Dr Aadil Chimthanawala
Homoeopathy postgraduate courses in India, has taken a front seat and is gearing up to meet coming challenges – After three years of a struggling voyage, it should bring about a greater conviction in the art and science of homoeopathy.
When the question of Post-graduation in Homoeopathy arises, I am tempted to pen down my thoughts. How the fraternity accepts the same is a question with an open – ended answer. Seeing the present scenario of homoeopathic academics, especially in India, it is obvious that post-graduation has taken a front seat and is gearing up to meet coming challenges. I sincerely believe that as time passes by and a greater polishing on this front is achieved, then the future of our pathy is quite bright.
Thesis & subject selection
What is the purpose of writing a Thesis? What is the end product that we wish to see after the latter is completed? Some say that writing a thesis is only a custom that all PG’s must accomplish. And how wrong they are! Writing a dissertation instills the confidence that is really required for the precept and practice of the subject but only if it is pursued faithfully. It is a concert of different notes – the aim, methods & materials required to fulfill that aim, review of available literature, observations, discussion of those observations in the light of the literature reviewed and finally the conclusions as to whether or not the aim is fulfilled. It gives the student a viable opportunity to explore and objectivate those arenas in homoeopathy that are yet unfathomed. Future homoeopaths could take up study of such subjects where very little work has been done like scope of homoeopathy in Medical Emergencies, Addictions, Surgery, Veterinary Medicine, Botany, posology & newer potencies etc.
The National Academy of Homoeopathy, India has undertaken some projects of Clinical and Literary Research. The Academy firmly believes that the authenticity of any Research in Homoeopathy is established if it passes through the sieve of Organon. Any venture other than this should not be considered as Homoeopathy. Now we shall dwell upon some areas in which Newer approaches are required.
They are
1. Case Taking – Much of the scenario of cases presenting at the Homoeopathic OPD / IPD has undergone a sea-change compared to those in Hahnemann’s time. A large number of mixed cases (70%) (Combination of natural, altered, suppressed & drug induced symptoms, secondary symptoms due to ultimates, those due to environmental influences, etc.) present to a homoeopathic practitioner. Hence different methods of case taking have to be evolved for different types of cases. It was this reason which prompted the Academy to adopt the approach of case types.
2. Diagnosis – In today’s era, the knowledge of Medicine is equally important as that of the drugs. One has to make both the nosological as well as the person diagnosis. Clinical Examination, pathological cum radiological investigations have become essential for diagnosing cases. Postgraduate research into this area should make Homoeopaths abreast with modern diagnostic technologies & their clinical application in therapeutics.
3. Drug Selection– As mentioned, the varied cases presenting to the homoeopath now demand of him to use even rare remedies apart from the usual ones. Some form of specialization must be introduced in the curricula so that the homoeopath has a defined set of patients to work upon. He will then be able to use “the lesser used remedies” often and add clinical symptoms to the Materia medica. The Academy has undertaken such works in the field of Cardiology, Gynecology and Allergic disorders.
Clinical training
Apart from PG subjects that are already introduced in the Universities throughout India, certain others need early induction.
These are
1. Gynecology – When one studies the homoeopathic therapeutics, one is surprised to find that homoeopathy has many solutions to gynecological & obstetric problems. It is that area of medicine which is in demand even in the smallest of villages. Systematic and rigorous training in homoeopathic gynecology and skills in managing obstetric patients should be imparted at postgraduate level. Only then would one see the miracles of Caulophyllum in the induction of labor or the effects of Gelsemium in cervical dilatation.
2.Pathology & Micro-biology – These are purely investigatory areas of medicine. A homoeopath has as much a right to practice Pathology as our colleagues of the orthodox school. If a degree course is instituted, a battalion of homoeopaths would be quite eager to pursue it.
3. Radio-diagnosis – Same holds true for Radio-diagnosis. The orthodox field of medicine has advanced leaps and bounds- courtesy Radiology. It is one area that has bridged the gap between physics and medicine, between the empirical and the factual. Homoeopaths skilled in radiology would be able to authenticate the results of our dynamic remedies at the structural level and we would not be dependent on the experts of the modern school.
4. Genetics – It is still in its infancy. The scope of homoeopathy is these disorders as of today is limited. But if a greater thrust is given at the post-graduate level one may open up the Pandora’s Box in this field.
5. Preventive & Social Medicine – Homoeopathy is not only a clinical medicine. Its expanse encompasses Preventive and Social Medicine too. Rather much better than other prevailing systems of our day. Only if there is a separate specialization in this field, the homoeopathic fraternity in particular and the masses in general would realize the vast benefits. Vaccination schedules, recurring viral / bacterial epidemics, etc. have yet not fully seen the permeation of homoeopathy.
Group discussion
Group Discussion is a process where the participant’s skills like communication, presentation, vocabulary and leadership are brought to the fore-front. For a post-graduate of any modern discipline, GD becomes a simulated exercise where the participant cannot suddenly put up a show. It’s his /her chance to be more vocal. There are two ways of conducting GD. By forming a group of 10-12 candidates and giving a topic for discussion or by dividing the group into two and the topic would be debated. It develops reasoning ability and is one of the most effective methods for Case Discussion. Also thesis of each student can be discussed in this way and that too at each stage of writing. So that experience of all other colleagues and teachers can also be incorporated in the dissertation apart from that of the guide. Alas! it is lacking in most of our PG institutes.
Drug proving
It should be made mandatory that each individual who becomes a post- graduate has at least proved one drug with factual data and on the terms put forward by our Master. In this way, many old drugs can be reproved and many new ones discovered. This shall not only increase the repertoire of drugs but also the confidence of the dynamic action of homoeopathic remedies. The Academy has already started this practice since past three years.
Evidence based homoeopathy
The concept of evidence based medicine has been evolving over the past 35 years. Evidence-based homoeopathy is the integration of best research evidence with clinical expertise and patient values. One may ask, then as to what is the Best evidence? The answer is that evidence which is
1. Increasingly available in the literature
2. Focuses on outcomes that matter to the patient
3. Helps the patient to make decisions whether or not to take homoeopathy
4. Gives real value to statistics making sense to the homoeopath and patient.
Furthermore the ability to use our clinical skills & past experience to rapidly identify each patient’s unique health state, individual risks and benefits of potential interventions, & their personal values and expectations is called clinical expertise. Patients values on the other hand are defined as the unique preferences, concerns, and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient. There are many Misconceptions that homoeopaths hold about Evidence Based homoeopathy like “what I learned in medical college is enough”, “an expert opinion is the best evidence”, “I always did it this way”, etc.
So then the need for EBH is as follows –
- Daily need for valid information
- Inadequacy of traditional sources of information
- Disparity between our diagnostic skills and clinical judgment vs. up-to-date knowledge and clinical performance
- Up to 40% of clinical decisions are not supported by evidence from research
- Increasing volume of published evidence
- Wide variations in clinical practice
- Concerns about cost and quality
- Gap between research and practice
Journal reading
The medical faculty in the 21st century is over burdened with information. A simple statistics would open our eyes. It is estimated that about 20,000 biomedical periodicals, 6,000,000 articles and 17,000 biomedical books are published annually. There are around 30,000 recognized diseases and about 3,000 or more therapeutic agents. To add to this mountain of information, database internet engines like “Medline”, “Cochrane”, and “Best Evidence” survey about 4,000 journals, about 1.27 million articles related to a single subject as oncology per year. So the bottom line for a Post-graduate in homoeopathy is “We need to learn not only how to read the medical literature, but what to read and when”. Postgraduates should select journals that provide structured abstracts with balanced commentary. The articles should be selected from high quality publications. Such journals can be the best resource to start with when investigating rare clinical conditions or drugs.
Postgraduate guides
The aim of any Post graduate Teacher is to stimulate the teacher within his student. A Guide should stimulate the student enough to observe and think. This, I believe is yet not the order of the day. Very few Guides really do guide. But as post graduation grows so will this concept.
Metamorphosis in a homoeopath
The final goal of any post graduate program especially in homoeopathy should be to initiate a metamorphosis in a homoeopath. The transformation should be from an ugly duckling to a graceful swan. After three years of a struggling voyage, it should bring about a greater conviction in the art and science of homoeopathy in the participants.
Whatever You Do – Do It Well
Dr Aadil Chimthanawala
MD (Hom), BHMS, DNB (Med), MBBS, FNAHI, PGNAHI
Head: Dept of Homoeopathic Cardiology
Director: Shaad Homoeopathic Hospital Complex & Research Centre
Near Itwari Railway Station, Nagpur -2
Email : adilchimthanawala123@gmail.com
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