Academic Reforms in Ayurveda – Do they Serve the Real Purpose?

Introduction

Curriculum reforms happen in every education system integrating the advancements in the concerned sector and also based upon feedback from the academy. These are essential to keep up the academy updated and time tested, the absence of which may render the education as mere donation of degree and will create a generation of graduates without merit and substance. When it comes to medical systems, it becomes more essential as this stream deals with the health of the entire society. Again, the case of Ayurveda deserves special attention since there are many controversies and grey areas in the educational system of Ayurveda, where unfortunately clinical importance and practicality are given least importance when compared to ancient literature and its linguistic decorations. The ancient Greek medicine, in its developmental phases, had been depending on the Greek language; but they have been transformed into the universal language, incorporating the concepts and words into the common pool of medical language. Similarly, instead of going back to the Sanskrit language, the educational sector of Ayurveda should focus on the addition of these terms and concepts into the universally acceptable pool of medical terms, thereby updating the Ayurvedic literature. Thus, there is need for involvement of medical professionals, researchers, policy makers and patients in order to construct an internationally acceptable way of academic model in the teaching of Ayurveda [1].

Amalgamating the ancient knowledge into the current medical practice, the system of Ayurveda demands more dynamic and scientific activities to keep the content updated and fruitful so as to make the graduation meaningful. But whether the reforms are in the right direction, or whether they are able to address the core issues in the field of education, practice and research of Ayurveda is a grey area that no one dare to deal with [2]. There are many areas Opinion like clinical importance, updated literature and must know areas in the syllabus, which deserve their importance in the curriculum. Unfortunately, these are least considered in every curriculum reform, which instead make revisions in a ‘beating around the bush’ manner rendering the old wine in new bottle, thereby deceiving the entire beneficiaries of this system including the students, patients, doctors and the political leadership.

The first and foremost reason behind this attitude can be traced out as ‘over possessiveness towards Ayurveda’. The majority of policy makers are reluctant to remove any racially motivated, gender discriminating as well as elementarily rude statements from the ancient textbooks which can never take its place in the 21st century education scenarios. To add to this, every academician will argue for his subject contents in the curriculum reforms, how much outdated the content might be. Everyone will agree to the statement that the syllabus is very vast and many irrelevant portions should be removed; but when it comes to the core issue no one will be willing to remove portions from their subject [3] and they will go to any extent similar to the political representatives arguing for their constituencies.

How can be the Model Reforms in Ayurveda Education?

Reforms in the Ayurveda education system should be focusing on the core Ayurveda philosophy and the essential technical adaptations for its implementation according to global need, unlike mere changing of the duration or shuffling the subjects as always being the practice [4]. The textbooks and activities have to be updated and prepared in concordance with research and developments in the medical field. Peer reviewed; curriculum-based textbooks written under the supervision of multi-disciplinary expert committees incorporating the recent advances in the field are the need of the hour [5].

Any portion from the Samhitha, however popular it may be, has to qualify the testing of current requirements and competency-based advantages compared with other available options in this regard [6]. For example, the descriptions regarding mrijjanya pandu (pica leading to anemia), is outdated since advanced investigation techniques have proven that the process happens in the opposite direction (anemia leading to pica). Hence, mugging up slokas related to the pathogenesis and symptomatology of this condition is pointless, thus making those portions suitable to find a place only in the history of Ayurveda. Removing such areas from the mainstream of Ayurveda serves two purposes. Primarily it improves the scientific outlook of Ayurveda. Secondly, it provides space for many clinically relevant topics to get a place in the syllabus and curriculum. Overall, it can add enormously to the confidence of the students and future practitioners. The inclusiveness in the approaches of Ayurveda has to be projected emphasizing its strength in areas of prevention and in managing chronic disorders ultimately leading to better positive health [7]. This will add to the global acceptance of Ayurveda and can serve as the stepping stone for Ayurveda into the public health sector [8].

How can the academic sector contribute to education reforms in Ayurveda?

Faculty development coupled with educational research is an essential part of curricular reforms [9]. Lack of orientation regarding educational research among the faculties can backfire on the smooth communication regarding the principles and application of academic reforms. Topics like laws governing the intellectual property rights, essentials of healthcare management and the basics of cultivation and marketing of medicinal plants are to be included as many branches in the list of electives [10]. The transformation from the ‘Gurukula system’ to ‘Modern classrooms’ might have included many action researches during their times; similar to the process happening currently when the focus is shifted onto technology-based learning. These works have to be explored in a systematic manner for proper standardization and development [11].

The first impression of the students after getting admission in an Ayurveda College is very much important. This impression is the driving force for the clinical journey of the student throughout the course. So, there is a need to add more application-based content in the first year of BAMS itself. Students have to be given good clinical exposure from the beginning itself [3, 12]. Even though this has been incorporated in the new NCISM curriculum, there is need to make clarity and uniformity in the implementation level. Adequate exposure of the students to basic clinical skills can ensure good participation of Ayurveda graduates in healthcare delivery system of the country [13]. Not only in applications level, but also in the conceptual domains, there is need for gross level changes and upgradation of standards. Concepts in Ayurveda, such as the rasa of a material being an indicator of its action on the body, are new to biomedicine and the modern nutritional sciences and can provide practical ways to create balanced diets [14]. This is an indication of how concepts and applications can be updated at the same time.

Future reforms in Ayurveda educations – The way forward

Educational researches are more common recently even in the field of Ayurveda, making it worth to discuss on the principles behind curriculum and syllabus revisions. The importance of subjectivity and qualitative aspects in case of Ayurvedic interpretations need special concern and should be tackled first before mimicking changes in objectively and quantitatively defined reforms of modern medicine. A case study from Sweden pointed towards important aspects of participant experience of Ayurveda [15]. An attitude of open-minded professionalism is vital here since the individual perceptions have to be transformed and replaced with the philosophically fine-tuned essence of Ayurvedic conceptualizations which can create new horizons in Ayurveda education [16].

A study conducted by Kishor Patwardhan, et al. showed that it is possible to implement hybrid problem- based learning (HPBL) method in a large classroom in the context of Ayurveda education [17]. The inclusive pattern of Ayurveda can accommodate and grow with the exclusiveness of modern medicine in a scientific and integrative manner. Thus, Ayurveda comprises all the three levels of western prevention (primary, secondary, tertiary) with stress on a personalized approach in diet and lifestyle planning preventing the disease occurrence at physical, physiological and psychological levels [18]. Still, the rationality behind the usage of these principles into practice needs some standardization through interdisciplinary researches, which has to consider academy and educational reforms as a focus area to meet the global standards [19].

Changing the entire system in one day is not at all practical. But it is possible to identify the different segments in the implementation of academic reforms and to make positive changes in one by one. For example, many progressive changes can be implemented in the teaching of Ayurveda in the university level, even though the syllabus points are confusing or outdated. The decision not to set questions from outdated areas can be taken at individual levels, at institutional levels and at university levels instead of blaming the syllabus and curriculum for the entire issues. Such efforts at various levels can act as a feedback mechanism in future framing of the curriculum and syllabus. Unfortunately, there is no such remarkable efforts from universities. Firstly, most of the apex bodies of the universities are filled with individuals who only want their name in the paper but not ready to invest time and effort for its cause. Secondly, everyone including university officials, faculties and students are satisfied with a syllabus in capsule form and not ready to think beyond this, only to complain at the end of the course or career. Keeping some visionaries in key positions and facilitating fruitful discussion can change the destiny at implementation level.

Conclusion

It is high time that the Ayurveda education system needs a well-made curriculum and syllabus owing to many reasons. The frequent changes in curriculum and syllabus do more harm than support to the Ayurvedic sector. The root causes behind the issues are never addressed and some magical results are being expected every time from ordinary rather regressive revisions. Even the progressive student fractions do not ask for positively framed curriculum reforms. Thus, it is time to introspect and change ourselves towards research oriented and evidence-based approaches in the triad of academy, clinics and literature. The common practice of balancing between modern and ancient portions like adding a primitive area (eg:- jyotisha) when a modern element (eg:- bioinformatics) is added in the syllabus has to be stopped as it is irrational and moreover it destroys outlook of the medical system. The admirers of ancient and ‘pure’ Ayurveda can refer them in museums instead of spoiling the future of Ayurveda by driving back the academy and clinical practice to the bullock cart era.