Research Directorate, Immigration and Refugee Board of Canada

1. Medical Reports

The website for the Nigeria Social Insurance Trust Fund (NSITF), which was established by law to compensate employees and their families in the case of a work-related injury, illness or death (Nigeria n.d.a), indicates that a medical report is a "comprehensive record of a patient's condition, treatment, and … outcomes" that "helps to ensure continuity of care, facilitates communication between healthcare providers, and provides a record of medical interventions" (Nigeria n.d.b). In correspondence with the Research Directorate, a verification officer at the Embassy of Canada in Nigeria and the High Commission of Canada in Nigeria and the former Head of the Diplomatic Section of the Nigerian Police's Special Fraud Unit (PSFU) [1] indicated that the following institutions can issue medical reports:

• state public hospitals;
• teaching hospitals;
• federal medical centres; and
• local government area hospitals, called "local primary healthcare centres" (Verification Officer 2025-09-22).
  
  

1.1 Content

In correspondence with the Research Directorate, a Lagos-based law firm with a full-service practice, including in immigration law, stated that medical reports include patient information, "findings," and an "endorsement" from a physician (Law firm 2025-09-25). In correspondence with the Research Directorate, a legal practitioner and medical law and human rights specialist in Nigeria noted that a medical report "generally" includes

• the patient's "biodata," e.g. "full name, age, sex and hospital number";
• the dates of examination, admission, discharge and/or treatment;
• a summary of clinical findings;
• diagnosis and treatment details;
• the physician's observations and recommendations;
• the "name, designation and signature of the attending physician"; and
• the hospital's contact information (Legal practitioner 2025-10-07).
  
  

According to the NSITF, a "comprehensive medical report" issued for an injury, disability, "occupational diseas[e]" or death includes the following sections:

• patient information, i.e. name, age, gender, and contact information;
• medical history;
• physical examination;
• diagnostic test results;
• treatment plan;
• outcomes and follow-up; and
• doctor's information, i.e. their name, signature, practice number, and the date and time of the report (Nigeria n.d.b).
  
  

In correspondence with the Research Directorate, an attorney who is Principal Counsel at a law firm in Ilorin, Kwara State, Nigeria, noted that medical reports "usually" include contact information for the issuing institution, as well as hospital reference numbers and stamps (Principal Counsel 2025-10-01).

A blank sample medical report for "[a]ccident" or "[o]ccupational [d]isease" is available on the NSITF's website (Nigeria n.d.d). A 2025 sample of a medical report issued by University of Ilorin Teaching Hospital, a public hospital in Kwara State, provided by the Principal Counsel, is attached to this Response (Attachment 1). An undated sample of a medical report issued by the Federal Road Safety Corps (FRSC), the regulatory agency responsible for administering traffic laws and regulations in Nigeria (Nigeria n.d.e), provided by the Principal Counsel, is attached to this Response (Attachment 2). Another undated sample of a medical report issued by Araville Health Consult, a private health clinic in Lagos, is also attached to this Response (Attachment 3).

1.2 Appearance

Sources indicated that there is no "standardized" format for medical reports (Law firm 2025-09-25; Principal Counsel 2025-10-01; legal practitioner 2025-10-07). The legal practitioner noted that medical reports "vary significantly depending on the type of healthcare facility, its ownership, location, and jurisdiction" (2025-10-07).

Sources state that medical reports are usually issued on the hospital's official letterhead (Legal practitioner 2025-10-07; Nigeria n.d.b; Principal Counsel 2025-10-01). The law firm stated that while government hospitals, most notably teaching hospitals and federal medical centres, typically issue reports "with detailed letterheads referencing the relevant state or federal health authority," private hospitals "may use simpler formats" while nevertheless adhering to the "same general structure" (2025-09-25). The law firm indicated that reports from urban centres are "usually more structured and typed," whereas handwritten certificates "may still be issued" in "some rural or smaller facilities" (2025-09-25). The same source noted that the report structure "may also vary" depending on the types of test results included (Law firm 2025-09-25).

The Verification Officer noted that medical reports issued by state public hospitals are affixed with the logo of the State Health Management Board, whereas each federal medical hospital affixes its own logo on medical reports (2025-09-22). The same source added that local primary health care centres also affix their own logos on the medical reports that they issue (Verification Officer 2025-09-22). In correspondence with the Research Directorate, a professor of internal medicine at the University of Port Harcourt Teaching Hospital stated that institutional stamps and seals are "a constant feature," whether the hospital is public, private, urban, rural, municipal or state level (2025-09-23).

1.3 Security Features

According to the Verification Officer, medical reports from both public and private hospitals lack security features (2025-09-22).

The legal practitioner added that "most healthcare institutions" authenticate reports using official stamps or seals and the hospital's letterhead, as well as the attending physician's signature (2025-10-07). The same source stated that some tertiary hospitals use "embossed seals" (Legal practitioner 2025-10-07). The law firm indicated that, to be "vali[d] and fina[l]," medical reports must include the name and signature of the issuing authority or physician, as well as the official stamp of the hospital or clinic (2025-09-25).

The Professor noted that security features include a "seal or stamp" specific to the doctor signing the report; it is issued by the Nigerian Medical Association (NMA) [2] and includes the doctor's registration number with the Medical and Dental Council of Nigeria (MDCN) [3] (2025-09-23). Sources indicate that in 2018 the NMA "introduced" a doctor's seal (ICIR 2022-04-16) or made a doctor's stamp mandatory (The Punch 2018-03-17). Sources indicate that the NMA doctor's stamp includes

• the practitioner's name (The Punch 2018-03-17; Daily Post 2023-09-11),
• the practitioner's licence number (Daily Post 2023-09-11; Daily Trust 2017-08-19),
• the year the practitioner completed their training (The Punch 2018-03-17; Daily Post 2023-09-11) and the university attended (The Punch 2018-03-17),
• the NMA logo (Daily Post 2023-09-11),
• additional security features visible under ultraviolet light (Daily Post 2023-09-11; Daily Trust 2017-08-19).
  
  

Sources note that the NMA's seal can be used to track the doctor signing the report, which facilitates authentication (Professor 2025-09-23; ICIR 2022-04-16). However, a 2022 investigative report by the International Centre for Investigative Reporting (ICIR) [4] found that "many" hospitals do not affix the NMA stamp to their documents (ICIR 2022-04-16). Similarly, a 2023 article by the Nigerian newspaper Daily Post cites a press release from the Kogi State NMA chapter as stating that doctors in the state were "poor to non-complian[t]" with using the stamp (Daily Post 2023-09-11).

According to the legal practitioner, a "few private and specialized hospitals" are "gradually" implementing electronic medical record systems (EMRs), which can create barcodes linked to patient files or test results (2025-10-07). However, barcode use "remains limited," particularly for "standard narrative medical reports" (Legal practitioner 2025-10-07).

2. Level of Standardization of Medical Reports

In follow-up correspondence with the Research Directorate, the Verification Officer noted that, when issuing medical reports, each teaching hospital affixes the logo of its university, and each private hospital affixes its own logo (2025-09-23). The legal practitioner indicated that there are differences depending on whether the issuing facility is private, public, urban, rural, or owned by states or municipalities (2025-10-07).

The information in the following three tables on typical characteristics of medical reports by the issuing institution was provided by the legal practitioner:

Public Hospitals	Private Hospitals
official hospital letterhead institutional stamps signature of an attending physician, "senior consultant," or medical director	personal letterhead "may not" use embossed seals

Urban Facilities ("[E]specially" Tertiary and Teaching Hospitals)	Rural Facilities (Clinics and Primary Health Centres)
more detailed and "professionally formatted" "sometimes" with EMRs	"sometimes" handwritten with "minimal" formatting

State-Run Hospitals	Local Government Primary Health Care Centres
more detailed more "forma[l]" structure	less detailed, focused "mainly" on "routine clinical documentation" simpler formatting "less likely to include institutional endorsements"

(Legal practitioner 2025-10-07)

According to the law firm, medical reports are issued by the physician providing care to the patient, by a physician authorized by the institution to conduct the health check for the report, or by the head of the medical records unit (2025-09-25). The Professor indicated that reports can be written by the doctor treating the patient, the hospital director, or government health authorities depending on the person requesting the report and the purpose of the report (2025-09-23). The legal practitioner stated, however, that government authorities do not themselves issue reports, though they "may verify or authenticate them" (2025-10-07).

Sources noted that ["in most cases" (Legal practitioner 2025-10-07)], medical reports are signed by the attending physician (Legal practitioner 2025-10-07; Principal Counsel 2025-10-01; law firm 2025-09-25). The legal practitioner added that a signature from the hospital's medical director or a "senior consultant" "may be required" if the report is for legal or "official" use (2025-10-07). However, other sources indicated that all medical reports should be signed by either the head of the hospital in question or by an individual appointed to sign on the director's behalf (Verification Officer 2025-09-22; Principal Counsel 2025-10-01), typically another doctor with similar seniority (Verification Officer 2025-09-23). The law firm indicated that the practice varies among medical facilities, as each institution has its own policy determining who has signing authority for medical reports (Law firm 2025-09-25).

3. Requirements and Procedure to Obtain a Medical Report

3.1 In Nigeria

Sources indicated that, prior to being issued a medical report, a patient must provide certain personal information, including their name, residential address, and date of birth (Verification Officer 2025-09-22; law firm 2025-09-25). The Verification Officer added that the patient will also be asked their tribe, next of kin, and state of origin (2025-09-22). The law firm noted that required information may also include the patient's phone number, hospital number (if an existing patient), and an emergency contact, as well as "background" health information (2025-09-25). The law firm further stated that obtaining an "official" medical report based on clinical findings "typically" requires the following steps:

• creating a file with a health facility (if one does not already exist);
• consulting a medical doctor at the facility, who may refer the individual for testing;
• paying the consultation and test fees; and
• undergoing the relevant tests (2025-09-25).
  
  

According to the legal practitioner, to obtain a copy of a past medical report, a patient must

• apply in writing to either the medical records department at the health care facility or the attending physician,
• provide valid identification, and
• pay a processing fee (2025-10-07).
  
  

The legal practitioner stated that the processing time to receive a copy of a report "typically" varies from 3 to 14 business days, adding that "some public hospitals may require administrative approval" before issuing the report, "particularly if it is intended for legal, insurance, or immigration purposes" (2025-10-07). The law firm indicated that processing time for records requests is between 2 and 4 weeks, though it may be longer for "teaching hospitals with older archives" (2025-09-25).

The legal practitioner noted that if the request is made on behalf of another person, the applicant must additionally provide proof of a relationship or authorization (2025-10-07).

3.2 Abroad

The law firm indicated that, for Nigerians residing abroad, there is no "standard procedure" to obtain a copy of a previous medical report; however, stipulations in the National Health Act 2014 mean that hospitals will require "a formal, written request" and proof of identity before providing a medical report (2025-09-25). Applicants will "typically" need to submit

• patient details, including full name, date of birth, hospital number, and dates of admission or treatment;
• proof of identity; and
• a written application or "records-release form" addressed to the hospital's medical records department or chief medical director (Law firm 2025-09-25).
  
  

The legal practitioner stated that a Nigerian residing outside the country who wishes to request a copy of a previous medical report must write directly to the hospital where they were seen, "clearly stating the purpose of the request," and include their patient or hospital registration number, if available, as well as copy of valid identification (2025-10-07). The same source further noted that "in some cases" the relevant hospital may request consular attestation of documents prior to releasing the report (Legal practitioner 2025-10-07). The source added that the patient must provide a notarized authorization letter if a proxy will be collecting the report on their behalf (Legal practitioner 2025-10-07). The law firm similarly stated that if the request for a copy is made on behalf of another person, the applicant must provide either the patient's written authorization or a power of attorney and a copy of the patient's ID (Law firm 2025-09-25).

The information in the following 2 paragraphs was provided by the law firm:

The application for a medical report can be submitted by email, mail, or courier, though hospitals "sometimes require original signatures or in-person verification." The fee for such a request is "usually modest."

When intended for use outside Nigeria, a medical report "may" require additional attestation and authentication measures, including the signature of the attending physician, a stamp with the hospital's seal, and, "in some cases," the signature of a senior official such as the chief medical director. To "strengthen its evidentiary value," the report may also be notarized by a Nigerian notary public, and the Ministry of Foreign Affairs may further authenticate the document by verifying the hospital's seal and the doctor's signature (Law firm 2025-09-25).

4. Fraud Related to Medical Reports

When asked about the prevalence of medical report fraud in Nigeria, the Verification Officer indicated that "forgery is endemic" (2025-09-22). The law firm similarly stated that fraud relating to medical reports in Nigeria is "widely reported" (2025-09-25).

The Professor stated that the 2 "most prevalent" types of fraudulent reports are those issued by "non-medical personnel" and those that make "false declarations … without evidence of hospital attendance" (2025-09-23). The law firm listed the following categories of fraud related to medical reports:

• health care workers issuing medical reports for a fee without conducting any tests;
• hospital staff requiring "bribes" to "falsify medical reports";
• forgers creating or altering medical documents, including signatures, stamps, or test results; and
• patients offering "bribe[s]" to hospital staff in order to "bypass standard admission, consultation, and diagnostic processes" (2025-09-25).
  
  

The law firm further noted that in certain health care centres, the sale of false medical reports has become an organized "[c]ommercial [e]nterprise" among officials (2025-09-25).

The Verification Officer indicated that the states of Anambra, Ebonyi, Edo, Ekiti, Imo, Ogun, Ondo, Osun, and Oyo have the "highest rate of fraud and forgery," noting that medical reports from these states "require thorough verification" (Verification Officer 2025-09-22). The Daily Post article quotes the NMA as stating that "fake medical and medicolegal documents" are "proliferat[ing]" in Kogi State (2023-09-11).

In a 2019 article, the Premium Times, an English-language news website in Nigeria, cites the NMA's Code of Ethics as stating that practitioners issuing false reports are "'liable to disciplinary proceedings'," but notes that the "absence of effective implementation of regulations" has allowed for a "booming market" in fraudulent medical certificates from "corrupt" hospital and lab staff across Nigeria (2019-07-07). In their investigation for the same article, the reporter was able to obtain a medical report from Lagos State University Teaching Hospital that included a doctor's NMA-issued stamp, despite not having seen the doctor or undergone any testing (Premium Times 2019-07-07). An investigative report by Solacebase, a Nigeria-based online newspaper (Solacebase n.d.), notes that in "government-owned hospitals" in Sokoto State the production of fake medical documents for a fee by health care staff is "rife" (2024-03-09). The reporter for Solacebase was able to obtain medical reports from officials at 3 different hospitals in the state, all of which bore a doctor's signature despite no tests having been conducted (Solacebase 2024-03-09). A report by the Collaborative Media Engagement for Development, Inclusivity, and Accountability (CMEDIA) [5] similarly indicates that medical staff at 2 hospitals in Kwara State—Ilorin General Hospital and Offa General Hospital—issued fraudulent medical reports for an undercover journalist for a fee (CMEDIA 2024-03-19). In the first instance, the journalist underwent tests but obtained a report in someone else's name, and in the second instance the journalist obtained a report, again in someone else's name, and did not undergo any tests (CMEDIA 2024-03-19).

The Verification Officer indicated that "fake" medical reports issued by hospital staff would not be filed in hospital records (2025-09-25). Corroborating information could not be found among the sources consulted by the Research Directorate within the time constraints of this Response.

The Verification Officer indicated that "forgery" of medical reports is "more prevalent" in private hospitals than in public ones (2025-09-22).

5. Registry of Doctors and Medical Practitioners in Nigeria

The Medical and Dental Council of Nigeria (MDCN) is responsible for establishing and maintaining a registry of individuals "entitled to practice" medicine and for periodically publishing a list of registered practitioners (Nigeria n.d.f). According to the Professor, the MDCN's national registry is "reliable" and can be verified for petitioners for a fee (2025-09-23).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of sources consulted in researching this Information Request.

Notes

[1] The Police Special Fraud Unit (PSFU) is a section of the Nigeria Police Force that researches and investigates potentially fraudulent activity (Nigeria n.d.c). ^[back]

[2] The Nigerian Medical Association (NMA) is a professional association for medical and dental practitioners in Nigeria, whose objectives include "enforcing adherence to the core ethical principles" of the profession (NMA n.d.). ^[back]

[3] The Medical and Dental Council of Nigeria is the regulatory body for medicine, dentistry and alternative medicine in Nigeria (Nigeria n.d.f). ^[back]

[4] ICIR is a Nigeria-based "independent, non-profit news agency that promotes transparency and accountability" (ICIR n.d.). ^[back]

[5] CMEDIA is a project by the Wole Soyinka Centre for Investigative Journalism (WSCIJ) in partnership with 26 other organizations that aims to promote "media independence and government accountability" (CMEDIA 2022-07-09). WSCIJ is a non-profit NGO that uses investigative journalism to expose corruption and human rights violations in Nigeria (WSCIJ n.d.). ^[back]

References

The Collaborative Media Engagement for Development, Inclusivity, and Accountability (CMEDIA). 2024-03-19. "Investigation: Inside the 'Doctored' Medical Certificates in Kwara Hospitals." [Accessed 2025-09-19]

The Collaborative Media Engagement for Development, Inclusivity, and Accountability (CMEDIA). 2022-07-09. "Collaborative Media Project: Targeting Issues at Sub-National Levels." [Accessed 2025-09-19]

Daily Post. 2023-09-11. John Akinfehinwa. "NMA to Enforce Mandatory Use of Doctor's Stamp in Kogi." [Accessed 2025-10-14]

Daily Trust. 2017-08-19. Christiana T. Alabi & Balarabe Alkassim. "Minister Launches Doctor's Stamp to Check Quackery." [Accessed 2025-10-14]

The Guardian [Nigeria]. 2017-08-18. "Health Minister Launches 'Doctor's Stamp' to Check Quackery." [Accessed 2025-10-14]

International Centre for Investigative Reporting (ICIR). 2022-04-16. Nurudeen Akewushola. "Investigation: How Corps Members Falsify Medical Documents, Feign Illness to Bypass NYSC Protocols." [Accessed 2025-09-19]

International Centre for Investigative Reporting (ICIR). N.d. "About." [Accessed 2025-09-19]

Law firm, Lagos. 2025-09-25. Correspondence with the Research Directorate.

Legal practitioner. 2025-10-07. Correspondence with the Research Directorate.

Nigeria. N.d.a. Nigeria Social Insurance Trust Fund (NSITF). "About Us." [Accessed 2025-10-20]

Nigeria. N.d.b. Nigeria Social Insurance Trust Fund (NSITF). "Parameters for a Comprehensive Medical Report in Event of Injury/Disability/Occupational Diseases/Death." [Accessed 2025-09-22]

Nigeria. N.d.c. Police Special Fraud Unit (PSFU). "About." [Accessed 2025-09-22]

Nigeria. N.d.d. Nigeria Social Insurance Trust Fund (NSITF). "Medical Report for Accident/Occupational Disease." [Accessed 2025-09-22]

Nigeria. N.d.e. Federal Road Safety Commission (FRSC). "About Us." [Accessed 2025-10-21]

Nigeria. N.d.f. Medical and Dental Council of Nigeria (MDCN). "MDCN Mandate." [Accessed 2025-09-22]

Nigerian Medical Association (NMA). N.d. "About." [Accessed 2025-09-19]

Premium Times. 2019-07-07. Oladeinde Olawoyin. "Investigation: Inside Nigeria's Haven of Fake Medical Reports, Corrupt Health Officials." [Accessed 2025-09-19]

Principal Counsel, Ilorin, Kwara State. 2025-10-01. Correspondence with the Research Directorate.

Professor of internal medicine, University of Port Harcourt Teaching Hospital. 2025-09-23. Correspondence with the Research Directorate.

The Punch. 2018-03-17. "NMA Introduces Doctors' Stamp to Check Quackery." [Accessed 2025-10-14]

Solacebase. 2024-03-09. "Investigation: How Sale of Unverified Medical Documents in Sokoto Hospitals Is Undermining Public Trust, Put Communities at Risk." [Accessed 2025-09-19]

Solacebase. N.d. "About Us – Solacebase." [Accessed 2025-09-19]

Verification Officer. 2025-09-25. Correspondence with the Research Directorate.

Verification Officer. 2025-09-23. Correspondence with the Research Directorate.

Verification Officer. 2025-09-22. Correspondence with the Research Directorate.

Wole Soyinka Centre for Investigative Journalism (WSCIJ). N.d. "About Us." [Accessed 2025-10-17]

Additional Sources Consulted

Oral sources: Afrika Eyes; Association of Nigerian Physicians in the Americas; Association of Nigerian Private Medical Practitioners; Canadian Association of Nigerian Lawyers; Canadian Association of Nigerian Physicians and Dentists; Frontex; Ilera Healthcare; Ilera Nigeria; International Centre for Investigative Reporting; International Organization for Migration; law firms (5); Nigeria Health Watch; Nigerian Bar Association; Nigerian Canadian Association of Calgary; Nigerian Canadian Association GTA; Nigerian Canadian Association Hamilton; Nigerian Canadian Association Ottawa; Nigeria – Embassy of Nigeria in Washington, DC, federal medical centres (11), Health Records Officers Registration Board of Nigeria, Medical and Dental Council of Nigeria, National Hospital Abuja, Nigeria High Commission to Canada, Nigeria Social Insurance Trust Fund, Police Special Fraud Unit; Nigerian Medical Association; public health physician at a Nigerian university; professor of internal medicine and consultant physician at a Nigerian university; UN – WHO.

Internet Sites, including: Blueprint Newspapers; Foundation for Investigative Journalism; Independent [Nigeria]; Neusroom; Nigeria – Economic and Financial Crimes Commission, Federal Ministry of Health & Social Welfare; Nigeria Crime; The Nation [Nigeria]; The Street Journal; The Sun [Nigeria]; Tekedia; Top Court News; University of Salford Manchester; US – Department of State; Vanguard.

Attachments

1. University of Ilorin Teaching Hospital. 2025. Sample of a medical report. Sent to the Research Directorate by the Principal Counsel at a law firm in Ilorin, Kwara State, 2025-10-01. Translated into French by the Translation Bureau, Public Services and Procurement Canada.
2. Nigeria. N.d. Federal Road Safety Corps (FRSC). Sample of a medical report. Sent to the Research Directorate by the Principal Counsel at a law firm in Ilorin, Kwara State, 2025-10-01. Translated into French by the Translation Bureau, Public Services and Procurement Canada.
3. Araville Health Consult. N.d. Sample of a medical report. Sent to the Research Directorate by Araville Health Consult, 2025-09-30. Translated into French by the Translation Bureau, Public Services and Procurement Canada.