The National Youth Service Corps (NYSC) Program
Benefits and Challenges of the National Youth Service Corps Program among Medical Doctors in Nigeria
The National Youth Service Corps (NYSC) is a compulsory one-year program for graduates of tertiary schools including doctors. This study was conducted to find out the benefits and challenges of the program among corps medical doctors as well as their treatment in their places of primary assignment (PPAs). The study would influence policymaking so as to improve the experiences of corps medical doctors and help NYSC to achieve its objectives.
Survey and Outcome Variables
A descriptive cross-sectional survey was conducted among 399 medical doctors doing their compulsory national youth service in Nigeria. The research instrument was developed by the researchers and pretested before use. The outcome variables were: overall benefit, overall challenge and overall PPA treatment. The data obtained were analyzed using descriptive statistics and chi-square test using p < 0.05.
Benefits and Challenges of the Program
Majority of respondents (83.5%) believed that the scheme offered one or more benefits to corps medical doctors (overall benefit). These benefits include exposure to new culture (47.6%), gaining medical/surgical skills (36.3%) and finding a lover/spouse (4.5%). Similarly, most of respondents (89.2%) reported one or more challenges (overall challenge). Some of the challenges reported include; no provision of accommodation (51.6%), poor remuneration (44.7%) and exploitation of corps doctors by their employers (41.4%).
There was a statistically significant association between overall benefit and region of deployment (p value: 0.013). Region of deployment and marital status were found to have a statistically significant association with the overall challenge with p-values of 0.031 and < 0.001 respectively. Overall treatment at PPAs was mostly reported to be bad (77.2%) and it had a statistically significant association with marital status (p-value: 0.002) and religion (p-value: 0.024).
Poor PPA Treatment
Most respondents reported poor PPA treatment and this calls on the government and other stakeholders to take drastic measures to improve the welfare of corps medical doctors in order to positively influence their perception of the scheme and encourage their continued participation.
Problems Associated with the Program
The National Youth Service Corps (NYSC) was established by decree No.24 of 22nd May 1973  and since its inception, the program has been met with criticism from participants (corps members), who have identified problems faced by corps members including medical doctors [2,3,4]. These problems are likely to influence the performance of corps medical doctors during the scheme.
Some of the problems associated with the program include being posted to harsh, unfavorable or undesirable locations , insecurity due to religious, ethnic and political violence [6, 7], accidents and deaths due to poor transportation networks , exploitation and poor welfare at places of primary assignment , refusal of relocation requests , unavailability of decent accommodation facilities [3, 4] and poor remuneration .
Most corps medical doctors earn less than half of what they earned during their internship. This gross reduction in income in spite of the higher skill level afforded by prior internship training could be discouraging and this could lead to poor patient care due to lack of motivation. According to a study done in 2015, the prevalence of anxiety, depression and stress was found to be high among corps members . With studies having shown that mental health problems are more common among medical personnel , corps medical doctors are at risk of various psychosocial problems which may or may not be related to their profession.
Relevance of the Program and Study Objectives
There have been some concerns over the relevance of the scheme. There was a recent bill sponsored by a lawmaker in the national assembly demanding that the scheme be scrapped but the bill is yet to be approved . Despite the challenges bedeviling the scheme, it has not only provided an avenue for corps doctors to gain medical and surgical skills but also an opportunity to help cushion the devastating effects of industrial action by resident doctors in Nigeria . This is beneficial to the doctors as well as the general public as these doctors develop more confidence in patient care.
A study focused on the experiences of corps medical doctors in Nigeria does not currently exist. The challenges of the scheme faced by the average corps medical doctor go a long way to influence his/her general attitude towards the scheme, mental health status and essentially the quality of medical care they offer to patients in their places of primary assignment. An understanding of the experiences of the service year among corps medical doctors would guide stakeholders on how best to meet the psychosocial needs of corps doctors and this will help in reducing the prevalence of mental health problems among them and potentially improve the quality of care they offer to patients in the communities they get posted to work in.
International Youth Service Programs
Similar national youth programs exist in other countries of the world such as Israel, France, United States of America, Ghana, Uganda, Zimbabwe, South Africa, etc. [17,18,19], however, the mode of operation, requirements and demographic categories involved in such schemes vary widely among these countries. Therefore, this study will add to the existing literature and fill up the gap created by the paucity of data on the benefits, challenges, and PPA experience of corps medical doctors in Nigeria.
Sampling and Data Collection
This study was carried out among serving corps medical doctors in Nigeria. The NYSC was founded in 1973 for tertiary education graduates including doctors to undergo one-year service to fatherland. About 150,000 corps members are recruited yearly but the exact number of doctors recruited yearly could not be ascertained . Corps members are recruited in 2 to 3 batches per year and each batch has 2 streams. The program runs in cycles such that as one stream is passing out, another stream is being recruited.
A descriptive cross-sectional study was conducted among 399 serving corps doctors at various places of primary assignment across all states in the 6 geopolitical zones of the country, including Abuja. All corps doctors, irrespective of age or sex, serving at the time of the study and gave consent, were recruited for the study. Corps medical doctors who had not completed camp orientation were excluded.
The minimum sample size of 384 was calculated using the Cochran’s formula using the proportion of 50% as the researchers could not find a similar and acceptable study on the subject to adopt a specific prevalence value from.
Data on participants’ socio-demographics as well as the benefits, challenges and treatment at PPA was obtained with a pre-tested, semi-structured, self-administered e-question
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