In healthcare, knowledge has an expiry date. Scientific evidence, digital tools, biomaterials, pharmaceuticals, and clinical guidelines all evolve so rapidly that what was standard practice a few years ago can quickly become outdated.
Alas, medical education in Nepal struggles to keep up with this pace of change. The number of medical, nursing and dental schools in the country has surged in the past three decades, but instruction and training remains poor and largely uneven.
Curricula often take years to change, faculty development varies widely between institutions, and many educators have limited access to or knowledge of the latest scientific advances.
The bigger problem begins once students graduate. They leave medical school believing that a degree marks the end of formal learning rather than the beginning of a career of continuous education. That is not a personal failing as much as a systemic one. Our education system still treats a medical degree like it is a one-time vaccine providing lifelong protection.
It is tempting to argue that reforming this will take time, and that better governance will eventually solve this problem. But medicine cannot wait for bureaucracy. Every year that medical education falls behind, patients receive care that may already be obsolete.
LIFELONG LEARNING
This is where continued professional development (CPD) becomes indispensable. While universities and medical schools work to modernise undergraduate and postgraduate education, CPD ensures that practicing healthcare professionals are not left behind.
It transforms learning into a lifelong professional responsibility through accredited courses, conferences, workshops, self-directed learning, and peer collaboration. Clinicians can keep pace with evolving evidence, emerging technologies, and continually changing standards of care.
Around the world, CPD systems differ in how they are funded and delivered, but the strongest ones share the common principle that lifelong learning is a professional responsibility rather than a personal choice.
Nepal has been laying the regulatory foundations for such a system. The Nepal Nursing Council now requires nurses and midwives to complete 60 CPD credits over six years, with at least 10 credits earned annually, for license renewal.
The Nepal Medical Council has also introduced a framework requiring doctors to complete 100 CPD credits every five years, although this has yet to be enforced as a mandatory requisite for license renewal.
Yet, mandating credits is the easy part, creating high-quality learning opportunities across the country is far more difficult. This demands coordination between employers, professional associations, regulators and government to identify national learning priorities, accredit educational activities, assure quality, and evaluate whether CPD is actually improving clinical practice and patient outcomes.
Without such coordination, CPD risks becoming a box-ticking exercise in which credits are accumulated but competence remains unchanged. Many CPD systems in low and middle income countries have struggled because of inadequate funding, limited technological infrastructure, insufficient administrative capacity, and the absence of robust strategies to address the shortage of training resources in rural regions.
No amount of regulation or infrastructure can, by itself, create a culture of lifelong learning. Policies may require clinicians to participate in CPD, but they cannot compel intellectual curiosity or professional generosity.