The document discusses issues with the current medical profession selection process in Nigeria and proposes a new, more rigorous process. The current process lacks the ability to properly assess candidates' intelligence, aptitudes, academic achievement, and personality, resulting in many unqualified or dangerous doctors. The proposed new process would evaluate candidates based on intelligence, aptitude, and achievement tests as well as a personality assessment to identify the most qualified candidates with the appropriate traits for the profession. The goal is to improve quality and safety in the medical field by only admitting the best candidates.

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
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2. Abstract
From experience and research it is clear that the medical profession in Nigeria is
littered with dangerous doctors. This is because the present admission process
into the profession lacks the capability to select only the best candidates. Hence a
new selection process has been described in detail, and recommended. 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. The training
programme should also have inbuilt continuous selection procedures. A school
testing programme will make the proposed selection process rather easy. The
overall aim of the new process is to produce the best crop of medical doctors for
Nigeria.
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3. Introduction
Some years ago, in interactions with his Masters and doctoral students
concerning the job performance and behaviours of Nigerian medical doctors, the
writer found out that the picture was gloomy. He decided to extend his curiosity
to members of the public. The picture that emerged was similar to the one
painted by the students. It was then that the writer recalled what happened in a
part of Nigeria much earlier; which he commented on (Ikeotuonye 1986). A
doctor 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 Nigerian
medical doctors got heightened when he became Dean of postgraduate school. A
good number of medical doctors applied for admission into Postgraduate Diploma
in Business Administration and Masters in Public Administration. He could not
believe his eyes and ears. He engaged some of them in conversation in order to
find out why they were interested in postgraduate studies in business and public
administration instead of medicine. The answers he got actually pointed to
interest in making money rather than professional growth and development.
There is still another incident worth narrating here. The writer went to a Nigerian
university to clarify the issue of admission for his daughter. While he was with the
Head of Department, a man walked in. He was anxious to know if his Joint
Admissions and Matriculation Board (JAMB) score came within the cut-off point.
The HOD checked through the list and congratulated him. In the process of
jubilating, he revealed that it was his fifth attempt at the JAMB examinations. The
writer quickly estimated his age, and put it at 25 years. The man said that he got it
right. You can imagine that man becoming a medical doctor. The question is: Did
he get through, that time around, because his capabilities suddenly increased; or
because he became sophisticated in test- taking skills? Another question that
could be raised is: Was he the one who wrote the examination in that fifth
attempt?
The cumulative effect of the experience narrated above was a very strong doubt
about the competence and the behaviours of Nigerian medical doctors. The
writer decided to do something about it. He, therefore, got one of his doctoral
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4. students to research into the personality characteristics, vocational interests and
job satisfaction among medical doctors in hospitals in a location in Nigeria. The
study (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 rigorous
selection process into the medical profession.
The Present Selection Process
It is known that there is no special selection process into the medical profession in
Nigeria. Secondary school students or graduates who wish to read medicine sit for
the Joint Admissions and Matriculation Board examinations. Those of them who
come within the cut-off point of various universities are given admission to read
medicine. It is only recently that some universities introduced post JAMB
examination. Even then, the one that the writer has seen comprises objective
questions in English, Mathematics and General Knowledge. This, of course, is
similar to JAMB examination in some respects.
In addition to secondary school graduates who are admitted into medicine, there
are university graduates in the sciences who are also admitted. This also is not the
kind of selection process that will bring out candidates who are talented and
properly disposed to read medicine.
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5. The Uniqueness of the Medical Profession
The medical profession is one of the few areas of human endeavour that require
special talents. It is not an all comers’ profession. Even engineering cannot
compare with medicine in its requirement of a very high level of talent. If we may
compare medicine with teaching, for example, it is easy to see that the teaching
profession, particularly at the primary and secondary levels, has tolerance for a
very broad spectrum of talents. The medical profession has spaces only for the
best of human abilities. The writer is a teacher; thus, he has no intention of
discrediting his profession. Some professions or areas of human endeavour have
tolerance 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. A
teacher, for example, can give wrong information and correct it immediately or
later. An engineer can come out with a faulty design and correct it later. A lawyer
can err in law. If a court judge errs in law at a lower court, the mistake can be
taken care of at a higher or appeal court. What has been written can go for some
other professions. The question is: Can the medical doctor afford mistakes with
human life? Another question is: Can the medical doctor afford to be unethical
with human life? The answer to the two questions is: Even the slightest mistake
or unethical behavior by the medical doctor can cost human life.
Need for a Very Rigorous Selection Process
The need for a very rigorous selection process into the medical profession cannot
be overemphasized. In one of his publications (Ikeotuonye 1990) the writer
presented 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 is
a complex counseling situation that should bring future happiness to the student;
but conversely can spell disaster if mishandled” (Ikeotuonye 1990:204). It is very
important to add that if the counseling is properly done, it brings happiness not
only to the student but also to society. On the other hand, if the situation is
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6. mishandled, it spells disaster, for sure, not only for the individual but also for
society.
The suggestion was also made (Ikeotuonye 1990) that the following questions are
pertinent.
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 process
short of that will continue to present the situation of littering the Nigerian nation
with 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 hardly
know 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 selection
process must be rigorous. It is absolutely important to determine a person’s
general scholastic and occupational ability (Ikeotuonye 1990, 2003). Here comes
the 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 in
seconds. As far as the writer is concerned, the medical profession is not for
persons with average intelligence. Average intelligence, which is probably where
most Nigerian doctors belong, is not for the medical profession.
Just imagine that Nigerian medical doctors, unfortunately like their counterparts
in other professions, view developments in the medical profession with awe and
bewilderment. For the average Nigerian medical doctor, practice comprises
listening impatiently to patients and prescribing drugs, sometimes the wrong
drugs. It is unfortunate. You can imagine what the situation will be in future with
ill-prepared Federal, State, and Private Universities pretending to train medical
doctors.
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7. As stated above, the beginning point of selection into the medical profession is
the determination of the person’s general scholastic and occupational ability by
means of a valid and reliable intelligence test. The next step is to assess the
person’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 as
stated elsewhere (Ikeotuonye 1990, 2003) an intelligence test can tell you the
occupational level at which an individual can perform, but it cannot tell you
anything 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 and
weaknesses. The aptitude profile shows the occupational cluster in which the
individual will rely mainly on his strengths with little or no demand on his
weaknesses. The write notes with pleasure the recent development in the
banking industry whereby selection into the industry is now based on aptitude
testing.
The selection process into the medical profession is only about half-way through
if the individual scales through the intelligence and aptitude tests. It is now time
to look at his school attainment. School achievement helps to determine an
individual’s readiness to benefit from a course of training leading to a desired
occupation. The training programme that leads to a first degree in medicine
requires excellent achievement in the prevocational subjects, namely,
mathematics, biology, chemistry, physics and English Language. The person
aspiring to be a medical doctor needs to show excellent attainment in the named
prevocational subjects.
This is now the juncture at which it is appropriate to recall that Nigerian
universities base selection into the medical profession mainly on JAMB scores and
school achievement. Even then, very low levels of school achievement are
acceptable to most universities in Nigeria, particularly when they are backed up
with personal intervention variables, including the notorious quota system of
selection. Those interested in the writer’s views on the quota system of selection
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8. can see a couple of his previous publications (Ikeotuonye 1986, 2003). A summary
of his view suggests that for very sensitive situations like selection into the
medical profession, the quota system should not apply, not at Local, State or
Federal levels. Only the best is good for the medical profession.
If a person who desires to go into the medical profession scales through the
intelligence, aptitude, and achievement tests levels, he is close to the end of the
initial selection process. What is left is the assessment of his personality. This is as
important as the levels before it. Ikeotuonye (1986, 1990, 2003), Ikeotuonye,
Maisamari and Badu (2003) and Ojiah (1998) made it very clear that personality
characteristics are as important as intelligence, aptitudes and school attainment
in 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 choice
and 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 their
personality types. The medical profession is social service oriented. Thus, the
importance of appropriate personality characteristics for success in it cannot be
overemphasized.
Some readers may see the selection process recommended as laborious. Yes, it
should be. One reason why the process may seem laborious is that Nigeria has no
school testing programme. If it has, all that the counselor needs to do is to call for
the 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 means
of an effective school testing programme.” In fact, in that lecture, ‘A Schedule of
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9. School Testing Programme’ is given. It is up to the Federal and State governments
of Nigeria to decide to establish school testing programmes.
The Training Process for Medical Students
It is not enough to have a good admission selection process into the medical
school, it is absolutely important that the training process has inbuilt continuous
selection procedures. This is because human personality is fluid. If, for example, a
student develops very unethical behaviors, he has to be shown the way out. This
inbuilt selection process will help to ensure that at the end of the day, Nigeria has
the best crop of medical doctors; quite unlike the present situation whereby the
profession is littered with dangerous doctors.
Summary
The medical profession in Nigeria does not have a shortage of dangerous doctors.
This is because the present admission selection process into the profession does
not have the capacity to bring in only the best into the profession. A new
selection process has been described in detail, and recommended. This new
selection process will help Nigeria to produce a good crop of medical doctors. To
continue with the present situation is to place the lives of Nigerians in the hands
of many dangerous doctors.
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10. References
Crites, 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.
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