'Nepal's medical education could become best in SEAsia'

jagdish agrawalProf. Dr. Jagdish Prasad Agrawal is a well-known name in the health professions education sector of Nepal. Having joined Maharajgunj Medical Campus under Tribhuvan University (TU) as a lecturer in 1991, Prof. Agrawal has been serving as the Dean of the Institute of Medicine (IoM) for the last one year. Before taking up this challenging position, Prof. Agrawal had worked in key positions in various departments, like Internal Medicine and National Centre for Health Professions Education.

Born into a middle-class family in Rangeli of Morang in 1957, Prof. Agrawal is the recipient of numerous decorations and medals, including the Suprabal Jansewa Shree.

Prof. Agrawal is dedicated to upgrading the quality of health education. The outspoken IoM official spoke to Ballav Dahal of The Rising Nepal on different issues ranging from the IoM’s existing challenges, its new plans and programmes to the reform measures being taken to improve the quality of health professions education. Excerpts: 



As the Dean of the IoM, how do you see Nepal’s health professions education system?

In fact, the IoM is an important institution in Nepal. Established in 1972, the institute pioneered the health professions education in the country. This is one of the oldest institutions of the country. It incorporated the world’s latest innovations in its curricula after studying the national problems and needs. The institute has really created history in this sector.

But, it is needless to say that the world has made tremendous advancement in health professions education as well as medical technology during the last four plus decades. We also need to make relevant improvements in this sector.

Imparting quality education to students is our major concern. Since we have to assess the students’ skills and learning in different aspects, we need to carry out in-depth studies on the overall aspects and make reforms accordingly.

However, the IoM has been playing a lead role by producing quality human resources required for the country. It has been running 55 various programmes through its constituent and affiliated colleges.

As a whole, our medical education needs an overhauling in view of the recent advances and innovations made in the world’s medical education sector. We have to opt for student-centred and competency-based teaching-learning methodology. Under this methodology, the students’ required competency can be evaluated individually.


What are the major challenges and prospects of this sector?

Quality assurance is one of the major challenges facing this sector. This is possible only when there is an individually monitoring system in place. Besides, having competent, honest and dedicated faculty members and managing adequate resources are necessary for quality assurance. Besides, the unwanted political interference is another challenge.

There has been a growing tendency among the medical graduates and other health professionals to go abroad for study and return home with questionable competency.  I think, this now has become the biggest challenge.

Though there are so many things to be improved, the quality of health professions education imparted by the IoM constituent colleges is much better than the one provided by the colleges in some neighbouring countries. In terms of cost, our education is more affordable. That is why we have been able to attract many foreign students.

I would like to assure everybody that Nepal’s medical education will be the best in the entire Southeast Asia if we get all the necessary support and cooperation from the government and other stakeholders. 


The government recently issued the National Health Education Ordinance-2074 and the President has certified it. You were one of the members of the Health Profession Education Commission that was mandated to draft the bill. What will be its implications for the country’s health professions education system?

 As I mentioned earlier, our health professions education needs a new vision and thought. I am confident that the new Act will fulfill this and help lead the nation’s health education system in the right direction. It will address many problems and anomalies seen in this sector. Since the Act has focussed on quality, access and affordability, it could be a milestone. 

You have also been lobbying hard for improving the country’s medical education system since long.  One year has passed since you took up the responsibility as the Dean of the IoM. What efforts have you made in this regard?

As quality is our main concern, we have made it sure that meritorious students are selected in all the programmes. We were successful in enrolling MBBS and BDS students in all the affiliated colleges on a merit basis last year. To materialise our plan, we had to hold several rounds of meetings with related institutions.

Similarly, after a long struggle, we were also able to admit Post-Graduate students in all the affiliated colleges on a merit basis. We are trying to get students admitted to all the TU-affiliated colleges based on merit this year as well. Besides, we have also made it mandatory for the affiliated colleges to charge only prescribed fees.

We have implemented an open house counseling system. Under this system, the students acquiring the highest marks in the entrance exams can choose colleges and study there by paying the fees fixed by the government. Our main intention is to provide quality education to students at affordable fees.

After I assumed the office, we have started the repairs of the Dean’s Office and International Hostel.  Those buildings were damaged by the devastating earthquakes in 2015. We hope to complete the maintenance work within two or three months. A multi-storey building for the Maharajguj Medical Campus and hostels are going to be constructed soon.

Although we wanted to start the BDS programme from this year, we could not do so due to logistic and other reasons. The government has also allocated about Rs. 40 million for this. We are going to launch this programme next year.

With this new physical infrastructure, we are in the process of increasing the number of seats for MBBS students from next year. We now are working out a plan to materialise it.

I am also happy to share it with you that the IoM has recovered back dues worth millions of rupees from different affiliated institutes.  

What challenges have you faced during the period?

Development of any institute depends on many stakeholders. Without concerted efforts, nothing can be done successfully. We need support and cooperation from the government, university authorities and others.  In a country like ours, getting the necessary support from one and all in time is a challenge.

Anyway, I have received cooperation from the Assistant Deans and other employees. As a team, we are committed to bringing about tangible changes in the health professions education system.


There are frequent misunderstandings between the IoM and new private medical colleges when providing affiliation to them. What is the main reason?

I think, there should be a national policy on this issue. Providing affiliation to such colleges is a serious matter. We have to understand the fact that giving affiliation to colleges means taking up the responsibility of maintaining their academic quality. The IoM has also to monitor them and conduct their exams. It has been difficult for us to shoulder our responsibilities towards the colleges affiliated to us. So, we now are not in a position to provide affiliation to new colleges.


Based on a probe report, the TU has asked your office to decide whether to accept the results of the fresh MBBS entrance exams or conduct the exams again. What will be the IoM’s move in this connection?

The IoM has initiated the process of consulting various stakeholders and committees. We will take an appropriate decision based on their suggestions.


Finally, would you like to add something to this?

The IoM had conducted the entrance exams as per the rules and regulations. But that was unbearable for a certain group of people as they failed to benefit.

I would like to express our firm determination that we will not give up our stance when it comes to reforming the medical education system. My view is that one and all should work together to produce a highly competent health workforce required for the country. Without such a workforce, we will not be able to provide quality health services and facilities to the people. 


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