The case for specialised medical universities – Part 6

At UNIMED, our stakeholders value transparency and to actualize this treasure, I organize weekly consultative meetings with all senior teaching and non-teaching staff. Despite this effort, there are still some stakeholders who frequently fall prey to dissension and who do not support the University in its quest for academic excellence. Nevertheless, we have continued with the weekly consultations to ensure that the new University is on a solid foundation for future growth and development.

4) Medical Universities and Teaching Hospitals: The advent of medical universities has provided the opportunity to rethink the relationship that should exist between universities that teach health sciences professionals and their corresponding teaching hospitals. In traditional Universities, the two institutions (universities and teaching hospitals) have often been administered in parallel fashion, a situation which has tended to delimit the training component attributable to the teaching hospitals. Most teaching hospitals affiliated to traditional Universities are presently run as commercial outlets with little consideration for the teaching, training and clinical experience for students and post-graduates that were intended for the hospitals in the first place. In many cases, teaching hospitals often fail to include teaching and research in their annual budgets, with many arguing that these are supposed to be provided by the parent Universities. In some cases, acrimony has emanated from the use and sharing of resources between the teaching hospitals and the parent universities, a situation which has tended to severely reduce the quantum and quality of clinical training of health professionals in many traditional Universities/Teaching hospitals. Medical Universities provide an opportunity to correct this incongruity. This can be done easily since it would be expected that in Medical Universities, both the University campus and the Teaching Hospital complex should be in one location. Ideally, they should never be on different sites. This unified location allows for the development of a harmonized administrative structure for both institutions, which will help to improve efficiency and effectiveness, and also prevent the unnecessary duplication of resources.

At UNIMED, we have proposed the adoption of a unified administrative structure under the leadership of the Governing Council of the University. The Governing Council will include individuals from the University and the Teaching Hospital components, external members, and internal members from both the University and the Teaching hospital. The Vice-Chancellor will work under the supervision of the Council. He or She will have two Deputy Vice-Chancellors, one of whom will oversee the teaching hospital as the Chief Medical Director, as is presently practiced in traditional teaching hospitals. The other DVC will be in charge of academic matters, while other functionaries of the Teaching Hospital and the University, including the Chairman of the Medical Advisory Committee, Senate, Deans and Heads of Departments will perform roles that are assigned for them in traditional universities and teaching hospitals. We believe that this will significantly reduce the cost of running the University and teaching hospitals as separate institutions and will also increase the impact of medical universities. I have reviewed the administrative patterns of several Universities of Medical Sciences in many parts of the world, and I have not found one where the university and the teaching hospital components are administered as separate institutions.

5) Funding and Accountability Issues: One of the significant challenges of all Universities, especially the new institutions are funding. A Medical University is costly to establish, and in our estimation, it is more expensive to develop one than a traditional university. The NUC and the MDCN recently pronounced that individuals wishing to establish medical and dental programs must first build a functioning teaching hospital with the appropriate level of academic and non-academic personnel. This policy has enlivened the debate on the cost of developing a Medical University.

A Medical University (or any university for that matter) must never be established for the sole purpose of profit-making because financial gains are typically not realized in the first ten years. Profits will come from grants, possibly fees paid by the increasing number of undergraduate and post-graduate students, patents from research findings, and clinical service provision, etc., and will only manifest when the University has entirely taken off and is fully operational. Thus, efforts must be made by the proprietors at the onset to make substantial provision for funds, especially for infrastructure, equipment, staffing, and related matters. Such projected funds should cover ten years and should be done possibly with a bank guarantee to ensure continuous availability of funds. Even with the best intentions, a proprietor may not always be able to provide all the funds required to run such a University. Therefore, the university administration must not leave the issue of resource mobilization to the proprietor. Hence, the administration must begin a fund-raising drive right from the very onset to augment the funds from the proprietor.

At UNIMED, we established a Resource Mobilization Unit within the Vice-Chancellor’s office right from the inception of the University. The Unit has now grown in leaps and bounds, raising considerable funds and other physical assets for the University. These include the donation of a Faculty of Basic Clinical Sciences building to the University by Chief IF Akintade, an indigene of Ondo State. This gift is in addition to a grant from Seedling Lab based in the USA that donated 200 pieces of ultra-modern laboratory equipment. Recently, Hon Akinlaja, a member of the Federal House of Representatives, gave a Faculty of Clinical Sciences building to the University. Our unique innovation at fund-raising is through the Friends of UNIMED Fund (FUF) established in July 2016, to “raise small amounts of money from various stakeholders each year for the sustained development of the University.” The initial goal set was to raise at least one billion Naira from our stakeholders annually. We anticipate our one million Friends of the University members will donate at least N1,000.00 (one thousand Naira) each. The FUF has raised substantial funds dedicated to building an edifice on campus to be named the “Friends of UNIMED Building.” Every donor will have his/her name inscribed on a billboard that will be installed in the building, to honor such donors in perpetuity. Donations to the University can only happen when stakeholders believe that their funds will be used judiciously just for the designated purposes, and solely for the advancement of the growth and development of the University. To facilitate donation, UNIMED has come up with the TEA – Transparency, Effectiveness, and Accountability – agenda which affirmed that all our projects would be handled based on the principles of openness and anti-corruption.

We have demonstrated this in many ways, which has helped our stakeholders to continue to make donations to the University. Indeed, I believe very firmly that substantial funds can be raised in many ways when the donors are convinced that their gifts will be judiciously used to address some of the University’s developmental challenges in a meaningful and realistic manner.
Conclusion

I want to conclude my presentation by averring that the recent establishment of Specialized Medical Universities is one of the most significant developments in the training of health professionals in Nigeria.

Conclusion
I want to conclude my presentation by averring that the recent establishment of Specialized Medical Universities is one of the most significant developments in the training of health professionals in Nigeria.

The concept is an enormous paradigm shift from the traditional medical education that focuses on silo-experience of the different professionals to an interprofessional, multi-system approach that focuses on healthcare systems improvement for the sustainable reduction of the burden of disease and disability. For a Specialized Medical University to be successful and impactful, it must be driven by visionary, selfless and purposeful leadership that embraces accountability and transparent use of available resources. Similarly, the university administration must systematically engage all its stakeholders in the health and education sectors and the power brokers in the local communities. The establishment of more Specialized Medical Universities in Nigeria will positively change the trajectory of our healthcare system. Hopefully, it will correct some of the curriculum deficits in traditional medical schools in Nigeria. I anticipate that when UNIMED graduates are produced a year from now, they will be clinically competent practitioners ready to deliver high-quality healthcare services to diverse populations. They will have the entrepreneurial skills needed to start their private practice after registering with the MDCN. They will also be more collaborative and less combative in their approach to the practice of medicine because they will have the skills needed to work in interdisciplinary teams, organizations, or systems. Furthermore, and most importantly, they will be in a unique position to prevent illnesses of the type that resulted in the sudden death of Professor Sofoluwe. Thank you very much for giving me your undivided attention!

Concluded
Professor Okonofua, is Vice-Chancellor, University of Medical Sciences (UNIMED), Ondo City, Ondo State. Being an address delivered at the seventh Professor Sofoluwe memorial lecture, organized by the alumni association of the university of Lagos recently.