Reforms in Ayurveda Education: Challenges & Roadblocks
Throughout the ages, Ayurveda was taught in the “gurukula†system of education and was an oral tradition where the “shlokas†or verses were passed on to the generation of students along with the applied aspects in clinical practice. It was during the early part of the 20th century concerted efforts were made to revive traditional Ayurveda system. Many committees were set up by the Government of India to investigate various aspects of Ayurveda and its education across India and the recommendations of a couple of these committees were not altogether supportive of Ayurveda as such. Many types of council were established but the educational system could not be standardised and the syllabus that we have today seems based on the modern medical system rather than concentrating on the core philosophy and practice of Ayurveda. Ayurveda today has become a multi-billion-dollar industry with the entire world wanting a share of the pie of it’s: health and wellbeing sector, the herbal medicine sector, the spa and resort sector, medical tourism sector and the education sector. Education in Ayurveda is caught at the cross roads of increasing global demand and declining local standards. It is high time that the regulatory bodies and all the stakeholders take serious note of this and intensify their efforts to standardize the education in Ayurveda failing which the science will be brought into disrepute and hijacked by vested interests who will then stake claim on the ownership of Ayurveda. This paper discusses the challenges and roadblocks faced at the entry level, undergraduate level, the curriculum and the regulatory bodies in the present scenario in India and propose certain solutions for the same.
Introduction
The ancient science of Ayurveda which literally means “the science of life” is not just a herbal medicine nor a system of charms and amulets and pulse diagnosis but a scientific system of understanding the true meaning of life and how one can lead a happy, healthy and a prosperous life without diseases [1, 2]. The origins can be traced back to mythological times with Lord Brahma himself said to be the creator of Ayurveda. Lord Dhanwantari, the incarnation of Vishnu during the ‘samudramanthan-churning of the ocean” is the deity of Ayurveda. It is a sub-branch of Atharva Veda, one of the four Vedas. The original treatises of Ayurveda date back to nearly 5000 years and have stood the test of time amidst the various political, social, cultural and religious influences that India has experienced. The principles hold true even today and it is no wonder that the entire world is looking to Ayurveda for solving lifestyle diseases and other health issues.
Ayurveda has eight disciplines which include surgery, rejuvenative medicine, toxicology, science of infertility etc. which offer tremendous insight into the advanced knowledge that our seers possessed back then. All of these have been recorded into texts which are called as ‘samhitas” as they are available today. All samhitas have been composed in the Sanskrit language. Throughout the ages, Ayurveda was taught in the “gurukula” system of education and was an oral tradition where the “shlokas” or verses were passed on to the generation of students along with the applied aspects in clinical practice. With the invasions of different countries that India has sustained for the past 500 years prior to independence, the patronage of Ayurveda was lost, and the traditional teaching and learning methods were systematically dismantled especially by the colonial rule of the British Empire. The traditional methods were declared unscientific and not worthy of continuing. The modern medical system which was just beginning to find its existence was deemed superior because of the inventions like the microscope etc which helped in the development of many theories of modern medical science as we see today.
It was during the early part of the 20th century concerted efforts were made to revive traditional Ayurveda system especially in the Maharashtra region. Many committees [3, 4] were set up by the Government of India to investigate various aspects of Ayurveda and its education across India and the recommendations of a couple of these committees were not altogether supportive of Ayurveda as such. Many types of council were established but the educational system could not be standardised and the syllabus that we have today seems based on the modern medical system rather than concentrating on the core philosophy and practice of Ayurveda.
The Present Scenario
Ayurveda today has become a multi-billion-dollar industry with the entire world wanting a share of the pie of it’s: health and wellbeing sector, the herbal medicine sector, the spa and resort sector, medical tourism sector and the education sector. The regulatory mechanism has the following components which look into the education, research as well as propagation of Ayurveda across the world: The ministry of AYUSH, established in 2014, the CCIM established in 1970, Directorates of AYUSH in all states across India & Health Universities in each state in India.
The streams of courses that are offered in Ayurveda are:
- BAMS (Bachelor of Ayurvedic Medicine & Surgery -Undergraduate level-5 ½ years
- MD / MS (Doctor of Medicine/Surgery)-PG level-3 years duration-in 21 disciplines
- Diploma courses-16 disciplines
- Certificate courses These courses are offered through Ayurveda colleges which must be recognised and permitted by the regulatory bodies mentioned above. Apart from these, there are many organisations which offer short duration courses in Ayurveda which may or may not have valid permissions.
Ayurveda Statistics in India at a glance (Table 1) [5]
| Particulars | Total Number | |
|---|---|---|
| 1 | Undergraduate Colleges | 219 |
| 2 | Admission Capacity-Undergraduate Level | 11,622 |
| 3 | Postgraduate Colleges | 64 |
| 4 | Admission Capacity-Postgraduate Level | 1067 |
| 5 | Total Number Of Registered Ayurveda Practitioners in Ayurveda | 4,38,721 |
| 6 | Total Number of Ayurveda Dispensaries In India | 15,193 |
| 7 | Total Number of Ayurveda Hospitals | 753 |
| 8 | Total Bed Strength | 35,182 |
| 9 | Licensed Pharmacies Preparing Ayurveda Medicines | 7021 |
Table 1: Particulars/Total Number.
The CCIM has issued a MINIMUM STANDARDS REQUIREMENT (MSR) [6] guideline to establish an Ayurveda college which covers the college and hospital infrastructure and teaching and non-teaching staff pattern standards required. Every year state university and the CCIM conduct inspection of all colleges and forward the recommendations to the ministry of AYUSH for approval. Subjects taught in Ayurveda course: Sanskrit, Ayurveda anatomy and physiology, Philosophy of Ayurveda, Ayurveda herbs and minerals, Principles of pathology and diagnosis in Ayurveda, Preventive and Social Health principles in Ayurveda, Internal Medicine, Paediatrics, Gynaecology and Obstetrics, Surgery, ENT and Ophthalmology and Research Methodology and Biostatistics.
Course Pattern (Table 2)
| I Year BAMS | 1 YEAR Duration |
| II Year BAMS | 1 YEAR Duration |
| III Year BAMS | 1 YEAR Duration |
| IV Year BAMS | 1 ½ YEAR Duration |
| Mandatory Clinical Internship | 1 Year |
| Total Duration Of Course | 5 ½ Years |
Table 2: Year /Time Duration.
Exam Pattern
Yearly exams which include theory and viva-voce conducted by the State University.
Challenges in Ayurveda Education
Entry Level Challenges
Starting from last year, NEET is the qualifying exam to enter the undergraduate course in Ayurveda. NEET considers physics, chemistry and biology to be eligible for admission. This poses an interesting set of challenges. To be eligible to enter Ayurveda, a cut off percentile is declared, and it is not mandatory that a student must secure a minimum percentage in all the three subjects to qualify. To illustrate: if the eligible marks is decided as 300 to secure a general merit seat, a student can score 10 marks in physics, 30 marks in chemistry and 260 in biology to qualify. Whereas, another student who scores 75 in physics, 75 in chemistry and 125 in biology may not qualify. Where is the merit in such a scenario? These issues must be resolved.
Challenges at the Undergraduate Level
From a students’ perspective: A student from physics, chemistry and biology enters Ayurveda and is expected to learn Sanskrit which is the basic language in which all the texts of Ayurveda are written in. The terminologies are all in Sanskrit and students find it difficult to comprehend the subjects properly. This gets compounded by the fact that a vast majority of teachers in Ayurveda colleges are not competent to motivate and stimulate the students to learn and understand Ayurveda. Even though Sanskrit is taught as a subject, the curriculum does not allow enough time to learn it and being clubbed with other subjects in the daily time table, a student does not really connect with either Sanskrit or other subjects. Ayurveda is based in philosophy and it requires a holistic approach to understand the basics correctly. One must understand that Ayurveda is not merely a medical science, but a science of life of which medicines and treatments are a part of.
Thus, without a proper understanding of the core concepts in the first year, the students progress to the next subsequent years which includes practical training in dealing with patients and planning treatments. At this stage what is required is an extensive training protocol which is missing from the curriculum.
One cannot deny the fact that a vast majority of Ayurveda practitioners who also teach in colleges practice modern system of medicine and to expect that these teachers will motivate students to practice Ayurveda is highly questionable. To complicate matters, we have a situation in the country where Ayurveda practitioners and teachers protest to demand that they should be allowed to practice the modern system of medicine. This takes away the sanctity of Ayurveda and sends a wrong message to the society. How can we expect the students to learn traditional Ayurveda in such an environment?
Challenges in the Curriculum
The Ayurveda curriculum in existence today is predominantly modern science oriented and does not give importance to traditional Ayurveda teaching. A student needs to be taught the conventional science as we live in a society where allopathy is accepted predominantly than Ayurveda, but this takes precedence over Ayurveda subjects.
The patient input in Ayurveda hospitals is very low compared to modern medicine hospitals and thus there is an acute shortage of exposure to good clinical practices for students. There are only a few states in India like Kerala, Southern part of Karnataka, Maharashtra and Goa where Ayurveda is the preferred medical system.
Challenges in Getting Good Quality Teachers
The regulatory bodies that govern Ayurveda as mentioned above have not done their job with responsibility over decades and this has resulted in setting up of many sub-standard colleges without the basic infrastructure throughout the country. The data exists only on paper and there is nothing concrete to show. The basic eligibility criteria to be appointed as a teacher are a postgraduate degree in respective disciplines. The quality of postgraduate teaching is very poor in a majority of Ayurveda colleges and this does not bode well for the future of Ayurveda. The curriculum of the post-graduate level is also very complex and there is not much scope to train the scholar to become effective teachers. Teaching is an art which requires dedication, devotion and discipline and most importantly passion for the science and the present frame work of academic and clinical activity does not take into consideration the development of good quality teachers.
Challenges with the Regulatory Bodies
Though the ministry of AYUSH and CCIM have inspiring vision and mission statements and objectives, the actual reality on the ground is very different. It is duty of these bodies to ensure that strict standards are implemented through consultation with the concerned stake holders. Yearly inspections are carried out through these bodies in Ayurvedic college across the country and these inspections concentrate more on the physical parameters of the hospital building rather than required levels of education and the outcome in terms of benefit to the society through the doctors passing out of the institution. Certain standards are described which seem absurd and questionable and they highlight lack of vision and progressive thinking.
Ayurveda is now getting recognized across the globe and has footsteps in the following countries [4]- America, Canada, UK, Germany, Italy, France, Ireland, Slovenia, Greece, Finland, Caribbean countries, South Africa, UAE, Australia, New Zealand. Though the regulatory bodies have inked several PACTS it remains doubtful whether India has the necessary infrastructure, training facility, research and development to meet the demands of the global healthcare and wellbeing industries.
Roadblocks in The Field of Education in Ayurveda
- Lack Of A Vision To Develop Ayurveda
- A Blind Tunnel Vision to Follow Modern Medical Science Model at All Levels
- Mushrooming of Ayurveda Colleges
- Unscientific Minimum Standards
- Patronising Attitude
- Unscientific Syllabus Pattern
- Disorganized Teaching Fraternity
- Corrupt Practices
- Scant Regard for Research and Development
- Vested Interests
- Very Limited Career Prospects Proposed Solutions
- Only biology to be considered as qualified through the NEET.
- Revision of the current curriculum.
- Sanskrit to be taught in more effective way.
- Clinical and applied teaching from the first year BAMS itself.
- Changes in the examination question paper pattern.
- Hands on training in all subjects.
- Improve the diagnostic and treatment making skills in students.
- Inclusion of assignment, projects and activity throughout the year to assess the performance of the student rather than a yearly exam or week.
- More emphasis on teachings based on original text of Ayurveda.
- Good quality text book publication and revised editions with updated knowledge should be made available.
- Regular consultation with teachers of the university and central regulatory bodies level.
- Performance based indices to be developed for teachers
- A robust research and development wing to be established.
- Collaboration with other allied sciences.
Conclusion
Education in Ayurveda is caught at the cross roads of increasing global demand and declining local standards. It is high time that the regulatory bodies and all the stakeholders take serious note of this and intensify their efforts to standardize the education in Ayurveda failing which the science will be brought into disrepute and hijacked by vested interests who will than stake claim on the ownership of Ayurveda.
References
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(2004) Charaka Samhita, Chukhambha Orientalia.
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(2004) Sushruta Samhita, Chaukhambha Orientalia.
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(2005) The evolution of Indian Government Policy on Ayurveda in the twentieth century, DW in “Modern & Global Ayurveda: Pluralism and Paradigms. New York, SUNY Pres, pp.43-76.
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(2005) Trends and Developments in Ayurveda: Hemachandran Nair G, University of Calicut.
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www.ayush.gov.in
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www.ccimindia.org
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