The government has issued a notification authorising post-graduate practitioners in specified streams of Ayurveda to be trained to perform surgical procedures such as excisions of benign tumours, nasal and cataract surgeries, a move which has drawn flak from the modern medicine fraternity.

The November 20 gazette notification by the Central Council of Indian Medicine (CCIM), a statutory body under the AYUSH Ministry to regulate the Indian systems of medicine, listed 39 general surgery procedures and around 19 procedures involving the eye, ear, nose and throat by amending the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016.

The Indian Medical Association (IMA), the largest body of modern medicine doctors, has condemned the move, describing it as "poaching the disciplines of modern medicine through back door means" and a "retrograde step of mixing the systems".

Demanding that the order be withdrawn, the IMA urged the CCIM to develop their own surgical disciplines from their own ancient texts and not claim the surgical disciplines of modern medicine as their own.

Attempting to clarify the notification, AYUSH Ministry Secretary Vaidya Rajesh Kotecha said it does not amount to any policy deviation or any new decision.

"This notification is more of the nature of a clarification. It streamlines the existing regulation relating to post graduate education in Ayurveda with respect to the specified procedures.

"Further, the notification does not open up the entire field of surgery to Ayurveda practitioners and specifies a set of surgical procedures. It outlines that not all post-graduates of Ayurveda can perform these procedures. Only those specialised in Shalya and Shalakya are allowed to perform these surgical procedures," Kotecha said.

Chairman of Board of Governors, CCIM, Vaidya Jayant Devpujari said that these surgical procedures were being performed in Ayurveda institutes for over 20 years and the notification legalises them.

"The purpose of bringing out the notification is also to set boundaries by specifying the list of procedures so that practitioners restrict themselves to the set of surgical procedures as mentioned in the regulation," Devpujari said.

The AYUSH ministry also issued a clarification stating the notification is a clarification of the relevant provisions in the previously existing regulations of 2016 and that the use of modern terminology in the said notification does not amount to "mixing" of Ayurveda with conventional (Modern) medicine.

"Since beginning, Shalya and Shalakya are independent Departments in Ayurveda colleges, performing such surgical procedures.

"While the notification of 2016 stipulated that the students shall undergo training of investigative procedures, techniques and surgical performance of procedures and management in the respective specialty, the details of these techniques, procedures and surgical performance were laid down in the syllabus of respective PG courses issued by CCIM, and not the regulation per se," the clarification stated.

The present clarification was issued in overall public interest by CCIM by bringing the said details into the regulation. Hence this does not signify any policy shift, it stated.

The ministry also said, "All scientific advances including standardized terminologies are inheritances of the entire mankind. No individual or group has monopoly over these terminologies."

Modern terminologies in the field of medicine, are not modern from a temporal perspective, but are derived substantially from ancient languages like Greek, Latin and even Sanskrit, and later languages like Arabic, it said.

"Evolution of terminologies is a dynamic and inclusive process," the AYUSH ministry said, adding use of modern terminology in the said notification does not amount to "mixing" of Ayurveda with conventional (Modern) medicine.

The notification issued by the Central Council of Indian Medicine stated, "These regulations may be called the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020.

"In the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016, in regulation 10, after sub-regulation (8), the following sub-regulation shall be inserted, namely -- During the period of study, the PG scholar of Shalya and Shalakya shall be practically trained to acquaint with as well as to independently perform the following activities so that after completion of his PG degree, he is able to perform the following procedures independently," it read.

According to the notification, the procedures listed include removal of metallic and non-metallic foreign bodies from non-vital organs, excision of simple cyst or benign tumours (lipoma, fibroma, schwanoma etc) of non-vital organs, amputation of gangrene, traumatic wound management, foreign body removal from stomach, squint surgery, cataract surgery and functional endoscopic sinus surgery.