AYUSH Medical Education

GS-II: Health | Education | Governance | Regulatory Institutions | AYUSH

Context

• Private-Sector Dominance: Non-government institutions accounted for 86% of Ayurveda colleges and 85% of homoeopathy colleges in 2024.
• Rapid Expansion: Permitted seats increased by 43% and total admission capacity by 25% between 2021 and 2024.
• AYURGYAN Allocation: The Centre’s allocation for AYUSH education, training, research, innovation and capacity-building increased nearly sixfold.
• Quality Concerns: The expansion has renewed questions regarding the quality of training, infrastructure, faculty and student intake in AYUSH institutions.
• Broader Question: Unlike concerns surrounding allopathic education, the debate around AYUSH also concerns what students are being trained to practise and the evidence backing AYUSH medicinal systems.

Existing Quality Concerns

• CAG Audit, 2005: Found insufficient hospital beds, outpatient services and/or staff in many homoeopathy colleges.
• Bed Occupancy: Bed occupancy across institutions ranged from 1% to 71%.
• Teaching Staff Shortage: A 2020 Journal of Ayurveda and Integrative Medicine article reported that many institutions had a shortfall exceeding 50% in required teaching staff.
• Regulatory Action: The National Commission for Indian System of Medicine (NCISM) has withheld or denied permission to institutions after inspections found deficiencies in faculty strength and infrastructure.
• Private Institutions: Expansion led by private institutions raises additional concerns because of incentives to maximise student intake while maintaining faculty size and laboratory infrastructure.

Evidence of Regulatory Non-Compliance

• Denied Permissions: As of August 21, NCISM had listed 17 Ayurveda colleges—all private—whose permissions had been denied.
• Inspection Issues: Several institutions faced action for non-compliance with the inspection process.
• Excess Admissions: In Hillside Ayurveda Medical College (2023), the Karnataka High Court acknowledged concerns that educational institutions may admit excess students for financial gains.
• Homoeopathy Colleges: The National Commission for Homoeopathy gave 41% of all homoeopathy colleges the lowest grade.
• Private Sector: Nearly half of all private homoeopathy institutions received the lowest grade.

Key Quality Issues

• Faculty Deficiencies: Inadequate or disputed faculty strength.
• Infrastructure Gaps: Shortfalls in required hospital beds, laboratories and other infrastructure.
• Inspection Failures: Non-compliance with prescribed inspection requirements.
• Excess Intake: Incentives may encourage institutions to admit students beyond appropriate capacity.
• Fictitious Faculty: Allegations of fictitious faculty have also emerged.
• Training Quality: Questions remain over whether students receive adequate training for the practices they are expected to undertake.
• Evidence Base: There are broader questions concerning the evidence backing AYUSH medicinal systems.

Role of Regulators

• NCISM: The National Commission for Indian System of Medicine regulates education and professional standards relating to the Indian systems of medicine.
• Regulatory Action: Permission can be withheld or denied where institutions fail to meet prescribed requirements.
• National Commission for Homoeopathy: Grades homoeopathy institutions and exercises regulatory oversight.
• Regulatory Challenge: Existing regulatory action demonstrates a functioning system, but persistent non-compliance indicates the need for stronger quality control.

Why It Matters

Quality of Medical Education

• Rapid expansion in seats and institutions must be accompanied by adequate faculty and infrastructure.
• Expansion without corresponding quality assurance can affect the standard of professional training.

Patient Care

• Deficiencies in hospitals, outpatient services, laboratories and faculty can affect the practical training available to students.
• The quality of training has implications for the practices students undertake after graduation.

Private-Sector Incentives

• Private institutions may have incentives to increase student intake while limiting corresponding investments in faculty and infrastructure.
• This creates a potential conflict between commercial incentives and educational quality.

Evidence-Based Practice

• The debate is not limited to infrastructure and faculty.
• It also raises questions about the evidence backing AYUSH medicinal systems and the nature of practices students are trained to perform.

Way Forward

• Tougher Quality Control: Strengthen monitoring of faculty, infrastructure and admission capacity.
• Effective Inspections: Ensure strict compliance with inspection requirements.
• Re-examine Incentives: Review the incentives that encourage private institutions to maximise student intake.
• Faculty Verification: Address concerns regarding inadequate, disputed or fictitious faculty.
• Infrastructure Standards: Ensure institutions maintain required hospitals, beds, laboratories and other facilities.
• Capacity-Linked Admissions: Student intake should remain aligned with available faculty and infrastructure.
• Evidence-Based Evaluation: Strengthen scrutiny of the evidence backing AYUSH medicinal systems.
• Balance Expansion with Quality: Rapid growth in AYUSH education should be accompanied by commensurate improvements in educational and training standards.

Conclusion

The rapid expansion of AYUSH medical education, particularly under private-sector leadership, represents significant growth in educational capacity. However, persistent concerns regarding faculty, infrastructure, inspections, student intake and the evidence base of AYUSH practices indicate that expansion cannot be pursued at the expense of quality.

The priority should therefore be to strengthen regulatory oversight, re-examine private-sector incentives and ensure that expansion is matched by credible standards of education, training and practice.

UPSC Mains Practice Question

Q. “The rapid expansion of AYUSH medical education must be accompanied by stronger quality assurance and regulatory oversight.” Discuss the challenges associated with the expansion of AYUSH education in India. (250 words, 15 marks)