Only one third of the specialist positions sought by the Health Ministry got applicants, in yet another grim reminder that specialist doctors do not want to work in government hospitals.

The ministry on February 17 had announced 117 vacancies for doctors while 38 doctors expressed their interest to work. Some of the positions including of ENT surgeons and medical generalists saw zero applications for the required 32 positions of specialties. Among the 22 anaesthesiologists sought, two doctors submitted their applications but did not show up for an interview last week.

The inability to attract specialist doctors remains a longstanding problem of the government. Before announcing the vacancies on February 17, the ministry had notified vacancies for 158 specialists on November 3 last year. Only 135 had applied then and 41 hired. “We have already proposed a 50 percent increase in the allowance for specialist doctors. Yet they do not want to work with us,” said Health Minister Gagan Thapa.

The ministry has completed interviews and the hiring process is underway. Yet, given the low application rate, officials are weighing other options to send specialist doctors in partnership with its academies, big private hospitals and some INGOs.

Recently, the government and the Nick Simons Institute, an NGO, have been in talks about increasing the salary of specialist doctors in 10 districts. Once an agreement is reached, under the District Hospital Support Partnership Programme, the latter will top up the additional money required for the salary for these doctors. The NSI has already hired 18 general physicians who are serving in various rural districts.

The ministry is in talks with the NSI after the failure to increase the allowance to specialist doctors by 100 percent.

A major reason for doctors not joining the government service is the meagre pay despite expensive post-graduate studies. It requires over Rs5 million to do a post-graduate course in medicine but the government pays just over Rs40,000 in monthly salary.

The Health Ministry is also collaborating with the Tribhuvan University Institute of Medicine and the National Academy of Medical Sciences, which has been deploying specialist doctors in Tulsipur, Rajbiraj, Mahendranagar, Sarlahi, Nuwakot and Rolpa, among other districts.

“These are short-term initiatives. To sustain these efforts, we should produce our own specialist doctors. For this, specialty courses in certain subjects will be run in big government hospitals outside the Valley from this year,” said Minister Thapa.

Given the acute shortage of specialist doctors, a committee led by Dr Chop Lal Bhusal, former chairman of the Nepal Health Research Council, has recommended leniency in their appointment and waiver of the compulsory one-year experience for doing a post-graduate course in subjects including general medicine, anaesthesiology, radiology and pathology at state-run hospitals.

The committee has proposed several regional and zonal hospitals where the courses could be run. They include Mechi Zonal Hospital, Jhapa; Koshi Zonal Hospital, Morang; Seti Zonal Hospital, Dhangadhi; and Sub-Regional Hospital, Dadeldhura.