Three Countries, One Profession

Medical school was not a breeze.

There were ups and downs, strikes, delays and the frustrations that come with spending years pursuing something difficult while life outside the university continues moving.

Then, in March 2010, it ended.

I graduated from medical school, took the Hippocratic oath and was inducted into the profession of medicine. My parents were proud. For my father in particular, it was the fulfilment of a dream. For me, it was the useful end of years of sweat and rigour.

Or so I thought.

As they say, the reward for hard work is more work.

There had been several times during medical school when I flirted with dropping out and pursuing entrepreneurship instead. I had always been interested in business, politics and building things. But I was also keenly aware that I did not have the technical ability or exposure of a Mark Zuckerberg or Steve Jobs. What I did have was my father's faith in my ability and examples within my own family that made ambition seem normal.

So I finished medicine.

And then actual medicine began.

Welcome to adulthood

My house job started at Lagos State University Teaching Hospital, LASUTH.

It was an education in every possible sense. You begin medical school surrounded by books and examinations. Then suddenly there is a human being in front of you and what you know, what you do not know and how quickly you can learn actually matter.

Like many young doctors, I began thinking about residency and postgraduate training.

Then another resident doctors' strike came.

I had been at LASUTH for about five months when I realised something that has stayed with me ever since: nothing happens unless you make it happen.

There is no vacuum.

If you do not move, life moves. Medicine advances. Opportunities shift. Time passes whether you have made a decision or not.

So I moved.

I completed my housemanship at the Military Hospital in Ikoyi, working with military personnel, Ministry of Defence staff, colleagues and their families.

Same profession, different institution, different culture.

That became a recurring theme in my career.

The medicine changes less than you imagine. The system around it changes enormously.

Medicine beyond the consulting room

After house job, instead of going directly into traditional residency training, I went into government.

It suited several sides of my personality at once. I liked medicine, but I was also interested in politics, business and how institutions actually worked.

I practised primary care and general medicine, treating government employees and senior officials. But there was another side to the work. People sometimes sought direct government intervention for serious health problems, and I could be asked to meet them, understand the problem and help arrange appropriate care.

Sometimes that meant organising treatment locally. At other times, where the necessary treatment was not readily available in Nigeria, it meant helping arrange care abroad and occasionally accompanying patients.

Medicine in that environment was not simply diagnosis and prescription. It sat at the intersection of healthcare, bureaucracy, politics, logistics and human distress.

I was also heavily involved in the public health response during the Ebola period and later completed a master's degree in public health.

Eventually, I wanted to see medicine from another perspective.

So I went to Britain.

Starting again without starting from zero

Britain was not completely foreign territory to me. I was born in Wales and had visited the UK before.

Working there was different.

One of the first things I discovered was that knowing medicine was only part of being able to practise medicine effectively.

There were electronic medical records, digital workflows, referral pathways, protocols, documentation standards and an entirely different healthcare culture.

You can be clinically experienced and still feel like a beginner because the machinery surrounding the medicine has changed.

That was humbling and useful.

I eventually entered GP training and spent the next few years moving through hospital specialties and primary care before completing training in 2021.

I had considered other specialties, including dermatology, but I increasingly understood something about myself.

I was a generalist at heart.

I liked the breadth of medicine. I liked uncertainty. I liked the fact that the person walking through the door might bring almost anything with them.

And during those years, something else became increasingly clear.

Many of the things that mattered most in medicine survived the move from Nigeria to Britain.

Work ethic transferred.

Curiosity transferred.

Empathy transferred.

And listening transferred.

The underestimated value of listening

I have always had a tendency to give people a listening ear.

Sometimes, more than the clock would prefer.

Medicine teaches you efficiency because time matters. Primary care particularly forces you to make decisions quickly. There is always another person waiting.

But there is a difference between working efficiently and treating human beings as items moving along a conveyor belt.

It is possible to practise medicine as if patients are products in a manufacturing process. Ask the required questions. Click the boxes. Make the decision. Move on.

There is also another way.

You can remember that the person sitting opposite you is not an appointment slot or a collection of symptoms. They are a human being who has usually come because something matters to them.

Sometimes what they need from you is complicated.

Sometimes it is simple.

Sometimes the diagnosis becomes obvious only after they have been allowed to finish the sentence they were trying to say when the consultation started.

My tendency to listen gradually became one of the most useful tools in my practice.

It also turned out to be remarkably transferable across cultures.

Different countries. Different accents. Different dialects. Different languages.

People still want to be heard.

Then came Canada

Canada, famous for warm and pleasant people, made me feel at home remarkably quickly.

Again, it confirmed something I had believed for years.

Kindness and empathy are among the foundations of primary care.

It does not matter very much where you practise or who sits opposite you.

Of course there are different styles of medicine. There is room for high-volume practice. There is a real need for doctors, and in many communities access itself is the immediate problem. Not every consultation can become a philosophical encounter.

But efficiency does not require indifference.

There is a difference between moving quickly and behaving like a robot trying to complete an interaction in five minutes.

Canada also introduced me to yet another healthcare system with its own strengths, frustrations and imperfections.

Like every system I have worked in, it needs practical solutions rather than endless declarations that something is broken.

What I particularly appreciate is the opportunity physicians have to diversify, expand their practices, build services and contribute ideas beyond the traditional consulting room.

Healthcare systems are not maintained by government alone. They require physicians, nurses, pharmacists, administrators, entrepreneurs, technologists and patients all contributing time, ideas and rigour.

And then there is Alberta itself.

Alberta has personality.

It is resilient, practical and occasionally slightly absurd in the best possible way.

Snowy mountains and wildlife are part of normal life. Camping is normal. Hunting is normal, within the law of course. People seem remarkably relaxed about sharing their province with animals that could, theoretically, kill them.

Elk and bison are discussed with the sort of casual familiarity people elsewhere might reserve for neighbourhood dogs.

Bears are simply part of the conversation.

For someone who had spent much of his life in Nigeria and Britain, this required some adjustment.

And yet, beneath all that cold, I encountered warmth again.

What travelled with me

Nigeria, Britain and Canada have very different healthcare systems.

The institutions are different. The funding structures are different. The technology is different. The expectations placed on physicians are different.

But some things have travelled with me everywhere.

Work ethic is a transferable skill.

Empathy goes beyond borders.

Curiosity remains useful in every system.

And the need to be treated like a human being transcends culture, geography and race.

Medicine has taken me through very different countries, institutions and systems.

The systems changed.

The patients changed.

I changed.

But the basic relationship at the centre of medicine remained remarkably familiar: one human being asking another for help.

Canada has simply given me another setting in which to understand that truth.

A cold place with warm people.