| Username |
Post |
| nEIL rUDESTINE |
Posted
on 29-Jan-01 02:40 PM
Taken from Harvard Gazette
http://www.hno.harvard.edu/gazette/2001/01.24/14-nepalmed.html
An aerial view of the village of Dhulakiel in Nepal, the site of a new Western-style medical school. (Photo by Cliff Tabin)
Teaching medicine Western-style:
SPH student to help establish medical school in Nepal
By Christina Roache
Special to the Gazette
When School of Public Health (SPH) doctoral student Mark Hickman goes to medical school in September, he will not be commuting. He is flying off to the green farming terraces of the village of Dhulakiel in Nepal where, on a swath of land jutting from the side of a Himalayan mountain, engineers are laboring in the thin air to erect a building that may revolutionize medical education in Nepal. The building will be a medical school organized by Nepalese officials with the help of Harvard professors.
And Hickman is not going there to learn medicine, but instead to help establish the first Western-style medical school in the country. He will teach basic science to a new generation of Nepalese doctors.
SPH doctoral student Mark Hickman will be teaching basic science at a new medical school in Nepal. (Photo by Christina Roache)
Hickman, 26, was working on his thesis in the laboratory of Leona Samson, professor in the Department of Cancer Cell Biology, last fall when he received an e-mail that would change his life. The message was from Harvard Medical School (HMS) Professor Cliff Tabin inviting him and other specialists in biomedicine at SPH and HMS to learn more about temporary teaching opportunities at a yet-to-be-established medical school in Nepal. Hickman was intrigued.
"I was trying to figure out what I wanted to do next in life, and this sounded like a unique chance to interact with people from another country and gain new experiences," said Hickman.
The school is the brainchild of a Nepalese physician, Arjun Karki, who received his training in the United States. One night over dinner with an American ophthalmologist friend, Karki expressed his desire to create a Western-style medical curriculum in Nepal. The ophthalmologist piped up that his brother was a professor at Harvard Medical School and could help him. Soon after, Cliff Tabin received an e-mail from Karki.
Tabin was surprised, but he was also interested — and energized. He sent out a call for volunteers and received about 40 responses. From those, a core group of 15 SPH and HMS members have committed themselves to traveling to Nepal next fall and teaching basic science classes in blocks of six, 12, or 15 weeks. The effort is, indeed, a volunteer one. The travelers' airfare and room and board will be paid for, but they will receive nothing else in finances. The rewards are purely personal.
"One would hope to expect this kind of response," said Tabin. "We have so many resources and a responsibility to give back to the world. This is an opportunity to have a large impact on the health of a group of people."
There are currently seven private medical schools and just under 900 doctors in Nepal. Some of the doctors received their training in India and China and, rarely, the United States, but many attended Nepalese medical schools where the quality of education is poor, said Tabin.
He explained that curricula are often dated and taught by retired faculty members who may be unemployable elsewhere. And, in a country with a per capita annual income of $200, medical education is very expensive, said Tabin. Only a privileged class can afford to attend. One of the goals of the new school's organizers is to make the price of medical education more reasonable while dramatically increasing the quality.
Despite the high cost of training doctors in Nepal, the need for more of them is painfully apparent. Infant mortality rates run at 83 deaths per 1,000 births, and those infants who do survive face a 63 percent risk of being chronically malnourished before they reach the age of 3. Approximately 20,000 new cases of tuberculosis are diagnosed each year. The average life expectancy is 57 years.
The medical school will be run under the auspices of Kathmandu University, 30 miles away, and will be called Kathmandu University Medical School. Officials expect to accept about 40 students in the first year. Similar to the education system in England, these students will attend the school fresh from high school.
"It will be an experience getting there and figuring out where they are in terms of their knowledge," said Hickman. "If I see them looking at me with blank stares, I'll know that I have to slow down."
A jazz piano hobbyist, Hickman said he's not afraid to improvise. That notwithstanding, a lot of thought and effort has been put into deciding how best to teach students who are trained from an early age not to ask questions of their teachers; queries are considered disrespectful. Organizers have decided that a problem-based, case-study approach would work best, with students attending a lecture each day and then discussing how to approach specific cases.
Hickman has worked as a tutor and teaching assistant before, but he has never taught a full course himself. To bolster his knowledge, he has been practicing with an HMS medical instructor and has been sitting in on lectures that reflect the teaching style he will use in Nepal. Hickman engages in all of this while continuing to conduct lab research for his thesis, but he says the hard work is worth the opportunity to help put together a medical school curriculum from scratch.
"We are hoping and working to make the school well established and respected," said Hickman.
The school's organizers have applied for grants, but money and supplies are still needed (the SPH and HMS teachers will bring many of the classroom and laboratory supplies with them).
To learn about how to donate used textbooks, microscopes, slides, and other equipment, contact Mark Hickman at (617) 797-1544 or mhickman@hsph.harvard.edu.
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| Biswo |
Posted
on 29-Jan-01 10:25 PM
One of the best news for our country! Nepalese need to profit
from such opportunity.
The US Government is widely criticized for its parsimony(it
donates 0.1% of its GDP while Europeans donate as much as 0.75%
of their GDP) regarding aid to foreign nations, its citizens
and philanthropic associations have assisted needy people,
irrespective of their origin,faith and system of governance.
Now it is our common responsibility to provide security in the
nation, and create conducive environment for these scientists
going far away to Nepal to teach our kids/brothers.
and hey, isn't Neil Rudestine name of the president of Harvard
also?
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| SM |
Posted
on 30-Jan-01 04:08 PM
Its a great news and for sure, another benefit to the country.
>The school is the brainchild of a Nepalese
>physician, Arjun Karki, who received his
>training in the United States. One night
>over dinner with an American ophthalmologist
>friend, Karki expressed his desire to create
>a Western-style medical curriculum in Nepal.
>The ophthalmologist piped up that his
>brother was a professor at Harvard Medical
>School and could help him. Soon after, Cliff
>Tabin received an e-mail from Karki.
Surely, Dr. Karki must be commended for his initiative and for the noble idea of quality education of the western style (British).
>There are currently seven private medical
>schools and just under 900 doctors in Nepal.
Are you sure that Nepal has just under 900 doctors? This might be true for the Doctors working for the Government. Sometime people tend to show such data, only to show the pathetic medical condition in Nepal.
The number of doctors registered with the Nepal Medical Council (the governing body that regulates the doctors and registers as practitioners) shows more than 3000.
>Some of the doctors received their training
>in India and China and, rarely, the United
>States, but many attended Nepalese medical
>schools where the quality of education is
>poor, said Tabin.
Hey, the TU teaching hospital has proved to be a institute that is the assembly line of producing graduates for US. I can not exactly give you the number of its graduates who have passed USMLE with flying colors and are residents or practicing doctors in the US, but that is the institution that provides quality care to the US citizens.
Most of the Doctors who are "serving the country" are the graduates of mostly India, Bangaladesh, Pakistan, China and of course Russia. TUTH produced approximately 40 students annually for around 20 years and most of them are "brain drained" to US.
The word "some" mentioned really bothered me! (sorry) It should be most.
On top of everything, most of the private medical schools (e.g Nepal Medical College,Kathmandu, Manipal College of Medical Sciences, Pokhara, College of Medical Sciences, Bharatpur, Nepalgunj Medical College, Nepalgunj Kathmandu Medical College, Kathmandu) in business in Nepal ARE AFFILIATED (five out of seven)to the Kathmandu University, the same parent institution that this proposed Western style medical school. I think, its not the right way to undermine the Nepalese institutions academically, while you are also affiliated to the same KU.
Some of the institutes even boast of training their students for USMLE (check web page of Nepal Medical College. You know what I mean!
BTW, the AHW and HA are serving the most of the needy population in Nepal where the doctors do not intend to stay.
>He explained that curricula are often dated
>and taught by retired faculty members who
>may be unemployable elsewhere.
Absolutely right!
This is the problem faced by most of the medical school administrations. No practising doctors wanted to teach in an institution whose salary are nominal compared to the amount they make in the private practice. A whole contingent of doctors resigned from the TUTH for not being able to practice outside of the university practice.
The situation must have changed now because most the people who finance and run these medical colleges are the same old doctors. To make the matters worse, doctors let them use their name only and not work and charge the school. So sad, ke garne?
I sincerely hope this proposed institution will have able teachers preferably from Harvard.
And, in a
>country with a per capita annual income of $2
>00, medical education is very expensive,
>said Tabin. Only a privileged class can
>afford to attend.
Yes absolutely right! Its universal!Is medical education cheap in western countries? Only the previledged and politically connected can have the medical education especially after the so called induction of democracy in Nepal.
I hope this new institution will again change the trend to some extent and establish itself as a role model, running the medical school with unpriviledges class yet brilliant students. Don't let them know about USMLE so that they will stay back in Nepal to serve those whose per capita is less than 200$.
One of the goals of the
>new school's organizers is to make the price
>of medical education more reasonable while
>dramatically increasing the quality.
I wonder about this statement of offering dramatic quality medical education, yet compromise with the cost of education!
How are they going to make it happen?
I hope other several medical colleges that have affiliations with the same Kathmandu University are equal in quality defined by the University standards. If the proposed school comes out better in quality and less costly as planned, KU may have to think of increasing the standards of other (provisionally)affiliated schools and decrease the admissions/capitation fees, which is certainly better for the potential students and the University will have same standards with it's six (medical schools)affliates.
>The medical school will be run under the
>auspices of Kathmandu University, 30 miles
>away, and will be called Kathmandu
>University Medical School. Officials expect
>to accept about 40 students in the first
>year. Similar to the education system in
>England, these students will attend the
>school fresh from high school.
I guess, this is also following the Russian style fresh from high school, which will save some precious years of Intermediate level education (say A levels in UK and College in US). Cool! In Nepal high school means tenth grade.
Please feel free to disagree.
Open for further arguments.
MS
|
| Biswo |
Posted
on 31-Jan-01 11:02 PM
>>
Hey, the TU teaching hospital has proved to be a institute that
is the assembly line of producing graduates for US. I can not
exactly give you the number of its graduates who have passed USMLE
with flying colors and are residents or practicing doctors in the
US, but that is the institution that provides quality care to the
US citizens.
Most of the Doctors who are "serving the country" are the
graduates of mostly India, Bangaladesh,Pakistan, China and of
course Russia. TUTH produced approximately 40 students annually
for around 20 years and most of them are "brain drained" to US.
The word "some" mentioned really bothered me! (sorry)
It should be most.
Given the 'national pride' inherent in migration, it is not
strange that TU doctors choose to live somewhere else than in
Nepal.But the commentator (MSji) seems to have missed one point:
there is no moral depravity in serving the nation after you
self-finance your study in other countries,but it is a treason
when you flee the country when the country needs you most and
when you are financed by national treasury to attend a medical
school in Nepal.
Again to say that brain draining is a particular trait of some
'country' graduate is also a somewhat erring conclusion.Brain
draining is a particular trait of those people in Nepal who
scores high in their class. Brain draining of Nepalese doctors is
equally prevalent among those smart students who attended good
colleges of India,China,Bangladesh and others.
|
| Trailokya Aryal |
Posted
on 31-Jan-01 11:11 PM
A great NEWS. Everyone involved with this project deserves a big THANK YOU.
And, if others don't laugh at me-
I myself am thinking of starting a liberal arts college (liberal arts in true sense) to get all rounded, well educated nepali students. BUt this will be 10-15-20 years down the road. So, wish me luck, guys!
Regards
Trai
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| Biswo |
Posted
on 31-Jan-01 11:47 PM
WISH YOU GOOD LUCK,BUDDY.
|
| MS |
Posted
on 01-Feb-01 02:01 PM
> Given the 'national pride' inherent in
>migration, it is not
>strange that TU doctors choose to live
>somewhere else than in
>Nepal.But the commentator (MSji) seems to
>have missed one point:
>there is no moral depravity in serving the
>nation after you
>self-finance your study in other countries,
>but it is a treason
>when you flee the country when the country
>needs you most and
>when you are financed by national treasury
>to attend a medical
>school in Nepal.
Yes! You are absolutely right, when they receive expensive medical education from the national treasury and flee the country. I am in the process of finding out the acutual cost of education for the students from a friend of mine who happened to be one of those looking for better oppurtunities in US.
The heavily subsidized programs for producing "doctors" in the TUTH is a enormous financial burden to the poor country and it tax payers, especially when expectations are not met from the recipients. Don't you think its the weakness of the government not being able to get hold of them? It becomes even dramatic when these come to US and find no place to work (some of them) and end up working in a gas station or change the profession.
> Again to say that brain draining is a
>particular trait of some
>'country' graduate is also a somewhat erring
>conclusion.Brain
>draining is a particular trait of those
>people in Nepal who
>scores high in their class. Brain draining
>of Nepalese doctors is
>equally prevalent among those smart students
>who attended good
>colleges of India,China,Bangladesh and
>others.
I agree with you that brilliant students do flee to "better" places that matches their potentials. In addition, I see some other factors too for those who are not that smart.
Recommendations, knowing someone big and right connection play equally big part in the game, when brillience and intelligence are not in the scene.
SM
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| Biswo |
Posted
on 01-Feb-01 05:57 PM
MSji:
Doctors, more than those involved in any other professions,
should involve themselves in their profession more honestly and
responsibly.Sadly,the prevalent narcissism of doctors and the
people running nursing homes has been expressly manifested in
the market of Kathmandu where healthcare has been a commodity,
the standard of which has been maintained by its price.A friend
of mine,who currently,I guess temporarily unless he manages to
stay there, migrated to Europe told me his plight this
way (he used to work in a nursing home plus TU hospital):
They used to wake me up in the night, and ask me to perform
surgery along with a senior surgeon. A lot of time, I knew the
surgery was not necessary,but the surgery was to be performed to
increase the income of the nursing home. In those nights,while
incising the carnal flesh with cauterized incisors, and while
suturing it back,I could feel my breathe betraying my deploration
in sad/surly/swift inhalation/exhalation.The only urge I felt
was to leave the whole profession, the whole locality, and feel
safe by residing in somewhere safe and reassuring place.
In our blinkered drive to capitalistic utopia,incidents like this
are norm.For a lot of doctors,the bottom line is money, and rest
is conversation.
|
| MS |
Posted
on 02-Feb-01 11:57 AM
>MSji:
>
> Doctors, more than those involved in any
>other professions,
>should involve themselves in their
>profession more honestly and
>responsibly.Sadly,the prevalent narcissism
>of doctors and the
>people running nursing homes has been
>expressly manifested in
>the market of Kathmandu where healthcare has
>been a commodity,
>the standard of which has been maintained by
>its price.A friend
>of mine,who currently,I guess temporarily
>unless he manages to
>stay there, migrated to Europe told me his
>plight this
>way (he used to work in a nursing home plus
>TU hospital):
>
> They used to wake me up in the night, and
>ask me to perform
>surgery along with a senior surgeon. A lot
>of time, I knew the
>surgery was not necessary,but the surgery
>was to be performed to
>increase the income of the nursing home. In
>those nights,while
>incising the carnal flesh with cauterized
>incisors, and while
>suturing it back,I could feel my breathe
>betraying my deploration
>in sad/surly/swift inhalation/exhalation.The
>only urge I felt
>was to leave the whole profession, the whole
>locality, and feel
>safe by residing in somewhere safe and
>reassuring place.
>
> In our blinkered drive to capitalistic
>utopia,incidents like this
>are norm.For a lot of doctors,the bottom
>line is money, and rest
>is conversation.
Hi Biswo,
There is no question about unethical practices in Nepal with no patients right and ignorant with the treatment protocols. The educated and uneducated population unequivocally accepts what their doctors tell them to do.
There is a book written by Dr. Prakash Adhikari (? I am not very sure about his last name, sorry!), the cardiologist working in Bir Hospital about how the doctors take advantage of the patients ignorances and indulge them selvs into highly unacceptable unethical and immoral medical malpractices, simply to make money: the book is called, "Mero Mutu Dukhcha".
At this time, I highly recommend the administrators of new western style medical school in Nepal, include "Ethical and Moral Issues in Medical Practice and Malpractice in Nepal" in their curriculum.
SM
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| Biswo |
Posted
on 02-Feb-01 02:12 PM
I have heard about the book,most probably in some comments in
Kantipur. Is the writer Dr Prakash Regmi,the cardiologist? This is
just a guess,though probably more than the guess only.
|
| MS |
Posted
on 02-Feb-01 02:25 PM
Biswo,
That right, Prakash Regmi not Adhikari. Thank you for the correction.
MS
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