1.0. At the end of this article, it shall be abundantly clear that the Medical and Dental Council of Nigeria (MDCN) is not empowered by law to demand for money from specialists in Nigeria for the specialists' inclusion of their additional qualifications to their names in the Medical Registers.
1.1. What is even more baffling and embarrassing is that the MDCN does not just demand for money from the specialists to include their additional qualifications to their names in the Medical Registers in Nigeria, but that MDCN goes ahead to peg a timeline within which the additional qualifications must be brought for registration and failure to bring such additional qualifications the specialist is charged a whopping penalty of twenty thousand naira.
1.2. Worse still, the timeline starts on the date of passing the relevant postgraduate exams and not even from the date of award of the additional qualifications. The question there is then whether the specialist is registering result or registering awarded Fellowship. For while passing the Fellowship Exam is the first step to the award of Fellowship, passing Fellowship Exam is not synonymous with the award of Fellowship.
1.3. One is then left without any iota of doubt that the officials at the MDCN, against the clear provisions of all the laws regulating MDCN, snatched the ram of medical standards and slaughtered it right on the altar of questionable revenue drive.
2.0. At the threshold of this discussion, it must be stated clearly that Fellowship qualification is not an "approved qualification" as envisaged by section 6(2) of the Medical and Dental Practitioners Act (MADPA). Fellowship is a creation of laws (see National Medical College Act and the Medical Residency Training Act). Fellowship is not under the MDCN, much less being "approved" by the MDCN. Fellowship is superior to the MDCN. The remotest possibility is that it could fall within what MADPA stated as "accepted qualification" as provided in section 6(4)(c) of the Act. Yet, Fellowship cannot be said to be an accepted qualification or recognized qualification in any way whatsoever, as it is a legal entity in itself superior to the purported state of mind of MDCN as per acceptance or recognition by the MDCN. The mental position of the MDCN is immaterial when considering the appropriateness of the Fellowship. However, for the purposes of this discussion, we shall assume that Fellowship is registrable with the MDCN; if not for anything, the registration of additional qualifications by the Fellow will serve the purpose of Notice to the entire world that he is a specialist and thus a Consultant in that area. After all, that is what the Medical Register is all about - Notice. It is thus incumbent upon and imperative of the MDCN to include Fellowship qualifications of practitioners in the Medical Register as of exigent unconditional responsibility and function.
2.1. It is also submitted that section 6(3) of the MADPA provided for the keeping of three Registers (of the names, addresses and approved qualifications) only, by the Registrar of the MDCN. These were stated in the Act to be Registers of Fully Registered Practitioners, Provisionally Registered Practitioners and Practitioners of Limited Registration. No other Register is allowed by the Act. Section 6(7) even goes ahead to state that no one person shall have their name on more than one Register. Therefore, there is nothing like a Specialists Register in the law. Whether a practitioner is a Fellow or a Medical Officer, his name appears once in the Medical Register as a Fully Registered practitioner. Thus, the additional qualifications are not registered by the MDCN Registrar but instead are included to the qualifications of an already registered practitioner.
2.2. The three Medical Registers provided by section 6(2) of the MADPA are registers of names, addresses and approved qualifications. Thus, the entries that shall be made in the Registers are entries of: names, addresses and approved qualifications.
2.3. The Act expressly stated at section 6(4)(d) that while alterations of the names, the addresses and approved qualifications would be made free of charge, any entry of name shall be charged a fee. In other words, only the entry of the name of a practitioner in the Medical Register can be done on payment of fees. Once the practitioner's name has been entered in the Medical Register, subsequent additions or alterations regarding names, addresses and additional qualifications particulars of the registered practitioner is not subject to any fees whatsoever!!!
2.4. The Act was even explicit when it made the inclusion of an additional qualification free of charge at the discretion of the practitioner and not on the authority of the MDCN. See section 8(2) of the MADPA. It must be noted that Rule 6(a)(iv) of the Code of Medical Ethics 2004 did not help at validating the MDCN's imposition of the arbitrary fees for the registration of additional qualifications for the Fellows in anyway whatsoever. Non-registration of Fellowship with MDCN carries no benefit or penalty in all the laws in Nigeria. In fact, the award of Fellowship is complete in itself without the need for validation or assurances of the MDCN, and the registration of the Fellowship with the MDCN affords the practitioners no extra advantage in any way whatsoever except as a Notice to the world.
3.0. The imposition of N38,000.00 as fee for registration of Fellowship qualification on unsuspecting innocent practitioners, and the imposition of N20,000.00 penalty in addition to the N38,000.00 registration fee (ie now N58,000.00 in grand total) for those that did not register their "additional qualifications" within 6 months of passing the Fellowship exam, has become a thing of utmost concern to all standard-loving Nigerians. It is not long ago that the Federal High Court of Nigeria sitting in Enugu state declared the practice of the officials of the MDCN extorting building levies from medical practitioners across Nigeria as illegal and ultra vires.
3.1. Those practitioners who were extorted of the levy are already in court to get their money refunded. It is also not long ago that foreign medical graduates were compelled by the MDCN officials to pay N900,000.00 each for a botched compulsory pre-registration training. With this compulsory Fellowship registration at an unauthorized charge of N58,000.00 each, it has become urgent and imperative that the National Assembly of Nigeria and the Presidency examine the decision-making apparatuses and the source of legal advice of the MDCN as presently constituted to ascertain the motive behind the numerous illegal activities going on in that nobel medical body, and purge the body now before all the medical practitioners in Nigeria disappear from this country. The author of this article can no longer guarantee his continued stay to practice medicine under this oppressive and unlawful regulatory environment.
3.2. The harvest of unauthorized charges and fees from medical and dental practitioners across Nigeria in the name of NMA building levy, compulsory training and registration of additional qualifications, just to name a few, have no connection whatsoever to the statutory functions of the MDCN.
3.3. The MDCN officials are not a law unto themselves. The magnitude of authorities exercisable by a statutory body have been exhaustively decided upon in the cases of Amasike v. Reg.-Gen., C.A.C. (2010) 13 Nwlr (Pt. 1211)337 S.C., Inec V. Musa (2003) 3 Nwlr (Pt.806)72 And A Host Of Other Authorities. See Also The Orations Of Aniagolu J.S.C In Dominic Onuorah Ifezue V Livinus Mbadugha & Anr (S.C. 68/1982)[1984] Ngsc 36 (18 May 1984) on the Canons of interpretation of statutes particularly the Medical and Dental Practitioners Act itself.
3.4. The MDCN receives 30% of N10,000.00 to N20,000.00 annual Practising Fees paid by each of over 80,000 Nigeria-certified doctors across the world. It is therefore obvious that the only motivating factor for the imposition of fees additional qualifications and additional penalty for registration after six months of passing exams, is nothing more than an insatiable pulchritudinous revenue quest.
3.5. The time is now come, for the refund of all the fees paid by medical and dental practitioners across Nigeria for the registration of Fellowship and additional qualifications to MDCN. All the practitioners that have so far made such payments are entitled to a quick refund. We need not approach the court for this. But where this simple task becomes neglected, the court remains the last hope of the common man. And this time around, spurning a request for peaceful refund shall yield to a punitive cost of an aggravated litigation.
Fredrick Ikenna Awkadigwe (MBBS NIG, LLB NIG, MWACS, FWACS, SC)
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