Historical evolution and present status of general practice in Nepal
Bibliographic record
Abstract
In 1981, in the face of no post-graduate training programs, health policy makers realized that Nepal needed "generalist" physicians who could cope with the wide range of preventive and curative medicine required in rural areas.From discussions between His Majesty's Government (HMG) and the University of Calgary, the Medical Doctorate in General Practice (MDGP) programme was launched in 1982 by the Institute of Medicine (IOM), Tribhuvan University and the Ministry of Health (MOH).Phase 1 was from 1982-1987 when half the training (18 months) was in Calgary, Canada with the rest in Nepal, including 6 months in Surkhet in mid-western Nepal.A total of 11 doctors undertook at least part of the training programme, with 7 completing the training and 6 passing the final examination, receiving a Postgraduate Diploma in General Practice.Phase 2 was from 1987-1988 with 3 months training in Malaysia.A further six doctors successfully completed training to receive the MD (GP) degree.During 1989 and 1990, the program accepted no new intake of trainees while the University re-evaluated the feasibility and requirements of the programme.Phase 3 started in 1991 continues to the current time with all training in Nepal.In a 1994 evaluation, it was recommended to establish linkages between the IOM and Patan Hospital to supplement weaknesses in the curriculum, provide resources for facility development and provide the basis for future collaboration.In 1994, the IOM programme officially accepted Patan Hospital general practice residents into the MDGP programme.In 1998, the IOM programme also included residents in BP Koirala Institute of Health Sciences (BPKIHS) but this ceased after BPKIHS established its own programme.Subsequently BP Koirala Institute of Health Sciences (BPKIHS) started its own MD in Family Medicine in 2002.The National Academy of Medical Sciences (NAMS) approached Patan Hospital and its Department of General Practice and a 3 rd MDGP course based in Patan was started from 2005.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".