Early career doctors (ECDs) are faced with many unique challenges; this is even more pronounced in low resources setting like country Nigeria. To unravel and improve understanding of these challenges the National Association of Resident Doctors of Nigeria (NARD) initiated a trainee driven research initiative. NARD initiated the Research and Statistics Committee (RSC), a six member team derived from her membership. In an attempt to carry out her responsibility efficiently the committee created the Research Collaboration network (RCN), a 43 member team comprising ECDs from across Nigeria. The key themes to be explored under this initiative include demographic, work and psychosocial issues as it affect ECDs in Nigeria. This article is set out to describe in detail the NARD initiative in term of the structure, operational modalities and agenda for the year 2018/19.Keywords: Research, Early career doctors, Residents Doctors, Nigeria, Junior Doctor

Adebayo, Oladimeji

Aigbomian, Ehiosun

Buowari, Dabota Yvonne

Ibiyo, Morohunmubo

Ibrahim, Yahya Abdulmajid

Kpuduwei, Selekeowei

Olaopa, Olusegun

Oluwafemi, Efuntoye

Oluwaseyi, Ogunsuji

Omotayo, Francis Fagbule

Wasinda, Umar Francis

English

AJOL - African Journals Online

93Nigerian Journal of Medicine, Vol. 28  No. 1, January - March, 2019,  ISSN 1115-2613                TRAINEES COLLABORATIVELY INVESTIGATING EARLY CAREER DOCTORS' THEMES:  A NARD INITIATIVE IN NIGERIA1 1 1  2  Oladimeji Adebayo, Oluwaseyi, Ogunsuji, Olusegun Olaopa, Selekeowei Kpuduwei ,1 1 3  1   Oluwafemi, Efuntoye, Omotayo Francis Fagbule, Ehiosun Aigbomian, Morohunmubo Ibiyo,4  5 Dabota Yvonne Buowari, Umar Francis Wasinda, 6 Yahya Abdulmajid Ibrahim on behalf of Research Collaboration Network(RCN)1University College Hospital, Ibadan, Oyo State2Federal Medical Centre, Yenagoa, Bayelsa state3University of Calabar Teaching Hospital, Calabar, Cross River State4University of Port Harcourt Teaching Hospital, Port Harcourt, River State5Federal Medical Centre, Katsina, Katsina State6Federal Teaching Hospital, Gombe, Gombe StateABSTRACTEarly career doctors (ECDs) are faced with many unique challenges; this is even more pronounced in low resources setting like country Nigeria. To unravel and improve understanding of these challenges the National Association of Resident Doctors of Nigeria (NARD) initiated a trainee driven research initiative. NARD initiated the Research and Statistics Committee (RSC), a six member team derived from her membership. In an attempt to carry out her responsibility efficiently the committee created the Research Collaboration network (RCN), a 43 member team comprising ECDs from across Nigeria. The key themes to be explored under this initiative include demographic, work and psychosocial issues as it affect ECDs in Nigeria.This article is set out to describe in detail the NARD initiative in term of the structure, operational modalities and agenda for the year 2018/19.KEYWORDS: Research, Early career doctors, Residents Doctors, Nigeria, Junior DoctorsCommentaryINTRODUCTIONNigerJmed2019: 93 -97© 2019. Nigerian Journal of Medicine Correspondence to: Dr. Oladimeji AdebayoDepartment of Medicine, University College Hospital, Ibadan, Oyo State.E-mail: moadebayo2018@gmail.comTel: +234 805 6582 113octors in the early stage of their medical Dcareer or early career doctors (ECDs) are essentially medical practitioners who are resident doctors, medical ofcers below the rank of Principal Medical/Dental Ofcers and 1,2medical/dental interns.  This category of medical practitioners are inundated with many unique challenges due to peculiarities of work aside those that affect the generality of physicians in low resource countries such as Nigeria. Some of these challenges include but are not limited to poor manpower supply, inadequacies 3and overstretch of services.   Majority  of ECDs are in rigorous and intense residency training programme which rests on the tetrapod of clinical service delivery, training, research and health 2services management.   In more advanced countries, various issues facing this category of medical doctors and dentists are widely researched giving useful input for policy formulation. This changes the pattern of interaction or relationship with various stakeholders that interphase with ECDs. Furthermore, the more researched themes especially psychosocial issues among this sub-occupational group in Nigeria are subjects of single or regional studies. The National Association of Resident Doctors of Nigeria (NARD) is the umbrella body of all resident doctors, medical & dental interns and medical ofcers below the rank of Principal Medical  ofcers(PMO)/Principal  Dental 4Ofcers(PDO) in Nigeria.  The association in a bid to bridge the gap of the perceived dearth of data as it affects ECDs, initiated the Research & Statistics Committee (RSC), which hitherto was not available as one of the committees operating in the association. This committee was commissioned with the responsibility of exploring and bringing forth the availability of such data with emphasis on demographic, psychosocial and workplace related issues among her members who form a sizeable proportion of doctors providing medical care to over 180million Nigerians.Structure of RSC and RCNThe RSC in a bid to effectively discharge her duties and bequeath a legacy of trainee-driven research collaboration initiated the Research Collaboration Network (RCN). This initiative draws inspiration from well entrenched trainee-driven research collaboration in the United Kingdom. Of note is the West Midlands Research Collaboratives (WMRC). NARD decided to create the rst national, multi-centre and multi-disciplinary trainee driven research collaboration, to best of 5-8our knowledge, in Nigeria.  The RSC and RCN work as a sub-structure of the overall network to investigate the objectives as will be highlighted later.The RSC is a six membered committee appointed by the National Executive Committee (NEC) of NARD, ratied by National Executive Council (NEC) of the same body. The RSC led by a cha i rman has  overa l l  respons ib i l i ty  to coordinating this research initiative while reporting to the NARD leadership. The RSC sent out a “call for collaborators” to members across the 74 local branches of NARD through the heads of these branches. Following a rigorous review of applications, 43 ECDs at various level of training in the residency programme and from different specialties were recruited into the RCN. (Table 1 &2 ) The RSC and RCN work together, with the RCN reporting to RSC with an aim of achieving its set out objectives as mandated by NARD.Both bodies subscribed to a set of rules and regulations called Collaboration/Authorship/ Draftsmanship Rules for Research & Statistics Committee (RSC) and Research Collaboration Network(RCN) developed at the inception of the committee (The document is available at   https://drive.google.com/le/d/1a4TUTxuI9t36BA3tWM8bN-s2LhJXbSqH/view?usp=sharing). The document explicitly highlighted the principles behind the research collaboration, the ownership of the proprietary right of the document created which is NARD, rules on authorship which was based on the International Committee of Medical J o u r n a l  E d i t o r s  ( I C M J E )  u n i v e r s a l l y 9-11 acknowledged criteria for authorship. The document highlighted the abhorrence of plagiarism in the collaboration's documentary activities while also providing relevant guiding resources. All collaborators are required to sign the document before they can be involved in research activities in the collaboration.Table 1: Distribution of collaborators across the countryCentres  Numbers of collaborators Irrua Specialist Teaching Hospital, Irrua 1 Federal Medical Centre, Abeokuta 1 Olabisi Onabanjo University Teaching Hospital, Sagamu 2 Federal Medical Centre, Jabi, Abuja 1 Federal Teaching Hospital, Ido-Ekiti 2 University of Port-Harcourt Teaching Hospital, Port-Harcourt 1 Federal Teaching Hospital, Gombe 2 Federal Medical Centre, Umuahia 1 Aminu Kano Teaching Hospital, Kano 2 Obafemi Awolowo University Teaching Hospital, Ile-Ife 5 Jos University Teaching Hospital, Jos 1 Babcock University Teaching Hospital, Ilishan-Remo 1 University of Uyo Teaching Hospital, Uyo 1 Federal Teaching Hospital, Abakaliki 1 Federal Medical Centre, Yenagoa 1 University of Calabar Teaching Hospital, Calabar 1 Kebbi State Medical Centre, Kebbi  1 Delta State University Teaching Hospital, Oghara 1 University College Hospital, Ibadan 15 Federal Medical Centre, Owo 1 Federal Medical Centre, Katsina 1  94Nigerian Journal of Medicine, Vol. 28  No. 1, January - March, 2019,  ISSN 1115-2613                95Nigerian Journal of Medicine, Vol. 28  No. 1, January - March, 2019,  ISSN 1115-2613                Six advisors who are Fellows of either the West African College of Surgeons and/or National Postgraduate Medical College of Nigeria with sound research background were sought and appointed to be advisors to the network.. Ad-hoc staffs were utilized to carry out operational activities of the research network.Categories Number  House ofcers(Interns) 4Registrars 14Medical/Dental ofcers 3Senior Medical/Dental ofcers 0 Senior Registrars 22Table 2: Distribution of employment cadres of collaborators  RSC (6 members)RCN (43 members)Staff (4)Figure 1 : Structure of the RSC & RCN( there are6 advisors to advise RSC & RCN)OBJECTIVES The project is to research into key issues affecting resident doctors and other members of NARD; to develop a database of key issues affecting resident doctors and other members of NARD; and to 1initiate  the Nigerian resident doctors database.  Specically the project would investigate demographic issues (migration; distribution, gap ,distribution of ECDs across the country), workplace issues (practice satisfaction/ dissatisfaction, training and skills acquisition, conict and conict resolution and leadership 6issues) and psychosocial issues(burnout issues).Specic objectives of RSC& RCN  1. Demographic issues a. Migration b. Distribution, gap , misdistribution 2. Workplace issues a. Practice satisfaction/ dissatisfaction  b. Training and skills acquisition c. Conict and conict resolution  d. Leadership issues 3. Psychosocial issues a. Burnout issues                                                                           Table 3: Specic objectives of RSC& RCNSTRATEGIESOnline social media tools were used to allow for effective communication among RSC and RCN. Routine communication is being done using emails and Whatsapp application, while structured meetings are held through free c o n f e r e n c i n g  a p p  ( a v a i l a b l e  a t https://play.google.com/store/apps/details?id=com.freeconferencecall.fccmeetingclient&hl=en) regularly. The meeting are usually bimonthly with the date of meeting chosen democratically from the highest poll among three dates proposed by the RSC chairman/RCN coordinator using doodle poll app.(Available at https://play.google.com/ store/apps/details?id=com.doodle.android&hl=en )Drafting of necessary document is crowd-drafted real time using google document app with collaborators using android devices or computers.A single protocol for institutional ethical approval by the National Human Research Ethical C o m m i t t e e  ( N H R E C )  w a s  c r e a t e d .  A protocol/method paper will be drafted for publication in a peer review journal to increase the openness of this research initiative. The exact data collection methods would include retrieval of administrative data from NARD branches and other stakeholders that may have data related to ECDs, individual level from 2000 ECDs  using structured self-administered questionnaires and selected focus group discussions(FGD). The key timelines have been identied and would serve as a guide to this 96Nigerian Journal of Medicine, Vol. 28  No. 1, January - March, 2019,  ISSN 1115-2613                initiative. (Table 3) The life cycle of the current RSC & RCN is to run with the current 2018/19 NARD executives. The data will be used to generate relevant policy briefs to the NARD leadership and necessary infographics will be available for print and non-print media use. It is hoped that this undertaking would be institutionalized in NARD administrative structure.Expected output in 2018/1911. At least two (2) monographs.2. At least two (2) technical reports.3. At least six (6) research articles published in recognized and superior peer review journals.4. At least two (2) workshops during the NARD Ordinary General Meeting/ Annual General Meeting.5. Creation of an operational website.6. Quarterly newsletters.7. Monthly briefs to the NARD presidency on policy thrust, info graphics and media intelligence.CHALLENGESThe erratic and poor availability of reliable internet access in some part of the country is a serious constraint to the leverage information technology would have helped to galvanize in making the RSC & RCN function effectively and efciently.  Targets 11/18 12/18 01/19 02/19 03/19 04/19 05/19 06/19 07/19 08/19 09/19 1. Submission of concept paper            2. Setting up of structure            3. Recruitment of collaborators            4. Recruitment of core staff            5. Data collection (MDCN)            6. Data collection  (ARDs’ leadership)            7. Ethical approval via NHREC       8. Data collection  (via collaborators)        9. Monthly brief             10. Quarterly newsletter             11. Media intelligence            12. Setting up and maintenance of database            13. Preliminary data on resident workforce gaps and needs  14. Full data on resident workforce gaps and needs             15. Setting up of website            16.  Report of resident doctors and interns distribution, gap needs assessment, supply and demand disparity             17. Report of migration issues            18. Final report             Table 4: Timeline of the RSC& RCN. Source: NARD. Initiating Trainee Research Collaboration Network:  A NARD initiative in Nigeria. Abuja: National Association of Resident Doctors of Nigeria (NARD); 2019.CONCLUSIONIt is our hope that this collaboration would aid scholastic comradeship among NARD members across the country while generating the necessary data to bridge the current dearth of information  regarding ECDs in Nigeria. ACKNOWLEDGMENTWe like to acknowledge the NEC of NARD and RSC advisors.FUNDINGNational Association of Resident Doctors (NARD) of NigeriaREFERENCES1. NARD. Initiating Trainee Research Collaboration Network:  A NARD Initiative in Nigeria. Abuja: National Association of Resident Doctors of Nigeria(NARD); 2019.2. ARD U. Technical Report:Guidelines on Residency Training Programme University College Hospital, Ibadan. Ibadan2017 31 July 2017.3. Adebayo O, Labiran A, Emerenini CF, Omoruyi L. Health Workforce for 2016-2030: Will Nigeria have enough? Int J Innovative Healthcare Res 2016;4:9-16.4. History of NARD. National Association of Resident Doctors of Nigeria, 2019. (Accessed 04/02/2019,2019,at https://nardnigeria.com.ng/ download/ history-of-nard/.)5. Vohra R, Adedeji O. Collaborative Networks: Bookbuilders; 2015.6.   Bhangu A, Kolias AG, Pinkney T, Hall NJ, Fitzgerald JE. Surgical research collaboratives in the UK. The Lancet 2013;382:1091-2.7. Bartlett D, Pinkney TD, Futaba K, Whisker L, Dowswell G, Collaborative obotWMR. Trainee led research collaboratives: pioneers in the new research landscape. Bmj 2012;345:e5084.8. Kolias AG, Jones TL, Cowie CJ, et al. A report from the inaugural meeting of the British Neurosurgical Trainee Research Collaborative held in the Royal College of Surgeons of England, 19 October 2012. Taylor & Francis; 2013.9. Editors ICoMJ. International Committee of Medical Journal Editors (ICMJE): Uniform Requirements for Manuscripts Submitted to Biomedical Journals: writing and editing for b i o m e d i c a l  p u b l i c a t i o n .  H a e m a t o l o g i c a 2004;89:264.10. Editors ICoMJ. Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication International Committee of Medical Journal Editors Updated October 2005 (www. icmje. org). Indian Journal of Pharmacology 2006;38:149.11. Editors ICoMJ. Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication (Updated October 2008)2008.97Nigerian Journal of Medicine, Vol. 28  No. 1, January - March, 2019,  ISSN 1115-2613                

Trainees collaboratively investigating early career doctors' themes: a nard initiative in Nigeria

https://www.ajol.info/index.php/njm/article/download/185284/174605

Trainees collaboratively investigating early career doctors' themes: a nard initiative in Nigeria

Abstract

Similar works

Full text

Available Versions

AJOL - African Journals Online