Ayurvedic curriculum, clinical practice & teaching - emerging issues

Ayurvedic curriculum is undergoing rapid changes. Introduction of new courses like Ayurvedic Biology, and Network Pharmacology and induction of non Ayush professionals in subjects like pharmacology, translational medicine, and medicinal plants in faculty is a clear-cut sign of massive changes in nearby future.

Ayurvedic Biology is a unique programme conducted by Jawaharlal Nehru University, New Delhi as dual degree programme (BSc-MSc). Although this programme is not available at National Commission of Indian System of Medicine recognized Ayurvedic colleges and not included in the list of recognized medical qualifications under Section 35 of NCISM Act, 2020. Keeping in mind the expanding horizons of Ayurveda education Ayurvedic Biology programme can be initiated as add on programme in Physiology Department of recognized Ayurvedic colleges. Alternatively postgraduate diploma in Ayurvedic Biology on lines similar to postgraduate diplomas in other subjects can be planned.

MSc Phytomedicine course hosted by Baba Farid University of Health Sciences, Faridkot is yet another significant course having relationship with Ayush. The Ayush undergraduate degree holders are eligible to sit in the entrance examination leading to admission.
In recent employment notices issued by All India Institute of Ayurveda, New Delhi and Shri Krishna Ayush University, Kurukshetra, non Ayush vacancies in domains like pharmacology and translational research are testimony to the changing spectrum of the education.

Perhaps the student community and teaching fraternity are suffocated with the present model of Ayush teaching and training. Colleges and Universities having faculty of Ayush are fighting battle for existence and probably the introduction of new subjects can provide a fertile ground for nourishing the traditional systems of medicine.

The dissolving of Central Council of Indian Medicine (CCIM), establishment of National Commission of Indian System of Medicine, initiatives by Ministry of Ayush at global levels are some of the landmark episodes in the history of Ayush. With establishment of the National Commission of Indian System of Medicine (NCISM) it is expected that the aims and objectives not achieved by the Central Council of Indian Medicine shall be fulfilled. 

Ayush systems of medicine are propagating more in non Ayush institutions as compared to conventional schools of traditional systems of medicine. New courses which are not part of the newly designed NCISM syllabus or old syllabus of CCIM are being introduced.

With established subjects loosing charm and emerging one having roots in modern medicine, it is really confusing for the aspiring Ayurvedic or more correctly Ayush professionals from where to start.  Majority of the established subjects lack practical backing. These subjects have evolved over the time by observation of traditional healers.
Let us site example of dosha (biological humour), dhatu (tissue) and mala (waste product) vigyan and sharira kirya (human physiology).  The former name provides insight of traditional aspect of human body functioning and later seems to be the modern equivalent to medical physiology.  Which path to adopt for learning physiology from Ayurveda point of view is the major hurdle for the aspirants? It is interesting to mention that here that emerging discipline Ayurvedic biology and genomics has roots in core concepts of Ayurvedic physiology.

Dravyaguna yet another discipline having roots in medicinal plants is passing through a surviving phase.  Revamping of the syllabus and overpopulation of dravyaguna fraternity are two factors having a limiting effect on the credibility. Reverse pharmacology, ethnopharmacology and network pharmacology correlate with Ayurvedic Medicine especially targets dravyaguna. Based on this a bifurcation into traditional dravyaguna and evidence based dravyaguna is emerging.

We have cited examples of Ayurvedic physiology and dravyaguna only. Other subjects are facing equal challenge.  A comparative critical analysis of the curriculum prescribed by CCIM and NCISM reveals that radical changes have crept in. 

This academic year has witnessed big scam in National Eligibility Entrance Test and it is going to affect admission process in Ayush colleges due to delay in Central and State counseling. Things need to be streamlined at the level of Ayush and NCISM so as to foster the struggling ancient systems of medicine.

So many committees had been constituted in the post-independence era and all of them stressing on revamping of the curriculum with applied aspect. Bodies like Ayush, CCIM and NCISM despite strenuous efforts have not been able to bring uniformity in the curriculum.

Introduction of NExT and NTET examinations have not received much response from the student community.  NExT for granting of license for clinical practice for graduates is not justice to the potential of students admitted after cracking NEET. Similarly, NTET is not justified for a postgraduate seeking career debut after passing AIPGET conducted by NTA. Both of the above examinations may leave detrimental impact on Ayush teaching and clinical practice.

As far as the academic session 2024-25 is concerned, it is passing through a critical phase. The admission process in the Ayush colleges is already running behind the scheduled time. The NEET controversy has not done anything good for the medical and Ayush stream.  The teaching faculty is private institutions are without salary for several months.  Keeping in mind the lack of practical human resource in Ayush institutions the faculty is double minded whether to join new one or continue with the current one. Despite issuance of guidelines by NCISM related to joining/resignation/promotion cases related to tussle between the faculty and management are escalated almost every day.    

The Ayush department has taken several steps at international level and admission of foreign nationals in colleges and establishment of chairs in international universities are two major breakthroughs.  NCISM every year comes out with new initiatives and schemes to bolster interest in the student community.  Ayurgyan, Smart and other schemes have failed to win hearts of the student community as far as popularity is concerned.
Compulsory internship is an integral part of Ayush undergraduate course. 

Barring few institutions, attached hospitals have negligible rush of patients making clinical exposure impossible for the student community.  Some colleges are imposing student’s community with internship based on Ayush principles and practices which may have importance form academic point of view but far away from the learning or practical aspect. When modern subjects are part and parcel of the syllabus designed by CCIM or NCISM then there must be space of practical training in modern subjects while undergoing the compulsory internship. 

Ayush and NCISM are operating at Centre level along with state Ayush department and registrar office for implementing provisions of the central and state acts. Honestly speaking, the apex bodies dealing with Ayush systems of medicine follow the guidelines framed by the apex bodies dealing with Allopathic systems of medicine. Ayush systems of medicine have an independent existence as per acts constituted by government of India. 

Without scanning the practical problems responsible for dissatisfaction among the teaching fraternity and perspective students the Ayush model of teaching and clinical practice cannot flourish. Disseminating circulars, notifications and orders on the part of the apex bodies are part of the good governance only. The scenario is changing rapidly and without induction of the evidence-based model in ancient medicine no other alternative is viable. A lot depends upon the apex bodies to protect the future of the ancient medicine.