RE: RESTORING MICROBIOLOGY GRADUATES TO NIGERIA’S HEALTHCARE SYSTEM
By Dr. Kemzi Elechi-Amadi (BMLS, MSc, PhD, HMD, D.Th, AMLSCN)
An online post with the above heading has been circulating on several social media platforms, including some academic platforms. Ordinarily, one would have ignored it as obviously a cry of someone who desperately desires what he is not qualified to have, borne out of sheer ignorance. But, in the interest of the general public, and to set the records straight, it is important that this publication is made.
The author(s) of that social media post ignorantly stated that “Microbiology graduates despite their specialized training in diagnosing infectious diseases, they are systematically excluded from hospital laboratories, where Medical Laboratory Scientists (MLS) who only borrowed Microbiology courses monopolize all roles, including Microbiology units” (sic).
Firstly, there is no comparison whatsoever between Medical Laboratory Science and Microbiology or any other discipline. Medical Laboratory Science is a globally recognized and regulated healthcare profession. There is no such status for Microbiology anywhere in the world. Again, the philosophy of Medical Laboratory Science, and the globally recognized professional roles of Medical Laboratory Science, are not shared with any other discipline or profession.
Graduates of Microbiology, Biochemistry and related disciplines have been made to think that they have a role in the medical laboratory services/hospital laboratories. They have also been made to believe that Medical Laboratory Scientists came into existence in the year 2003 with the enactment of the Medical Laboratory Science Council of Nigeria (MLSCN) Act 11 of 2003 (Cap M25 LFN 2004) and displaced them from the hospital laboratories. This obviously wrong mentality has been transferred from “one generation of their graduates to another” in a systematic fashion. They now see Medical Laboratory Scientists as their enemies. This is quite unfortunate.
It is important to state here that the training of Nigerian Medical Laboratory Scientists started with the colonial masters, wherein students of Medical Laboratory Science were made to do a two-year programme in Nigeria and then taken to the United Kingdom to complete the remaining two years of their Medical Laboratory Science programme (Medical Laboratory Science started as a 4-year programme). In order to commence the full training of Medical Laboratory Scientists in Nigeria, independent of United Kingdom, the Federal Military Government of Gen. Yakubu Gowon promulgated Decree 56 of 1968, which established the Institute of Medical Laboratory Technology of Nigeria (IMLTN), the regulatory body for Medical Laboratory Science. This agency of the Federal Government was given the legal and absolute power to regulate the training and practice of Medical Laboratory Science in Nigeria from 1968 (8 years after Nigeria gained her independence).
It was the amendment of that Decree that gave rise to the Medical Laboratory Science Council of Nigeria (MLSCN) in 2003. Therefore, saying that the profession of Medical Laboratory Science came into existence in 2003 and that Medical Laboratory Scientists used the MLSCN Act 11 of 2003 to displace graduates of Microbiology and other disciplines from health/hospital laboratories is nothing but a display of ignorance taken too far; Medical Laboratory Science has always been a regulated profession even from the United Kingdom where we copied from. Again, Medical Laboratory Scientists have never shared their professional status or their “shrine” (medical/hospital laboratories) with any other professional group.
Secondly, there is no evidence that graduates of Microbiology have ever been trained and licensed to practice the profession of Medical Laboratory Science; neither the Decree 56 of 1968 nor the MLSCN Act 11 of 2003, ever recognized Microbiology graduates to be eligible or qualified to practice Medical Laboratory Science. It has never happened anywhere in the world that the government of any country would give licenses to different groups of people to practice the same profession. That would be a recipe for anarchy in the society. One could imagine graduates of Physics, Chemistry or Mathematics asking to be integrated into Engineering practice and be licensed by COREN (Council for the Regulation of Engineering in Nigeria) to practice as Engineers simply because Engineers must undertake studies in these areas before becoming registered Engineers, or graduates of Philosophy being asked to be licensed as Lawyers simply because Lawyers do courses in Philosophy. Would these graduates of Microbiology sincerely allow themselves to be taken to the theatre for surgery by graduates of Anatomy? Would these same graduates of Microbiology subject themselves to physiotherapy treatment by a graduate of Physiology or Physical Education? Can a graduate of Pharmacology degree programme claim to be competent to perform the professional duties of a licensed Pharmacist? This madness must stop.
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Microbiology has several aspects, including Medical/pharmaceutical Microbiology, Environmental Microbiology, Industrial Microbiology, Food Microbiology, etc. Students of health professional programmes take courses in Medical Microbiology as a part of their training curriculum. Thus, students of Medical Laboratory Science, Nursing, Medicine & Surgery, Dentistry, Pharmacy, Optometry, and other healthcare professions must necessarily take courses in Microbiology at the foundational (pre-clinical) stages of their training (most often at 200L). If the graduates of Microbiology are asking to be licensed to practice Medical Laboratory Science, they should also ask to be licensed to practice Pharmacy (because Pharmacy has a specialty known as Pharmaceutical Microbiology) and indeed other health professions. They should also tell Nigerians how their knowledge of industrial, environmental and food microbiology make them more competent to practice in the hospital laboratories.
Every field of human endeavour must necessarily undergo growth and advancement. This is a proven historical fact. However, it becomes worrisome when such professional advancement begins to make people in that discipline to seek to encroach into the domain of another globally established professional discipline. What manner of growth and advancement will make any government to entrust the lives and healthcare needs of Nigerians to people who do not have the requisite training, competence, knowledge and licensure to man diagnostic laboratories? Students of Medical Laboratory Science undergo rigorous training in Basic Sciences (Physics, Chemistry, Biology, Mathematics), Basic Medical Sciences (Anatomy, Physiology, Biochemistry, Microbiology) as well as Pathology, Pharmacology and other areas. The students then proceed to study clinical topics in Haematology/Blood Transfusion Science, Clinical Chemistry (Chemical Pathology), Medical Microbiology and Histopathology in addition to other professional courses like Medical Ethics, Laboratory Management, Medico-legal studies, and so on. The students must also undergo Clinical Laboratory Posting from 300L to 500L, and must pass Professional Examinations as well as the regular semester examinations (minimum pass mark is 50%) before they are licensed provisionally by the MLSCN to undergo one-year Internship training in approved hospitals, where they are further exposed to real-life healthcare diagnostic services under the supervision of qualified Medical Laboratory Scientists, after which they can embark on the mandatory one-year National Youth Service Corps (NYSC). This mean that it takes a cumulative of seven (7) years of training to obtain the Bachelor of Medical Laboratory Science (BMLS), unlike the Microbiology graduates who go through a 4-year training in the Faculty of Science or Faculty of Biological Sciences, with no clinical component, as can be seen in their training curriculum as approved by the National Universities Commission (NUC). In order to specialize in any Specialty of Medical Laboratory Science, a Medical Laboratory Scientist is expected to undergo further postgraduate training (MSc, PhD and Fellowship programmes). Therefore, the practice of Medical Laboratory Science is way beyond what the graduates of Microbiology have been made to believe. Anyone of them who wishes to practice Medical Laboratory Science should do well to enroll into any accredited university in Nigeria or abroad to undergo the rigorous training and become licensed to practice as a Medical Laboratory Scientist anywhere in the world.
There is no short cut to entering into any professional practice. The National Universities Commission (NUC) will never be a part of the confusion by approving the same training curriculum for different programmes. They already know that the philosophies for each the programmes in Nigerian universities are clearly different.
The author(s) of the online post also made some other requests; that the National Assembly should pass Laws to “integrate Microbiologists into hospital laboratories” and also “create a regulatory council for fair representation”. As clearly enunciated above, graduates of Microbiology do not have the requisite training (as seen in their NUC approved curriculum), knowledge, skills and competence to practice Medical Laboratory Science. Therefore, they cannot be licensed to do so. Secondly, the government cannot set up two different regulatory agencies to regulate the same practice. So, there is no wisdom in calling on the Federal Government of Nigeria to set up a separate regulatory council to regulate Microbiology for the sole purpose of bringing them into the hospital laboratories. It is pertinent to note that there is no country in the world that has a regulatory council for Microbiology. Nigeria cannot continue to be a banana republic where absurdities happen.
Again, the demand of the Microbiology graduates to relocate the Departments of Microbiology in the universities to the College of Medical Sciences of each university, is clearly a sign of inferiority complex. One wonders how this relocation of the Departments would change their NUC-approved curriculum from non-medical to medical, or make them eligible for licensure to practice as Radiographers, Physiotherapists, Optometrists or Nurses. If they are moved to the respective Colleges of Medical Sciences of the universities, where would the Departments of Microbiology in polytechnics be relocated to? What of the universities that do not have Colleges of Medical Sciences? In all, there is no merit in what these graduates of Microbiology are demanding for.
It is understandable that they feel suffocated by the harsh economic realities in Nigeria. Graduates of Biochemistry, Physiology, Anatomy, Pharmacology, also suffer the same harsh realities after graduation from higher institutions. No one will be happy and fulfilled being stagnated after graduation from the university. The truth is that these graduates have potentials and can contribute to health/medical research, environmental management, agricultural research, and industrial advancement of Nigeria. Most importantly, they are full citizens of Nigeria, and therefore should enjoy all the rights and privileges of being indigenes of Nigeria. A better way to seek better opportunities is to urge government at all levels to create the conducive economic atmosphere for the establishment of industries, which will employ these graduates and engage them meaningfully. It may also be advisable for these graduates to urge the Federal Government of Nigeria to amend the Nigerian Institute of Science Laboratory Technology (NISLT Act 12 of 2003) to make Science Laboratory Technology a professional postgraduate programme. The NISLT has the following tracks/options: Microbiology Technology, Biochemistry Technology, Pharmacology/Physiology Technology, Chemistry Technology, Physics/Electronics Technology, Geology Technology, Petroleum Technology, etc. Thus, graduates of Microbiology, Biochemistry, Chemistry, Physics, Anatomy, Physiology, Pharmacology, Geology, Agriculture, etc, can undergo some specialized trainings with the NISLT to enhance their competence and skills. This will not only make these graduates more useful in Nigeria but will also make them relevant abroad. This will be more beneficial for the country than this misguided push for inclusion in the hospital laboratory services.
Another solution is to urge the Federal Government to pass an Act of the Parliament to establish and recognize the Physician Associate programme in Nigeria. Physician Associates (or Physician Assistants) are health workers who are trained and licensed to offer primary clinical care to the sick under the supervision of licensed physicians. This is necessary because of the inadequate number of physicians in the country. The Physician Associates can provide primary care, so that more medical doctors can be deployed to other critical areas of need in the healthcare system. When this programme is established under the Medical and Dental Council of Nigeria, graduates of Microbiology, Biochemistry and related disciplines can be admitted into the training and become licensed to practice as such on graduation.
Dr. Kemzi Elechi-Amadi (BMLS, MSc, PhD, HMD, D.Th, AMLSCN), writes from Port Harcourt, Nigeria
DISCLAIMER : the views expressed are the opinion of the author and it doesn’t in anyway reflect the views of this platform.
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