Recently, the Nigeria Society of Physiotherapy stunned the nation when it disclosed that there are no Clinical Residency Programmes available to professionals in the field. They are, therefore, imploring the Federal government, the National Assembly and all other relevant stakeholders to partner with the society to establish one so as to ensure that Nigerians receive efficient physiotherapy care.
The residency programme when put in place, will help physiotherapists develop required professional expertise that will ensure efficient patient management through acquisition of clinical skills and multi-disciplinary approach to patients’ care.
It is important to point out that Physiotherapy is a patient-centred health care profession which deals with disease prevention, health promotion, diagnosis, treatment and medical rehabilitation of persons with disability through specialised applications. It follows, therefore, that specialised study and training are required to provide the skills practitioners need to enhance better outcome in patient management.
It is needless to emphasise that Post-graduate clinical education is necessary in bridging the gap between what physiotherapists with first university degree know and what they need to know to efficiently manage patients. In physiotherapy as in medicine, it is only specialisation that can help practitioners apply advanced clinical techniques in a specific area of physiotherapy practice, a factor that ensures competence.
It is sad and regrettable, in our view, that Physiotherapists working in the Academia with Master’s and Doctorate degrees are regarded by some hospitals as irrelevant for their services and for career progression. Those working in hospitals spend all their working years with only a first degree or an academic postgraduate programme that is not recognised by hospitals. This denies them the chance for skill acquisition provided by post-graduate clinical programmes, expertise they desperately need to manage their patients more efficiently. This lack has put them at a disadvantage with regards to career progression.
It is lamentable, in our opinion, that the absence of clinical residency programmes in Nigeria has made many otherwise first class professional physiotherapists to indulge in avoidable brain drain, leave the country in search of greener pastures abroad.
Many of them are working in the United States, Canada and Europe, countries that have clinical programmes in Physiotherapy. In Nigeria, people with injuries and diseases that are amenable to Physiotherapy end up having only relief of their problems through other treatments rather than elimination of the problem. Patients with mechanical low back pain, for example, that keep taking drugs for years until they don’t have pain relief anymore could be treated by a technique referred to as Manipulative Therapy, a technique that could be carried out by a specialist in Orthopaedic Physiotherapy. Physiotherapy postgraduate clinical programme can, therefore, reduce brain drain, ensure clinical expertise and efficient services to patients and curb medical tourism that consumes much foreign exchange especially during the time of recession.
Physiotherapy specialisation training, by its very nature, is best conducted in hospitals through clinical residency training. The residency programme in physiotherapy leading to certification as a clinical specialist is well established in several countries of the world with physiotherapists in such countries specializing in areas such as Orthopaedic physiotherapy, Neurological physiotherapy, cardiopulmonary physiotherapy, Women’s health physiotherapy and paediatric physiotherapy. Physiotherapists should be exposed to that kind of training.
We are appalled that no such programme exists in the country. There are many hospitals, not just teaching hospitals but also some private hospitals that are designated as facilities where young doctors can spend a number of years in Residency. In actual fact, these resident doctors are the main stay of healthcare delivery in most hospitals. They qualify eventually to become consultants and high grade specialists.
Physiotherapy services in Nigeria date back to 1945. A BSc degree in Physiotherapy started in October 1966 in University of Ibadan with the first degree awarded in 1969. Since then Universities in Nigeria have been awarding Bachelor’s degree in Physiotherapy through a four-year and later a five-year programme. Yet, till date, there has not been a single post-professional clinical programme in Nigeria.
While we blame the health authorities for this obvious lapse, it is also our opinion that the Nigeria Society of Physiotherapy should share in the blame. Their complacency in waiting for the government to initiate the move to put in place such a programme has resulted in this situation that has exposed patients to not- too- professionally trained personnel handling intricate cases that require high level expertise.
But it is better late than never. We urge the society to generate a bill which when enacted into law, will form the legal basis for the establishment of the Clinical Residency Programme for Physiotherapists. The time to do it is now.