By Sakariyah Ridwanullah
The Nigerian health system is bleeding out. Its vital workforce (doctors, nurses, and specialists) is fleeing the country in a mass exodus so severe that it now threatens the entire system with collapse. This looks like a brain drain, but it’s actually a systemic failure. As of 2025, the crisis has spiralled out of control, while continually leaving hospitals critically understaffed and patients vulnerable. The immediate consequences of this exodus are crystal clear; they have started manifesting in tragic delays and increased mortality rates across Nigeria’s public hospitals.
The official numbers confirm this catastrophe. According to the Nigeria Health Statistics Report released by the Federal Ministry of Health and Social Welfare, a staggering 4,193 doctors and dentists left Nigeria in 2024 alone. This figure, reported by Punch Newspapers in November 2025, represents a 200% surge in health worker migration across all medical cadres between 2023 and 2024. The crisis is not limited to doctors; the report also showed that more than 23,000 Nigerian nurses and midwives migrated abroad in 2024. The destination is overwhelmingly the United Kingdom (UK), which receives approximately 66% of Nigerian doctor and dentist emigrants, fueling the desperate search for better conditions and livelihood abroad.
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More importantly, this accelerating trend, popularly known as “Japa” (a Yoruba term for “to flee”), is driven by a consistent set of systemic failures. Doctors mention the lack of basic equipment, the poor state of facilities, and insecurity in some areas as major push factors. Furthermore, the Consolidated Medical Salary Structure (CONMESS) has not kept pace with the high inflation rates. This failure is leading to remuneration that is grossly inadequate.
As one doctor noted in a report by The Guardian in September 2025, the remaining staff are stretched beyond limits, with some managing more than 70 patients a day. Consequently, this results in severe burnout and compromises patient safety.
What is more saddening about it is that the brain drain has widened the patient-to-doctor ratio to a catastrophic level. While the World Health Organisation (WHO) standard is 1:600, Nigeria’s ratio has been estimated to be as low as 1 doctor to 10,000 patients in some areas, according to the Nigerian Medical Association (NMA). This massive disparity means that patients wait longer, their conditions worsen, and the likelihood of medical error and mortality increases.
The loss of senior consultants and specialists, usually the most experienced trainers, severely restricts the capacity of teaching hospitals to train new doctors with a view to ensuring that the shortage continues for years. A November 2025 editorial in the NIH’s PMC highlighted that a 15-year cohort study found nearly half of graduates from a major Nigerian medical school had migrated within 15 years of qualification, which is suggestive of the fact that Nigeria is training physicians more for other countries than for its own growing population.
Consequently, the gravity of the situation prompted health workers to take drastic action. The Nigerian Association of Resident Doctors (NARD) commenced an indefinite nationwide strike starting November 1, 2025, mentioning the government’s failure to meet long-standing demands on unpaid arrears, improved welfare, and the implementation of previously reached agreements. Despite this action, the Federal Government, in a November 1, 2025 press release, reaffirmed its commitment to the welfare of doctors and claimed to have released ₦10.6 billion as full payment for the 2025 Medical Residency Training Fund (MRTF) and granted special waivers for the “massive recruitment of healthcare professionals.”
However, these interventions have been widely criticised as insufficient. The National Executive Council (NEC) of the NMA, following its meeting in Abuja in November 2025, voiced deep concern about the “alarming brain-drain” and its adverse effect on the care economy, which promotes medical tourism and limits accessibility for the poor. The union specifically charged the government to re-evaluate the push and pull factors to retain and attract health workers. The NARD’s ongoing strike underscores the deep lack of trust between the medical community and the government, as healthcare services remain limited in several tertiary health institutions across the country.
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As it stands now, the only way forward requires immediate, radical policy intervention to avert a potential system collapse by 2030. Experts and medical unions consistently recommend implementing immediate salary and condition reforms, providing modern equipment, and ensuring safety. Furthermore, ethical migration policies, such as the debate around mandatory service bonds for publicly trained doctors or international partnerships to compensate Nigeria for its loss of talent, are necessary to stem the tide. Until the government demonstrates a genuine commitment to investing in its medical professionals, the exodus will continue to fuel health inequities, leaving the Nigerian populace stranded in a crisis of care.