When I arrived in Australia more than two decades ago, Nepali doctors were so few that many of us could work for years without meeting another Nepali physician in the same hospital system. Gaining registration was a lonely trial by fire: unfamiliar examinations, demanding regulations and almost no professional community to guide us.
Australia was only one chapter in a much older story. Nepali doctors had already established themselves in the United Kingdom for decades, followed by a large community in the United States and important groups in the Maldives, Gulf states and elsewhere.
When I arrived, there were probably fewer than ten Nepali doctors in Australia. Today, based on more than twenty years of professional and community involvement—including serving as president of the Australasian Nepalese Medical and Dental Association—I estimate that more than 500 doctors of Nepali origin practice here.
This is an informed estimate, not an official count: Australian registration data do not classify doctors by Nepali origin. Yet professional networks, community knowledge and searches involving even one common Nepali surname make a total above 500 highly plausible.
They work alongside thousands of Nepali nurses, engineers, information-technology professionals, academics, accountants, researchers, managers and entrepreneurs. Labor migration remains central to Nepal’s national story, but it now exists beside a vast professional, technical and entrepreneurial diaspora.
A new global Nepali identity
Nepalis have long enjoyed a positive international reputation. The Gurkha legacy established an image of courage, loyalty and discipline; generations of migrant workers added resilience, adaptability and trustworthiness.
That reputation is a national asset, earned through sacrifice. Yet even positive stereotypes can limit. To be seen mainly as loyal, quiet and hardworking is not necessarily to be seen as intellectually authoritative, strategically influential or capable of institutional leadership. Nepalis were trusted to carry responsibility, but not always imagined as those who would design systems, lead organizations or make final decisions.
The stereotype was complimentary, but incomplete.
The growth of Nepali doctors, engineers, scientists, academics, technology professionals and entrepreneurs is broadening that image. When Nepali doctors lead clinical teams, engineers design infrastructure, nurses manage complex services, researchers contribute to international research, and technology professionals build new systems, they expand the world’s understanding of Nepali capabilities.
This is not a movement from inferior work to superior work. Gurkhas, laborers, nurses, doctors, engineers and entrepreneurs all belong to the same national story. The change is that the world now sees a wider spectrum of Nepali ability.
This may be one of Nepal’s most important forms of rebranding, achieved largely without a government strategy or diplomatic campaign. The diaspora has done it through performance. A Nepali professional trusted with lives, infrastructure, research or major decisions quietly improves Nepal’s reputation every day.
That reputation has economic and diplomatic value. Countries are judged not only by governments, passports and gross domestic product, but also by the caliber of their people. A successful professional diaspora is therefore a form of soft power.
Professional associations abroad reinforce it by mentoring younger migrants, organizing educational and charitable activities, and building links with Nepal. They are an organized reservoir of expertise, relationships and leadership.
But pride should not prevent a harder question: why must so many Nepalis leave before their abilities are fully recognized and used?
The silent national loss
The professional diaspora is both a success story and a warning. Every Nepali leading a department, designing infrastructure or contributing to an international institution shows what is possible with functional systems, professional respect and credible advancement. Their success also reveals what Nepal has failed to retain or use.
Nepal Medical Council figures illustrate the medical outflow. In 2025, 2,390 doctors obtained Good Standing Certificates, while 2,122 new domestic practice licenses were issued. Since 2020, more than 11,000 doctors have reportedly sought certificates for overseas professional or academic opportunities. The main destinations were the United States, United Kingdom, Maldives, Australia and United Arab Emirates.
A Good Standing Certificate does not prove permanent emigration; it may support registration, training, examinations or temporary work. Still, when applications exceed new domestic licenses, the direction of professional aspiration is clear.
Professionals do not leave only for higher salaries. Many see no credible future at home because of limited postgraduate training, uncertain progression, inadequate remuneration, institutional politics, administrative delay and workplaces lacking necessary equipment, staffing or culture. Migration becomes a route out of stagnation.
The problem is that a state cushioned by migration can become less responsive to what drives people away. Migration absorbs unemployment, eases labor-market pressure and supplies foreign currency. The inflow is counted; lost expertise is not.
A departing doctor may take decades of clinical service, teaching, research and leadership. An engineer may take technical expertise and mentorship; an academic or entrepreneur may take future organizations, innovations and networks. Nepali families and institutions bear much of the cost of developing these professionals, while wealthier countries receive their most productive years. Remittances and distant prestige cannot fully replace them.
Modern careers need not involve choosing between staying forever and leaving forever. People can train abroad, return, work across countries or contribute remotely. Nepal’s failure is not migration itself, but the absence of effective ways to remain connected, turning mobility into permanent institutional loss rather than circulation of knowledge.
The usual response is that successful professionals should return. Yet many who try struggle.
Some returnees succeed and are celebrated, but visible success can conceal a quieter reality. International qualifications may not be readily recognized or used. Returnees may face opaque licensing, administrative delays, rigid hierarchies, institutional defensiveness or appointments in which merit is only one consideration. Advanced skills may be unusable without suitable equipment, teams, support or authority.
The whole family bears the risk. A spouse may lose a career; children may struggle with education, language or adjustment; families may confront concerns about healthcare, pollution, traffic, unreliable services, political instability or security.
Many return with optimism, then leave again after frustrating years. Others remain because of parents, obligations, investments or commitment, but privately regret the decision. They rarely speak openly because regret may be seen as arrogance, failure or lack of patriotism.
They are Nepal’s invisible returnees: praised for returning, then left to manage the consequences alone.
This does not mean every return ends badly or every Nepali institution is hostile to international experience. It means the system is inconsistent: some people find supportive colleagues and workable opportunities, while others with comparable ability encounter barriers they could not reasonably have anticipated. A national strategy must make successful reintegration predictable rather than dependent on the right institution, personal contact or fortunate timing.
One failed return discourages more than one person; the story spreads through diaspora networks and deters others. Reintegration too often depends on resilience, connections, wealth or luck. National policy cannot rely on exceptional cases.
Return must become a national responsibility
Nepali public discourse often repeats John F. Kennedy’s appeal that citizens should ask what they can do for their country. Civic responsibility matters. But the phrase can be used to transfer institutional responsibility to individuals.
A doctor questioning unsafe conditions is told to serve the nation. An engineer without meaningful work is told to be patient. A researcher without resources is asked to sacrifice. A professional who leaves to protect a career or family may be called materialistic or insufficiently patriotic.
That is not a fair social contract. Patriotism cannot require indefinite risk to career, family welfare and professional dignity while the state accepts no reciprocal responsibility. Citizens have duties, but so does the state: to create fair opportunities, transparent administration and institutions in which competence can be recognized and used.
Telling professionals to ask what they can do for Nepal addresses only half the question. Nepal must also ask:
What can the country do to make their return workable, productive and sustainable?
The aim is not to prevent international mobility or grant returnees automatic appointments, seniority or privilege. Professionals who remained in Nepal also possess valuable experience, often gained under difficult conditions. The goal is fairness, not preference.
Nor is this a demand for comfort or guaranteed success. It is a request for conditions in which contribution has a reasonable chance. Inviting expertise without a navigable way to use it is not welcoming return; it is appealing to sentiment.
Nepal must move from one-way brain drain to brain circulation. Regulators need clear, published and time-bound processes for recognizing international qualifications and experience, with workable routes for temporary registration, visiting appointments, teaching, telemedicine, research and specialist collaboration.
Hospitals, universities and government bodies should create joint appointments and knowledge-transfer programs instead of relying on personal contacts. A one-stop service should guide returnees through licensing, taxation, investment, employment, schooling and relocation. Reintegration concerns the whole family, not only one professional.
Appointments must remain merit-based. International experience should neither guarantee privilege nor be treated as a threat.
Contribution should not require permanent relocation. Doctors can teach for several weeks, engineers advise remotely, academics jointly supervise research, and technology professionals establish teams without uprooting families. Some will return permanently; others will contribute periodically or from abroad. Policy should support all these relationships.
Nepal’s institutions can change course. In an earlier Setopati English article, I questioned the Nepal Medical Council’s decision to remove Nepali-origin doctors who had acquired foreign citizenship from its register. After public concern, the Council withdrew the cancellation affecting 36 non-resident doctors, retained their names and indicated that other non-resident Nepali doctors could register through an appropriate process.
That was a wise correction. It showed that standards can be protected without severing ties with experienced diaspora professionals, and that regulators can listen and adopt a proportionate approach.
The same principle should guide Nepal’s broader diaspora policy. Government, bureaucracy, professional councils, private institutions and development partners should stop viewing overseas Nepalis mainly as sources of remittances, donations or occasional assistance. It is equally unfair to dismiss them as people who abandoned Nepal merely for personal comfort. Migration is a global phenomenon, and Nepal’s professional diaspora should be recognized as an extension of the country’s intellectual and professional capacity.
The global Nepali story now contains two realities: the capable professional who earns trust in demanding institutions and expands what it means to be Nepali, and the citizen whose ambition travels further than Nepal’s institutions, whose overseas success is celebrated, but whose return is treated as a private experiment.
Nepali capability is visible across countries and professions on an unprecedented scale. That deserves celebration—but diaspora success must not become an alibi for state failure.
Nepal must ask why so many leave to fulfill their potential, why returning remains difficult and why failed returns are rarely heard. Returning should not require professional martyrdom, and contributing should not depend on connections, persistence or appeals to patriotism.
The responsibility cannot rest solely on the person who left.
The state must create a country to which capable people can return, contribute and belong—without regretting that they tried.
(Dr Anupam Pokharel is a consultant psychiatrist based in Melbourne and a former president of both the Australasian Nepalese Medical and Dental Association and the Nepalese Association of Victoria. He has been involved in the Nepali medical and wider professional community in Australia for more than two decades. The views expressed are personal.)
