Information Booklet-2017New_BlinkIco

MBBS Information Booklet-2017

1. Introduction

Patan Academy of Health Sciences (PAHS) is a public, autonomous, not-for-profit, Health Science University established in 2064 B.S. (2008 A.D.) with the charter granted by the Parliament of Nepal. PAHS aims to work in close partnership with the National Health System to improve the health care services in the remote/rural areas through, among others, producing technically competent and socially responsible health care personnel, facilitating their deployment in the underserved rural areas and providing the needed technical and professional support while they work there.

In order to achieve this goal, PAHS School of Medicine has adopted innovative strategies in medical education, especially in areas such as student selection, curriculum, teaching-learning methodology, student assessment, faculty recruitment and community engagement. PAHS MBBS curriculum focuses on holistic care of the individual and community.

For inspiring its graduates to serve in remote/rural areas of Nepal, PAHS has adopted a multi–pronged approach which includes preferential enrollment of students of rural origin, training them in a value based curriculum with emphasis on community health sciences and exposing them to rural health care institutions. By helping them acquire required competencies and instilling values of social responsibility in its graduates, PAHS intends to inspire/motivate and enable its graduates to become health care providers in the challenging settings of rural Nepal, as well as to become future leaders of Nepal’s health care system.

PAHS School of Medicine runs the teaching learning activities within the complex of Patan Hospital, the tertiary care institution, upon which PAHS is founded and which provides a natural ambience for learning holistic and compassionate care. Its history of more than 25 years (more than 50 years if one takes into account its mother institution Shanta Bhawan) with an enormous trust that the general public places on it, provides the very basis for this.

PAHS has already built a rich network with prestigious academic institutions and medical education leaders in many universities around the world so as to learn and benefit from the national as well as international experiences and best practices for the proper development, effective implementation and the continuous improvement of the quality of its academic programs.

2. Overview of PAHS MBBS Curriculum

The total duration of PAHS MBBS curriculum is five and a half years. Different components of the curriculum are as follow:

Components

Foundation course

Basic Sciences

Clinical Sciences

Internship

Junior Clinical Clerkship

Rural Rotation/

Advanced Clinical Clerkship

Duration

2 months

2 years

1½ years

1 year

1 year

Community Health Sciences and Medical Humanities will go longitudinally over the entire course.

Two-month long Foundation Course is designed to teach the students about the fundamental concepts of ethics, professionalism, communication skills, basic principles of community health sciences and the basics of history taking and physical examination skills, under the course called Introduction to Clinical Medicine (ICM).

During the two years long Basic Sciences Course, students are introduced to fundamental concepts about the structure and function of the human body in health and disease as well as the principles of using medicine to treat disease according to organ-systems of the body in an integrated manner rather than disciplinary approach. This will help them develop an insightful and meaningful understanding of the basic sciences concepts and principles as applied in analyzing and resolving real patient problems using the Problem Based Learning method.

During Clinical years students will rotate through different clinical specialties in the hospitals, learning how to evaluate, diagnose and take care of patient’s health problems in an evidence based scientific approach guided by compassion and empathy. During the final year the students will undergo six months of rural rotation where they will learn to manage patients in resource poor settings.

Community Health Sciences (CHS) forms a core part of the curriculum and occupies 25% of the curricular time. PAHS believes that in order to make a significant impact on the health of Nepali people, medical graduates need to have a firm grasp of concepts and principles of preventive health and social determinants of health as well as having skills in health management, biostatistics, epidemiology and research. The course will help the students learn about the health care system in Nepal, their roles in the system and will provide the opportunity to think about how one  might improve that system.

Primary Care is internationally recognized to be a key area that must be implemented to make a nation’s health care system effective and efficient. PAHS is including a longitudinal primary care course during the Clinical Sciences years, and the five-month long district health system rotations (district hospital and district public health office) during the final year of MBBS program. District hospital placement will be supervised by a primary care physician like the MDGP. This rotation will allow students to integrate knowledge and skills acquired in tertiary level hospital and community postings and to apply them effectively and judiciously in the context.

Thus, in summary, the PAHS MBBS curriculum uses a variety of innovative strategies in order to help students become the kind of doctors who are able and willing to address the real health care needs of Nepal. Depending upon whether the students have received partial or full scholarship, the PAHS graduates will be required to serve in rural areas for at least two and four years respectively.

 3. Teaching-Learning Methods

Teaching-learning methods applied at PAHS School of Medicine are as follows:

  • Problem Based Learning (PBL)
  • Community Based Learning and Education (Residential Community Posting)
  • Lectures/ Seminar
  • Lab works / Practical Classes / Demonstrations
  • Clinical Presentation
  • Clinical Classes
  • Small Group Sessions
  • Practical Skills Teachings
  • Self-Directed Learning

Among these methods, Problem Based Learning (PBL), Clinical Presentation Curriculum (CPC) with small group sessions, as well as Community Based Learning and Education (CBLE) are the principal teaching learning methods adopted for PAHS MBBS program.

Problem Based Learning (PBL) is an instructional method in which learners first encounter a problem followed by a systematic, learner-centered inquiry and reflection process. The problem given to the student will serve as a stimulus to self directed learning independently or in a group. Students develop skills of independent enquiry as well as learning to identify their knowledge gaps, and thereby inculcate a habit of lifelong learning skills that is so important for all doctors, but particularly those working in a challenging environment such as in remote rural areas of Nepal.

Community Based Learning and Education (CBLE): It is a well recognized fact that the production of technically competent health care professionals or the advancement of medical technology alone is not enough to solve the health problems of population. Hence the health care professionals of the present generation must acquire the essential competencies for identifying and addressing population health related issues effectively. Because PAHS has a philosophical commitment for experiential learning, a significant part of the Community Health Sciences curriculum will be learnt in diverse rural community settings through regular periodic postings. It is envisaged that such experiential learning will help students develop clear insights about the nature and magnitude of community health problems and their causes as well as foster an attitude of compassion and desire to contribute towards their resolution

The Clinical Presentation curriculum is based on the premise that the body responds to insults like infection, trauma etc in finite ways and the patient presents to the doctor with one of these responses we call symptom, sign or abnormal lab result. Clinical teaching, based on the presentation (or the body responses) rather than learning a list of disease entities will help the students approach a problem in a practical way.

 4. Student Assessment Scheme

The principle of ‘Assessment Drives Learning’ has been the fundamental premise for developing the student assessment scheme. During the MBBS course, students will be assessed not only in the area of knowledge and skills but also in the areas of attitudes/behavior and professionalism- using the PAHS attributes assessment tool. Students who fail to acquire and demonstrate appropriate professional attitudes and behavior will NOT graduate. Students will be subjected to and are required to do well in the Formative as well as Summative Assessments.

Formative/ Continuous Assessments: There will be formative assessments in each of the three phases of the MBBS curriculum to assess the mastery of both content (knowledge and skills) and the process (learning process and development of professional values and behaviors). It will be done on a regular basis so as to provide both the students and the faculty with appropriate and timely feedback regarding their academic performance. This will not only help them identify their deficiencies but also prompt them to take corrective measures in time.

Students MUST pass the formative/ continuous examinations (in aggregate) before  each Summative examinations.

There will be one formative retake exam for those who fail in the aggregate marks of formative exams and if they fail the formative  retake exam, they wont be eligible to sit for the respective summative examination and have to repeat the year.

Summative Examinations: There will be two annual and three comprehensive summative examinations as following:

  • Basic Science Annual Exam (at the end of first year of Basic Sciences)
  • Comprehensive Basic Sciences Examination (CBSE – at the end of two years of Basic Sciences)
  • Clinical Sciences Annual Exam (at the end of first year of Clinical Sciences)
  • Comprehensive Clinical Sciences Examination I (CCSE I) – at the end of one and half years of Clinical Sciences. This is the final examination for all of the minor specialties
  • Comprehensive Clinical Sciences Examination II (CCSE II) – at the end of four and a half years of curriculum.This is the final exit exam of MBBS.

Students who fail the Comprehensive Basic Science examination  (CBSE) cannot proceed forward  into Clinical years.

 5. Internship

Like all medical graduates in the country, PAHS medical students will have to undergo a one year long compulsory rotating internship as per the prescribed scheme and guidelines of the Nepal Medical Council (NMC). During this time students will work in the hospital as a student doctor and participate in taking care of the patients as a responsible member of the health care team. Following this the students will have to sit for the NMC administered National Medical Licensing Exam before becoming eligible for NMC registration.

 6. Teaching facilities, Teaching Hospital and Training Sites

Besides the usual classrooms, a well-resourced library, e-Resource Center with computers and Hi-speed internet facilities, well equipped Basic Science Labs will be available to students. In addition, adequate rooms are available for the purpose of running the small group learning tutorial sessions.

Patan Hospital is the principal Teaching Hospital of PAHS. PAHS has also been building partnership with other hospitals, Ministry of Health, local bodies and communities in selecting appropriate training sites for periodic residential community field postings as well as district health system rotation.

7. Eligibility Criteria

  • All Nepali citizens who have completed seventeen (17) years of age and have not exceeded forty (40) years of age on the last day of submission of application.
  • Must have passed 10 + 2 or equivalent qualifications recognized by Universities/ Board of Nepal with Physics, Chemistry, Biology (PCB) and having passed in each subject securing a minimum of 50% in PCB and also in aggregate

or

Must have completed Proficiency Certificate Level in Health Sciences (General Medicine, Medical Lab Technology, Dental Hygiene, Ophthalmic Science and Pharmacy) securing a minimum of 50% in aggregate and have passed “Bridge Course” from Higher Secondary Education Board/National Examination Board with Physics, Chemistry, Biology and securing a minimum of 50% in each subject

8. Types of Seats

There will be following types of seats in the PAHS MBBS Program: Full Scholarship, Partial Scholarship, Collaborative Scholarship, Special Area Partial Scholarship and Full Fee Paying. There is a provision of Reservation as stipulated in the PAHS Act. One full and one partial scholarship seats have been reserved for a child of permanent staff/faculty of PAHS.

Full Scholarship Category:  Full scholarship will be provided for 15% of the students and fortyfive percent (45%) full scholarship seats will be reserved for Female, Dalit, Adhivasi/Janajati, Madhesi and those residing in the Backward Region.

Only those applicants who are “economically marginalized” and have done their schooling (grade 8, 9, 10) and SLC/SEE from ‘public’ school can apply for these seats.

The applicant will have to score minimum score designated by PAHS in the entrance exam failing which the seat will be awarded to the best candidate in the other categories.

For seats remaining after reservation as above, preference will be given to applicants who:

  • are the permanent resident of districts with low Human Development Index (HDI)
  • have done Certificate in Health Sciences and have worked in Government Health institutions of remote regions for at least 2 years

Mandatory service obligation: four years in government or PAHS designated Health institutions in rural areas of Nepal.

Partial Scholarship Category: Anyone who meets the eligibility criteria can apply in this category but preference in selection will be given to applicants who

  • have done their schooling (grade 8, 9, 10) and SLC/SEE from ‘public’ school
  • fall under the category of Female, Dalit, Adhivasi/Janajati, Madhesi
  • are the permanent resident of districts with low Human Development Index (HDI)
  • have done Certificate in Health Sciences and have worked in government institutions of remote regions for at least 2 years

Mandatory service obligation: two years in government or PAHS designated Health institutions in rural areas of Nepal.

Special Area Partial Scholarship: Two Partial Scholarship seats (1 male, 1 female) are reserved for candidates from rural municipality (Gaupalika) of Lalitpur district.

Only those applicants who are permanent residents of any of the rural municipality (Gaupalika) of Lalitpur district and have done their schooling (grade 8, 9, 10) and SLC/SEE from ‘public’ school of the Lalitpur district can apply for this seat.

Mandatory service obligation: two years in government or PAHS designated Health institutions in rural areas of Nepal, for those who are in partial scholarship scheme

Collaborative Scholarship Scheme:  This scheme will be activated only when an agreement is reached with a Local Government Body, an organization or an individual to the effect that such Body, organization or individual will support student/s from a particular district, preferably remote.

This will be open to all students who are residing permanently in a particular district and have done their schooling (grade 8, 9, 10) and SLC/SEE from ‘public’ school of the same district.

Preference in selection will be given to applicants who

  • fall under the category of Female, Dalit, Adhivasi/Janajati, Madhesi
  • have done Certificate in Health Sciences and have worked in government institutions of remote regions for at least 2 years

The candidates will have to meet the minimal standard set by PAHS, failing which the seat will not be awarded to that particular district.

Mandatory service obligation: at least four years (may be more depending on condition led down by the Sponsor) in Sponsor/ PAHS/ Government designated Health institutions in rural areas of Nepal.

Staff Scholarship Quota: One full scholarship for the permanent staff of PAHS and one partial scholarship for permanent faculty of PAHS, have been reserved. Applicant must be son/daughter of currently working permanent staff or faculty of PAHS.The faculty/staff must be working in the permanent position for at least 3 years and should not leave the institute for the duration of the course. If one son/daughter of faculty/staff has already received scholarship in any academic programs of PAHS then other children of same family, irrespective of the fact that both parents work at PAHS, will not have this privilege again.

Mandatory service obligation: four years in government or PAHS designated Health institutions in rural areas of Nepal.

Full Fee Paying Category: Anyone who meets the eligibility criteria can apply in this category.

Service obligation: Students in this category are strongly encouraged and expected to serve in rural areas.

Reservation under Partial scholarship and Full  Fee Paying seats: Ten percent of seats have been reserved for those who have lived in ‘village’ and have studied in ‘public’ school of which one seat each has been reserved for applicants under the category of  Female, Dalit, Adhivasi/Janajati, Madhesi and permanent resident of backward  region. The applicant will have to score minimum score designated by PAHS in the entrance exam, failing which the seat will be awarded to the best candidate in the other categories.

Applicants who belong to the above mentioned category and are also “economically marginalized” and wish to avail full scholarship should apply in the Full Scholarship category only, as provision has been made for reservation, under Full Scholarship category as well.

Mandatory service obligation: two years in government or PAHS designated Health institutions in rural areas of Nepal, for those who are in partial scholarship scheme

9. Student Selection Process

The selection process employs Aptitude tests along with Multiple choice questions (MCQs) based on the knowledge of 10 +2 or equivalent Science Course. The MCQs will be at a level of assessing the application of Knowledge

Aptitude tests are the test designed for testing a person’s natural ability to do something or testing the ability for learning and proficiency in a specific area or discipline. The Mental agility test (MAT) is designed to test fluid intelligence. It is high level reasoning ability test which includes verbal reasoning, numerical reasoning, abstract reasoning and logical sequencing. Situational Judgment Tests (SJTs) are a type of Aptitude tests used to assess individual’s reaction to a number of hypothetical scenarios.

The Situational Judgement test are designed to test moral orientation, social responsibility,decision making skills, professionalism and ethics, empathy and justice.

Examination: The Entrance Examination will consist of written examination which will comprise of:

  • Paper I: Multiple choice questions (MCQs) on Science
  • Paper II:  Mental Agility test (MAT)
  • Paper III: Situational Judgment Tests (SJT)

The applicants scoring less than 50% in Science test (Paper I)  will be considered ‘fail’ and applicants falling below Two (2) Standard Deviation in Aptitude tests (MAT and SJT) will be considered ‘fail’.

 Tie

In case of ‘Tie’ in the total score of written examination among applicants, the following mechanism will be used to further rank the applicants:

     First tie: percentage score of 10+ 2 or equivalent

     Second tie:  percentage score of SLC/ SEE

     Third tie: average score of Physics, Chemistry and Biology in

10+2 or equivalent

 Result

The Admission Committee will produce a final list of selected students and a waiting list and post this in the National Daily, PAHS Notice Board and Website. The decision of the Admission Committee will be final.

 10. Fee Structure

 Candidates selected for admission into the MBBS program will be enrolled into the MBBS program only upon payment of the Tuition Fee as given below immediately after the announcement of the list of selected candidates and after they are declared fit to pursue the study of Medicine by the Medical Committee set by PAHS. Failing to do so will lead to cancellation of his/her admission and the candidate on the waiting list shall be admitted in his/her place in the respective categories.

Table 1: Tuition fee for MBBS course, School of Medicine, PAHS 

Year Full Scholarship Partial Scholarship Special Area Partial Scholarship Collaborative Scholarship Full Paying
First Waived 962,500 962,500 513,400 1,925,000
Second Waived 300,000 300,000 513,400 600,000
Third Waived 237,500 237,500 513,400 475,000
Fourth Waived 237,500 237,500 513,400 475,000
Fifth Waived 187,500 187,500 513,400 375,000
Total Waived 1,925,000 1,925,000 2,567,000 3,850,000

Table 2: Other fees for MBBS course, School of Medicine, PAHS

Admission fee Rs. 20,000.00 (one time)
Library Fee Rs. 6,000.00 (per annum)
Lab fee Rs. 8,000.00 (per annum)
Extracurricular activities Rs. 5,000.00 (per annum)
Examination fee Rs.15,000.00 (per annum)
Computer and IT Rs. 6,000.00 (per annum)
Health Insurance Fee Rs. 3,000.00(per annum)
Hostel Fee Rs. 5,000.00 (per month)
Miscellaneous Rs. 5,000.00 (per annum)
Nepal Medical Council fee Rs. 3,000.00 (one time)
Deposit (refundable) Rs. 35,000.00 (one time)

Students staying in the PAHS managed hostel have to deposit a refundable amount of Rs.20,000.00 at the time of enrollment.

Students and their guardians are requested to deposit all the fees within the given timeframe. There will be a late fee charge of Rs. 150/day if the dues are not cleared within the given timeframe.

The full scholarship students will not have to pay tuition fee. Other fees mentioned above will have to be paid by all students including full scholarship students. All students will have to bear their living costs including food and hostel fees. All fees are subject to revision as and when necessary.

 11. Mandatory Service obligation

All candidates who have been selected for admission under any category of Scholarship Scheme will have to sign a written agreement agreeing to fulfill the required mandatory service obligation before they could be admitted into the program. Parents/ guardians of these candidates will also be required to be present for endorsing the bond. Under no circumstances will any candidate be exempted from this obligation. PAHS Act mandates the provision of withholding candidates’ MBBS certificate till the obligation has been fulfilled.

 12. Examination Centre

The examination will be held in Kathmandu. The Center will be notified at the time of distribution of Admission Card.

13. How to Apply

Applicants should buy the Application Form from PAHS Admission Information Desk with a bank voucher of Rs. 500 from any branch of Laxmi Bank or Agricultural Development Bank. The bank account number for PAHS is 00181040000455 (Laxmi Bank) and 0211600180090014 (Agricultural Development Bank). The forms should be submitted at PAHS with a bank voucher of Rs. 3,500 as Examination Fee from the bank mentioned above.

Early submission is advised so as to allow adequate time required for rectification of any shortcomings in the forms or timely submission of required documents.

Applicants will be informed of the dates of distribution of the Admission card, required for the entrance exam, during registration.

PAHS Admission Committee reserves the right to disqualify forms which are improperly or incompletely filled or if the required documents are missing. Hence, candidates are strongly advised to read the instructions for filling the application form carefully and do a thorough check to ensure that all fields on the application form are filled properly and all required documents have been submitted along with it.  

 14. Health Checkup

All students need to undergo a health examination upon their selection. Their personal health files will be created, and remedial measures will be taken if needed. All admitted students will have to comply with the rules made by the Medical Committee.

 15. Hostel

Hostel will be made available, as far as possible, for those students who wish to stay in the hostel. Preference will be given to those students coming from outside the valley. Students who sign up for hostel will have to abide by the rules and regulation of the Hostel Management Committee.

 16. Sample AptitudeTests

 Example of MAT:

Example of MAT

 

 

Example of SJT

Part 1

Your friend Ram had borrowed money from you and now he does not mention about returning it. You have not told your parents about it fearing that they might scold you. You have saved that money over several years and is very valuable to you.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

a. Talk to your friend about it

b. Let it go as  is one of your close friends

c. Wait for some more time as Ram might be in a problem

d. Tell your parents

e. Ask another friend to talk to Ram

Example of SJT Part 1

 

 

 

 

 

 

Part 2

Your close family member has Diabetes and the doctor advised him to cut off sugar in his diet. However as he likes high sugar diet he continues taking it without bringing in notice of the family members.

Choose the THREE most appropriate actions to take in this situation

a. Ask the doctor to talk to him

b. Ask family members to keep an eye on him

c. Do not bring any high sugar food at home

d. Talk to him about his behaviour

e. Let him fulfill his wish

f. Ask the doctor to increase his medicine

g. Ignore the situation

Example of SJT Part 2

(Disclaimer: The above examples are only for demonstration and the answers are not necessarily correct)

 References:

  1. Backward region is defined as following districts Humla, Jumla, Mugu, Dolpa, Kalikot, Achham, Bajhang, Bajura, Jajarkot. (Sambhidhan Sabha Sadasya Nirwachan Ain 2064 and Sambhidhan Sabha Sadasya Nirwachan Niayamawali, 2064, dapha 7,updapha (3) anasuchi-1)
  2. Remote region will be as defined by Government Policy Document (Nepal Rajpatra, Bhag 4, Khanda 42, Sankhya 50, 2049/12/16 )
  3. HDI will be as per the latest document published by National Planning Commission/UNDP.

 

 

 Good Luck!