Examining the perception of residency training among Nigerian medical students: a nationwide pilot survey

Residency training is critical for preparing medical graduates for independent practice, yet Nigeria's healthcare system faces challenges like resource constraints and brain drain, potentially shaping medical students' perceptions of residency. This study examines Nigerian medical students' attitudes, expectations, and concerns regarding residency training.

A nationwide, multi-center, cross-sectional study was conducted among 687 undergraduate medical students across Nigeria's six geopolitical zones from May to July 2024. A validated online questionnaire, adapted from the UK AIMS study, assessed specialty preferences, overall perception of residency (poor, fair, good), and satisfaction with training factors. Universities were selected from each zone, and students were recruited via student platforms. Data were analyzed using chi-square tests and multinomial logistic regression to identify factors associated with positive perceptions (p < 0.05).

Of 687 respondents (99.6% response rate), 31.1% rated residency training poorly, 59.7% fairly, and 9.2% favorably. Obstetrics and Gynecology (31.3%) was the top specialty choice, followed by Pediatrics (18.6%) and Neurosurgery (18.5%). Dissatisfaction was high for ease of entry (60.9%), remuneration (47.8%), and work-life balance (35.8%). Academic level was significantly associated with perception (p < 0.001), with first-year students showing higher odds of good perception (OR = 17.414, p < 0.001). Age and prior degree also correlated with perception (p = 0.002, p = 0.015), but not gender or income source. Emigration intent was notable, with 36.4% planning to train abroad.

Nigerian medical students express significant dissatisfaction with residency training, driven by systemic challenges that threaten healthcare workforce retention. Early mentorship and improved training conditions are needed to foster positive perceptions and curb brain drain. Limitations include reliance on self-reported data and preclinical students' indirect exposure, suggesting future longitudinal research.