A recent government notification listed out specific surgical procedures that a postgraduate medical student of Ayurveda must train themselves in and acquire skills to perform independently.
The notification has invited sharp criticism from the Indian Medical Association (IMA).
How far is surgery part of Ayurveda?
Ayurveda practitioners are trained in surgeries, and do perform them.
In fact, they take pride in the fact that their methods and practices trace their origins to Sushruta, an ancient Indian sage and physician.
Sushruta’s comprehensive medical treatise Sushruta Samhita makes descriptions of illnesses and cures.
It also has detailed accounts of surgical procedures and instruments.
There are two branches of surgery in Ayurveda:
Shalya Tantra refers to general surgery
Shalakya Tantra pertains to surgeries related to the eyes, ears, nose, throat and teeth.
All postgraduate students of Ayurveda have to study these courses.
Some go on to specialise in these, and become Ayurveda surgeons.
How about the procedures?
For several surgeries, Ayurvedic procedures almost exactly match those of modern medicine about how or where to make a cut or incision, and how to perform the operation.
There are significant divergences in post-operative care, however.
The only thing that Ayurveda practitioners do not do is super-speciality surgeries, like neurosurgey.
For most other needs, there are surgical procedures in Ayurveda, and is not very different from allopathic medicine.
What were the earlier regulations for postgraduate students?
Postgraduate education in Ayurveda is guided by the Indian Medical Central Council (Post Graduate Education) Regulations framed from time to time.
Currently, the regulations formulated in 2016 are in force.
The latest notification in November 2020 is an amendment to the 2016 regulations.
The 2016 regulations allow postgraduate students to specialise in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynaecology).
These three disciplines involve major surgical interventions.
Students of these three disciplines are granted MS (Master in Surgery in Ayurveda) degrees.
Students enrolling in Ayurveda courses have to pass the same NEET (National Eligibility-cum-Entrance Test).
Their course runs for four-and-a-half years, followed by one year of internship, 6 months of which are spent at an Ayurveda hospital.
The remaining 6 months is spent at a civil or general hospital, or a primary health care centre.
Postgraduate courses require another 3 years of study.
They also have to undergo clinical postings in the outpatient and in-patient departments at hospitals.
This is apart from getting hands-on training in Ayurvedic treatment procedures.
Medico-legal issues, surgical ethics and informed consent are also part of the course apart from learning Sushruta’s surgical principles and practices.
What is new now?
The surgeries mentioned in the notification are all that are already part of the Ayurveda course. But there is little awareness about these.
So the latest notification just brings clarity to the skills that an Ayurveda practitioner possesses.
With the notification, patients now know exactly what an Ayurveda doctor is capable of as the skill sets have been defined clearly.
It mentions 58 surgical procedures that postgraduate students must train themselves in and acquire skills to perform independently.
These include procedures in general surgery, urology, surgical gastroenterology, and ophthalmology.
Why is IMA opposing the move?
IMA doctors are not opposed to the practitioners of the ancient system of medicine.
But the new notification seems to give the impression that the skills or training of the Ayurveda doctors in performing modern surgeries are the same as those practising modern medicine.
IMA sees this as misleading, and an “encroachment into the jurisdiction and competencies of modern medicine”.
IMA questions the competence of Ayurveda practitioners to carry out surgical procedures.
It also called the notification an attempt to legitimise “mixopathy”.
The IMA is also upset with the recent decision of NITI Aayog to set up four committees for integrating the various systems of medicine.
This is in terms of medical education, practice, public health, and administration, as well as research.
IMA says such an integration would lead to the death of the modern system of medicine.
The IMA has demanded that the notification as well as the NITI Aayog move towards ‘One Nation One System’ be withdrawn.
