Article:
Nepal's healthcare sector has made notable strides, yet it continues to grapple with significant challenges influenced by its socio-political landscape. The nation's commitment to universal health coverage is evident in the Nepal Health Sector Strategic Plan (NHSSP) 2023-2030, which outlines objectives to enhance healthcare accessibility and quality.
Despite these efforts, political interference and systemic corruption hinder progress. Allocating less than 10% of its GDP to healthcare, Nepal faces constraints in adequately serving its population of over 29 million. This underfunding is exacerbated by bureaucratic challenges, such as the dominance of providers over purchasers and staffing inadequacies, leading to inefficiencies in healthcare delivery.
The federalization process, aimed at decentralizing governance, offers opportunities for improved health sector accountability and transparency. However, its success heavily relies on the political will of locally elected governments to implement reforms effectively.
Recent developments, such as the termination of 36 nurses due to a freeze in USAID funding, underscore the vulnerability of Nepal's healthcare system to external financial dependencies. Health experts warn that such funding disruptions could unravel years of progress, highlighting the need for sustainable, internally supported healthcare initiatives.
In summary, while Nepal has demonstrated a commitment to improving healthcare, persistent socio-political challenges and financial constraints continue to impede the realization of comprehensive, equitable health services for all citizens.
Recently, Dr. Bivek Singh was honored with the ‘Outstanding Contribution in Education’ award for his crucial role in improving Nepal’s healthcare sector. Here’s what we talked about.
AED: Can you share a brief overview of your journey in healthcare education and what inspired you to dedicate yourself to this field in Nepal?
Dr. Singh: My journey in healthcare education began in 2009 when I enrolled in medical school at Tribhuvan University. Early in my career, I developed a passion for teaching and knowledge dissemination, which led me to start mentoring students in public health and nursing in 2010. This inspired me to write A Journey into the Human Body (2013), my first educational book. Over time, I expanded my focus beyond clinical practice to medical education, research, and mentorship, recognizing that Nepal’s healthcare system needed a stronger foundation in evidence-based learning and innovation. My father’s 50-year-long dedication as a healthcare provider in rural Nepal deeply influenced my path, instilling in me a commitment to improving medical education, research culture, and professional networking in Nepal.
AED: What were some of the biggest challenges you faced when working to improve healthcare education in Nepal?
Dr. Singh: One of the primary challenges has been the lack of access to modern resources for medical students and professionals. Many institutions still rely on outdated curricula and limited digital integration, making it difficult for students to stay updated with global medical advancements. Another major challenge is the shortage of mentorship opportunities, which often leaves young healthcare professionals without proper guidance. Additionally, brain drain continues to be a pressing issue, with many talented doctors leaving Nepal due to limited research funding, career growth, and working conditions. Overcoming these obstacles requires stronger policies, better funding, and international collaborations to enhance medical education and retain skilled professionals in Nepal.
AED: How has the healthcare education system in Nepal evolved over the years, and what changes have you observed firsthand?
Dr. Singh: Nepal’s healthcare education system has seen incremental progress, particularly in the expansion of medical colleges, digital learning platforms, and research awareness. There is a growing interest among students in clinical research, publication, and evidence-based practice, which was not as prominent a decade ago. The COVID-19 pandemic played a significant role in accelerating telemedicine and online education, making remote learning and virtual mentorship more acceptable. However, despite these advancements, the system still struggles with limited hands-on clinical training, insufficient research exposure, and disparities between urban and rural medical education.
AED: What are the major gaps in Nepal’s healthcare education system, and how can they be addressed?
Dr. Singh: The biggest gaps include inadequate research training, limited technological integration, and disparities in educational resources between urban and rural institutions. Many students graduate without proper exposure to scientific research, clinical trials, and AI-driven healthcare solutions, putting them at a disadvantage in the global medical landscape. These gaps can be addressed by integrating structured research programs in medical curricula, expanding digital learning platforms, and establishing mentorship initiatives to support young professionals. Additionally, government policies should prioritize investment in healthcare education and research infrastructure to create a more sustainable system.
AED: How have limited resources, infrastructure, and technology impacted medical and healthcare education in Nepal?
Dr. Singh: Limited resources have significantly affected medical training quality and professional growth opportunities. Many institutions lack modern laboratories, simulation centers, and access to global medical journals, making it difficult for students to gain practical exposure to advanced medical procedures. In rural areas, inadequate healthcare infrastructure forces many students to learn in environments with outdated equipment and limited faculty support. Additionally, technological gaps mean that Nepal is still behind in AI-driven diagnostics, telemedicine, and digital healthcare training, which could otherwise bridge these disparities. Addressing these issues requires stronger investment in medical infrastructure, better faculty development programs, and the integration of AI and telemedicine in education.
AED: Can you share specific initiatives or programs you have implemented to enhance medical training and education?
Dr. Singh: One of my most impactful initiatives is the Nepalese Doctors Lounge (NEDOL), an online platform with over 11,300 members, where Nepalese doctors and medical students share knowledge, discuss medical cases, and seek mentorship opportunities. I have also authored several medical textbooks, including Clinical Companion for Paramedics, which has become an essential resource for healthcare professionals preparing for public service exams. Additionally, I have organized research training programs, mentorship sessions, and community-based healthcare initiatives, such as establishing a clinic that provides affordable healthcare and free diabetic screening to underserved populations.
AED: What role do you think technology and AI can play in improving medical education and training in Nepal?
Dr. Singh: Technology and AI have the potential to revolutionize Nepal’s medical education system by providing personalized learning experiences, AI-powered diagnostics, and virtual simulations for clinical training. AI can help analyze large datasets, predict disease patterns, and enhance medical decision-making, improving patient care outcomes. Moreover, AI-driven adaptive learning platforms can tailor educational content based on individual student needs, making medical training more efficient. Expanding the use of telemedicine and online education will also help bridge the healthcare gap between urban and rural areas, ensuring equitable access to knowledge and clinical exposure.
AED: Have you seen successful examples of digital learning or AI-driven medical education making an impact in Nepal?
Dr. Singh: Yes, the pandemic accelerated the adoption of online medical education and telemedicine, making digital learning a more accepted norm. Initiatives like NEDOL have successfully created a virtual knowledge-sharing platform, connecting Nepalese doctors worldwide. AI-powered telemedicine platforms have also helped improve healthcare accessibility in rural Nepal, allowing patients to consult specialists remotely. These examples show that digital learning and AI have the potential to redefine Nepal’s medical education landscape if adopted on a broader scale. NEDOL was among the first few to start 24/7 free counseling during the COVID pandemic’s first peak, and our initiative was well appreciated and the impact was covered by the National news television.
AED: What steps should institutions take to integrate modern medical advancements into healthcare training?
Dr. Singh: Institutions should invest in digital learning platforms, AI-based medical simulations, and telemedicine training. They should also encourage international collaborations to provide students with exposure to global research, clinical trials, and modern treatment protocols. Additionally, integrating mandatory research training in medical curricula will ensure that future doctors are well-equipped with evidence-based knowledge and critical thinking skills.
AED: What advice would you give to young students and aspiring healthcare professionals in Nepal?
Dr. Singh: I encourage young healthcare professionals to be proactive in learning, seek mentorship, and embrace research opportunities. Rather than looking for opportunities abroad, they should focus on contributing to Nepal’s healthcare system. Success in medicine is not just about academic excellence but also about innovation, compassion, and dedication to lifelong learning.
AED: How can international collaborations help improve Nepal’s healthcare education system?
Dr. Singh: International collaborations can provide funding for research, facilitate exchange programs, and bring technological advancements into Nepal’s medical institutions. Partnerships with global universities can help improve curriculum standards, provide access to modern medical literature, and create professional development opportunities for Nepalese doctors and students.
AED: What are your future goals and vision for transforming healthcare education in Nepal?
Dr. Singh: I aim to strengthen the research culture, expand mentorship programs, and integrate AI-based learning into Nepal’s medical education. I also plan to establish a structured physician well-being initiative, addressing the burnout and mental health challenges faced by Nepalese doctors.
AED: What message do you have for policymakers, educators, and healthcare professionals working to improve healthcare education?
Dr. Singh: Nepal’s healthcare education system needs urgent reforms in curriculum modernization, faculty training, and technology integration. Policymakers should focus on providing funding for research, improving healthcare infrastructure, and retaining medical talent. Collaboration between educators, doctors, and policymakers is key to creating a sustainable and progressive medical education system.
AED: How can the global medical community support Nepal’s efforts to enhance healthcare education?
Dr. Singh: The global medical community can support Nepal by providing training opportunities, funding research projects, and facilitating faculty exchange programs. Access to online learning platforms, AI-based diagnostic tools, and telemedicine collaborations can also help bridge existing gaps in education and healthcare access.
AED: Finally, what keeps you motivated and committed to this mission despite the challenges?
Dr. Singh: The legacy of my father, my passion for education and research, and the belief that Nepal has immense untapped potential in healthcare keep me motivated. I see every challenge as an opportunity to drive meaningful change in Nepal’s medical education and healthcare system.