Hindrances In Ensuring Quality In Ayurvedic Academia

The Government of India has established the National Commission for the Indian System of Medicine as a legal and regulatory entity. Its primary purpose is to develop policies for institutions and medical professionals involved in the Indian system of medicine. The commission comprises Boards responsible for assessment and rating, as well as a Board dedicated to ethics and the registration of practitioners in Indian systems of medicine.

The Medical Assessment and Rating Board for Indian System of Medicine (MARBISM) is responsible for various functions, including:

i) Establishing the procedure for assessing and rating medical institutions based on their adherence to the standards set by the Board of Ayurveda or, as applicable, the Board of Unani, Siddha, and Sowa-Rigpa.

ii) Granting permission for the establishment of new medical institutions, initiation of postgraduate courses, or an increase in the number of seats.

iii) Conducting inspections of AYUSH medical institutions to evaluate and rate them in accordance with the regulations established under the NCISM Act.

iv) Conducting assessments and ratings for all AYUSH medical institutions.

v) Implementing measures such as issuing warnings, imposing monetary penalties, reducing intake, halting admissions, and recommending to the Commission the withdrawal of recognition for a medical institution that fails to meet the minimum essential standards, among other actions.

Nevertheless, MARBISM encounters numerous obstacles in carrying out its designated functions. These challenges are associated with ensuring fair practices among diverse stakeholders. Unfair practices detrimentally impact the field of Ayurveda, leading to the discrediting and disrespect of this scientific discipline within society. Subsequently, the forthcoming discussion will address some hurdles in instilling quality within academic institutions.

Guest / Ghost Faculty: Guest faculty is a teacher who visits college for the sake of teaching once in a while whereas a ghost teacher never teaches. During the period of the Central Council of Indian Medicine, the erstwhile apex body, many teachers were physically working in their clinics/hospitals and were shown as teaching faculty by the institute to the visitors of inspection. These are generally called on-paper staff. There were many reasons for this, viz, low salaries offered by colleges prompted teachers to opt for such malpractices. The lack of an adequate number of faculty in a few subjects and the lack of commitment by either teachers or institutes or even the apex body allowed this menace to propagate.

MARBISM is keen to see that each teacher performs their duty of imparting teaching and training to students, hence the availability of teachers at the institute is highly essential. Therefore, serious efforts are being made by MARBISM to address this issue. During the inspection, particular attention is placed on validating the local address proof and practitioner registration of the teacher within the same state. In case of suspicion, inquiries are conducted using available evidence, such as CCTV footage. The teachers and institutions are cautioned against engaging in such activities, and in case of establishment of guilt, both teachers and institutions face penalties. The implementation of rigorous monitoring and disciplinary measures has proven effective, bringing this issue close to resolution. It is anticipated that the problem of on-paper staff will soon be eradicated.

Data Fabrication/ Falsification: A crucial element in the operation of any teaching hospital revolves around the diverse patient population it serves. NCISM establishes specific statistical parameters, including bed occupancy and student-patient ratios. Unfortunately, it has been noticed that numerous institutions resort to producing fraudulent documents by either manipulating or falsifying data. It is disheartening to observe that certain institutes have adopted this practice as a routine, with dedicated personnel tasked with fabricating fake case sheets. This poses a significant problem, negatively impacting the clinical proficiency of aspiring doctors from those institutions.

MARBISM carefully cross-verifies all records to find correlations with the records about patient flow in OPDs, IPDs, Pharmacy, Laboratory, diet registers, etc. Cross-verification with the purchase and sale ratio of medicine, chemicals, and consumables gives a fair idea of data fabrication. If the fake data is identified that leads to the denial of permission to the institute.

Lack of infrastructure: Few colleges have inadequate infrastructure. By and large almost all colleges have their physical infrastructure concerning land, buildings, etc intact. However, shortages in library infrastructure, clinical facilities audiovisual educative tools, etc are considered major shortcomings and can lead to denial of permission.

Finance: A majority of colleges operate as self-financing institutions. In many cases, the management of these colleges places a higher emphasis on commercial aspects, leading to a detriment in the quality of education and academics. The primary source of income, derived from student fees, should not bear the sole burden. Since these are professional colleges, the associated hospitals should generate sufficient finances to meet various needs, including salaries. The management’s focus on hospitals, with the provision of decent salaries, sets a positive example. This practice should be embraced by other colleges facing financial challenges. It is worth noting that a few colleges function as standalone institutes, exclusively running a single Ayurveda College, which occasionally subjects them to financial hardships.

Distribution of colleges: A noticeable trend exists in the uneven distribution of colleges, with a higher concentration in states such as Maharashtra, Karnataka, Uttar Pradesh, etc. Some colleges are situated in extremely remote areas, posing challenges to accessibility by students, patients, and even those conducting inspections. Many individuals urge MARBISM to address this imbalance. While MARBISM fulfills its role, it is crucial for the respective State AYUSH administration to determine the number of colleges needed in the state and their optimal locations. This evaluation can be conducted prior to issuing No Objection Letters by the relevant universities and state governments.

By bringing fair, just, objective, and transparent practices in the administration of MARBISM, many challenges are being addressed. However, support from the college administration, state govt administration, university administration, teaching community, and others would help enhance the quality of academia.