Hospitals across Nigeria have turned to 564 contract (locum) doctors to fill critical staffing gaps amid an escalating shortage of medical personnel, findings from the Nigerian Association of Resident Doctors (NARD) have revealed.
The use of locum doctors—medical professionals employed on a temporary basis—is increasingly becoming the norm as the country’s healthcare system struggles with mass emigration of health workers, especially doctors.
This trend, experts warn, not only threatens the stability of healthcare delivery but also undermines doctors’ welfare and long-term career prospects.
The widespread use of temporary hires reflects Nigeria’s growing dependence on casual labour to prop up a strained health sector. Unlike permanent staff, locum doctors work without job security, pension benefits, or guaranteed employment continuity.
In 2024, NARD raised the alarm over what it described as the “casualisation” of the medical profession, insisting it poses a serious risk to service delivery.
The association said it was particularly troubling that such a practice was expanding at a time when government hospitals were battling severe manpower shortages.
Despite government reforms such as the One-for-One Replacement Policy—which allows immediate replacement of exiting healthcare workers—and the National Policy on Health Workforce Migration, implementation has been slow.
As a result, hospitals continue to rely heavily on short-term contracts and locum positions to plug staffing holes.
According to Coordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, Nigeria currently has about 55,000 doctors, far below the minimum recommended by the World Health Organisation.
Over 16,000 Nigerian doctors have reportedly emigrated in the past five to seven years, worsening the already low doctor-to-population ratio, which now stands at roughly 3.9 per 10,000 people.
Speaking to The PUNCH, NARD President Dr. Tope Osundara said systemic changes were urgently needed to offer doctors permanent employment and create an environment that promotes retention rather than emigration.
“Contract employment reduces doctors’ morale and pushes many to seek better opportunities abroad.
Locum doctors are not entitled to the full salary structure or benefits of their permanent colleagues, even though they work in the same environment,” Osundara said.
He acknowledged that locum appointments were originally designed to temporarily address manpower shortages.
However, many hospitals have kept doctors on these short-term contracts for extended periods without upgrading them to full employment, which he described as exploitative.
According to him, locum doctors face constant uncertainty and are often subjected to the discretion of hospital management.
“Facility heads can terminate their contracts after three or six months without explanation or accountability. There’s no job protection,” he noted.
Osundara warned that the continued reliance on locum staff is counterproductive.
“It exposes doctors to discrimination, makes them vulnerable, and weakens the profession.
If the original purpose of the locum system is no longer being met, it should be abolished,” he declared.
He urged the Federal Government to fully implement workforce policies and invest in long-term solutions that provide secure, fair employment conditions for health workers.