North-South Divide in the Distribution of Medical Schools in Nigeria: A Tale of Internal Inequity.

Background: Nigeria, the most populous country in Africa, is broadly divided into Northern and Southern geopolitical regions based on a historical, geographic, and political divide. While this division is predominantly geopolitical, it also aligns with deep-rooted disparities in socioeconomic development, educational attainment, infrastructure, and healthcare access. Methodology: This opinion paper sheds light on the inequitable distribution of the 65 Medical and Dental Council of Nigeria-approved medical schools (as at July 2025) between Northern and Southern Nigeria. Results: The inequitable distribution of accredited medical schools between Northern and Southern Nigeria is in a ratio of 1:3. Six states in the North do not have any fully accredited medical schools. The North's 13 fully accredited schools have the capacity to graduate a little above 1,700 medical students, whereas the South's 32 fully accredited schools have the potential to graduate almost 4,000 medical doctors in every given academic calendar. Factors including historical educational disadvantage, economic constraints, sociocultural factors, and insecurity were major contributory factors to this disparity. Conclusion: Strengthening political will, using public-private partnerships and innovative funding mechanisms, and encouraging inter-regional migration of health workers are key to a multipronged approach to addressing this inequity.