Ayurveda PG students to perform surgeries: Key details of CCIM Regulations Amendment Act

The Central Council of Indian Medicine’s, CCIM has decided to allow Ayurveda practitioners to perform surgeries. IMA has also demanded the withdrawal of the notification allowing Ayurveda students to do general surgeries like ophthalmology and dental procedures. Get to know the details of the amendment made by the Centre and the details of Ayurveda and CCIM and amendments in Indian Medicine Central Council Regulations 2016  below. 

Why in News?

On November 19, 2020, the Central Council of Indian Medicine, CCIM, allowed Ayurvedic PG students to receive formal training to perform a variety of procedures, including general surgery, orthopedic, ophthalmology, ENT, and dental procedures and surgeries. CCIM made an amendment in Indian Medicine Central Council, PG Ayurveda Education Regulations, 2016. The amendment includes the regulation to allow the PG students of Ayurveda to practice general surgery.

About the amendment

The Act has now been renamed as the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020. As mentioned in the notification, students would be trained in two streams of surgery and would be awarded the titles of MS (Ayurveda) Shalya Tantra general surgery and MS (Ayurveda) Shalakya Tantra which include diseases of the eye, ear, nose, throat, head or dentistry.

PG scholars of Shalya and Shalakya would be practically trained independently perform the following activities so that after completion of their PG degree, they are able to perform the following procedures

The list of procedures that will be taught includes the following:

1. All types of skin grafting
2. Ear lobe repair
3. Excision of a simple cyst and benign tumors (includes lipoma, fibroma, schwannoma, etc.) of non-vital organs, 
4. Excision/amputation of gangrene, traumatic wound management 
5. All types of suturing, ligation, and repair of tendon and muscles 
6. Foreign body removal from the stomach
7. Colostomy cataract surgery
8. Local anesthesia in the eye
9. Rhinoplasty
10. Hair lip repair
11. Loose tooth extraction, 
12. Caries tooth/teeth
13. Root canal treatment

The training modules for surgical procedures would be added to the curriculum of Ayurvedic studies, according to the notification.

Does the amendment mix Ayurveda with Modern medicine?

The purpose of all modern scientific terminology is to facilitate effective communication and correspondence among the different stakeholders. The stake-holders of the instant notification include not just the Ayurveda practitioners but also professionals of other stake-holding disciplines like the medico-legal, health IT, insurance, etc., as well as the members of the public. Hence the use of modern terminology was required. 

Will there be any policy shift?

As per CCIM, the gazette notification is a clarification of the relevant provisions in the previously existing regulations of 2016. Shalya and Shalakya have always been independent departments in Ayurveda colleges, performing surgical procedures. The notification of 2016 stipulated that the students would undergo training in investigative procedures, techniques, and surgical performance of procedures along with the management in the specialty. The details of techniques, processed and surgical performances were laid down in the syllabus of respective PG courses issued by CCIM. There has been no regulation in this regard. The present clarification was issued by CCIM bringing the details into regulation. So it would be safe to say that there has been no such policy shift.

What is CCIM?

Central Council of Indian Medicine, CCIM is the statutory body regulating the Indian Medical systems of Ayurveda, Siddha, Sowa-Rigpa, and Unani Medicine. Its major work is to

1. To prescribe minimum standards of education in Indian Systems of Medicine viz. Ayurved, Siddha, Unani Tib. and Sowa Rigpa.
2. To recommend Central Government in matters relating to recognition (inclusion/withdrawal) of medical qualifications in/from Second Schedule to Indian Medicine Central Council Act, 1970.
3. To maintain a Central Register of Indian Medicine and revise the Register from time to time.
4. To prescribe Standards of Professional Conduct, Etiquette, and Code of Ethics to be observed by the practitioners.
5. To consider and furnish the recommendation to the Government of India on the proposal received from various institutes from the Government of India for the establishment of new colleges of Indian Systems of Medicine, to increase intake capacity in undergraduate, Post-graduate and to start new or Post-graduate additional subjects. 

What is Ayurveda?

Ayurveda means "the science of life" (that is, Ayur stands for "life" and Veda stands for "science" in Sanskrit). It is a discipline of the up-veda or known as auxiliary knowledge, in the Vedic tradition. Ayurveda has its prime origin from Atharva-Veda and apart as a supplement of the Rig-Veda. Dhanvantari is worshipped as the God of Ayurveda. The aim of this system is to prevent illness¸ heal the sick and preserve life. The Ayurveda is indigenous and was originated in India. It was taught in the Gurukula system in ancient days, which is now been evolved into undergraduate & postgraduate courses from Institutions

Outcomes of the amendment

1. There would be more skilled doctors and medical practitioners performing surgery on patients in India once the process is completed.
2. It can also be noted that as of now no allopathic doctor has been asked to not practice in rural areas and there is no such provision that after the implementation of ayurvedic doctors performing surgery, this norm would be diluted. However, it is expected that now since the number of practitioners would increase the villages and other rural parts of the country would not be at the suffering end. 
3. Now that the Ayurvedic practitioners can also perform surgeries, it would be beneficial for those patients who prefer to receive treatment from AYUSH providers only. 

The patients must be provided prior information about their caregivers and their surgeons. They have all the right to know about them before choosing their treatment. Also, the government must ensure that the quality of treatment given to both Ayurvedic and Allopathic patients must be the same.