Introduction: The Clinical Presentation (CP) curriculum was first formulated in 1990 at the University of Calgary, Canada. Since then, it has been adopted at various medical schools, including Patan Academy of Health Sciences (PAHS), a state-funded medical school in a low-income country (LIC), Nepal. This study aims to evaluate the perceived effectiveness of the CP curriculum by students and faculty at PAHS, and test knowledge retention through a surprise non-routine exam administered to students.  Method: This is a cross-sectional study to evaluate the efficacy of the CP curriculum in teaching clinical medicine to the first batch of MBBS students of PAHS School of Medicine. Ethical approval was obtained from the Institutional Review Committee (IRC)-PAHS (Ref no std1505911069). Perceived effectiveness was evaluated using a set of questionnaires for faculty and students. A total of 33 students and 34 faculty filled the perception questionnaires. Subsequently, a questionnaire consisting of 50 Multiple Choice Questions (MCQs) from different clinical medicine disciplines was administered to test students’ knowledge retention. Out of 49 students, 38 participated in the surprise non-routine exam.   Result: A significantly higher number of faculty preferred the CP curriculum compared to the traditional system of teaching clinical medicine (16 vs 11, Kruskal Wallis: 0.023, ie. P-value < 0.05). A significantly higher number of the students liked and recommended CP curriculum in the clinical year of medical education (20 vs. 13 with p-value < 0.05). In the non-routine surprise exam, two thirds of the students scored 60% or above.  Conclusion: Both faculty and students perceive that the CP curriculum system is an effective teaching and learning method in medical education, irrespective of their different demographic and positional characteristics. The students’ overall performance was good in surprise, non-routine exams taken without scheduling or reminders.

Poudel, Sangeeta. Diploma in mountain medicine: a perspective of a female doctor from Nepal. High Alt Med Biol. 22:000-000, 2021.-Mountaineering is an alluring recreation receiving increasing global attention. With increasing adventure activities in the mountain, the risk of mishaps is high. Each year many trekkers, athletes, pilgrims, and porters are significantly affected and some even lose their lives due to a lack of knowledge in identification and management of altitude illness and other traumatic injuries. The diploma in mountain medicine (DiMM) trains participants in high-altitude environments to access area safety, diagnose, treat, and evacuate victims using available resources, improvised techniques, and rope skills. Doctors willing to work in the wilderness have to work in austere medical clinics, participate in search and rescues, volunteer at sporting events, or work on an expedition often being the only available doctor. Despite challenges, mountain doctors work in the wilderness as a hobby and some make a career of it, as in certain countries mountain medicine is now recognized as a subspeciality. As it becomes more accessible, the mountain medicine course is becoming increasingly popular, with the course in Nepal being no exception. It is developed as a specialty in developed countries, whereas in developing countries it will soon reach maturity. This is a personal report of a young female doctor taking part in a DiMM course in 2019 from Nepal.

Introduction: Anesthesiologists play an important role in the management of peri-operative risk and the perception of patients towards anesthesia and the role of anesthesiologists are often underestimated. Newer initiatives are required to increase communication with patients and educate them about the importance of anesthesia during surgery. The study aims to assess perception in relation to education level and patients’ previous exposure to anesthesia about anesthesia and the role of the anesthesiologist. Method: A cross-sectional, predesigned Nepali questionnaire-based study was conducted after approval from the Institutional Review Committee (IRC), Patan Academy of Health Sciences. A total of386 above 14 years old hospital admitted patients undergoing elective surgery in different departments of Patan Hospital were included. Data was collected during the pre-anesthetic evaluation one day before surgery. Perception of patients in relation to educational level and previous exposure to surgery and chi-square test was done at p<0.05 statistically significant. Result: Among 386 participants, 246(63.4%)participants had no previous anesthetic exposure and showed significant difference on perception about the meaning of anaesthesia and administration of anesthetic medicine among patients with previous exposure of anaesthesia and without. Among participants,38(9.8%) were uneducated and awareness about anesthesia and different techniques of anesthesia was poor. Only 193 (50%) participants knew that anesthetic medicine is given by anesthesiologist and 131 (33.9%) knew that anaesthesiologist were responsible for controlling vital signs during surgery. Study revealed poor knowledge regarding the role of anesthesiologist and showed a statistically significant difference in educational level of patient. Conclusion: Perception on anesthesia and role of anaesthesiologist was less in relation to educational level and previous exposure to anesthetic among study participants.

The vaccine rollout has started for the health workers as well as common people all around the world. The production has been going on rapidly, but the poor and low income countries are still lagging behind to get in the vaccine race and have their people vaccinated. A group of several international non-governmental organizations have warned about 90% of people in 67 low-income countries to have a low chance of being vaccinated in 2021 due to more than a necessary number of vaccines reserved by developed countries. COVAX program, co-led by Gavi, the Vaccine Alliance, along with the World Health Organization (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI) has raised rays of hope but it’s still long way to go. Vaccine hesitancy among the public, logistics and storage difficulty and emergence of new variants has emerged as potential challenges for COVID-19 vaccination in developing countries.

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