Dear Editor,

Coronavirus 2019, a world pandemic virus was first reported in Nigeria on 27 February 2020.¹ Since then the number of cases kept on increasing. To curb the further spread of the virus, several decisions were made by the government which included closing schools, preventing social and religious gatherings, prevention of interstate movement and implementation of other infection prevention methods.² Hospitals providing care to both covid-19 and non- covid-19 patients, also made adjustments aimed at protecting both workers and vulnerable patients from COVID-19. These decisions cut across different array of services in the hospitals. Some out-patient clinics were closed down while some others scaled-down number of outpatients, admissions were restricted to only emergency cases and elective surgeries were cancelled. In addition, some patients on admission signed leave against medical advice (LAMA) when they learnt that in some cases, isolation centers were situated within the hospital premises where they were admitted. Likewise, some out-patients stopped coming for follow up. These decisions by government, individual hospitals and some patients affected internship training.³

Internship training is the transition from academic to clinical training where an intern is expected to develop clinical skills.⁴ It is a mandatory full 12 months calendar year expected to be completed by graduates of almost all discipline in the health system: the nurses, doctors, physiotherapists, pharmacists, radiographers, optometrists, dieticians and dentists. Internship is the nomenclature used by all health professional bodies when referring to this one-year training with the exception of the medical and dental council of Nigeria, where the training is termed housemanship. However, it was also called internship in the study by Makinde,⁵ therefore, in this paper internship is generally used.

The lockdown and the prevention of interstate movement has prevented hospitals from conducting an interview for new interns, despite the fact that some of the existing interns have finished their training. Thus, some hospitals decided to extend the duration of training of existing interns beyond the mandatory 12 months. Though it was an advantage for them in skills acquisition and financially, it prevented them from proceeding for another mandatory one-year youth service which in turn hindered them from advancing their career. The extension was optional, but most of them accepted because the youth service program was also suspended, and as such they have no better option than staying back. At the same time, this delayed prospective interns that were waiting to be called for an interview to commence their internship training.

In addition, it is expected that during internship training, an intern should learn clinical skills, perform clinical procedures, develop good clinical judgment, and acquire communication skills relevant to patient care.⁴ However, it was stated that the pandemic hindered interns from effective skill acquisition,⁶ which may be linked to the closure of some out-patient clinics, scaling down of number of patients in some clinics, admission of only emergency patients, cancellation of elective surgeries and other related decisions. This is because, the aim of clinical skills acquisition among others can only be achieved when there are patients with health conditions to serve as an avenue for acquiring knowledge through self-learning and supervision. 

Furthermore, the interns could be at higher risk of altered psychological wellbeing than any other health worker during the pandemic.⁷ This is because interns are usually the ones to assess patients first before any other person.⁸ This could also be true considering their little experience with patient-handling, especially during the pandemic. In addition, when down with coronavirus, the intern will be isolated which in turn will not only affect his mental well-being but also skills acquisition, as time passes without exposure to patients. We were only able to find one documented hospital-organized seminar on infection prevention and control for these set of young professionals during the pandemic.⁷

The pandemic is a justification of the request by some stakeholders to consider central posting of interns, as the delay seen in recruiting new interns during the pandemic wouldn’t have occurred if there was a central posting.  In conclusion, the coronavirus-induced decisions have negatively affected internship training in Nigeria and the effect will transcend the pandemic period, provided that inexperienced interns are being hatched into the community.

AUTHORS’ CONTRIBUTIONS

Both authors wrote the first and second draft of the manuscript and approved the final version of the manuscript.

COMPETING INTEREST

Authors declare no competing interest