Nepal's first medical school, Tribhuvan University Institute of Medicine, opened in late 1970s. The Tribhuvan University Teaching Hospital opened in 1982. For the first 5 batches of students only Health Assistants were admitted.

In recent years there has been an explosion of medical schools, at least a dozen by the end of 2008. Three (Tribhuvan University Institute of Medicine, National Academy of Medical Sciences and B.P. Koirala Institute of Health Sciences) are government institutions. The rest are private, though many are affiliated with affiliated with Tribhuvan University. For a listing of medical schools in Nepal see medical schools and dental schools.

"Medicine as a career choice", Thakur et al, Journal of the Institute of Medicine 1999; 21: 118 reports a survey of 110 medical students. They found that medicine is the most sought after professional career in Nepal. The reasons cited included service to the sick, social prestige, possibility of self employment and good employment prospects.

Approximately 700 students enter medical school each year. Only 40-50% are Nepali nationals (around 300). Another 150-200 Nepalis get medical education in other countries. Approximately 500 Nepali physicians graduate annually. For a population of 25 million, the physician to patient ratio will be approximately one doctor to 1600 patients.

A 12/7/08 article on eKantipur.com recently reported:

According to Dr Subash Pyakurel, director at RISE, an institute that counsels people on medical career, more than 250 medical graduates from Nepal are going abroad annually, mainly to the US...

Nepal's 11 medical colleges produce at least 700 doctors every year. Dr. Pyakurel estimates that another 500 Nepalis return home from after obtaining MBBS [Bachelor of Medicine and Bachelor of Surgery] degree in China, Bangladesh, Phillipines, India, Pakistan and a number of other countries.

According to Nepal Medical Council (NMC), there are 8,076 registered doctors in Nepal. The number of doctors seeking the NMC licence is on the rise.

In the year 2007 alone, 870 graduates passed NMC test and got the licence. Only 488 had received medical licence in 2003. Many of the registered doctors have left for Europe and the US, according to sources at the Council.

"Every year, around 300 doctors manage to go to the US and other developed countries...

Health professionals say low pay, lack of research facilities and lack of opportunities for further education in Nepal are among the major factors that have prompted exodus of doctors to the west.

A student invests up to three million rupees to obtain a medical degree. "It is difficult to get back the investment through government salary," says Neupane [Maniraj Neupane, an MBBS student].

Lack of basic medical equipment in district hospitals deters doctors. "Our district hospitals do not even have basic medical equipment. This discourages our doctors," accepts Dr. Sudha Sharma, acting secretary at the Ministry of Public Health.

On top of that, there are just a handful of seats in Nepali medical colleges for postgraduate studies. According to Dr Sharma, there are only 200 postgraduate seats in Nepal every year.

Recognized medical education problems in Nepal include inadequate regulation, shortage of faculties and the cost of education. Currently quality assurance / regulatory agencies are the Nepal Medical Council and the Post-graduate Medical Education Coordination committee. At this time a large number of medical instructors in Nepal are from other countries, primarily India. There is an urgent need for faculty trained in basic sciences and specialty/subspecialty training.

To combat these problems there is a need for faculty exchange programs, subspecialty or other fellowship training, department to department affiliations, library assistance, technical help / technology transfer, telemedicine and CME / refresher courses.

For a listing of medical schools and facilities in Nepal, please refer to Health Providers in Nepal.

 

12/7/08