Professor Dr. Kirata Moorthy PP, BAMS, MD(Ay)
Former Head of Department of Samhita, Sidhaanta and Sanskrit
Vaidyaratnam PS Varier Ayurveda College, Kottakkal
How Ayurvedic Education Should Be?
Ayurveda happens to be the bio-medical system with longest surviving pedigree in the planet. During the different socio-political milieu of oppression it had passed through, it survived the storms and struggles because of the unique educational system through which the fundamental aspects of the science and the art of patient care had been handed down to generations. But later these Gurukula system had given ways to modern day academies and the stalwart ayurvedists of the byegone era had embraced the changes considering the positives. The article discusses in detail the merits and demerits of the gurukula system and modern day academic system, and tries to synthesize the positives together into a framework, which shall better serve the cause.
Models of Education
As discussed earlier, there are two basic models of Ayurveda education- an institutional model, which is currently in practice and the Gurukula model, which has been outdated. The Gurukula model, which had been existent since centuries, and had given way to the institutional model were of two types- A gurukulam with multiple teachers (Bahuguru) and with a single teacher (Ekaguru). The institutional model, were of puritan (s’udha s’aastra, as propounded by Ashtavaidya) and composite (encompassing the s’aastra with current advances in medical practice). The need for an institutional model had been rightly portrayed by Vaidyaratnam PS Varier, the legendary entrepreneur who had initiated the Aryavaidyasala, Kottakkal. He had observed that the existing Ashtavaidya gurukula model was futile, in that, the student happens to be from the economically weakest sections of the society, who comes for survival, and the teacher happens to be happy of the fact that he got the services of an unpaid servant. The warm, heartful exchange of knowledge and transmission of the skill sets were lost somewhere. So he insisted that there shall be a rapid shift to the institutional model, unless, the death of the system is at the doorstep. Thus, the opening of the colleges, wherein the students were totally freed from the household chores of the teacher and were fully focused on their studies, were the need of the hour, and the statement that, such a transition had saved the existence of the science, happens not to be an underrated one.
But the institutional model, had not served its full purpose, though it had been in existence for past 150 years. In an article ‘ Ayurveda Education in India, how well are the graduates exposed to basic clinical skills’, Kishore patwardhan et al, had came to the conclusion that, the practical aspects of the theoretical constructs is not taking place adequately, and that the system is not capable of producing competent clinicians. Hence, a rethinking regarding the existing model and to reenergize it in creative ways is the need of the hour. For that, an understanding of the ancient teaching and learning methods, will be a support.
Ancient Teaching and Learning Methods
To convey the right purport of a concept and to implement it into the clinical practice, the ancient teachers had followed different methods, many of them can be traced back to the ages of Upanishads.
To name a few they are the enigmatic method (through the riddles and puzzles; seen in S’wetas’ataropanishad; the concept of roga-aarogya eka kaaranam), aphoristic method (through aphorisms; Maandookyopanishad; the concept of dosha eva hi sarvesham rogaanam kaaranam), etymological method (by deriving the etymologies; Brhadaaranyaka Upanishad; the concept of Puri s’ete iti pursha), mythical (by creating myths; Kenopanishad; the concept of Brahma smrtwa ayusho vedam), Analogical method ( by creating analogiesYaajnavalkyam; the concept of vishena eva visha krme), Dialectical method (through extensive discussions and conclusions; Kathopanishad; rasavicaaram ); Synthetic method (through synthesis of different opinions; Brhadaaranyaka Upanishad; veerya vicaaram), Monologic method (through speech, Kathopanishad, the discussions in Carakam S’aareeram) etc.
The mention of ancient teaching techniques was done to emphasize the fact that there are different techniques and methods which we rarely use in the academic institutional model consciously, and in such a case, an extensive exploration of the merits and demerits of both will help us for evolving a better fusion model.
Strength and weakness of Gurukula and Institutional models
Strengths of Gurukulam
- More practical oriented
- Role modeling
- Experience of generations
- Character building
- Experience oriented
Weaknesses of Gurukulam
- Lack of different specialities
- Not open to different school of thoughts
- Lack of bahusruta sastra
- Personal errors may occur
- Hardships in learning
Strengths of Institutional model
- Student open to different school of thoughts
- Exposure to different specialities
- Exposure to the guidance by different acharyas
- Less hardships
Weaknesses of Institutional model
- Lack of personal attention
- Lack of hands on training
- Lacking orientation and connection
- Lack of role model
- Lack of traditional knowledge
Having a bird’s eye view of the above facts, it is pertinent to look into the existing Ayurveda Curriculum and Syllabus.
There are three major stakeholder view points regarding Ayurvedic graduates. They are as follows
- The Government – Wants to use the Ayurvedic graduate to fill the lacunae in the Primary healthcare sector
- The Teachers and a majority of the society – Wants an Ayurvedic graduate to provide natural solutions for diseases diagnosed in the Bio-medical method
- The Puritans – Wants an Ayurvedic graduate to be uncorrupted by western Bio-medical education
There are other socio-cultural attitude related aspects, which also play a role in shaping the objectives of the syllabus. They are
- Regional socio-cultural/educational demands – Healthcare scenario in UP may be different from that of Kerala (People accept Rasaushadhis more in the north, while they have poor acceptance in the south)
- Changing social scenarios – People today expect a doctor to have a fair understanding of and ability to interpret modern biomedical concepts
So, we came to a point of understanding that, as we have varied demands from an Ayurvedic practitioner and also, we have to preserve the originality of the s’aastra, yet never fail to accommodate the advances in bio-medical sciences, there shall be three different category of institutes which offer differed training, focussig on the needed end-point skill. They are as follows-
- Institutions that Produce Integrated medical practitioners with specific biomedical skill sets to fill the lacunae in Primary healthcare
- Institutions that produce Ayurvedic practitioners with fair understanding of Biomedicine but exclusively practice Ayurveda
- Institutions of Excellence that produce Global ambassadors of Ayurveda with a scrupulous fundamental training in Ayurveda & ancilliary sciences and exposure, a fair understanding of biomedicine, personality and soft skill training and training in cutting edge bio medical research
The current Ayurveda education fails to produce standardized output may be due to following facts
- Modelled on a need to confirm to the standards and models set by western paradigms
- Structure, contents and outcomes are modeled along western bio-medical education
- Gives little emphasis on the aptitude of the aspirants
- Leaves the graduate without inculcating the thought culture and skills of Āyurveda and without confidence to preach and practice his/her system
If a new system is adopted, it should have to keep the following facts in focus.
- The aptitude of the Aspirants – Need to check aptitude and career goals of an aspirant. The current Entrance examination must have two additional levels of selection based on aptitude (written examination and personal interview)
- The placement of fundamentals-The goal is to equip the student with the linguistic and analytical skills to understand a patient according to Āyurvedic paradigms.
- Training in Sanskrit and Nyāya, therefore should be progressing and continued throughout the course period.
- Also essential is the student becoming an embodiment of the principles that he will practice. Therefore training in Yoga also should be a part of the student life.
- Opening of the uddes’a stage – Introduction of the subject matter is called uddeśa. In the first stage of study, the student is introduced to the various facets of an Āyurvedic physician’s life such as witnessing his teachers examining patients, drugs being collected, prepared and administered, pathyāhāra being prepared and treatments being performed.
- Subjects during the uddeśa stage – Primary Sanskrit, Darśana with special focus on Nyāya, Aṣṭāṅgahṛdaya siddhānta chapters (1-14), Śārīra (without the artificial delineation into Racanā and Kriyā), Fundamentals of Modern anatomy and physiology
- Vaidyaka stage I- Vaidyaka slowly begins to acquire the skills of a physician such as identification of drugs and their pharmaceutical preparation (dravya vijñāna and bheṣajakalpanā), pathophysiology of diseases of all eight aṅgās of Āyurveda
- Vaidyaka stage II – Auṣadha training- Treatments and recipes for diseases under eight aṅgās
- Acquires the skill to prepare and administer medicines and specific treatments under the watchful eyes of his/her guru
- Acquires the skills needed to conduct researches and guide his/her juniors.
- Vaidyaka stage III -When he is trained he has to treat patients his own
- Acharya supervises the whole procedure
- Scholar teaches the juniors
- He / she learns upari granthas
- He /she has to study allied sciences and gets chance to go in depth in his subject of interest
The syllabus has to be remodeled by keeping the following facts in mind
- Syllabus shall be reworked , so that the learner is trained in such a way as to face the clinical challenges of current era .
- More emphasis on Value based learning that integrates demands of daily life
- Apart from teaching samhitha as such, the content has to be delivered in a problem – solution format for better understanding and application in the field
- However due importance has to be given parallelly so that the learner is well acquainted in relevant Samhithas inorder to apply the basic tenets of the science in practice
Also, when defining the syllabus, a specific learner outcome based on the cognitive, affective and psychomotor domain of the student shall be placed.
The teaching methods also need adequate revision, which can be done in the following way
Teaching methods –theory
- Employing different and innovative teaching methods
Teaching methods –practicals
· Case-based discussion (CbD)
· Mini-clinical evaluation exercise (mCEX)
· Direct observation of procedural skills (DOPS)
· Mini-peer assessment tool (mPAT)
- Evaluation also has to be modified in such a way that proper assessment of three important domains viz.
There is renewed interest for Ayurveda round the globe. But, the quality of the graduate and post graduate education needs to be augmented for catering the global needs and to serve the needs of the country. For that, a thorough revision of the syllabus and curriculum, keeping in mind, the advantages of both gurukulam and institutional models is to be done. Also, the possibilities to bring the goodness of gurukulam into the dynamic milieu of an institutional framework, needs to be explored.
Collated into words by
Dr.Rahul.R.Nair, BAMS,MD (Ay)
Associate Professor & Head
Ashtamgam Ayurveda Vidyapeedham, Kootanad