Foreign-Trained Graduate Asked to Cover Night Calls Before MDCN Registration
Dr. Amina Bello graduated with an MBBS from a university in Ukraine in June 2023 and returned to Lagos in January 2024. She holds her degree certificate, academic transcript, a certificate of good standing from the Ukrainian regulator, and a letter from her former clinical supervisor. She has not registered with the Medical and Dental Council of Nigeria (MDCN) and has not sat the Council's assessment examination. A private 20-bed hospital in Lekki offers her a 'medical officer' post with immediate night cover because its only full-time doctor is travelling for three weeks. The hospital administrator tells her that registration is 'just paperwork' and that she can start on Monday. On her first night, a 28-year-old woman arrives with acute severe asthma: respiratory rate 34/min, oxygen saturation 88% on room air, and she is unable to complete sentences. There is no other doctor on site; a nurse asks Dr. Bello to prescribe salbutamol nebulisation and steroids. Dr. Bello is unsure whether she can act.
1. Can Dr. Bello lawfully accept the post and independently prescribe for the asthmatic patient? Explain the registration principle and the immediate options.
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No. The controlling principle is that independent medical practice in Nigeria requires registration with the MDCN and a valid Annual Practising Licence (APL). A foreign degree, transcript or certificate of good standing is evidence of training, not a licence to practise. Dr. Bello has neither registration nor an APL, so she cannot lawfully hold herself out as a medical officer, prescribe, or sign clinical documents.
The emergency does not create a general exception. She may give basic first aid, summon a registered practitioner and assist under that practitioner's direct supervision, but she must not independently prescribe salbutamol or steroids. The nurse should activate the hospital's emergency protocol and call the medical director or another registered doctor; oxygen and basic monitoring can be started under nursing protocols while that call is made.
If she accepts the post and prescribes, both she and the hospital risk professional and legal consequences, and the hospital's indemnity may not cover an unregistered practitioner. Her immediate step is to decline night cover in writing, explain why, and ask the hospital to arrange registered cover. She should also begin her MDCN application and clarify whether she must sit the assessment examination and complete housemanship before full registration.
2. Set out the registration route Dr. Bello should follow, including the role of the assessment examination, housemanship and the Annual Practising Licence.
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She should apply to the MDCN with her degree certificate, transcript, certificate of good standing, passport data page and other documents the Council requires. The Council, not the hospital, determines whether her foreign qualification is recognised and whether she must sit the MDCN assessment examination. Passing that examination is not itself full registration; it establishes that her knowledge and skills meet the Council's standard.
The Council will then decide whether she requires a period of supervised housemanship. If it does, she needs provisional registration and must complete the prescribed 12-month housemanship in an MDCN-approved centre, with rotations and a logbook signed by appropriately qualified supervisors. Retrospective credit for unsupervised work is not automatic. After satisfactory completion, she can apply for full registration.
Only after full registration should she apply for an Annual Practising Licence for the year in which she intends to work. The APL is the document that makes current clinical practice lawful; registration alone does not remove the need for the annual licence. She should not accept independent clinical duties until both steps are complete.
3. If the hospital insists she cover nights before registration, what are the professional and legal consequences, and what should she do?
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The hospital would be employing an unregistered person to perform medical acts, and Dr. Bello would be practising without registration and without an APL. That exposes both parties to regulatory action, and it may invalidate indemnity cover for any adverse event. A patient harmed by an unregistered practitioner would also have a strong medico-legal claim against the hospital. The administrator's assurance that registration is 'just paperwork' does not change the statutory position.
Dr. Bello should decline in writing, keep a copy, and avoid any shift in which she would be the most senior or only doctor. She can offer to work in a clearly supervised, non-prescribing capacity only if the MDCN permits it and a registered practitioner accepts responsibility; otherwise she should not be on the clinical roster. She should report the hospital's insistence to the MDCN if it persists, because patient safety is at stake. Her career interest is also served by documented compliance rather than a short period of unlawful practice that could delay or destroy her registration.