A five-and-a-half-year full-time coursework covering the basics of medicine including a one-year rotatory internship across various departments at the hospitals equips a BAMS graduate Ayurvedic Doctor to effectively diagnose and prescribe the right medicines to a patient. The proposed bridge course is a positive step in this direction which will bring together the best practice from across the ‘pathies’, enabling the patient to get a wholesome treatment from their doctors.
A provision of the National Medical Commission Bill proposing the AYUSH Doctors to prescribe allopathic medicine following the completion of a bridge course has met with severe criticism from various corners, most particularly, from the allopathic fraternity including the Indian Medical Association. Some of the opponents have gone so far as to call ayurvedic doctors a ‘quack’, which only shows their lack of proper knowledge about the other ‘pathies’ of medicine except allopathy.
The Ayurvedic system of medicine is one of the oldest medical systems in the world and is based not merely on literature, but on scientific texts. Just like their MBBS counterparts, the Bachelor of Ayurvedic Medicine and Surgery (BAMS) students undergo a rigorous full-time instruction for five-and-a-half years, with the coursework including the study of Anatomy (Sharir Rachna), Physiology (Sharir Kriya), Pharmacology (Dravya Guna & Ras Shastra), Community Medicine (Swasthavrutta), Forensics (Agada Tantra), Pathology (Rog Nidan & Vikriti Vigyan), General Medicine (Kaya Chikitsa), Pediatrics (Kaumarbhritya), Ophthalmology & ENT (Shalakya Tantra), Gynaecology & Obstetrics (Prasooti Tantra evam Stree Rog), and Surgery (Shalya Tantra) with the addition of unique practices like Panchakarma and Yoga. A comprehensive study of these subjects prepares a solid foundational base of medicine for Ayurvedic graduate students at par with other ‘pathies’. The proposed bridge course is, therefore, not a substitute for the five-and-a-half year of medical training, but a complement to bridge any differences in the two coursework.
In addition to the coursework, just like their MBBS counterparts, the BAMS students undergo one full year of rotatory internship serving across departments such as Surgery, Orthopedics, Gynecology and Obstetrics, among others. Such a rigorous training over more than five years of medicinal practice enables a BAMS graduate to perform normal delivery, attend to patients in emergency cases, suturing, and setting fractures with casts, among other things. Additionally, each BAMS student works for at least three months in an Allopathic Hospital as part of their internship exposing them to the best of both – traditional and modern medicinal practices. Therefore, any concerns of Ayurvedic graduates not being well-trained to diagnose a patient and prescribe right medication are not only ill-founded but demonstrates their lack of knowledge about the breadth of the Indian Medical field.
Another major criticism to this provision has been with regards to the Ayurvedic graduates being allowed to perform surgery. Many allopathic doctors have raised concerns about the Ayurvedic doctors not being competent to perform surgeries. However, what all of them are unaware of, is that Surgery has been a core part of the Ayurvedic medicine system for centuries, and the BAMS students are trained in surgery as part of their coursework. While the MBBS students are taught excision, incision, scraping, puncturing, probing, extraction, drainage, and suturing, the BAMS students are taught the same practices, albeit with a different name of chhedan, bhedan, lekhan, vedhan, eshan, aaharan, visravan, and seevan. Merely, a difference in language does not make one pathy superior to the other, as the underlying principles behind the two practices are exactly the same. Therefore, to say that an MBBS graduate has the only right to perform a surgery could not be farther from the truth.
A large section of the medical fraternity has also questioned the decision to allow the Ayurvedic doctors to be able to prescribe modern medicines after completing the bridge course. However, a research study conducted by the pharmacology department of KEM hospital in 2013 had found that 67% of allopathic doctors prescribed Ayurvedic Medicines without even learning the basics of Ayurveda. Ayurvedic medicines such as Liv 52, Cystone, Neeri, Shatavari, and Septilin are some of the most commonly prescribed Ayurvedic medicines by the Allopaths for conditions ranging from liver disorders to kidney stones among others. On the other hand, the Ayurvedic graduate students are taught about allopathic medicines as part of their coursework, enabling them to prescribe these medicines under certain conditions.
It is a common myth that Ayurvedic medicine is only limited to rural areas and the bridge course is merely to fulfill the shortage of doctors in the under-served rural areas. Ayurvedic colleges and hospitals such as Ch. Brahm Prakash Ayurved Charak Sansthan and All India Institute of Ayurveda which are situated in New Delhi, serve the rural and urban population equally and effectively. During my internship, I have first-hand observed patients who had been undergoing treatment for over five to six years in premier allopathic hospitals of Delhi for concerns such as non-healing ulcers, hyperacidity, osteoarthritis, rheumatoid arthritis, migraine and various such ailments, and were successfully treated for their conditions at our Ayurvedic hospital.
While the Allopathic medicines are preferred in the treatment of emergency conditions and trauma, there is a growing use of the Ayurvedic Medicine system for treatment of chronic conditions such as fistula, where the ayurvedic kshar-sutra has proven very effective. Therefore, the introduction of the bridge course is a positive step in this direction to bring together the best practice from across the pathies, enabling the patient to get a wholesome treatment, which must be lauded for its forward-thinking approach. In fact, the provision of pursuing such a bridge course must also be extended to the MBBS students, enabling them to prescribe traditional medicines upon satisfactory completion of their study of traditional medicines. Not only will this allow the medical students to gain a more holistic learning of all the medicinal systems available in the world, but also enable them to become better doctors, serving the diverse needs of the patients as per the applicable case, making the ultimate winners of this proposal – the patients at-large.
(The Author is a 5th-year student of Bachelor of Ayurvedic Medicine and Surgery (BAMS) course at the Ch. Brahm Prakash Ayurved Charak Sansthan, New Delhi, currently pursuing her internship at the same hospital.)