Homeopathy Education
Monday, September 17, 2012
Alternatives in homeopathy education
Wednesday, June 13, 2012
Outline of Workshop to review the newly gazetted curriculum for Homeopathy Postgraduaion
- To design a curriculum for the MD (Hom) courses
as per the revised ordnance dated 5th March 2012
- Discuss the amendments that are gazetted
- Brainstorm on the strengths and weaknesses of
the proposed syllabus
- Identify areas that need to be clarified for a
realistic implementation of the syllabus in the affiliated homeopathic
institutions
- Indicate objectives for the teaching – learning
of the major and subsidiary subjects
- Develop interdisciplinary objects of learning
for the subsidiary subjects under each of the major subject
- Provide parameters for formative evaluation of
learners during the course of study
- Suggest scheme of summative evaluation
- Design the curriculum for implementation in the
affiliated homeopathic institutions
- Inauguration of the workshop
- Introduction to the purpose of workshop
- Participants getting to know each other
- The
NASA Exercise: Lost on the Moon
- Introduction to curriculum designing
- Group work on Curriculum Designing
- Plenary presentation by each group followed by
discussion
- Documentation of the Curriculum
- Vote of thanks
Critique on the Revised Curriculum for MD (Homoeopathy)
- Retain the distribution of subjects as it is
given in the said CCH ordnance
- Maintain the scheme of examinations and marks
distribution, as per the directions given in the said CCH ordnance
- Pass a resolution to notify the provisions of
Homoeopathy (Postgarduate Degree Course MD (Hom) Regulations as amended
and gazetted in the 5th March 2012 gazette of India for the
distribution of subjects, marks and examination scheme, so as to ensure
that the regulations for admission of students to the MD (Hom) course
comply with the CCH directions
- Conduct a workshop with experts drawn from each
of the seven postgraduate subjects, so as to evolve specific objectives
for the subsidiary subjects under each of the major subjects. This would
ensure that the relevance of the subsidiary subject for aligning it to the
main subject and developing an interdisciplinary study.
- Add the recommendation of workshop after a
process of scrutiny and publish it as annexure to the ordinance that is
already published.
- For the long
term course correction, there has to be national debate with a fair
representation of the stakeholders, so as to make –
- Recognise the prescription needs of homeopathic
practitioners
- Master most of the competencies related to case
taking and case analysis, so as to generate totality of symptoms for
repertorisation
- Acquire a spirit of scientific enquiry and gain
orientation to the principles of research methodology for developing
yardsticks for improving the applicability of repertory
- Justify the importance of case analysis and
symptom analysis for repertorisation
- Practice repertorisation ethically and in step
with principles of homeopathy
- Demonstrate sufficient understanding of
competencies associated with case taking and case analysis
- Align unprejudiced methodologies in the
practice of repertorisation
- Interpret the rubrics of repertories in the
light of symptom analysis
- Develop interdisciplinary approach for
homeopathic philosophy and
repertory
- Demonstrate the prescription needs of
homeopathic practitioners
- Master most of the competencies related to case
taking and symptom analysis, so as to generate totality of symptoms for
repertorisation
- Acquire a spirit of scientific enquiry and gain
orientation to the principles of research methodology for developing
yardsticks for improving the applicability of repertory
- Justify the importance of case taking and
symptom analysis to differentiate the similimum\m after repertorisation
- Practice repertorisation with the objective of
differentiating similar medicines for a group of symptoms
- Demonstrate sufficient understanding of
competencies associated with case taking and symptom analysis
- Interpret rubric information with drug action
- Develop interdisciplinary approach for materia
medica and repertory
Sunday, April 15, 2012
Challenges for healthcare education in 21st Century and the Role of Health Science Universities
Preamble
Higher education is juxtaposed between the needs to sustain the singularity of knowledge in higher echelons of intellect and a compulsion to provide pragmatic solutions to the issues that matter for a sustainable world. If one factor places intellectual demand on the system, the other factor tweaks at the conscience of the establishment. Such a position demands a delicate balance to strike, so that the scarce resources can be optimised.
Healthcare education is in a much more edgy flux. A significant portion of knowledge in healthcare education is drawn from various components of higher education, which could range from anthropology to zoology. Thus, healthcare education can essentially be termed to be deriving philosophical moorings from higher education and practically responding to the needs of society.
Further, healthcare is not a monolithic entity. It is more of a team-based service that includes medical, nursing and allied healthcare professionals. The medical profession encompasses clinicians of western biomedical stream, the dentists, surgeons and the various AYUSH healthcare professionals. Pluralism of healthcare sector is not only an opportunity for the policy makers, but also a challenge to provide inclusive growth.
With this unique position, it would be worthwhile to examine the challenges in the healthcare sector, what are the resources needed to address to these issues and what role should a health university play in moderating the resource generation.
Challenges in the healthcare sector
The century we just left behind has been a remarkable one for human development. Fifty years ago, the majority of the world's population died before the age of 50. Today average life expectancy in developing countries is 64 years and is projected to reach around 70 years by the year 2020.
Health demography is concerned with study of the characteristics of human populations, such as size, growth, density, distribution, and vital statistics. This is a newly emerging discipline that emphasizes the interdisciplinary nature between the population science and health science. Studies conducted in this domain reveal changing landscape of health awareness among populations. This has brought in a paradigm shift in their healthcare priorities.
Moreover, epidemiological trends have undergone a seismic shift in the pattern of morbidities. If a century ago, the major healthcare concern was infectious diseases, today, the need is to tackle non communicable chronic metabolic disorders. Changes in lifestyle and cultural shift have contributed to this change.
A look at the population pyramid of India today and its projections over the next fifty years shows that nearly half of our country’s population will be below 25 years of age. This is a determining force in understanding the nature of morbidity that we can expect on a mass scale.
Increased urbanisation has also given rise to many cross cultural practices. Coupled with this is the phenomenon of democratisation of information with internet as a medium. Such a cultural shift has enabled people to become aware of many health beliefs that were not well known on a larger scale. Many traditional healthcare practices which were confined to select geographical or cultural zones are now in the public domain.
The importance of community based healthcare, rural healthcare, etc, have become influential variables in the healthcare domain. The flagship project of India’s healthcare broadband –National Rural Health Mission, and now proposed National Urban Health Mission have fired public imagination on the multitude of healthcare options. These projects have also challenged the policy makers to rethink and relook on the need for policies that would be sensitive to the needs of people.
Along the way, the corporatisation of healthcare in various forms like swanky hospitals, healthcare insurance, package deals in health check-ups, medical tourism have bred a new wave of practices. These have also had a salutary effect in innovating mass health projects like health insurance for populations Below Poverty Line.
Thus, on the whole, the outlook of healthcare sector presents a dynamic kaleidoscope of opportunities and some unexplored vistas of potential solutions.
Resources needed to address to these challenges
The resources needed to address these challenges could fall into infrastructure development and capacity building of human resources. What is significant for the Universities is to generate resources that are either human in nature or resources that could be utilised by human component of healthcare system.
This effectively means generating knowledge, skills and values that are relevant for the practice of healthcare and capacity building of human resources to optimally utilise these resources.
Thus far, the medical education was an exclusivist and discipline based study, with some amount of informal vertical integration during the clinical postings. This would apply to all disciplines of healthcare education like medical, dental, nursing, pharmacy, AYUSH, allied health sciences, etc. What is remarkable is that all these professions are interdependent on one another at some point in time.
A perusal of human resources available under various categories of health professions as per the official documents, can be listed as below –
- Doctors having medical qualifications under Indian Medical Council Act are around 640,000
- Dental Surgeon registered with Dental Council of India are around 80,000.
- Registered AYUSH Doctors is around 850,000
- Nursing staff is around 1800,000
- Pharmacists are around 700,000
As per the documents of World Health Organisation, the number of physicians per 10,000 populations for the world is 1.5. For India it is 7, which is at par with low income countries. Similarly, number of nurses per 10,000 population in India is 8, while it is 33 for the world and 16 for low income countries.
India has an abysmally low doctor-patient ratio - one doctor for 1,953 people, or a density of 0.5 doctors per 1,000 population. This reflects a serious issue in human resource management is huge gaps in critical health manpower in government institutions, particularly in rural areas, that provide healthcare to the poorer segments of population. These statistics reiterate a need for both long term and short term measures to overcome this serious challenge.
The Indian Government is seized of the gravity of this matter and therefore has asked the health ministry to work towards "strengthening of public health through creation of necessary human resources capacities at all levels." The Planning Commission's high-level expert group recently suggested the setting up of a Public Health Service Cadre that would be responsible for all public health functions starting at the block level, and going up to state and national levels.
We also need to look at the leadership role that India is expected to play in the future, especially in contributing to the mentoring of healthcare and education systems of the underdeveloped countries. Passing over the phenomenon of Brain Drain to the developed western countries, we need to frame a policy of intellectual and social harvest for the unfortunate humanity in countries like Africa and Asia. We need to prepare some fraction of our health human resources with a global outlook.
The challenge for future is certainly a human resource cadre that is responsive to the needs of India’s healthcare needs. Alongside, we also have an obligation towards the international community of underprivileged countries that look at us with hope and expectations to mitigate their sufferings.
Role of health sciences’ universities for resource generation
Health Sciences Universities were envisaged as hubs for the generation, nurturing and dissemination of knowledge, skills and values that are essential for viable and valuable healthcare practices. Various committees appointed by the World Health Organisation have stressed on the need for a inclusive and integrative healthcare education. Such an education is desirable to mirror the realities of healthcare practices.
Healthcare education faces several important challenges. Changes in healthcare scenario have had an enormous impact on the relevance of the current healthcare training. Such a situation calls for strong academic leadership in healthcare sector. We need to be aware of the complexities and challenges that confront the academic leadership of healthcare. There is a need to answer questions like ‘how do we prepare tomorrow’s doctors and nurses and pharmacists and a host of healthcare professionals today?’. Education of health professionals is critical to meeting global and national health challenges.
This throws up the challenge as to how best we could converge the needs of future healthcare and the emerging frontiers of knowledge into the curriculum so as to produce a more complete physician – the one who meets the needs of individuals and communities. We also need to look at the best way to mainstream disciplines as significant as molecular medicine, genetics, palliative care, AYUSH systems, nutrition, medical ethics, information technology, and many more into the existing curriculum. Exclusion of these neglected areas of medical education produces an incomplete physician.
Information and Communication Technology is another area that needs to converge with healthcare practices. There is a trend in healthcare education to absorb the best of all inventions and innovations. This healthy trend has given rise to not only many effective solutions in patient care, but also thrown up many interdisciplinary areas like Healthcare Informatics, Tele Medicine, etc.
Application of technology in healthcare education has also sprouted newer ways of teaching and learning. Blended Learning, which is a judicious mix of face-to-face teaching methods and digital teaching techniques offers new panorama of educational landscape. Considering that the future practitioners of healthcare would use computer technology as a matter of routine for many of their clinical decision making, we need to train our students to be able to survive and flourish in such an environment. We should train our students in such a way that they use the computer technology for their self-directed learning. It is not only a matter of using technology, but also being critical in evaluating the information available through technology.
The success of Open and Distance Learning as a medium in the Higher Education Domain opens up newer avenues of administering healthcare education. It may not be an alternative to the conventional form of undergraduate and postgraduate healthcare education. There is possibility to include certain modules of learning in this medium. However, a significant application of this form of education could be harnessed for Continuing Professional Development. This is because, healthcare education is also is about teaching how to manage change.
We live in a rapidly changing world. As educators, we need to inspire the future health professionals to embark upon a lifelong learning and applying quest. That will be their assurance of being able to provide their future patients with the best quality care they need for many years from now.
Conclusion
The challenges of healthcare in the new millennium are complex and multiple. The solutions for these ought to be appropriate and dynamic. Health Universities have their role cut out, not just to generate relevant human resources who are capable of solving the health related issues, but also instil into them ethical and social responsibility to perform as leaders of healthcare movement.
Thursday, October 13, 2011
Specific Proposals for AYUSH Education in the 12th Plan
1. Training of Trainers (ToT) for AYUSH Faculty
2. Training for Principals of AYUSH Institutions in Educational Management
3. Training of AYUSH Hospital Superintendents in Clinical Leadership
i. What is the context of proposed programs/schemes? (Mention gaps, magnitude of the problem, issues that need to be focused upon, challenges, potential solutions and their limitations related to programs/schemes)
Training of Trainers (ToT) for AYUSH Faculty
Teachers of AYUSH Sector are selected from a pool of postgraduates in the relevant discipline. This ensures that the selected teachers have some degree of authority in their subject speciality. This procedure, however doesn’t guarantee that those who are selected have proficiency in teaching; because educational techniques are not a customary component of postgraduate syllabus in any of the AYUSH sector. Therefore, these ‘teachers’ may not be sensitised to the various basic norms of teaching and student evaluation.
To rectify this gap, it is necessary to institutionalise the process of training teachers in the field of Educational Science and Technology. This can be achieved by dedicating a certain percentage of syllabus in postgraduate education for imparting knowledge and skills of teaching and evaluation. For those teachers who are already in service, there has to be a program of training in the relevant skills that are benchmarked as necessary for proficiency in teaching and evaluation of higher education.
This proposal is in tune with the experience of medical education in India. In the 1970s, the Government of India initiated an ambitious project to impart the principles of higher education to the medical teachers and align their practices to be compatible to the global standards of medical teaching. As part of this initiative, Centres for Medical Education were established. The National Teachers Training Centre at JIPMER, Puduchery and K. L. Wig Centre for Medical Education at AIIMS, New Delhi are examples of this organisation building.
Much of the reforms in medical curriculum in India emerged as a result of this ingenuity. The faculty who were the beneficiaries of this project are in the forefront of the educational reforms that are driving the Indian medical professionals as major players in the global healthcare delivery.
AYUSH education is passing through a phase, from which it has to emerge stronger and firmer in the mainstream of both national and global healthcare management. Therefore, a project that takes care of Training of Trainers for AYUSH Faculty is necessary and justified.
Training for Principals of AYUSH Institutions in Educational Management
The pace of educational change has been accelerating in the past few years. The forces of economic liberalisation and social awareness have coupled and aligned to create consumer consciousness for rights in the field of health and education services. This wave of consumer rights has heightened the demand for strong links between education and perceived needs of healthcare services of the community. Medical institutions are increasingly required to deliver students prepared to contribute to the healthcare of the society.
The documents of National Policy on Education, National Policy on Medical Education and National Policy on ISM & H, among others represent a trend towards quality in education and institutional responsibility that are hypothecated on the assumption that decisions should be made by those who best understand the needs of the students and the society. The outcomes of such initiatives include Internal Quality Assurance Cells in various universities and the constituting of National Assessment and Accreditation Council under the aegis of University Grants Commission.
AYUSH institutions serve a multidimensional role of providing educational activities and experiences for the students, healthcare services to the patients and research and development potential for the doctor and teachers. Thus, the responsibilities imposed on Principal or the academic leader of AYUSH institution place a premium on high quality management. Management of patient care or financial planning require skills that are distinct from those needed to plan and deliver the curriculum. Principals of AYUSH colleges have qualifications in AYUSH with little or no formal qualification in management discipline. They usually grow into the job over the years and some do remarkably well, while others falter along the way. The situation can be remedied to a large extent if the educational leaders are provided with awareness of theoretical concepts and their practical application in a systematic manner.
Training is a vital component in the acquisition of managerial competence as is a clear understanding of how to ensure successful implementation of change. Thus, there is a need to enhance the capacity of principals as good administrators / managers as well as instructional leaders, so that the future generations of AYUSH practitioners are imbued with confidence and competence to be torch bearers of AYUSH practice. This could be achieved by instituting a program for training principals in the principles and practice of education management.
Training of AYUSH Hospital Superintendents in Clinical Leadership
The global healthcare market is now appreciating the contemporary relevance of AYUSH. Health seeking behaviour studies suggest that a new regime of ‘Medical Pluralism’ based on inputs provided by various health care systems of the world, will govern healthcare delivery systems in modern societies.
Given the shift in consumer trends, towards pluralism and growing acceptance of AYUSH, opportunities in mainstream healthcare market for AYUSH systems are expanding. They include preventive, curative and wellness services. This new regime is creating demand for highly skilled AYUSH clinician leaders who can rub shoulders with specialists of conventional medicine in both corporate and community healthcare situations. The superintendents of the hospitals that are attached to the AYUSH institutions need to be aware of the principles that drive effective hospital management in the areas of clinical training for the students and healthcare services for the patients. Therefore, an organised program for capacity building the managerial and leadership abilities of these human resources managers is justified.
Recommendation to 12th Plan for AYUSH Sector
Sub-Committee on Education & International Cooperation
Reply to the Terms of Reference
1. What kind of schemes are needed in 12th FYP to strengthen and streamline UG and PG education (for eg; are more PG seats needed to be created, supported by fellowships in order to meet the shortfall of teachers?)
The AYUSH education, in the current state, is to a significant extent influenced by the medical model of curriculum. This has stunted the blooming of AYUSH academics in its natural state. Therefore, the most important step to revitalize AYUSH education is to have a rethink on the content and process of both UG and PG education.
The duration and focus of the educational programs may be approached with the performance profiling of the AYUSH doctors, who would be required to provide evidence-based healthcare in an environment that is getting increasingly complicated by many socio-economic factors and yet preserve the ideals of the individual AYUSH components.
The current structure of UG and PG education may be retained to a significant extent for the purpose of uniformity in a pluralistic educational environment, while accepting the reality for individual growth and sustenance of these disciplines.
It is estimated that the current human resource volumes of AYUSH doctors is around seven lakh in India, which is comparable to the numbers of conventional medical doctors. The numbers that would be needed to address to the future needs have to be calculated on the basis of population projections for the next fifty years and the roles that the AYUSH doctors are expected to perform during this period. Perhaps the numbers would be available with the relevant documents of Planning Commission.
In case of the undergraduate education, the number of basic AYUSH doctors that is needed can be a benchmark for deciding on the number of colleges, the admission capacity and their geographic locations. Further, the profile of Basic AYUSH Doctor can decide on the duration, content and thrust of the course.
In case of postgraduate education, the inherent strengths of each of the AYUSH system can be objectively assessed and the clinical focus areas for each may be determined. It does not matter if any of the focus areas have more than one system claiming effective performance. Whichever system has effective strength, in spite of the overlapping with another system, may be given equitable presence in those clinical focus areas.
The PG courses for each AYUSH system may be determined on the basis of their clinical focus area. The numbers of PG seats and colleges may be based on the human resource projections for each of the clinical focus areas and matching them with the community requirements.
Considering the volumes of AYUSH doctors needed for the fifty year projection, there has to be a matching upscaling of infrastructure, teachers, paramedical professionals and financial outlay. Regarding the increase of numbers of teachers, there could be some innovative strategies to harmonise the quality with quantity. For teachers of non-clinical subjects, there could be teaching based fellowship programs like MSc in Anatomy or Physiology or Biochemistry or Forensic Medicine or Community Medicine ( or equivalent disciplines to suit the inherent nature of each of the AYUSH system).
This program may provide knowledge and skills to equip teaching the undergraduate course. The teachers who hold these qualifications acquired after the basic AYUSH graduation may be treated on par with the teachers holding MD / MS of the clinical or non-clinical subjects for all purposes like recruitment, promotion, financial parity, etc.
2. Is it justified to provide one time grant in aid support by Government of India, to model UG and PG colleges? These should be colleges with track-record of high (above the average) performance. They may be government or not for profit non-govt. educational institutions in the country. Must they full-fill certain quality parameters of educational service? What should these quality parameters be (enrolment, fee structure, pass-percentage, percentage of students getting over 60%, basic clinical infrastructure, evidence of some specific innovative practice)?
If the committee believes a scheme of grant-in aid to model colleges is justified, what specific kind of infrastructure needs (eg IT infrastructure) and what specific types of non-recurring expenses (eg; visiting faculty, student fellowships) should be supported? What should be the quantum of support per institution, should this depend on student enrolment?
As a first measure, the colleges have to be classified in to something like three categories – high performing, moderately performing but with good potential and low performing.
The classification may be made on the parameters accepted and practiced by organizations like National Assessment and Accreditation Council of India or even the Educational Institutional Standards proposed by the Deming’s Institute.
The high performing institutes may be provided with rewards apart from the extra financial grants to motivate a continued high performance level. The moderately performing institutions that are having potential to improve may be provided with mentoring and incentives to perform better and reach the top bracket. The low performing institutes may be offered remedial services to move up the ladder and in case they are not showing signs of improvement against the accepted benchmarks, may be closed down.
Each college must be mandated to constitute and operationalise Internal Quality Assurance Cell to monitor the progress of learners and teachers and also the administrative, clinical, research and extension activities of the institution.
The future of education is in the technology. The stakeholders of education must have a significant literacy level in educational technology. This medium has provides the option of resource sharing even at geographic distances.
Providing appropriate technology infrastructure and linking the institutions enables not just resource sharing, but also harnessing the best practices. For example, the application of videoconferencing can provide realtime learning for the students from the best of faculty across the country. There could be a dedicated timing when interactive virtual classroom can get the assembly of a renowned teacher presenting his / her lecture for a widely distributed audience. This will also economise on time and money.
These facilities may initially start with all the National Institutes and later trickle down to the Model Colleges. In the later phase, these could extend to cover all the recognised colleges.
3. Given the need for well trained para-medics in AYUSH sector, should there be a provision in 12th FYP to support ‘not for profit’ initiatives of new institutions be supported for designing and implementing paramedical courses? Should a necessary requirement be that such institution be affiliated to universities and the curriculum of such para-medical courses be required to be approved by the university, board of studies?
Paramedical human resources form the backbone of any healthcare service. The paramedical training as vocational course is conducted by the paramedical boards of various states. The university level qualifications in paramedical sciences like nursing, physiotherapy, operation theatre technology, perfusion technology, radiation technology, optometry, etc are conducted by both general and health universities across India. Except for the Rehabilitation Council of India, which regulates some of the paramedical courses like occupational therapy, there are no apex bodies as there are MCI, CCIM, CCH, etc. Therefore each university has evolved its own standards for these courses.
The paramedics play an equally important role in AYUSH healthcare. But there is no systematisation of their educational courses. Very often the organization that needs paramedical staff evolves its own standards, designs the course as per its requirement and conducts it in-house. Most of the times these are on-the-job-training. Thus there is no universally standardised paramedical course in AYUSH systems.
The emergence of National Rural Health Mission as a mass movement has brought into sharp focus the need for either sensitising the existing paramedics for AYUSH specialities or evolving a separate cadre of AYUSH paramedics.
It is advisable to keep the NRHM needs also in the loop while designing the AYUSH paramedic courses. There can be a separate Board that would manage these courses. This board may be under the Directorate of AYUSH of the respective states and a separate register of these paramedics may be maintained for legal purposes. As of now there seems to be no requirement and justification for the AYUSH paramedical courses at university level.
4. Should AYUSH dept. in 12th FYP launch a new scheme to support a certain number of doctoral and post doctoral fellowships programs on the financial basis of JRFs and SRFs and Post Doctoral fellows in reputed AYUSH institution and Centres of Excellence?
Research is one of the important ‘triads of education’ along with teaching and extension services. However, this is not given the importance that it merits in the mainstream of AYUSH establishment.
Schemes to support potential research scholars in the areas of finance, infrastructure and legally have to be evolved. These schemes could be in the form of provisions made by organisations like CSIR for JRF / SRF.
Those who successfully clear the entrance tests of JRF / SRF qualifying exams may be given preference for appointments to the research projects run by or funded by the respective research councils.
Post doctoral fellowships may be awarded for exploring frontier areas of clinically relevant issues in AYUSH streams.
The scheme initiated by the Higher Education Commission of Pakistan to promote high quality research scholars and retain them can also be looked at as a prototype to build our own model.
5. Should the 12th FYP support a new flexible scheme for in service ‘teacher-training in AYUSH Institutions to upgrade their knowledge and skills? Should selected teacher training centers in colleges be designated as Centers of Excellence for teachers training in specific subjects? Should the Vaidya-Scientist program (a teacher-training initative) be up-scaled?
Training of trainers in the domain of educational science and technology is a concept that has to be made more accessible and acceptable to all the teachers in AYUSH. Teaching is a highly delicate activity that has to be nurtured sufficiently so as to enable the teachers not only to have mastery in the subject that they teach, but also in the Softskills of teaching.
These Softskills include the overall view of education in the context of society, the responsibility of teachers towards students and the institution, ability to define and articulate the objectives for teaching, identifying appropriate teaching – learning method and media to realise the stated objectives, assigning appropriate evaluation methods and instruments to assess the learner competency to realise the intended learning objectives.
The teachers also need to have an understanding of educational planning process, so that they can suggest appropriate and suitable modifications to the existing courses of study. They should also be aware of the skills to motivate learners, manage discipline related issues like conflicts in the academic domains, provide leadership to their students and the other junior faculty.
Therefore, a National Campaign for Faculty Development in AYUSH Sector is an immediate necessity. In fact a proposal was sent to the AYUSH Department and the RAV in the year 2010 for a comprehensive restructuring of the RoTP in AYUSH. This included development of a national pool of master trainers who would in turn train subject specific resource persons at zonal level who would in turn train all the teachers in the subject-specific RoTPs. One of the outcomes that was envisaged was the preparation of standard and uniform training methodology, so that there are National Benchmarks of Education against which the standards of learning can be mapped. (schedule for this training that was presented to the Department is also attached with this mail).
These training shall be conducted or moderated by a specially designated institute such as the existing National Teachers’ Training Centre at JIPMER, Puduchery for medical teachers, or the National Institute of Technical Teachers' Training and Research, Chandigarh.
UGC has the scheme of National Eligibility Test to identify teachers who are eligible to apply for university level teaching jobs. Various states also have State Level Eligibility Tests. These tests ensure a minimum standard in teaching content. Further, the Academic Staff Colleges conduct Continuing Professional Development to the faculty. Attendance of a minimum number of programs is built into the eligibility criteria for promotions to the next higher cadres.
This model can be suitably modified to provide a dedicated pool of teachers in each of the AYUSH system. There would be better professionalism among these teachers and they would also transfer a greater sense of confidence because of their ability to objectivise teaching. They would also be better prepared to convert the implicit knowledge of many of the AYUSH systems into transferable knowledge, ensuring easy comprehension.
Unique Identification Number may be assigned to each teacher to track their career growth and also to prevent the possible duplication of faculty in different institutions.
Postgraduate education is a growing area in AYUSH streams. Many specialities are covered under these programs. For the areas that are not represented in the PG programs, there could be provision to start Fellowship courses. These could be started in interdisciplinary areas like Sports Medicine with Panchakarma.
6. Should Govt. of India move CCIM to support the recognition of autonomous UG and PG colleges of AYUSH on principles similar to recognition by the UGC to colleges in other disciplines? If so, what should be the criteria to select such autonomous colleges?
The committee may also advise on what autonomy should include for example freedom to make curricular changes keeping a core-curriculum intact and only freedom to change the sequence of subjects taught in year 1, 2, 3 and 4? And or freedom to innovate in teaching and evaluation methods? And or freedom to introduce clinical experience from year 1? And or freedom to involve visiting faculty and send students to earn credits for specific courses from empanelled Guru’s outside the Institution?
Autonomy to institutions having excellent academic track record is a good practice to improve innovation in education. Such institutions are usually identified by the university that affiliates them for granting autonomy to develop their own curriculum, academic schedule and conduct examinations. However, the degree is awarded by the university.
To implement this in the AYUSH stream, there has to be modifications in the relevant acts like the CCIM and CCH, so that the provision for deviating from the syllabus is provided and the degrees conferred under such arrangement are also listed in the schedule 2 of the relevant acts and these degree holders also enjoy such professional and legal benefits as enjoyed by the degree holders of the mainstream courses.
Credit based courses are gaining popularity in many domains of higher education. This system provides flexibility to choose a mix of subjects as per the desire and aptitude of the learners. This could mean a drastic shift of present paradigm. However, there could be provision for electives at the final year, so that some degree of specialisation can be achieved within the undergraduate course.
Additionally, there could be a provision for undergraduate students from third year onwards to enrol of professionally relevant course from the existing distance education providers like IGNOU, which offers some health related course for those who have completed 10+2. Further, there could be MoU with the Distance Education Council to design Diploma / PG Diploma courses that are relevant for the AYUSH graduates.
7. Should AYUSH dept. support a new scheme for E-learning initiatives related to CME and teachers training with a flexible framework of support that allows scope for creativity and innovation?
The E learning scheme may be aligned with the Faculty Development campaign as explained under item no. 5 above.
8. Should the Dept. of AYUSH encourage the creation of institutes of national importance in both Govt. and non-govt. sector under schedule VII of the constitution in order to promote innovation in the AYUSH sector? What should be criteria and modus-operandi for selection of institutions who aspire for such recognition?
There is a need for Institutes of National Importance to explore the intricacies of various AYUSH systems and clarify these issues on a realistic platform. There can be a national debate to identify the areas of innovation and institutions with potential to be productive may be awarded these projects.
The potential institutes may be identified on the parameters of proven experience in the field, the infrastructure capacity, human resources availability, etc.
9. What should be the statutory role of CCIM in 12th FYP in regulating AYUSH education?
The role of CCIM, CCH may be continued in the present format.
10. Should govt. of India move CCIM to recognize Rashtriya Ayurved Vidyapeeth (RAV) as a post-graduate centre implementing PG diploma and degree courses via the guru-kul methodology.
There can be additional streams of formal and non-formal education in the AYUSH sector. The formal could be in the form of constituting a body like the National Board of Examinations in modern medicine that awards DNB qualifications that are recognised on par with the MD / MS courses by Medical Council of India. In the non-formal sector, Gurukul system may be explored.
11. In respect of international cooperation, the 12th plan needs to advise firstly on policy goals for international cooperation and accordingly devise strategy to appraise, select and support well designed and coordinated programs in education, clinical services, pharmaceutics, basic research, advocacy, trade and commerce on size and scale that are in line with policy goals and can impact the international community.
The thrust areas for international cooperation in education could be short term internships in AYUSH systems for the medical graduates, interdisciplinary modules for the graduates / postgraduates of medical humanities like Medical Philosophy, History of Medicine, Medical Anthropology, Health Economics, etc.
Thursday, January 27, 2011
Alternatives in homeopathy education
The purpose of sectoral education is to create avenues for the continuity of that sector. Homeopathy education is no different in this respect. The current system of homeopathy education was modelled after the Medical Council of India’s undergraduate education. This system has maintained status quo for the past many years. However, there is no record of any serious study to assess the impact of this course over the years.
An anecdotal review would reveal the current status of homeopathic practitioners for practicing homeopathic system of medicine. It is accepted fact that a sizeable number of homeopathy graduates gravitate away from homeopathic practice; something that is more notable in certain geographic locations in India. there are many lamentations in the professional circles, but little concrete measures to tackle this trend.
One of the factors that emerges from discussions with newly qualifying graduates is that there is sufficient knowledge of homeopathy and allied medical disciplines, appreciable level of clinical skills, but a rather low confidence to practice homeopathy among the young professionals from the geographic areas referred to earlier.
It is a serious identity crisis for any sector that finds its brand suffering low self esteem among its stakeholders. The solution to this crisis is preparing and implementing a major rebranding strategy. In this exercise, the strengths of the product / service has to be highlighted in the light of its relevance to society and the awareness of its simplicity in application should be created among its practitioners. Further, newer methods of presenting the product / service to its beneficiaries should be evolved.
Considering the above strategy, we need to look at homeopathy in its original form, devoid of the expectations that were heaped on over the centuries. An objective SWOT (Strength, Weakness, Opportunities and Threat) analysis of homeopathic practice would bring out the areas that we need to be focussing on, without being apologetic about anything. The frontier areas of healthcare services where homeopathy has strong and decisive role to play should for the core of training in homeopathic discipline.
We have a firmly established education system at both undergraduate and postgraduate levels. To shake it up drastically might prove disastrous for the continuity of education system. Instead, it is better to experiment with an alternative in controlled environs and mainstream it gradually. I propose two suggestions for the experiment. These can be debated for further refinement.
1. To start ‘Finishing Schools’, that would cater to honing the skills and attitude of newly qualified homeopathic graduates to provide the much needed confidence to practice homeopathy. The curriculum can build upon the strengths that are already acquired during their BHMS course. The content of this course could include communication skills, marketing skills, improving analytical skills for clinical decision making, etc. This course could be in the duration of three to six months. The participants in this course will have some didactic learning in new areas like business development, social leadership, etc. There could be clinical case discussions – both in the clinic / ward / community and in the discussion room. This can improve the clinical decision making skills. It is also a good idea to run it along with the internship, without affecting the requirements of Central Council of Homoeopathy / University for completion of the internship program.
2. This is an elaborate system, which can provide an alternative to the existing PG programs. We can model it after the DNB program in modern medicine. The Centres of Excellence identified by Government of India, Regional Research Institutes of the CCRH, reputed homeopathic hospitals, recognised homeopathic colleges that have superfluous capacity (beyond the minimum required by the statutory bodies) can be the nodes for conducting this program. There need not be a fixed syllabus for teaching, rather a set of clearly defined learning objectives in cognitive, psychomotor and affective domains of educational taxonomy. There could be courses of study in the core homeopathic areas and also in the frontier areas of clinical disciplines (as trandisciplinary stuies)
Entrance for this course may be through a national entrance test. During the two or three years of rigorous training there shall be continuous monitoring by way of portfolio comprising of case records, group discussions, seminars, symposia, journal clubs, articles in peer reviewed journals, etc. At the end of the course, the participant is evaluated for the attainment of the learning objectives that are listed for the course. There shall be a 3600 evaluation – theoretical, clinical, attitudinal – by internal faculty, external board comprising of homeopathic professionals (and other professionals too in case of a transdisciplinary course of study), self evaluation, peer evaluation and evaluation by the stakeholders (i.e., patients).
Certification for the course may be given in collaboration with the Indira Gandhi National Open University, which is pioneering innovative education. There need not be any stand off with regulatory authorities as these courses in their experimental form are not tipped to vest registration to practice (in fact there is no scope for confrontation, as those enrolling for the course already have their registration).