The New CCMAS And The Teaching Of Medicine In Nigeria

As part of the celebrations of the 60th anniversary of the National Universities Commission (NUC), the Vice-President of the country, Professor Yemi Osinbajo, GCON,on Monday December 5, 2022, launched the new Core Curriculum and Minimum Academic Standards (CCMAS) for 17 programmes covering various first-degree courses that are offered in Nigerian Universities. The CCMAS documents, of which that for Medicine and Dentistry is part,have been prepared by the NUC to replace the Benchmark Minimum Academic Standards (BMAS) which have been in use in the Nigerian University System (NUS) for decades.

Following that unveiling and the availability of the documents to the public, I received congratulatory messages from a number of colleagues on what they see as the superiority of the CCMAS over previous curricula in Medicine on the grounds that at various times, I supervised the teams that put the document together on behalf of the NUC. Of course I promptly deflected and directed them aright. The applause, I demanded of them, should rather go to two principal persons: Professor Abubakar Adamu Rasheed, the Executive Secretary of the NUC who had the vision and idea of rapidly Revitalising the Nigerian University System and Professor Emeritus Peter Okebukola, the foreman who works like fourmen(according to President Olusegun Obasanjo) whom Professor Rasheed got to head a group of accomplished and purpose- driven men and women as a Strategy Advisory Committee (STRADVCOM) to his Commission. The CCMAS documents have thus become  some of the major outcomes of the original concept of rapidly revitalisation the system on which STRADVCOM has worked for over five years.

All the same, I thanked my colleagues and reminded them that they too made very useful contributions when I called on them, as very senior members of the Medical Profession to seek their stamp of approval on the document – Idris Mohammed, Sonny Kuku, Okey Mbonu, Dipo Otolorin, Yinka Omigbodun, Osato Giwa Osagie, Musa Borodo and Abba Hassan to mention just a few. One of them, I recollect clearly, asked if, looking at the quality and content of the CCMAS in Medicine and Dentistry, itis fair on the students for the MB. BS. degree to  continue to be regarded as a first degree?

The Letter and Spirit of the new CCMAS

The CCMAS is forward looking; a document for the 21st centurythat seeks to stand shoulder- to- shoulder with the best curricula in the world. It emphasises skills acquisition and tests  for clearly defined learning outcomes, not fleeting knowledge memorization.

It provides for 70% of the core knowledge required of a student to obtain a baccalaureate and allows the Senate of each university to provide the balance of 30%, as it deems fit, to reflect local peculiarities and problems, bearing in mind that curriculum development is really the function of university Senates. Thus, each curriculum becomes locally relevant from the 30% content, and globally competitive from the 70% core. Furthermore, it provides for a minimum standard every degree awarded from a university in Nigeria should attain and espouses entrepreneurship as essential component of university education to enable graduates understand the rudiments of job creation in the current global knowledge economy.

The MB. BS. remains an unclassified degree and so its credit units for graduation are far in excess of those of others. But it still needs a reflection of local content and Professor Okebukola, the STRADVCOM Leader requested me to advise on what this could be for aninstitution like the University of Port Harcourt, located in the Niger Delta of Nigeria which has borne the brunt of over 60 years of fossil oil exploration in the country. Of course, what immediately runs into one’s mind is the vast environmental degradation, sea and river contamination by crude oil, destruction of marine life, ambient air pollution from soot (carbon particles), unabated gas flaring, widespread ecological damage and much more from the legal and illegal exploration and exploitation of petroleum products. These events have impoverished the people of the area, changed their lifestyles,made them vulnerable and imposed new disease patterns on them, which should engage the attention of Senates of universities in the area, like that of Port Harcourt, in their formulation of the additional 30% of the curriculum.Furthermore, there is the problem of flooding which from time to time, as it did this year (2022), assumes catastrophic dimensions. It was partly to find solution to this perennial problem that the forerunner of the Rivers State University, as it is now known, was founded in 1972 as a College of Science and Technology.

Protein calorie malnutrition which was hardly encountered in the area because of easy accessibility to marine life and abundance of food, is now being seen because the marine lives have died or driven far into the ocean. Furthermore, agricultural lands have been made unproductive on account of frequent oil spills. What is the effect of regular breathing of soot on the lungs and kidneys? How will the eyes of those who live close to constant gas flaring sites react? In an environment saturated with hydrocarbons as the Niger Delta, what effect will this have on tumours – benign and malignant. What of issues of congenital malformations? Will obstructive lung diseases and diseases of the heart a result of diseases of the lungs not become commoner. I was going to reflect on these when I read the excellent lecture given by Professor Chinedum Nwajiuba, Lion Uncaged: The New NUC CCMAS and the Agriculture Programmes at the UNN on the occasion of the First Biennial International Conference on Sustainable Tropical Agriculture and Food Security of the Faculty of Agriculture, University of Nigeria Nsukka, 15 December 2022. Making the case for the merit in the 70/30% arrangement, the professor argued that there is no way the curriculum for a BSc degree in Geography should be the same at the Usumanu Dan Fadio University,  Sokoto which is located in a city where it hardly rains to that of the University of Calabar, in a city where it almost never ceases to rain. In support of Professor Nwajiuba’s paper and in response to Professor Okebukola’s request to me therefore, I decided to write and send this to wider audience in order to give the debate a greater rigour.There are parallels to draw not just by medicine but also by the biological and physical sciences as well as humanities and social sciences.

Medical educators in Nigeria should have course to beat their chests with some pride; the quality of their products have generally been good. The strong demand for and massive presence of Nigerian- trained doctors in the Health Services of several nations, especially those of the United Kingdom and the United States of America bears adequate testimony to this success. But the medical  curriculum in the country has not changed substantially from that which was handed down by the British colonial masters and which is largely tuned to their local circumstances in the United Kingdom. Thus, we teach fibres of Astley Cooper in Anatomy, Islets of Langerhans in Histology, Billroth operations in Surgery and Kielland’s Forceps in Obstetrics. Surely, the time has come for medical education in the country to address some local problems strongly, while retaining its competitive edge internationally. This is the essence of the 70/30% arrangement of the CCMAS and I am pleased that a lot of people find merit in it.

But the CCMAS is not done yet; there are still a number of is to dot and ts to cross. For one thing, universities have to build up the 30% balance required in each discipline. This is a process that will take some time. Then the pedagogical delivery of the curriculum has to be taught, followed by the production of appropriate textbooks. But I am confident that the sense of  joy and fulfillment that have been revved up by the success so far will ensure all hands remain on deck to accomplish what is left.  

Only a few days ago, specifically, on Wednesday, December 14, 2022, the Tertiary Education Trust Fund (TETFund) of the Ministry of Education launched its one-year long TETFAIR programme which is a collaborative venture with INNOV 8 Technology Hub, a firm championing the advancement of Science and Technology Education in Nigeria. The event took place in Abuja as part of the various innovative initiatives by TETFund that are designed to promote the institutionalisation of Research and Development and to ensure that research outputs from universities are tailored towards solving societal problems by taking teams of researchers from academia through a journey that combines product development and venture creation. In their individual contributions at the event, the Executive Secretaries of the TETFund and NUC, Arc. Sonny Echono and Professor Abubakar Rasheed, respectively, advocated the importance of a strong link between academia, government and industry, as is advocated in the Triple Helix Paradigm of Development as the pattern of Advancement which the new CCMAS seeks to encourage through the introduction of entrepreneurial education. They left no one in doubt that despite recent upheavals in the nation’s universities, the prospects are bright as the faithful application of the new CCMAS curriculum coupled with the current efforts by TETFund to make instutionalised Rand D the driving force for societal progress and wellbeing, will enable Nigerian universities, sooner than later, to justify their existence by providing solutions to society’s problems.

But entrepreneurship has not been a strong aspect of medical education and research in Nigeria. Directing clinical practice and publications in Journals and books rather than influencing policy, acquisition of patents and production of protypes for manufacture have been the preferred outlets. It was this situation that led me to title my lecture at the just concluded 11th. International Scientific Conference and the 56th. Annual Meeting of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) in Abuja, 22nd 25th November 2022, The Triple Helix Paradigm of Development. Does it involve us also?In that lecture, I wondered why, despite the humongous research of global public health significance of the likes of Kelsey Harrison in Zaria, Ladipo Akinkugbe in Ibadan, Adetokunbo Lucas in Ibadan and Umaru Shehu in Zaria, there has been nothing named after anyone of them to the best of my knowledge. True, each of them has received local and global recognitions in multiple forms but by now, there should be a Kelsey Harrison Delivery Bed or a LadipoAkinkugbe Sphygmomanometer and so on, based on the tremendous impact of their research activities.

The new CCMAS, I believe will strengthen the success medical education has already made in Nigeria. I encourage all medical educators to embrace and make it work.

 

Nimi Briggs, MD.

Professor Emeritus, University of Port Harcourt.

December 16, 2022.

 

Link for downloads of any of the 17 CCMAS document: https://nuc-ccmas.ng/downloads/documents  . Downloads are free of charge.