Thursday, January 27, 2011

Alternatives in homeopathy education

The purpose of sectoral education is to create avenues for the continuity of that sector. Homeopathy education is no different in this respect. The current system of homeopathy education was modelled after the Medical Council of India’s undergraduate education. This system has maintained status quo for the past many years. However, there is no record of any serious study to assess the impact of this course over the years.

An anecdotal review would reveal the current status of homeopathic practitioners for practicing homeopathic system of medicine. It is accepted fact that a sizeable number of homeopathy graduates gravitate away from homeopathic practice; something that is more notable in certain geographic locations in India. there are many lamentations in the professional circles, but little concrete measures to tackle this trend.

One of the factors that emerges from discussions with newly qualifying graduates is that there is sufficient knowledge of homeopathy and allied medical disciplines, appreciable level of clinical skills, but a rather low confidence to practice homeopathy among the young professionals from the geographic areas referred to earlier.

It is a serious identity crisis for any sector that finds its brand suffering low self esteem among its stakeholders. The solution to this crisis is preparing and implementing a major rebranding strategy. In this exercise, the strengths of the product / service has to be highlighted in the light of its relevance to society and the awareness of its simplicity in application should be created among its practitioners. Further, newer methods of presenting the product / service to its beneficiaries should be evolved.

Considering the above strategy, we need to look at homeopathy in its original form, devoid of the expectations that were heaped on over the centuries. An objective SWOT (Strength, Weakness, Opportunities and Threat) analysis of homeopathic practice would bring out the areas that we need to be focussing on, without being apologetic about anything. The frontier areas of healthcare services where homeopathy has strong and decisive role to play should for the core of training in homeopathic discipline.

We have a firmly established education system at both undergraduate and postgraduate levels. To shake it up drastically might prove disastrous for the continuity of education system. Instead, it is better to experiment with an alternative in controlled environs and mainstream it gradually. I propose two suggestions for the experiment. These can be debated for further refinement.

1. To start ‘Finishing Schools’, that would cater to honing the skills and attitude of newly qualified homeopathic graduates to provide the much needed confidence to practice homeopathy. The curriculum can build upon the strengths that are already acquired during their BHMS course. The content of this course could include communication skills, marketing skills, improving analytical skills for clinical decision making, etc. This course could be in the duration of three to six months. The participants in this course will have some didactic learning in new areas like business development, social leadership, etc. There could be clinical case discussions – both in the clinic / ward / community and in the discussion room. This can improve the clinical decision making skills. It is also a good idea to run it along with the internship, without affecting the requirements of Central Council of Homoeopathy / University for completion of the internship program.

2. This is an elaborate system, which can provide an alternative to the existing PG programs. We can model it after the DNB program in modern medicine. The Centres of Excellence identified by Government of India, Regional Research Institutes of the CCRH, reputed homeopathic hospitals, recognised homeopathic colleges that have superfluous capacity (beyond the minimum required by the statutory bodies) can be the nodes for conducting this program. There need not be a fixed syllabus for teaching, rather a set of clearly defined learning objectives in cognitive, psychomotor and affective domains of educational taxonomy. There could be courses of study in the core homeopathic areas and also in the frontier areas of clinical disciplines (as trandisciplinary stuies)

Entrance for this course may be through a national entrance test. During the two or three years of rigorous training there shall be continuous monitoring by way of portfolio comprising of case records, group discussions, seminars, symposia, journal clubs, articles in peer reviewed journals, etc. At the end of the course, the participant is evaluated for the attainment of the learning objectives that are listed for the course. There shall be a 3600 evaluation – theoretical, clinical, attitudinal – by internal faculty, external board comprising of homeopathic professionals (and other professionals too in case of a transdisciplinary course of study), self evaluation, peer evaluation and evaluation by the stakeholders (i.e., patients).

Certification for the course may be given in collaboration with the Indira Gandhi National Open University, which is pioneering innovative education. There need not be any stand off with regulatory authorities as these courses in their experimental form are not tipped to vest registration to practice (in fact there is no scope for confrontation, as those enrolling for the course already have their registration).

There is a scope for ushering in innovation in homeopathic education. But there has to be guarded optimism while planning this. The success of this program will depend on framing of the courses, selection of hubs for training, selection of the internal and external faculty. If guidelines are framed for transparency of actions and if they are implemented impartially and rigorously, there is likelihood of this program succeeding.

Thursday, January 6, 2011

Curriculum Reforms – suggestions to re-engineer future of homeopathy

Homeopathy is gaining significant patronage across the globe as a result of rational therapeutic practices that it ensures. This trend is likely to intensify in spite of the biased negative propaganda that it is attracting from the cartels. India has established as the leader of mainstream homeopathy education in the world. In this situation, it is worth reviewing the need to effect reforms in the existing curriculum, both at undergraduate and postgraduate levels.

Education is the vector that carries strands of influence to modulate practices. This is no different for the relationship between of health education and healthcare delivery. The ultimate objective of healthcare education is to address the health related issues of population. Therefore, anchoring education with the intent of ensuring desired healthcare is an essential element in policy planning.

Healthcare needs of the population as projected by World Health Organisation’s health report centre around infectious diseases and lifestyle dependent chronic diseases. The report states, “of more than 50 million deaths worldwide in 1997, about one-third were due to infectious and parasitic diseases such as acute lower respiratory diseases, tuberculosis, diarrhoea, HIV/AIDS and malaria; about 30% were due to circulatory diseases such as coronary heart disease and cerebrovascular diseases, and about 12% were due to cancers. … the increased life expectancy recorded in recent decades, together with changes in lifestyle stemming from socioeconomic development, have paradoxically favoured non-communicable diseases, especially circulatory disorders, cancer, and some forms of mental illness” (

The survival of homeopathy is linked to the robust and future ready education that we can offer. It is needed to have coordinated efforts to interweave emerging explosion of biomedical knowledge and new technologies on the scaffold of homeopathic principles. This would involve adapting proven experiences in skills training like integrating learning content, problem based learning strategies among other innovative initiatives.

This initiative has to be a wide network of academicians who are sensitive and open to adapt instruments of change and revival. As a foundation for this debate, I am presenting a roadmap for the future of homeopathy education. Let there be constructive debate on this, so that a final draft can emerge on the basis of consensus.

Roadmap for BHMS Curriculum Review

1. Draft the vision statement for homoeopathic healthcare in the national health policy

2. List competencies that are expected of the basic homoeopathic doctor

3. Assign competences in departments / trans departmental streams

4. State the departmental objectives of each of the departments and the inter / trans departmental objectives

5. Generate the specific instructional objectives for each of the discipline / subject and the instructional objectives for the inter / trans departmental areas

6. Categorise each of these objectives into ‘must know’ and ‘desirable to know’ areas

7. Identify the content for realising each of the listed instructional objectives

8. Suggest the appropriate Teaching / Learning methods and media

9. Indicate the feasible evaluation methods to assess the learners for the achievement or otherwise of the intended learning objectives

10. Train the teachers of the homoeopathic institutions in the principles of educational science and technology

11. Conduct the course and the examinations as per the reviewed curriculum

12. Obtain regular feedback and rectify the errors on a priority basis

13. Provide transparency for all the stakeholders like students, teachers, administrators and parents in the educational process

14. Evaluate the effectiveness of this program as an experiment against the control group of the existing curriculum

15. Rectify the gaps and improve upon the program