Medical dental council of Nigeria Medical Dental Practitioners

Medical & dental council of Nigeria

Medical & Dental Practitioners’ Act Cap M 8 (1990) was set up to regulate medical/dental practice in Nigeria MDCN mandates: 1. Regulation of training in Medicine, Dentistry and Alternative Medicine in Nigeria � � 2. Regulation of Medical, Dental and Alternative Medicine practice in Nigeria. �

3. Determination of the knowledge and skills of these professionals. 4. Regulation and control of Laboratory Medicine in Nigeria.

� Health System: “all organizations, people and actions, whose primary interest is to promote, restore or maintain health” (WHO, wpro, 2015) Medical doctors/dentists/optometrists nurses/midwives/orderlies pharmacists/technicians/assistant lab scientist/technologists/assistants radiographers/US techs/ CT techs etc CHEW/jchews/vhw etc physiotherapists/occupational therapists/speech

� Trado-medical practitioners � Herbalists/”babalawos” � Acupuncturists � Traditional bonesetters � Church midwives/preachers casting out devils � Muslim clerical healers � Quacks Grandmothers

� Health system can be broken down into six different “building blocks”, namely: leadership/governance, healthcare financing, health workforce, medical products/technologies, information & research and service delivery

�Leadership & Governance: “involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, the provision of appropriate regulations and incentives, attention to system design, and accountability”

Leadership & governance encompasses – (USAID) o Strategic direction o Plans & policies o Effective oversight o Regulation o Motivation o partnerships

� MDCN was set up by the Medical and Dental Practitioners’ act 221, laws of the Federal Republic of Nigeria ( decree no. 23 of 1988)

Responsibilities: 1. To determine the standard of knowledge and skill for those seeking to become medical doctors & dentists and reviewing the standards from time to time

2. Creating and maintaining a register of persons entitled to practice as members of the medical and dental professions

� 3. Reviewing and preparing a code of conduct which the council considers desirable for the practice of the profession in Nigeria

� 4. Performing other functions conferred on the council by the law

� In 1992, its functions were expanded to include: � -supervising and controlling the practice of homeopathy and other focus of alternative medicine( naturopathy, acupuncture, and osteopathy)

Naturopathy or naturopathic medicine is a form of alternative medicine employing a wide array of "natural" treatments, including homeopathy, herbalism, and acupuncture, as well as diet and lifestyle counseling.

Osteopathy (from Greek ὀστέον, "bone" and – πάθεια, "disease of") is a type of complementary and alternative medicine which primarily consists of moving, stretching and massaging a person's muscles and joints. a system of complementary medicine in which ailments are treated by minute doses of natural substances that in larger amounts would produce symptoms of the ailment

Homeopathy is a system of alternative medicine created in 1796 by Samuel Hahnemann based on his doctrine of like cures like: a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people. a system of complementary medicine in which ailments are treated by minute doses of natural substances that in larger amounts would produce symptoms of the ailment

� -Making regulations for the operation of clinical laboratory practice in the field of pathology, histopathology, forensic pathology, autopsy and cytology, cytogenetics, hematology, medical microbiology, medical parasitology, chemical pathology, clinical chemistry, immunology and medical virology

History of regulation of medical practice in Nigeria � 1789 - A Medical Examining Board recorded doctors’ names, mainly Dutch, Danish & British doctors practicing in the general territory that became Nigeria. � 1902, Medical depts of British colonies of Nigeria, Ghana, Sierra Leone & Gambia were established and with it, the medical practitioners’ disciplinary board.

� In 1951, Dr Samuel Manuwa (surgeon & tropical medicine specialist) was made the 1 st Nigerian director of medical services & also became the inspector general of medical services � In 1954, he was appointed the chief medical adviser to the federal government of Nigeria � In these positions, he worked for the establishment of a university teaching hospital, resulting in the establishment of UCH, Ibadan

� He also put in place the 1 st regulatory body (forebearer to MDCN) for the medical and dental professions leading to the Medical & Dental Practitioners’ Act of 1963 � Medical & Dental Practitioners’ Act, 1963. (Established the Nigerian Medical Council{NMC}). Drs Awoliyi & Graham-Douglas were the 1 st president & registrar of the NMC respectively. � The NMC was succeeded in 1988, by the Medical & Dental Council of Nigeria (MDCN).

� Divisions & depts of MDCN -administration -registration -account -medical education -inspectorate -professional discipline -audit -legal -corporate affairs -information, education and communications -library -planning, research and statistics

The MDCN has two main publications: � 1. Guidelines on Minimum Standards of Medical and Dental Education in Nigeria. � 2. Rules of Professional Conduct for Medical and Dental Practitioners in Nigeria

Registrar & CEO- Dr Tajudeen Sanusi, BDS, MSc Bioethics, LLM(Cardiff) (Appointed December 2016) Chairman of council(board): Prof Abba Hassan, MBBS, FRCS(Glasg), FWACS; Wazirin Mubi, former CMD, Unimaid Teaching Hospital; (Appointed November 2018) Members; approx 60. No list of names is available at the moment.

� Functions of MDCN: 1. Registration and licensing maintaining a register of licensed practitioners in Nigeria -provisional -temporary -full -additional qualification

� 2. Education and Training a. accreditation of all medical/dental schls b. accreditation of hospitals for internship training c. continuing medical education (CME/CPD) d. assessment examinations (for graduates of foreign institutions & local graduates who fail to complete internship within 24 months of graduation)

Other functions: -discipline of erring practitioners Medical & Dental Practitioners Disciplinary Tribunal (MDPDT)- has the status of the High Court & judgements can be appealed to the Appeal Court Medical & Dental Practitioners Investigating Panel (MDPIP) -publications(Rules of Professional Conduct for Medical and Dental Practitioners in Nigeria)

Other organs: � Medical Education Committee � Finance and General Purposes Committee � Appointment, Promotion & Disciplinary committee � Registration committee � Alternative Medicine committee � Junior staff appts & promotion committee

To practice medicine in Nigeria, you must fulfill the followings: A. Be duly registered & licensed B. Pay your licensing fees annually(payment for 2018 must be made on or before 31 st December 2017). Punishment for delayed payment is 100% surcharge. C. Have 20 units of CPD annually D. Obey at all times, the conditions present in the two main publications guiding the conduct of medical/dental practitioners in Nigeria.

Physician’s oath (Hippocratic oath) v Adopted 1948 by the World Med Association, Geneva, v Amended 1968 by the World Med Assembly, Sydney, v (WMA is an association of national medical associations eg NMA and others) v May have been adopted in response to atrocities committed by doctors in NAZI Germany 1939 -1945

Physician's Oath At the time of being admitted as a member of the medical profession: �I solemnly pledge myself to consecrate my life to the service of humanity; �I will give to my teachers the respect and gratitude which is their due; �I will practice my profession with conscience and dignity; the health of my patient will be my first consideration; �

�I will maintain by all the means in my power, the honor and the noble traditions of the medical profession; my colleagues will be my brothers; �I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient; �I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity; �I make these promises solemnly, freely and upon my honor.

WMA Intl Code of Medical Ethics • • Initially adopted in 1949, London Several amendments, last one in 2006, Pilanesberg, RSA • DUTIES OF PHYSICIANS IN GENERAL • A PHYSICIAN SHALL always exercise his/her independent professional judgment and maintain the highest standards of professional conduct. •

�A PHYSICIAN SHALL respect a competent patient's right to accept or refuse treatment. �A PHYSICIAN SHALL not allow his/her judgment to be influenced by personal profit or unfair discrimination. �A PHYSICIAN SHALL be dedicated to providing competent medical service in full professional and moral independence, with compassion and respect for human dignity

�A PHYSICIAN SHALL deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception. �A PHYSICIAN SHALL not receive any financial benefits or other incentives solely for referring patients or prescribing specific products.

�A PHYSICIAN SHALL respect the rights and preferences of patients, colleagues, and other health professionals. �A PHYSICIAN SHALL recognize his/her important role in educating the public but should use due caution in divulging discoveries or new techniques or treatment through non-professional channels.

�A PHYSICIAN SHALL certify only that which he/she has personally verified. �A PHYSICIAN SHALL strive to use health care resources in the best way to benefit patients and their community. � A PHYSICIAN SHALL seek appropriate care and attention if he/she suffers from mental or physical illness �A PHYSICIAN SHALL respect the local and national codes of ethics.

� DUTIES OF PHYSICIANS TO PATIENTS �A PHYSICIAN always bear in mind the obligation to respect human life. �A PHYSICIAN SHALL act in the patient's best interest when providing medical care. � A PHYSICIAN SHALL owe his/her patients complete loyalty and all the scientific resources available to him/her. Whenever an examination or treatment is beyond the physician's capacity, he/she should consult with or refer to another physician who has the necessary ability.

�A PHYSICIAN SHALL respect a patient's right to confidentiality. It is ethical to disclose confidential information when the patient consents to it or when there is a real and imminent threat of harm to the patient or to others and this threat can be only removed by a breach of confidentiality. � A PHYSICIAN SHALL give emergency care as a humanitarian duty unless he/she is assured that others are willing and able to give such care.

�A PHYSICIAN SHALL in situations when he/she is acting for a third party, ensure that the patient has full knowledge of that situation. �A PHYSICIAN SHALL not enter into a sexual relationship with his/her current patient or into any other abusive or exploitative relationship.

DUTIES OF PHYSICIANS TO COLLEAGUES �A PHYSICIAN SHALL behave towards colleagues as he/she would have them behave towards him/her. �A PHYSICIAN SHALL NOT undermine the patientphysician relationship of colleagues in order to attract patients. �A PHYSICIAN SHALL when medically necessary, communicate with colleagues who are involved in the care of the same patient. This communication should respect patient confidentiality and be confined to necessary information.

SUMMARY 1. MDCN is the regulatory body for medical practice in Nigeria 2. It regulates practice, registers practitioners, sanctions infractions & prescribes code of conduct for physicians 3. Once you graduate, you need to register & must keep renewing registration for as long as you practice in Nigeria (you stop paying annual fees from the age of 70 yrs)