1. ENHANCING PATIENT’S CARE IN
NIGERIA: THE CENTRAL ROLE OF
THE LABORATORY PHYSICIAN
ANATOMICAL PATHOLOGY SERVICES
IN NIGERIA
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2. 144 million population
35,000 medical doctors
<500 pathologists
Per capita (p.c.) income $300
Health budget $50 p.c.
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3. *How many
of these are
Nigerians?
307 million population
814,000 medical doctors*
20,000 pathologists*
Per capita (p.c.) income $39,000
Health budget $2,250 p.c.
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4. WHO ranking- health systems
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5. Central role of pathologists
• Pathology is the clinical diagnostic science
that underpins patient care (Royal College
of Pathologists, 2006)
• Pathologists apply laboratory methods,
and their interpretation to tissues and
fluidsobtained from the human body for
the purposes of patient diagnosis and
management (Bryant, 1993)
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6. Anatomical pathologist
A medically qualified physician who has
received specialised training in the
handling, processing, interpretation and
diagnosis of surgical pathology, cytology
and autopsy cases
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7. Methods in anatomic pathology
1. Gross morphology
2.Light microscopy
a.Histochemistry
b.Immunohistochemistry
c.In situ hybridisation, PCR, etc.
3. Electron microscopy
4.Ancillary techniques
a.Flow cytometry
b.Microarray technology
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8. Misconceptions about pathologists
• Pathologists are inquisitors
• Purely laboratory based and not a clinical
discipline
• Laboratory based data may be
incomprehensible to other clinicians
• A physician in the laboratory is not relevant
other clinicians (Anim, 2007)
• Human butchers (“laóku-laóku”)
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9. Roles of the pathologist
The pathologist interprets laboratory
data, manages capital and people and is
a quality and investigational resource
person serving in the roles of
1. Physician
2. Scientist
3. Educator
4. Leader
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10. Pathology training in Nigeria
Two sister Colleges (NPMCN and WACP)
Same basic philosophies, but slightly different
training rotations and examination formats
Junior rotation- entry with Primary
qualification- 2-3 years, both colleges
Senior rotation- specialist training in
Anatomic Pathology for 2-3 years;
dissertation
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11. NIGERIAN PATHOLOGISTSContributions
 Practising pathologists at every level in the country
and in the Diaspora
 A former State governor
 Chief Medical Directors
 Acting Vice Chancellors
 Provosts
 Deans
 Vice Deans
 Professors of Pathology, both at home and abroad
 ?Members of senate
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12. CONCLUSIONS
• There are several challenges- attrition of
pathologist population; inadequate funding of
service, training and research; misconceptions
from colleagues, public, administrators and
patients
• These challenges must be met head on by
ensuring maintenance of professional
standards, quality control, advocacy, serving as
role models to potential pathology trainees
• Pathologists should take up their role as leaders
in the medical profession and in society
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13. Thanks for listening!
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