(1) The prescribed posts at the following levels of the Health Service shall be filled as follows:- Levels Open by recruitment Internal by recruitment by competition Evaluation of work experience by adjustment from competitive examination evaluation
(a) 4th 100% –  –  –  –  –
(b) Fifth 65% – 20% 15% (c) Seventh 65% –   20% 15% (d) Eighth
(Physician) 100% –                                 –                              –
(e) Ninth
(Physician) 20% 40% 40% –
(f) Ninth
(Nursing) 20% 40% 40% –
(g) Ninth
(Excluding Physicians and Nursing) 20% 50% 30% –
(g) Eleventh        10%            50% 40% –
(h) Twelfth – 100% – 100% –
(2) The minimum educational qualification required for the open competition shall be as prescribed.
(3) Any employee who has been promoted to a position of the same level or has been promoted to the same level in a position filled by open and internal competitive examination but has not been adjusted and posted in accordance with this Act, if he has fulfilled the prescribed qualifications for such examination, he may also be included in that examination.
(4) Notwithstanding anything written in sub-section (1), in case there is no employee at a lower level than the post to be filled, such post shall be filled by open competition.
(5) Notwithstanding anything written in sub-section (1), in order to make the health service inclusive, forty-five percent of the posts to be filled by open competition shall be allocated and the said percentage shall be considered as 100%, and the posts shall be filled by competition only among the following candidates:-
(a) Women – thirty three percent
(b) Tribals/tribes – twenty seven percent
(c) Madheshi – twenty two percent
(d) Dalits – nine percent
(e) Handicapped – five percent
(f) Backward Areas – Four percent Explanation:
(1) For the purposes of this sub-section, "backward area" means the districts of Achham, Kalikot, Jajarkot, Jumla, Dolpa, Bajhang, Bajura, Mugu and Humla.
(2) In clause (a) of this sub-section,For the purpose of (b), (c) and (d), "women, tribal/tribals, Madhesi and Dalits" means economically and socially backward women, tribals/tribals, Madhesi and Dalits.
(6) When determining the percentage in accordance with sub-section (5), the coefficient (fraction) of less than one percent will be shifted to the next group immediately after the coefficient of the group from which it came.
(7) If a suitable candidate is not available in the advertisement of the year for which the advertisement has been made for the post allocated as per sub-section (5), then such post shall be included in the advertisement of the next year and if no suitable candidate is available even after such advertisement, such post shall be filled in the next year through open competition. Should be included in the post to be fulfilled.
(8) The system of filling posts by the percentage determined in accordance with sub-section (5) shall be reviewed every ten years.
(9) If there is any dispute while determining the number of posts according to the percentage as per sub-section (5), the decision of the Public Service Commission will be final.
(10) Apart from the posts filled as per sub-section (1), other posts or levels will be upgraded in accordance with section 9.
(11) Other arrangements related to the filling of posts shall be as prescribed.