Updated: December 5, 2020 11:01:30 pm
Medical students on the faculty of the Maharashtra Institute of Medical Education and Research in Talegaon pledge to resist ‘myxopathy’. (Source: Indian Medical Association)
On November 19, a government notification listed the specific surgical procedures that an Ayurveda graduate medical student should be “practically trained to become familiar with as well as to perform independently.” The notification has drawn strong criticism from the Indian Medical Association, which questioned the competence of Ayurvedic practitioners to carry out these procedures and called the notification an attempt at “myxopathy.”
The IMA has planned nationwide protests on December 8 against this notification and has threatened to remove all non-essential and non-essential services on December 11.
To what extent is surgery part of Ayurveda?
It is not that Ayurvedic practitioners are not trained in surgery or do not perform it. Indeed, they pride themselves on the fact that their methods and practices have their origins in Sushruta, an ancient Indian sage and physician, whose extensive medical treatise Sushruta Samhita has, in addition to descriptions of diseases and cures, also detailed reports of surgical procedures and Instruments
P Hemantha Kumar, professor and head of the department of general surgery at the government-run National Institute of Ayurveda in Jaipur, says that at least 1,000 major surgeries are performed at his hospital every year. “There would be many more minor surgeries,” he said.
There are two branches of surgery in Ayurveda: Shalya Tantra, which refers to general surgery, and Shalakya Tantra, which refers to surgeries related to the eyes, ears, nose, throat, and teeth. All Ayurveda graduate students must study these courses, and some specialize in these and become Ayurveda surgeons.
Nandkishore Borse, head of the department of surgery at Tilak Ayurveda College and Tarachand Hospital, a semi-government facility in Pune, said that for various surgeries Ayurvedic procedures almost exactly match those of modern medicine on how or where to make a cut or incision. , and how to perform the operation. However, there are important divergences in postoperative care.
“The only thing we don’t do is super specialty surgeries, like neurosurgery. For most other needs, there are surgical procedures in Ayurveda. It is not very different from allopathic medicine, ”said Hemantha Kumar.
Before the notification, what were the regulations for graduate students?
Postgraduate education in Ayurveda is guided by the Regulations of the Central Medical Council of India (Postgraduate Education) framed from time to time. Currently, the regulations formulated in 2016 are in force. The last notification of November 19 is an amendment to the 2016 regulations.
The 2016 regulations allow graduate students to specialize in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology), the three disciplines that involve major surgical interventions. Students in these three disciplines earn Master of Surgery degrees in Ayurveda.
Ayurveda practitioners point out that students who enroll in Ayurveda courses must pass the same NEET (National Entry and Eligibility Test). Its course lasts four and a half years, followed by a year of internship, six months of which are spent in an Ayurveda hospital and the remaining six months in a civil or general hospital, or in a primary care center of Health.
Graduate courses require another three years of study. They also have to go through clinical positions in the outpatient and inpatient departments of hospitals, as well as receiving practical training in Ayurvedic treatment procedures. Medico-legal issues, surgical ethics, and informed consent are also part of the course, in addition to teaching Sushruta surgical principles and practices, said Dr. Vinayak Temburnekar, national president of the National Integrated Medical Association (NIMA).
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So what’s up?
Ayurveda practitioners say that the latest notification only brings clarity to the skills that an Ayurveda practitioner possesses.
“The surgeries that have been mentioned in the notification are all those that are already part of the Ayurveda course. But there is little awareness about these. It is usually unclear to a patient whether an Ayurvedic practitioner has the skill to perform one of these operations. Now they know exactly what an Ayurvedic doctor is capable of. The skill sets have been defined. This will remove the question marks about the ability of an Ayurveda practitioner, ”said Hemantha Kumar of the National Institute of Ayurveda based in Jaipur.
The notification mentions 58 surgical procedures in which graduate students must train and acquire skills to perform independently. These include procedures in general surgery, urology, surgical gastroenterology, and ophthalmology. 📣 Follow Express explained on Telegram
What are the IMA’s objections?
IMA doctors insist that they are not opposed to the practitioners of the old system of medicine. But they say the new notification somehow gives the impression that the Ayurvedic physician’s skills or training to perform modern surgeries are the same as those of those who practice modern medicine. This, they say, is misleading and an “invasion of the jurisdiction and powers of modern medicine.”
The fact that Ayurveda institutions prescribe textbooks of modern medicine, or that they perform surgeries with the help of practitioners of modern medicine, is not reason enough to allow this invasion, said KM Abul Hasan, president of the Network of IMA Youth Doctors.
A statement from the IMA said it condemned the “predatory poaching of modern medicine and its surgical disciplines” by the CCIM (Central Council of Indian Medicine, under the Ayush Ministry). “This is another step to legitimize myxopathy,” he said.
Avinash Bhondwe, president of the Maharashtra chapter of IMA, said that the CCIM had claimed that all these modern surgeries are actually Ayurvedic procedures and have Sanskrit names. “All the usual procedures in all surgical specialties have been included in the notification. They have been reported as Ayurveda procedures. They must also explain, with evidence, how each of these procedures mentioned in the Ayurveda literature is equivalent to modern surgical procedures, ”said Bhondwe.
The IMA is also upset with NITI Aayog’s recent decision to establish four committees to integrate the various systems of medicine in medical education, practice, public health and administration, as well as research. He says that such integration would lead to the death of the modern system of medicine.
The IMA has demanded that the notification be withdrawn, as well as the NITI Aayog move towards the ‘One Nation One System’. “If the government does not accept our demands, IMA will petition the Supreme Court,” said RV Asokan, IMA Secretary General.
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