Hybrid International Emergency Medicine (HIEM)

Hybrid International Emergency Medicine (HIEM)

 Hybrid International Emergency Medicine (HIEM) is the first collaborative international Emergency Medicine training developed in the UK, the main objective of which is to develop a systematic approach to support international trained doctors to bring benefit for both the Emergency Department in UK and their home nations. Chitwan Medical College (CMC) has been recognized as one of the Quality improvement Medical Education Training (QiMET) centers which is responsible for recruitment of the trainees.

The successful candidates (selected trainees) will be designated as International Training Registrars (ITRs). They will go through 4 years of training (1st and 4th year training in Nepal at CMC and 2nd and 3rd year training in the UK (in NHS services) through Medical Training Initiative (MTI) national scheme). Trainees will follow Royal College of Emergency Medicine (RCEM) curriculum and Fellowship in Quality improvement (FQim) modules as part of the training. In this training pathway, trainees do not need to sit for the PLAB exam. However, to continue the training in the UK (during 2nd and 3rd year), a sufficient proficiency in English language is required (For requirements, see below).

At the end of the training process, trainees will appear for Member of Royal College of Emergency Medicine (MRCEM) exam and if successful, will receive two qualifications (MRCEM and FQim). The degree of MRCEM will be awarded by Royal College of Emergency Medicine. The degree of FQim will be awarded by International Academy of Medical Leadership (IAML).

This training is recognized by Nepal Medical Council (NMC) and RCEM-UK. The trainees, upon successful completion of the process will be able to work as emergency medicine specialists in Nepal after selection in the HIEM training.

The advertisement will be published in the months of July/August every year. Applications are invited through countrywide advertisements in leading newspapers and in the college website (www.cmc.edu.np). The candidates are advised to follow-up the CMC website for advertisements regarding application procedure for the HIEM program.

The annual intake of trainees is 4-6 in total.

The entrance exams will take place on the last Wednesday, Thursday and Friday of September every year. The entrance examination consists of 2 sections- Theoretical and Objective structured clinical examination (OSCE)/English test. The shortlisting of the candidates is done on the basis of MCQ-type question paper (100 MCQs related to the subject (Suggested book: Oxford Hand book of Emergency Medicine). The shortlisted candidates will undergo English test (500 words essay) and OSCE that consists of 4 stations (clinical questions, practical OSCE, Leadership and management and general questions) after which the final candidate selection will be done. The successful candidates will be enrolled in the program after signing of the agreement with the institution.

  1. Eligibility criteria of HIEM entrance exam

MBBS degree with one-year internship registered in Nepal Medical Council (NMC)


  1. Eligibility criteria of applying MTI application to continue HIEM UK training (2nd year and 3rd year training)
  2. Have completed at least 3 years postgraduate experience, including an internship; selected candidates who have completed only internship should work for one year as Medical Officer in the Emergency Department of CMC and then they can continue into the first year of HIEM Training at CMC, thus completing three years of post-graduate experience.
  3. Be certified in at least one life support course - ALS (or RCEM recognised Equivalence).
  4. Have achieved a minimum score of 7.0 in each section (speaking, listening, reading and writing) of the academic module of the IELTS and an overall minimum score of 7.5. Test should have been taken within the last 2 years.


have achieved a grade of at least 'B' in each testing area (speaking, listening, reading and writing) of the Occupational English Test (OET)-medicine version. Test should have been taken within the last 2 years.


 If the candidate fails to clear IELTS or OET – medicine version, the candidate will undertake                     all four years of HIEM Training at Chitwan Medical College.

[Attachment]- HIEM program details

HIEM trainees will follow 1st year HIEM Emergency Medicine training in Nepal. They will receive continuous support from CMC-Emergency Department. Clinical supervision will be given by Nepalese consultants whereas educational supervision will be given by UK consultant team. At the end of 1st year HIEM training at CMC-Nepal, candidates will be eligible to apply for 2nd and 3rd year HIEM UK training through QiMET-center, Nepal (CMC).

Trainees have to provide evidence of satisfactory progression through Annual Review of Competency Process (ARCP) every year. Trainees have to maintain a RCEM e-portfolio.

After the completion of the training period, trainees have to travel to Hyderabad, India to give their MRCEM exam. Passing the MRCEM exam is solely the responsibility of the trainee.

Admission fee: 1 lakh NPR

Tuition fee: 22 lakhs NPR (on installment basis)

Deposit: 5 lakhs NPR (during admission, which is refundable at the completion of HIEM training)


  • Stipend during CMC Training (1st and 4th year): NPR 18,000 per month in the 1st  Year and NPR 20,000 per month in the 4th  Year
  • Stipend/Benefits during UK Training (2nd & 3rd year): £35,000 + 50% banding £17,500 (per annum)
  • Other funding benefits during UK Training (£3800) as follows:
    - Fellowship in Quality improvement (FQim) course fund - £2000
  • ALS, ATLS, APLS course funding support ( £1200)
  • E-portfolio funding support (£400/ year)
  • First month accommodation (£175)
  • Entitle to bring your immediate family (wife+ children)


Successful applicants can obtain full General Medical Council UK (GMC) registration without taking the Professional and Linguistic Assessment Board (PLAB) test.


QiMET International Executive Director:

  • Dr Prakash Subedi

HIEM Program Director:

  • Dr Naushad Khan

FQim Director:

  • Dr Jill Ayelott

Educational Supervisors:

  • Dr Naushad Khan, DBTH, UK

Emergency Medicine: Prof. Dr Dayaram Lamsal & Dr Krishna Raut

ITU: Prof. Dr Gopendra P Deo & Dr Bishow Shrestha

Anaesthesia: Dr Suresh Gautam & Dr Indra Shrestha

Pediatrics: Dr Santosh Pathak & Dr Prativa Dhungel

Medicine: Prof. Dr Shyam Raj Regmi & Prof. Dr Sudhir Regmi

  • Dr Bibhab Koirala
  • Dr Manas Pokhrel
  • Dr Sushil Khadka
  • Dr Rojina Shrestha
  • Dr Suchit Amatya
  • Dr Tilak Sapkota

Further information

For any information regarding HIEM program at CMC, please contact

Ms. Indira Nepal, Manager-Medical Education Department

Chitwan Medical College

Phone: 977 056 532933/532936, Email address: pg@cmc.edu.np