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Responding to the Macedonia Call: Online tDPT and Clinical Specialization Certification Program for Nigerian Physiotherapists

Dear Colleagues,

Happy New Year to you all!

It is my special pleasure to announce to all our colleagues in Nigeria and in the diaspora concerning an online transitional DPT and Clinical Physical Therapy Specialization program we have brokered between some US Physical Therapy programs and the Nnamdi Azikiwe University (NAU), Nnewi, Nigeria. The purpose of this communication is to bring you up to speed on what we have been able to put together so far to help bolster the standard of physiotherapy practice in Nigeria.

We are at an advanced stage of negotiating access to online transitional DPT and clinical specialization certification programs for Nigerian physiotherapists. This collaboration being brokered by the Nigeria Physiotherapy Network is between some United States Physical Therapy Schools and (for now) a partnering Physiotherapy Training School in Nigeria, Nnamdi Azikiwe University, Nnewi. Hopefully, more Physiotherapy Schools in Nigeria will sign onto this partnership in the near future.

For some years now, Doctor of Physiotherapy (DPT), Transitional DPT (tDPT) and Clinical Residency programs (CRP) have been identified as the next logical paradigm to pursue in Nigeria physiotherapy education and training. To this end, various bodies and other stakeholders including Nigerian Physiotherapists, the Nigeria Society of Physiotherapy (NSP) and the Medical Rehabilitation Therapists (Registration) Board of Nigeria (MRTRB) have debated this clinical education issue. Different strategies for achieving this next advance in PT education in Nigeria were proffered. From what we gathered, the possibility of Nigerian training programs transitioning from Bachelor degree (BSc, BPhysio or BMR) to Doctor of Physiotherapy (DPT) degree programs is a few years away because of the procedures and processes such a proposal goes through to get statutory approval from the National Universities Commission (NUC). Similarly, the strategies to implement a CRP in Nigeria are still being hotly debated. Major concerns include the credential of PTs who will administer such CRP clinical specialists program, mode of implementation and funding, etc. Meanwhile, PTs at home in Nigeria continue to very strongly clamor for an immediate pathway NOW to achieving post-baccalaureate clinical education, either through a tDPT and/or a CRP. Some have indeed made efforts to enroll in online tDPT programs in the United States, but were not permitted for lack of US PT license.

This was the status of PT education in Nigeria until March 28, 2010, when I received an email from a Nigerian PT based in Nigeria. I publish here below, an excerpt of his email:

“I see one critical need where I feel judging by your antecedents you will make an impact if only you get involved. It is about the transitional DPT program. It is a critical need. Nine out of ten PT in Nigeria will confess this. Quite a number of these t-DPT are online in the US. What can you do to help facilitate and make this opportunity available (to) us in Nigeria? Not just for me but for all. You can make an impact in this..…... In the alternative, one of the private universities in Nigeria e.g. IGBINEDION can be encouraged to start the t-DPT program”.

Prior to this email, the involvement of a few PT colleagues in the diaspora on the DPT/CRP issue was limited to giving inputs into the curriculum design of the proposed DPT and CRP programs. However, I was unable to overlook or ignore this email which came across to me so strongly like the biblical ‘Macedonian Call’ to the great Apostle Paul (Acts 16:6-10). In fact, I felt so compelled that this call to action remained in my thoughts day and night for several days. I seem to have no rest within me until I made a decision to do something about it.

After several weeks of musing over this call to action, and in consultation with a few likeminded colleagues here in the US, some ideas were proposed to help fast track the tDPT/CRP issue in Nigeria from here. It was decided that while we will continue to support every effort by the NSP and the MRTRB towards getting the NUC to approve DPT program, we can help facilitate offering of online programs between some US PT programs and Nigeria. Until now, most US PT programs require US PT licensure to enroll in their tDPT programs.

In consultation with some colleagues here, it took a few weeks for us to be able to convince ourselves that making online tDPT/CRP program available to colleagues in Nigeria is feasible, and possible. Considering the cost and the infrastructure needed to effectively transmit a long-distance education curriculum to Nigeria using quality broadband internet access with capability of transmitting audio and video data was very daunting and looks like an insurmountable endeavor. We therefore initiated a proposal to bring online long-distance education tDPT and CRP program to Nigeria.

We consulted with some of the major stakeholders. First, we conducted a needs assessment online straw poll of Nigeria PTs via the website of the NSP. Then we travelled to Nigeria in July, 2010 to consult with some PT lecturers and professors from Nigerian universities; we made a presentation of the proposal to Nigerian PTs who attended the WCPT Africa Region Conference in Accra, Ghana in July 2010 and got direct feedbacks from colleagues in Nigeria for whom these programs are targetted. (Most colleagues were extremely excited and xheered us on, a few were cautiously optimistic, and a handful felt it was a bad idea). We severally consulted with the MRTRB and the NSP Leadership. We paid visits to two (2) Nigerian Universities (Bayero University, Kano and NAU) meeting with top University Administration and soliciting for possible partnership. Based on results from our consultations in Nigeria, on returning back to the US, we approached and/or visited some US Universities including, University of St. Augustine, Rocky Mountain University, NOVA Southeastern University, University of Kansas Medical Center and University of Michigan-Flint among others.

After these wide consultations spanning from the US to Nigeria and back to the US, we decided that the overwhelming need of the tDPT and CRP in Nigeria NOW far outweighs the seeming impossibilities and oppositions of very few colleagues in Nigeria. We concurred that there is a good chance we might just be able to accomplish this audacious task. We therefore decided that for the love of the country, the profession and most of our colleagues back in Nigeria who really wanted this to happen, it was probably worth our very best efforts.

The goal of the online tDPT and CRP to be offered to Nigerian PTs will be to fill in the gap until all plans by the NSP, the MRTRB and other stakeholders in Nigeria are able to achieve the reality of DPT and/or CRP in Nigeria as desired by Nigerian PTs. Our goal is not to bring in a program that will compete with Nigerian PT schools, but rather to compliment their efforts in response to this great need in PT clinical Education. Further, Nigerian PTs who will be able to take advantage of the online tDPT and CRP programs can themselves later on become resource persons in Nigeria and in the future will be in a better postion to adapt these programs specifically for the Nigerian environment. We project that this program will have a 3-5 years lifespan by which time we expect a Nigeria PT School to have built up enough human resources and specific expertise to continue the programs.

Current Status of Online tDPT/CRP for Nigerian PTs
At this time, two (2) major Universities here in the US have agreed to work with us. Specifically, University of Michigan-Flint (UMFLint) has made an exception for us, and will be offering Nigerian PTs, online tDPT program and an online CRP with specialization in orthopaedics, geriatrics, neurology, pediatrics and cardiopulmonary PT. They agreed to waive the US PT license pre-requisite and some other requirements. Similarly, the University of Kansas Medical Center (KUMC), Kansas City, KS will collaborate with us in training lecturers up to PhD level to achieve excellence in research and teaching. Discussions are still underway with a third and a fourth University to join the US-Nigeria PT Collaborative Alliance. Below are the highlights:
  • Nnamdi Azikiwe University, Nnewi has agreed to be the Nigerian Partnering PT Institution to pilot this initiative. The University will provide the entire infrastructure needed to transmit a tDPT and CRP curriculum long-distance over broadband internet access. Details will be worked out and finalized before the 1st cohort of tDPT and CRP students begin classes in August 2011.
  • The content of the tDPT and CRP programs will be delivered 100% online to Nigeria.
  • There is a possibility to make arrangements for Nigerian PTs with clinical specialization or certification in the diaspora to visit Nigeria at intervals for hands-on clinical block lectures.
  • The first cohort of 20 students will be allowed to enroll in the tDPT and/or CRP program with an expected start date of August 2011.
  • 12-24 months of study may be required to complete either of the two programs depending on the diligence of each student and current degree status, BSc or MSc. It may be possible for credits or waivers to be given for some courses if a PT already has a MSc degree in physiotherapy.
  • It is possible to combine a tDPT with a CRP clinical core; i.e. tDPT with specialization. This may extend the length of program for another 8-12 months.
  • We are still negotiating waivers for TSE, TOEFL, GRE, and other standardized tests generally required for graduate school admission in the US.
  • We were able to negotiate a student exchange program. Nigerian PT students who have funding or who are able to sponsor themselves will have the opportunity to participate in a 3-4 weeks elective education experience at UMFlint, Michigan, USA in July/August 2011. If successful, it could become an annual opportunity for Nigerian PT students.
  • We were able to negotiate Faculty (lecturer) exchange programs. Specifically, the UMFlint will support sponsorship of two (2) lecturers from Nigerian PT schools to come each on a 9-months program to under-study the program curriculum, technology, and organization of DPT and CRP programs so that they can adapt and implement in Nigerian PT Schools on their return to Nigeria. The two lecturers are expected to be sponsored by the US State Department under the Fulbright Scholar Fellowship program. NAU will be given the opportunity to nominate one of their lecturers for one Fullbright position, and the second position will go to a lecturer to be chosen from any of the other PT schools. We will make a determination on this position at the appropriate time.
  • We are also working on making it possible for Nigerian PTs who are PhD students in Nigerian PT programs to be able to come to the US on Research internships for their doctoral dissertation research as Visiting Research Scholars (VRS). We are currently actively pilot testing the possibility of bringing two (2) currently enrolled PhD students (PTs) from Nigeria for research internships as VRSs.
  • Many more goodies for Nigerian PTs, Lecturers and Professors and students are still in the works. As God grant us successes in our negotiations, we will make such information available.
Cost of the Programs
At this time, we are still negotiating to see if we can get special tuition discounts. But to give an idea, tDPT programs generally cost (tuition and fees) between $10,000 - $26,000 and higher depending on the University and current degree status (whether BSc or MSc; BSc status requires more courses to be taken in order to complete a tDPT and hence costs more compared to if a Nigeria PT already has MSc in physiotherapy - not in any other field). Books and other materials are at extra cost. The UMFlint cost for either a tDPT or CRP is $16,000 per student. We are still negotiating. We are therefore asking that Nigerian PTs desirous of any of these programs should start preparing towards it financially, by saving! Some of our colleagues in Nigeria indicated to us that they are willing and will be able to afford the cost of these programs only if granted access. Now, they will have access! If a Nigeria PT were to travel abroad to take this courses in person, it will cost in tuition and living expenses about $25,000 - $30,000 (in the US) or £20,000 - £25,000 (in the UK or Europe) per year (travel expenses not included). Therefore these online programs we are facilitating eliminates traveling and living expenses, we are working to see if we can also have tuition fee reductions.

In Conclusion
We are very cautiously optimistic of the success of this initiative, simply because the challenges are enormous. However, we believe that to help move physiotherapy forward in Nigeria, this Macedonian call to action from Nigeria is worth giving our very best efforts. We have been working on this continously for over 9 months now.

We therefore look forward to, and will appreciate the support, counsel and guidance of our respected senior colleagues in the profession at home and abroad on this initiative. IWe also look forward to having a few of our colleagues in Nigeria who felt this was a very bad idea to reconsider, see look long-term benefits if indeed we are successful in implementing this program. We will be happy to receive comments, suggestions, questions or request for clarification on this initiative directly via the tDPT/CRP online discussion forum on the website of the Nigeria Physiotherapy Network at the link below:
The forum is closed to the public and will require a user account login via a user account. Create an account if you don't have one already. All general, non-confidential questions should be asked and will be answered directly on the forum so that we do not duplicate answers to similar questions. More personal questions can be directed to me at: ebjohn@nigeriaphysio.net.

I hereby acknowledge the immense contributions and significant inputs of the following eminent Nigerian PTs to this initiative:
  • Prof. Chukuka Enwemeka, Dean College of Health Sciences, University of Wisconsin-Milwaukee, WI, USA.
  • Mr. Lukman Ganiyu, President, Spine and Orthopedic Physical Therapy, Beloit, WI, USA
  • Dr. Abiodun Akinwuntan, Associate Professor, Dept. of Physical Therapy, Medical College of Georgia, Augusta, GA, USA
  • Mr. Samuel Olawuwo, PT, Jos, Nigeria (this guy is a constant 'bug', he will not let me rest until this program takes off)
  • Mr. Abayomi Olatemiju, PT, Owner Joymax PT Clinic, Akure, Ondo State, Nigeria (his email to me triggered off this initiative)
Without all these eminent PTs, this initiative will not even have taken off.

We also acknowledge the tremedious boost, encouragement and counsel received from Prof. M.O.B. Olaogun, Drs. Ronke Akinpelu, Babatunde Adegoke, Rufus Adedoyin, and Ayodele Onigbinde during the presentation of this proposal to them at a private session at the WCPT Africa Region, Accra Conference. We also acknowledge the tremendous support of our PT colleagues in Nigeria who kept cheering us on to make this possible for them. We similarly acknowledge the contributions of our colleagues who were very sceptical and critical of this initiative. (We too were initially very skeptical and critical, but had to overcome our cynicisms). Their constructive criticisms especially during the proposal presentation in Accra, Ghana made us become even more aware of better strategies to make this work. We salute them all!!

Next Steps
Therefore to move these initiatives forward, we need our colleagues in Nigeria and around the world to help us do the following:
  1. Please complete immediately the online PhysioSurvey on tDPT and CRP preferences. This needs assessment data is needed by partnering US PT programs, and may also become a strong tool to help us in our negotiations for discounted tuitions and fees. You will receive a separate email to this effect. Please complete the questionnaire as soon as you receive it. This survey is a closed survey, with unique links to your email. Other colleagues will NOT be able to complete the survey link in your email, as it can only be completed once from the link receieved in your email. By so doing, we ensure that only one set of data is submitted by individuals.
  2. Register your interest for any of the programs at the link below; i.e. tDPT, CRP (stating your preferred specialization) or tDPT/CRP (i.e. tDPT with specilization stating your preferred specialization). http://www.nigeriaphysio.net/physiosurveys/index.php?sid=39848. Feel free to share this link with others.
  3. Forward this email to every Nigerian PT on your mailing list.
  4. If you have any questions, please ask directly on the DPT/CRP Discussion Forum directly on the website of Nigeria Physiotherapy Network at the link below. You will need to login to your PhysioNet account or create an account if you do not have one yet. The forum will be closed to the public. There all questions would be answered so that other colleagues can benefit from the response, instead of repeating answers to same/similar questions by individual emails to several colleagues:
View tDPT/CRP Discussion Forum:

More personal and confidential questions should not be posted online, please direct such to me at: ebjohn@nigeriaphysio.net.

Thank you and God bless. Once again, Happy New Year 2011!

Sincere Regards.

Emmanuel B. John, PT, PhD
Executive Director
Nigeria Physiotherapy Network
Silver Spring, MD
Email: ebjohn@nigeriaphysio.net
Web: http://www.nigeriaphysio.net

February 1, 2011.