PG Ayurveda Performing Surgeries: IMA rebuts Union Minister's Statement in Parliament

Medical Dialogues team had earlier reported that the recent session of parliament saw an address related to the issues of PG Ayurveda practitioners performing surgeries with the minister giving justification from the AYUSH ministry on the said CCIM move. During the session, the acting Minister for AYUSH, Shri Kiren Rijiju had given a thorough justification on the matter while responding to the questions brought forth by Shri Anand Sharma on whether trained Post Graduate practitioners of Ayurveda are permitted to perform surgery under the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020.

Answering the question of whether the trained post-graduate practitioners of Ayurveda are permitted to do surgeries, the minister had added, that the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020 specifies (in clearer terms than the earlier notification on the subject) that a total of 58 surgical procedures need to be practically trained by PG scholars of Shalya and Shalakya (cumulatively), so as to enable them to independently perform the said activities after completion of their PG Degree. The CCIM notification is specific to these specified surgical procedures and does not allow Shalya and Shalakya Post Graduates to take up any other types of surgery. Further upon being asked that whether such procedures are identical in any form to those practiced in allopathic medicine, the minister clarified that the use of modern terminology was also required by maintaining the authenticity of Indian Systems of Medicine.

Opposing the justification of the minister, the Indian Medical Association (IMA) has recently submitted a letter to the minister. Stating that surgery is a complex procedure and it is never a straight-line course from start to end, the association added, " There are additional surgeries & procedures which erupt during or post-surgery. Even in this era of modern gadgets of diagnosis, the abdomen being a Pandora's Box, on the table surgeon often find surprises. If limited training and restricted license to do only limited procedures, if he come across a difficult diagnosis after opening the abdomen what should he do? Close the abdomen and refer back or continue with his untrained skill and bring catastrophe to the patients?"

The letter signed by IMA President Dr. Jayalal also mentioned that though, in response to the question of ensuring the health, safety, and post-surgical care of patients, the minister added that the infrastructure by CCIM in this regard as very well regulated.

" However, sir as per the minimum requirement for Ayurveda medical college is only 60 bed with 40 percent occupancy for the undergraduate and the total various procedures like cholecystectomy, intestinal resection anastomosis are hardly ever conducted and the faculty available for training is dismally poor, then how you are ensuring adequate training will be given for carrying out 58 procedures", asked the association.

IMA raised the question if there are any scientific & full-proof mechanisms in place as far as curriculum, scientific & practical teaching & experienced faculty to inculcate the expertise for AYUSH people.

The doctor's body further stated, "However, we want to know is it for Ayurveda teaching or Modern medical surgical procedures as the NABH very clearly states only in the system in which you are trained the doctor should practice. How NABH allow the doctor trained in Ayurveda to do Modern medicine surgeries? Out of 411 Ayurveda medical colleges how many have NABH Accreditation?"

The association also expressed his surprise over the minister's statement that "Modern terminology like Appendectomy and cataract are used for purpose of maintains the authenticity of Indian System of Medicine & for medico-legal or its purpose of understanding...!!", IMA mentioned "It is contrary to the principle of Make in India oriented Government which even changed the terminologies like Planning commission to NITI AAYOG, the traditional terms of shalya and shlakya tantra are replaced with MS General surgery. When the people of our country have the right to choose the system of Medicine they want to receive this duplicating terminology of Modern medicine in Ayurveda will it not create confusion and overlap?"

IMA reassured, " India needs various systems of Medicine and each system of medicine is unique and indispensable for humankind. Polypathy is the choice of the individual. But mixing the different systems of medicine based on different principles together and dispensing it by a half-trained physician will bring catastrophe to our humanity." Asking how can practice of one system can be given by the authority of another system, IMA further added, " AYUSH Ministry and the CCIM have jurisdictions for practice AYUSH Medicine, how they are privileged to give direction or amendment to one to practice another domain? Is the CCIM is above the wisdom and authority of parliament? "

Hence, the association asked, " To ensure the purity of various system of medicine, enhance research to unearth the depth of traditional Ayurveda system and develop surgical principles and procedures akin to Ayurveda, empower teaching milieu and manpower in Ayurveda before making a halfhearted attempt to produce partially trained Mixopathy surgeons and play on the health of our country."

IMA has also requested to withhold the CCIM Notification on 19th November and to constitute a committee to research on the issue and bridge the gap with mutual cooperation before adopting such measures or it will hamper the growth of Ayurveda and the health of the nation.