From Training Tables to Departure Gates: The Data Behind Nigeria’s Doctor Shortage

Nigerian doctors wrote the latest exam for the West African Colleges of Physicians (WACP) and the West African College of Surgeons (WACS), which helps to ensure the standard of residency training across the region. For a country estimated to have over 200 million citizens, a significant number of new doctors would be expected to join the workforce and prepare the country to deal with any health-related challenges. 

Registration data of the primary examinations of National Postgraduate Medical College of Nigeria that went viral earlier this year had about 825 registrants. Data obtained from the West African College of Surgeons indicated that a total of 927 Nigerian candidates sat the August 2025 primary examination across Abuja, Enugu and Ibadan centres and about 73.1% of the candidates representing 678 passed to commence residency in the College. Another 522 Nigerian candidates took the primary examination of the West African College of Physicians in August 2025 across the three centres, out of which 381 representing 73% passed the examination. 

Despite the high pass rate, the numbers show a startling worry - Nigeria does not have enough medical practitioners to take care of its population.

The president of the Medical and Dental Consultants of Nigeria, Professor Aminu Mohammad, in November 2024, revealed that the country has just about 6,137 medical and dental consultants. The National Association of Resident Doctors in their press statement in October 2025 decried the doctor to patient ratio in Nigeria which stands at an alarming one doctor to 9,083 patients. 

Faced with desperate shortages, many teaching hospitals now employ doctors who have not yet passed the qualifying examinations, using them as a stopgap. While expedient, this practice undermines the integrity of training and compromises patient care and the resilience of medical practitioners, who are exposed to extreme fatigue. 

Nigeria has about 3.8 doctors per 10,000 population, in contrast, Algeria has 16.6 doctors per 10,000. Brazil has a population similar to Nigeria, about 215,000,000, has about 23.6 doctors per 10,000 population while Ghana has about 2.7 per 10,000. Compared to other countries in the region, Nigeria does have a stronger density rate, but when its regional burden and disease risk are factored in, this is a challenge that could pose a threat if not managed. 

The Retention Problem

Paradoxically, Nigeria does not lack the capacity to train doctors. With 45 fully accredited and 20 partially accredited medical schools, the country can produce an estimated 7,600 doctors annually. This shows that production, especially at the undergraduate level is not the central challenge. Many, after foundation training, leave the country to ply their trade elsewhere at the expense of a teeming population desperate for doctors. 

In 2022 alone, over 3,000 doctors left the country according to the MDCN. About 68% of them went to the United Kingdom. Other countries of destinations are Canada (10%), USA (7%) and United Arab Emirates (5%). About 3% each left for Australia and Ireland, while another 1% each went to Saudi Arabia and Maldives in search of greener pastures.

The absence of clear policies to stem brain drain means that many doctors emigrate shortly after graduation or within the first years of residency. This issue has been highlighted by different groups within the sector. Dr. Muhammad Suleiman, president of the National Association of Resident Doctors (NARD), recently highlighted that the number of resident doctors has reduced from about 15,000 over the last 10 years to the current number of about 8,000. Similarly, at a recent summit, the Registrar of the National Postgraduate Medical College, Professor Temitope Esan, shared concerns that despite having 8,500 doctors in their register, only 2,500 - 3,000 actually subscribe to write exams. This revolving door, where new doctors leave as quickly as they enter, presents a vacuum. 

A Potential Solution?

In August 2024, the Federal Ministry of Health and Social Welfare launched the National Policy on Health Workforce Migration, in order to stem the tide of emigration by healthcare workers, particularly doctors. Its goal is not to ban migration outrightly but to manage it better by tackling the root causes that push workers to leave, improving working conditions, and creating incentives to retain and reintegrate health professionals.

A major focus of the policy is incentives and motivation for health workers. It proposes structured recognition programmes, better pay, and clear career pathways to reduce the desire to migrate. Health workers serving in rural areas are to receive additional allowances, housing benefits, and improved social amenities. 

The policy also recommends the use of digital tools such as telemedicine to improve professional support and reduce isolation. In addition, it calls for improved work-life balance, mental health support, and stronger measures to ensure the safety of health workers in their workplaces. It also emphasizes capacity building through expansion of medical and nursing schools’ capacities, upgrading of training facilities, improved remuneration and accessible postgraduate education within Nigeria.

Despite the robust framework, implementation has been weak due to lack of political will, ineffective monitoring and evaluation system and bureaucratic bottlenecks. Many of the proposals have not been executed or adequately funded by the federal government. Dr Suleiman during an interview on Arise TV said house officers are not issued their payslips, so the association suspects there could be allowances payable to them that were not being made. He added that efforts to collect the payslip have been unsuccessful as the Office of the Accountant General of the Federation and the Medical and Dental Council of Nigeria have been 'dilly-dallying' about who is supposed to issue the payslip.

Most health facilities remain under-equipped, while health workers continue to face heavy workloads and poor pay with no policy or measure that ensures accountability. This prompted NARD to issue a 30-day ultimatum to the Federal Government (FG) during its 2025 Annual General Meeting held in September. The Association intends to embark on an indefinite strike action at the expiration of the ultimatum and there has not been any sign of negotiation between them and the federal government. If the strike action persists, it could paralyse an already fragile health system and could leave helpless patients at the mercy of private healthcare facilities. 

The economic climate and insecurity in Nigeria have further worsened the situation. Poor economy and inflation, poor infrastructure, and insecurity continue to drive skilled professionals abroad, according to a recent study conducted at the Enugu State University Teaching Hospital. Destination countries like the UK, Canada, and Saudi Arabia offer better pay and safety, creating powerful pull factors that Nigeria's current incentives cannot match. As a result, the trend of emigration has continued unabated. 

Stopping the Exits

Medical personnel continue to persist despite the challenges, but Nigeria’s robust training and significant workforce mean that there will always be demand for its doctors. It also means that those who are left behind are faced with tremendous workloads. For many, issues around relocation costs, domestic investments, and personal motivation for building at home are reasons why doctors are still present. 

However, this might not be enough. Without deliberate investment in retention strategies in the form of competitive remuneration and improved working conditions, the country will continue to serve as a supplier of talent to wealthier nations. Retaining doctors requires structural reforms and adequate funding of teaching hospitals and policies that incentivise service in underserved regions.

The shortage is a matter of public health concern. A weakened residency pipeline undermines the entire healthcare system, from specialist services in tertiary centres to basic interventions in communities. If unchecked, the consequences will extend beyond overworked doctors to patients denied access to timely and quality care.

Nigeria stands at a critical juncture, as the country cannot afford to lose more doctors. A strategic pivot towards retention, grounded in data and policy reform, is essential to stabilise the system and safeguard the health of its people.

Taiwo Fatola is a freelance journalist and health policy researcher.