Nepal Medical Elective

INCLUDES

• Four week elective period- includes the payment to the teaching hospital
• Airport transfers – pick up and drop off
• Bed and Breakfast accommodation in our guest house for four weeks
• Staff available throughout including guesthouse housekeeper and elective manager

EXCLUDES

• International airfare to Kathmandu
• Visa and vaccinations and travel insurance
• Travel to and from the hospital
• Lunches and dinners

From your first enquiry you will have experienced people to talk to in the UK office who will give you an honest appraisal of the placement, specifically you can talk to our Medical Electives co-ordinator, Andy MacDonald. This personal service and warm welcome will also await you in Kathmandu where Tsering Sherpa runs Adventure Alternative Nepal.

The elective program at TUTH (Tribhuvan University Teaching Hospital) is open to any medical student to complete their official elective, and we have had students from all over the world attending since 2005. We also have run electives for midwifery, physiotherapy, dentistry and nursing students too. Please contact us in advance if you have an enquiry about a specific type of elective.

The hospital is a major teaching hospital with 600 beds attached to Maharajgunj Medical Campus for training undergraduate and post-graduate students in Health Sciences. The Maharajgunj Medical Campus also runs the community-based field programmes.

All foreign medical students applying for enrollment in the Clinical/Community Elective Programmes are required to register at the National Centre for Health Professions Education (NCHPE) of Institute of Medicine. IOM is situated at Maharajgunj about 5 KM north of centre of Kathmandu. We will help you do this.

The standard elective programme is wide ranging multi-departmental. It is a rolling structured programme with lectures and ward work under supervision from English speaking Doctors and consultants. It is income generating for the institution and attracts students from all over the world at all times of year. Students generally work five days a week from 9am to 5pm, and additional study and research is often required. The minimum elective period offered by the hospital is two weeks but in our experience four weeks is a far better time period, and many students opt for six weeks.

To confirm a place on an elective you should first give us your preferred dates, so please send us an email and our office will start the process of registering for your elective at Tribhuvan teaching hospital. We require a letter from your university stating that you are a genuine medical student at that institution and which year you are expected to graduate, as well as your CV and a letter of motivation (we can help with that). We can also provide a confirmation letter for your elective department which will have all the information required such as name of supervisor, hospital details, address of Adventure Alternative Nepal and so on.

Initially you will meet with the medical director or consultant to discuss your daily routines and timings. You will be able to mention your preferences for departments before arrival in Nepal, and the medical staff are keen to accommodate preferences but it does depend on how busy they are. If your elective is more than six weeks then it’s possible to spend time in more than one department.

Departments at TUTH include Accident & Emergency, Anaesthesiology, Anatomy, Biochemistry, Cardiology, Dentistry, Dermatology, ENT, Gastroenterology, Haematology, Paediatrics, Obstetrics and Gynaecology, General Surgery, Internal (General) Medicine, Nephrology, Neurology, Orthopaedic Surgery, Ophthalmology, Psychiatry & Mental Health, Physiotherapy, Pathology, Microbiology, Radiology and Urology.

There are daily ward rounds conducted by the consultants of the respective clinical departments. You will also be posted to the outpatient departments and the casualty rooms where you can see a variety of clinical cases. You will also be involved with interviewing and examining the patients and observe various diagnostic and therapeutic procedures under the direct supervision of the consultants.

You will be encouraged to participate in clinical bedside teachings regularly conducted for the undergraduate students of the Institute of Medicine in Kathmandu. In such sessions you can discuss the clinical findings, investigation plans and therapeutic management of the patients. These regular journal clubs, case presentations and topic discussions provide a rich learning environment for students. Such sessions are particularly useful to develop critical reasoning skills and the skills of problem solving based on case histories and the real patients.

Most students find they leave the house at around 8.00am and start at 9.00am, finishing mid-afternoon, which generally leaves enough time to do study at home until dinner. At weekends most people go sightseeing or exploring the Kathmandu valley, and many people extend their trip with a trek to one of the famous areas like Everest or Annapurna, or the less famous lower Solukhumbu, off the traditional tourist trail, where our charity Moving Mountains have been developing the villages of Bupsa and Bumburi.

There are always lots of other medical students around, so we find it is very sociable and lots of people club together to go on weekend trips or treks after Electives.

Our guesthouse is a large three storey home in an area north of the city called Kapan, and it is in a secure compound. The office is within the compound too, so you always have access to our staff. The house is spacious and comfortable, the area is safe and quiet and a 25 minute drive from the Tribhuvan Hospital, which is in an area of town called Lazimpat.

Our role is to provide for your safety and welfare as well as co-ordinate with the hospital regarding your elective. Many students do apply directly to the hospital, but we are offering a homestay and support too. We also generally try to ensure that there are always two or three medical students staying in the house at any one time, which makes the whole shared experience much more fun and also allows you to share some costs like travelling to and from the hospital.

The house has rooms with beds and bedding, some are ensuite and there are also communal bathrooms. There is a lovely living area with TV, high speed wifi, a kitchen and a small garden. The house has a roof terrace which overlooks the city below and there are lovely walks in the Kapan area which is residential. Nearby there are plenty of shops for the basics, or you can pop into town for a meal. There is a lot to see and do in Kathmandu, and loads of places to visit on the weekends. Our staff can assist with whatever you would like to do.

There will be a housekeeper to keep things tidy and she will also prepare breakfast. Lunches are normally at the cafe in the hospital and you have various choices for dinner – either order a dinner at home in the morning, or eat out, or order a takeout. There are plenty of apps for food takeaways, the same as Deliveroo in the UK.

Transport to and from the hospital takes about 25 minutes and is best done by car. The best way these days is to order a car using one of several apps like Uber. Pathao is the most common local one and if you share the car, then it’s obviously much more economical. Bikes are possible but for safety reasons we would recommend a car.

Visa for medical elective in Nepal

You only need a normal tourist visa for this elective and it can be purchased before travel from the Nepalese Consulate or on arrival in Kathmandu. The most current information on costs can be found on the website for the Nepalese Consulate in the UK or on the website for the Department of Immigration in Nepal. A 30 day visa is USD$50 and a 90 day visa is USD$100, payable in all major currencies. Full details on the Nepalese visa can be found under ‘Information Nepal’, or by clicking here.

If you would like to visit a rural clinic then our charity Moving Mountains built one in the solu Khumbu region some years ago and we employ two community health workers there. It’s a health post and the remit of the CHW is quite limited, but they manage about 30 patients a week with basic complaints and it’s a lovely experience to drive/trek there (3 days from Kathmandu) and stay in a traditional Sherpa home for a few nights, explore the area, and come back. Moving Mountains has also built schools, monasteries and even a hydro electric plant in the area, and you can visit all of these places and spend some with with our co-ordinator Geljun Sherpa at his lodge in Bupsa which is a few hours walk from the clinic. If you would like to visit for a week then contact us, and hopefully you would also like to raise a bit of money for Moving Mountains to help contribute towards the salaries for the CHWs and the medicines which we try to provide for free.

There is a also Government clinic at a nearby village called Juving which you could also visit, and a private hospital supported by a Swiss NGO in a village called Khari Khola which is about an hour from our health post. It’s possible to visit all these places and get an idea of how health is tackled in these regions, plus also experience some wonderful Sherpa hospitality. It’s important to mention that as a student you would be limited in what you can actually do since there is no supervising Doctor, and the language is an issue. However, from a point of view of experience and knowledge, it’s a superb opportunity.

The Adventure Alternative Nepal office is located on the north east side of the city, about half an hour from the airport. Kapan area is above the city, so there is no smog, and has amazing views over the whole valley.

The route to the hospital is about 25 minutes and generally best done with an app like Pathao which costs about 500 rupees. You can download the app and order a car in minutes.

The teaching hospital is on the way to the popular tourist area of Thamel which takes a further ten minutes by car. You can get dropped at the Garden of Dreams and walk in, there are loads of restaurants, bars, shops and places to visit. It’s an energetic place! There’s a great Himalayan Java Coffee House just near the Garden of Dreams where you can hang out, get some coffee and cakes, use the wifi for work and watch the news.

The Adventure Alternative guesthouse is within a compound, perfectly safe, with bedrooms for seven people, some ensuite, kitchen and living room area, and a rooftop terrace. The AA Nepal office is within the compound too.

• Selection of normal clothing, should be conservative and comfortable but include rainjacket, umbrella and a warm jumper or jacket for the evenings. It will be much colder in the winter months.
• Comfortable footwear & trainers, and smarter shoes for your rounds. Flip flops or sandals also recommended. Trekking boots if you plan to go into the mountains.
• Protection from the sun, like a hat, sunglasses, suncream, especially if you planning to go trekking.
• Wash kit, but remember you can buy all consumables in the local shops. We provide all bedding and towels.
• Camera, mobile phone, laptop, tablet – plus charger units with two round pin plugs (some rooms do have three pin plug sockets. A surge protector is also recommended because of power cuts in the city.
• Several white coats, your own stethoscope, name badge, personal hand gel and hairnet if necessary, and a box of latex gloves
• Trekking clothes if you plan to get out on the trails

The guesthouse has showers and flush toilets and you can buy everything locally, such as shampoos and soaps and razors, so don’t feel you need to bring it all with you! Do however bring your own stock of work gloves, and your own white coats.

• We are very well established in Nepal (since 1996) and we have a particular interest in the developmental perspective and emphasis on global health education through our partnership with Moving Mountains and the local Village Development Committees.
• Flexible electives with no fixed dates, we work with you on your preferences.
• Good working relationships with placement hospitals and rural clinic.
• All our full time staff are experienced working with foreigners and their expectations
• We actively promote local economies in the villages through an equitable model of collaboration and ‘trade not aid’. In this case the trade comes from tourism.
• We do not sub-contract our responsibilities. AA Nepal is linked to AA UK and we work together to create professional, safe trips.
• Comprehensive pre-departure advice and support
• Safe and comfortable accommodation throughout your Elective in our guesthouse

The link with Moving Mountains

Adventure Alternative works with the Moving Mountains Trust which operates NGOs in Kenya and Nepal and carries out many long term projects and programmes. ‘MM’ was started by Director Gavin Bate during many years working in aid work and development, and ‘AA’ is the company that provides revenue and investment for many of them to become financially self-sufficient.

This relationship between company and charity began in 1991 and our elective programme has sprung from the relationships we have with the medical authorities and the communities which you can visit.

More than just an elective provider, we run long term ongoing medical programmes alongside our NGO and also at the request of local communities and hospitals. We have worked with medical authorities in many locations to ensure ongoing continuity as well as medical co-operation with other aspects of our work, for example the children’s homes we build and run, and the satellite private clinics which serve smaller remote communities. This is in Nepal and in Kenya.

Clearly there is an appeal in visiting a different country and culture, but this is also a chance to see relief work first hand and understand how an NGO runs.

Perhaps most importantly it will allow you to see how an organisation with a developmental perspective is upholding the principles of the Millennium Development Goals. Director Gavin Bate has been involved in the overseas development industry for many years and has developed a structure in Adventure Alternative which reflects the unprecedented opportunity of the post-2015 agenda once the MDGs expire. He regularly attends events at the Overseas Development Institute and Business Fights Poverty.

Adventure Alternative has won the World Responsible Travel Awards twice now, once for ‘Best Personal Contribution’ and once for ‘Best for Poverty Reduction’. The company also received accreditation by Sustainable Travel International for our internal processes. We have also won the Roger Diski Community prize delivered by the Association of Independent Tour Operators twice in a row, and we are founding members of Fair Trade Volunteering and the Tourism Concern Volunteering Group.

In all countries where we have set up full time offices and companies we use our sister charity, Moving Mountains to manage all our international development projects (Nepal and East Africa). Further information on our work in Nepal can be found on the Moving Mountains website.

Our ethos aims to make a profit with a sustainable tourism model that delivers positive economic benefits to the communities and areas where we work.