institutions to organize befitting update courses for their residents.

There can thus be update and sundry courses organized by one or more training institutions in one state if one institution cannot organize the conduct, or if it comes to the worst, all the training institutions in one geopolitical zone of Nigeria could come together and organize update courses for their examination candidates. This is because, by virtue of Section 10 of the National Medical College Act, only an approved training institution can determine that a candidate has attained the requisite course qualification for the examination, and not the College organized courses.

However, if in the opinion of the postgraduate medical colleges, there are courses that training institutions cannot conduct for the residents, then the colleges could push for the amendment of the National Medical College Act to accommodate them in the training portfolio of residents. This is because, at the moment, the Act does not provide for direct College training of residents. Training institutions must be hospitals as provided by the Act.  The Colleges cannot approve themselves as residency training institutions as they are not hospitals as clearly defined in the enabling statutes. According to the Supreme Court in Afribank (Nig,) Plc. v. Akwara 2006 on the power OF THE CHIEF JUSTICE OF NIGERIA: Whether the chief justice of Nigeria has the power to extend the time to appeal] "The Supreme Court Act above having specifically granted power to the Supreme Court to extend the periods prescribed in subsection (2) has thus taken the matter out of the power of the Chief Justice of Nigeria in the exercise of his authority to make rules of court pursuant to section 236 of the 1999 Constitution. In other words, whereas the procedure for bringing an application for extension of time to appeal shall be in accordance with the rules of court, the power to extend the periods to appeal is directly vested in the Supreme Court. That power clearly derives from Statute. There is therefore no power in the Chief Justice of Nigeria to extend the time to appeal even if he could make rules governing the procedure to be followed. The rules of court could not therefore prescribe an extension of time to appeal." Per Oguntade, J.S.C. (Pp.14-15, Paras.G-D)

Awkadigwe Fredrick Ikenna
awkadigweikenna@gmail.com

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