(KAHS) Karnali Academy of Health Sciences

Jumla, Nepal

Undergraduate Program (MBBS)

Karnali Academy of Health Sciences (KAHS) was established in 2011 by an Act of parliament of
Nepal in Jumla (mid-western hilly region of the country) to provide health services in the region, to
produce skilled health professionals, and to conduct research in different settings. The Academy
was established to promote health of Nepalese people, especially the people of the Karnali Province
and far western Nepal. We aim to produce knowledgeable, skilful, and well-motivated medical
graduates who are dedicated to patient care being socially responsible.
For the development of this curricular document KAHS formed an MBBS Curriculum
Development Committee having two core members. The Committee went through an exhaustive
but fruitful milestone. In the process of developing an appropriate medical curriculum for KAHS
MBBS program, the Committee studied the entire leading national and some international medical
curricula extensively and intensively. It studied the curricula of different Institutes, Academies and
Universities. They were Kathmandu University School of Medical Sciences, Tribhuvan University
Institute of Medicine, BP Koirala Institute of Health Sciences, Patan Academy of Health Sciences
of Nepal. Similarly, the Committee reviewed the curricula of All India Institute of Medical Sciences
(New Delhi), Jawaharlal Institute of Postgraduate Medical Education & Research (Pondichherry),
Maharashtra University of Health Sciences, and Rajiv Gandhi University of Health Sciences
(Karnataka), Sri Lakshmi Narayan Institute of Medical Sciences (Puducherry), Bangladesh Medical
and Dental Council, and the Oxford University. The curriculum has been designed as per the
standards of the Nepal Medical Council. The academy is aware of the fact that there is “no best
way” but always “a better way” and is always committed to improve the curriculum, as necessity
demands.
KAHS has adopted the recent innovation in the field of medical education. The MBBS curriculum
emphasizes the common health problems prevalent in remote and hilly region of Nepal like Karnali.
Early exposure to clinical and community medicine, evidence-based practice, integrated approach
of teaching/learning method, student centred, and self-directed with adequate community exposure
are the key strategies of MBBS curriculum of KAHS.
Curriculum is a dynamic process which needs to be updated and revised regularly as per need of the
community and the country. Trend of medical education has been changing from traditional system
to innovative type where students are actively engaged in their learning process and the teachers act
as facilitator. The students learn by themselves with their active participation, self-directed learning

approach. It has been proven by educational research that knowledge and skill acquired by self-
directed learning which enhances memory. In view of this fact, KAHS has designed a hybrid model

of integrated, community based, self-directed, problem based medical curriculum.
Due to its distant location, geographical circumstance, and difficult road access, the Karnali
Province remains isolated from federal government’s reach. We hope the Academy designs
appropriate health science academic curricula, and it carries out need-based research of national or
international standards, to uplift the health awareness, health status, and reduce the burden of
morbidity and mortality of the region and surrounding districts. In turn, KAHS hopes that its health

Karnali Academy of Health Sciences

viii

sector activities would help overall development of the region. The curriculum has explicitly
mentioned its components as description of the course like learning objectives, content, hours,
teaching/learning method and evaluation scheme has been placed distinctly. The duration of the
course is five and half years which consist of four and half years of academic study and one year of
compulsory rotating internship in various departments.
The committee members (Prof. Dr. Sunil Budhathoki and Dr Kapil Amgain) after reviewing the
curricula of various Institutions, planned and designed the MBBS program goals and aims, set the
program objectives and the course contents, teaching-learning methods, academic calendar, and
modality of student evaluation for theory as well as practical examinations.
In the process, the Committee also looked into the KAHS Act and other rules and regulations
related to academic activities. At the same time, the committee members also followed the WHO
guidelines on production of health professionals and the guidelines of the World Federation for
Medical Education (WFME) on starting a New Medical School. While preparing the curriculum,
we looked into the advancement in educational technology, namely creating an environment for
active learning by the students and use of technical devices and media in education.
A Curriculum Development Workshop was organized in KAHS, Jumla and in Kathmandu engaging
the stakeholders to finalize the document. Many people were involved in the process of curriculum

We are also grateful to all the experts, Prof. Dr. Ramesh Kanta Adhikari, Prof. Dr. Jagdish Prasad
Agrawal, Prof. Dr. Kanak Babadur Raut, Prof. Dr. Trilok Pati Thapa, Prof. Dr. Mandira Shahi, Prof.
Dr. Ram Chandra Adhikari, Prof. Dr. Sekhar Babu Rizyal, Prof. Dr. Dinesh Banstola, Prof. Dr.
Saraswoti Neupane, Prof. Dr. Prakash Baral, Dr. Sambhu Upadhaya, Dr. Sangha Ratna Bajracharya,
Dr. Nirju Ranjit, Dr. Asish Upadhaya, and Dr. Shailesh Mani Pokhrel for their expertise, suggestion
and providing necessary materials. Similarly, we would like to express our special thanks to Prof.
Dr. Bharat Mani Pokharel (Academic Adviser, KAHS), Prof. Dr. Bishnu Hari Paudel (Medical
Educationalist and Physiologist, BPKIHS), and Prof. Dr. Sunu Dulal.
We would like to express our gratitude towards Prof. Dr. Kiran Regmi, Prof. Dr. Bhola Ram
Shrestha, Prof. Dr. Tarun Paudel, Prof. Dr. Kamal Raj Sharma, Prof. Dr. Bijay Aryal, Dr. Niresh
Thapa, Dr. Seshananda Sanjel, Dr. Deepak Sharma, Mr. Prem Prasad Pant, Dr. Bishal Pokhrel, Dr.
Poojan Kumar Rokaya, Dr. Suryaman Limbu, Dr, Gakul Bhatta, Dr. Sanjib Pandit, Dr. Sandeep
development directly and indirectly. First of all, we would like to express our sincere gratitude to
our Vice Chancellor Dr. Mangal Rawal for his regular support and guidance. We would like
to thank our Rector, Dr. Niresh Thapa, Registrar, Nirpendra Mahat and then Dean, Dr. Ramesh
Bhattarai for their valuable support. Faculty members of KAHS who were involved in the process
of curricular draft preparation. We are also thankful to people of the Jumla who took part active role in
questionnaire session for the need of MBBS program and the quality of product thus produced in
the region. I would like to thank previous executives of KAHS Former VC Prof. Dr. Rajendra Raj
Wagle, Rector Dr. Dharma Raj Shrestha and Dean Prof. Dr. Resham B. Rana for their great help.

Shrestha, Dr. Nirajana Kayastha, Dr. Poojan Kumar Rokaya, Dr. Dhan Karki, Dr. Rajib Shah,
Dr. Dhiraj Gurung, Dr. Ganesh Prasad Neupane, Dr. Maya Rokaya, without whom this herculean
task of drafting and finalizing the curriculum would have Rai and Dr. Yegya been incomplete. We
hope we will get similar guidance and support in the future as well.

MBBS Curriculum – Integrated Basic Medical Sciences

ix

We would have failed to perform our duties without the supporting hands of KAHS administrative
staffs including Mr. Indra Raj Dangi, Mr. Amrit Bdr. Bhandari, Mr. Sameer Neupane, Mr. Binod
Adhikari, Mr. Jay Bahadur Manandhar, Mrs. Sabina Bhandari, Mr. Dan Bahadur Makim. We also
thank Mr. Raju Budhathoki (Chief Examination Division, Institute of Medicine) for his valuable
suggestions to improve the standardization of examination system. Finally, we would like thank all
the stakeholders who have connected in the process of curriculum development process of KAHS
directly and indirectly.
Last but not the least; it is merely impossible to finalize this curriculum without the contribution of
following various subject experts.

Prof. Dr. Sunil Budhathoki
Dr. Kapil Amgain
MBBS Curriculum Development Core Committee

MBBS CURICULUM DEVELOPMENT COMMITTEE

Curriculum); Head of Department of Clinical Anatomy and Cell Biology, KAHS
Prof. Dr. Rajendra Raj Wagle, Former Vice Chancellor, KAHS
Prof. Dr. Resham Bahadur Rana, Former Dean, School of Medicine, KAHS
Prof. Dr. Bharat Mani Pokhrel, Academic Adviser, KAHS
Prof. Dr. Mandira Shahi, Medical Educationist and Director, NCHPE, IOM, TU
Prof. Dr. Bishnu Hari Paudel, Physiologist and Medical Educationist, BPKIHS
Prof. Dr. Sunil Budhathoki, Coordinator (Clinical Sciences Curriculum); Department of Pediatrics
Dr. Kapil Amgain, Coordinator (Basic Medical Sciences and Community Health Sciences

Karnali Academy of Health Sciences (KAHS) was established in 2011 by an Act of parliament of
Nepal in Jumla (mid-western hilly region of the country) to provide health services in the region, to
produce skilled health professionals, and to conduct research in different settings. The Academy
was established to promote health of Nepalese people, especially the people of the Karnali Province
and far western Nepal. We aim to produce knowledgeable, skilful, and well-motivated medical
graduates who are dedicated to patient care being socially responsible.
For the development of this curricular document KAHS formed an MBBS Curriculum
Development Committee having two core members. The Committee went through an exhaustive
but fruitful milestone. In the process of developing an appropriate medical curriculum for KAHS
MBBS program, the Committee studied the entire leading national and some international medical
curricula extensively and intensively. It studied the curricula of different Institutes, Academies and
Universities. They were Kathmandu University School of Medical Sciences, Tribhuvan University
Institute of Medicine, BP Koirala Institute of Health Sciences, Patan Academy of Health Sciences
of Nepal. Similarly, the Committee reviewed the curricula of All India Institute of Medical Sciences
(New Delhi), Jawaharlal Institute of Postgraduate Medical Education & Research (Pondichherry),
Maharashtra University of Health Sciences, and Rajiv Gandhi University of Health Sciences
(Karnataka), Sri Lakshmi Narayan Institute of Medical Sciences (Puducherry), Bangladesh Medical
and Dental Council, and the Oxford University. The curriculum has been designed as per the
standards of the Nepal Medical Council. The academy is aware of the fact that there is “no best
way” but always “a better way” and is always committed to improve the curriculum, as necessity
demands.
KAHS has adopted the recent innovation in the field of medical education. The MBBS curriculum
emphasizes the common health problems prevalent in remote and hilly region of Nepal like Karnali.
Early exposure to clinical and community medicine, evidence-based practice, integrated approach
of teaching/learning method, student centred, and self-directed with adequate community exposure
are the key strategies of MBBS curriculum of KAHS.
Curriculum is a dynamic process which needs to be updated and revised regularly as per need of the
community and the country. Trend of medical education has been changing from traditional system
to innovative type where students are actively engaged in their learning process and the teachers act
as facilitator. The students learn by themselves with their active participation, self-directed learning

approach. It has been proven by educational research that knowledge and skill acquired by self-
directed learning which enhances memory. In view of this fact, KAHS has designed a hybrid model

of integrated, community based, self-directed, problem based medical curriculum.
Due to its distant location, geographical circumstance, and difficult road access, the Karnali
Province remains isolated from federal government’s reach. We hope the Academy designs
appropriate health science academic curricula, and it carries out need-based research of national or
international standards, to uplift the health awareness, health status, and reduce the burden of
morbidity and mortality of the region and surrounding districts. In turn, KAHS hopes that its health

Karnali Academy of Health Sciences

viii

sector activities would help overall development of the region. The curriculum has explicitly
mentioned its components as description of the course like learning objectives, content, hours,
teaching/learning method and evaluation scheme has been placed distinctly. The duration of the
course is five and half years which consist of four and half years of academic study and one year of
compulsory rotating internship in various departments.
The committee members (Prof. Dr. Sunil Budhathoki and Dr Kapil Amgain) after reviewing the
curricula of various Institutions, planned and designed the MBBS program goals and aims, set the
program objectives and the course contents, teaching-learning methods, academic calendar, and
modality of student evaluation for theory as well as practical examinations.
In the process, the Committee also looked into the KAHS Act and other rules and regulations
related to academic activities. At the same time, the committee members also followed the WHO
guidelines on production of health professionals and the guidelines of the World Federation for
Medical Education (WFME) on starting a New Medical School. While preparing the curriculum,
we looked into the advancement in educational technology, namely creating an environment for
active learning by the students and use of technical devices and media in education.
A Curriculum Development Workshop was organized in KAHS, Jumla and in Kathmandu engaging
the stakeholders to finalize the document. Many people were involved in the process of curriculum

We are also grateful to all the experts, Prof. Dr. Ramesh Kanta Adhikari, Prof. Dr. Jagdish Prasad
Agrawal, Prof. Dr. Kanak Babadur Raut, Prof. Dr. Trilok Pati Thapa, Prof. Dr. Mandira Shahi, Prof.
Dr. Ram Chandra Adhikari, Prof. Dr. Sekhar Babu Rizyal, Prof. Dr. Dinesh Banstola, Prof. Dr.
Saraswoti Neupane, Prof. Dr. Prakash Baral, Dr. Sambhu Upadhaya, Dr. Sangha Ratna Bajracharya,
Dr. Nirju Ranjit, Dr. Asish Upadhaya, and Dr. Shailesh Mani Pokhrel for their expertise, suggestion
and providing necessary materials. Similarly, we would like to express our special thanks to Prof.
Dr. Bharat Mani Pokharel (Academic Adviser, KAHS), Prof. Dr. Bishnu Hari Paudel (Medical
Educationalist and Physiologist, BPKIHS), and Prof. Dr. Sunu Dulal.
We would like to express our gratitude towards Prof. Dr. Kiran Regmi, Prof. Dr. Bhola Ram
Shrestha, Prof. Dr. Tarun Paudel, Prof. Dr. Kamal Raj Sharma, Prof. Dr. Bijay Aryal, Dr. Niresh
Thapa, Dr. Seshananda Sanjel, Dr. Deepak Sharma, Mr. Prem Prasad Pant, Dr. Bishal Pokhrel, Dr.
Poojan Kumar Rokaya, Dr. Suryaman Limbu, Dr, Gakul Bhatta, Dr. Sanjib Pandit, Dr. Sandeep
development directly and indirectly. First of all, we would like to express our sincere gratitude to
our Vice Chancellor Dr. Mangal Rawal for his regular support and guidance. We would like
to thank our Rector, Dr. Niresh Thapa, Registrar, Nirpendra Mahat and then Dean, Dr. Ramesh
Bhattarai for their valuable support. Faculty members of KAHS who were involved in the process
of curricular draft preparation. We are also thankful to people of the Jumla who took part active role in
questionnaire session for the need of MBBS program and the quality of product thus produced in
the region. I would like to thank previous executives of KAHS Former VC Prof. Dr. Rajendra Raj
Wagle, Rector Dr. Dharma Raj Shrestha and Dean Prof. Dr. Resham B. Rana for their great help.

Shrestha, Dr. Nirajana Kayastha, Dr. Poojan Kumar Rokaya, Dr. Dhan Karki, Dr. Rajib Shah,
Dr. Dhiraj Gurung, Dr. Ganesh Prasad Neupane, Dr. Maya Rokaya, without whom this herculean
task of drafting and finalizing the curriculum would have Rai and Dr. Yegya been incomplete. We
hope we will get similar guidance and support in the future as well.

MBBS Curriculum – Integrated Basic Medical Sciences

ix

We would have failed to perform our duties without the supporting hands of KAHS administrative
staffs including Mr. Indra Raj Dangi, Mr. Amrit Bdr. Bhandari, Mr. Sameer Neupane, Mr. Binod
Adhikari, Mr. Jay Bahadur Manandhar, Mrs. Sabina Bhandari, Mr. Dan Bahadur Makim. We also
thank Mr. Raju Budhathoki (Chief Examination Division, Institute of Medicine) for his valuable
suggestions to improve the standardization of examination system. Finally, we would like thank all
the stakeholders who have connected in the process of curriculum development process of KAHS
directly and indirectly.
Last but not the least; it is merely impossible to finalize this curriculum without the contribution of
following various subject experts.

Prof. Dr. Sunil Budhathoki
Dr. Kapil Amgain
MBBS Curriculum Development Core Committee

MBBS CURICULUM DEVELOPMENT COMMITTEE

Curriculum); Head of Department of Clinical Anatomy and Cell Biology, KAHS
Prof. Dr. Rajendra Raj Wagle, Former Vice Chancellor, KAHS
Prof. Dr. Resham Bahadur Rana, Former Dean, School of Medicine, KAHS
Prof. Dr. Bharat Mani Pokhrel, Academic Adviser, KAHS
Prof. Dr. Mandira Shahi, Medical Educationist and Director, NCHPE, IOM, TU
Prof. Dr. Bishnu Hari Paudel, Physiologist and Medical Educationist, BPKIHS
Prof. Dr. Sunil Budhathoki, Coordinator (Clinical Sciences Curriculum); Department of Pediatrics
Dr. Kapil Amgain, Coordinator (Basic Medical Sciences and Community Health Sciences