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ACCESS AND QUALITY IN THE MEDICAL PROFESSION IN NIGERIA VIA                 PSYCHOLOGICAL TESTING                         ...
AbstractFrom experience and research it is clear that the medical profession in Nigeria islittered with dangerous doctors....
IntroductionSome years ago, in interactions with his Masters and doctoral studentsconcerning the job performance and behav...
students to research into the personality characteristics, vocational interests andjob satisfaction among medical doctors ...
The Uniqueness of the Medical ProfessionThe medical profession is one of the few areas of human endeavour that requirespec...
mishandled, it spells disaster, for sure, not only for the individual but also forsociety.The suggestion was also made (Ik...
As stated above, the beginning point of selection into the medical profession isthe determination of the person’s general ...
can see a couple of his previous publications (Ikeotuonye 1986, 2003). A summaryof his view suggests that for very sensiti...
School Testing Programme’ is given. It is up to the Federal and State governmentsof Nigeria to decide to establish school ...
ReferencesCrites, J.O. (1969). Vocational Psychology. New York: McGraw-Hill.Holland, J.L. (1966). The Psychology of Vocati...
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Access And Quality In The Medical Profession In Nigeria Via Psychological Testing

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This new process has the capacity to identify the best candidates for the profession; candidates with the appropriate levels of intelligence, aptitudes, and school achievement, as well as appropriate personality characteristics.

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Access And Quality In The Medical Profession In Nigeria Via Psychological Testing

  1. 1. ACCESS AND QUALITY IN THE MEDICAL PROFESSION IN NIGERIA VIA PSYCHOLOGICAL TESTING BY PROFESSOR ALPHONSO I. IKEOTUONYE, fnae FACULTY OF EDUCATION UNIVERSITY OF ABUJA, ABUJA 1
  2. 2. AbstractFrom experience and research it is clear that the medical profession in Nigeria islittered with dangerous doctors. This is because the present admission processinto the profession lacks the capability to select only the best candidates. Hence anew selection process has been described in detail, and recommended. This newprocess has the capacity to identify the best candidates for the profession;candidates with the appropriate levels of intelligence, aptitudes, and schoolachievement, as well as appropriate personality characteristics. The trainingprogramme should also have inbuilt continuous selection procedures. A schooltesting programme will make the proposed selection process rather easy. Theoverall aim of the new process is to produce the best crop of medical doctors forNigeria. 2
  3. 3. IntroductionSome years ago, in interactions with his Masters and doctoral studentsconcerning the job performance and behaviours of Nigerian medical doctors, thewriter found out that the picture was gloomy. He decided to extend his curiosityto members of the public. The picture that emerged was similar to the onepainted by the students. It was then that the writer recalled what happened in apart of Nigeria much earlier; which he commented on (Ikeotuonye 1986). Adoctor forgot a pair of scissors in a woman’s belly. Strange! Isn’t it?The writer’s curiosity about the job performance and behaviours of Nigerianmedical doctors got heightened when he became Dean of postgraduate school. Agood number of medical doctors applied for admission into Postgraduate Diplomain Business Administration and Masters in Public Administration. He could notbelieve his eyes and ears. He engaged some of them in conversation in order tofind out why they were interested in postgraduate studies in business and publicadministration instead of medicine. The answers he got actually pointed tointerest in making money rather than professional growth and development.There is still another incident worth narrating here. The writer went to a Nigerianuniversity to clarify the issue of admission for his daughter. While he was with theHead of Department, a man walked in. He was anxious to know if his JointAdmissions and Matriculation Board (JAMB) score came within the cut-off point.The HOD checked through the list and congratulated him. In the process ofjubilating, he revealed that it was his fifth attempt at the JAMB examinations. Thewriter quickly estimated his age, and put it at 25 years. The man said that he got itright. You can imagine that man becoming a medical doctor. The question is: Didhe get through, that time around, because his capabilities suddenly increased; orbecause he became sophisticated in test- taking skills? Another question thatcould be raised is: Was he the one who wrote the examination in that fifthattempt?The cumulative effect of the experience narrated above was a very strong doubtabout the competence and the behaviours of Nigerian medical doctors. Thewriter decided to do something about it. He, therefore, got one of his doctoral 3
  4. 4. students to research into the personality characteristics, vocational interests andjob satisfaction among medical doctors in hospitals in a location in Nigeria. Thestudy (Ojiah 1998) came out with very important findings: 1. Only 44 percent of the medical doctors involved in the study (that is 51 out of 116) had personality characteristics appropriate for the medical profession. This is not only unbelievable but depressing. 2. Only 50 percent of the medical doctors (that is 58 out of 116) had vocational interests appropriate for the profession. Again, this is unfortunate. 3. On the average, the medical doctors liked their job and felt satisfied with it.One of the recommendations by Ojiah was that there was need for a rigorousselection process into the medical profession.The Present Selection ProcessIt is known that there is no special selection process into the medical profession inNigeria. Secondary school students or graduates who wish to read medicine sit forthe Joint Admissions and Matriculation Board examinations. Those of them whocome within the cut-off point of various universities are given admission to readmedicine. It is only recently that some universities introduced post JAMBexamination. Even then, the one that the writer has seen comprises objectivequestions in English, Mathematics and General Knowledge. This, of course, issimilar to JAMB examination in some respects.In addition to secondary school graduates who are admitted into medicine, thereare university graduates in the sciences who are also admitted. This also is not thekind of selection process that will bring out candidates who are talented andproperly disposed to read medicine. 4
  5. 5. The Uniqueness of the Medical ProfessionThe medical profession is one of the few areas of human endeavour that requirespecial talents. It is not an all comers’ profession. Even engineering cannotcompare with medicine in its requirement of a very high level of talent. If we maycompare medicine with teaching, for example, it is easy to see that the teachingprofession, particularly at the primary and secondary levels, has tolerance for avery broad spectrum of talents. The medical profession has spaces only for thebest of human abilities. The writer is a teacher; thus, he has no intention ofdiscrediting his profession. Some professions or areas of human endeavour havetolerance for a wide range of talents; others do not have that kind of tolerance.A teacher can afford some types of mistakes which he can correct later. Ateacher, for example, can give wrong information and correct it immediately orlater. An engineer can come out with a faulty design and correct it later. A lawyercan err in law. If a court judge errs in law at a lower court, the mistake can betaken care of at a higher or appeal court. What has been written can go for someother professions. The question is: Can the medical doctor afford mistakes withhuman life? Another question is: Can the medical doctor afford to be unethicalwith human life? The answer to the two questions is: Even the slightest mistakeor unethical behavior by the medical doctor can cost human life.Need for a Very Rigorous Selection ProcessThe need for a very rigorous selection process into the medical profession cannotbe overemphasized. In one of his publications (Ikeotuonye 1990) the writerpresented a very common situation that students go to counselors with, namely,“I would like to be a medical doctor.” It was stated in that publication that “this isa complex counseling situation that should bring future happiness to the student;but conversely can spell disaster if mishandled” (Ikeotuonye 1990:204). It is veryimportant to add that if the counseling is properly done, it brings happiness notonly to the student but also to society. On the other hand, if the situation is 5
  6. 6. mishandled, it spells disaster, for sure, not only for the individual but also forsociety.The suggestion was also made (Ikeotuonye 1990) that the following questions arepertinent. 1. At what occupational level can the student perform? 2. What are his or her specific abilities? 3. What is his or her level of school attainment? 4. What are his or her personality dispositions?A good selection process into the medical profession must provide concrete,precise, valid and reliable answers to the questions stated above. Any processshort of that will continue to present the situation of littering the Nigerian nationwith dangerous doctors. In fact, Nigeria has no shortage of dangerous doctors.The reason why the situation has not come to the fore is that Nigerians hardlyknow or bother about their rights. Again medical doctors are still in short supply.Thus, if the Nigerian nation wants a good crop of medical doctors, the selectionprocess must be rigorous. It is absolutely important to determine a person’sgeneral scholastic and occupational ability (Ikeotuonye 1990, 2003). Here comesthe need for intelligence tests. Medicine requires a very high level of intelligence.Split second decisions have to be made. Human life can be saved or lost inseconds. As far as the writer is concerned, the medical profession is not forpersons with average intelligence. Average intelligence, which is probably wheremost Nigerian doctors belong, is not for the medical profession.Just imagine that Nigerian medical doctors, unfortunately like their counterpartsin other professions, view developments in the medical profession with awe andbewilderment. For the average Nigerian medical doctor, practice compriseslistening impatiently to patients and prescribing drugs, sometimes the wrongdrugs. It is unfortunate. You can imagine what the situation will be in future withill-prepared Federal, State, and Private Universities pretending to train medicaldoctors. 6
  7. 7. As stated above, the beginning point of selection into the medical profession isthe determination of the person’s general scholastic and occupational ability bymeans of a valid and reliable intelligence test. The next step is to assess theperson’s specific aptitudes, that is, if he has the appropriate level of intelligence.If he does not, the selection process, for him, comes to a close. This is because asstated elsewhere (Ikeotuonye 1990, 2003) an intelligence test can tell you theoccupational level at which an individual can perform, but it cannot tell youanything about the individual’s specific abilities and limitations.An individual’s specific aptitudes are easily identified by means of aptitude tests.The aptitude profile of a person very clearly shows his or her strengths andweaknesses. The aptitude profile shows the occupational cluster in which theindividual will rely mainly on his strengths with little or no demand on hisweaknesses. The write notes with pleasure the recent development in thebanking industry whereby selection into the industry is now based on aptitudetesting.The selection process into the medical profession is only about half-way throughif the individual scales through the intelligence and aptitude tests. It is now timeto look at his school attainment. School achievement helps to determine anindividual’s readiness to benefit from a course of training leading to a desiredoccupation. The training programme that leads to a first degree in medicinerequires excellent achievement in the prevocational subjects, namely,mathematics, biology, chemistry, physics and English Language. The personaspiring to be a medical doctor needs to show excellent attainment in the namedprevocational subjects.This is now the juncture at which it is appropriate to recall that Nigerianuniversities base selection into the medical profession mainly on JAMB scores andschool achievement. Even then, very low levels of school achievement areacceptable to most universities in Nigeria, particularly when they are backed upwith personal intervention variables, including the notorious quota system ofselection. Those interested in the writer’s views on the quota system of selection 7
  8. 8. can see a couple of his previous publications (Ikeotuonye 1986, 2003). A summaryof his view suggests that for very sensitive situations like selection into themedical profession, the quota system should not apply, not at Local, State orFederal levels. Only the best is good for the medical profession.If a person who desires to go into the medical profession scales through theintelligence, aptitude, and achievement tests levels, he is close to the end of theinitial selection process. What is left is the assessment of his personality. This is asimportant as the levels before it. Ikeotuonye (1986, 1990, 2003), Ikeotuonye,Maisamari and Badu (2003) and Ojiah (1998) made it very clear that personalitycharacteristics are as important as intelligence, aptitudes and school attainmentin talent hunt and development.In a similar vein some vocational psychologists, for example, Holland (1966, 1973)and Crites (1969) insist on the importance of personality in occupational choiceand development. Crites wrote: People whose personality are congruent with their vocations or environments are likely to experience a more stable vocational choice, higher vocational achievement, better maintenance of personality stability and greater satisfaction…..(p.116)Holland’s (1973) occupational theory also stated that people are most satisfied,productive and stable in work environments that are congruent with theirpersonality types. The medical profession is social service oriented. Thus, theimportance of appropriate personality characteristics for success in it cannot beoveremphasized.Some readers may see the selection process recommended as laborious. Yes, itshould be. One reason why the process may seem laborious is that Nigeria has noschool testing programme. If it has, all that the counselor needs to do is to call forthe counselee’s cumulative record folder and get all the tests results from there.In the writer’s inaugural lecture (Ikeotuonye 2003:22) it was made clear that“ability differentiation and personality clarification are easily achievable by meansof an effective school testing programme.” In fact, in that lecture, ‘A Schedule of 8
  9. 9. School Testing Programme’ is given. It is up to the Federal and State governmentsof Nigeria to decide to establish school testing programmes.The Training Process for Medical StudentsIt is not enough to have a good admission selection process into the medicalschool, it is absolutely important that the training process has inbuilt continuousselection procedures. This is because human personality is fluid. If, for example, astudent develops very unethical behaviors, he has to be shown the way out. Thisinbuilt selection process will help to ensure that at the end of the day, Nigeria hasthe best crop of medical doctors; quite unlike the present situation whereby theprofession is littered with dangerous doctors.SummaryThe medical profession in Nigeria does not have a shortage of dangerous doctors.This is because the present admission selection process into the profession doesnot have the capacity to bring in only the best into the profession. A newselection process has been described in detail, and recommended. This newselection process will help Nigeria to produce a good crop of medical doctors. Tocontinue with the present situation is to place the lives of Nigerians in the handsof many dangerous doctors. 9
  10. 10. ReferencesCrites, J.O. (1969). Vocational Psychology. New York: McGraw-Hill.Holland, J.L. (1966). The Psychology of Vocational Choice: A Theory of Personality Types and Environmental Models. New York: Gin.Holland, J.L. (1973). Making Vocational Choices: A Theory of Careers. Englewood Cliffs: N.J. Prentice Hall Inc.Ikeotuonye, A.I. (1986). Assessment of Affective Behaviour for Effective Nurse Midwife Education: Guidance for Nurse and Midwife Trainers. Nigerian Journal of Counseling and Development, 1, 133-139.Ikeotuonye, A.I. (1990). Appraisal in Vocational Guidance. In A.I. Ikeotuonye et al. (Eds.). Careers Guidance: A Vocational Approach for Schools. Zaria: Hudahuda Publishing Company, 201-214.Ikeotuonye, A.I. (2003). Talent Hunt: A Basis for Optimum Human and National Development. Inaugural Lectures Series 2. University of Abuja Publication.Ikeotuonye, A.I., Maisamari, J.Y. and Badu, J.B. (2003). The Vocational Interests of Medical Doctors in Hospitals and Clinics in the Federal Capital Territory, Abuja. Abuja Journal of Education 5, I, 1-18.Ojiah, P.O. (1998). A Study of Personality Characteristics, Vocational Interests of and Job Satisfaction among Medical Doctors in Hospitals in the Federal Capital Territory, Abuja. Unpublished PhD Thesis, University of Abuja. 10
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