By Abujah Racheal

Every morning, Dr Adamu Inusa checks his phone, hoping to find the email that will define the next phase of his medical career.

For 18 months, he has scanned the recruitment portals of federal teaching hospitals for a residency position, but the offer he worked for years to secure has yet to arrive.

He spent six gruelling years in medical school, endured prolonged strike, and completed the one-year housemanship.

After taking the Hippocratic Oath, he expected to begin building a career in Nigeria.

Instead, he works 12-hour night shifts as a locum doctor in a private clinic in the Federal Capital Territory (FCT), while struggling to meet his financial obligations.

“To keep from starving, I work 12-hour night shifts as a locum doctor at a makeshift private clinic in the FCT, earning less per hour than a rideshare driver, while treating complex cases without basic equipment,” he said.

Inusa’s experience is shared, to varying degrees, by other young doctors seeking specialist training after housemanship.

It exposes a less-discussed dimension of Nigeria’s health workforce crisis: the country is losing doctors to migration, while some qualified doctors who want to remain are unable to find a clear pathway into specialist training.

Data from the Nigerian Association of Resident Doctors (NARD) indicates the severity of the country’s doctor shortage, with the doctor-to-patient ratio remaining far below what is required to adequately serve the population.

Yet alongside the shortage is another contradiction: Nigeria has doctors who are qualified and available to work, but many face fierce competition for limited residency positions.

After medical school and housemanship, doctors can practise as general practitioners. Those seeking specialisation in paediatrics, surgery, oncology, orthopaedics, or anaesthesia must secure residency positions at accredited tertiary hospitals.

Residency is a critical stage in the medical career pathway. But passing the necessary examinations does not guarantee admission.

According to registry data from recent examination cycles, more than 900 Nigerian candidates sat for the West African College of Surgeons (WACS) primary examinations across major centres including Ibadan, Abuja and Enugu, with about 73 per cent recorded as successful.

Similarly, the National Postgraduate Medical College of Nigeria (NPMCN) regularly clears hundreds of general practitioners who are academically and professionally qualified to proceed with specialist training.

At major training institutions such as the Lagos University Teaching Hospital (LUTH) and University College Hospital (UCH), Ibadan, hundreds of doctors compete for positions across numerous specialities.

LUTH, for instance, opens applications across several specialised fields, including anaesthesia and maxillofacial surgery.

In highly competitive recruitment cycles, a single teaching hospital can receive between 400 and 600 applications from qualified doctors seeking residency positions.

However, experts say the number of available places could be dramatically smaller.

Because of budget ceilings, structural underfunding and stagnant departmental quotas, funded positions across specialities may be between 30 and 50.

In some departments, including paediatrics and orthopaedics, only two or three doctors may be admitted in an entire recruitment cycle.

Dr Judith Nalukwago, a dental surgeon who advocates for young medical professionals affected by health-sector funding cuts, said hundreds of qualified applicants could be turned away because there were simply not enough training places.

“The country needs more specialists, yet its major training institutions are often unable to absorb the doctors seeking to become those specialists,” she said.

Dr Mohammad Suleiman, National President of NARD, said the situation had created a serious mismatch between demand for healthcare and opportunities for young doctors to progress professionally.

“We have a situation where the demand for care is astronomical, yet young doctors are being locked out of training.

“When the system creates administrative bottlenecks around the Medical Residency Training Fund (MRTF) and slot allocations, it leaves brilliant minds completely stranded,” he said.

Doctors waiting outside the residency system must keep applying, paying examination and application fees, and looking for ways to survive while their professional progression remains uncertain.

A doctor may complete years of training, housemanship and professional examinations, yet access to postgraduate training can ultimately depend on whether a hospital has an accredited and funded vacancy.

Doctors may be qualified to practise as general practitioners while remaining unable to enter the specialist programmes they need to advance their careers.

The problem is therefore larger than unemployment in the conventional sense. It is a question of whether Nigeria’s medical education system, postgraduate training capacity and workforce planning are moving in the same direction.

Medical schools produce graduates; housemanship prepares them for independent practice; residency develops the specialists Nigeria needs.

But when residency places fail to keep pace with the number of qualified doctors seeking them, a gap opens between graduation and professional advancement.

The Federal Government says it is investing in healthcare infrastructure, recruitment and workforce development.

The Minister of State for Health and Social Welfare, Dr Iziaq Salako, announced a N43 billion release for health-sector reforms, including N10.6 billion earmarked for the 2025/2026 MRTF.

Under the Nigeria Health Sector Renewal Investment Initiative, the government granted special recruitment waivers that added more than 20,000 healthcare personnel to the public-sector payroll.

Funding doctors already admitted into residency is different from creating additional accredited positions for doctors waiting outside the system.

With limited access to residency, some doctors turn to private facilities for locum work.

Stakeholders estimate that doctors working in parts of Lagos and Abuja may be earning between N80,000 and N150,000 monthly, depending on the facility, workload and number of shifts.

A clinical psychologist, Mr Phillip Dimka, said some private hospitals, aware of the desperation among young doctors, employed them on poor terms.

“Private hospitals, acutely aware of the desperation brewing in the medical community, recruit these overqualified general practitioners to run their entire facilities for a fraction of standard pay.”

Dimka said some doctors worked long shifts with inadequate equipment and limited access to consultant supervision.

“In these underregulated settings, young doctors face immense medical and legal risks,” he said.

Behind the statistics are graduates who invested years of their lives and significant family resources in becoming doctors.

Mr John Umoh, a civil servant and father of a 200-level medical student, said parents often sacrificed savings and other opportunities in the belief that their children would eventually become financially independent professionals.

“For some graduates, that expectation is delayed indefinitely. They continue to depend on ageing parents, struggle with rent and transportation, and accept whatever locum work is available,” Umoh said.

Mrs Martha Yohanna, a human resources manager, said the impact was also professional.

“Doctors who remain outside residency may continue to gain clinical experience through locum work, but they lack the structured progression, supervision and specialist development provided by formal training programmes.

“The longer they remain outside the system, the more difficult it can become to plan their careers. For a country already struggling to retain doctors, which represents another form of loss,” she said.

Stakeholders say the situation is worrisome as doctors continue leaving for the UK, the U.S., Canada and other countries in search of better opportunities.

Records indicate that more than 10,000 Nigerian-trained doctors are registered with the UK General Medical Council, while NARD has documented the continuing departure of resident doctors from Nigeria.

A doctor who cannot secure residency may eventually look abroad not because the desire to build a career has disappeared, but because the opportunity to build one at home has.

NARD has repeatedly linked migration to poor remuneration, difficult working conditions, manpower shortages and inadequate career prospects.

Dr Augustine Uchenna, a health entrepreneur, said the country needed accurate workforce projections showing how many doctors were graduating, entering housemanship and seeking residency, as well as how many specialists would be required.

“Recruitment processes must be transparent and predictable so that doctors understand how positions are allocated and why applications succeed or fail.”

He said private hospitals that depended heavily on locum doctors also needed stronger oversight to ensure temporary employment did not become a substitute for safe staffing and fair professional conditions.

“The objective should not be to force every doctor to remain in Nigeria. Rather, it should be to ensure that leaving is a choice, not the consequence of a system that has left qualified professionals with no viable route forward,” he said.

Recently, Inusa received information about registering for the Professional and Linguistic Assessments Board (PLAB) examination, a key requirement for doctors seeking to practise in the UK.

He said the message was not the residency offer he had been waiting for. It represented a different future.

It is about whether Nigeria can provide a professional future for someone it has spent years training.

For outside observers, Inusa’s departure from Nnamdi Azikiwe International Airport would likely be categorised as just another statistic in the country’s medical brain drain.

However, that label oversimplifies his journey. Leaving wasn’t his initial goal; his first instinct was to find a reason to remain in Nigeria.

This highlights the true gravity of the nation’s healthcare workforce crisis.

Analysts say Nigeria is not just losing doctors to only active emigration—it is losing them because systemic delays leave them waiting so long that departure becomes their only viable path forward.(NAN)

By Uddin Ifeanyi

The spectacle of a senior adviser on economics to the Tinubu government dissing the numbers on the economy issued by the National Bureau of Statistics (NBS) offered far more lessons than the first reactions to the television interview suggests.

Sure, there were considerations of politics in the adviser’s responses. Ahead of a general election, his brief must have been to “Go there and make the government’s position on these matters look as good as possible!” And, as Aeschylus may not have said, in politics as in war, truth is the first casualty. Was there a smidgen of one-upmanship? Probably. In Nigeria, we do not discuss how to advance the boundaries of mutual understanding. No. The goal of every conversation, which is why they invariably break down into verbal slugfests, is to outdo or keep one jump ahead of other discussants. If this practice involves excruciating mental contortions to keep one’s reasoning from keeling over, it also presumes a trusting and dim-witted set of listeners — in this case, with some hope, potential voters, too.

Even then, the numbers from the NBS matter, not just as fire-and-forget projectiles in partisan disputes. They, more importantly, inform how the economy works. If nothing at all, the planning and strategy decisions of a lot of economic actors, both local and foreign, depend on the pictures that our national bean counters paint. Which sectors of the economy are growing, and where the unemployment level is, all this drives investment decisions. To say that these numbers ought not to be trusted is to invite the question: “Which other data sources are available for government use besides the publicly available official ones?”

Knowing what datasets the government relies on to make its choices will assist those who look to profit from such decisions or to hedge against their more adverse outcomes. Indeed, the whole point of “forward guidance” as a policy principle is to make market expectations and behaviour less muddled today, by communicating future policy intentions. More important still than the statistics that go into government’s decision-making is a working acquaintance with the government’s thought processes. Successive Nigerian governments have, sadly, dropped the ball on this dimension of governance. Most carry on as if they are treasurers of social clubs and party organising committees. In these roles, their job description requires them to put together the most impressive parties in whatever ecosystem they happen to inhabit. The only let to these bookkeepers’ ambitions in this circumstance are the subscriptions that club members pay. Raise this high enough and you have the social clubs that were the staple of Yorùbá juju musicians’ paeans in the 1970s.

It is no accident that few of those clubs survive today. Most had no way of influencing their members’ incomes and ability to meet their membership subscriptions on an ongoing basis. While this left the clubs and their management vulnerable to whatever vicissitudes affected their patrons, it is still one of the main differences with running an economy. Government managers and the choices they make have a deeper and wider reach. Increase the subscriptions due from eligible citizens (the tax they pay) and you might find that you have reduced the share of domestic output accounted for by consumer spending.

How does the added government revenue from an increase in taxes matter? By a painstaking choice of how, where, and what it pays for (salaries as against investment in fixed capital growth in the efficient production of public goods, for instance) government spending can boost or impede aggregate domestic demand. Moreover, in democracies with fixed electoral cycles, there is an extra incentive for the government to loosen its purse strings in the run up to general elections. Just about everywhere, this siren song is almost impossible to resist.

It helps in this circumstance that macroeconomic management readily decomposes into fiscal and monetary policy components. When the tax and spend side is suckered by political considerations to return money to potential voters, the monetary policy side tightens monetary conditions to avoid inflation taking off. This is to avoid rising prices ratcheting consumer spending down. In turn, falling retail purchases put businesses off new investments — sometimes forcing them to retreat from current operations. When businesses stop spending, unemployment rises. And with a lot more people out of jobs, consumer spending falls farther. Is a vicious cycle, thus kicked off? Yes.

Far more significant, however, is the fact of the connectedness of the different parts of an economy that this cycle points to, and which the special adviser’s blasé treatment of domestic economic statistics seems to have missed. Nigeria’s continuing difficulty with managing this cycle, by, as The Economist recently described it in a piece on India, “…cleaning up public finances and letting central bankers fight inflation in peace,” arises from the fact that the dynamics of the business and economic cycle, of course, do not make much sense to folks who are at their best when running social clubs.

Uddin Ifeanyi, a journalist manqué and retired civil servant, can be reached @IfeanyiUddin.

By Kayode Adebiyi

For more than 400 years, the global view of geography has been quietly distorted by a 16th-century map projection.

Designed for navigation, it drastically misrepresents the actual sizes of the world’s continents.

On Sept.

4, however, the UN General Assembly voted to challenge this long-standing visual convention.

With 164 countries voting in favour, one against, and six abstentions, the UN adopted a landmark resolution that calls for phasing out the classic Mercator projection in official, educational, and public contexts.

Also, it voted in favour of equal-area map projections that accurately represent the true physical dimensions of Africa and the Global-South.

Spearheaded by Togo on behalf of the African Union and backed by a broad coalition of civil society groups, supporters say the decision marks a pivotal moment.

Robert Dussey, Togo’s Foreign Minister, said: “For over four centuries, the world has viewed Africa through a distorted lens that diminished our physical footprint.

“This resolution is not merely about geometry; it is about dignity, historical accuracy, and ensuring that our youth see their continent as it truly exists.”

Tunde Familokun, a supporter of the resolution who termed the old map as “psychological colonialism”, said the resolution marked a victory for accuracy.

“The unanimous vote is a victory for accurate decisions in global diplomacy, educational reform, and cultural advocacy, because it confronts what scholars and diplomats have long described as cartographic psychological colonialism.”

To understand the necessity of the UN resolution requires a return to 1569, when Flemish cartographer Gerardus Mercator introduced his revolutionary world map.

An analysis of media content shows that Mercator created his projection primarily for maritime navigation.

He was said to keep lines of latitude and longitude at straight right angles so that sailors could plot straight-line compass bearings across long oceanic voyages.

However, flattening a spherical planet onto a two-dimensional plane requires mathematical trade-offs, and Mercator’s design distorts relative scale as landmasses stretch farther from the Equator toward the poles.

Put in plain terms, the map was deliberately designed (although inaccurately) for ease of navigation.

The implication under this inaccurate traditional Mercator grid, for instance, is that Greenland appears roughly equal in surface area to the entire continent of Africa.

However, in geographic reality, Africa covers approximately 30.3 million square kilometers, whereas Greenland covers 2.16 million square kilometers, making the African landmass roughly fourteen times larger.

Similar visual compression affects equatorial regions across South America, South Asia, and the Caribbean, while expanding the visual footprint of European and North American landmasses.

As European nations expanded global trade networks and formal education systems over subsequent centuries, Mercator’s specialised nautical chart gradually transformed into the default world map for classrooms, news broadcasts, atlases and digital applications.

In recent years, momentum to challenge this convention has been organised around the global #CorrectTheMap campaign.

Championed by pan-African advocacy platforms such as Africa No Filter and Speak Up Africa, civil society groups argued that maps are not neutral geometric diagrams but active tools that shape cultural perception.

Advocates emphasised that when generations of children grow up seeing their home continent visually diminished, it subtly reinforces geopolitical biases and underestimates the continent’s demographic weight, environmental stewardship, and economic resource scale.

The diplomatic push finally culminated at the UN General Assembly, where Robert Dussey formally introduced the draft resolution on behalf of AU member states.

The resulting vote reflected strong global alignment, with 164 member states voting in favour, the U.S. casting the single opposing vote, and six nations: Estonia, Georgia, Lithuania, Moldova, Serbia, and Ukraine, abstaining.

It is important to note that, as a General Assembly resolution, the measure functions as a non-binding policy recommendation rather than an absolute prohibition.

Experts say it does not ban Mercator-based nautical or aviation systems where directional angle accuracy remains essential.

Rather, the initiative encourages member states, textbook publishers, software developers, and international media organisations to adopt equal-area map templates for general public reference, classroom instruction and diplomatic documents.

Familokun provided further insights.

“The principal model endorsed by the UN resolution is the Equal Earth projection, developed in 2018 by cartographers Bojan Šavrič, Tom Patterson, and Bernhard Jenny.

“It was specifically to overcome the visual distortions of older cartographic systems, as the Equal Earth projection maintains accurate proportional land sizes across all continents.

“It also preserves natural continental shapes, avoiding the severe vertical stretching associated with earlier equal-area models like the Gall-Peters projection,” he said.

Reactions across the African continent were swift and celebratory, with political leaders and diplomats framing the vote as a vital milestone in historical reconciliation and spatial equity.

Representatives from the AU observed that presenting true geographical proportions reinforces regional development frameworks like Agenda 2063.

They said it would strengthen local self-reliance and encourage balanced international partnerships.

In fact, following the adoption, Togo announced plans to immediately incorporate Equal Earth wall maps and updated geography curricula into its national school system.

Civil society organisations that spearheaded campaign mobilisation also celebrated the resolution as a major milestone.

Representatives from Africa No Filter highlighted that altering the visual baseline of world geography plays an essential role in shifting broader international narratives surrounding Africa.

They also said the move would ensure future generations evaluate the continent based on physical reality rather than cartographic habit.

Educational cartographers commended the choice of the Equal Earth projection, noting its ability to balance mathematical area accuracy with clear visual aesthetics suitable for modern classrooms.

Conversely, the proceedings leading to the adoption of the resolution reflected distinct views regarding international governance and cartographic standards.

Delegations that abstained or opposed the measure voiced concerns regarding the precedent of an international political body endorsing specific map formats.

They maintained that textbook selection, educational software guidelines and cartographic choices should remain within national domestic jurisdictions.

Some professional geographic organisations also noted that classroom instruction should ideally teach students how to analyse different map projections critically rather than treating any single flat rendering as absolute perfection.

They said every flat map projection, whether Equal Earth or the Mercator grid, must compromise between area, shape, distance or direction.

There are also some opposers of the resolution who believe that Africa should focus more on the issues that matter to the continent, rather than how it’s being projected on a map.

Joy Ameh, a civil society worker, asked whether the continent is the biggest or smallest.

We are the poorest continent and come last in every development index, yet our concern is about a map?” he queried.

The practical implications of the resolution are expected to unfold across education, media, and digital technology over the coming years.

Educational ministries throughout Africa and supporting nations are preparing revised textbook publishing standards to ensure classroom atlases and wall maps reflect equal-area proportions.

Also, tech developers and software engineers face growing interest from educational institutions and public agencies to offer equal-area defaults across digital mapping applications.

For neutrals, replacing a centuries-old navigational habit with accurate proportional representation ensures that future generations will view Africa and the world through a clearer, more balanced lens. (NAN)