The PhD vs. Fellowship Debate: the facts, the myths, and responding to the needless mudslinging in the ongoing LASU VC selection process

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By Dr Olayinka Atilola

Background

It is public knowledge that the tenure of the incumbent VC of LASU, Prof. Lanre Fagbohun will come to an end on 11th January, 2021. As is the usual tradition, a joint Selection Committee of the Senate and Council has been set up by the university to interview candidates for the position of new VC and submit the names of the three best candidates for the job for onward transmission to the Visitor (the Lagos State Governor) for final selection of one successful candidate for the job. The advertisement for the post required a successful applicant to be a Professor of at least 10 years standing, with good track-record of academic excellence of local and international repute including supervision and mentoring of postgraduate students, demonstration of continuous capacity for academic leadership, track record of experience in university administration at high levels, and evidence of unassailable grounding in the finest academic traditions.

More than eighteen Professors, academic giants in their own right, from almost ten different universities both within and outside Nigeria applied for the job. Among these fine applicants, the Selection Committee settled for three top candidates including Prof Olumuyiwa Odusanya, a Professor of Public Health; Prof Senapon Bakre, a Professor of Microbiology, and Prof Kabiru Akinyemi, another professor of Microbiology made the list of the top three. The names of these candidates have since been forwarded to Governor Sanwo-Olu for consideration and selection of the final candidate for the job. 

That was the point when the controversy broke out. In the center of the controversy is the insinuation that one of the candidates is not qualified for the job because his entry qualification to the university was the Fellowship of the Nigerian Postgraduate Medical College (hereafter referred to as the Fellowship) and not the PhD, which according to some of the agitators, makes him unqualified for the job of LASU VC. The argument quickly degenerated to a devaluation of the Fellowship degree as a sub-academic degree and holders of the Fellowship as some inferior academics that should stay in the background when it comes to university leadership.

In addition, an old, previously adjudged misguided, and subsequently withdrawn circular from the NUC which misrepresented the Fellowship as inferior to PhD for the purpose of appointment and promotion for clinical lecturers in Nigerian universities resurfaced again and contents of same circular was being mischievously cherry-picked to suit the resurfaced Fellowship vs. PhD debate. In the process, the fellowship-holder among the selected candidates, was wickedly projected as a pseudo-academic while the Fellowship degree was bandied as an inferior stop-gap qualification for academics who are unable or unwilling to earn a PhD.

While I usually will refrain from joining the politics of the jostle for the plum job of VC LASU, my interest, which stimulated this write-up, stems from the fact that I am also a holder of the Fellowship degree and someone who is a staunch believer in the finest academic traditions that the current needless bruhaha about the status of the Fellowship within the university is generating. I am, therefore, obliged to set some perspectives right for the records.

The Facts

What is the Fellowship?

The Fellowship is the highest obtainable academic and professional qualification in Clinical Medicine and Dentistry today. The certification is issued by the National Postgraduate Medical College of Nigeria, a Postgraduate Institution established by the Act of the National Assembly (National Postgraduate Medical College Decree No. 67 of 24th September, 1979, now Cap N59, Laws of the Federation 2004). The institution was established in 1979 and it is till today, the apex and only tertiary institution in Nigeria for postgraduate academic and professional education in Clinical Medicine. The highest postgraduate certification awarded by the College is the Fellowship. It is the only qualification recognized by the NUC to teach in the Faculty of Clinical Sciences in the whole country. There is no alternative. In other words, as things stands today, Faculties of Clinical Sciences in Universities in Nigeria only employ holders of the Fellowship, under normal circumstances. Any other postgraduate qualification obtained from Universities in Nigeria such as Msc. or PhD is NOT acceptable by the NUC to teach clinical medicine and Dentistry in any University in Nigeria.  The philosophy behind the establishment of this special postgraduate institution was because the founders of postgraduate Clinical Medicine thought it fit to integrate both professional and academic training together, a feat that may be impracticable within the regular university system. This way, the National Postgraduate Medical College is, therefore, able to meet the human resource needs of both the healthcare industry and the Colleges of Medicine.

What is the Structure of the National Postgraduate Medical College?

The College comprise of 15 Faculties which represents all the specialties and sub-specialities of Clinical Medicine. The Faculties are headed by a Chairman who is a Fellow of many years stranding, and mostly sourced from the Clinical Science faculties of Universities around the country. There is a College Senate, which comprises of the Principal Officers of the College and the Faculty Chairmen. The Senate oversees the academic programmes and the award of the Fellowship and other Certifications on the recommendation of Faculties. The College is headed by a President, a Fellow of many years standing, and a College Registrar who sees to the day-to-day running of the College. The current President of the College is Prof Musa Muhammed Borodo, a renowned Professor of Medicine at Bayero University Kano while the Registrar is Prof Owoidoho Udofia, a Professor of Psychiatry from the University of Calabar. As such, the College is not some backstreet institution without academic standing as many non-medics will want to see it.

How do you obtain the Fellowship?

First, you must be a holder of the MBBS Degree (a straight 6 calendar year university undergraduate program) and must be a fully registered medical practitioner. Then, if you desire to pursue postgraduate academic and professional training in Clinical Medicine and Dentistry, you will apply to the College. All applicants will be required to write an entry examination (called Primary Examination), usually covering the sciences basic to their specialty. For instance, in Psychiatry- which is my own field-, the Primary exams will cover neuro-anatomy, neuro-physiology, neuro-biochemistry, neuro-pharmacology, neuro-pathology, and neuro-psychology. Only successful candidates in these exams can start the postgraduate programme. The pass rate is often around 30%. If you are successful in the Primary exams, you will be required to seek employment as a resident (trainee) doctor in the department of your specialty in a tertiary health centre in Nigeria (usually teaching hospitals and at times the major medical centres) which must have been accredited by the College as a centre of excellence for postgraduate medical training. The moment you secure such placement, your postgraduate academic and professional training can then commence.

The training per se is a 6-7year programme of continuous, 70-80 hours a week of contact of the entire at-least 312 weeks (72 months) of the programme. The training is coordinated by Senior Fellows of the College who are consultants (and often University Professors) in your training institution. The postgraduate program is divided into two parts, usually referred to as Part I and Part II. The focus of the Part I is to equip you with clinical skills in your specialty while introducing you to basic research methodology and data gathering techniques in your field.  This involves the assessment and management of REAL patients in your field, under the direct supervision of your College approved Consultant/Supervisors. There are minimum numbers of postings and procedures you must log-in before you are eligible for assessment. During this period, you must leave your training post to attend a 2-week update course organised by the College to keep you abreast of cutting-edge practices/technology in your field and another 2-week intensive research methodology course. This is in addition to weekly academic seminar organised by the respective departments in the training institution. Attendance of all these courses and seminars is compulsory. After a 3-4year period of this intensive hands-on training and meeting all the other strict criteria, you will be eligible to sit for the Part I examination called the Membership Examination. This examination, which is central for ALL candidates in Nigeria, tests your clinical skills in theory and in practice. The week-long examination is coordinated by the Faculty Board of your specialty in the College. It consists of a theory part (MCQ and Essays) and a clinical examination using real patients. Success in these exams (usually less than 30% at first sitting) allows you to proceed to Part II of your training, which is another 3 years at least. Those who are not successful are eligible to repeat the examination 6 months after until they pass or are advised to withdraw from the postgraduate program as un-trainable (and people actually gets thrown out regularly). 

Unlike the Part I which focuses on the clinical skills in your specialty, the Part II focuses on research skill training in your specialty. While the candidate continues to hone their clinical skills, Part II candidates are expected to develop a PhD-level research proposal in their specialty. They will approach a potential supervisor, a Fellow of at least 5 years (and probably a University don) in their specialty who is willing to supervise them. After developing the proposal, the candidate will send it to the College Registrar who will pass it to the appropriate Faculty Chairman. The Faculty Chairman will then send the proposal to at least two anonymous Senior Faculty members who are known to have biases for your research interest as reviewers. The job of the reviewers at this stage is to advise the Faculty Board as to the suitability of your research topic and the soundness of your methods. They may accept the proposal, ask you to make some amends, or reject the proposal out-rightly.  If your proposal is accepted, you can then go ahead to start your research with your supervisor. During this time, you are required to attend research methodology courses organized by the College.

When you have collected your data, analysed it and have written-up your dissertation to you and your supervisor’s satisfaction, you will submit it to the College and apply to write your Part II examination which comprise of an advance examination of your current clinical skills and a DEFENCE of your Dissertation. At the dissertation defence, you will face two examiners appointed by the Faculty Board for that purpose. Such examiners must not be from your training institution and must neither be your supervisors or initial assessors of your proposal. The defence is as obtainable in any standard PhD defence. You may pass and you may fail

Part II candidates who passed the advanced clinical examination and successfully defended their dissertations are awarded the Fellowship of the College.

This is the summary of the 6-7 years journey of the Fellowship

The Myths

Having laid the facts, it is also important for me to dispel some of the myths

Myth 1: The Fellowship is just a mere professional certification and not an academic certificate. This is untrue. The first three years (Part I) of the Fellowship is geared towards clinical/professional skills, while the last three or more (Part II) is dissertation based. As things stand today, the Fellowship represents an all-round hands-on clinical skills and academic training in Clinical Medicine.

Myth 2: The Fellowship is just like ICAN, COREN, and other professional certifications, it for the health industry, it is not for University.  This is also not true. The NUC has assessed the course content and the dissertations of the Fellowship at some point. The conclusion was that it satisfies all requirements for a PhD-level academic qualification. It has been designated as the highest academic certification obtainable in Clinical Medicine for the purpose of being appointable as a lecturer. In fact, the approved entry point for Fellowship in ALL universities in Nigeria till today is Lecturer I.

Myth 3: Fellowship is a short-cut by medical doctors who couldn’t do the PhD. That is a fallacy. The Fellowship is an unnecessarily long route to academic career that if clinicians were given the option of Fellowship or PhD, no sensible person will opt for the Fellowship. Fellowship holders are not incapable of writing and defending a PhD level dissertation, they did defend one as part of the Fellowship! Even when the Fellowship is not disaggregated into the traditional Msc and PhD sequence as it is in other specialties, the Fellowship has all the components of Msc, PhD and more. The Part I stage of Fellowship is largely geared towards acquisition of the knowledge of the subject of the field (just like Msc candidates are required to) while the Part II is geared towards advanced knowledge, including sub-specialization, as well as research methodology and thesis (similar to what PhD candidates do). The only difference is that the Fellowship is a fine blend of both theory, practice, and research in its most advanced and thorough form.  

Myth 4: The Fellowship in clinical medicine and her status as a joint academic/professional certification is a Nigerian creation. This is not true. All over the world, from US, to UK, to Canada, the Fellowship is the joint professional/academic certification. You cannot be a clinical lecturer in any university in the world without the Fellowship of the Postgraduate Medical College of that country or that of a recognised country. The difference is that in some countries, their postgraduate medical college runs an intercalated Fellowship/PhD programme in clinical medicine with a collaborating University. This model is currently being recommended in Nigeria to put a rest to the PhD-Fellowship dichotomy in the country but this is still at infancy stage and not billed to commence as a condition for appointment or promotion until 2025. The NUC and the National Postgraduate Medical College is still working out modalities to achieve this. It is important to note that the move to integrate Fellowship and PhD programs together is not an indication of any inherent shortcoming of the Fellowship but a bid to streamline the conditions of service in Nigerian universities such that the Fellowship dissertation can have the additional value of being adoptable as a PhD dissertation by affiliated universities.

Myth 5:  If the Fellowship was such a big deal, why do Fellowship holders still go for PhD anyway? I have heard this argument being advanced to support the fact that Fellowship must be inferior to PhD. So, let us be clear. There are several motivations for clinical lecturers going for a PhD, Master’s, or even Diploma courses even when they have the Fellowship. Firstly, knowledge never ends and it is human nature to seek for more. I am a child psychiatrist and a clinical lecturer. After my Fellowship, I went for a Postgraduate Diploma in Children and Youth Studies in the International Institute of Social Studies, of the University of Rotterdam. My motivation was to gain more unique academic and professional insights into the sociology of childhood beyond the neuro-biological orientation to childhood I already acquired through the Fellowship program. It had nothing to do with whether my 6-year Fellowship was inferior or superior to a 6-month diploma, it was about the unique value it was to add to me. Others did a PhD having gotten a fat grant with a PhD opportunity attached to it, why not? Others like the idea of having multiple titles after their names, while others just did it to prove a point and remove any doubts about their academic credentials within a university where the dichotomy is still a debate. Others did it just for the hell of it! In any case, please be aware that a Masters or PhD in clinical medicine does NOT add any additional point to you for the purpose of appointment and promotion in any Nigerian University once you hold the Fellowship. In other words, such additional certifications are seen, as at today, as mere personal frolic.

Myth 6: The University Community does not accord the Fellowship the full status of highest academic qualification like they did the PhD, therefore it must be inferior. This is not true. While some academics, for reasons that is best known to them, have made several attempts to disparage the Fellowship as an inferior academic qualification, ALL universities in Nigeria continues to respect it. I make bold to say that in ALL universities in Nigeria (including LASU), the Fellowship is the ONLY qualification acceptable for appointment as lecturer in the Faculties of Clinical Sciences and Dentistry. The Fellowship gives you an entry point of Lecturer I in ALL universities in Nigeria (LASU inclusive), is scored the same mark as the PhD in A&P assessments in ALL universities (LASU inclusive); and holders of the Fellowship are appointable as and are appointed Professors of clinical medicine and dentistry in ALL Universities in Nigeria (including LASU). In short, no university in Nigeria currently discriminate against the Fellowship in appointment and promotion.

Myth 7: Someone without PhD cannot become VC because the university awards PhDs and you cannot confer what you do not have

For me, this is both a mischievous and, with due respect, ignorant view. Firstly, the Vice Chancellor dose not confer degrees, including PhDs on anyone, the University Chancellor (who could be anybody), on behalf of the Senate does. In any case, the university comprise of diverse faculties and colleges, of which the VC cannot possibly be an expert in ALL of them. There are already structures in place to direct the process of award of degrees, undergraduate or graduate, within the different Departments, Faculties, Schools, and Colleges. The job of the VC is to provide leadership for the process of university administration including teaching, research, and community service. The requirement to do that is to be a globally reputable Professor, extensive teaching and research experience, good understanding of the finest academic traditions, and leadership skills. Most universities and research institutes understand this fact and have always sought for these skills when appointing leaders of research institutes and academic outfits and consortia. I will give just one example. Take for instance, the case of Consortium for Advanced Research Training in Africa (CARTA), a consortium whose core mandate is to enhance “the capacity of African universities to create sustainable multidisciplinary research hubs by supporting junior faculty members to undertake their doctoral (PhD) training locally. Despite the fact that one of their activities include identification of, placement in, and mentoring junior faculties in Africa through their PhD programmes, Prof Akinyinka Omigbodun, the Chairman of the CARTA, does not hold a PhD but the Fellowship!  In appointing the internationally reputable Professor of Obstetrics and Gynaecology as the Chairman, the consideration of the Board of CARTA was not whether Fellowship is equivalent to PhD or whether someone without a PhD can direct the affairs of a Consortium which aims to advance the course of PhDs, but his foremost academic standing in Africa including his leadership capacity and track-record. This is the way the world is moving, and any suggestion to the contrary in the appointment of LASU VC is just plain mischief at best or deliberate ignorance at worst. 

Myth 8: Some Universities will not make you Vice Chancellor if you have the Fellowship and not PhD, therefore Fellowship is inferior to PhD.

The truth is that Professors of Medicine (who hold the Fellowship and not the PhD) has been and are still Vice Chancellors of Universities in Nigeria. See Prof Adeoye Lambo (UI 1967 – 1971, Psychiatry); Prof Babatunde Kwaku-Adadevoh (Unilag 1978 – 1980; Chemical Pathology); Prof Deji Femi-Pearse (Unilag Acting VC, 1980; Internal Medicine), Prof Akinpelu Oludele Akinsola (Unilag 1981-1988, Surgery); Prof Adeoye Adeniyi (Unilorin 1992-1997, Pediatrics); Prof Fatiu Akesode (LASU 1997 -2001, Pediatrics); Prof Oladosu Ojengbede (UI Acting VC 1995-1996, Obstetrics & Gynaecology); Prof Ayodele Falase (UI 2000-2004, Internal Medicine); Prof Isaac Adewole (UI 2010-2014, Obstetrics & Gynaecology); Prof John Obafunwa (LASU 2011 -2015, Pathology); Prof Fidelis Njokanma (LASU Acting VC 2015; Paediatrics), Prof Abdulmumini Rafindadi (Federal University Lokoja 2011- 2016, Pathology), and recently Prof Benjamin Ozumba (UNN, 2014-2019) till date, Obstetrics & Gynaecology) and Prof Folasade Ogunsola (Unilag Acting VC, 2020; Medical microbiology). In fact, as at the time of writing this letter, there are at least two Fellowship-without-PhD Professors serving as Vice Chancellors of Universities, examples are Prof Chigozie Ogbu (Ebonyi State University, 2017 till date, Pediatrics) and Prof Aliyu Usman El-Nafaty (Gombe State University, 2019 till date; Obstetrics and Gynaecology) . Granted that I know of at least two dual Fellowship/PhD holders who have been appointed VCs, in the persons of Prof Rogers Makanjuola (OAU 2001-2006, Psychiatry) and Prof Friday Okonofua (Ondo State University of Medicine 2016 -2020, Obstetrics & Gynaecology), they were both appointed VC in recognition of their academic standing as there is no evidence it was based on their possession of PhD in addition to their Fellowships.

Myth 9: The NUC says that there is no equivalent to a PhD; therefore, the Fellowship cannot be equivalent to a PhD.

This is an emotional argument, as far as I am concerned. The Fellowship is NOT equivalent to a PhD. Period. This is because they are two different certifications with different philosophies. While the PhD is a purely academic degree, the Fellowship is a combined academic and professional certification. What is an unassailable fact, however, is that as far as the NUC and the Senates of ALL universities in Nigeria (including LASU) is concerned today; the Fellowship is the minimum entry point for academics in Clinical Medicine & Dentistry and the highest academic qualification required to reach the top of academic career in clinical medicine and dentistry. This is exactly the status of PhD in every other academic discipline. Debating whether or not the Fellowship and PhD are equivalent is therefore, a needless, emotional, and wasteful academic exercise. Aside this, non-equivalence is not tantamount to superiority. The Bachelors of Engineering (B.Eng) is clearly NOT equivalent to the Bachelors of Laws (LLB). This is a fact. Will it then be logical to conclude from this premise that one is superior to the other?

Myth 10: Fellowship holders are weak academics because they do not possess a PhD.

This is untrue and it is contrary to the facts on ground. There are hordes of university lecturers in non-medical faculties (with PhDs) who are redundant academics. We also have Fellowship holders who are university lecturers and are equally academically redundant. This is a fact. If PhDs were the academic magic, we should not have plenty PhD holders who are struggling academics. In the same vein, if the Fellowship was the key to academic success, we shouldn’t have redundant Fellowship-holding clinical lecturers, but we do. This goes to show that academic excellence is not a PhD/Fellowship issue, it is the innate academic skill which the Fellowship or PhD help individuals to hone that really matters. Take for instance, while Prof Oshungade Isaac Olayiwola, a PhD in mathematics was the University of Ilorin Researcher of the Year 2014, Prof Wasiu Kolawole Wahab, a Fellowship holder without PhD from the Department of Medicine (Neurology) got the same award in 2016. It had nothing to do with their PhD or Fellowship; it was a reflection of their individual academic prowess. When Prof Friday Okonofua, a dual PhD-Fellowship holder was being admitted into the Nigerian Academy of Science (NAS) in the year 2010, Profs Akinyinka Omigbodun and Isaac Adewole who hold the Fellowship without a PhD were inducted into the academy same day. This was in recognition of their individual academic standing and contributions, not the nature of academic certification they held. In any case, and without attempting to sound immodest, clinical lecturers (with Fellowship) are often on the top echelon of academic excellence in any University. They belong to the crème and often among the most celebrated alongside their PhD holding counterparts in other Faculties within the University. Among recent inductees of the Nigerian Academy of Science are Profs Olayinka Omigbodun FAS (Psychiatry), Adesola Ogunniyi FAS (Medicine/neurology), and Wasiu Adeyemo FAS (Maxilofacial Surgery). Only the latter possess an additional PhD to his Fellowship, the rest are pure Fellowship holders.

Concluding remarks on the needless mudslinging in the ongoing LASU VC selection process:  

I have explained exactly what the Fellowship is, beyond misconceptions, and I have also debunked some myths around the qualification. While I understand that, the university is a politically charged environment, and when it comes to the appointment of Vice Chancellors, which is a political appointment, several sentiments come to play; the discourse so far shows clearly the error in the view and insinuations that a certain candidate is not qualified to be selected as possible VC of LASU based on the fact that he holds the Fellowship as primary postgraduate qualification and not the PhD. The candidate would not have been found appointable as Lecturer in clinical medicine in LASU if he had held a PhD in lieu of the Fellowship for reasons stated earlier. Also, if the VC interview he attended on the 21st of December, 2020 was for the purpose of appointment as Lecturer I in clinical medicine in LASU, he would still not be appointable by the conditions of service of LASU of today, if he had held the PhD and not the Fellowship. It is therefore illogical, to say that a certification that was not going to get a candidate appointable in the first instance will be required to be VC of same university that made him or her a Professor. Aside, it is ridiculous to say that someone who was found appointable in the university, promoted to the rank of Professor, made the HOD, Dean, and Provost of the College within the university; and admitted into the hollowed chambers of the University Senate, elected as Council member of same University is ineligible to be the VC of same University based on a certain certification that was never set as condition of appointment and/ or promotion at any point.

Like I said in my opening statement, the politics of who becomes the next VC of LASU is beyond me, but when it comes to this issue of Fellowship and PhD, we should follow the facts, not sentiments

Dr. Olayinka Atilola MBBS (Ilorin); FMCPsych (Nigeria); FWACP (West Africa); PGD (Rotterdam), is an academic staff of Lagos State University, a Clinical lecturer, and a holder of the Fellowship degree

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