‘Not all medical faculty members need PhD’

TRACKING_____Not all medical faculty members need a doctorate for career advancement, a team of Nigerian medical professionals plying their trade abroad has said.

This was contained in a statement written by four Nigeria medical experts who have garnered vast experience medical research and training in the United States, United Kingdom and Canada.

According to them, the controversy over having the terminal degree as a prerequisite for promotion is unnecessary and avoidable if Nigeria embraces facts, experiences and best practices from premier medical institutions in other parts of the world.

The team comprises Dr. Sotonte Bobmanuel, consultant psychiatrist, Royal Blackburn Hospital, UK; Dr. Okeowo D. Ibitoye, Medical Director, Fairwood Internal Medicine, Glendale, US; Dr. O. A, Sobowale, Clinical Asst. Professor, Department of Obstetrics and Gynecology, Queens University, Kingston, Ontario, Canada; and Dr. Dolamu O.B. Sokunbi, Nacogdoches Nephrology, Nacogdoches, Texas, US.

While the National Universities Commission (NUC) regulates academic activities in the universities, it does have the obligation to exercise that authority in line with worldwide best practices.

Furthermore, on medical education and training at undergraduate and postgraduate levels, the foreign-based experts say the NUC shares some of these responsibilities with the National Postgraduate Medical College of Nigeria.

“The NUC appears to have erred in making an additional PhD degree a requirement, or at least something “desirable but not necessary” for academic career progression in Nigerian medical schools.

The NUC Executive Secretary is even quoted as having said that ‘if you have a PhD, your promotion will be faster.’ As if merely having the PhD is all you need whether or not you then use that PhD to advance medical knowledge and scholarship on a regular basis.

“The MDCAN (Medical and Dental Consultants Association of Nigeria) disagrees. To them, a PhD “does not add any further value to our training’ and “it does not improve our ability to train medical students and it doesn’t improve our ability to take care of patients.

They cannot both be right, but both sides may be able to find common ground on this important issue. What is the role of the PhD in medical education and research? We cannot resolve this debate without first agreeing on a few definitions of the terms of the debate.

And since we are talking about best practices from some of the highest rated medical institutions from all over the world, some of the terms may be international.

“The arguments in this presentation are derived from experiences in the U.S., U.K., and Canada. These experiences may or may not be considered relevant to the Nigerian situation, but they represent some of the best practices at some of the top medical institutions in the world.

A PhD degree is a doctoral degree, the highest academic degree that can be earned. Most academic communities also consider other doctoral degrees to be equivalent to the PhD. In the U.S.A. these other equivalent degrees include the M.D. (Medical Doctor/Doctor of Medicine) awarded to graduates of all medical schools.

This M.D. degree is equivalent to the MBBS. degree awarded by Nigerian medical schools, as indicated on the licensing certificates issued to holders of Nigerian MBBS degrees when they receive licenses to practice and/or teach medicine in the U.S.

“It is true that some medical faculty members all over the world hold PhD degrees in addition to their MD (MBBS).

And that many of the top medical schools in the world even offer combined MD-PhD programmes which they fund with generous scholarships and stipends.

These programs are designed to attract the best and brightest of those students who have decided to pursue full time scientist-researcher careers where they will spend 80-100 per cent in their laboratories doing research.

These full-time scientist-researchers run the research in the laboratories of premier universities and organisations like the US National Institutes of Health, pharmaceutical industry laboratories and other research-oriented institutions.

They are not, however, the core of the general medical faculty in any of those reputable medical schools and universities.

“For the core medical faculty, an added PhD is not usually considered to be of any added benefit and could in fact be considered wasteful of scare resources when you consider the cost of producing each MD-PhD scientist (in the US approx. $1m over eight-10 years).

Most medical school faculty members the world over do not have PhDs in addition to their medical degrees. Data from the website of the AAMC (American Association of Medical Colleges) confirms that in 2019, fewer than 10 per cent of all medical faculty in all medical schools in the U.S. held a PhD in addition to a medical degree. The actual number is 13,666 out of a total of 179,238 or 7.6 per cent.

“All top medical schools in the world recognise and require postgraduate fellowship training/board certification/Royal College/Nigerian College/West African College and other national/regional professional college memberships and fellowships as evidence of the training and scholarship required for its faculty members.

Career progression is then determined by evidence of continued scholarship and excellence. These schools all allow their faculty members to demonstrate their career advancement and eligibility for promotion through several different optional career tracks. None of these tracks require anyone to hold a PhD for rapid promotion,” they said.

Using as example the Duke University School of Medicine, which has 5 tracks available to all its faculty members who can choose whichever one they like, experts submitted that the promotion criteria are spelled out for each distinct career track.

All are equivalent and no one results in “more rapid promotion” than the other, the said. “Track 1 (Clinician-Practitioner-Educator-Administrator) is for faculty who are primarily engaged in patient care, clinical service functions, teaching or administration; track 2 (Researcher/Clinician-Practitioner/Teacher) is for faculty who hold MDs, MD/PhDs, PhDs and who are either clinician-scientists or are scientists who perform basic or clinical research and are engaged in patient care or service functions; track 3 (Researcher/Teacher) is for faculty who hold MDs, MD/PhDs, PhDs and who typically spend 75 per cent or more of their time in research; track 4 (Academic Clinician Non-tenured) is for faculty who have some clinical component to their professional activity and are committed to a career on clinical medicine; while track 5 (Research) is for faculty who are engaged largely in research endeavors and instruction (usually >80 per cent or more of their time) and who have little or no involvement in patient care.”

According to them, it is in track 5 that many PhD holders can be found. They added: “This is where the added PhD is clearly an advantage.

But this group is less than 10 per cent of the entire faculty. And the faculty who choose to enter this career track do not necessarily get promotions any faster than faculty in any other track.

‘’Harvard Medical School has its faculty website and faculty handbook documents open to the public (fa.hms.harvard.edu). There you can see all the criteria for appointments and promotions to the various academic positions.

‘’Holding a PhD, by itself, is not a criterion for appointment or promotion to any position. In fact, a quick perusal of online adverts for appointments to Full Professor at Harvard Medical School and other top medical schools shows that they say nothing about the desirability or superiority of PhDs.

Even if you do have a PhD, if it’s a clinical position in a medical school, you MUST have that fellowship training and board certification. Absolutely necessary.’’

Non-negotiable. If fewer than 10 per cent of all medical school faculty in the US hold added PhD degrees, then what could be the basis of the current position of the NUC?”