International Journal of
Vol 1 Issue 1
Department of AYUSH,
Govt. of India
International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1 49
Global challenges of graduate level Ayurvedic
education: A survey
Kishor Patwardhan, Sangeeta Gehlot, Girish Singh1, H.C.S. Rathore2
Department of Kriya Sharir, 1Department of Community Medicine, 2Faculty of Education, Banaras Hindu University, Varanasi, India
In the present day scenario, Ayurveda is globally being perceived in several contradictory ways. Poor quality of Ayurveda
graduates produced as a result of poorly structured and poorly regulated education system is at least one of the important
factors responsible for this scenario. The present study was carried out to evaluate the ‘Global challenges of graduate
level Ayurvedic education’ and is based on the responses of Ayurvedic students and Ayurvedic teachers from various
educational institutions of India to a methodically validated questionnaire. As the study indicates, the poor standard of
Ayurvedic education in India is defi nitely a cause of concern. The curriculum of Bachelor of Ayurvedic Medicine and
Surgery (BAMS) course of studies is required to be reviewed and restructured. The syllabi are required to be updated
with certain relevant topics like laws governing the intellectual property rights, basic procedures of standardization of
medicinal products, fundamental methods of evaluating the toxicity of the medicinal products, essentials of healthcare
management and the basics of cultivation and marketing of medicinal plants. Furthermore, the study suggests that the
Ayurvedic academicians are required to be trained in standard methods of research and documentation skills, and the
educational institutions are required to be encouraged to contribute their share in building up the evidence base for
Ayurveda in the form of quality education and research.
Key words: Ayurveda education, global challenges, India, mailed survey
A B S T R A C T
Perceptions about Ayurveda in India and overseas have
undergone a phenomenal change during the last 20 to 25
years. A large population from all over the world is attracted
towards this ancient system of healthcare because of the
terms associated with it like ‘Holistic Medicine’, ‘Herbal’,
‘Free from side effects’, ‘Mind, Body and Spiritual approach’
etc. Centers offering ‘Panchakarma therapy’, ‘Ayurvedic
Lifestyle Management’ and ‘Ayurvedic Massage’ are being
increasingly established. The use of Ayurvedic medicines
has become accepted in other countries as well. For example,
according to the 2007 National Health Interview Survey, more
than 200 000 US adults had used Ayurvedic medicine in 2006
alone. Marketing strategies of major pharmaceutical fi rms
have changed and ‘Ayurvedic wings’ of drug manufacturing
have begun. In 2007, there were more than 8400 licensed
Ayurvedic pharmacies in India and the approximate turnover
of this industry was Rs. 4000 crore, which accounted for nearly
a third of the total pharmaceutics business of the country.
Many medical schools and other institutes all over the world
have started offering some degree or diploma in Ayurveda.
Several publication houses of international repute have started
publishing literature related to Ayurveda. Even the people with
no formal Ayurvedic education have started showing interest in
authoring books and research papers on Ayurveda. Ayurveda
is being seen as a rich resource for new drug development by
modern day pharmacologists.
On the contrary, questions on safety and effi cacy of Ayurvedic
products are also being raised.[5,6] In 2004 December, Journal of
American Medical Association (JAMA) published a research
paper, which concluded that one of the fi ve Ayurvedic Herbal
Medicine Products (HMPs) produced in South Asia and
available in Boston South Asian grocery stores contained
potentially harmful levels of lead, mercury and/or arsenic. The
paper also suggested that the users of Ayurvedic medicine may
be at risk for heavy-metal toxicity, and testing of Ayurvedic
HMPs for toxic heavy metals should be made mandatory. This
concern has led some countries like Canada to curb the import
of Ayurvedic preparations from India. In 2005, the testing by
Canadian Government revealed alarmingly high levels of heavy
metals in the exported Ayurvedic medicinal preparations. The
analysis highlighted the ‘higher than acceptable concentrations’
of heavy metals such as lead, mercury and arsenic. A similar
Address for correspondence:
Dr. Kishor Patwardhan, Department of Kriya Sharir, Faculty of
Ayurveda, Institute of Medical Sciences, Banaras Hindu University,
Varanasi, U.P. 221 005, India.
50 International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1
paper appeared in JAMA in 2008 too, raising an alarm against
the use of Ayurvedic products because of their possible heavy-
metal contamination. National Policy on Indian Systems of
Medicine and Homeopathy , 2002 has also admitted that the
safety, effi cacy, quality of drugs and their rational use have
not been assured in India. This document states that there is
no assurance whatsoever that formularies and pharmacopeial
standards are being followed by the Indian Systems of
Medicine drug manufacturers.
Thus, Ayurveda is globally being perceived in several
contradictory ways. Poor quality of Ayurveda graduates
produced as a result of a poorly structured and poorly regulated
education system is at least one of the important factors
responsible for this scenario. The number of Ayurveda colleges
has increased phenomenally to 242, out of which, about 150
colleges have been established after 1980. Though the Central
Council of Indian Medicine (CCIM) has implemented various
educational regulations to ensure minimum standards of
education, there has been a mushroom growth of sub-standard
colleges causing erosion to the standards of education. Liberal
permission by the State Governments, loopholes in the existing
Acts and weakness in the implementation of standards of
education have been held responsible for this state of affairs.
Considering the above facts, the present study was planned
to evaluate the global challenges of graduate level Ayurvedic
education. The study is based on the perceptions of Ayurvedic
students and Ayurvedic teachers from various educational
institutions spread all over India.
Mailed survey was the method that was used to carry out the
The population for the present study was defi ned in terms of the
students studying and teachers teaching in Ayurvedic colleges
of India during the period of September 2005 to October 2008.
All interns/house surgeons registered under Bachelor of
Medicine and Surgery (BAMS) course, who have successfully
passed their third professional BAMS examination in the
Ayurvedic colleges recognized by CCIM were included in the
study. Students who have not yet passed their third professional
examinations were excluded from the study to avoid possible
immature and biased perceptions.
All Post-graduate students registered for MD(Ay) or MS(Ay)
courses in the Ayurvedic colleges recognized by CCIM were
also included in the study.
All teachers working in Ayurvedic colleges / universities
recognized by CCIM, who possess at least a BAMS or an
equivalent degree, were included in the study.
The sample frame that became available constituted a list of
242 Ayurvedic colleges spread all over India. As the students
and teachers in these colleges formed the primary units of
sampling, it was essential to get a list of all these students
and teachers for the purpose of randomization. But, as no
such database is available in India, the list of 242 Ayurvedic
colleges was accepted as the sample frame for this study. With
the availability of the said sample frame, the Random Cluster
Sampling technique was considered to be the most appropriate
one. Hence, it was decided to include at least 10% of the total
institutions present in a specifi c geographical zone of India
(North, East, South and West). At the same time, an effort
was made to include as many states as possible. The colleges
from each geographical zone were selected randomly and
all the teachers and students from these colleges, as per the
operational defi nition stated earlier, were taken as the clusters
to constitute the sample. Thus, a total of 32 colleges were
included in the study.
Preparation of the Questionnaire
A preliminary list of items was prepared on the basis of
interactions we had with the students and teachers of several
educational institutions. Diverse sources of literature like
reports of various committees, journals, news reports, national
health policy documents and other articles were referred
to for collecting the items. The questionnaire comprised of
three sections dealing with three problem areas, viz., ‘Job
Opportunities’, ‘Global challenges’ and ‘Entrepreneurship
opportunities’. The respondents were given the option of
recording their responses in the form of ‘Strongly Agree’,
‘Agree’, ‘Undecided’, ‘Disagree’ and ‘Strongly Disagree’ by
recording a check mark (√) in the respective column provided
for the purpose. Apart from these statements, the respondents
were also asked to furnish some demographic details such as
their age, gender, institutional affi liation and the present status
(student or teacher).
Validation of the Questionnaire for its Reliability and
The preliminary questionnaire was distributed to 150
respondents who randomly fulfi lled the inclusion criteria in a
single institution. The validation process of the questionnaire
was carried out on the basis of the first 100 completed
questionnaires. The data entry was done using the software
‘Statistical Package for Social Sciences’, Version 11.5 (SPSS
Inc. Chicago, IL, USA). Demographic data were fed in
the ‘String’ format and the responses to the questionnaire
Patwardhan, et al.: Global Challenges of Ayurveda Education
International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1 51
were entered in the ‘Numerical’ format. For the purpose
of conversion of responses into the numerical format, the
following scoring system was used: Strongly Agree = 5; Agree
= 4; Undecided = 3; Disagree = 2 and Strongly Disagree = 1.
For the purpose of validation, each section of the questionnaire
was considered as an independent scale and these scales
were tested for their reliability using ‘Cronbach’s Coeffi cient
Alpha’. While validating the scales, value of alpha greater
than 0.7 and item-total correlation greater than 0.2 were
considered to be acceptable. Wherever the value of ‘Alpha
(when item deleted)’ was greater than Cronbach’s coeffi cient
alpha, the corresponding item was deleted and the whole
process of validation was repeated and thereafter, the scales
were fi nalized.
The fi nal questionnaire contained three sections (technically,
three independent scales) comprising of a total of 24 items.
Apart from these items, the questionnaire also contained a
copy of confi dentiality agreement stating the purpose of the
study and assuring strict confi dentiality of the respondents.
Collection of Data
After validation and testing the questionnaire for its reliability,
the questionnaire was printed on the A4-sized paper and
was mailed to 32 Ayurvedic colleges. Varying numbers of
questionnaires were mailed to different institutions considering
the total admission capacity, the total number of teachers
present, presence or absence of post-graduate courses etc. The
heads of the institutes were requested through a formal letter
to distribute the questionnaire among interns, post-graduate
students and teachers. A self-addressed stamped envelope
was also sent in order to facilitate the return of the completed
questionnaires. A period varying from 1 to 2 days was given
to the respondents to return the completed questionnaires. The
completed questionnaires were then collected and the data
entry was carried out as explained earlier.
The response rate for the student group was 59.6% and for the
teacher group it was 54%. A total of 1022 participants from 18
states responded to the questionnaire. This number included
644 students and 378 teachers.
Tabulation and Statistical Tests
The participants were grouped under two categories: ‘Students’
and ‘Teachers’. Tables of frequency and percentage were
framed on the basis of responses to individual items for each
group. Independent samples - t test was applied to compare
the mean scores of the two groups.
Tables 1–3 summarize the results of the present study. Tables
show the items covered in the fi nal questionnaire along with the
mean scores for both the groups separately. Also, the results of
independent samples - t test are shown in the form of t values
and p values. As per the scoring pattern followed in the study,
the mean scores greater than 3 indicate a tendency towards
agreement, whereas the mean scores lesser than 3 indicate a
tendency towards disagreement. Furthermore, the mean scores
greater than 4 indicate a strong tendency towards agreement.
As the tables show, mean scores for both the groups are greater
than 3 for all the 24 items indicating a general tendency towards
The observations related to this section [Table 1] of the
questionnaire indicate that there is a real problem related to
the job opportunities for BAMS graduates. Except for Q1.2
and Q1.7, the tendency for agreement towards all the items
is signifi cantly stronger among students than the teachers as
indicated by p values. This means that students perceive this
problem to be a more serious one in comparison to teachers.
This indicates that there is a considerable level of career-related
anxiety among students. This anxiety is noticeably less among
teachers because they are already into a job.
The Government is required to look into the matter related
to the creation of job opportunities for BAMS graduates in
certain departments like Railways and Defence. In teaching
institutions too, some posts like tutors and medical offi cers may
be created for BAMS graduates. Ayurveda may be included
as an optional subject in the entrance examinations leading
to Indian Administrative Services (IAS) just like modern
medicine. If the quality of education is improved, some job
opportunities may open up in research institutes and in other
places in the healthcare industry as well.
As the Table 2 shows, both the students and the teachers show
a strong tendency towards agreement that the issues related to
safety profi le and standardization of Ayurvedic products are
serious ones. A majority of students and teachers also tend to
agree that in many countries, practicing Ayurveda is not legally
allowed and therefore, there are no opportunities for BAMS
graduates in such countries. Also, there is a general tendency
towards agreement that Ayurvedic academicians do not fi gure
anywhere in authoring the scientifi c and evidence-based papers
in reputed international journals and they do not voluntarily
participate in international platforms to present their research
data. The study also suggests that Ayurvedic academicians do
not follow international standards while planning the protocols
of research projects and while writing research reports.
Ayurvedic scholars generally do not have knowledge regarding
Patwardhan, et al.: Global Challenges of Ayurveda Education
52 International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1
Table 1: Responses of the participants to the items related to the ‘Job Opportunities after BAMS
course’. The mean scores for both the groups are given along with the results of Independent
ItemsGroupMean ± SDtp
Q1.1Legally, in most of the states, a BAMS degree holder cannot practice
Allopathy and therefore hospitals generally prefer MBBS graduates as
medical offi cers instead of BAMS graduates.
Ayurvedic hospitals are less in number in comparison to Allopathic
ones and therefore job opportunities are limited.
Students4.39 ± 0.9456.7320.000
Teachers3.94 ± 1.142
4.41 ± 0.876
4.27 ± 0.881
Q1.3In Ayurvedic educational institutions, only Post-Graduate doctors are
employed and not BAMS degree holders.
4.15 ± 1.064
3.81 ± 1.165
Q1.4Most of the research institutions prefer Post-Graduate doctors and
therefore, job opportunities in research institutions are limited.
Students4.34 ± 0.8302.8660.004
4.19 ± 0.831
4.69 ± 0.610
4.53 ± 0.718
Q1.5Even in government sector, BAMS graduates are not treated at par
with MBBS graduates and therefore, job opportunities are limited in
certain areas e.g. Railways.
Ayurvedic pharmaceutical fi rms prefer Post-Graduate candidates to
BAMS degree holders as experts.
4.28 ± 0.803
4.09 ± 0.898
Q1.7There is lot of competition for jobs among BAMS degree holders as a
result of mushrooming of Ayurvedic colleges.
4.21 ± 0.955
4.14 ± 1.010
Table 2: Responses of the participants to the items related to the ‘Global Issues concerned to
Ayurveda’. The mean scores for both the groups are given along with the results of Independent
Q2.1Serious questions are being raised on the safety profi le of Ayurvedic
preparations in some countries posing a threat to the Ayurvedic
system of Medicine.
Students4.27 ± 0.8674.4960.000
Teachers 4.00 ± 1.013
Q2.2Standardization of Ayurvedic preparations is still a problem that
needs to be addressed.
Students4.47 ± 0.7063.3380.001
Teachers4.31 ± 0.738
Q2.3In many countries, legally, practicing Ayurveda is not allowed and
therefore, there are no opportunities for BAMS graduates in such
Students4.40 ± 0.8332.3800.018
Teachers4.27 ± 0.792
Q2.4Possible entry of foreign universities in India may pose a threat to the
existing educational institutions.
Students3.77 ± 1.1583.4600.001
Teachers3.51 ± 1.202
Q2.5Ayurvedic academicians do not fi gure anywhere in authoring the
scientifi c and evidence-based papers in reputed international
Ayurvedic academicians do not voluntarily participate in International
platforms to present their research data.
Students3.95 ± 1.0811.4900.136
Teachers3.84 ± 1.081
Q2.6Students3.79 ± 1.1310.7560.450
Teachers3.73 ± 1.138
Q2.7Ayurvedic academicians do not follow international standards
while planning the protocols of research projects and while writing
Students3.86 ± 1.045-0.0950.924
Teachers3.87 ± 1.020
Q2.8Ayurvedic scholars generally do not have knowledge regarding
‘Intellectual Property Rights’ and patenting procedures.
Students3.97 ± 0.943 0.8240.410
Teachers3.92 ± 0.975
Q2.9Authentic websites providing up-to-date knowledge in Ayurveda are
not hosted by Ayurvedic institutions.
Students4.20 ± 0.9180.0730.942
Teachers4.19 ± 0.769
Q2.10No standard international indexed and peer-reviewed journals are
published by Ayurvedic institutions making it diffi cult for Ayurvedic
researches have global attention.
4.19 ± 0.885
4.15 ± 0.853
Q2.11Pharmacodynamic/ pharmacokinetic properties / effi cacy / safety
profi les and chemical compositions of Ayurvedic formulations are
yet to be established making it diffi cult for experts in conventional
medicine to accept Ayurveda.
Students4.25 ± 0.8931.8960.058
Teachers4.15 ± 0.809
Patwardhan, et al.: Global Challenges of Ayurveda Education
International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1 53
‘Intellectual Property Rights’ and patenting procedures, which
is another issue that this study is indicative of.
The reasons for such perceptions need to be explored. The
current curriculum of BAMS does not include the relevant
and essential topics like laws governing the intellectual
property rights, patenting procedures, basic methods of
standardization of medicinal products, fundamental principles
of evaluating the toxicity of the medicinal products and
basics of pharmacovigilance. Experts in phytochemistry,
pharmacognosy, pharmacology, biotechnology and other
relevant fi elds may be appointed in teaching institutions as
teachers to teach these topics. Basics of research methodology
are also not introduced in the present BAMS course of study.
Some essential information related to these topics may
be introduced in the curriculum making BAMS graduates
conversant in these topics. Training programs and workshops
may be required to be introduced for Ayurvedic academicians,
where, training may be given in planning the research
protocols, preparing the research projects and in other various
areas of research methodology.
A very signifi cant proportion of the students and the teachers
in the present study tend to agree that authentic websites
providing recent advances in Ayurveda are not hosted by
Ayurvedic institutions. In this regard, the education institutions
are required to be encouraged to host authentic websites giving
information related to various aspects of Ayurveda. Classical
textbooks of Ayurveda may also be made available online at
these websites along with the information related to recent
advances. The Government also may take initiative in this
regard and launch authentic websites.
A signifi cant number of participants in the study tend to agree
that no standard international indexed and peer-reviewed
journals are published by Ayurvedic institutions making
it diffi cult for Ayurvedic researches have global attention.
However, recently, National Institute of Ayurveda (NIA),
Jaipur and Institute of Post-Graduate Teaching and Research
in Ayurveda (IPGTandRA), Jamnagar have launched their own
peer-reviewed journals, which is a positive sign. But their reach
is limited by the fact that online versions of these journals are
not available. The department of AYUSH has recently taken
initiative in this regard by launching the International Journal
of Ayurveda Research (IJAR), which is an online journal.
A majority of students and teachers in the present study tend
to agree that Pharmacodynamic / pharmacokinetic properties
/ effi cacy / safety profi les and chemical compositions of
Ayurvedic formulations are yet to be established making
it diffi cult for experts in conventional medicine to accept
Ayurveda. As a solution, the basic topics related to these issues
may be incorporated into the curricula of BAMS and post-
graduate courses of Ayurveda making the graduates and post-
graduates of Ayurveda effi cient in carrying out such studies.
Entrepreneurship / Business Opportunities
So far, unlike conventional biomedicine or Allopathy,
pharmaceutics has been a part of Ayurvedic education
in India in the form of ‘Rasashastra’. There is a need of
training to be imparted in the basic knowledge related to
pharmaceutical industry during graduate level Ayurvedic
education. Furthermore, Ayurvedic pharmaceutics is based on
a large number of medicinal plants and the basic knowledge
related to the cultivation and marketing of these plants is
Table 3: Responses of the participants to the items related to the ‘Entrepreneurship /Business
opportunities’ after the BAMS course. The mean scores for both the groups are given along with the
results of Independent samples-t test.
Item GroupMean± SDtp
Q3.1Students are not trained in management skills required to launch a new
Ayurvedic hospital / Panchakarma center / Ayurvedic Pharmacy during
Students4.18 ± 1.0512.1700.030
Teachers4.03 ± 0.981
Q3.2Students are not exposed to the basics of economical aspects related to
healthcare sector during BAMS course.
Students4.18 ± 0.8902.078 0.038
Teachers4.06 ± 0.856
Q3.3Most of the BAMS graduates prefer either studying PG course or they
go for private practice and therefore, inspiring examples of industrially
successful BAMS graduates are very few.
Students4.38 ± 0.7505.6930.000
Teachers4.09 ± 0.840
Q3.4Students are not introduced to the skills related to the management of
Health tourism and emerging opportunities in this fi eld during BAMS
Students are not exposed to the agricultural and marketing aspects of
medicinal plants making it diffi cult to go for cultivation / marketing of
Students4.35 ± 0.7822.4520.014
Teachers4.23 ± 0.776
Students4.39 ± 0.6903.4300.001
Teachers4.22 ± 0.800
Q3.6Students are not exposed to the manufacturing techniques related to
cosmetic products and such other popular dosage forms during BAMS
course making them unfi t for modern pharmaceutical industry.
Students4.34 ± 0.8673.1020.002
Teachers4.16 ± 0.864
Patwardhan, et al.: Global Challenges of Ayurveda Education
54 International Journal of Ayurveda Research | January-March 2010 | Vol 1 | Issue 1
required to be passed on during Ayurvedic education. This
will make an Ayurvedic graduate have a lot of opportunities
other than private practice. But, as the Table 3 suggests, such
entrepreneurship opportunities are scarce for BAMS graduates
because of poor training during their Ayurvedic education. As
a solution, some basic management skills that are essentially
required to launch a new Ayurvedic hospital / Panchakarma
center / Ayurvedic Pharmacy etc., may be included in the
curriculum. Also, basic cultivation and marketing aspects of
medicinal plants are needed to be introduced at BAMS level.
Some manufacturing techniques related to cosmetic products
and such other popular dosage forms may also be introduced.
Introductory lessons in the management of health tourism
may also be incorporated during the graduate level Ayurvedic
As the present study indicates, the poor standard of graduate
level Ayurvedic education in India is defi nitely a cause of
concern. The curriculum of BAMS course of studies is
required to be reviewed and restructured. The syllabi are
required to be updated with certain relevant topics like laws
governing the intellectual property rights, basic procedures of
standardization of medicinal products, fundamental methods
of evaluating the toxicity of the medicinal products, essentials
of healthcare management and the basics of cultivation and
marketing of medicinal plants. Ayurvedic academicians are
required to be trained in standard methods of research and
documentation skills, and the educational institutions are
required to be encouraged to contribute their share in building
up the evidence base for Ayurveda in the form of quality
education and research.
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Source of Support: Nil, Confl ict of Interest: None declared