Doctors are considered noble professionals synonymous with prestige, sacrifice, and dedication to humanity. One sacrifices their youth, family life, relationships, and hobbies to be a doctor. Yet, behind this facade of respect and admiration lies a grim reality. Doctors in Nepal face relentless hardship, systemic neglect, and outright exploitation by the government, corrupt institutions, toxic seniors, politicians, and an apathetic society.

The Unseen Struggles of Nepali Doctors

Even after years of tough schooling and training, Nepali doctors struggle for a livelihood. Salaries are low, job possibilities are severely restricted, and working conditions are degrading. Many hospitals hold salaries for several months putting healthcare professionals in financial distress. This fact is difficult to accept in a culture where doctors are supposed to devote their lives to the well-being of others while they are overworked, underpaid, and undervalued themselves.

Many healthcare workers are thinking of leaving their jobs in private and government hospitals due to unpaid salaries stretching as long as six months and years. The inability to take care of one’s own family while tirelessly caring for others is a cruel irony that Nepali doctors endure daily.

A Broken System: Corruption and Exploitation

The Ministry of Health and Population, along with powerful political figures, seniors, and bureaucrats, has turned the healthcare system of Nepal into a breeding ground for corruption. Policies are manipulated to serve the interests of private medical colleges and political allies of the government rather than the doctors and patients who need them the most. Private institutions frequently ignore the government’s directives, yet authorities turn a blind eye to these violations.

A recent example of this is the blatant disregard for the stipend regulation implemented by the full house meeting of the Medical Education Commission under the Honorable Prime Minister KP Sharma Oli, Honorable Minister of Health and Population Pradip Paudel, and Honorable Minister of Education, Science and Technology Bidya Bhattarai, which mandated that medical residents receive a stipend equivalent to 8th-level government officers during their 3 years residency program in both private and government medical colleges. Instead, private medical colleges continue to pay resident doctors a paltry sum of around NPR 18,000 per month, a disgraceful amount for professionals who have invested years into the medical profession. This salary is barely enough to survive in Nepal’s cities, let alone support a family or repay student loans.

Unemployment and Overcrowding in the Medical Field

The healthcare sector in Nepal does not suffer only from a shortage of doctors but from a shortage of job opportunities. Thousands of medical graduates enter the field each year, only to find that vacancies in hospitals are either nonexistent or fiercely contested. For example, when the Institute of Medicine (IOM) opened applications for medical officers recently, over 600 doctors applied for a handful of positions, an absurd ratio of 40 to 80 times more applicants for the position of medical officer. The numbers are staggering and paint a bleak picture of a broken system incapable of accommodating its own professionals while thousands of skilled and highly qualified doctors are forced every year to go abroad for a better future and job opportunities.

Political Interference: The Silent Killer of Healthcare

Healthcare in Nepal has become yet another tool for political parties to extend their control and influence. Politicians and their associates dictate the job placements and promotions in the hospitals and allocate resources based on favouritism rather than merit. Competent, deserving doctors are overlooked in favour of those with political backing and locals, further deteriorating the quality of healthcare services in Nepal.

Furthermore, policies are frequently designed not to better the system but to promote the deep-seated desires of those in power. Resources are mishandled, with monies routinely syphoned into private wallets rather than being used to modernise hospitals, purchase essential medications and equipment, or upgrade infrastructures. The final result? A compromised healthcare system where doctors are expected to work miracles and magic with little to no support.

Unsafe Work Environments and Violence Against Doctors

Adding insult to injury, doctors in Nepal are subjected to physical assaults, threats, and public humiliation regularly. Instances of angry mobs attacking hospital staff after unsatisfied results of the treatment are alarmingly common. The government has failed to implement stringent policies to protect medical personnel from such violence. Instead, doctors are often forced to choose between risking their lives or refusing to treat patients under hazardous conditions.

The Toxic Senior-Junior Dynamic in Nepali Healthcare

Apart from systemic corruption and government neglect, junior doctors in Nepal also suffer from mistreatment by their senior counterparts. For many young doctors, life has been challenging due to a deeply ingrained culture of domination and exploitation. Senior doctors usually set unattainable standards for their juniors, humiliating and verbally abusing them in the name of preparing for potential negative scenarios during clinical practice, rather than fostering a positive learning atmosphere.

One such instance occurred recently during a job interview where a senior doctor insisted that a candidate should be able to intubate a patient in a rural setup. But what if the patient dies during the intubation process? Who will ensure the safety of the junior doctor? Who will take responsibility for an intubated patient in health posts or primary healthcare centres with no ICU or ventilator support? Intubation in the emergency room is a procedure that even trained anesthesiologists struggle with at times, yet junior doctors are expected to perform it unsupervised under less-than-ideal conditions.

An example of this toxic atmosphere was recently noticed after the suicide attempt by a resident doctor of the psychiatric department at Dhulikhel Hospital as a result of continuous harassment and bullying by faculty members and senior doctors of the department. This event showed the harsh realities of the medical profession in Nepal, where young medical professionals’ mental health issues are commonly ignored, and screams for help go unheard. If the mental health of Nepali Doctors isn’t safe in their own psychiatric department, then where else can it be?

The Mass Exodus of Nepali Doctors

Given these circumstances, it is no surprise that thousands of Nepali doctors choose to leave the country each year in search of better opportunities abroad. Countries like the U.S., Australia, and the UK benefit from Nepal’s medical brain drain, as highly skilled doctors flee from a system that neither values nor supports them. The government, instead of addressing the root causes of this exodus, remains indifferent, allowing an ever-worsening healthcare crisis to fester.

A Cry for Change

Nepali doctors have reached their breaking point. The government should address the exploitation, corruption, and political interference that plague the Nepali healthcare sector before they collapse the system entirely. The government needs to appoint capable candidates and enforce policies that protect medical professionals, ensure fair wages, create more job opportunities, and put an end to the unchecked power of private medical institutions.

If Nepal truly values its doctors, then action must be taken immediately. Otherwise, the nation will continue to lose its most valuable assets: the very professionals who dedicate their lives to saving others.