Undergraduate medical education in Nigeria: a critical reassessment of regulatory frameworks, pedagogical practices and systemic reform

Abstract

This review critically examines the evolution, challenges, and reform prospects of undergraduate medical education in Nigeria, aiming to identify the structural, policy, and operational factors that influence its quality and effectiveness. Its foundation was established during the colonial era, with early medical schools focused primarily on training auxiliary health workers, and was later strengthened by the mandates of the Medical and Dental Council of Nigeria (MDCN) and the National Universities Commission (NUC), which continue to define accreditation, professional standards, and curriculum frameworks. Despite this institutional base, medical training faces persistent challenges, including chronic underfunding, inadequate infrastructure, faculty shortages and low motivation, outdated curricula, and overlapping regulatory oversight, all of which reduce instructional quality, limit clinical exposure, and weaken graduate competence. By reviewing historical records, policy documents, and contemporary literature, this paper highlights how traditional educational models have not adapted sufficiently to Nigeria’s changing healthcare needs. Recent reform efforts, however, show promise, including the introduction of competency-based curricula, blended learning, simulation-driven clinical training, and community-oriented education programs that follow international best practices. The analysis emphasizes that lasting improvement requires addressing foundational deficits in governance, funding, and infrastructure alongside curriculum and pedagogical innovations. The review concludes that harmonized regulatory standards, sustained political commitment, and strategic investment in modern teaching and learning approaches are essential to developing a medical education system in Nigeria that is effective, responsive, and aligned with national healthcare priorities.