The Nigerian Association of Resident Doctors (NARD) recently expressed strong opposition to the National Universities Commission's (NUC) decision to upgrade degree titles in Pharmacy, Physiotherapy, and Optometry to "Doctor" status. While NARD framed its objections as concerns over "confusion" and "professional clarity," a deeper psychological analysis reveals something far more profound—a resistance to modernization that is deeply rooted in hierarchical thinking and professional gatekeeping.

Globally, the titles of Doctor of Pharmacy (PharmD), Doctor of Physical Therapy (DPT), and Doctor of Optometry (OD) are well-established. These are not honorary labels handed out for superficial reasons; they represent the culmination of years of rigorous academic study, intensive clinical training, and advanced patient-centered care. In nations with forward-thinking healthcare systems, these titles are fully integrated into medical teams, contributing to efficient, collaborative care. Patients are not confused when their pharmacist, optometrist, or physical therapist is addressed as "Doctor"—they understand the distinction, just as they distinguish between a dentist and a cardiologist.

NARD’s opposition is not simply about professional titles; it is about control. This is a classic example of System Justification Theory, where groups with established power fight to preserve existing hierarchies, even when evidence shows that change would benefit the larger system. For NARD, maintaining exclusive rights to the "Doctor" title is less about public understanding and more about preserving psychological superiority. This mindset is rooted in professional gatekeeping, where acknowledging the expertise of others threatens the status quo.

Behind NARD's objections is a psychological attachment to hierarchy—a need to anchor itself as the sole embodiment of clinical expertise in Nigerian healthcare. This resistance is cloaked in arguments of tradition and patient clarity, yet it contradicts global evidence showing that interdisciplinary collaboration enhances healthcare delivery. This is not just a barrier to progress; it is a deliberate blockade against shared expertise and modern clinical integration.

What emerges from NARD's resistance is a deeper fear of professional dilution—an unwillingness to share clinical space with other healthcare experts who are equally trained to serve patients. It is a form of institutional defensiveness, driven not by patient safety but by a need to maintain symbolic dominance. NARD's stance reveals an entrenched belief that medical doctors must remain the unchallenged authorities in healthcare, even if it means stifling progress for others trained to enhance patient outcomes.

In this resistance, NARD overlooks the potential benefits of embracing a diversified healthcare landscape where pharmacists, physiotherapists, and optometrists contribute to broader patient access and improved care delivery. Instead of moving towards a model of collaboration and respect for diverse expertise, the association clings to a rigid structure that prioritizes title over teamwork, authority over advancement.

Psychologically speaking, NARD's reaction to these degree upgrades is not merely professional—it is rooted in what social psychologists term System Justification Theory. This theory posits that people are motivated to defend and justify the status quo, even when it is inequitable, to maintain their sense of order and predictability. In many parts of the world, healthcare systems have evolved to embrace the expanded roles of PharmD, DPT, and OD professionals, enhancing patient care and reducing bottlenecks in service delivery. Patients in the United States, Canada, Australia, and Europe navigate these distinctions without confusion. Yet, NARD’s opposition suggests a belief that Nigerian patients are somehow intellectually unprepared to distinguish between healthcare professionals.

This perspective is not just regressive—it is condescending. It implies that Nigerian communities lack the cognitive capacity to understand the difference between an optometrist and a cardiologist or a pharmacist and a neurosurgeon. The real issue here is ingroup bias, where NARD members instinctively protect their exclusive professional identity, fearing that extending "Doctor" status to others would dilute their authority. This bias is not rooted in empirical evidence but in a psychological need to preserve hierarchy.

NARD’s argument that recognizing pharmacists, physiotherapists, and optometrists with doctoral titles would lead to "confusion" is a classic example of Status Anxiety—a psychological phenomenon where one group feels threatened by the potential rise of another. This anxiety drives defensive behaviors aimed at maintaining dominance, even if it means hindering collective progress. In global healthcare settings, PharmD, DPT, and OD professionals are not just titleholders; they perform critical clinical assessments, prescribe medications, and manage complex conditions. Their roles enhance patient access to care, reduce waiting times, and create more fluid health service delivery.

By masking its opposition as concern for patient safety, NARD attempts to justify exclusionary practices that are, at their core, psychologically driven fears of status loss. The insistence that Nigerian patients are somehow incapable of understanding these roles is not only patronizing—it is unfounded. Research in cognitive psychology shows that patients adapt to healthcare structures when communication is clear and transparent. The confusion NARD fears is less about patients and more about its own refusal to accept evolving clinical realities.

NARD's justification for opposing these changes by citing Britain’s conservative model is a glaring example of Anchoring Bias—a cognitive shortcut where people rely heavily on the first piece of information encountered when making decisions. Britain’s model, which remains conservative in its recognition of clinical roles, is not the global standard. Nations like the United States, Canada, and Australia have embraced broader scopes of practice for PharmD, DPT, and OD professionals, leading to improved healthcare outcomes. Citing Britain as a justification for rejecting modernization is a retreat into familiarity, a psychological escape to a model that preserves the comfort of known hierarchies.

This is not just reluctance—it is resistance rooted in cognitive dissonance. NARD is aware that global best practices are advancing, yet clings to models that support its sense of superiority. The discomfort of acknowledging this gap results in defensive arguments and a refusal to adapt. In psychology, this is seen as Cognitive Entrenchment, where exposure to the same concepts repeatedly reduces openness to new ideas. NARD’s leadership appears trapped in a cycle of self-justification, reinforcing outdated beliefs despite global evidence to the contrary.

NARD’s insistence that medical doctors must always earn more than pharmacists, physiotherapists, and optometrists is not just economic conservatism—it is Institutional Gatekeeping. Psychologically, this reflects a fear of resource distribution and status dilution. In progressive healthcare systems, compensation is linked to specialization, expertise, and clinical impact—not merely a title. For instance, in the United States, nurse practitioners, clinical pharmacists, and physical therapists with advanced certifications often earn salaries that reflect their critical roles in patient care. This is based on market demand, expertise, and clinical contribution, not rigid professional hierarchies.

NARD’s argument is a textbook case of Scarcity Mindset, where access to prestige and financial reward is seen as finite. Rather than expanding the pie for all health professionals, it insists on a rigid hierarchy where only one group deserves top compensation. This outdated thinking contradicts global trends where interdisciplinary collaboration drives innovation and improves patient outcomes. In psychological terms, this is Status Quo Bias—a preference for the current state of affairs despite clear evidence that modernization would benefit the collective.

NARD's stance against recognizing PharmD, DPT, and OD professionals as "Doctors" symbolizes more than just professional disagreement—it is the psychological grip of a fading hierarchy, desperately clutching onto a structure that modern healthcare has long outgrown. It is almost like watching someone trying to protect their prized VCR in the age of streaming services—nostalgic, perhaps, but entirely out of touch with reality. The world has moved forward; healthcare is no longer the exclusive territory of one title or one profession.

For perspective, a VCR (Video Cassette Recorder) is that classic piece of technology from the '80s and '90s that let you watch movies and record TV shows on bulky video tapes called VHS (Video Home System) cassettes. You had to rewind, fast-forward, and sometimes even adjust the tracking just to get a clear picture. It was magical back then, but now it’s like a museum piece compared to streaming on Netflix or YouTube. Holding onto it in the modern world is like holding onto a typewriter in the age of laptops—stubbornly resisting change that everyone else has long embraced.

That is what NARD's resistance looks like: a psychological attachment to the past, desperately cradling old hierarchies while the rest of the world has upgraded to better, more inclusive models. Healthcare across the globe has recognized that modern challenges require modern solutions. PharmD, DPT, and OD professionals are not intruders—they are essential players stepping up to meet the complex needs of contemporary medicine. The idea that patients would be confused by the presence of different types of "Doctors" is almost comical. Patients are not sitting in clinics scratching their heads over whether the person with "Doctor" on their coat is going to prescribe heart surgery or fit them for glasses. They know the difference. It is not the patients that are confused—it is the professionals who are clutching their VCRs, hoping the world will rewind.

If there is a place where NARD can genuinely contribute to the future of healthcare, it is in the transformation of its residency programs. Residency training should not just be about reinforcing old hierarchies—it should be a gateway to modernity, interdisciplinary cooperation, and societal good. The essence of healthcare is evolving, and Nigeria cannot afford to sit on the sidelines. Residents should be learning how to collaborate with PharmDs, DPTs, ODs, and other healthcare specialists, not seeing them as competitors but as partners in patient care.

It is time for NARD to consider integrating courses in Interdisciplinary Healthcare Delivery, Collaborative Care Models, and Community Health Impact as part of its residency programs. Nigerian healthcare does not just need more doctors; it needs collaborative doctors—ones who can work seamlessly with a diverse range of health professionals to address complex patient needs. This shift would not just benefit patients; it would elevate the entire healthcare system, making it stronger, faster, and more resilient.

The world is moving toward integrated care, where pharmacists are medication experts, physical therapists are movement specialists, and optometrists are primary eye care providers—all working alongside medical doctors to improve health outcomes. It is no longer enough to hold on to tradition for tradition's sake. Residency programs should be breeding grounds for modern healthcare thinking, where the next generation of Nigerian doctors is not just trained to lead, but to cooperate, innovate, and elevate the standards of healthcare for the nation.

Progress in healthcare is not built by clinging to titles like lifeboats on a sinking ship. It is achieved through adaptation, learning, and collaboration. NARD's reluctance to evolve reflects not just fear of change, but a deep-rooted need to protect dominance. Ironically, in trying to secure its throne, NARD has exposed its own fragility. Healthcare is advancing globally, with or without NARD's blessing. Patients deserve a system that values expertise over ego, collaboration over competition, and progress over protectionism. If NARD cannot embrace that vision, then perhaps Nigerian healthcare must stream forward without its outdated VCR.

The barriers to progress are real, but they are not insurmountable. The irony is, you cannot fight the future—it arrives whether you want it to or not. It is not a matter of if Nigerian healthcare will embrace modernization; it is simply a matter of when. The question is whether NARD wants to be part of that evolution or sit back with its VCR, watching the rest of the world on a digital screen, wondering where it all went wrong.

Because here’s the truth: the world has already pressed "play," and there is no "rewind" button for progress. Modernity waits for no one. NARD can choose to modernize its residency programs, integrate real interdisciplinary cooperation, and redefine its purpose—or it can hold on to its dusty VCR, dreaming of a time that is never coming back.

Professor Oshodi has held faculty positions at Florida Memorial University, Florida International University, Broward College, where he also served as Assistant Professor and Interim Associate Dean, Nova Southeastern University, and Lynn University. He is currently a contributing faculty member at Walden University and a virtual professor with Weldios University and ISCOM University.

In the United States, he serves as a government consultant in forensic-clinical psychology, offering expertise in mental health, behavioral analysis, and institutional evaluation. He is also the founder of Psychoafricalysis, a theoretical framework that integrates African sociocultural dynamics into modern psychology.

A proud Black Republican, Professor Oshodi advocates for individual empowerment, ethical leadership, and institutional integrity. His work focuses on promoting functional governance and sustainable development across Africa.

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