ENHANCING PATIENT’S CARE IN NIGERIA: THE CENTRAL ROLE OF

THE LABORATORY PHYSICIANANATOMICAL PATHOLOGY SERVICES

IN NIGERIA

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144 million population35,000 medical doctors<500 pathologistsPer capita (p.c.) income $300Health budget $50 p.c. 2

307 million population814,000 medical doctors*20,000 pathologists*Per capita (p.c.) income $39,000Health budget $2,250 p.c. 3

*How many of these are Nigerians?

WHO ranking- health systems

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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 fluids obtained from the human body for the purposes of patient diagnosis and management (Bryant, 1993)

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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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Methods in anatomic pathology

1. Gross morphology2.Light microscopya.Histochemistryb.Immunohistochemistryc.In situ hybridisation, PCR, etc.3. Electron microscopy4.Ancillary techniquesa.Flow cytometryb.Microarray technology

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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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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 of1. Physician2. Scientist3. Educator4. Leader

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Pathology training in NigeriaTwo sister Colleges (NPMCN and WACP)Same basic philosophies, but slightly different training rotations and examination formatsJunior rotation- entry with Primary qualification- 2-3 years, both collegesSenior rotation- specialist training in Anatomic Pathology for 2-3 years; dissertation

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NIGERIAN PATHOLOGISTS-Contributions

Practising pathologists at every level in the country and in the Diaspora

A former State governorChief Medical DirectorsActing Vice ChancellorsProvostsDeansVice Deans Professors of Pathology, both at home and abroad?Members of senate

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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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Thanks for listening!

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