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M.B.B.S GRADUATES ARE NOT 'DOCTORS' – AN EXPLANATION

The word “doctor” is one that comes with so many intricacies and controversies, with many people of the opinion that the word relates more to one group of people than the other, and more specifically, should be abolished from the titles of certain people.  In the terms of origin, the word “doctor” comes from the Latin word docere, which means “to teach”. Later on, this word has also been accorded to people who practice the healing arts or are trained in treating illnesses. But, in more modern terms, the word has appeared to be reconciled more with its roots, as doctor, as of nowadays, is a word that can refer to anyone with a doctorate degree, or simply put, a degree higher than the normal undergraduate degrees such as the BSc. and BA. This appears to have solved the confusion concerning calling just anyone a doctor, because most people in the healing profession need a doctorate degree as a prerequisite of their profession, and so therefore, could be termed “doctor” in two ways; a.) that they are in fact, people who treat illnesses, and b.) because they have a doctorate degree.

What then is a doctorate degree? A doctorate degree, according to Wikipedia, can be defined as an academic degree or research degree that qualifies the holder to teach at the university level in the degree’s field, or to work in a specific profession. Traditionally, most doctorate degrees have the word “doctor” in the full meaning of the degree accorded. For example, degrees such as PhD (Doctor of Philosophy), MD (Medical doctor) or DVM (Doctor of Veterinary Medicine) are doctorate degrees because they can usually only be gotten after the holder has completed at least four years of an undergraduate degree, and they connote specialization and possession of further knowledge than mere BSc holders.

Because doctorate degrees require that much dedication and a higher level of work, they take at least eight years to get and a minimum requirement of having an undergraduate degree already. An exception is the DVM in Nigeria, which can be awarded without an undergraduate degree and with a programme that runs for only six years. But, despite the clear difference of two years, a DVM gotten in Nigeria is the same as a DVM gotten anywhere else in the world, because, regardless of the time difference, the subjects, workload, practicals and clinicals are essentially the same, and what would be frowned upon as dissimilar would only be purely in terms of lack of modern equipment to adequately teach some areas of the profession. In terms of theoretical knowledge, there would be essentially no difference.

Unfortunately, the same cannot be said for human medical students.

Like veterinary medicine, human medicine, studied in most parts of the world, is a doctorate degree. It requires at least 8 years, with four years of an undergraduate degree, four years of medical school, and, in most cases, three years of residency. It has also been compressed into six years in Nigeria, just like Veterinary Medicine. But, unlike Veterinary Medicine, the degree accorded to human medical students is dissimilar to that awarded to medical doctors in other parts of the world. The usual medical doctor has a BSc degree and an MD degree, or in the case of doctors in India, an MBBS degree and an MD degree. But, in Nigeria, the degree accorded to medical “doctors” is purely MBBS, a degree that stands for Bachelor of Medicine, Bachelor of Surgery. People with MBBS are not exactly doctors in the same way people with doctorate degree are doctors. The term “doctor” here is purely ceremonial, because medical students in Nigeria do not in fact have a doctorate degree, but only two bachelor degrees. The normal amount of years required to study for a single bachelor’s degree is four years, and since M.B.B.S students in Nigeria are required to acquire two bachelor degrees in six years, this could explain their increase in workload compared to other students studying for bachelor degrees. This can be further proved by the fact that human medical students in Nigeria, on arriving abroad, have to first go back to medical school for four years and be awarded the MD degree, before they can be regarded as doctors. This is not the same for veterinary medical students.

So, what exactly is the difference between the training of a veterinary medical doctor and an MBBS graduate in Nigeria, even though the two courses run for the same number of years? The difference simply lies in the fact that while veterinary medical students go on from the preclinical phase of their education to the paraclinical phase to learn more theoretical knowledge about the different kinds of illnesses that affect animals in both the country and other parts of the world, human medical students essentially go on straight to the clinical phase. Thus, there is no actual grounded knowledge in actual abnormalities in the human body before they are thrust into the clinical phase of their education. This results in two things; a.) the students are taught about illnesses they can’t fully appreciate, having not had basic knowledge of them yet, and b.) the only actual illnesses they can be taught about are those that are endemic, that is, without proper theoretical knowledge, they aren’t exposed to illnesses foreign to their country.

While it is true that human medical students learn subjects such as Pathology, Microbiology, Parasitology and Pharmacology during the clinical phase of their studies (the same subjects veterinary medical students learn during the paraclinical phase) it is quite evident that human medical students in Nigeria are taught these subjects rapidly and only on surface level. This means they know very little about it, and for those students that might be motivated to read outside the class, they might be hampered by the sheer amount of workload being a clinical student brings about. So, while veterinary students have more than one year to learn about the different abnormalities that might be present in the animal body, human medical students use far less time, and subsequently, garner far less knowledge. In addition, since there are courses like medical laboratory science (MLS) in the medical field, human medical students in this country are not taught certain things that one could argue every doctor should be taught, such as bacterial and parasitic identification in the laboratory.

Does this mean that human medical students in Nigeria are not qualified to treat illnesses? No. MBBS graduates have been taught sufficiently to be able to recognise clinical signs of endemic diseases in Nigeria, and have been exposed to many diseases in the course of their clinical study that they are equipped to handle these diseases after graduation. But, unfortunately, since a basic paraclinical phase is lacking, these graduates would be unable to go to another country and adapt easily to the medical practice there because of lack of knowledge of any other illnesses but illnesses they are exposed to on the ward.

MBBS degree holders can also be called doctors, because a doctor could be defined as “someone who treats illnesses” and since even dentists without doctorate degrees are sometimes referred to as doctors, MBBS graduates can also be accorded with the same term. But, as stressed earlier, they can’t be seen as real doctors, because they do not, in fact, hold a real doctorate degree. Presently, there is an ongoing debate to refer to MBBS graduates as “Physicians” and not “Doctors” because they do not satisfy the prerequisites to being a doctor.