The wrong policy that forced specialists to leave the country
The Philippines has adopted a medical education and residency training system similar to the US. Nepal, on the other hand, has followed the Indian model, which is influenced by the British model.
In recent decades, there has been a steady exodus of specialists from Nepal to foreign countries. This issue is usually discussed in hushed tones. However, it is an issue that needs to be addressed immediately.
This exodus is not just about higher salaries or modern facilities. It has to do with the difficulties and structural obstacles that specialists face within Nepal’s institutional structure.
One of the biggest challenges in this regard is the issue of equivalence (certificate of equivalence). Tribhuvan University (TU) has the authority to recognize foreign medical degrees. Without this recognition, specialists returning from abroad cannot apply for government jobs or academic careers.
In this regard, TU does not recognize doctors who have completed residency training in the Philippines. Their residency program was not recognized as a real course, but as a general training without a thesis.
This decision is highly contradictory. Before going to the Philippines, each doctor had received an official letter from the relevant Nepali government agency. Due to the limited number of postgraduate seats in the country, many doctors were forced to go abroad for further studies in the last two decades.
Moreover, members of the Nepal Medical Council themselves used to go to the Philippines to understand and observe the medical education system there. This also indicated a tacit approval for Nepali doctors to study in that country. But the harsh and dismissive approach of TU has now sidelined hundreds of skilled specialists in their own country.
What is more painful is that until the beginning of 2073, TU was issuing equivalence certificates to doctors who had completed their residency in the Philippines. Many specialists had applied, submitted the necessary documents, and even paid the fees. Suddenly, TU changed its policy and stopped issuing certificates without any warning. The applications of many doctors were still in process.
If rules are to be made, they should always be for the future, not for the past. For example, Tribhuvan University could have said, ‘Starting this year, equality will not be given to those doing residency in the Philippines.’ But instead of doing so, the rule was implemented immediately. Which completely ruined the future of doctors who had completed their studies abroad and are studying.
Imagine, what must have happened to doctors who were in the middle of their residency in 2017? Long duty, sleepless nights, hungry stomachs, physical and mental fatigue. What must have happened to doctors who were struggling for a happy future despite facing all this with this sudden decision?
The arbitrary and discriminatory policy of the system has shattered the hopes of many doctors.
Some doctors have said that this sudden decision has even made them victims of depression.
No decision has been made yet about what will happen to those who had submitted all the necessary documents and the 5,000 rupee fee for the equivalence certificate in 2073 BS, shortly before the implementation of this rule. What kind of justice is this done to citizens?
The lack of recognition is not only undermining the hard work of these doctors, but also weakening Nepal’s health system. Nepal’s much-needed specialist surgeons, physicians, and pediatricians have returned with experience abroad. However, they are not allowed to teach in Nepal’s medical colleges or work as specialists in government hospitals. This is because TU refuses to issue the necessary certificates. Yet these same specialists are welcomed in other countries, their skills are respected, and they are employed.
In addition, there is widespread discrimination within the health system. Nepali doctors who return from high-level training abroad, especially those from the Philippines, are often the target of suspicion, professional jealousy, and administrative obstruction. They are treated like outsiders in their own homeland.
They are deprived of leadership roles, excluded from decision-making processes, and kept out of opportunities to make meaningful contributions to the nation’s health sector. They have now emerged as a group of highly skilled and talented doctors trained abroad. The message is clear—an attempt is being made to discredit expertise and create administrative obstacles in Nepal.
The Philippines has adopted a medical education and residency training system similar to the US. Nepal, on the other hand, has followed the Indian model, which is influenced by the British model.
The residency years in Nepal and the Philippines are similar, with some being longer in the Philippines.
For example:
-General Surgery – Nepal: 3 years, Philippines: 5 years
-Radiology – Nepal: 3 years, Philippines: 4 years
-Orthopedic – Nepal: 3 years, Philippines: 4 years
-Internal Medicine – Nepal: 3 years, Philippines: 3 years
-ENT – Nepal: 3 years, Philippines: 4 years
-Obstetrics and Gynecology – Nepal: 3 years, Philippines: 4 years
Based on this comparison, the claim that Philippine residency is ‘mere training’ is baseless. Rather, the programs are more structured and longer than those in Nepal, which raises serious questions about the biased policy of TU.
What is even more sad is that all responsible institutions are aware of this problem. Dean of the Institute of Medical Studies (IOM), Nepal May The Dical Council, the Nepal Medical Association, the Ministry of Health and Population, and the Ministry of Education are all aware of this problem.
But no one has taken responsibility for solving it. The main players are the current and former two deans and the officials of the Curriculum Development Board of Tribhuvan University.
Was this decision approved by the Ministry of Education or the Ministry of Health? The answer to this question has not come from anywhere. Under whose direction were these decisions made? Was there an influence of money or power? Why was a policy made to stop the specialists needed by the nation? Will these responsible people ever be investigated and held accountable?
Recently, about 200 specialist doctors have filed a petition in the court, where a permanent order has also been issued. However, no concrete solution has been reached yet.
Why is there so much silence about this policy that has become a factor in the exodus of specialist doctors?
Nepal is already suffering from a shortage of specialists in fields such as cancer, neurosurgery, cardiology, and pediatrics. But the doctors who can fill these vacancies are migrating abroad in large numbers. Most of the doctors who have gone abroad have left the country permanently.
They have gone to places where their training is recognized, respected and valued. Nepali patients are forced to travel abroad for expensive treatment or rely on substandard services.
If Nepal wants to save its medical talent, urgent reforms are needed. Tribhuvan University and the Nepal Medical Council must adopt a transparent and fair policy for recognizing foreign degrees.
Especially degrees from countries like the Philippines, where residency is internationally recognized. Instead of abolishing these programs, Nepal should focus on evaluation, breeding systems and collaborative partnerships. It is also essential to end discrimination and create a culture of respect for all specialists.
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