DEMOGRAPHICS OF COLLABORATORS INVESTIGATING THE NIGERIAN MEDICAL AND DENTAL INTERNS: A MEDICAL INTERNSHIP TRAINING INNIGERIA (MINTING) STUDY COLLABORATION

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C. Eze¹, V.C. Eguogwu¹, K.I. Egbuchulem², I.S. Ojo¹, C. Iheme¹, M. Okor¹, S. Alawode¹, R. Ogunleye¹, N. Alozie¹, B.C.Obiora¹,T. Olatokun¹,C. Obere¹, P.O. Awoyomi³, K.K. Onyekweli⁴, P.E. Nkereuwem⁵, O.O. Adesina⁶, MJ Abulrazaq⁷, A.A. Isiaka⁸, A.B. Magaji⁹, C.E. Ofoha⁹, J.U. Mukoro¹, J. Negedu⁹, A.P. Omoloye¹⁰, F.I. Olapade⁶, E.O. Soyinka¹¹, G.C.Edeh¹², U.V. Ugwu¹³, S.I. Okogu¹³, M.D. Ogwuike⁹, M.O. Surakat¹, A.O. Adedire⁹ , F.C. Chukwu¹⁴, O.E. Babalola¹, E.O.Nwoye¹⁵, M.C. Nwokolo¹, R.B. Chima-Kalu¹, C. Onwurah¹, A.T. Adegboyega¹, S.O. Oluwalana¹, C.J Ezenwobi⁴, T.N.Agbo⁹, A.O. Afolayan⁸, S.O. Lawal³, C.H. Obodozie¹⁶, O.O. Omitoyin¹⁷, U.A. Iwuajoku¹, J.A. Sadiku¹⁸, O.O. Akintola¹⁹, P.O. Ogungbayi¹⁷, O.M. Bamigboye²⁰, H.D. Ogundipe², H.E. Akachuku²¹, R.O. Akinyemi²², O.A. Mokuolu²³,O.S. Ogah²⁴, D.I.Olulana², O.S. Ilesanmi²⁵, I. Adeagbo²⁶ on behalf of House Officers Research Collaboration Network (HRCN)

1. Department, University College Hospital, Ibadan, Oyo State.
2. Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan, Oyo State.
3. Federal Medical Centre, Abeokuta, Ogun State.
4. Federal Medical Centre, Jalingo, Taraba State.
5. University of Calabar Teaching Hospital, Calabar, Cross River State
6. Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State.
7. Federal Medical Centre, Bida, Niger State.
8. Federal Medical Centre, Jabi, Abuja.
9. Lagos University Teaching Hospital, Idi Araba, Lagos State.
10. Federal Teaching Hospital, Ido Ekiti, Ekiti State.
11. State Hospital Abeokuta, Ogun State.
12. University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State.
13. University of Uyo Teaching Hospital, Uyo, Akwa Ibom State.
14. Bowen University Teaching Hospital, Ogbomoso, Oyo State.
15. Jos University Teaching Hospital, Jos, Plateau State.
16. Federal Medical Centre, Umuahia, Abia State.
17. State Hospital Ijebu-Ode, Ogun State.
18. University of Benin Teaching Hospital, Benin, Edo State.
19. Hospital Management Board, Oyo State.
20. Federal Medical Centre, Owo, Ondo State.
21. Department of Orthopaedics, University College Hospital, Ibadan, Oyo State.
22. Department of Neurology, University College Hospital, Ibadan, Oyo State.
23. Department of Paediatrics, University of Ilorin, Ilorin, Kwara State.
24. Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Oyo State.
25. Regional Programme Lead, West Africa Centres for Disease Control and Prevention, Abuja, Nigeria.
26. Research Officer, AIPM and MINTING Study Collaborative.

Abstract

Introduction: The internship period is a peculiar time in a doctor’s career, and some have described it as a “nuisance year” during which the junior doctor assumes many roles at the same time. Junior doctors especially house officers are faced with many unique challenges; this is even more pronounced in poor resource settings like Nigeria. This study aimed to unravel and improve understanding of the challenges faced by medical and dental interns in Nigeria.

Methodology: A nine-member House officers Research and Statistics Committee (HRSC) was immediately set up to include three senior colleagues – Senior Registrars and Registrar. To carry out her responsibility efficiently the committee created the House Officers Research Collaboration Network (HRCN), a 103- member team comprising medical and dental interns from across Nigeria under a collaborative – Medical INternship Training in Nigeria (MINTING) study.

Result: Out of a total of the 103 House Officers Research Collaboration Network, 80 of them participated in this survey giving a 78% response rate. Ten of the intern Collaborators had additional qualification and seven of them had BSc as an initial degree. About 66 % of the Collaborators have never authored any publication. Of the 27 that have published an article; three collaborators are said to have published 15, 13, 16 articles respectively. Male collaborators where more likely to have published at least one article in the past. Thirty one of the 80 Collaborators have never been in a research collaborative group prior to this MINTING collaborative.

Conclusion: This commentary is set out to describe in detail Nigerian House Officers initiative in terms of the structure, functions, operational modalities, and to investigate the demographics of the HRCN collaborators which showed that over two third of collaborators have never authored any publication and about a third of them have never been involved in collaborative research. We also believe the findings will serve as policy guide and benchmark in training the critical medical health force.

Keywords: House officer, Housemanship, Intern, Junior doctors, Nigerian, Research, Trainee

Introduction

Doctors in the early stage of their medical career termed junior doctors or early career doctors (ECDs) are essentially medical practitioners who are resident doctors, medical officers below the rank of Principal Medical/ Dental Officers and Medical/ Dental interns.¹ House officers in Nigeria are young doctors, the most junior doctor of the team, supposedly fresh out of medical school, who have completed their medical training and have received a temporary license from the medical and dental council of Nigeria with which they proceed to embarking on a one-year uninterrupted practical training program called Internship (Houseman ship) under the supervision of a senior doctor referred to as a consultant, in any of the centers designated by the medical licensing council and are thereafter given a permanent practicing license upon completion of the training.
This is the formative stage in the career progression of a doctor and as such requires deliberate mentorship, networking, and guidance especially in research and clinical duties

This doctor is faced head on with an abrupt change in relationship with fellow colleagues, other health workers and patients.²

He is also at the same time undergoing training and research to practice as a professional in an increasingly
competitive society- https://youtu.be/SaaQmMHy_qI.³

Hence the importance of having a collaborative research network amongst young doctors cannot be overemphasized, as researchers are beginning to explore the many benefits that come with such collaborations.

Earlier studies have shown a strong association between collaboration and research productivity.⁴ Collaboration in research is said to have taken place when two or more investigators work together on a project and contribute resources and effort, both intellectual and physical.⁴

‘A house officer, therefore, is a doctor who is the most junior member of the medical staff of a hospital, usually resident in the hospital, United States and Canadian equivalent; Intern’.⁵

House Officers are in rigorous and intense mandatory one year training programme with accompanied workrelated challenges, which rests on the tetrapod of clinical service delivery, training, research, and health services management.^{1, 6}

In high income countries, various issues facing this category of medical doctors and dentists are widely researched giving useful input for policy formulation. This changes the pattern of interaction or relationship with various stakeholders that interphase with them. Furthermore, the more researched themes especially psychosocial issues among this sub-occupational group in Nigeria are subjects of majorly single institutional or regional studies.

Report from an institution-wide graduate medical education research collaborative amongst house officers in Nebraska showed a significant benefit for this type of collaborative resource to support and stimulate successful scholarly activity amongst house officers and this was evidenced by the number of projects they received in their first year of operation.⁷ However, in Nigeria today, there is no research collaborative network that exists amongst house officers nationwide. The closest to it is the early career doctors’ research network amongst Nigerian doctors in residency training.⁸

In view of this, a group of House officers at University College Hospital, Ibadan decided to create the first national house officers’ research collaborative network which was initially a Sixteen-man team but now has a membership strength of over a hundred house officers that cut across various houseman ship training centres in Nigeria.

This study will look at the demographics of this House officers research collaborative network while the MINTING Study in general is aimed at bridging the gap of the perceived dearth of data as it affects medical and dental interns in Nigeria. The House Officers Research Statistics Committee (HRSC) was created (Figure: 1) to drive this through the Medical INternship Training in Nigeria (MINTING) Study collaborative. This committee was commissioned by 11.00 Am on Friday, the 11th of August 2023 via a hybrid meeting; zoom and physical at the board room of Annals of Ibadan Postgraduate Medicine with the responsibility of exploring and bringing forth the available data on internship, with emphasis on demographic, psychosocial and workplace related issues among house officers in Nigeria who form a sizeable proportion of doctors providing medical care to over 200 million Nigerians. It started initially as a centerbased initiative and has grown to become a multicenter research collaborative project having the requisite resources and personnel to achieve its aims and objectives.