According to the Community Paramedic (CP) course guideline, CP students must complete a six-month clinical attachment during the final stage of their training in hospitals with 50 beds or more. In practice, however, access to government facilities had often been inconsistent due to the absence of formal government notice and standardised placement procedures. This created uncertainty around supervision, monitoring, and certification, limiting students’ exposure to public health facilities, which serve the low-income and underserved populations in rural communities.
To address these challenges, the officials from the Department of Hospital and Clinics under the Directorate General of Health Services (DGHS) conducted field visits to selected government facilities where CP students work, as well as to a Community Paramedic Training Institute (CPTI). These visits allowed officials to observe the ongoing teaching-learning and clinical attachments, assess supervision arrangements, and identify areas requiring clearer operational guidance.
Following this review process, DGHS formally approved the hospital attachment framework and issued guidance outlining procedures for placement, supervision, monitoring, reporting, and certification. Upon successful completion of the six-month attachment and assessment, students will receive certification from the respective Civil Surgeon, formally recognising their practical competence within the public health system.
Importantly, government health facilities serve a large number of rural, low-income, and underserved populations seeking affordable care. For CP students, this creates a valuable opportunity not only to gain clinical experience but also to build direct connections with the communities they are likely to serve after graduation. Working alongside government doctors, nurses, and health workers during the attachment period will also build their professional networks, which will help them to refer their patients to the public facilities.
The ASTHA project has been working in partnership with government counterparts to support the development of such a mechanism, particularly advocating for structured placements at government facilities located near CPTIs. Strengthening this hospital attachment will not only improve learning outcomes of CP students but also reinforce access to coordinated and affordable healthcare services in rural and underserved communities.