For nearly 75 years, the Nepal Medical Association (NMA) has been regarded as the guardian of doctors in Nepal. It is a professional organisation believed to advocate for ethical practice, the welfare of doctors, better working conditions, and improved healthcare.
Founded in 1951 by a few doctors, it now claims over 15,000 members, drawn from a pool of more than 40,000 registered medical and dental practitioners. Yet this seemingly impressive growth masks deeper problems. With membership hovering just around 35% of all doctors, questions arise about how effectively the NMA truly represents the profession it claims to speak for.
Critics within the medical community argue that low membership count and its own legislation undermine the legitimacy of the NMA. Many doctors choose not to join, citing high fees and a perception that the organisation serves narrow interests, associated with political interests rather than the broader fraternity.
Sources familiar with internal dynamics say that candidates aspiring to be part of the executive body pay membership fees to potential voters, a practice that raises serious ethical concerns and corruption within the organisation. Such actions suggest vote-buying, eroding trust in the leadership selection process.
The history of NMA is linked to the political evolution of Nepal. Established in the twilight of the Rana era, it grew together with democratic movements. Today, however, politics dominates its internal affairs. Elections for leadership positions often split along party lines, with alliances mirroring national rivalries between the Nepali Congress and the CPN-UML. Doctors form panels based on ideological affiliations, turning what should be a professional election into a proxy battle for political influence.
This politicisation has real consequences. Recurring candidates cycle through roles, starting in junior positions and aiming for senior ones in subsequent terms. Promises made during campaigns, from improved workplace safety to equitable postgraduate training, frequently go unfulfilled.
Past leadership teams pledged dedicated hospitals for complex cases, better duty-hour regulations, raised salaries, and paid travel leave for medical staff. Only a very few of these commitments have materialised, leaving many doctors disillusioned and angry over such betrayal slapped in their face.
One doctor, speaking on condition of anonymity due to professional repercussions, described the pattern as a “musical chairs game” among the same old faces. This cycle of repetition leads to stagnation, prioritising personal gain over collective progress.
It also erodes public trust. When political leaders notice doctors affiliated with opposing parties, they often treat them as pawns instead of collaborators in health policy. Conflicts within hospitals and public disagreements add to the strain on doctor-patient relationships.
Another concern involves financial transparency. The Nepal Medical Association receives financial assistance from the government and brings in revenue through its journal, rentals at its guesthouse, reading rooms, seminars, and membership fees.
Registered as a non-profit under Nepal’s Association Registration Act, it must go through audits and stay accountable. Still, its official website shows no recent audit reports, which sparks questions about proper oversight.
Under Nepal’s law, non-profits have to submit audited financial statements to officials like those at the District Administration Office, though the public has little access to them. This opacity fuels suspicions that funds organisation ways be used solely for professional welfare.
Doctors face numerous unresolved challenges that highlight the NMA’s shortcomings. Young doctors, particularly residents in private colleges, go through relatively long working hours with little or no stipend, unlike their counterparts in government institutions or neighbouring countries.
Workplace violence against health workers persists, despite laws meant to protect them. Post-study bonds and compulsory internships tie doctors to exploitative contracts, mental stress, and low pass rates in licensing exams, mostly below 40 per cent, which point to systemic flaws in the medical education system in Nepal.
We have extensively documented these issues. In our pieces for various media, we exposed the phenomenon of “phantom faculty” in private medical colleges qualified doctors were listed only for inspections but absent during actual teaching. We have highlighted defensive medicine driven by consumer court rulings that impose heavy fines on hospitals and doctors for perceived negligence.
We have also addressed professional mental health crises, when stress causes startling rates of burnout and, in severe circumstances, suicide. In contrast, the NMA has published various written comments on some issues but has failed to promote substantial improvements, such as uniform stipends or strict safety measures.
Broader scandals in medical education compound the problem. Investigations have revealed irregularities in college affiliations and seat allocations for undergraduate and postgraduate studies, with allegations of bribery involving regulators, business owners, medical mafias, and politicians. While these centre on the Nepal Medical Council and Medical Education Commission, the NMA’s silence or limited action allows such issues to fester, affecting the quality of new doctors entering the field.
Election controversies within the NMA further tarnish the organisation’s image. Reports of candidate disputes and procedural challenges have surfaced in media outlets. In a recent case, several nomination disputes resulted in legal notices, court orders, and delays, demonstrating how even an election committee for an association of educated professionals can devolve into power struggles.
The NMA’s potential remains vast. Acting as a bridge between doctors and the government, the NMA could push hard for universal health coverage. It could also champion welfare for doctors, medical students, and all healthcare workers, while encouraging incentives for postings in rural areas. On top of that, it could drive real policy reforms and maintain ethical standards without any political meddling. Yet it regularly faces low membership, politicises elections, fails to provide financial openness, and disregards its own commitments and obligations. NMA risks becoming a relic – respected in name but ineffective in practice.
In the wake of Nepal’s turbulent 2025 Gen Z protests, which toppled a government amid demands for an end to entrenched corruption, the appointment of Dr Sudha Sharma Gautam as Health Minister in October and the continued tenure of Prof Dr Anjani Kumar Jha as Vice Chairperson of the Medical Education Commission expose a stark irony.
Both rose to prominence through leadership roles in the Nepal Medical Association, an organisation long plagued by accusations of political partisanship, financial opacity, vote-buying in elections, and a failure to represent even a third of the country’s doctors or deliver on pledges for better conditions.
Dr Sharma Gautam presided over the NMA from 2005 to 2007, a period marked by emerging criticisms of transparency lapses, while Dr Jha’s term from 2013 to 2016 overlapped with escalating scandals in medical college affiliations, seat allocations, and unmet calls for reform.
Today, they occupy pivotal posts overseeing the very sector riddled with unregulated private institutions, abysmal license exam pass rates, rampant doctor migration, workplace violence, resident burnout, and exploitative training bonds, issues the NMA repeatedly failed to resolve under their watch or that of similar recycled leaders.
Nepal’s healthcare system supports millions of people in tough terrain ranging from the remote Himalayas to metropolitan areas. Doctors require a representation group that prioritises their well-being and patient care over internal power battles. Reform starts with introspection: expanding membership, releasing audits, and emphasising professional unity above partisan differences. Only then can the NMA reclaim its role as a true voice for the nation’s healers.
This constant shuffling between a politically charged professional group and a high-level administrative role sets up a vicious cycle of holdups and conflicts of interest. It chips away at public confidence exactly when Nepal badly needs firm, no-nonsense measures to fix its battered healthcare setup. People saddled with that tainted history ought to step aside, making room for fresh, neutral leaders to address the ingrained problems that continue to perplex patients and medical workers.
