The Indian healthcare landscape is transforming with the integration of traditional and modern medical practices. Andhra Pradesh has authorized qualified postgraduate Ayurvedic doctors to perform select surgical procedures, aligning with evolving national regulations. This decision regarding Andhra Pradesh Ayurvedic surgery is a significant step in mainstreaming AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) systems but has also ignited sharp criticism and debate from conventional medical bodies. This post details the decision, explores the historical and modern context of Ayurvedic surgery, outlines training, discusses the controversy, and examines its implications for Indian healthcare.
Andhra Pradesh Greenlights Ayurvedic Surgical Procedures
On December 23, 2025, Andhra Pradesh formalized a policy allowing qualified postgraduate Ayurvedic doctors to perform specific surgical interventions. This decision, by Health Minister Satya Kumar Yadav, aligns with the Indian Medicine Central Council (Postgraduate Ayurveda Education) Amendment Regulations, 2020, and guidelines from the National Commission for Indian System of Medicine (NCISM).
Eligible practitioners, holding a Bachelor of Ayurvedic Medicine and Surgery (BAMS) degree with postgraduate specialization in Shalya Tantra (General Surgery) or Shalakya Tantra (ENT, Ophthalmology, Dentistry), are permitted to perform up to 58 distinct procedures: 39 under Shalya Tantra and 19 under Shalakya Tantra. These include wound suturing, treatments for piles and fissures, excision of cysts and benign tumors, skin grafting, and cataract procedures. These procedures are restricted to government-run AYUSH institutions with necessary infrastructure and oversight. Proponents view this as an expansion of healthcare access, especially in underserved areas, while critics have raised considerable opposition and legal challenges.
Shalya Tantra and Shalakya Tantra: Ayurveda’s Surgical Heritage
Ayurveda has a rich surgical tradition, with Shalya Tantra and Shalakya Tantra being the specialized branches central to the new policy.
Shalya Tantra: The Ancient Art of General Surgery
Attributed to Sushruta, the “Father of Surgery,” Shalya Tantra focuses on general surgery. The Sushruta Samhita (circa 600 BCE) details surgical instruments, procedures, wound classification, reconstructive plastic surgery, surgical anatomy, and hygiene. Modern postgraduate Shalya Tantra training combines traditional Ayurvedic principles with contemporary surgical techniques for wound management, abscess drainage, treatment of fistulas and piles, excision of benign tumors, and management of certain abdominal conditions.
Shalakya Tantra: Specialized Surgery of the Head and Neck
This branch deals with the diagnosis and surgical management of diseases in the head and neck region, including the eye, ear, nose, throat, and oro-dental structures. Historically, practitioners performed procedures like cataract removal and oral surgeries. Modern postgraduate programs cover advanced diagnostics and surgical techniques for these areas, including cataract surgeries, septoplasty, polypectomy, and minor interventions for conditions affecting the eyes, ears, nose, throat, and teeth.
Together, these branches represent Ayurveda’s surgical heritage, now integrated with contemporary medical standards.
The 2020 Amendment: A National Framework for AYUSH Surgery
The Andhra Pradesh authorization is an implementation of the Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020, issued by the Central Council of Indian Medicine (CCIM) under the Ministry of AYUSH. This amendment clarified the scope of practice for postgraduate Ayurvedic surgeons.
Before 2020, the rights of Ayurvedic doctors to perform surgery were ambiguous. The amendment formalized these rights, allowing postgraduates in Shalya Tantra and Shalakya Tantra to perform 58 defined procedures. The Ministry of AYUSH stated this was a formalization of existing practices, not a new policy, and that modern terminology was adopted for clearer communication.
Breakdown of the 58 Permitted Procedures:
- MS (Ayurved) Shalya Tantra (General Surgery) – 39 Procedures: Includes debridement, incision and drainage of abscesses, skin grafting, excision of benign cysts and tumors, management of traumatic wounds, foreign body removal, appendicectomy, cholecystectomy, certain urological procedures, hernia repair, and anorectal interventions (haemorrhoidectomy, fistulectomy).
- MS (Ayurved) Shalakya Tantra (ENT, Ophthalmology, Dentistry) – 19 Procedures: Covers various eye surgeries (cataract procedures, pterygium excision, eyelid corrections), ENT procedures (septoplasty, nasal polypectomy, myringotomy, tonsillectomy, pharyngeal abscess drainage), and basic oral and dental interventions (tooth extraction, root canal treatment).
Rigorous Postgraduate Training in Ayurvedic Surgery
The competency of postgraduate Ayurvedic doctors is based on rigorous training in Master of Surgery (MS) programs in Shalya Tantra and Shalakya Tantra. These three-year programs, regulated by NCISM, require a BAMS degree and a qualifying AIAPGET score.
Comprehensive Training for Andhra Pradesh Ayurvedic Surgery Practitioners:
The curriculum is competency-based, blending classical Ayurvedic texts with modern clinical methodology.
- MS in Shalya Tantra: Covers Sushruta Samhita, modern surgical anatomy, physiology, pathology, hands-on training with instruments, aseptic techniques, advanced wound care, Ayurvedic para-surgical methods (Kshara Karma, Agnikarma, Raktamokshana), trauma care, orthopedic principles, integrated diagnostics, emergency management, surgical ethics, patient safety, and research methodologies.
- MS in Shalakya Tantra: Focuses on the anatomy and physiology of the eye, ear, nose, throat, and head from both Ayurvedic and modern perspectives. It includes integrated diagnostics, therapeutic approaches (Ayurvedic yogas, Panchakarma), practical training in surgical and para-surgical techniques, sterilization, anesthesia, specialized instrument handling, pathology, emergency management for head and neck conditions, preventive care, research, and ethical considerations.
These programs prepare Ayurvedic surgeons to deliver comprehensive care, blending Ayurvedic wisdom with modern surgical science.
The Raging Debate: IMA vs. AYUSH on Surgical Rights
The authorization of select surgeries for postgraduate Ayurvedic doctors in Andhra Pradesh has sparked a contentious debate between the Indian Medical Association (IMA) and the Ministry of AYUSH, highlighting disagreements on training standards, patient safety, and healthcare provision.
The Indian Medical Association’s Strong Opposition:
- “Mixopathy” and “Legalising Quackery”: The IMA argues that this integration blurs distinct medical systems, compromises patient care, and that Ayurvedic postgraduate programs do not adequately replicate the extensive training required for modern surgery.
- Competence and Patient Safety Concerns: The IMA questions the proficiency of Ayurvedic practitioners in advanced anesthesia, critical care, and handling complex surgical complications, fearing substandard care and jeopardized patient outcomes.
- Legal Validity and Constitutional Challenge: The IMA filed a Supreme Court challenge in December 2020 against the 2020 amendment, arguing the CCIM lacked authority to prescribe modern surgical procedures, potentially causing public health harm. A hearing is scheduled for January 8, 2026.
- Opposition to “One Nation One System”: The IMA criticizes this policy as a “cocktail of disaster,” arguing it dilutes the scientific rigor of modern medicine and has organized nationwide protests.
The AYUSH Ministry’s Justifications and Clarifications:
- Historical Foundation: The Ministry asserts that Shalya Tantra and Shalakya Tantra are integral to Ayurvedic education, rooted in the Sushruta Samhita, and have been taught and performed in Ayurvedic colleges for decades.
- Formalization, Not Innovation: The Ministry clarifies the 2020 amendment formalizes and streamlines recognition of existing practices, not introduces new ones.
- Specific, Limited Procedures: The amendment specifies only 58 distinct procedures, ensuring a controlled scope of practice.
- Patient Benefit and Healthcare Access: Proponents argue this policy expands healthcare access, especially in rural areas, by leveraging trained Ayurvedic postgraduates and AYUSH infrastructure.
- Modern Terminology for Communication: The adoption of modern terminology is justified for clearer communication with all stakeholders.
The ongoing legal battle and debate reflect deep ideological divides. The Supreme Court’s verdict will significantly shape the future of integrated medicine and surgical practice in India.
Implications and Future Outlook for Integrated Healthcare
The empowerment of postgraduate Ayurvedic doctors to perform select surgeries, as seen in Andhra Pradesh, has profound implications for India’s healthcare future, representing a bold step towards integration.
Proponents argue this policy addresses critical surgeon shortages, particularly in rural areas, by utilizing trained Ayurvedic postgraduates and existing AYUSH infrastructure, thereby expanding access to essential surgical services and fostering equitable healthcare delivery. It also validates the historical relevance and contemporary potential of Ayurvedic surgery within a formalized framework.
However, the IMA’s concerns regarding patient safety, training standard equivalence, and the risks of “mix-and-match” practices remain critical. Poorly regulated integration could compromise patient outcomes, erode public trust, and create systemic confusion. The pending Supreme Court verdict on the 2020 amendment will set a far-reaching precedent.
The path forward requires stringent regulatory guidelines, potentially independent regulatory bodies, and transparent outcome monitoring. Collaborative research is vital for establishing evidence-based protocols demonstrating the efficacy and safety of integrated surgical practices. The evolution of Andhra Pradesh Ayurvedic surgery will serve as a crucial case study for how ancient wisdom can effectively blend with contemporary scientific rigor in India’s dynamic healthcare ecosystem.
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