|LETTER TO EDITOR
|Year : 2013 | Volume
| Issue : 1 | Page : 129-130
Ayurvedic PG education and Panchakarma
Associate Professor, Department of Panchakarma, State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, Uttar Pradesh, India
|Date of Web Publication||23-Jul-2013|
Associate Professor, Department of Panchakarma, State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rastogi S. Ayurvedic PG education and Panchakarma. AYU 2013;34:129-30
I had read with great interest the "Status of Indian medicine and folk healing: With a focus on integration of AYUSH medical systems in health-care delivery" by Chandra published in a recent issue of AYU.  After going through the full report, I am tempted to share few of my opinions particularly on aspects of post-graduate (PG) education in Ayurveda and on building credibility to Panchakarma.
| PG Education in Ayurveda: Filling the Gaps|| |
The report focuses rightly upon the pathetic condition of PG education in Ayurveda prevailing country wide. There are horrifying deficits in terms of quality and quantity of the PG education in Ayurveda being offered in the country.  Being vital to the health of Ayurveda, this issue requires a critical examination. We prefer to examine the issue for its quantitative and qualitative aspects separately.
| Quantitative Aspects of Ayurveda PG Education|| |
PG education in Ayurveda is required primarily to build the human resource for the purpose of Ayurvedic teaching, practice, research and drug manufacturing with a view to cater the global needs. As Ayurveda happen to be originated from India, still the most dependable human resource in Ayurveda is being sought from India only.
A huge gap is observable between prospective demands and actual supply of Ayurvedic PG doctors. The total sum of Ayurvedic PG produced annually (around 1488) are far below the demands rose every year. If a faculty demand at Ayurvedic colleges is clubbed with other specialty areas such as Ayurvedic hospitals, research centers and pharmacies where Ayurvedic PGs are required, the gap widens by many folds. Here are some pragmatic solutions to deal with the acute shortage of specialty manpower in Ayurveda.
- Existing PG education system may be reinforced by increasing the PG seats in various disciplines on the basis of a realistic demand calculation based upon niche area identification
- New avenues may be identified to enhance the skills and qualifications of physicians and practitioners by allowing them to enter into the PG education through adoption of different mechanisms
- New avenues may be identified for offering the PG education in Ayurveda by utilization of the existing infrastructure and manpower in Ayurveda. Examples are using research structures of Central Council for Research in Ayurvedic Sciences, large Ayurvedic hospitals and Ayurvedic pharmacies into Ayurvedic PG education. 
| Qualitative aspects of Ayurvedic PG Education|| |
It is not that raising the number of PG alone in Ayurveda is going to serve the purpose. The quality of education would be imperative to produce the experts of a desired level. Present Ayurvedic PG education is seriously flawed at qualitative aspects. The current primary objective of taking up the PG courses among Ayurveda students is to secure a job and not to acquire skills and expertise rendering them to become a specialist. Unfortunately, a lack of quality education inevitably produces inefficient experts who continue to deliver inefficient knowledge. This is how the problem continues.
Lack of motivation among administrators and flawed operational mechanisms is one another important aspect affecting Ayurvedic education adversely. Public sector Ayurvedic institutions in India are found suffering with a serious lack of resources. There are fundamental flaws in planning both at the level of their drafting and execution. Ayurveda Department in Uttar Pradesh (UP) is exemplary to this bad governance. State of UP had not been able to continue its PG education in Ayurveda for past many years for reasons beyond the scope of this discussion. Many Central Council of Indian Medicine (CCIM) regulations are inferred ridiculously in the state and equally ridiculous actions had been taken to the net effect. Phenomenally, faculty members of the government sector of Ayurvedic colleges in UP are regularly shifted from one place to another in a bid to comply with CCIM minimum faculty norms. As an unprecedented consequence of this faculty reshuffle, State Ayurvedic College, Lucknow had to suffer a reduction in its PG seats to compensate the shift of its faculties to other colleges facing the faculty deficit. It is a simple example how a flawed mechanism employed to deal with a problem resulted in a double loss to a good college, one in term of losing its faculties and another in term of losing its PG seats.
Suggested remedies to improve the quality of education in Ayurveda may be many, but a few among them could be listed as: Employing various faculty empowering mechanisms to improve the skill of existing faculties; identification of infrastructural deficit and their rectification in a time bound manner on the basis of certain priority scales; linking academic excellence with career promotions to encourage excellence in work and promotion of interdisciplinary collaboration both intramural and extramural to imbibe newer ideas meant for the growth of the subject.
| Building Credibility for Panchakarma|| |
This chapter had been able to examine critically the issues of practice of Ayurveda in general and in particular to the practice of Panchakarma. Lack of uniform standards of practice and lack of dependable evidences to prove its effectiveness are two important reasons why Panchakarma is still lagging behind as dependable mean of health-care intervention. We can examine these two issues separately in order to build credibility for Panchakarma.
| Lack of Uniform Standards of Practice|| |
A huge inter-institutional, interpersonal and regional variation is observable in practice of Panchakarma throughout the country. This lack of uniformity among the practice standards is often reflected as variable response patterns among the same set of patients who are visiting different centers of Ayurveda in order to seek a relief from their ailments. ,
On the background of the lack of uniformity, there can be multiple reasons not limited to infrastructural deficits, resource limitation and inadequate skill, which may account for many.
Besides institutional practice of Panchakarma, we are also witnessing Panchakarma being practiced at the places called wellness centers. These places for their attractive ambience and better projectability often exploit Panchakarma for commercial gains and not for the real therapeutic purpose. There had also been many centers who continuously claim to offer remedies for many conditions, which are known to be incurable in light of contemporary knowledge of Ayurveda or Biomedicine. In lack of any effective curbing measure despite of the availability of drugs and magic remedies (objectionable advertisements) Act 1954, we regularly see such practices eventually diluting the Ayurveda or Panchakarma propositions of being a serious medical intervention. Creating effective guidelines for practicing Panchakarma and finding measures to apply them effectively in the practice could be two effective ways of initiating uniformity in Panchakarma practice.
| Lack of Dependable Evidences to Prove its Effectiveness|| |
In lack of effective evidences, Ayurveda and Panchakarma remains a claim based traditional health practice. Huge number of observational studies throughout the country may be required initially to steer the search for effectiveness in Panchakarma. These researches can be the third party observational studies aiming to identify the realistic and patient centered assessment of claims linked with various procedures of Panchakarma and associated clinical conditions. Depending upon the primary observations, these studies may subsequently generate an equal number of interventional studies aiming at the standardization of various procedures in order to maximize the therapeutic effects at the same time while reducing any chances of adversities. Subsequent to this, many specialized studies may be taken up to identify the mechanics involved behind the effectiveness of any such intervention in any given clinical condition.
At the same time, when we go for observational studies, we also need to understand that every observation, which is made upon the patient in terms of benefits or even the adversity can eventually turn out to be a practice based evidence (PBE) provided if the clinical records are being kept meticulously. Every Ayurvedic physician therefore should be taught the power of observation and also of meticulous medical record keeping. 
Building up a "Center for Scientific Research in Panchakarma" could be a good step to move ahead in this direction; however, this alone is not going to do much unless huge number of effectiveness researches are made available beforehand on which a mechanistic research can be made. Following are few ways to build a practice and research based credibility to Panchakarma: A focus upon observational, patient centered researches; converting the clinical observations into PBE, which may follow the subsequent research; and promotion of inter-disciplinary researches with due utilization of techniques and skills already available at various allied disciplines of science.
| References|| |
|1.||Chandra S. Status of Indian medicine and folk healing: With a focus on integration of AYUSH medical systems in healthcare delivery. AYU 2012;33:461-5. |
|2.||Rastogi S. Global challenges of graduate level ayurvedic education. Int J Ayurveda Res 2010;1:133. |
|3.||Rastogi S. Counting the strengths and countering the weaknesses: Applying SWOT analysis into AYUSH for its better appreciation and application. Ann Ayurvedic Med 2012;1:7-14. |
|4.||Rastogi S. Effectiveness, safety, and standard of service delivery: A patient-based survey at a pancha karma therapy unit in a secondary care Ayurvedic hospital. J Ayurveda Integr Med 2011;2:197-204. |
|5.||Rastogi S. Towards patient centered care: Inter system cross referencing may help optimize the vision of 'health for all'. Asian Bioeth Rev 2012;4:127-31. |
|6.||Hankey A. The need for Ayurveda practitioners to maintain clinical data. Ann Ayurvedic Med 2013;2:4-6. |