The Central Council of Indian Medicine (CCIM), under the Ministry of AYUSH, issued a crucial amendment on November 19, 2020, to the Post Graduate Ayurveda Education Regulations, 2016. The amendment specifies that postgraduate scholars of Shalya Tantra (General Surgery) and Shalakya Tantra (ENT, Ophthalmology, Dentistry) must receive hands-on training in various surgical procedures to perform them independently upon graduation.
This move has significant implications for Ayurveda practice, allowing trained Ayurveda surgeons to conduct over 50 types of surgical procedures in general surgery, ophthalmology, otolaryngology (ENT), and dental surgery.
Key Aspects of the Notification
1. Title and Implementation
- The amendment is titled the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020.
- It came into force upon its publication in the Official Gazette.
2. Practical Training Mandate
- PG scholars specializing in Shalya (General Surgery) and Shalakya Tantra (ENT, Eye, Dental Surgery) must be practically trained in surgical procedures.
- The purpose is to ensure independent competency in conducting surgeries without supervision post-degree completion.
MS (Ayurved) Shalya Tantra – General Surgery
Procedures
- Lekhna / Chhedana of DushtaNijaVrana (Debridement/fasciotomy / Curettage)
- Bhedana of Vidradhi (Incision and Drainage of abscess – Gudvidradhi, Stan vidradhi, Perianal abscess, breast abscess, Axillary abscess, cellulitis, etc.)
- Sandhan Karma (All types of skin Grafting – SSG, EEG, Cross Flaps) KarnaPaliSandhan (ear lobe repair), etc.
- Chhedan Karma of Granthi, Arbuda (Excision of simple cyst – Sebaceous cyst, Dermoid cyst, mucosal cyst, retention cyst, etc.) / benign tumours (lipoma, fibroma, schwanoma, etc.) of Non-vital Organs.
- Chhedan Karma of Sira-SnayuKotha (Excision / amputation of gangrene).
- Sadyo-vrana management (traumatic wound management):-
- (a) Sivan karma (all types of suturing, Haemostatic ligatures);
- (b) Sandhan Karma of sira-kandara-snayu (Ligation and repair of tendon and muscles).
- PranashthaShalyaNirharan (Removal of metallic and non-metallic foreign bodies from non-vital organs).
- BhagnaChikitsa (Aanchhan- Pidan – Sankshep – KushaBandhan) (close reduction, immobilization, splints/cast).
- Sandhimoksha (Reduction of dislocation and subluxation).
- UdarrognaChikitsa / AdokadarVisravan (Laparotomy/ paracentesis).
- Arsha – Ksharkarma, Chhedan (Various methods of haemorrhoidectomy, rubber band Ligation, Sclerotherapy, IRC, Radio frequency / Laser ablation, etc.).
- ParikartikaSaniruddhaGuda (Fissure in ano – Anal Dilatation, SphincterotomyAnoplasty).
- BhagandarChhedan, Ksharsutra (Fistulectomy, Fistulotomy).
- NadivranaChhedan, Ksharsutra (Excision of pilonidal sinus).
- Guda-bhransha- Sandhan Karma (Various Rectopexies).
- Ashmari- Nirharan (Suprapubiccystostomy/cystolithotomy).
- Mutraghata/ Mutrakrichha- MutramargVivardhan (Urethral Dilatation, meatomy).
- NiruddhaPrakash (Phimosis), Parivartika (Paraphimosis) Circumcision.
- VriddhiRogaChikitsa, Sandhan Karma (Congenital/ Inguinal/ Umbilical / Epigastric/ Femoral/ Incisional Hernia :-Herniotomy, Herniorrhaphy, Hernioplasty).
- Mutravriddhi-Vedhan (Hydrocele Eversion of Sac).
- Intercostal Drain for thoracic trauma.
- Ligation of Haemangioma, Vascular ligation, Ligation of varicocele, varicose veins/ stripping surgery.
- Stan Granthi / ArbudaChhedan (Excision of benign lesions, cyst/ tumour of breast, Lump biopsy).
- AshukariUdarshoolshastra karma-Udarpatan (Exploratory laparotomy).
- Foreign body removal from stomach (Pyloromyotomy).
- Use of Advanced Nadiyantra for strotodarshanarth-kriyasaukarya (Video proctoscopy, Sigmoidoscopy).
- Ileostomy, colostomy, Resection anastomosis in emergency.
- Sigmoidoscopic biopsies, polypectomy.
- UndukpuchhaShoth (Appendicectomy).
- Vedhan-Visravan of AbhyantarVidradhi (Appendicular abscess etc.).
- PittashmariNirharan-chhedan (Cholecystectomy).
- Laryngeal Mask Airway, Intubation, Bag/Mask Ventillation.
- SuprapubicCystostomy.
- SuprapubicCystolithotomy.
- Excision of Calcified Plaque Peyronie’s Disease.
- Orchidopexy.
- Orchidectomy.
- Varicocele High Ligation.
- Spermatocele, Chylocele, Pyocele, Hematocele Drainage.
MS (AYURVED) SHALAKYA TANTRA
(DISEASES OF EYE, EAR, NOSE, THROAT, HEAD, ORO-DENTISTRY)
Netra (Eye)
-
Vartmagatroga (Diseases of Eyelids):
- (a) VatahatavartmaShastrkarma (Surgery for ptosis i.e. sling surgery)
- (b) Vartmavikruti- Shastrkarma (Ectropion & Entropion – correction surgery)
- (c) Lagan – Bhedan & Lekhan Shastrkarma (Chalazion – Incision and drainage/ curettage)
- (d) AghatakVartmaArbud – Chhedan Karma (Benign Lid Tumor – Excision Surgery)
-
ShuklagatRog:
- Arma – ChhedanShastrkarma (Pterygium Excision & Conjunctival limbal autograft/amniotic membrane graft)
-
KrushnagatRog:
- Ajakajat – Chhedan Karma (Iris Prolapse-Excision Surgery)
-
SarvagatRog:
- Adhimanth – BhedanShastrkarma (Glaucoma-Trabeculectomy)
-
Nayanabhighat (Trauma to eye):
- Bhroo, Vartma, Shuklamandal, Krushnamandalabhighat – SandhanShastrkarma (Injury to eye brow, lid, conjunctiva, sclera, and cornea – Trauma repair surgery)
-
Tiryaknetra:
- PrakrutatnetrasthapanShastrkarma (Squint surgery – Esotropia, Exotropia, Horizontal muscle resection and recession)
-
Puyalas:
- Bhedan/ ChhedanShastrkarma (Dacrocystitis- DCT/ DacrocystoRhinostomy [DCR])
-
Linganasth (Kaphaj) Shastrkarma – Cataract Surgery with IOL implantation:
- (a) Intracapsular Cataract Extraction (ICCE)
- (b) Extra Capsular Cataract Extraction (ECCE)
- (c) Small Incision Cataract Surgery (SICS)
- (d) Phacoemulsification
Types of IOL:
- (I) PCIOL
- (II) ACIOL
- (III) Iris Fixated IOL
- Sthanikasangharan (Local Anesthesia in Eye – Ophthalmology):
- (a) Peribulbar
- (b) Retrobulbar
- (c) Parabulbar
- (d) Intra Cameral
Nasa (Nose)
- Nasajavanikavakrata – Shastrkarma (Deviated Nasal Septum Surgery – Septoplasty / SMR)
- Nasarsh – ChhedanShastrkarma (Nasal Polyp Polypectomy)
- Knowledge of FESS Surgery – Functional Endoscopic Sinus Surgery
- Aghatajanasavikruti – Nasasandhan (Deformed Nose – Rhinoplasty)
Karna (Ear)
- Karnapalisandhanshastrakarma (Torn Ear Lobule – Lobuloplasty)
- Ashukariamadhyakarnashoth – BhedanShastrkarma (Acute Suppurative Otitis Media/ Glue Ear/ Secretory or Serous Otitis Media – Myringotomy)
- Knowledge of JirnaMadhyakarnShothshastrkarma (Chronic Suppurative Otitis Media – Safe Tympanoplasty, Unsafe – Mastoidectomy)
Mukharoga
- Galrog (Throat Diseases):
- Pharynx:
- (a) AshukariIgalyuvruddhi – BhedanShastrkarma (Peritonsillar Abscess – Quincy – Incision and Drainage)
- (b) Jirnagilayushoth – GilayuNirharanShastrkarma (Chronic Tonsillitis – Tonsillectomy)
- Pharynx:
- Oshthatat – Oshthabhed – Sandhan Karma (Hair Lip Repair)
DantaRog
- Chaldanta – DantaNirharan (Loose Tooth Extraction)
- Krumidanta – Lekhan & Puranshastrakarma (Carries Tooth/ Teeth – Root Canal Treatment)
Impact on Ayurveda Surgery Practice
This notification strengthens the role of Ayurvedic surgeons in modern surgical practices by formalizing their training in essential surgical procedures. The amendment aims to enhance the clinical competency of Ayurveda PG scholars, allowing them to contribute effectively to the healthcare system.
Final Thoughts
The 2020 PG Ayurveda Education Amendment marks a significant evolution in Ayurveda’s surgical practice. By including hands-on training in complex surgeries, Ayurvedic PG scholars will be better equipped to handle surgical cases independently, bridging the gap between traditional medicine and modern surgical advancements.
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