The MBBS program in Nepal has steadily gained recognition as one of the most structured and affordable medical education systems in South Asia. Students from Nepal and neighboring countries, especially India, Bangladesh, Bhutan, and Sri Lanka, are increasingly choosing Nepal as their preferred destination for medical education. One of the defining features of the MBBS program is the strong emphasis on compulsory clinical postings, which ensure that students acquire practical skills in addition to theoretical knowledge.
The duration of compulsory clinical postings in Nepal MBBS is a vital aspect of the curriculum. These postings give students hands-on exposure to patients, hospital systems, and community healthcare services, thereby equipping them with the confidence and competence needed for professional practice.
This article provides a comprehensive analysis of the duration, structure, subject-wise rotations, and importance of compulsory clinical postings in Nepal MBBS. It also highlights the challenges faced by students and the potential improvements that could further strengthen clinical training in the country.
The MBBS program in Nepal usually extends over 5.5 years, which includes both academic study and internship. The structure can be broadly divided into four phases:
Pre-clinical phase (Years 1–2)
Students focus on foundational subjects like anatomy, physiology, and biochemistry.
No direct patient interaction occurs at this stage.
Para-clinical phase (Year 3)
Subjects include pathology, microbiology, pharmacology, and forensic medicine.
Students begin limited exposure to hospitals through laboratory visits and demonstrations.
Clinical phase (Years 4–5)
Students undergo compulsory clinical postings in different hospital departments.
This phase lasts around 18–24 months.
Compulsory rotating internship (1 year)
Conducted after the final MBBS exams.
Students rotate through every major and minor department in hospitals and community health centers.
Together, the clinical phase and internship make up the compulsory clinical postings, accounting for nearly half of the MBBS duration in Nepal.
Students generally begin their clinical postings from the third year, although initial exposure is limited to observation in hospital wards and community medicine activities.
3rd year: Introductory clinical exposure, including pathology labs, community medicine visits, and basic patient interaction.
4th and 5th year: Formal compulsory clinical postings in major and minor specialties.
Internship (6th year): One-year compulsory internship with structured departmental rotations.
Thus, clinical postings are not restricted to the final internship but span across the last three years of MBBS in Nepal.
The duration of compulsory clinical postings is divided into two stages:
Total duration: 18–24 months
Students rotate across different specialties.
Each rotation lasts between 2 weeks and 12 weeks depending on the department.
Total duration: 12 months
Internship is compulsory for all graduates to be eligible for Nepal Medical Council registration.
Students undergo practical training in medicine, surgery, pediatrics, obstetrics and gynecology, and other specialties.
Combined, the total duration of compulsory clinical postings in Nepal MBBS is approximately 2.5 to 3 years.
The clinical postings are carefully structured to ensure balanced exposure across all fields of medicine. While exact duration may differ slightly among universities such as Tribhuvan University, Kathmandu University, and B.P. Koirala Institute of Health Sciences, the standard model follows Nepal Medical Council guidelines.
Clinical phase: 10–12 weeks
Internship: 10–12 weeks
Focus: history taking, physical examination, patient diagnosis, ward rounds, and emergency care.
Clinical phase: 10–12 weeks
Internship: 10–12 weeks
Focus: pre- and post-operative care, surgical procedures, trauma management, and emergency surgery.
Clinical phase: 6–8 weeks
Internship: 6–8 weeks
Focus: neonatal care, pediatric emergencies, child growth monitoring, and immunization practices.
Clinical phase: 6–8 weeks
Internship: 8–10 weeks
Focus: antenatal care, labor ward duties, gynecological surgeries, and family planning.
Clinical phase: 4–6 weeks
Internship: 4–6 weeks
Focus: preventive medicine, epidemiology, rural health camps, and health awareness campaigns.
Clinical phase: 2–4 weeks
Internship: 4 weeks
Focus: mental health assessment, counseling, psychiatric emergencies, and drug de-addiction programs.
Clinical phase: 2–4 weeks
Internship: 4 weeks
Focus: eye examination, vision testing, cataract diagnosis, and minor procedures.
Clinical phase: 2–4 weeks
Internship: 4 weeks
Focus: ENT examinations, audiometry, infection management, and basic surgical procedures.
Clinical phase: 2–4 weeks
Internship: 4–6 weeks
Focus: fracture treatment, orthopedic emergencies, plastering, and joint diseases.
Clinical phase: 2–4 weeks
Internship: 2–4 weeks
Focus: skin diseases, venereal diseases, and dermatological procedures.
Clinical phase: 2–4 weeks
Internship: 2–4 weeks
Focus: airway management, anesthesia administration, ICU duties, and pain management.
Integrated within medicine and surgery postings.
Focus: resuscitation, trauma care, and critical case handling.
| Department | Clinical Phase (Years 4–5) | Internship (1 Year) |
|---|---|---|
| Medicine | 10–12 weeks | 10–12 weeks |
| Surgery | 10–12 weeks | 10–12 weeks |
| Pediatrics | 6–8 weeks | 6–8 weeks |
| Obstetrics & Gynecology | 6–8 weeks | 8–10 weeks |
| Community Medicine | 4–6 weeks | 4–6 weeks |
| Psychiatry | 2–4 weeks | 4 weeks |
| Ophthalmology | 2–4 weeks | 4 weeks |
| ENT | 2–4 weeks | 4 weeks |
| Orthopedics | 2–4 weeks | 4–6 weeks |
| Dermatology | 2–4 weeks | 2–4 weeks |
| Anesthesiology | 2–4 weeks | 2–4 weeks |
Hands-On Training – Students move from textbook learning to real patient care.
Skill Development – Essential medical procedures like suturing, dressing, and diagnosis are practiced.
Patient Interaction – Builds communication and empathy with patients and families.
Professionalism – Exposure to hospital ethics and interdepartmental coordination.
Preparedness – Readies students for licensing exams and independent practice.
Despite the structured program, some challenges remain:
Overcrowding: Large student batches can limit one-on-one patient interaction.
Variation in exposure: Rural postings may lack advanced medical facilities.
Assessment stress: Continuous evaluation can overwhelm students.
Cultural barriers: Some students may face difficulty in communicating with patients in local dialects.
Standardizing posting durations across universities.
Introducing simulation-based training before clinical exposure.
Using digital logbooks for tracking skills and competencies.
Enhancing rural postings to strengthen public health training.
Expanding exposure to emerging specialties like geriatrics and palliative care.
The duration of compulsory clinical postings in Nepal MBBS is designed to provide students with broad, in-depth exposure to all areas of medicine. Students spend about 18–24 months in clinical postings during the academic years and complete a 1-year rotating internship afterward.
These postings ensure that graduates are not only knowledgeable but also skilled and confident in handling real-world medical situations. With structured rotations in medicine, surgery, pediatrics, obstetrics, community medicine, and other specialties, Nepal’s MBBS program ensures comprehensive clinical training aligned with international standards.
By the end of their MBBS journey, students emerge as competent medical professionals, well-prepared for both national and global healthcare challenges.