Overview

Medical elective in Nepal

Adventure Alternative have been organising medical electives in Kathmandu since 2004, forming strong connections with both the Tribhuvan Teaching hospital, and the Nepal Medical College and Teaching Hospital, both located within this bustling capital of the Himalayan Kingdom. We also run a community health clinic up in the mountains with our charity Moving Mountains, and opportunities are also available to spend time there but without supervision from a Doctor (we employ nurses only in the villages). We also run annual free medical camps for the Sherpa communities in this area which you are welcome to join if the dates coincide. 

We have a lovely guesthouse in Kathmandu which is run as a homestay by Pasang Tendi Sherpa and his wife Sarasoti. They have two children and there is an office for the Adventure Alternative Nepal company, plus a big garden and room for ten visitors in comfortable rooms. Meals are provided, and local transport to the hospital is only fifteen minutes away. 

Medical elective types

The elective program is not only open to Medical students; we also have elective opportunities available for Midwifery, Physiotherapy, Dentistry and Nursing students too.  We can also cater for professional placements and work experience. Please contact us in advance if you have a preference or enquiry about a specific type of elective. The hospital is a major teaching hospital and the standard elective programme is wide ranging and visits most departments. 

Independent travel on a medical elective

Whilst in Kathmandu there is a lot to do. The city is full of fascinating tours and history, great restaurants and temples such as Pashupatinath and Boudhanath. The area of Thamel is the main Western hang out where you can relax in gardens or haggle over great bargains. Since the earthquake in April 2015, many of the great monuments have been damaged but much still remains. You can still visit Patan and even the ancient town of Bakhtapur and see the temples, and in Kathmandu the huge Boudinath stupa is still standing, as are many of the other attractions. 

For long weekends you can go to Pokhara for some fresh air near the Annapurna range, or drive up to famous places like Nagarkot outside Kathmandu city. Do take advice from Pasang about how best to travel and always stick to safe transport even if it's a bit more expensive. 

Application for a medical elective in Nepal

To confirm a place on an elective you should complete the application form online and give us your preferred dates. Andy MacDonald will then contact you to start the process for your elective at Tribhuvan teaching hospital and make all the arrangements in advance. We do 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. We can also provide a confirmation letter which will have all the information required for your University application (name of supervisor, hospital details, address of Adventure Alternative Nepal, etc).

Training for a medical elective

No specific training is required before an Elective however we would highly recommend that you read up on Nepal before you travel, in particular the areas that you are planning to travel to. Prior knowledge on the history and local customs will only enhance your trip. We also strongly recommend that you examine the ethics of your trip by reading our article titled Ethics of a Medical Elective, and also Resources and Reading. We really cannot stress enough the need to read widely about the nature of electives, the pros and cons and the wider picture regarding development and how we attempt to uphold the principles of the MDGs and the NGO Code of Conduct.

Do also learn some key words and phrases in Nepali and be prepared for standard customs on meeting people. Pasang and Sarasoti in the homestay will help you with this, since you will be living in their home, but it is good to do some research before leaving home.

Rural clinic for your medical elective

If you would like to stay on in Nepal and visit a rural clinic, our charity Moving Mountains has built one in the village of Bumburi where we have been running a very long running health campaign for the Sherpa and Rai communities in the solu Khumbu. You can see all the information on this clinic here. It would be wonderful if you spent some time there and raised some funds for the salaries of the nurses and maybe some medical items and pharmaceuticals. It might be relevant for your elective but there is no supervision from a Doctor. A lot of the work we do there is primary healthcare, monitoring, teaching and handling local medical situations. We deal with a lot of ante and post natal scenarios plus long term illnesses that more or less need palliative care. 

To reach the clinic is quite an adventure. You can either fly to Lukla and walk south (rather than north on the Everest trail), or you can take a bus and jeep to the administrative town of Saleri (where there is a district hospital) and then trek up the trails to Bumburi itself. This is a very traditional Sherpa village and you can stay in the home of Ang Chhongba Sherpa, with whom Gavin Bate started Moving Mountains in Nepal over twenty years ago. The clinic is very close to his house and the demographic of patients is very wide. We manage several hundred villagers, but we are looking to increase our remit, hopefully with financial support from people like yourselves. 

Staying at our guesthouse

At the house you can relax and move into your room. The house is spacious and comfortable. The area is safe and quiet and about ten minutes drive or twenty minutes walk from the Tribhuvan Hospital, and a little further to the city centre. The large supermarket nearby (Bhat Bhateni) sells everything you may need and there are ATM machines which accept all the major cards though you might want to let your bank know that you are going to be in Nepal. Expect there to be a 3.5% charge on cash withdrawals from ATMs. 

 This area of the ring road is about 20 minutes drive from the airport. We have wi-fi in the house and you can use your laptop or phones for skypeing home. Plugs are round two pin or round three pin so bring a convertor. There is a big issue in the city with power cuts but we have solar panels and storage batteries to handle all the usual needs such as charging. When the power is down the wifi won’t work but you can still get someone to call you on a VoIP line.

 There is no need to bring sleeping bags, towels or bedding, that is all provided. No need to fill your suitcases with toiletries either, you can buy everything in the supermarket nearby.

Itinerary

 Medical elective in Nepal itinerary

The medical elective programme in Nepal is based on a minimum duration of 4 weeks. We will talk to you individually to organize the specific dates, locations and durations that fit with your availability and aspirations.

 At the hospital you will work with the medical director or consultant to discuss your exact daily routines and timings. You will be able to mention your preferences beforehand and when you arrive, and you will find all the medical staff happy to try and accommodate you. There is a process of selection to Tribhuvan Teaching hospital but we help you with this and make the necessary arrangements, which are much easier to do on the ground. Since we are very well known to the elective staff, we can take care of any red tape and paperwork before you arrive, however you will need to supply a letter from your university and an application form for the hospital. 

At the hospital you will find various departments including Anaesthesiology, Anatomy, Biochemistry, Clinical Pharmacology, Clinical Physiology, Dental Surgery, Dermatology, ENT, Emergency Medicine & General Practice, Forensic Medicine, Obstetrics and Gynaecology, General Surgery, Internal Medicine, Orthopedic Surgery, Ophthalmology, Psychiatry & Mental Health, Pathology, Microbiology, Radiology and Community Medicine. It is possible to specialise in one department or to pick a number of departments to experience. 

During the elective period you will attend 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. Most students find they leave the house at 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. 

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 afterwards. 

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.

Logistics and arrangements for the medical elective

Our staff will have your information and provide the on-ground logistics for you on arrival at Tribhuvan International Airport, Kathmandu. You are assisted to the hospital initially to meet the staff, after which you organise yourself. You receive an allowance in local currency to take care of your food and transport daily costs which will be distributed upon arrival.

The guesthouse we run is comfortable and spacious with wifi, rooms for up to ten people, a big living room and kitchen area, roof balcony and large garden. It is only used for medical students and volunteers so it's perfect for long term stays, and Pasang Tendi Sherpa and his wife live there with their two children Jubilee and Elli Dolma. Sarasoti looks after the meals, but you can eat out when you want. Pasang can help with any weekend visits or treks, since the company is a registered trekking organisation too. 

Sometimes we have a full house, with people from many different countries, and other times there might be just a few people. In our experience people find the homestay and elective experience very enjoyable and sociable and good for their career, and we would be happy to put you in touch with previous students who have come to Nepal with us. 

Going to our rural clinic in Bumburi

If you would like to stay in Nepal and experience a rural clinic up in the mountains then feel free to ask us about visiting Bumburi in the solu Khumbu, staying in a traditional Sherpa home and helping the two nurses work in the health post that has been built by Moving Mountains Trust, the charity that Gavin started more than twenty years ago. Here you can get involved with all the primary healthcare programmes we run, plus diagnosis and treatment of symptoms, ante and post natal procedures, and health awareness classes in the schools. 

For this programme you would need to travel overland to Bumburi, either by flying to Lukla or driving to Saleri and walking to this area in Juving district of solu Khumbu. It's in the Everest region, so one option might be to trek through the villages and stop off at the clinic, and then carry on all the way to Everest base camp. We would ask that you cover your costs of staying in the homes but also to raise some money for Moving Mountains Nepal, in order to help us pay the nurses salaries and buy medical items and pharmaceuticals. 

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. A 30 day visa is USD$40 and a 90 day visa is USD$100, payable in most major currencies. A passport photograph is required to get the visa (you also need four for the hospital, so best to get a set made). On the Visa application form it will ask you where you are staying in Kathmandu, please use this address: Adventure Alternative Nepal, Chakrapath Dungedhara, Bansbari, Narayan Gopal Chowk, Kathmandu.

Cost

Medical Elective Nepal cost from £950.00

INCLUDES

  • £950 is based on a 4 week Elective, any extra weeks are £150 per week
  • Airport transfers
  • Transport to and from the hospital daily (self organised)
  • Accommodation and all costs in our homestay guesthouse in Kathmandu
  • Weekly allowance for meals and bottled water
  • The cost of your placement at the hospital plus all necessary medical supervision

EXCLUDES

  • Vaccinations estimate (£70)
  • Visa (15 days=$25, 30 days=$40, 90 days=$100)
  • Airfare estimate (£450 - £600)
  • Travel Insurance estimate (£70)


INSURANCE

You will need to organise your own insurance for your elective. If you plan to do other activities such as trekking during your trip you will of course need to check that these are covered by your policy, including helicopter rescue from high altitudes.

LOCAL PROVIDERS

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 Pasang Tendi Sherpa runs Adventure Alternative Nepal. He is the director of the company in Nepal, looking after every trek, visit or tour, from meeting people at the airport to taking them to the summit of Mt Everest! He has made nine expeditions to Mt Everest. He speaks excellent English and will be on hand all the time. AA Nepal company is a registered tour operator and looks after all of your daily needs and manages you whilst in Nepal. Check out the website - www.adventurealternativenepal.com - for more information on the house and location. 

Clothing

Medical Elective Nepal Clothing

  • Bag or suitcase, and hand luggage
  • Selection of clothing, should be conservative and comfortable and at least four or five sets (there are laundry facilities in the guesthouse)
  • Rainjacket, umbrella and a warm jumper or jacket for the evenings. It will be very cold 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. If you planning to go trekking then sun protection is equally as important.
  • Wash kit, but remember you can buy all consumables in the local shops. There is a Bhat Bhateni supermarket very near the house. We provide all bedding, towels and mosquito nets.
  • Camera, mobile phone, laptop, tablet - plus charger units with two pin plugs. A surge protector is also recommended because of power cuts in the city. We use solar panels and storage batteries when necessary. You might want to bring spare phone batteries too. 
  • Nepali phrase book, pens and papers
  • Several white coats, your own stethoscope, name badge, personal hand gel and hairnet if necessary, and a box of latex gloves 
  • Personal first aid kit

You will be expected to dress and behave quite conservatively, and always arrive at work clean and on time. Your attitude and demeanour and clothing will be noted by everyone, and in fatc form part of your assessment from the elective supervisor. Always wear a white coat at hospital. 

The guesthouse has showers and flush toilets but always take your hand gel and always wash your hands and keep as clean as possible. 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.

In summer stick to lightweight light clothing, it can get pretty hot inside, but no shorts or any sort of revealing clothing. In winter it can be very cold, so plenty of jumpers and warm clothing. The house has storage heaters in the rooms but no radiators. We have plenty of blankets and bedding. 

In the guesthouse you can wear pretty much what you would wear at home. There is a washing machine so don't worry about bringing everything you need for a month. Take a personal first aid kit as well. Common ailments include GI infections, headaches (often related to the heat and sun and dehydration) and occasionally a common cold. Please take your anti-malarial prophylactics very seriously, especially in the summer, and follow the entire course and don't miss out on any tablets. We cannot be held responsible if you forget to take, or choose not to take, such an important drug.

We have a policy and documentation for dealing with injuries you might receive at work, particularly related to the HIV AIDS virus. Please make sure you read our documentation very carefully on how to look after yourself, what to do if you get an accidental cut from a needle or if you are at all concerned about being in contact with potentially infected blood. Similarly you must ensure you are aware of where the nearest WHO clinic is, and where you can access the necessary retrovirals quickly. Some universities can supply these PEP kits for you, but you will find they are accessible in all major hospitals in Nepal. 

In terms of the best personal first aid kit and vaccinations you should get in advance of travelling to Nepal for a medical elective we advise that you visit your GP and also a specialist organisation like Interhealth, with whom we have a long standing contractual relationship. They provide a telemedicine service for us, which you have full access to as a client, but they also provide pre-trip screening (including psychological), an excellent preparation course and specific advice on anti-malarials for the areas you will be visiting. We strongly recommend Interhealth as an important place to visit prior to your medical elective. 

Why Us

Medical elective in Nepal - why us?

  • 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. 
  • Our funding model fulfils the criteria of Fair Trade Volunteering.
  • All our full time staff are experienced working with foreigners and western expectations
  • We actively 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
  • Our UK office staff regularly visit Kenya & Nepal so you can chat to people who understand what it's like to go to there for the first time
  • We run free Medical Camps in Nepal and depending on your Elective dates it may be possible to get involved with these
  • Comprehensive pre-departure advice and support, 24/7 medical support during your trip and qualified supervision who have worked with us for many years.
  • Safe accommodation and a cash kitty for your use to buy your own food and cook yourselves, or staff on hand to help teach you local culinary cuisine!
  • We work in just a few destinations where we have worked hard to promote long term relationships that have a clear benefit for all stakeholders.
  • Very interesting variety of cases, treatments and patient care in different .environments offering a chance to expand your medical knowledge and enhance understanding of disease progression.
  • Our electives meet the requirements of British medical schools.

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 will 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. 

We provide the convenience of an organised elective, and we work to ensure that the time overseas is a highlight of your undergraduate years as well as a necessary addition to your competencies and clinical experience. You can also explore non-clinical skills like teaching, or getting involved with the Moving Mountains programmes, such as helping out in the children’s homes. 

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 to ensure that th

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Rating

This medical elective in Nepal is run at the Tribhuvan teaching hospital for a minimum of four weeks and is an excellent opportunity for your professional training. Accommodation is in our own home stay near the city, a beautiful big house with all the facilities, plus you have the option of going to visit our rural health post in the solu Khumbu or going on a trekking holiday while in the country. Dates are flexible and all the organisation with the teaching hospital is taken care of by the AA staff. 

Key Information
  • Duration 4 weeks (minimum)
  • Numbers 1+
  • Comfort Guest House