At a time when doctors are migrating abroad due to lack of favorable working environment, the government is continuing the wrong practice of choosing executive leadership from political parties in health science institutes. Only on Tuesday, vice-chancellors have been appointed in Pokhara, Patan, BP Koirala and Karnali Institute of Health Sciences on the part of the ruling party Congress and UML.

 Also, 74 percent of the registered doctors in Nepal migrate abroad for lucrative jobs, professional development and studies. It also includes doctors who have recently completed their studies and are well versed in treatment practice. 8 thousand 624 doctors were registered in Nepal Medical Council from 2020 to 2023, while 6 thousand 368 people got good standing certificate to go abroad. 

In the year 2023, 2 thousand 318 doctors got the certificate to go abroad according to the data of the council. This year, 2,692 new doctors were registered in the council. Before that, in 2022, 2 thousand 85 new doctors were registered and 1 thousand 954 doctors got certificates to go abroad. Similarly, 1,716 new doctors were registered in 2021. That year, 1,327 people took certificates to go abroad. In 2020, 2 thousand 131 new doctors were registered and 769 doctors got certificates to go abroad.

There are about 35 thousand registered doctors in Nepal. Since 2020, 2,000 to 2,500 doctors have been registered with the council annually. It is mentioned in the report of the council that Nepali doctors are going to more than 20 countries.

There is data showing that the attraction of Nepali doctors is more in countries such as America, Britain, Maldives, UAE, Australia, India, Canada, Germany. In 2023, 843 doctors were certified to go to America. 505 for UK, 395 for Maldives, 186 for India, 166 for Australia, 142 for UAE. In 2022, 592 doctors were certified to go to the UK, 496 to the US and 453 to the Maldives. 

In this background, the two ruling parties have divided 4 medical educational institutions. Prime Minister and Chancellor KP Sharma Oli has appointed Buddhiprasad Paudel in Patan, Bharat Bahadur Khatri in Pokhara, Vikramprasad Shrestha in BP (Dharan) and Pujan Kumar Rokaya in Karnali (Jumla) on the recommendation of Health Minister and Vice Chancellor Pradeep Paudel. 

Paudel and Khatri from UML were appointed in Patan and Pokhara and Shrestha and Rokaya from Congress in BP and Karnali. Officials of the Ministry of Health say that there is a risk of increasing the rate of doctor exodus due to such a division in appointments. Among the newly appointed vice-chancellors, Poudel is a rheumatology specialist and Khatri, Shrestha and Rokaya are orthopedic specialists. 

Professor Krishna Giri and Suryaman Menyangbo, who were on the 'shortlist', have been replaced by Associate Professor Rokaya as Vice-Chancellor. 55 people applied for the four vice-chancellorships. The 'shortlist' was made public after the Congress and UML shared two posts each.

It is being criticized for appointing the vice-chancellor for political reasons by leaving aside the senior and qualified people who are on the shortlist. After the selection of the vice-chancellor, Ramesh Koirala, a cardiologist from the shortlist, has resigned from Shahid Gangalal National Heart Disease Center. He is the head of cardiovascular department and senior consultant cardiac surgeon there. 

Koirala, who has recently arrived in the US, published his resignation letter on social media and wrote, "Suddenly leaving skills, country and profession made me feel sad."

Koirala had applied for BP and Pokhara Institute of Health Sciences Vice-Chancellorship. An official of the Ministry of Health said that when Health Minister Poudel tried to recommend him to the Vice Chancellor of Pokhara, he was stopped at the beginning.

The Secretary of the Ministry of Health in the recommendation committee formed on June 14 under the coordination of Paudel. Vikas Devkota and member of the National Planning Commission Dr. RP Bichha was a member. UML Patan and Pokhara and Congress BP and Karnali Institute's vice-chancellor were in a stand that they could not leave, said the official, Ramesh's name was removed from the shortlist as Pokhara fell under the UML quota. Biccha, who is also a doctor, was appointed to the Planning Commission on the recommendation of Foreign Minister Arju Rana Deuba. It was he who had been holding a different opinion in the recommendation committee saying that the party leaders were saying that Koirala could not be made the vice-chancellor.

Congress General Minister Gagan Thapa and Health Minister Pradeep Paudel had met with Chairman Sher Bahadur Deuba several times to make Ramesh the Vice Chancellor. "Initially, the Speaker refused to talk to Home Minister Ramesh Ukhtar. In the meantime, Arju had told Ramesh not to be made through the chairman and members of the committee," said a leader close to the health minister. "The scorpions in the committee did not want to recommend the above order. When I went to convince the chairman again, he said that I have promised someone, Ramesh won't. But the then Prime Minister Pushpa Kamal Dahal appointed Rajkumar Rauniyar as the Vice-Chancellor under the pressure of politics within the Congress. Rauniar was suspended for some time on the charge of abuse of office. 

In his resignation letter, Koirala has also expressed his belief that Congress General Minister Thapa and Health Minister Paudel will help to make the heart disease center a nerve center as well. "I am confident that the federal government will expand this center from the heart and give the country a chance to be proud as Shahid Gangalal National Heart and Nerve Center from this year and I am always available for advice and suggestions in every such work," he wrote. 

BP's 'shortlist' included Shrestha and Koirala along with Krishna Kumar Rai, Pashupati Chaudhary, Prahlad Karki and Rohit Prasad Yadav. In Patan, along with Paudel, Gehnath Baral, Deepak Thapa Magar, Pawan Kumar Sharma, Bishnu Prasad Sharma, Srijana Shrestha were in the shortlist. Along with Khatri, Arjun Acharya, Chandika Pandit, Narayan Singh Gurung, Vidhannidhi Paudel and Maya Lama were on the 'shortlist' for Pokhara. Eliza Shrestha, Double Bahadur Dhami, Pawanjung Rayamazhi, Srikrishna Giri and Suryaman Menyangbo were kept on the 'shortlist' along with Rokaya in Karnali. 

Jagdish Prasad Agarwal, an expert in medical education and a former professor of the University, commented that it was wrong to appoint a vice-chancellor from Bhagbanda in the institution. "Officers should be appointed based on seniority, bhagbanda does not benefit the organization," he said. Only the appointer will know.' 

According to a doctor close to the ruling party, an agreement has been reached to appoint rectors, registrars and hospital directors in high positions, including the Congress-UML division. "There is an agreement to appoint other positions from the Congress quota in the establishment where the vice chancellor was obtained by the UML, and from the UML where the vice chancellor was obtained by the Congress," he said. 

The Nepal Medical Association published a research article in 2024 on the analysis of migration trends and policy implications of Nepali doctors. It states that job dissatisfaction is the main reason for doctors to migrate abroad. Lack of proper appraisal, low pay facilities, long duty and overwork are cited as reasons for dissatisfaction. A study committee consisting of experts from the Ministry of Health has also pointed out the lack of skill development, low salary facilities, study-research and other reasons for Nepali doctors going abroad.

Vice chancellor of which health science institute?

Patan : Buddhiprasad Paudel

Pokhara : Bharat Bahadur Khatri