Richard Liang

Richard, a fifth-year medical student from Charles Sturt University, travelled to Kathmandu, Nepal, to complete his overseas placement. Richard wanted to develop his skills and knowledge in his selected area of interest – psychiatry – and go overseas to gain insight into how different cultures and beliefs impact healthcare in Kathmandu.

“I took an overseas placement to experience healthcare within a different cultural context. I wanted to explore the similarities and differences in medical practice and broaden my understanding of global health.

My first impressions were very eye-opening. While the doctors in Nepal demonstrated the same level of medical knowledge as Australian doctors, the infrastructure, funding and cultural perceptions of health were distinctly different. 

An interesting observation was the active involvement of patients' families in their care. Every patient had at least one family member present, as families were responsible for purchasing medical supplies for treatment.

I spent most of my time with the psychiatry team and was intrigued by the profound role that spirituality and religion played in the lives of patients and doctors. The Nepalese people reflected this influence through their kind and compassionate approach to life.

These experiences gave me a rich understanding of the interplay between culture and healthcare.

The clinical knowledge and skills I gained through psychiatry included rapport building and patient-team communication. I also gained a deeper appreciation for the mind-body connection and its integration with the spiritual principles of Buddhism and Hinduism, learning how health, religion, and spirituality intersect in this context.

During my time in the emergency department, I learned the critical importance of thorough history-taking and physical examinations, especially in settings where patients face financial barriers to accessing blood tests, imaging, and medications.

A memorable case I observed during my time in Kathmandu involved a patient with treatment-resistant schizophrenia. I could compare how community services differ in Australia and Nepal and how the patient's life would look outside the hospital, whether through vocational training services or, more specifically, different roles within his village, such as basket weaving. 

It was very interesting to observe inpatients with dissociative disorder as many patients with mood symptoms such as anxiety or depression aren’t treated until they present with dissociation of their mind and body with somatic symptoms such as excruciating pain or motor symptoms. 

A notable difference I observed was Nepal's lack of community mental health services. The stigma surrounding mental health conditions, particularly anxiety and depression, often prevents individuals from seeking help early, which leads to patients presenting at later stages of their condition. 

Another significant distinction is the financial structure of healthcare. In Australia, Medicare provides access to subsidised healthcare services, making treatments, medications, and investigations more accessible. In Nepal, however, patients must pay out of pocket for their medications and investigations, which can pose a significant barrier to receiving timely and appropriate care.

During my free time, my housemates and I explored Kathmandu. We visited cultural sites in the city centre and different bars and restaurants in the Thamel district. 

One weekend, we went hiking in nearby Pokhara, and the following weekend, we went on a safari in Chitwan National Park. 

If you’re considering an overseas placement, do it! Book that flight — you won’t regret it. Learning through experiences is the best way to learn. Travel open-mindedly, take it all in and appreciate another country’s culture.”

Start Your Journey

Want to go on your own once-in-a-lifetime adventure? Get started below:

Browse Destinations