Neuropsychiatry Training in Nepal: Experiences of Trainees and Psychiatrists

Abstract

Introduction: Training, practice and continuing professional development in neuropsychiatry and clinical neuroscience vary across different countries. However, little is known about the opinions of the Nepalese psychiatrists about the provision of neuropsychiatry training. This study evaluates the current training in neuropsychiatry and clinical neurosciences during the postgraduate psychiatry training and reflect on current practice.
 Material And Method: The participants were psychiatrists (qualified and psychiatry residents). An online questionnaire using Survey Monkey electronic Platform was emailed with a uniform resource locator (URL).
 Results: Sixty-four out of ninety-five participants responded with response rate of 65.3%. Two-third of the respondents were qualified psychiatrists. The duration of neurology rotation ranged from 1 to 3 months and it was reported to be mandatory. Two-thirds reported that there is no clinical neuropsychiatry training during psychiatry residency. On a ten-point Likert scale (with 10 being the highest possible score), the participants rated their neuropsychiatry training as 5.16±1.84 while they rated the necessity for further training in neuropsychiatry as 7.92±1.96. Two-thirds identified a lack of interest by the specialty society as an obstacle for the implementation of neuropsychiatry training for psychiatrists. More than half viewed that neuropsychiatry training to be incorporated into the existing psychiatry training scheme whereas three-fifths favoured a one-year specific training program in neuropsychiatry after completion of psychiatry training.
 Conclusion: The current psychiatry training is inadequate to meet substantial neuropsychiatry training opportunities for a high proportion of psychiatrists in Nepal. This finding may be used to improve and standardize neuropsychiatry training in postgraduate psychiatry training.

Training in neuropsychiatry: views of early career psychiatrists from across the world

“…However, in a study on neuropsychiatry training in Nepal the majority of ECPs (85%) stated that neurology is integrated into their training course as a mandatory rotation. 29 These results highlight the need for specific training in neuropsychiatry beyond the neurology rotation.…”

“…This finding is consistent with previous reports from the UK, in which 73% of the sample had no previous clinical training experience in neuropsychiatry, but 74% expressed a wish specifically to train in this subject and 87% stated a desire for a clearly defined curriculum. 28 , 29 In the UK the RCPsych curriculum was amended to enhance neuroscience and neuropsychiatry (MRCPsych Syllabus amendment 23 ). According to a survey of psychiatry residency programme directors in the USA, 64% and 60% agreed that knowledge of neuropsychiatry and knowledge of psychiatric neuroscience respectively were either very important or critically important for providing excellent care.…”

“… 30 This is consistent with other findings in Nepal concerning the need for future training in neuropsychiatry, where the median score on a ten-point Likert scale was 7.9. 29 In two different USA nationwide surveys, most participants (chairs of psychiatry departments, psychiatrists and psychiatric trainees) agreed with the need for more neuroscience education. 18 , 20 Similar results were reported in the UK.…”

History of psychiatry in Nepal

“…Although there are child and adolescent clinics at Kanti Children's Hospital in Kathmandu, there is no Doctor of Medicine (DM) programme in this psychiatric discipline. 7 The Narcotic Drugs Control Act was framed in 1976 and amended in 1981 and 1987. The Drug Abuse and Demand Reduction Project was initiated in 1995 and several demandreduction activities are carried out by national and international NGOs.…”

“…Although there are child and adolescent clinics at Kanti Children's Hospital in Kathmandu, there is no Doctor of Medicine (DM) programme in this psychiatric discipline. 7 …”