Requirements and what to expect
All newly graduated Doctors both foreign and home trained must undergo one year of Internship (Housemanship) before they can gain full registration with the Medical and Dental Council of Nigeria (MDCN). Housemanship is a one year postgraduation supervised clinical training.
It generally involves clinical training in all Medical & Surgical specialties such as Surgery, Internal Medicine, Obstetrics & Gynecology and Pediatrics. Interns usually refers to as House officers are required to learn basis of diagnosis and management of common cases. Everything learnt in Medical school is expected to be practicalized at this stage. House Officers would work under the guidance and supervision of senior doctors such as a Consultant or Senior registrar. The House officer work routine includes; attending ward rounds, making patient treatment progress note, clerking new patient, carrying out some treatment instruction, attending Consultant clinic and doing emergency call-duty.
In order to qualify to apply for housemanship, a newly graduated doctor must possess provisional registration and annual practice licence certificate from MDCN. This is usually issued to Nigerian trained doctors after graduation, where as foreign trained medical doctors obtain these certificates after passing MDCN assessment examination. Other documents that might be requested by the prospective hospital includes; Medical degree certificate, state of origin, birth certificate et al. Posting into house positions is not arrange in Nigeria, individual doctors have to find placement by themselves. Usually due to large number of doctors seeking placement, prospective hospitals might request doctors to undertake pre-employment interview/examination.
Finding the housejob
The MCDN usually provide to newly inducted doctors among other things a booklet that contains information about the hospitals that has approval to take house doctors across Nigeria. Because housemanship positions are limited and very competitive. It is important to apply to as many place as possible within one’s catchment area. It is helpful to list out the hospital of interest, find out their application date, fill their forms if application is ongoing and follow up to know the time for pre-employment interview/examination (if applicable).
Pre-employment interview for housejob usually involves oral examination on medical and non-medical subjects. Medical aspect of the exam at most times involves emergency scenario. For example you can be ask to explain the steps you would take if an unconscious patient is suddenly rushed into the Emergency. It is important for you to be calm and show confidence while answering the question. Examiners usually take fidgeting as a sign of incompetence and inability to work under pressure. Non-medical questions will usually include current affairs, some knowledge about the city/state where the hospital is situated and even the hospital itself. Get yourself updated before the interview date. Remember a simple click on “google” can make a difference.
Due to the limited number of paid position available, some doctors opt to take on a supra-numerary position. This means they would work as intern in an approved centre without being paid. This sort of arrangement helps them to save time usually spent in looking for a paid position, hence allowing them to fulfill the internship obligation required to gain permanent registration with MDCN. Not everybody can take this option, especially without having a strong family support.
The work environment
There are different types of hospital approved to take doctors for housemanship. There are tertiary level hospitals, secondary level hospitals and private hospitals. Tertiary level hospitals includes all teaching hospital, secondary level includes hospital such as Federal Medical Centre (FMC), General Hospital/State specialist hospital, Military hospital, some Mission Hospitals et al. Private hospitals can either fall into the category of tertiary or secondary level hospital.
Teaching hospitals are attached to a university. they are usually big with many specialist, professors and all kinds of medical practitioner. Teaching hospital usually is the last hope for most patient. They are very busy centres sometimes having long admission waiting list. If you gain a house position in this kind of hospital, you will be expose to a lot of teaching, see different kinds of uncommon ailments and observe rare & simple procedures. The only disadvantage most people have observed is that intern might have limited opportunity to try out basic procedure due to availability of more competent hands such as residents doctors.
Secondary level hospitals have been said to give house officers more opportunity to try out procedures. This enables them to therefore develop confidence in handling patient and also perfect the various procedure. They carry out most of the treatment instructions and reach out to a senior doctor only if they are having challenges. However house officer may not have the same level of exposure to cases, clinical teaching and procedure observation as one who intern in a teaching hospitals.
Personally, it is my believe that it really does not really matter where you gain a position. The most important thing is to be prepared to learn and work hard. Medicine as a profession involves lifelong learning and commitment to self improvement. This is the only way a doctor can be well equipped to serve his/her patient better.