The Chief Medical Director at Lagos University Teaching Hospital, a maxillofacial surgeon and professor at University of Lagos, Wasiu Adeyemo speaks to OGHENOVO EGODO-MICHAEL about his career, growth in the medical field and other issues

what inspired you to pursue a career in medicine?

There was no particular interest. I came from a very humble background and my parents sent me to school. Back then in secondary school, we mostly followed the crowd. Most of us wanted to either be a doctor, pharmacist or engineer and I was good in science so the option for me was the medical field. I applied to study Dental Surgery at the University of Ibadan, and that was how I found myself in this profession.

What are the most significant challenges you've faced in your journey as a medical doctor?

Back then in medical school, there were no serious challenges aside from the fear of whether you were going to make it or not, especially for someone like me who attended the University of Ibadan. In Ibadan, you had to spend about three years on the main campus after which you had to pass an exam to move to the University College Hospital. It was a big deal because if you didn't move, people would know that you had failed. That was just the fear. Back then, when I was returning home from school, I had to pass in front of UCH so the fear was more pronounced for me. As a matter of fact, from the moment you get into the university to study medicine, everyone starts to call you doctor. The most important thing for me then was to get into UCH. During that time, funding was not a problem because we mostly went to school for free, which is why some of us, especially those who benefited from such, cannot be part of those who say Nigeria is useless. Nigeria cannot be useless. We are where we are today because of Nigeria.

What motivated you to specialise in maxillofacial surgery?

When I was an undergraduate, we did many courses including oral and maxilla surgery. So, I picked interest in being an oral and maxillofacial surgeon. In medical school, there are two stages -- preclinical and clinical. The preclinical was in UI campus while the clinical was in UCH campus. For the preclinical, we studied Physiology, Biochemistry and Anatomy. When we were done, we usually gave our books out to juniors or even sold them as the case might be. I also gave out my books, except one, which was anatomy. I kept it because I knew I was going to be a surgeon and still needed to be proficient in anatomy. When I came to medical school, oral and maxilla surgery was my first choice since I already knew I wanted to be a surgeon. So, I made up my mind and followed that path.

I applied to the Ahmadu Bello University Teaching Hospital and Lagos University Teaching Hospital but the LUTH letter came before that of ABU. I had already started here when I received the letter from ABU six months later. I then started my residency training but during the period, so many things happened. It was during the period I was exposed to academia and research, and I started getting interested in it. I wanted to be an academician. I went on one year of clinical training abroad. I attended the University of Vienna Medical School for one year, where I got involved in a lot of first class research and I was able to publish lots of papers. It was during that one year abroad that I got a scholarship for my PhD in Germany to start immediately. But, I needed to come back and finish my programme. Few months after my return, I became a maxilla surgeon, after which I travelled to Germany to pursue my PhD. During my time overseas, I didn't burn the bridges here. Towards the tail end of my PhD, there was an opening for a lecturing position at UNILAG and I applied. I returned here but went back to Germany a few months later to defend my thesis. Then, I became a lecturer in UNILAG and a year after, I became a consultant surgeon in LUTH.

With the roles and responsibility you currently hold, do you still actively perform surgeries?

Yes, I do but not as much as I used to do because I have other responsibilities. As a surgeon, you can't but perform surgery. If you run away from surgery for one year, surgery will run away from you for another three years. So, as a surgeon, you need to "wet your hands". If I can't have surgery during the week, then I schedule it for the weekend. My area of specialisation is cleft lip and palate surgery.

Can you share the most common conditions you treat in your day-to-day practice?

Oral and maxilla surgery is a sub-specialty that deals with diseases of the face, jaw and teeth. One can have diseases that are infections. They can be infections related to the teeth and the gum. They can also be infections around the mouth, jaw and face. There could be cancer of the jaw, mouth and face. There can also be congenital malfunction. Congenital means something that one is born with.

What are your thoughts on cosmetic procedures such as facelifts and Botox, especially in light of modern beauty standards?

Some 20 years ago, that was not popular around here. But now, the world is a global village because of the Internet and everybody can see everything happening in different parts of the world. So, things that were not popular in the past are quite popular now. People now do a lot of cosmetic surgery in Nigeria and some go far to Asia, America or Canada to get it done. It is also coming up in Nigeria, especially among the younger generation. It is no longer uncommon, especially amongst ladies who want to look ageless. It is unlikely that I would do it myself but I have no problem with anyone doing it.

Would you have any problem with it if your wife decides to do such?

I would have no choice, but she won't do it because I know her. Based on what I know about her, she is unlikely to do it.

As the Chief Medical Director at LUTH, what moments have stood out as highlights in your leadership journey?

There are two things. First, I did not plan to be the CMD but I prepared for it. When I became a surgeon and returned to be a lecturer, my intention was to be a professor. I became a professor in nine years and I knew that any other thing could come as a professor. My direction was clinical and genetic research but whether you like it or not, as you grow, it gets to a time where you will either be the Head of Department, the Dean or even Vice Chancellor. There were different possibilities as a young person but those who believe in God know that as they are planning, God is the ultimate planner. The immediate past CMD invited me to be the deputy to his deputy, i.e Deputy to the Chairman, Medical Advisory Committee. That was how I got into administration without planning to be. When I was done, I became the CMAC. As God would have it, I had eight years experience in the administration before the previous CMD left, so naturally, when the advert was out, I applied and here we are. The role of deputy helped me a lot because by the time I became the CMD, I was not new to LUTH and its administration.

As a result of my understanding of the system, I knew that I was going to have challenges with power and payment for it, so I was extra prepared. In the hospital, we need a lot of energy. There are many parts of LUTH that must have uninterrupted electricity. A good example is the theatre or Intensive Care Unit. If someone is on a ventilator for instance, you can't switch it off. There must be power. I planned ahead and that is how we have been able to manage it.

Also, luckily for us, we have been getting a lot of support from the government. The funds injected into our teaching hospitals has had over 900 per cent increase, and it can still be better.

The personnel issue was also major. We have more problems with personnel than power, and as people are leaving, we have to replace them. Meanwhile the number of patients keeps increasing. However, I am aware that the government is doing a lot, because there are many reasons people are leaving, and the major one is the economy.

You also have a degree in Public Administration. Did you take the degree with the mindset that you were preparing to head such an institution?

I didn't know I was going to be the CMD but I knew I was going to be a manager later because I was rising in the system. I was going to be a professor and there was a possibility of being a head of department, and HODs manage people so, I knew that it was just a matter of time. It has been really helping me. That was why I said earlier that I didn't know where I was going to be but I prepared. That is why I tell my mentees, you don't know what God has in store for you but prepare. When something is required and you don't have it, that may be the end of the story.

You're also a professor at the University of Lagos. How do you manage to balance research, teaching, and your administrative duties?

This job is a political appointment by the government. Based on our rules and regulations, when one has such appointments, one has to go on university leave. Presently, I am not teaching but as a professor, there are still researches I am doing.

Can you tell us about a research project or academic initiative that you're particularly proud of?

I enjoy research. During my residency training, I was lucky to have my teachers who are also my mentors and they involved me in what they were doing. I was able to publish many papers. I also had experiences in Vienna and Germany at top rated clinics. I recall when I got to Vienna, I was asked if I was interested in research and I said "yes". That was the first time I was given a laptop though I had a desktop before I travelled. I have published in many areas and I currently have over 250 papers published. But now, my major areas are cleft lip and palate research -- both clinical and genetics -- and I am still doing that because we have some grants from UNILAG and the United States.

In terms of research published in genetics of cleft and palate in Africa, UNILAG and LUTH is the number one. We didn't only go ahead to start corrective surgeries for the cleft of the lip and palate, we also made sure to find out the theology and causes. The causes are essentially divided into two -- the syndromic and non-syndromic. For the syndromic, there is a particular gene responsible, while for the non-syndromic, it is a combination of environment and the gene, i.e the genetic factor is there but it needs to have a suitable environment for it to be expressed. It is more complex than the syndromic.

Humans are a product of nature and nuture. Nature is the gene, nurture is the environment. Putting this in perspective, let's take Somalia as an example. You would hardly see obese people in Somalia but I can assure you that some of them have obesity genes. For those who have the gene, if you take them out of that environment, they would express it.

In the whole of Africa, my team is the first group to identify genes responsible for cleft and palate. There are so many genes associated but we have been able to identify novel genes, i.e genes that have not been reported to be associated with the condition. We have identified several and we will still continue with it. We have the largest database on cleft in Africa, and we have won many awards for that.

In 2015, you were ranked as the most cited researcher at the University of Lagos and 13th in Nigeria by Webometrics. What do you think contributed to this recognition?

It is about our accomplishments and what we have done. It is verifiable and if you go to Google scholar, you will see my publications, citation index and the other statistics. There are also many of our other scholars that are doing very well.

You hold a PhD in Genetics from the University of Cologne, Germany; and a certificate in Genetics and Genomics from Stanford University, Canada. What sparked your interest in genetics?

My PhD was on molecular jaw augmentation. When I came to Nigeria, I wanted to push it forward but unfortunately there were so many issues. Between 2006 and 2008, it was the most challenging period of my career. As a young researcher who came back, a lot of people asked why I came back. I had to deal with that for two years and I was trying to find my feet amidst so much pressure. In 2007, cleft came and I got a collaborator in the US, and we started research in genetic theology of cleft. That stabilised me and we took it from there. Going into that, I realised I needed to equip myself with genetics, so I started attending courses. I took a two-week course in Bar Harbor, US, and thereafter, I enrolled for a course in genetics at Stanford.

What key skills are essential for success in the medical profession today?

Aside from the hard skills, there are many other soft skills one needs to have. One, you need to learn patience. I tell many of my mentees that God is there but He is not going to come down. It's just like a child. A child needs to crawl before he can walk. But, some people just want to fly and it doesn't happen like that most times. Whatever will be will be, you don't need to push it. However, during that period, you have to equip yourself. Nigerians sometimes make it seem as if nothing works here, or as if there is no merit here. That is not true. Many people don't know the process of getting appointed as a VC or CMD. They think it's just a political process but rigorous exams are usually involved. There are criteria that must be followed and one must be competent.

As a fellow of the International College of Surgeons, what are some of your core responsibilities and contributions?

There is no responsibility. One is conferred based on CV and accomplishments.

How do you cope with setbacks or failures in your career?

Thank God that I can't mention many failures in my career. When I got to UNILAG, we were given something called a "yellow book" that essentially contained the rules and regulations. I love to follow the rules so I study them very well. I am respectful, do my duties and follow the rules. If they tell you that you need 10 papers to move from A to B, give them 25. Don't do nine and a half, and say it is approximately 10. People break rules a lot in Nigeria and it is one of the issues we have.

There is a common perception that professionals are always serious and rigid. How would you respond to that?

If you look at me from afar, you might think I'm too serious but this job is tasking and one needs to have ways of refreshing oneself. Yesterday, I was in the cinema watching a movie titled, Owambe Thieves; while my daughters were watching Sinners. On May 1, I also went to the cinema to watch Muyiwa Ademola's Ori: The Rebirth. I watch TV a lot too.

Recently, I joined a social club because I am getting older. I enjoy socialising online, especially in some of the groups on WhatsApp. I am also family oriented and I spend a lot of time with my family doing things together. I enjoy travelling a lot as well.

What kind of relationship do you share with your family?

I talk with my children, and we share so many things together. I don't go out much, except for work and a few occasions. With my wife, I share the same values and she is also a professor. We try not to put our children under any pressure.

I also relate with everyone in my extended family. I go home regularly to visit my father and other family members. I don't consider myself a party person, but I attend parties and socialise.

Having dealt with many traumatic cases, how do you maintain your mental well-being and emotional resilience?

It is actually very difficult but luckily for us, by virtue of the training we are given, we were exposed to those things from the early stages of our career. As a medical student in preclinical years, when doing anatomy, chemistry and physiology, you see dead bodies and even work on them. Many people think they will never do it but when the fear of failure creeps in, they get used to it. Also, the training takes four years or thereabouts, so you get used to it.

Are there still other things you hope to achieve?

My major objective now is to deliver well on the job I have been given. Any other thing can come. God is the one in control of our affairs but, when given an opportunity, one must also deliver well. People recognise efforts when they see one. I need to do my best. Once I am done with the job here, I will return to the university.

Have you missed being in the university?

I have not because this is the same university. Just before you got here, I was in my departmental office. I go there every day. I am on leave of absence but the school is just a few metres away. I still relate with the VC and other colleagues. The only thing I don't do is to give lectures to the undergraduates. I still give lectures to postgraduates, such as resident doctors, because they are doing training here. We are conducting postgraduate exams this week and I examined four students this morning. I am still active and doing my research.

What kind of childhood did you have?

I came from a very humble background. It wasn't something bad nor fantastic. My father was a public servant, and we grew up together with several family members. Many of us didn't know what we were going to become but somehow, we are here. That is why I believe that your background doesn't define you. I grew up in Oja Igbo (Ibadan North East) and it used to be a very notorious place like Ajegunle. It made me tough because I was at a disadvantage, and I had to find a way to put myself out there. I became conscious of the need to be competitive as early as Class 1. I went to a public primary school during the Bola Ige period. Then, whenever we read English comprehension, there were usually questions to answer. There was this guy named Abraham. He attended nursery school unlike many of us then. He could speak English well and the rest of us were struggling. When asked question one in the class, he will raise his hand and answer, for number two, he will do the same and so on. It happened the first and second time. By the third time, I already knew the comprehension we would be reading so I took it to my sisters and I crammed it. The next time in class, we became two answering the questions. If he answered one, I will answer another one. Back then, we would cram our notes from the first page to the last page.

What are the values that guide your life?

First, it is honesty. I could be honest to a fault and that has put me in trouble many times because I will say it the way it is. I also believe in hard work. I believe in doing to others what ordinarily you will expect. I treat people well for two reasons. First, that is my nature. Second, that is exactly what I will expect from you. Of course, one also has to be Godly. There are so many things that one could do with the position one occupies and nobody would know, but what about God? I also have a principle I live by based on my religious belief. The principle states that do not let the hatred of some people stop you from doing justice. It is in human nature to like or dislike people, with or without a reason, but no matter what, there should be justice. If the person is due for something, you must not deny them of that thing. You cannot be perfect but you must try as much as possible to be fair to everyone.