27/03/2026
Thank you to NEPAL MEDICAL COUNCIL ( NMC ) for this opportunity to participate in the National Clinical Fellowship Guidelines Workshop. I was able to share some of my
perspectives on improving the current fellowship framework, which were:
• Hospital Criteria:
The requirement of a minimum 50-bedded hospital should be specialty-specific. In fields like Ophthalmology, Dermatology where many procedures are day-care based, greater emphasis should be placed on patient volume, particularly daily OPD load, rather than number of bedded hospital.
• Post-PG Experience Requirement:
The current criterion requiring 1 year of experience after MD/MS before entering fellowship should be reconsidered. This is especially relevant when many of us are advocating to remove the mandatory 1-year experience after MBBS for PG entry.
• Working Hours:
While a minimum of 24 hours per week is defined, guidelines should also specify a maximum duty limit to prevent burnout and ensure trainee well-being.
• Role of Societies:
Specialty societies and sub-specialty societies should be entrusted with developing the curriculum and training standards, with NMC serving primarily as a regulatory and monitoring authority.
• Certification:
Fellowship certification should be conducted by the respective societies in collaboration with NMC to maintain both academic rigor and specialty relevance.
• salary
The defined minimum 9th-level salary is a positive step; however, additional benefits such as accommodation should also be incorporated. Importantly, existing fellowships offering higher pay should not be forced to reduce their compensation.
• Feedback Mechanism:
Fellow feedback systems should go beyond general work environment and include accountability measures such as timely disbursement of salary—for both fellows and faculty.
• Expert Criteria:
The criteria for defining “experts” or trainers should be developed by the respective societies in collaboration with NMC and should be uniform
• CPD (Continuing Professional Development):
If CPD requirements are made mandatory, their design and implementation should be coordinated with specialty societies.
• Research & Academic Output:
As fellowship is primarily a skill-based training program, emphasis should be placed on national and international presentations rather than mandatory journal publications.
These refinements can help ensure that fellowship training in Nepal becomes more practical, specialty-relevant, and trainee-friendly while maintaining high standards.
