Patients stranded as specialist shortage hits public hospitals

As Nigeria’s non-communicable disease burden grows, patients are paying the price for a critical shortage of specialists, enduring long waits, postponed appointments and restricted access to life-saving care. PUNCH Healthwise investigation exposes the widening gulf between the rising demand for specialist care and the country’s inadequate specialist workforce. JANET OGUNDEPO reports

Every day, more Nigerians are diagnosed with non-communicable diseases, including hypertension, diabetes, obesity, cancer, mental health conditions, kidney disease and cardiovascular disorders.

The persistent trickle of cases has become a growing burden, but as cases rise, the number of trained specialists to treat, manage, and care for the teeming numbers of patients who throng public secondary and tertiary hospitals on clinic days continues to dwindle.

This leaves patients and specialists on an uneven playing field, with the growing patient population tipping the balance.

Visits to hospitals in some states reveal large crowds of patients waiting to see the few available specialists.

For example, at the Federal Medical Centre, Idi-Aba, Abeokuta, Ogun State, patients described long waiting times and early daily cut-off limits for registration as challenges that made accessing specialist care stressful.

One outpatient, who identified himself simply as Ademola, told one of our correspondents on Thursday that he had been turned away when he first visited the hospital about three weeks earlier.

“I was here about three weeks ago. I got to the hospital around 8am, but I was surprised when they told me that the number of patients to be attended to had been selected. I think they said about 70 patients,” he said.

Ademola said he was advised to return the following morning and arrive earlier to secure a place. He eventually registered after arriving shortly after 7am but did not see the doctor until about 3pm.

Another patient, Mrs Adelaja, said the experience differed from the services she received at the hospital when she gave birth a decade earlier.

“I have been here since past 7am, but it is almost 12 pm and I have not been called in to do any registration, not to talk about seeing the doctor,” she said.

In the North-East, patients at the Specialist Hospital, Gombe, also raised concerns about delays, bed shortages and the cost of repeated visits.

Maryam Ahmed, who accompanied her brother for eye surgery, said they were unable to see a specialist when they arrived at the hospital and that his condition subsequently worsened.

“Unfortunately, we came at a time they considered wrong, and we couldn’t get the help, so the case worsened,” she said.

Ahmed added that the family could not afford to seek treatment elsewhere, making the experience more distressing.

In Lafia, Nasarawa State, patients at the Federal University Teaching Hospital, Lafia, said the shortage of doctors and overcrowding had pushed some of them towards private healthcare facilities.

Boniface, a patient who had been seeking answers to persistent testicular pain, said he had visited the hospital for about three months, undergoing investigations at intervals without a clear resolution of his condition.

“I have been in the hospital for over three months now with no obvious results because they have yet to attend to me,” he said.

Another patient, Ibrahim, who visited the hospital’s ear, nose and throat department, said he had spent more than N80,000 over three weeks without seeing a consultant.

“I have spent over N80,000 while visiting this hospital in the past three weeks, but I have not been able to meet with a consultant doctor at the ENT department,” he said.

Ibrahim said he was told that his condition required assessment by a senior doctor who did not live in Lafia and only visited the hospital to see patients.

He warned that he might have to seek treatment at a private facility if he could not see the consultant soon, despite the financial burden.

High burden of NCDs, fewer specialists

On Thursday, the Coordinating Minister of Health and Social Welfare, Muhammad Pate, admitted that NCDs had become “an increasingly faster-growing segment of our burden of disease.”

Last week, the death of a popular gospel singer, Olayemi Bolaji, popularly known as Toluwanisings, sparked outrage following allegations that several hospitals in Ibadan, Oyo State, failed to provide him with emergency treatment after he slumped.

Toluwanisings’ personal assistant, Babadunni Olayemi, said, “They took him to different hospitals. Some said the doctors were on strike, while others said he was rejected at the hospitals. We all tried, praying for him and taking him around to hospitals. We took him to about seven or eight different hospitals here in Ibadan, but God said it was his time.”

According to the World Health Organisation’s Noncommunicable Diseases Data Portal, NCDs, including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, account for nearly three-quarters of deaths globally.

Every year, 17 million people under the age of 70 die from NCDs, with 86 per cent of these deaths occurring in low- and middle-income countries.

In 2021, NCDs were estimated to have caused 467,800 deaths in Nigeria, compared with 194,000 deaths from malaria. This means the estimated number of deaths from NCDs was approximately 2.4 times the number attributed to malaria that year.

Despite the increasing burden of NCDs and communicable diseases, the number of licensed doctors has dropped to about 40,000, far below the estimated 300,000 needed to adequately serve a population of over 220 million.

PUNCH Healthwise previously reported that a former President of the Nigerian Medical Association, Prof. Mike Ogirima, described Nigeria’s doctor-to-patient ratio as “horrible”, noting that the country had about one doctor to 8,000 patients, far below the World Health Organisation’s recommendation of one doctor to 600 patients.

Ogirima said Nigeria produced an average of only 3,000 doctors annually, making it difficult to bridge the estimated deficit of nearly 300,000 doctors.

“If we are producing just 3,000 doctors yearly, it will take at least 10 years to catch up—and that is assuming no doctor leaves the system.

“We cannot afford to wait that long. That is why doctors are overworked, exhausted, and burned out,” he said.

In this report, PUNCH Healthwise examines the available specialists across the country.

The figures presented are estimates obtained from the specialists’ associations unless otherwise reported.

About 200 endocrinologists despite 15 million people with diabetes

With diabetes affecting six to seven per cent of Nigerians, representing about 15 million people, the Endocrine and Metabolism Society of Nigeria has said that the country has between 150 and 200 practising endocrinologists.

The EMSON President, Prof Andrew Uloko, exclusively told PUNCH Healthwise that the shortage, compounded by the migration of specialists abroad, inadequate diagnostic infrastructure and poor support for those who remain in the country, was placing an enormous burden on endocrinologists and limiting access to specialist care.

He said the situation was particularly concerning as NCDs, including diabetes, obesity, thyroid disorders and cholesterol-related conditions, continued to pose a growing health challenge.

Uloko said the number of endocrinologists in Nigeria had remained around 200 because specialists continued to leave the country in search of better remuneration, improved welfare and opportunities for professional development.

“Our figure still revolves around 200. Sometimes you come across documentation that we are somewhere between 150 and 200. That’s our number currently in the country,” he said.

Uloko said endocrinologists were concentrated in major cities, where specialist facilities and diagnostic services were more readily available, leaving rural and underserved communities.

He explained that even urban centres did not have enough endocrinologists, while primary and secondary healthcare facilities rarely had specialists in the field.

The EMSON president identified the North-East, South-West and North-Central as areas with relatively lower numbers of endocrinologists, while noting that the South-West might have the highest concentration.

He attributed the uneven distribution partly to the demands of endocrinology, which requires specialised equipment, laboratory investigations and diagnostic infrastructure that are not readily available in many parts of the country.

He said the limited availability of such facilities also encouraged specialists to move abroad, where they could access the infrastructure needed to practise their speciality.

Uloko added that the number of patients requiring specialist care was increasing, while the few facilities with endocrinologists continued to receive referrals from across their regions.

He said some patients had to travel long distances to obtain specialist consultations and investigations unavailable in their communities.

The EMSON president said the combination of high patient numbers, inadequate infrastructure and poor support services affected the practice of endocrinology and the well-being of specialists.

“Workload is stupendously heavy. You practically do not even have time for yourself,” Uloko said.

The endocrinologist said improving remuneration and welfare would be essential to retaining endocrinologists and encouraging more specialists to remain in Nigeria.

He also called for improved diagnostic and laboratory infrastructure across the country, including at secondary healthcare facilities, to reduce pressure on tertiary hospitals and limit the need for patients to travel between states for investigations and treatment.

“We hope that in the coming years, it should catch the attention of the government that Nigeria needs many more endocrinologists, and all that is required will be tailored into training and retaining endocrinologists in Nigeria,” he said.

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Nigeria needs 2,400 endocrinologists to meet global benchmark

The National President of the Diabetes Association of Nigeria, Prof. Ejiofor Ugwu, said Nigeria needs at least 2,400 endocrinologists to meet the international benchmark of one specialist per 100,000 people, warning that the country currently has only 120 to 150.

Ugwu said the shortage was worsening care for people with diabetes and other endocrine disorders.

He said the country’s estimated population of 240 million meant that each endocrinologist was serving about 1.6 million people, compared with one per 70,000 in the United Kingdom and one per 35,000 to 40,000 in the United States.

The DAN president said the shortage was compounded by the concentration of specialists in major cities, leaving rural communities with little or no access to endocrinologists.

He said patients with diabetes, thyroid disorders and other endocrine conditions in underserved areas often resorted to herbal homes and prayer houses or received care from general practitioners who might lack the expertise to manage their conditions appropriately.

Ugwu disclosed that a typical clinic day at his teaching hospital could involve between 80 and 120 patients, despite having only two consultant endocrinologists working with trainees.

He said an endocrinologist should see no more than 10 patients daily to allow adequate time for medical history, evaluation, diagnosis and treatment. Each consultation, he added, could take between 20 and 30 minutes.

The excessive workload, he said, placed specialists under considerable stress and reduced the time available for individual patients, potentially affecting the quality of care.

The DAN president said investments in local healthcare facilities could also reduce spending on medical tourism while improving access to specialist care across the country.

Less than 400 ENT specialists

As of 2023, the ear, nose and throat specialists and trainees combined in Nigeria numbered about 400, leaving the country far below the recommended workforce benchmark for the speciality, the National President of the Otorhinolaryngological Society of Nigeria, Prof Aliyu Kodiya, has said.

With about 10 new specialists produced by the two postgraduate training colleges each year, the estimated deficit against the workforce benchmark is 2,024 specialists.

Kodiya said the number of specialists and trainees combined was about 400 in 2023, while the current total was unlikely to exceed 500, even if residents in training were included.

The ENT specialist said the estimated time required to produce the 2,024 additional specialists at an annual output of 12, assuming all new specialists remain in the workforce and there are no retirements, migration or other losses, is 169 years.

The ORLSON president said the shortage of specialists, compounded by migration, inadequate facilities and limited training opportunities, was restricting access to ear, nose and throat care and contributing to delayed diagnosis and treatment.

He warned that patients could face long waiting times or travel considerable distances to access specialist services, with potentially serious consequences for conditions such as childhood hearing impairment and head and neck cancers.

He called for deliberate government investment in specialist training, better working conditions and the establishment of dedicated ear, nose and throat care centres across Nigeria’s six geopolitical zones.

The ORLSON president said the country’s estimated population of 242.4 million made the shortage particularly concerning.

“If we consider all the 400 specialists and trainees as specialists, then the ratio is 1:606,000 population density benchmark instead of 1:100,000,” he said.

He also said the loss of specialists placed additional pressure on those who remained, increasing workloads and the risk of burnout while reducing the time available for research, mentorship and training younger doctors.

The ORLSON president urged the government to establish dedicated ear, nose and throat care centres in each of Nigeria’s six geopolitical zones to bring specialist services closer to patients and expand opportunities for training.

Kodiya maintained that improving specialist numbers alone would not be enough without investment in diagnostic equipment, rehabilitation services and facilities to support training and patient care.

He urged the government to take deliberate steps to strengthen ENT services, warning that continued shortages could affect patients’ health, educational outcomes and national productivity.

Over 124,000 cancer cases versus fewer than 100 specialists

According to the National Cancer Control Programme of the Federal Ministry of Health, Nigeria records about 124,000 new cancer cases and over 80,000 cancer deaths annually.

2024 data from the Global Cancer Observatory show that, within a five-year period, Nigeria recorded 292,934 prevalent cancer cases.

Yet, there are “fewer than 100 Radiation and Clinical Oncologists in Nigeria,” according to the Association of Radiation and Clinical Oncologists in Nigeria.

The President and Chief Executive Officer of the Nigerian Cancer Society, Prof Abidemi Omonisi, explained that cancer care requires a multidisciplinary team comprising surgical oncologists, pathologists, oncology nurses, onco-pharmacists, psycho-oncologists, physicists and cancer epidemiologists, among others.

However, “Nigeria has less than 200 trained Pathologists, giving a population ratio of less than 1 per million. The African Society for Laboratory Medicine recommends at least 1 Pathologist per 100,000 population. Nigeria therefore has a shortfall of well over 1,800 trained Pathologists,” Omonisi stated.

Providing more figures of oncology specialists in the country, the NCS president said, “168 trained oncology pharmacists are still practising in Nigeria, 400 oncology nurses trained and licensed to practice in Nigeria as of November 2025, but currently less than 200 are practising in Nigeria. Over 200 of them have migrated abroad due to the ‘Japa Syndrome.’”

250 specialists to 24 million Nigerians living with kidney disease

With one in 10 Nigerians, or 10 per cent of the adult population, living with chronic kidney disease, PUNCH Healthwise investigations reveal that the country has between 200 and 250 nephrologists.

Already, there are limited facilities available to manage the rising number of cases. The shortfall of kidney specialists, especially nephrologists, who number about 250, means the country has approximately one kidney specialist for every 96,000 to 120,000 affected people.

1,109 practising physician anaesthetists

As of March 2023, Nigeria had 1,109 physician anaesthetists practising in the country, with about 40 others practising in the diaspora, the President of the Nigerian Society of Anaesthetists, Prof Alhassan Mohammed, exclusively told PUNCH Healthwise.

While the possible current number of the specialists is estimated at 1,500 due to growth in training and expansion of specialist training centres, the NSA president said updated figures were not yet available.

Mohammed, however, warned that the country remained grossly short of physician anaesthetists, with the shortage compounded by the migration of specialists abroad, poor remuneration and unfavourable working conditions.

The NSA president explained that physician anaesthetists were medical doctors who had obtained a basic medical degree and undergone specialist training in anaesthesia and critical care, while non-physician anaesthetists underwent a separate training programme.

Mohammed said the shortage of specialists had placed considerable pressure on those remaining in the country, leading to burnout and affecting their well-being.

He attributed the situation partly to the growing number of Nigerian doctors leaving the country in search of better remuneration, improved working conditions and opportunities to provide for their families.

Mohammed said better pay and improved welfare could help retain specialists and encourage some who had emigrated to return.

The NSA president also called for better equipment in public hospitals and measures to make healthcare more accessible and affordable, including expanding health insurance schemes.

Mohammed said the government could also re-engage specialists who had left the country, arguing that their return would strengthen the workforce and help train more doctors in anaesthesia.

150 neurologists for 240 million Nigerians

The President of the Nigerian Society of Neurological Sciences, Prof Morenikeji Komolafe, told PUNCH Healthwise that the association’s database showed that Nigeria had 150 neurologists.

However, a Professor of Neurology and Precision Medicine at the University of Ibadan, Mayowa Owolabi, earlier told PUNCH Healthwise that the country had “roughly 400 neurologists and neurosurgeons” serving over 240 million people.

Meanwhile, a Professor of Internal Medicine and Neurology at the University of Nigeria, Nsukka, Ikenna Onwuekwe, said Enugu State had fewer than 10 neurologists, with many states having few or none.

Few cardiologists available

Although PUNCH Healthwise could not establish the estimated number of cardiologists in Nigeria, independent findings indicate a severe shortage of the specialists nationwide.

Sources also revealed that some states in the northern region have no resident cardiologists, leaving patients dependent on visiting specialists based in other parts of the country.

However, over 50 million Nigerians are suffering from hypertension, and one Nigerian suffers a stroke every minute.

PUNCH Healthwise also reports that there are 250 psychiatrists available to cater for the over 60 million Nigerians living with mental illnesses.

Burnout, heavy workload, long consultation times, amid poor remuneration and equipment are factors specialists in Nigeria face daily.

Additional reporting by Chima Azubuike, Collins Agwam and Taiwo Bankole.