Background:
The Federal Democratic Republic of Nepal is a developing country in South Asia with apopulation of 29.8 million. In September 2011, there were 18 medical schools with 14 beingin the private sector. KIST Medical College is a private school in Lalitpur district. Thepresent study was conducted to obtain information on student perceptions about working inrural Nepal after graduation.
Methods:
The study was conducted among first- and second-year undergraduate medical students usinga semi-structured questionnaire developed by the authors using inputs from the literature andtheir experiences of teaching medical students. Year of study, gender, method of financing ofmedical education, place of family residence and occupation of parents were noted.Participant responses were analysed, grouped together and the number of respondents statinga particular response was noted.
Results:
Of the 200 students, 185 (92.5%) participated with 95 being from the first year and 90 fromthe second. Most students were self-financing and from urban areas. Regarding the questionof working in rural Nepal after graduation, 134 (72.4%) said they will work after theirundergraduate course. Students preferred to work in the government or nongovernmentalsector. Student felt doctors are reluctant to serve in rural Nepal due to inadequate facilities,low salary, less security, problems with their professional development, less equipment inhealth centres, decreased contact with family and difficulties in communicating with anilliterate, rural population. About 43% of respondents felt medical education does notadequately prepare them for rural service. Repeated rural exposure, postings in rural hospitalsand health centres, and training students to diagnose and treat illness with less technologywere suggested. The median monthly salary expected was 60 000Nepalese rupees (US$ 820)and was significantly higher among first-year students.
Conclusions:
The majority of respondents were in favour of working in rural Nepal after graduation. Theywanted facilities in rural areas and health centres to be improved. Changes in the educationsystem were suggested. Providing relatively better facilities for rural doctors compared withurban doctors and reorienting medical education for producing doctors for rural Nepal can beconsidered. Further studies are required in other private medical schools.