Window Dressing: The State Of Ayurveda Education Around The World
The educational system of a country acts as a foundation on which its population grows, learns, and gets assimilated into the country’s workforce. This has far-reaching effects that trickle down into almost everything that happens within that country. High standards of education almost always correspond to higher standards of living, higher GDPs, low unemployment rates et al.
This applies to Ayurveda education as well. Today, there are a plethora of institutions around the world offering a wide variety of courses in and related to Ayurvedic medicine and there are thousands of Ayurvedic practitioners graduating from these institutions every year. This contemporary resurgence of Ayurvedic practice and Ayurvedic education can be attributed to a growing fascination with this ancient medical system from India.
Even though conventional western medicine has now become mainstream throughout the world, Ayurvedic medicine, especially in India, flourishes alongside Western allopathic medicine. While the structure of professions in regards to western medicine and Ayurvedic medicine may seem similar in some ways, their approach to diseases and general health and wellbeing are entirely different.
Classical Ayurveda is defined as “a holistic health care system that prioritizes the individual’s role and responsibility for personal health through proper living and prevention.”
Western medicine and healthcare are based on the statistical model of treatment. Western medicine focuses on treating the disease rather than the individual as a whole. Statistical studies on the effects of treatments on a wide variety of diseases inform physicians what methods will alleviate the symptoms of a particular disease or condition.
Ayurvedic medicine, on the other hand, does not apply the same one-size-fits-all approach to treating diseases. Ayurveda treats every disease, condition, and individual as unique with each patient’s treatment plan being equally unique and tailor-made for the individual.
According to the AYU Council (an Ayurvedic regulatory body from the United States), ‘Classical Ayurveda’ is defined as “a holistic health care system that prioritizes the individual’s role and responsibility for personal health through proper living and prevention.”
“It includes scientific practices, protocols, and methods to remove, alleviate and manage acute and chronic health disturbances from their root. It originated in the Indian subcontinent where it continues to be the longest continuously practiced health care system known today.”
Now that Ayurveda is rapidly gaining popularity in western countries, it is essential to look at how Ayurvedic medicine is perceived, taught, and regulated in these countries and how these standards of education and practices compare to those in India.
Ayurveda In The 21st Century
To analyze how Ayurvedic medicine is taught, practiced, and regulated around the world, one must first acknowledge the presence of the various distinctions within Ayurveda that have cropped up as Ayurvedic medicine has grown internationally.
According to Modern and Global Ayurveda: Pluralism and Paradigms by Dagmar Wujastyk and Frederick M. Smith, alongside ‘Classical Ayurveda’, Ayurveda has branched out into ‘Modern Ayurveda’ and ‘Global Ayurveda’.
As described by Smith and Wujastyk, modern Ayurveda is seen as the system of medicine geographically set in India which follows the processes of regulation, professionalization, and institutionalization introduced in India during the ‘nineteenth-century revivalism of Ayurveda’ (Leslie 1998; Brass 1972; Jeffery 1988).
Modern Ayurveda is characterized by its disassociation from religious/spiritual concerns of Ayurvedic knowledge and its adaptation into biomedicine along with efforts to formulate a unified theory of medicine based on the doctrines and guidelines found in classical Ayurvedic medical texts.
Global Ayurveda, as the name suggests, refers to Ayurvedic knowledge propagated to areas outside the Indian subcontinent. This globalization of Ayurveda can be further differentiated into two major lineages.
Global Ayurveda stresses the ‘scientific’ aspects of Ayurvedic medicine and “promote a secularized discipline stripped of its traditional religious and spiritual connotations.”
The first one is primarily focused on Ayurvedic pharmacopeia that includes the “analysis and dissemination of Ayurvedic botanical and pharmaceutical lore of the sixteenth century.” This study of Ayurveda (solely focused on Ayurvedic pharmacopeia) has now become a full-blown scientific discipline whose effects trickle into the massively profitable pharmaceutical industry as well.
The second lineage of global Ayurveda, popularly dubbed as “New Age Ayurveda” (Zysk 2001; Reddy 2000) follows the recent globalization of Ayurvedic knowledge which tends towards reinterpreting, if not reinventing the philosophical and spiritual aspects of Ayurveda. Zysk defines the characteristics of ‘New Age Ayurveda’ as follows.
- Attributing a remote age to Ayurveda and making it the source of other medical systems
- Linking Ayurveda closely to Indian spirituality, especially Yoga
- Making Ayurveda the basis of mind-body medicine
- Claiming the “scientific” basis of Ayurveda and its intrinsic safety as a healing modality
Interestingly, New Age Ayurveda also marks a shift in its modus operandi from being reactive medicine to preventive medicine offering “a positive lifestyle index”.
Diverging further away from the definition of Classical Ayurveda, New Age Ayurveda has become increasingly dominant in the United States and European countries. New Age Ayurveda has further been incorporated into the wellness industry in the form of cosmetic and massage treatments in spas, over-the-counter cosmetics, and nutritional supplements, and self-help literature.
Consequently, this dominance of New Age Ayurveda in western countries has also had a profound impact on the institutionalization, education, representation and regulation of Ayurveda in these countries.
Ayurvedic Education Around The World
A qualified Ayurvedic doctor in India is someone who has completed the minimum level of Ayurvedic medical education of at least 5.5 years at a state-recognized institution. Graduates are conferred with the degree of BAMS (Bachelor of Ayurvedic Medicine and Surgery).
The regulations for establishing qualified Ayurvedic physicians vary widely in different countries and do not adhere to a standardized curriculum like in India.
Unlike western countries, India officially recognizes Ayurveda as a system of medicine. The government of India established a separate department for the Indian Systems of Medicine and Homeopathy in 1995 which was recently renamed as the Ministry of AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy).
Ayurveda plays the dominant role among all the different systems in AYUSH and has a major share in infrastructural and institutional facilities in regards to the number of hospitals, dispensaries, educational institutions, and registered medical practitioners.
The main governing body for Ayurveda in India is the Central Council of Indian Medicine (CCIM), which was established through the Medicine Central Council Act of 1970. At present, there are more than 200 Ayurvedic colleges in India that offer BAMS, a 5.5 year-long course under standardized curricula that is usually pursued right after high school.
Ayurveda Education In The United States
The way Ayurvedic education is regulated in India is noticeably different from how it is regulated in western countries like the United States. The growth of Ayurveda in the United States can be traced back to the 1970s. Qualified Indian physicians like Dr. Vasant Lad and Dr. Sunil Joshi started coming into the US in the late 1970s and 80s.
During this time, Indian authors launched several introductory books on Ayurveda which opened the doors to this ancient medical system for many westerners. Also, American pioneers like Dr. David Frawley and Dr. Robert Svoboda (one of the first westerner to complete India’s BAMS program) were instrumental in shining the American public’s collective spotlight on Ayurvedic medicine.
With the growing interest and awareness in Ayurveda, various training programs emerged for training Ayurvedic practitioners.
The first American schools of Ayurveda – The California College of Ayurveda and the New England Institute of Ayurvedic Medicine were established by two students of Dr. David Frawley in 1995. Since then, several regulatory bodies and institutions have been established throughout the United States.
Even now, the quality and curricula of Ayurvedic educational programs tend to vary widely in the United States.
NAMA: Standardizing Ayurvedic Education In The United States
The largest association of Ayurvedic practitioners in the United States, the National Ayurvedic Medical Association (NAMA) was established in 2000 by Kumar Batra, Cynthia Copple, Marc Halpern, and Wynn Werner. In 2004, NAMA established the first known educational standards for Ayurvedic medicine in the United States. These educational standards were minimum requirements for qualified physicians to receive ‘practitioner’ status in NAMA.
Over the years, these educational standards have motivated some Ayurveda schools in the US to improve the quality of their practitioner training programs. While some schools in the US focus exclusively on training students in lifestyle management and wellness programs (New Age Ayurveda), there are some schools like the California College of Ayurveda that educate their students to be “fully qualified practitioners capable of disease management as well as preventative medicine lifestyle training”.
Even though organizations like NAMA have made efforts in standardizing Ayurvedic education in the United States, there are a plethora of schools offering programs that are considered to be less thorough and more focused New Age Ayurveda than the full-time qualification courses offered by popular schools that focus on teaching Classical Ayurveda.
Currently, Ayurveda training programs in the United States can be categorized into four major types –
- Full-Time Training Programs
- Correspondence Programs
- Weekend Training Programs
- Short-Term Seminars
Full-Time Training Programs – As of today, the two main Ayurvedic institutions offering full-time courses in the United States are the California College of Ayurveda and the Ayurvedic Institute. Some of the full-time training programs offered by schools like the California College of Ayurveda include – Ayurvedic Health Counselor (600 hours), Clinical Ayurvedic Specialist (830 hours), and Ayurvedic Doctor (3100 total hours).
Correspondence Programs – These programs allow students to study remotely. There are quite a few correspondence courses in Ayurvedic medicine available in the United States. Since these aren’t regulated and don’t have standardized curricula, organizations like NAMA don’t’ recognize these programs towards national certification.
Short Term Seminars– These programs are quite popular in the US. While they vary widely in quality and content, they are easily available and accessible. Programs include introductory courses, self-healing courses, massage training, and spa therapy courses
Certification And State Approval Of Ayurvedic Schools
Ayurveda schools require state approval to operate in most states. This approval is based on “professional operation and financial stability”. However, several institutions in the United States have figured out loopholes and bypassed these State regulations by declaring themselves as religious institutions or structuring their Ayurveda programs in ways to bypass State regulation.
Such schools operate illegally and are not run as professionally as the regulated ones. The limited oversight in Ayurvedic institutions and regulations allows such schools to continue operating. This is a major reason why the quality of Ayurveda education varies greatly throughout the US.
Ayurvedic Associations In the United States
Like NAMA, the Association of Ayurvedic Professionals of North America (AAPNA) was established in 2007. AAPNA has consistently focused on maintaining a close relation with India and the recognition of Ayurvedic practitioners from India. States like California have also established their own associations like the California Association of Ayurvedic Medicine (CAAM).
Such state associations follow the education guidelines established by national bodies like NAMA and AAPNA. CAAM was founded in 2000 as a state-wide non-profit professional medical organization. According to CAAM’s website, their goals include “Establishment of an accreditation agency for Ayurvedic colleges; A state-approved license for Ayurvedic practitioners; A recognized definition of Ayurvedic practice and scope; Development of a Doctor of Ayurveda degree; A published peer-reviewed journal of Ayurvedic medicine.”
New Ayurvedic associations have also been cropped up in the last few years. The Ayu Council was established in 2015 as “A Public Benefit Corporation working to establish, promote and advance American Ayurveda to improve health and happiness.”
The Ayu Council is now enforcing the highest standards for Ayurveda in the United States. Recently, the Ayu council published their first set of ‘Competency Guidelines for Professional Āyurvedic Education at the level of Svastha Āchārya.’
These guidelines are the kind of steps national Ayurvedic councils like The Ayu Council are taking to standardize Ayurveda education in the US.
The Ayu Council officially recognizes three levels of Ayurvedic educational programs. Svastha Āchārya (SA) is the entry professional level for Āyurveda. Paricharaka (PC) is the secondary professional level for Āyurveda and Āyurveda Āchārya (AA) is the third professional level for Āchārya.
Regulation of Ayurveda In the United States
In the United States, there is no significant regulation of Ayurvedic education or its practice. While schools must apply for a State license or State approval to provide educational courses, most states do not have this requirement as far as Ayurveda is concerned. This follows from the fact that the practice of Ayurveda itself isn’t formally regulated in the United States either.
In the United States, Ayurveda is considered a form of complementary and alternative medicine (CAM). While practices like Ayurvedic massages are regulated via massage laws in most states, none of the states require a specific license for practicing Ayurvedic healthcare.
Specific laws like the “Health Freedom Acts” have been passed in states like California, Idaho, Minnesota, New Mexico, and Rhode Island for protecting the practice of alternative medicine and the practitioners that provide the services.
Ayurvedic practice is “protected under these laws as long as the practice falls within the limitations of the law and does not impinge on the scope of practice of other licensed healthcare professions”.
According to Ohio-based Ayurvedic practitioner Deepti Singh (now retd.), until Ayurvedic education and Ayurveda practice are standardized and regularized throughout the country, qualified practitioners (both foreign practitioners and American practitioners) would be forced to establish their practice in states with the Health Freedom Acts.
NAMA’s Regulatory Standards
According to NAMA, “these standards were designed to improve and promote the safety, efficacy, recognition, and legitimacy of the practice. They were also intended to serve as a framework for state licensing and regulation of Ayurveda in the United States.”
Three professional practice categories are recognized by NAMA’s regulatory standards namely Health Counselor, Ayurveda Practitioner, and Ayurveda Doctor. NAMA’s official descriptions of these categories are mentioned below.
Ayurvedic Health Counselor: Ayurvedic professionals trained to focus on preventive healthcare as well as health promotion, with a specific focus on diet and lifestyle.
Ayurvedic Practitioner: Ayurvedic professionals with additional training in pathology and disease management beyond that of the AHC. These professionals also practice preventive healthcare and health promotion, using diet and lifestyle.
Ayurvedic Doctor: Ayurvedic professionals with additional training and knowledge beyond the AP. Although an AD is not permitted to diagnose a Western disease entity, they are taught to refer out appropriately.
The interface with Western medicine, are well versed in all branches of Ayurveda and possess substantial research skills. The AD has significantly more clinical experience based on a more extensive internship.
According to NAMA’s official website, the Ayurvedic Doctor (AD) designation represents the highest level of professional practice recognized by NAMA. It requires education and training well beyond that required of Ayurvedic Health Counselors and Ayurvedic Practitioners.
Ayurvedic Doctors must have extensive, in-depth education, and relevant clinical experience in all eight branches of Ayurvedic medicine. They must also have substantial experience in teaching, demonstrations, panchakarma, and research methods.
In addition to their academic studies, Ayurvedic Doctors must possess clinical experience equal to one year of supervised clinical practice, and including a minimum of 250 documented patient encounters.
Ayurvedic Doctors must understand disease from an Ayurvedic perspective, and have a working knowledge of Western medical pathology, pharmacology, diagnoses, and treatment, enough to correlate with the practice of Ayurveda. Ayurvedic Doctors are not required to order western diagnostic tests or prescribe western medicines.
Legality Of Ayurvedic Practice in the United States
Ayurvedic professionals are not always able to legally practice Ayurveda to its full extent in the United States under the current legal paradigms. States have their own laws that prohibit the unlicensed practice of medicine.
These laws majorly restrict the services that Ayurvedic professionals can offer their clients. Each state has laws prohibiting the unlicensed practice of medicine. Ayurveda, as practiced in India, does not always translate to the Ayurveda that can be legally practiced in the United States.
These laws often restrict the services that Ayurvedic professionals can offer their clients. Violating these laws can result in both civil and criminal penalties for Ayurvedic professionals and clinics.
Some states have laws referred to as “Health Freedom Act” laws as mentioned earlier, which provide methods, which if followed, help to insulate a professional from liability for violation of the medical licensing laws.
This is also why some schools have chosen not to add higher-level programs like the Ayurvedic Doctor program to their current curriculum. Others are choosing to open new schools and clinics in health freedom states.
Ayurveda Education in the UK
In the 1990s, the Ayurvedic Company of Great Britain (ACGB) established the British Ayurvedic Medical Council and the British Association of Accredited Ayurvedic Practitioners (BAAAP). While ACGB was forced to close down in 2008, BAAAP continues to operate with a small membership.
Initially, for about five years, ACGB offered undergraduate degree programs in Ayurveda validated by London’s Thames Valley University. Later in 2004, ACGB started offering a new degree in association with a south Indian institution called the Mayur Ayurvedic University of Europe that offered Bachelors of Science (B.Sc.) programs in Ayurveda.
Meanwhile, in 1996, a professional association of qualified Indian and Sri-Lankan Ayurvedic practitioners was formed. Called the Ayurvedic Medical Association (AMA), they offered Ayurvedic training at the College of Ayurveda in Milton Keynes and even ran degree programs at the Middlesex University in London.
Later in 2005, the Ayurvedic Practitioner Association (APA) was established to regulate and standardize Ayurveda practice and education in the UK. Since its inception, APA has merged with older associations like AMA and has worked with larger counterparts like the European Herbal and Traditional Medicine Practitioners Association.
Recently in 2018, the Association of Ayurvedic Professionals UK was established in response to the growing number of practitioners graduating from Ayurveda schools in the UK needing further support.
Schools like the College of Ayurveda UK offer complete Ayurvedic training programs comparable to India’s BAMS degrees. According to the College of Ayurveda’s website, the college now offers a program similar in structure and credit to the Bachelors of Science and Masters of Science programs in Ayurvedic medicine that had earlier been offered in collaboration with the University: an undergraduate Diploma (3 years) and postgraduate/advanced Diploma (1 year).
The curriculum is based on the WHO’s Benchmarks for Training in Ayurveda for Category I, Type I training for Ayurveda practitioners (2010), supported by the Ministry of AYUSH (Ayurveda, Yoga, and Naturopathy, Unani, Siddha, and Homoeopathy), India, and is the first of its kind to be professionally accredited by the Ayurvedic Professionals Association (UK) and the British Complementary Medicines Association.
Future of Ayurveda Education
As Ayurveda and Ayurvedic education continues to grow and evolve globally, India’s role in the development of this medical system becomes more crucial than ever. The way Ayurvedic practice and educational institutions are regulated in India is a model for other countries to follow.
Although the process is slow, it will help in making Ayurveda mainstream in Western countries and will greatly improve the quality of Ayurvedic education and standards of practice globally.
While educational practices and standards evolve, what is important is that they remain true to Ayurveda’s classical body-mind-consciousness paradigm.