KATHMANDU: Nepal’s medical education sector faces an unprecedented crisis that threatens the very foundation of healthcare in the nation. A systematic investigation reveals that numerous private medical colleges across the country have been operating with “phantom faculty”—qualified doctors who exist only on paper during regulatory inspections but never actually train the students.

This deception, combined with the government’s recent decision to increase medical seats despite Dr. Govinda KC’s protests, has created a dangerous tsunami that endangers both the quality of medical education and public health.

The Anatomy of Academic Deception

The phenomenon of fake faculty, colloquially known as “Khade Babas” in Nepal’s medical fraternity, represents one of the most egregious forms of educational fraud plaguing the country’s healthcare system. These ghost faculty members are typically qualified doctors who are paid substantial sums to appear during government inspections, creating an illusion of compliance with regulatory standards, but disappear once assessments conclude.

Although previous investigations have exposed the alarming scale of this deception, the government seems to favor it. In 2015, the Nepal Medical Council published a list of 212 doctors purportedly serving as teaching faculty but, in reality, functioning as “stand-in instructors to evade inspection.”

The breakdown revealed the systematic nature of this fraud: 71 fake faculty members at the College of Medical Sciences in Bharatpur, 46 at Nobel Medical College in Biratnagar, and 36 at Universal Medical College in Bhairahawa. Unfortunately, such strict investigations conducted by governing bodies such as the Nepal Medical Council and the Medical Education Commission are almost extinct nowadays.

Evidence from the neighboring country, India, provides additional context to this regional problem. In the same year, an investigation by the Punjab Medical Council revealed that over 400 fake teachers were enrolled as full-time faculty members across four private medical colleges in Punjab, Haryana, and Himachal Pradesh.

At Maharishi Markandeshwar Medical College in Solan alone, 74 out of 155 current faculty members were identified as ghost members, with entire departments such as ENT, forensic medicine, and dermatology existing only on paper.

Dr. Gobinda KC’s Relentless Battle Against Systemic Corruption

Dr. Gobinda KC, a senior orthopedic surgeon at Tribhuvan University Teaching Hospital, has emerged as the most prominent voice against corruption in Nepal’s medical education sector. His recent warnings and protests against the Medical Education Commission’s decision to increase MBBS seats from 100 to 130 and BDS seats from 50 to 60 represent the latest chapter in his decade-long struggle for reform.

In August 2025, Dr. KC issued a stern ultimatum to the government, giving authorities one week to reverse the decision to increase the medical seats in MBBS and BDS. His statement warned that “increasing the number of these seats might help politicians and mafias to make additional money, but it lowers the quality of medical education in the nation. In a sensitive field like medical education, this drop in quality will directly affect public healthcare, which means putting the health of Nepali citizens at risk.”

The medical education activist has accused former Prime Ministers KP Sharma Oli, Sher Bahadur Deuba, and Pushpa Kamal Dahal of siding with what he terms the “medical mafia.”

His protests have consistently targeted the fundamental issues plaguing Nepal’s medical education: fake faculty, inadequate infrastructure, and the commercialization of medical training at the expense of quality.

Dr. KC’s 22 hunger strikes since 2012 have repeatedly forced governments to make commitments, only to see those promises broken when political priorities shift. His latest threat of protest specifically targeted the government’s violation of previous agreements that limited the expansion of medical seats without corresponding improvements in educational infrastructure and faculty quality.

Moreover, this has drawn the suspicious eyes of many social activists and concerned authorities, as this increment was focused heavily on private medical colleges only.

The Devastating Impact on Medical Education Quality

The consequences of fake faculty extend far beyond administrative irregularities, fundamentally undermining the quality of medical education in Nepal. Recent data from the Nepal Medical Council reveals the stark reality of this educational crisis: only 31% of candidates passed the medical licensing examination in January 2025, while over 70% of medical doctors failed. This represents a consistent pattern, with nearly 58% of MBBS and BDS graduates failing licensure tests in September 2022.

The failure rates highlight a systemic breakdown in medical education that directly correlates with the prevalence of phantom faculty. When students are taught by inadequate or non-existent faculty, the natural consequence is graduates who lack the fundamental knowledge and skills required for medical practice.

Some candidates have reportedly failed the licensing exam multiple times, with one doctor failing 34 times, illustrating the profound inadequacy of their initial education.

Experts frequently attribute these concerning tendencies to a lack of resources, trained professors, and insufficient clinical expertise. The fake faculty phenomenon exacerbates all these issues by creating an illusion of adequate staffing while students receive substandard education from overworked or absent instructors.

Economic Exploitation and Job Market Distortion

The phantom faculty system has created a vicious cycle of economic and physical labor exploitation that disadvantages legitimate medical professionals while enriching those who profit from these educational frauds. Many medical colleges in Nepal have been found reaching out to Indian doctors and paying them “handsome amounts” to pose as full-time faculty members during government inspections.

These fake faculty members stay for days or weeks and then return to their actual workplace once assessments conclude, leaving the future of Nepali medical students in the dark.

This system has particularly created difficulties for young medical graduates seeking legitimate academic positions in the Nepali medical sector. The Institute of Medicine recently announced applications for medical officers and received over 600 applications for just a handful of vacancies, highlighting the shocking ratio of 40 to 80 applications per post.

Meanwhile, established doctors listed as phantom faculty collect payments from multiple institutions while practicing privately, monopolizing opportunities that should be available to emerging professionals.

Numerous in-depth studies have revealed a significant number of cases that illustrate this problem. While examining the list of faculties published by the Medical Education Commission on their website, our team has noticed that multiple faculty members listed there are actually working abroad—in Bhutan, the Caribbean, the UAE, and India—while maintaining their positions as faculty on paper in Nepali medical colleges.

Others practice privately while drawing money and prestige as full-time faculty from the medical colleges, with some described as “Evergreen Khade-Babas” who have maintained this fraudulent arrangement for years.

The Medical Mafia’s Influence on Policy

The concept of the “medical mafia” gained significant attention in Nepali public health discourse to describe a handful of powerful individuals who have commercial interests in the country’s healthcare system and prioritize profits over medical treatment and academic excellence.

This shadowy network includes private medical college owners, corrupt government officials, and political figures who benefit from the current healthcare system’s dysfunction.

The Medical Education Commission’s recent decision to increase MBBS and BDS seats despite widespread opposition demonstrates the medical mafia’s influence on policy decisions. Critics argue that this expansion serves to increase profits for private institutions rather than addressing the genuine healthcare needs of civilians.

The Commission’s hasty decision to increase the number of seats under the guise of providing stipends equivalent to those of 8th-level civil servants for resident doctors has been condemned as a profit-driven approach for private medical colleges, facilitated by the Medical Education Commission itself.

The silence of prominent and well-known doctors in Nepal, including Bikash Devkota, Bhagawan Koirala, Anil Karki, Sanjib Tiwari, Anjani Kumar Jha, and others, is a cause for concern, as it undermines the integrity of the Medical Education Commission and endangers the futures of aspiring doctors.

The current government’s heavy influence by this medical mafia group has resulted in a loss of commitment to providing excellent medical care, prioritizing commercial interests over public health.

International Context and Comparative Analysis

Nepal’s fake faculty crisis mirrors similar problems in neighboring countries, suggesting a regional pattern of educational fraud in medical institutions. CBI investigations into medical education scams in India have uncovered a complex web of bribery, criminal conspiracy, and forgery involving fictitious faculty and patients presented during inspections.

The scheme involved over 40 institutions nationwide and implicated senior officials from the Ministry of Health and the National Medical Commission.

The modus operandi described in India, including the manipulation of digital records, fake attendance, and fraudulent patient records, closely parallels the practices documented in Nepal. This regional pattern suggests that the phenomenon of phantom faculty represents a systemic failure of medical education governance across South Asia, necessitating a coordinated international response.

The Brain Drain Catastrophe

The combination of poor educational quality and limited legitimate opportunities has accelerated Nepal’s medical brain drain. Approximately 6,500 doctors left the country in the past two years due to various circumstances, including lack of secure employment, poor infrastructure, and inadequate salaries.

Meanwhile, reports indicate that doctors are not paid their wages for six months to several years, creating an environment where even qualified professionals cannot sustain their careers domestically.

This exodus of medical talent occurs against a backdrop of apparent oversupply. Nepal has already achieved a doctor-to-population ratio of 1:900, exceeding the WHO standard of 1:1000. However, the quality concerns revealed by licensing exam failure rates suggest that numerical adequacy masks a crisis of competence. The country produces doctors who cannot pass basic licensing requirements while losing qualified professionals to international markets.

Over 100,000 Nepali students went abroad for education in 2023 alone, with medical students comprising a significant portion of this exodus. Meanwhile, a decline in domestic enrollment has been observed compared to past years.

Infrastructure Deficiencies and Regulatory Capture

Private medical colleges in Nepal consistently lack the necessary infrastructure, qualified faculty, and adequate patient flow to provide comprehensive medical education. These fundamental deficiencies are masked by the phantom faculty system, which creates an appearance of compliance during inspections, discrediting the future of the students.

The regulatory capture evident in this system extends to the highest levels of government. The Medical Education Commission, which should serve as an independent regulator, has been compromised by political and commercial interests that prioritize expansion over quality. Recent decisions to increase seats despite overwhelming evidence of educational inadequacy demonstrate how regulatory bodies have been co-opted by the medical mafia.

Recent Protests and Civil Society Response

The medical community’s response to these systemic failures has intensified in recent years. The Sangaarsha Samiti (Struggle Committee), along with Dr. Gobinda KC, have been constantly organizing widespread protests demanding the implementation of previous agreements and opposing the arbitrary increase in medical seats. Resident doctors, too, have previously staged hunger strikes and boycotted non-emergency services frequently, highlighting the exploitation they face in private medical colleges.

The Nepali medical fraternity has repeatedly called for government intervention to address Dr. KC’s demands and reform the medical education sector. The governing authority has ignored these criticisms, and in some cases, private medical college owners have even fought back by spreading disinformation to preserve their business interests.

Immediate Dangers to Public Health

The fake faculty crisis poses immediate and long-term dangers to public health in Nepal. Nepali medical doctors with inadequate training due to non-existent and fake faculty are forced to enter into practice without essential clinical skills and knowledge.

The 70% failure rate on licensing exams is strong proof that the majority of medical graduates are currently unprepared for independent practice, creating a public health emergency.

The situation becomes more dangerous when these inadequately trained doctors eventually pass licensing exams after multiple attempts and enter clinical practice. The cumulative effect of clinical mistakes and compromised patient safety due to inadequately qualified professionals threatens to create a catastrophic breakdown of public confidence in Nepal’s healthcare system.

Case Study: Ethical Collapse in Dental Education

This degrading situation is now clearly visible in the dental field. Nepal’s dental program, initiated in 1999 with BPKIHS and People’s Dental College and later expanded through Kathmandu University, has also been marred by the phantom faculty problem.

A senior dental surgeon revealed that KIST Medical College has lacked a Pedodontist for two years, forcing faculty from unrelated departments to teach pedodontics. At People’s Dental College and Hospital, an oral surgeon was even listed as an oral pathologist in the official records. In many dental colleges, one faculty member teaches multiple subjects while being paid a salary for a single subject.

The practice of “clubbing” subjects, which was officially to be lifted in July 2021, continues in the form of external faculties appearing in unrelated departments. This distortion has not only violated the curriculum and ethical codes but also jeopardized the careers of dental students and dental surgeons.

The Path Forward: Urgent Reform Imperatives

Addressing Nepal’s fake faculty crisis requires immediate and comprehensive action across multiple fronts. The government must prioritize quality over quantity in medical education, implementing Dr. KC’s long-standing demands for transparent faculty appointments, adequate infrastructure requirements, and non-commercial medical education.

The Medical Education Commission, Nepal Medical Council, and Nepal Medical Association must be reformed to eliminate conflicts of interest and ensure genuine independence from political and commercial pressures. Regulatory inspections must be strengthened through surprise visits and direct observation of faculty, rather than relying solely on paper documentation.

International cooperation with regulatory bodies in neighboring countries could help address the cross-border nature of the fake faculty phenomenon. The Nepal Medical Council’s collaboration with India’s Medical Council to identify doctors working simultaneously in both countries represents a positive step that should be expanded.

Conclusion: A System in Crisis

Nepal’s medical education sector stands at a critical juncture. The phantom faculty crisis, combined with the government’s continued prioritization of commercial interests over educational quality, threatens to undermine the entire healthcare system.

Dr. Gobinda KC’s warnings and protests about the dangers of increasing medical seats without addressing fundamental quality issues have proven prescient, as licensing exam failure rates continue to climb.

The medical mafia’s influence on policy decisions, the exploitation of legitimate faculty and students, and the resulting brain drain create a tsunami that endangers both current and future healthcare in Nepal.

Without immediate and comprehensive reform in the Nepali medical education system, the country risks producing generations of inadequately trained medical professionals while losing its qualified doctors to international markets.

Patients should have access to a medical system that is based on skill, morality, and a sincere interest in public health rather than private gain. Problems like phantom faculty serve as an urgent warning in the healthcare sector, as such deception can cost individuals their lives.

The decision between safeguarding the medical mafia’s interests and providing great treatment is a watershed moment for Nepal’s future.