Though there is a quantitative extension of exposure to academic institutions, qualitatively, the paucity of the nature of clinical material and inadequacy in training of clinical skills continue. Patwardhan et al
. have recently demonstrated these serious flaws in a large nationwide survey of undergraduates, postgraduates and teachers of Ayurvedic medical colleges. They show that students at the end of training remain ill-equipped to handle both the simple emergencies of primary health care and the specialized Ayurvedic procedures like panchakarma
] Unfortunately, theoretical debates without bedside relevance further intensify frustration of students during this period of postgraduation. Access to latest scientific literature is nearly absent in our libraries, where the potential of library and information science lies untapped. Without a foundation of knowledge acquisition, processing and retrieval systems, students in this system feel obsolete outside their academic institutions.
For my postgraduate (PG) dissertation, I had naively hypothesized the possibility of 'neuro-regeneration' in patients of Parkinson's disease (PD). I have painfully realized the inadequacies to design a study for PD that demands (1) specialized clinic with attendance of adequate number of patients, (2) clinical acumen for diagnosis and (3) research methodology with understanding of sample size. To traverse these difficulties, I had to contact neurologists at public hospitals and private practice. Sensing an enthusiasm, the busy residents and faculty at the Department of Neurology, KEM Hospital, Mumbai, kindly took an initiative to teach me. Through a rapport built with few senior neurologists in India with a wide experience in PD, I got an opportunity to address patients of the support groups of PD and Movement Disorder Society. Gaining confidence after an interdisciplinary exposure, it became feasible to conduct a successful camp to study multiple aspects of the disease. Meanwhile, after a brief exposure in the neuroscience laboratory of Dr. Vidita Vaidya at Tata Institute of Fundamental Research, Mumbai, which works on neurogenesis in the adult brain, the complexity and depth of neuronal plasticity research became evident.[9
] The diversity and sophistication of concepts and methods involved in neuro-regenerative studies at different levels of biological organization, from molecules to man, were mind-boggling. I then realized that the lack of meticulous study designs influenced the outcome and relevance of PG dissertations. Merely applying randomized controlled trial designs and probability-based biostatistics to Ayurveda is less likely to enhance research in disease management. We must cognize the pramanas
, the Ayurvedic modes of evidence,[10
] the availability of other trial designs and develop robust skills of observational therapeutics and experiential documentation. As a student, I wonder if this learning, which was achieved through self-motivation and initiative and tremendous support from family, teachers and friends could be facilitated as a norm by models like "Bilateral Education."[11