NPR: Medical students aren't showing up to class. What does that mean for future docs? (3)

5 June, 2023


Thank you so much for sharing this and bringing the content forward for the widest possible discussion.

We (at the Centre for Clinical Governance Research and Patient Safety ( have for long debated the impact of remote training of medical students on their skills and performance, including professionalism and the doctor-patient relationship. The discussions started when we noticed during job interviews for doctors that many declared that they missed good parts of their practical in-person training postings, including actually taking deliveries in Labour ward, for instance. Yet they were signed-off for the posting and went on to take and 'pass' the examination in Obstetrics and Gynaecology. And this was happening in countries with some of the highest maternal and newborn mortality. And this was well before COVID-19 pandemic and its restrictions and lock-downs. And of course before AI.

The article seems to refer to the pre-clinical period of training ('first two years'), but even then how do these students learn practical laboratory work skills, anatomy dissection, etc. We are keen to know. [*see moderator note below]

Surely, the traditional medical curriculum needs updating and upgrading to meet the knowledge, skills and attitude requirements for 21st century medical doctors, but is remote / virtual training of doctors the way forward? We doubt it!

Joseph Ana.

Prof Joseph Ana

Lead Senior Fellow/ medical consultant.

Center for Clinical Governance Research & Patient Safety (ACCGR&PS) @ HRI GLOBAL

P: +234 (0) 8063600642


8 Amaku Street, State Housing, Calabar, Nigeria.

HIFA Profile: Joseph Ana is the Lead Senior Fellow/Medical Consultant at the Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). He is a member of the World Health Organisation’s Technical Advisory Group on Integrated Care in primary, emergency, operative, and critical care (TAG-IC2). As the Cross River State Commissioner for Health, he led the introduction of the Homegrown Quality Tool, the 12-Pillar Clinical Governance Programme, in Nigeria (2004-2008). For sustainability, he established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria. His main interest is in whole health sector and system strengthening in Lower, Low and Middle Income Countries (LLMICs). He has written six books on the 12-Pillar Clinical Governance programme, suitable for LLMICs, including the TOOLS for Implementation. He served as Chairman of the Nigerian Medical Association’s Standing Committee on Clinical Governance (2012-2022), and he won the Nigeria Medical Association’s Award of Excellence on three consecutive occasions for the innovation. He served as Chairman, Quality & Performance, of the Technical Working Group for the implementation of the Nigeria Health Act 2014. He is member, National Tertiary Health Institutions Standards Committee of the Federal Ministry of Health. He is the pioneer Secretary General/Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers. ( Email: info AT and jneana AT

[*Note from HIFA moderator (NPW): Apologies, I didn't put the URL for the original news article. Here it is:

The authors specify: 'Activities such as anatomy lab, patient interviewing and physical exam practice and special guest lectures would remain in-person.']