Medics oppose AYUSH internship for MBBSAugust 7, 2021
The mandatory internship for MBBS students proposed by National Medical Commission (NMC) in AYUSH streams has drawn sharp reactions from allopathic practitioners and students of modern medicine. NMC, in the recently released Draft Regulations for Compulsory Rotating Internship, proposed a week’s internship in any one of the AYUSH streams – Ayurveda, Yoga, Unani, Siddha, Homeopathy and Sowa Rigpa — as an elective for MBBS students.
Terming it as an attempt to promote mixopathy, various associations representing allopathic doctors and resident doctors, including Indian Medical Association (IMA), Federation of All India Medical Association (FAIMA) and Federation of Resident Doctors Association (FORDA), have demanded NMC withdraw the proposal. Dr Sahajand Prasad Singh, a member of NMC, has also come out against the proposal.
Opposing the one-week exclusive elective posting, IMA stated that it is contrary to established norms and termed it superfluous and an attempt to initiate mixopathy. In a letter written to the NMC, IMA, the largest body of modern medicine practitioners in the country, has raised its objection to the proposal. “It is not prudent for an intern trained in modern medicine to partake and practice a system of medicine which he has not learned. Coming to do it straight away in an internship is dangerous to the public and the system,” said Dr A Jayalal, President, IMA.
In a letter sent to the NMC Chairman, IMA pointed out that as AYUSH and its components are vast subjects, the intern will not learn “any new thing” by working there for a week. It also stated that there is no clarity on who will be their mentor and whether they will be assessed by NMC faculty norms or not. IMA warned that the one-week exposure, especially in another system of medicine, will only pave the way to a half-baked mixopath, which will be disastrous for the country.
Supporting the observation of IMA, FAIMA also stated that the move will promote mixopathy in the future and open a path towards its complete inclusion in the curriculum of modern medicine. FAIMA, in its letter to the NMC chairman, stated that the undergraduate student studying several subjects in his graduation needs to get exposed to and learn about those in clinical scenarios during internship, but the addition of seven days of elective posting in Indian medicine, which the student has not studied at all and won’t be practicing in the future, will lead to a waste of time and energy and turn out to be superfluous. Instead, it could be utilised in some other specialty.
Expressing its concerns over the provision, FORDA stated that different systems of medicine have their own treatment guidelines for managing various health conditions. “Internship is a period for MBBS graduates to integrate the theoretical knowledge of 4.5 years with adequate clinical skills. Deployment of MBBS interns in the clinic of any other system of medicine is a waste of precious time. The inclusion of posting in an alternative system of medicine for a period of one week is unnecessary and should be omitted exclusively.”
Speaking on the proposal, Dr Rohan Krishnan, Vice President, FAIMA called the proposal impractical and “an insult not only to the MBBS students, but to AYUSH students also”.
“If an MBBS student does an internship for a week or month in Ayurveda, he is not going to learn anything. The proposal is totally unacceptable.”
In his letter to the NMC Chairman, Dr Sahajanand Prasad Singh said there is also a rider in the new provision to the effect that the said discipline be available in the same college/ institution where the internship is being done. But homeopathy is expected to be taught in unitary institutions, in terms of the governing provisions of the Parliamentary enactment and enabling regulations, he pointed out.
Therefore, he noted, the chances of this stream being available in a college of modern medicine under Ministry of Health and Family Welfare with NMC as the regulatory authority seems far fetched and impossible.
Include Family Medicine Instead: IMA
The Supreme Court, IMA pointed out, had in a series of judgments had made it clear that a registered medical practitioner in a given system whereunder he/she has been trained and possesses qualifications is entitled to practice the said possession and not trespass on any other profession in any manner by practicing the same.
“This being the binding and established position of law, any posting in the name of an elective in the period of internship which has no bearing in regard to the competencies that the intern would be entitled to practice as a registered medical practitioner are neither open nor permissible for inclusion in the said internship programme. Otherwise, it will be in violation of this binding settled legal position in terms of it being law of the land,” IMA stated.
Meanwhile, IMA advocated the inclusion of Family Medicine as an elective “as it is the need of the hour”.
“Family Medicine is a specialty which is the need of the hour for catering to the common people with multifaceted, continuous, comprehensive, cost-effective, community-oriented concepts and values of family care. The new, competency-based medical education has multiple hours of learning and practical sessions on Family Medicine subjects. That there is no opportunity to practice Family Medicine in the internship period is against the healthcare policy of the country,” stated the association, adding that the AYUSH internship should be replaced by one or two weeks of Family Medicine and bioethics.