MOVEMENT TO ANOTHER CENTER

Sometimes, a resident might decide to move to another center, either because of better training facilities, better remuneration or both. In the presence of scarcity of doctors or inexplicable peculiar characteristics of some senior colleagues, all impediments real and imaginary are placed on his/her path. The resident is exposed to shuttling between the old and new center for some time trying to untangle all the webs. This is a distraction.

RELOCATION

In many other areas of civil service, just as in the organized private sector, on employment or reposting to a new location, funds are made available for transportation and accommodation (known as passage allowance and first 28 days' allowance).For example, in the banking sector, employing a young banker or on transfer to a new location, the bank takes care of his transport and accommodation, either in their guest house or a standard hotel facility until such a time as he would have been advanced money to source his own accommodation. This is a man who handles just monetary transactions.

The resident doctor in most cases on employment is treated like an orphan, and an outright reject of the society. With little or no saving from his house job or many years of locum services, he assumes duty at an institution. No idea of a facility where he could eat good food (most hospital canteens from my experience prepare food for aliens). No accommodation: some residents on employment have been known to encamp for sometime in hospital common rooms and call duty rooms. Others hop from the house of one relative/friend to another. Those that are lucky to be blessed with cars only need safe parking spaces and places to toilette.

Multiple and scattered protocols that one has to pass through in the guise of acceptance of offer of employment and pay-rolling is better imagined than experienced. Due to lack of proper job/facility orientation, the resident “wobbles” and “tumbles” until the light borne out of bitter experiences shines through. Not knowing the hospital organogram or how it works impacts negatively on his/her productivity. Frustration blossoms and the doctor is highly distracted.

The attitude of some unit consultants who should show some direction but usually act as if the doctor has no problem and is just unserious compounds the feeling of rejection and oppressive aggression. This does not mean that a lousy resident should be condoned.

INTER-PROFESSIONAL HOSTILITY

Many of us have experienced this, but it's worse on residents who did not have their undergraduate training at the residency training center. Depending on the level of hostility in the center, there could be attempts to “fry”, ''tar and feather'' him/her. I salute all centers where this does not exist or is barely perceptible. They have removed one ingredient from the cocktail of frustration and distraction.

THE UNIT/DEPARTMENT

The unit consultant should know that stratifying the unit and yielding necessary power to people occupying the different strata makes the unit run freely and efficiently. It is unfair to punish all members of the unit when the guilty one is known. It is unfair to punish a senior registrar for not taking care of the unit when you left him powerless. In some units, the senior Registrar is not aware of when house officers join and leave. There surely will be a problem in such units. For any problem in any unit, the resident is worse off and thus detracted.

Units/departments should also plan their programmes in such a way as to leave some free time for the residents to engage in reading. All work and no reading make the resident a G.P.

PRIVATE PRACTICE (P.P)

This is one of the possible solutions to poor remuneration and erratic pay day. Speaking from a personal perspective, i dare say that full scale private practice by a resident is a distraction. Where the resident gets bogged down with the exigencies of private practice especially early in the programme, he is in for a turbulent time ahead as residency programme is a ''jealous husband/wife''. This could lead to a miscarriage of focus, many times with a grievous fall out.

MARRIAGE

C.O. Onyebuchi Chukwu in his lecture titled ''the resident doctor as a change agent'' stated that it was on record that only bachelors were admitted into residency training programme at its inception. Reason being presumably to enhance concentration and diminish social and family distractions.

In our peculiar society, it is a fact that the period of residency coincides with the age interval when marriage is expected. The average resident is now faced with the option of marriage with attendant distractions or remaining single and facing other forms of distraction. If he decides for marriage, the process and multiple financial and logistic hurdles that have recently been interwoven into it, hit him like a blizzard. A resident being involved with a troublesome spouse faces a real and present danger of losing focus. If a resident is scared of going home, then the regulated process of rest/eating, sleep, work and reading is interrupted. Other things related to marriage such as pregnancy/delivery, child up-bringing and home up-keep not only prey on the little time but also bring a psychological stress/distraction when coupled with poor pay and fibrillating pay day. Married life in residency is not all woes as in some cases, it provides a solid base from which one can bounce back when hurt. The story was told of a bunch of residents who were on their way back after an unsuccessful “pilgrimage” to Lagos. All were very bitter except one who was all smiles. On inquiry, he said that he just can't wait to be home as his wife knowing that he failed would have prepared lots of delicacies and stocked the fridge with beer so as to help him forget his sorrows. Sometimes mere seeing your kids gives you the greatest focus as you work harder to make their future brighter.

SINGLE HOOD

From a non-religious point of view it is a fact that when marriage is delayed, other substitutes with the attendant risks have to be employed. Sometimes, the time and money it takes to court and convince partners (a.k.a ''Igba-treasure'', TMA) is enormous. Instability of such relationships and high tendency towards unfaithfulness might leave the resident an emotional wreak and thus distracted.

Some also make the best of single hood by focusing on the work ahead without some of the distractions imposed by marriage.

EXTENDED FAMILY AND FRIENDS

They on their own set standards for him/her to measure-up as a good child, cousin, sibling, niece/nephew, uncle/aunt and friend with attendant emotional, financial, social, and even spiritual implications. Hitherto unreckoned-with acquaintances suddenly emerge, and the kindred and town meeting groups will be interested in him, with the accompanying levies. Traveling home to the village is no longer for rest and relaxation but for pro bono consultation and wholesale financing of the prescriptions he makes.

PEER PRESSURE

Do not allow your residency peers make you feel like a dunce. Have a plan. Prepare for the exams at your own pace but make sure your pace falls within the allotted time. I know of a resident that withdrew from the programme because he felt that other residents are too far ahead of him. The fear of your fellow resident is an unnecessary distraction. Resist it!

SOCIALIZATION

Everything worthy in moderation is good. Excessive socialization under the influence of your peers is one luxury you can not afford. When on an outing take what you need and not what they are taking. Stand out as a man of character and not just a reed blown about by the wind of friendship. As the holy book said, show me thy friends and I will tell you the kind of man you are.

POLITICS AND STRIKES

Some one must lead residents in their association. This calls for a perfect balancing act. It will be wise to achieve some academic stability before taking sensitive posts. Respect your senior colleagues and don't view yourself as a rebel with or without a cause. One or two years without a strike do not make the ARD a weak group. In essence do not court strikes, remember that it is a distraction but if all peaceful avenues fail, then go with God. It must be said here that NARD does not encourage strike as first option.

EXTERNAL POSTINGS

This for some residents, instead of complementing their training has become a distraction. The resident faces all that the newly employed resident in unfamiliar environment faces.

CONCLUSION

Life itself has many distractions but we still live on and make a success of it. The government must provide better funding for training centers and adequate state-of-the-art facilities. Remuneration should be encouraging and attractive to get the best brains into the programme. There is need for an honest and serious management of health institutions to end most of the distractions. Provision should be made for the newly employed resident to settle in quickly and comfortably. A productive resident is an asset to the hospital and a good shoulder for the consultant to lean on. Though the consultant should give positive and strong leadership, sometimes there is need to hear the resident out and empathize with him/her (sometimes a mother's cuddle passes a stronger and more positive message than a father's ''bark'').

Accommodation facility should be provided in different centers for those on external posting. The resident must acquit him/her self well as an adult and tame the immediate environment.