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BACKGROUND

Pathology is the medical specialty that deals with the study of diseases by employing laboratory techniques to determine the cause, pathogenesis, structural and functional changes that may be responsible for the clinical manifestations of diseases. The specialty also uses the aforementioned techniques to determine the cause of death, and prevent further evolution of diseases. This process involves application of laboratory methods to tissues and fluids obtained from the human body. A basic understanding of pathology is the foundation for a thorough understanding of clinical medicine. It in turn demands familiarity with normal structure (anatomy and histology), and function (physiology and biochemistry) of organs.

The subject matter of pathology bridges basic sciences (anatomy, physiology, and biochemistry) and clinical medicine (medicine, surgery, paediatrics, obstetrics and gynaecology, public health).

The Department of Pathology, University College Hospital, Ibadan was created by the authorities of the University of Ibadan in 1961. The department was founded on its present site in the hospital complex. The Department is an amalgam of professionals (Anatomic Pathologists, laboratory scientists and Nurses) and ancillary staff (technical and administrative). Since its inception, the department has largely remained unchanged in site, structure and location but has increased in functions and facilities over the years.

The pioneer Head of the Department was Professor B.G.T. Elmes. He was succeeded by Professor G.M. Edington. Subsequent Heads include Professors A.O. Williams, A.A. Abioye, T.A Junaid, P.U. Aghadiuno, J.O. Thomas, J.O. Ogunbiyi, E.E.U. Akang, O. A. Oluwasola and Dr G.O Ogun. The current head of department is Dr. C. A. Okolo

 

ACTIVITIES

The department started as a pure morphology based Unit. Subsequently, services such as electron microscopy service, tissue culture facilities and Cytology facilities were added to the department. In 2006, the department started offering immunohistochemistry (IHC) services. At present, the IHC service of the department is offered in collaboration with the breast cancer research laboratory of the Institute of Advanced Medical Research and Training. The department also has cryostat machines and offers frozen section services. In collaboration with the Institute of Advanced Medical Research and Training, the department has started to embark on molecular pathology services which will further add to the arsenal of facilities in making diagnosis and these facilities will position the department on the cutting edge of research.

Currently, the department has seven Consultants and is involved in the training of students for the MBBS and BDS degrees. It is also involved in specialist training and other related paramedical courses for resident doctors at the postgraduate level. The department has been responsible for the training of many of the faculty members of other sister pathology departments in the country and still continues to fulfil this role through the production of museum specimens and histology slides which helps new medical schools to start off. Additionally, the department has a well-stocked museum that is very useful in the training of medical students and postgraduate doctors.

In 1960, the department started the first cancer registry in the country through the efforts of Professor Edington who collaborated with other stakeholders from the University of Ibadan, University College Hospital, Ibadan and the School of Hygiene to get the unit started. The registry is still the only WHO recognised population based cancer registry in the country. The registry collects data of malignancies from the hospital, private hospitals and other hospitals within the city of Ibadan and its environs. Through the data collected, numerous publications on the changing epidemiology of cancers and some other disease conditions in Nigeria have been produced.

Teaching and Research Activities

Among others, the Department offers a wide range of clinical services, cancer registration services, full-time undergraduate, and part-time postgraduate courses in Medicine, Medical Laboratory Sciences and Histopathology including training for Cancer Registry staff and Mortuary attendants. It is hoped that the department would offer molecular diagnosis in the very near future with the commissioning of the Special Diagnostic Laboratory of the department.

The department offers both undergraduate and postgraduate courses leading to the award of Degrees and Professional Diplomas in Medicine and Histopathology. At the undergraduate level, the department teaches students for MBBS, BDS and BMLS degree. At the postgraduate level, the department teaches students of Masters of Forensic Science of the department of Archeology and Anthropology, Masters in Surgery and Masters in Molecular Biotechnology of the University of Ibadan. It has trained registered Physicians for the Doctor of Philosophy (Ph.D.) and Doctor of Medicine (M.D) Degrees, Fellowship of the National Postgraduate Medical College of Nigeria (FMCPath), Fellowship of the West African College of Physicians and the Membership/ Fellowship of the Royal College of Pathologists of U.K. (M.R.C.Path and F.R.C. Path). The Department also teaches histopathology and surgical pathology to postgraduate students specializing in Surgery.

The department is involved in the teaching of anatomic pathology to medical undergraduates and postgraduate students in pathology from other medical and surgical specialties and subspecialties rotating through the Department of Pathology as part of the training requirements in their curriculum such as Neurosurgery, Ophthalmology, Internal Medicine, Obstetrics and Gynaecology, and Family Medicine.

The department takes care of research and training in various sub-specialties in Pathology in a general pathology setting. However, faculty staff  have specific interests in Hepatology, Pulmonary pathology, Neuropathology, Paediatric pathology, Head and Neck Pathology, Breast Pathology, Gastrointestinal pathology, Gynaecological pathology, Renal pathology, Soft-tissue and Bone pathology, Haematopathology, Endocrine pathology, and more recently, Forensic Pathology and Molecular Pathology and  Cytogenetics.

Services currently rendered by the department, include:

• Autopsy services: The department performs an average of 200 full autopsies in a year

 

• Routine Histopathology with Histochemistry. The department runs an average of 4,000 surgical pathology specimens in a year and about 400 histochemistry per year

 

• Fine Needle Aspiration Cytology Clinic and full cytology service. The department runs an average of about 3,500 fine needle aspiration cytology, fluid cytology and cervical Pap smears in a year

 

• Immunohistochemistry is done in conjunction with the breast cancer laboratory of the Institute of Medical Research and Training (IMRAT) of the University of Ibadan. IMRAT is located on the north campus of the University College Hospital, Ibadan. This association has been effective for over 12 years. The Department runs an average of 650 request for patients per year.

Units and Laboratories in the Department           

The department offers surgical pathology, histochemistry, immunohistochemistry. It also offers functional and very active autopsy services. These services are run by a dedicated staff complete on regular rota with specific duties assigned to make the services run smoothly.

The department has the following dedicated Laboratories namely; a Main Histopathology Laboratory, Cytology, Immunohistochemistry, Histochemistry and Surgical Pathology grossing room.

The Fine Needle Aspiration Clinic has a dedicated room for the service which runs daily and is located in the Department. The Unit is run by a consultant and resident doctor on take, assisted by a nursing sister and a laboratory attendant.

The Department has a Cancer Registry jointly supported by the College of Medicine of the University of Ibadan, and the University College Hospital. The Registry has a Director in the person of Professor Ogunbiyi and a Registrar of the registry and complement of 5 other staff. The UCH management recently helped in the publication of the report of the registry 2009-2012.

The Mortuary

The mortuary complex has undergone a complete renovation and upgrade of the cooling unit for bodies and air conditioners. There are 53 functional air conditioners. A service maintenance contract for 4 years for the body cooling unit and air conditioners was recently awarded to NASCO Technical Enterprises (2016-2020). The management of the hospital and the department of Pathology is committed to ensuring that the mortuary functions at an optimal level at all times. The old mortuary wing-cooling units had (18 body capacity) with 3 dissecting tables, while the new mortuary wing-cooling units has 66 body capacity. It also has 6 dissecting tables, changing rooms for doctors, students and staff, a seminar room, a demonstration room, staff resting room, reception room for relatives, dressing room/chapel, archive room for blocks and slides.

The Special Diagnostic Centre

This unit is the newest addition to the department and it fulfils one of the primary vision of the department in developing molecular capacity in the hospital. It was formally opened in 2016. It is primarily affiliated to the Department of Pathology, University College Hospital, Ibadan, and it is a purpose built Molecular Diagnostic Centre. It is located behind the School of Nursing Hostel, designed to offer Undergraduate and Postgraduate education, alongside state-of-the-art Special Diagnostic Services as well as research opportunities. Data generated from this venture will be useful for understanding and treating a variety of diseases. It would also be used for teaching and research in genetics and forensic sciences in Nigeria. This fascinating 24-room Complex is situated beside the UCH recreation field behind First City Monument bank and the School of Nursing hostel. It has 6 standard size Medical laboratories, office spaces, 9 conveniences and 2 baths, a 40-seater seminar room/conference room, large lounge, store, wash-up room, reception room and refrigeration/ freezer room.

The complex was carefully designed by a host of technical experts from both the building industry and various fields of biological sciences and can without equivocation be adjudged to be of global standard. The vision of the designers is to put an end to out-sourcing critical tests from overseas facilities at exorbitant costs which are often beyond the reach of the average Nigerian. The Centre was endowed by a Nigerian octogenarian philanthropist based in Lagos State.

The Centre plans to evolve into a center of excellence in offering a host of preventive and clinical diagnostic services as well as state-of-the-art research opportunities. Services contemplated shall include amongst others:-  Karyotyping – Sex determination;  Molecular oncology : Solid tumour mutation panel; Haemato-oncology- Flow cytometry to evaluate lymphoproliferative diseases; HPV genotyping – for screening women for risk of cervical cancer, Forensic sciences- STR analysis for: Disaster victim identification, Disputed paternity tests, Criminal investigation- semen, blood stain, hair shaft e.t.c.;

Identity Testing: HLA typing for matching in hematopoietic stem cell transplantation and solid organ transplantation. Non- invasive clinical tests – testing for cell free DNA in mothers’ blood for early diagnosis of chromosomal abnormalities. The Centre is also well powered with 24/7 generator set  backed with solar powered inverters to be able to provide Tissue bio-repository services to facilitate basic, developmental, and translational studies in many areas of cancer research including molecular biology, immunology, and genetics.

The Centre shall promote multi-disciplinary and interdisciplinary partnership to foster a healthy and harmonious atmosphere for quality and excellent health care delivery in all fields of clinical care. At present Prof A.O Oluwasola serves as the Director of the Centre.

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BACKGROUND

The department started in 1953 as a Unit in the Department of Medicine under the headship of Professor Alexander Brown who brought 2 visiting Radiologists to assist in establishing the X-ray Department at the Adeoyo Hospital. These were Dr. (later Professor) Howard Middlemiss and Dr. J.B. King, from the Bristol Royal Infirmary and the Anatomy Department of the University of Edinburgh, respectively.

Dr. W. Peter Cockshott arrived at Ibadan in January, 1957 as the first Lecturer in Radiology of the University College, Ibadan and Honourary Consultant Radiologist to the University College Hospital, Ibadan. He pioneered the move from the X-ray Department Adeoyo Hospital to the newly completed University College Hospital in May 1957.  Peter Cockshott later left Ibadan on the15^th of July, 1967.

Headship of the Radiology Department from Inception

S/N	Name	Period of Headship
1.	Dr. Howard Middlemiss (Bristol) Foundation Radiologist
2.	Dr. J.B. King
3.	Dr. Peter Cockshott	1957 – 1967
4.	Dr. Stanley P. Borher	1967 – 1977
5.	Prof. S.B. Lagundoye	1977; 1982; 1987; 1990; 1996-2000
6.	Prof. T.M. Kolawole	1984-1985
7.	Dr. A. O. Okubanjo	1987
8.	Dr. Ayotunde. O. Ogunseyinde (now Prof.)	1989-1990;1994-1996; 2006-2010
9.	Dr. O. B. Campbell	2000-2002
10.	Dr. A. O. Adeyinka (now Prof.)	2002-2004;2015-till date
11.	Dr. Millicent O. Obajimi (now Prof.)	2004-2006; 2010-2015
The current head of the department is Prof. A.O. Adeyinka		2015-till date

 

Physical development of the Radiology Department

Phase I

Shortly after the movement from the Adeoyo Hospital, it became clear that the space allocated for X-ray services in UCH was inadequate. Cockshott pressed for and got additional space in this regard. This was the basement of the Casualty Department (now Otunba Tunwase Children Emergency) which was originally used as a Car Park to compliment the Consultants’ Car Park under the ramp still being used till today.

An Out-patient X-ray Department with (2) two X-ray rooms was hurriedly built and is still in use for routine x-rays of referred patients during the day from the GOPD, Staff Clinic and the various Out-patient Clinics, thus relieving the burden and congestion in the Central X-ray where Ward cases, specialized procedures and emergencies after normal working hours are carried out on a 24-hour basis.

Phase II

In 1961, Lord Nuffield of Oxford through the Nuffield Foundation donated to UCH what was (at the time) the state of the art (i.e. the latest) Radiological equipment – an Angiographic Unit with Biplane Elema-Schonander Film changer and the biggest capacity generator available anywhere (1000 MA) with Image Intensifier, TV Monitor and Cine Camera attached.  A room double the size of the standard x-ray had to be constructed and this was carved out of the western corridor leading to the Hospital dining hall and linked to the X-ray Recovery area of the Central X-ray Darkroom. The 1000 MA generator was so large and heavy that it came with a pulley and iron chains fixed to it permanently and was moved into place through a separate doorway in the aforementioned corridor. This space is now the waiting area for patients outside the Ultrasound suite of the West Wing extension to Central X-ray.

Phase III

This also commenced in 1961 and was completed in 1962.  Four additional rooms were constructed by an extended cantilever from the eastern corridor leading to the Hospital dining room to provide an office for the Chief Radiographer, a Radiologist Reporting Room, a lounge for Radiographers and a Store for Museum/teaching x-ray films.

Phase IV

This was also executed in 1961 pare passé Phases II & III.  A seminar room and an x-ray reporting centre were carved out of the waiting area of the central x-ray.

Phase V

The North extension to central x-ray: This project was commenced in 1966 but was stalled during the “stand-still” budget imposed by the Federal Government during the Nigerian civil war. This Northward extension was made possible by relocating the Hospital Stores Department to the basement area between the telephone exchange room and the blood bank.  The vacated space was then divided between Radiology and the Staff Nurses’ common room before coming to the dining hall and Catering Department. From this space, 3 x-ray rooms with a new darkroom for automatic film processing and Head of Department’s office were carved out. A separate Central Air-conditioning system was installed.  Only 1 of the 3 new x-ray rooms could be equipped with the Uro-radiology table donated by the WHO and the Welcome Foundation for Schistosomia Research to the Radiology and Preventive and Social Medicine Department.  One of the other 2 rooms was not equipped till 1974 when the Phillips Angiography Unit was donated by the Western Germany Government. The 3^rd room was occupied when the Hospital purchased a new Philips Fluoroscopy Unit with Image Intensifier and TV monitoring in March 1980. Prior to this, all fluoroscopy procedures were carried out in complete darkness with the conventional unit requiring the use of dark adaptation goggles which were prior to that time the hallmark of Radiologists as stethoscopes around the necks were for Physicians.

Phase VI

The Radiotherapy Building

For many years in the University College Hospital, Ibadan, radiation therapy was only carried out in the Department of Obstetrics and Gynaecology using caesium insertion for cervical carcinoma. In 1972, a joint UCH/UI Committee on a Radiotherapy Unit in the Department of Radiology was inaugurated by the Dean of Medicine, Professor O.O. Akinkugbe and the first Nigerian UCH House Governor, the Late S. Ladeinde.  A link with Karolinaska Institute in Oslo, Sweden was formed to assist with the plan.  In 1977, the new Dean of Medicine, Professor B.O. Osuntokun and the first African Head of Radiology, Professor S.B. Lagundoye, visited Karolinska in connection with the proposed building and secondment of staff.  The construction to the Radiotherapy building commenced later in 1977 but financial limitations impeded its completion and commissioning till 10 years later (1987).  Dr. O.O. Agboola, an alumnus of the Ibadan Medical School who completed his training in Radiotherapy in Canada, was appointed as the pioneer Consultant/Lecturer in Radiotherapy in 1977.  Dr. Agboola returned to Canada in 1987 and was succeeded by Dr. O.B. Campbell who was attracted from the Lagos University Teaching Hospital.  The department was created by the Hospital Board of Management in 1993. It was an academic unit of the Radiology Department in the College of Medicine of the University of Ibadan until 2004 when all criteria for creation of an autonomous Department in the University were fulfilled.

Phase VII

The West Wing Extension to Central X-Ray Department

The need to extend the Casualty, Accident and Emergency Departments of UCH was a product of the post-war oil boom coinciding with the emergence of OPEC as a force in determining economic pricing for oil.  Following the 2^nd Arab-Israeli War of 1973, world oil prices soared to unprecedented levels and great wealth accrued to producers including Nigeria who had become a new member of OPEC, a year earlier.  The original drawings of the new Casualty and OPD complexes made allowance for 1 room for portable x-ray storage.  A memorandum was raised in 1974 to the Hospital Management indicating the need for simultaneous expansion and the provision of x-ray services for teeming patients in the Accident and Emergency Department. The memo attached a users’ sketch for a 4-room X-ray department in the Casualty complex proposing an inner and outer circle.  The inner circle was to form the reception and waiting areas while the outer circle was to house the 2 x-ray rooms each to the East and West being mirror images of each other.  Separating the x-ray rooms were the 2 darkroom areas facing the Registration and Waiting areas.  The prototype was accepted by the Architects in 1975 with one modification – the inner and outer circles concept to be replaced by inner and outer squares for ease of construction.  The idea as adopted by the Architects was the Reception/Registration bay and in-casualty X-ray Department to the rest of the Casualty, OPD and Staff Medical Services Extensions. By 2011, the A&E X-ray unit housed a Conventional x-ray machine and a Helical CT. Plans are however underway for an Ultrasound unit for ease of access to our teeming patients in the Emergency Department.

Phase VIII

The West Wing Extension to the Central X-ray was designed at the same time as Phase VII using the Casualty prototype but this time, the room had x-ray rooms, 4 in the North and South sides in a mirror image pattern.  Construction work on these projects were started in 1977 and were fully completed 14 years later, although a part of the building had to be hurriedly finished to “house the CT equipment in 1987”.  The rationale for the West Wing Extension was to match the expansion of the Theatre Complexes and the North West and West West ward complexes by a corresponding enlargement in Radiological space allocation.

Several crated equipment dot many establishments in the developing countries including our own which rot away because the building to house them was never completed, started or could not be started owing to lack of funds.  When in 1987, a new CT equipment was delivered to the Hospital and space was being sought outside of Radiology, attention was directed to the West Wing Extension and Rooms 7 and 8 of the extension to house the CT Suite.  Similarly, Rooms 3 and 4 have been modified for the Angiography suite after the equipment was ordered for in 1988. However, the equipment was not delivered untill 1993, two years after the modification of the rooms was completed.  At the availability of funds, a space had been made available for the accommodation of a Fluoroscopy suite and Magnetic Nuclear Resonance (MRI) equipment.

Phase IX

The MRI complex: This is a 6 room bungalow, comprising of a reception, 4 office rooms, a records bay and the MRI room.

Physical Development

Shortly after the movement from the Adeoyo Hospital, the X-ray Department got additional space i.e. an outpatient x-ray Department of 2-xray rooms.  The donation of an Angiographic Unit with Biplane Elemase honander Film Changer/Cine Camera in 1966, by the Nuffield foundation and this led to the construction of an additional room double the size of a standard X-ray Room as the Western Corridor of the Hospital.

The department witnessed some infrastructural growth in the period between 1961 and 1980.  There was expansion both along the North and East extension of the Central X-rays with creation of Offices, Darkrooms and more x-ray Rooms which accommodated new equipment such as the Philips Angiographic Unit donated by the Welcome Foundation in 1974 and the Philips Fluoroscopy Unit purchased by the Hospital in March, 1980. The West wing extension of the central X-ray was commenced simultaneously in 1977 which now accommodates the Computerised Tomography scan (1987), the Ultrasound Machine donated by Siemens and the Angiographic Unit donated by the Presidency. This extension included the 4-room-X-ray facility in the Casualty/Accident & Emergency Complex which was completed in 1991.  The MRI (Magnetic Resonance Imaging) equipment is now housed in the space provided which is along the corridor to the Emergency complex.

 

Pioneer Radiologist Trained In Ibadan/UK

The pioneer Radiologists trained in Ibadan/the United Kingdom include: Dr. Obisesan, Dr. (Mrs.) Beetlestone, Dr. Nwaka, Dr. Ogunbiyi, Dr. (Mrs.) Ojemuyiwa, Dr. (Mrs.) Sijuwola, Dr. Okubanjo, Dr. (Mrs.) Osinaike, Dr. (Mrs.) Odutola, while those trained primarily in Ibadan include Dr. Komolafe, Dr. (Mrs.) Ogunseyinde, Dr. Taiwo and Dr. Daini.

 

ACTIVITIES

The department comprises of Radiologists, Radiographers and some other support staff including Nursing Sister, Medical Secretaries (trained in verbatim reporting of medical/radiology anatomy terms), X-ray Equipment Service Technologists, Registration and film filling clerks, Darkroom Technicians, X-ray Porters and Cleaners and Typists

 

Staff Development

Training of Radiologists

The appointment of Dr. W. Peter Cockshott in January, 1957 just before the movement from Adeoyo into UCH brought into being a shining star in the academic firmament of the new medical school and first teaching hospital in West Africa.  He virtually converted the X-ray department to the epicenter of the Hospital’s clinical services.

The department became the first training centre for Radiologists in West Africa on the 1^st of August, 1968.  Dr. Obisesan who was in the first set to graduate MBBS of Ibadan University in 1967 after achieving autonomy from the University of London in 1962 was later appointed.  Dr. Cockshott had as far back as 1962 got the Royal Colleges of Surgeons and Physicians of England to approve his Ibadan department for one of the two years training leading to the award of their Diploma in Medical Radiology (DMRD).  The strategy was to get resident doctors to undertake all the practical aspects of radiology which was in essence Year 2 work done in Ibadan before proceeding to the UK to do Year 1 work. He also intended for resident doctors to attend lectures in Radiological Physics for which there was no one in Ibadan (at the time) to teach, and as well, get the resident doctors to take other prescribed lectures and all the Examinations of the Royal Colleges. Dr. Obisesan went to Dr. Middlemiss at the Bristol Royal Infirmary and successfully completed the programme in April 1970 before returning home. The trail brazed by Dr. Obisesan in the IBADAN/UK Training Programme was to be followed by Dr. (Mrs.) Beetlestone (Glasgow), Dr. Nwaka (Birmingham), Dr. Ogunbiyi (Cardiff), Dr. (Mrs.) Ojemuyiwa (Bristol), Late Dr, (Mrs.) Sijuwola (London), Dr. Okubanjo (Bristol), Dr. (Mrs.) Osinaike (Newcastle) and Dr. (Mrs.) Odutola (Newcastle) in October 1970,  April 1971, October 1973, October 1974, October 1975, April 1976 and October 1976 respectively.

The 4-year Nigerian Fellowship programme in Radiology FMCR (Nig) commenced in 1976 when the UK Ministry of Overseas Development that contributed to financing the UK/UCH training scheme discontinued their support. The pioneer class of 4 was made up of Drs. Komolafe, Ogunseyinde, Taiwo and Daini who passed the Part I examination half way through the course in May 1978.  By May 1980, Dr. Komolafe was able to present his books of Dissertation and Case Reports for the final examination and thus became the first to obtain the FMCR (Nig) by examination. He was appointed Lecturer with Consultant status in the department in October 1980 and shortly after the end of his first year, he was attracted by the University of Ilorin to start their academic department of Radiology where he showed his prodigy and rose to the Chair of Radiology in 1987.  Drs. Ogunseyinde and Taiwo completed the Fellowship in November, 1980 and Dr. Daini in May 1981.  Dr. Ogunseyinde was retained in the department and thus became the first Nigerian female lecturer and consultant Radiologist in UCH in 1981 and has remained a pillar of the department ever since.

The department has continued to train radiologists for the Nigerian and the International markets and was the only Institution that did so between 1968 and 1988. The department has trained more than half of the radiologists in Nigeria. The department still trains radiologists (through the UCH supernumerary resident doctors’ scheme) for the Army, Navy, the Universities of Maiduguri, Ilorin, Lagos, Benin, Ife, ABU Zaria, Othman Dan Fodio, Sokoto and State Governments such as Oyo, Bauchi, Kaduna, Ogun, Osun and Kwara.  Most of the other training centres have been greatly influenced by the department.  Their trainees continue to come to Ibadan to update themselves and share in the reservoir of materials such as books, journals, teaching aids, slides, films, guidance, counselling and vetting of their research projects.  Indeed, the department of Radiology, University College Hospital, Ibadan has continued to play the role of the ‘mother’ department of radiology in Nigeria and West Africa.

The department also initiated the training of Dr. Oyesegun in Radiotherapy in Ibadan and the University of Zimbabwe followed by Dr. Adenipekun who was fully trained in UCH with a year abroad attachment at the Tata Hospital, Bombay. They were both appointed Lecturers and Consultants in Radiotherapy in the University and Hospital on completing their training.

About 400 publications including books, journal articles, monographs, dissertations, case reports, have emanated from the work carried out in the department in the last 40 years.  The department has hosted weekend courses, updates, seminars and scientific conferences in Radiology more than any other centre in Nigeria. Also, the department has consistently provided an alternative venue for the Association of Radiologists of West Africa whenever centres assigned to host the annual conference fails to honour their pledge for any unforeseen reason.

At the UCH, the department holds all year round joint sessions with the departments of Surgery, Medicine, General Practice and takes active part in the weekly ground rounds of these departments as well as in Paediatrics, Pathology, Obstetrics and Gynaecology, Cardiology, Otorhinolaryngology etc. The department participates in International Conferences where it presents invited and proffered papers & exhibits and group discussions over the years.

Two Professors from the department, contributed to the Chapter on Tropical Diseases in the “Global Textbook of Radiology” published by the NICER Institute, Oslo, Sweden, to commemorate the 100 years of Roentgen’s discovery of x-rays.  As part of the worldwide activities marking the Centenary in 1995, Prof. Lagundoye gave a commemorative Guest Lecture (THE ROENTGEN CENTENNIAL LECTURE) at the Obafemi Awolowo University, Ile-Ife to the Association of Medical Physicists of Nigeria in collaboration with the Radiology Departments of the Lagos, Port Harcourt, Ilorin, Enugu, Benin and Ibadan teaching hospitals respectively.

 

Training of Radiographers

In the first 2 decades of UCH, there was no difficulty recruiting radiographers. The first Superintendent radiographer was Mr. Benson and Assistant Superintendent was Mr. Pallister (both Britons). When the Lagos University Teaching Hospital was opened in 1962, radiographers were enticed by being offered Superintendent positions, the highest in UCH, while Lagos created the Chief Radiographer post.  Of course, UCH was to follow suit and Mr. David True another Briton became the first Chief Radiographer.  He was to follow Prof. Cockshott to his new department at McMaster University, Hamilton, Ontario, Canada in 1967 and appointed Assistant Professor of Radiography. The first Nigerian to be Chief Radiographer in Ibadan was Mr. Peter Okonji in 1967 and he was to leave to occupy the same post at the newly opened University of Benin Teaching Hospital’s             Radiology department.  He was succeeded by Mr. Iwuoha who retired from the service in 1982.  Mr. Iwuoha was succeeded by Mr. Alara who in turn was succeeded by Mrs. P.I. Alade, the first female to become Chief Radiographer in the Department. When in 1989, the exodus of radiologists and radiographers as well as consultants, laboratory technologists and nurses reached its peak, she left the hospital and was succeeded by Mr. Owasonoye who became the Chief Radiographer and has remained so till date.  Since there can be only one Chief Radiographer, several other  long serving radiographers reached the Assistant Chief Radiographer grade. In the first decade, (the Cockshott era) they were all expatriates.  Indeed, expatriates mostly Britons were at this time in the majority in all departments at the senior cadres’ level in the UCH. In the second decade, Mr. Mike Iwueze who was being groomed to succeed Mr. Trew as Chief Radiographer suddenly left UCH with the mass exodus of Easterners to the Eastern Region as a prelude to the Nigerian Civil War (1967-1970).  He was to become Chief Radiographer at the University of Nigeria Teaching Hospital Enugu.

Mr. Patrick Olowa was the first radiographer to transfer his service to the University of Ibadan, Department of Radiology without physically leaving the department. This was in 1971. He eventually rose to the position of Chief Laboratory Technologist which is the equivalent grade to Chief Radiographer at the University Establishment. Mr. Alara also moved from UCH as a radiographer to the University of Ibadan as a Technologist and came back to the UCH when the position of Chief Radiographer became vacant.

Although, the full complement of radiographers had declined from 24 in 1980 by about 50% at present, the excellent standard of radiography for which UCH is well known has continued to be maintained by the dedicated few who have chosen to remain namely – Mr. Olasubulu (Mr. “Lash”), Late Mrs. Oyedele, Mrs. Ojo, Mrs. Ajakaiye, Mrs. Ajayi, Mrs. Ezinma, Mrs. Adepoju, Mr. Osunbunmi, Mr. Desalu, Mr. Adewoyin and their Chief, Mr. Owasonoye.

 

School of Radiography

The UCH School of Radiography was started on the 1^st of December, 1972, with a pioneer group of 10 students recruited after a competitive entrance examination taken by over 200 candidates with 5 ‘O’ level credits in their GCE or WAEC certificates.  The school, like its elder counterpart (The Federal School of Radiography {started in 1965}), runs a 3-year course leading to the DCR (Diploma of the College of Radiographers, London). Between 1975 and 1980, the school had graduated 105 radiographers now practicing all over the world.  The first Principal of the school, Mr. M.B. Ore left to become a Priest in the Anglican Church at Ado-Ekiti in 1977, and was replaced by Miss Conroy, an Irish recommended by the College of Radiographers. She left for a similar post in Malawi in 1981 and was succeeded by Mrs. Onabanjo. Other teachers in the school were Mr. Ogunro, Mr. Adeyemi, Mrs. Williams, Mrs. Otunla and Mr. Ogunjimi. The last (Mr. Ogunjimi), transferred to hospital administration, while the rest, left the service of the hospital for the proverbial “greener pastures”.  What they earn in one year in Nigeria could be earned in one month or less in the Gulf States who maintain aggressive recruitment agents. With no teachers on ground, the UCH School was closed.  Efforts are continuously being made to resuscitate the school at a degree level so as to return it to its previous position as a national resource centre for the production of radiography manpower.

Equipment Maintenance

In order to ensure a longer life span for machines and accessories, the department sees to it that only x-ray manufacturers that have capable engineers to provide after sales service in Nigeria are patronized.  In 1969, a talented young man, Mr. J. Adewole, was attracted from the photography section of the Medical Illustration Unit to the Radiology department as a laboratory assistant on the payroll of the University.  By dint of hard work and dedication, he underwent part-time evening studies at the University of Ibadan Laboratory Technicians Training School. He successfully went through the courses and passed the OND and HND examinations of the City and Guilds of London. Mr. Adewole proved himself by solving numerous breakdown problems by ingeniously improvising when necessary in the repair of equipment. He was later recommended for attachment to the factories of Manufacturers that supplied major equipment to the hospital prior to shipment. These were located in Europe and North America. He was also in the installation crew before these equipment were commissioned after delivery in Ibadan.  When he reached the limit of promotability in the University establishment, the UCH realizing his invaluable services over the years got him to transfer his service while remaining in radiology. Furthermore, because he kept on proving his ingenuity by rehabilitating hospital equipment, the hospital found a place for him as a Chief Technologist in the recently created Biomedical Instrumentation Unit.

Nursing Services in the X-Ray Department

The first nurse to receive training on the nursing requirements of Radiology was Sister (Mrs.) Akinleye.  She was sent by Cockshott to the Radiology Department of the Royal Infirmary of Edinburgh and she returned to train generations of nurses posted to the department.

Secretariat Service

Secretaries in the department were specifically trained to type radiologist’s report at dictation speed and were made to memorize the spellings of scientific anatomical and pathological medical terms. These they did at great speed to the amazement and envy of their colleagues. It was no wonder they moved rapidly by being taken to sister departments as new teaching hospitals were founded.  One of the remarkable secretaries was Mr. J.O. Tella who worked under Professors Cockshott, Bohrer and Lagundoye and trained many colleagues in the art of handling the secretarial aspects of medical publications.  He later left the hospital to take up appointment as an Insurance Executive from which position he was recalled home by his people to become His Royal Highness, Oba OluTella II, the Onisaga of Isaga, a town on the Abeokuta – Ilaro road in the Yewa district (formerly Egbado) of  Ogun State.

 

ACHIEVEMENTS

Some of the achievements of the Radiology department are as follows:

• Digital Radiography – The Department currently renders clinical radiological services through the digital radiographic equipment installed in the Emergency Unit of the Department.

 

• High resolution CT, MRI and Clinical Ultrasound services are also available 24 hours in the department. In addition, the department conducts prenatal diagnosis of fetal anomalies with the ultrasound machine.

 

• Two resident doctors from the department received distinguished prize awards offered at the last convocation ceremony of the National Postgraduate Medical College on the 15^th of September, 2016.

 

The recipients of these prize awards are:

 

• Best Part II candidate in the Faculty of Radiology prize and the best Dissertation prize was received by Dr. Olubunmi O. Odafe-Oyibotha

 

• Best Part I candidate of the Faculty of Radiology prize was received by Dr. Adaora E. Smart.

 

• The department presently has on its staff list, 3 Professors of Radiology in addition to the past Professors of the Department who have retired from service.

 

• The department has continuously increased her research base within the areas of interest of her staff with many scientific publications in both local and international journals.

 

• Collaborations with other professional institutions include, the Radiological Society of North America, World Medical Ultrasound Society, North Western University, Chicago, USA, University of Chicago, USA, etc.

 

• Most of the Consultants in the department have recently made exploits with international and local organizations. These include Chairmanship/membership of:
• Regional Committee for Middle East and African Radiological Society of Radiology (RSNA) USA.

 

• Radiological Society of Radiology (RSNA), International Advisory Committee (IAC)

 

• RSNA Committee on International Radiology Education

 

• World Federation of Paediatric Imaging (WFPI)

 

• West African College of Surgeons (WACS)

 

• National Postgraduate Medical College, Nigeria (NPMCN)

 

• Editors of West African Journal of Radiology (WAJR) and West African Journal of Ultrasound (WATU)

 

• Nigerian Medical Association (NMA) Executive Committee, Oyo State Branch

 

• Additionally, some of the consultants have occupied administrative positions in the Hospital and the College of Medicine, University of Ibadan. These positions include:
• Chairman, Research Committee of College

 

• Deputy Chairman, Medical Advisory Committee, Ethics & Research, University College Hospital, Ibadan

 

• Chairman, Ceremonial Committee of the University of Ibadan.

 

• Chairman, Ceremonial Committee, College of Medicine, University of Ibadan.

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BACKGROUND

In 1962, the University College Ibadan (UCI) became an autonomous institution (from the University of London). Sequel to this achievement, the Dean of the Faculty of Medicine, at the time, Professor J.O.C. Edozien, tried to explore the possibility of inviting the Havard Medical School to come to assist in the establishment of a Radiotherapy Unit in Ibadan. However, the events of the period that culminated into the civil war did not permit the continuation of the contacts and the matter was suspended. In 1972, a UCH/UI joint Committee on a Radiotherapy Unit in the Department of Radiology was inaugurated by the Dean of Medicine in conjunction with Chief S. Ladeinde, who was the first Nigerian House Governor (as the Chief Executive and Director of Administration-as it was in those days). In May 1973, the Dean, Professor O. O. Akinkugbe paid a visit partly sponsored by the WHO to the Karolinska Radium Institute in Stockholm. He had some discussions with Professor Jerzy Einhorn, who was the Director of the Institute and his colleague, Professor Rune Walstam. The two Professors were consequently invited to visit UCH Ibadan in September 1973 for a period of two weeks.

In April, 1976 a 2-man delegation made up of Dr O. Solheim, a Radiotherapist and Mr Hjelm-Hansen, a Medical Physicist, came with the Architectural drawings and divided the establishment of Radiotherapy Centre in UCH into 3 phases as indicated below:

Phase I

• 60 Cobalt- external beam therapy unit
• Impoved Intracavitary 137 Cs-thearapy unit
• Low voltage x-ray unit for Superficial therapy
• Dosimetry facilities (Dose and doserate)
• Isotope therapy (Unsealed sources)

Phase II

• Second 60 Cobalt –external beam unit
• Simulator
• Intra-cavitary-after-loading unit
• In vivo dosimetry system (TLD)

Phase III

• Electron Accelerator for x-ray and electron therapy (Linear Accelerator)
• Sophisticated dosimetry section (Standard Dosimetry Laboratory)
• Computerized dose planning and treatment verification

Before they left, Professor A. Adeloye, who was the Head of Surgery, wrote the Dean that his Department would like to have a discussion with the visitors. As a result, a meeting was held on the 7^th of April, 1976 and was attended by Prof F.D. Martinson, the head of the Ear, Nose & Throat Department (and the oldest Consultant in the Hospital at the time), Dr I. A. Grillo, Thoracic Surgeon, Mr O. O. Ajayi, General Surgeon and Oncologist who had submitted a memo in 1974 to the visitors which had not been replied and Mr Akinradewo, the Medical Physicist who represented Prof Bohrer, the Head of Radiology. As an outcome of the meeting, the Surgeons suggested that the Radiotherapy ward should be incorporated in the first floor of the complex rather than depending on bed allocation courtesy of the Department of Surgery. This was agreed upon and carried out.

However, as a result of the enormity of the cost of implantation, the Phase III of the establishment plan was deleted, thus depriving the hospital the opportunity to have a Linear Accelerator facility to this day.

In 1977, an alumnus of the Ibadan Medical School who had just completed his training in Radiotherapy in Canada, Dr. O.O. Agboola was appointed by the University of Ibadan as the first Lecturer in the Radiotherapy unit of the Department of Radiology with concomitant appointment as a honorary Consultant in Radiotherapy and Oncology to UCH, with the assurance that the University would bear the cost of transportation of himself, wife and up to a maximum of 4 children from Canada  as was the terms applicable for those recruited from outside the country. He had reached the position of Senior Lecturer when a department in Canada was desperate for his service. This was in 1987, a period when the economic situation at home was sour thus leading to the exodus of professionals to greener pastures. A successor was immediately hunted for. A Nigerian by a Scottish name, Campbell was found at the Department of Radiotherapy and Radiation Biology at LUTH who had trained in Radiotherapy under Professor Campbell of Edinburgh. He was at the time a Senior Registrar at LUTH. He was thereafter appointed as a Lecturer at Ibadan and he was a perfect replacement for his predecessor now to continue the pioneering work of Radiotherapy in Ibadan as a unit in Radiology Department till it became a Department first at the Hospital in 1993 and at the University in 2005.

The department was commissioned in May 1987 by the then President and Commander in Chief of the Federal Republic of Nigeria, General Ibrahim Babangida, (GCFR).  At inception, the Radiotherapy unit had Dr. O. O. Agboola (FMCR, FWACS) as the pioneer Consultant and Senior Lecturer in Radiation Oncology, Mrs Alao and Mrs Odunlami as the Chief Radiotherapy Technologists, Mr S. A. M. Adeniran as the Medical Physicist, Mrs O. Ojo as the Nursing Officer, and Mr J. Adewole as the Chief Technical Officer.  In 1988 (August 7^th) Professor O.B. Campbell (then Dr. O.B. Campbell) joined the unit as Lecturer/Consultant in Radiation Oncology. This group of personnel constituted the Core Pioneer Staff of the unit.

The therapy facilities at the disposal of the unit at its inception included a 1.25 MeV Theratronics Tele-Cobalt unit, 1 – Theratron Simulator, 300 Kilovoltage therapy machine and a manual afterloading Caesium-137 low dose rate (LDR) brachytherapy unit. Between 1988 and 1995, the Radiotherapy unit was the only regular functioning Radiotherapy centre in Anglophone West Africa to which thousands of cancer patients were referred for treatment. In 1992, the UCH management under Professor O.O. Ajayi, C.O.N., the then Chief Medical Director, upgraded the Radiotherapy unit to a fully-fledged autonomous clinical department and appointed Professor O. B. Campbell (then Dr. O. B. Campbell) as the pioneer clinical head of the new department. Following the upgrading of the unit to a clinical department, the department started gaining recognitions within and outside Nigeria. Details of the Heads of the department are presented below:

Headship of the Radiation Oncology Department from Inception

S/N	Name	Period of Headship
1.	Prof O. O. Agboola	1985-1992
2.	Prof O. B. Campbell	1992-2008
3.	Dr. T.N. Elumelu-Kupoluyi	2008-2010; 2013-2016
4.	Prof. A. A. Adenipekun	2010-2013; 2016-till date

 

ACTIVITIES

The services offered by the Radiation Oncology Department include:

1. External beam radiotherapy with Cobalt-60 machine
2. High dose rate (HDR) Brachytherapy
3. Chemotherapy
4. Psycho-Oncology
5. Counselling
6. Cancer Health Education
7. Clinical Oncology Services
8. Training in Therapy Radiography, annual oncology nursing workshop, residency training programme, psycho-oncology, radiation protection and industrial attachment.

ACHIEVEMENTS

• The clinical department of radiotherapy was accredited as the centre for Radiation Oncology by the West African College of Surgeons.

 

• The department was permitted to present its resident doctors for Fellowship examinations by the West African College of Surgeons and the National Postgraduate Medical College. In 1995, the first set of Resident doctors (Dr. A. R. Oyesegun and Dr. A. A. Adenipekun) who sat for both W.A.C.S. Fellowship and National Postgraduate Medical College examinations, passed. Among the first eight Fellows that the department produced in Radiation Oncology for the two postgraduate colleges (National and West Africa) was the first female Fellow of Radiotherapy in Nigeria, Late Dr T. N. Elumelu-Kupoluyi, who qualified in 1999.

 

• For several years, the Radiotherapy department was the only regular functioning Radiotherapy centre in Anglophone West Africa countries to which thousands of cancer patients were referred for treatment.

 

• Through the linkage of the department with the International Atomic Energy Agency (IAEA), the Physics Laboratory in the department was equipped with dosimetry equipment for radiation quality control measurement of all the treatment machines in the department. This took place between 1995 and 2006.

 

• Through the technical assisted project, the IAEA donated the first High Dose Rate (HDR) remote afterloader Brachytherapy unit in West Africa to the department in 2007. This was commissioned in August, 2008.

 

• The collaborations of the department with international bodies, especially the IAEA, afforded members of staff namely Radiation Oncologists, Medical Physicists, Therapy Radiographers, Technical Officers and Oncology Nurses the opportunity to obtain fellowship to travel abroad for training courses, conferences and workshops in Radiation Oncology.

 

• In 2000, the Department produced its pioneer Professor of Radiation Oncology in the person of Professor Oladapo Babatunde Campbell. This boosted the academic strength of the department.

 

• In recognition of the academic, research and teaching efforts of the department, the University of Ibadan upgraded the department of Radiotherapy to a fully autonomous academic department in the year 2005 and appointed Professor O. B. Campbell as the pioneer head of department.

 

• The department also accepts and trains undergraduate and postgraduate students from Nigerian Universities for industrial training. The department provides Radiation Oncologists for places like the National Hospital Abuja, the University of Benin Teaching Hospital, the University of Nigeria Teaching Hospital, the Usman Danfodio University Teaching Hospital, the Federal Medical Centre Gombe and others.

 

• The first Psycho-Oncology unit in the history of the University of Ibadan was created in the year 2010 in the department of Radiotherapy UCH, Ibadan.

 

• The department has since witnessed tremendous growth in the area of intensive training of the following personnel:
• Resident doctors from all over Nigeria.

 

• Therapy Radiographers: The department in collaboration with the Radiographers’ Registration Board of Nigeria started a Postgraduate Diploma in Radiography in 2005. The program eventually metamorphosed to the Post Graduate Diploma of the University of Ibadan.

 

• Oncology Nurses through yearly oncology training workshop for Nurses all over Nigeria

 

• Medical Physicists (on-the-job-training) from other radiotherapy centres in Nigeria.

 

• Commencement of Post graduate (MSc) training in therapy Radiotherapy and Psycho oncology.

 

• The first set of MSc. Psycho Oncology, resumed in February 2017.

As part of the efforts of the hospital management to improve on the quality of care for cancer patients, the hospital procured a Tele Cobalt Machine and a Simulator which became operational in 2013. The management has been very active in the maintenance of the equipment to ensure uninterrupted effective and quality cancer care.

The department remains the first and only one in Nigeria to have a dedicated ward for the admission of patients on Radiotherapy.

• Local/International collaborations

The department established linkages with the following bodies:

1. International Atomic Energy Agency, IAEA, Vienna Austria
2. National Cancer Institute, Bethesda, USA
3. International Agency for Research in Cancer Lyon, France.
4. International Union for Campaign Against Cancer, UICC