Bridge course for Homeopaths

Homeopathic doctors & NMC Bill – In defence of the bridge course allowing them to prescribe allopathic medicines

January 9, 2018, 2:00 AM IST Kushal Banerjee in TOI Edit Page | Edit Page, India | TOI

The National Medical Commission Bill, in its first iteration, proposes a bridge course which will allow homeopathic and ayurvedic practitioners to prescribe some allopathic medicines. This proposal of a bridge course has met with opposition by members of the medical fraternity and, surprisingly, some practitioners of alternative medicine.

I must begin by stating that homeopathy is a complete science and is in no way limited by the inability to prescribe allopathic medicines. However, each system of medicine has its scope and limitations. The bridge course should be understood with the reasons behind its proposal; principal among which is to ease the burden on overworked allopathic doctors and to share the disease burden of the nation.

Homeopaths undergo a five and a half year, full time, undergraduate course in India. They are trained in every subject that a student of allopathy is taught except pharmacology. This includes anatomy, physiology, biochemistry, pathology, gynaecology, obstetrics and internal medicine. The students use the same textbooks, the syllabi for these subjects are the same, and the time allotted for these to be taught is also almost the same as the MBBS (Bachelor of Medicine, Bachelor of Surgery) syllabus.

In universities where both MBBS and BHMS (Bachelor of Homeopathic Medicine and Surgery) courses are taught students may often share lecture halls for common lectures. The faculty is often the same! As in the MBBS course, the students must complete a rotational internship. This includes six months at a regular hospital.

There are concerns that homeopaths may not be able to interpret modern investigations and diagnostic tests. These concerns are entirely unfounded. Homeopaths all over the country are using modern diagnostic techniques to assess outcomes of their treatment. Patients themselves are doing this! It is ludicrous to suggest that a homeopath is unable to interpret diagnostic test results because of an inherent and insurmountable lack of understanding.

I have sat in rooms with various kinds of doctors, surgeons and paramedical personnel, in my undergraduate years, in my time as an MD-Homeopathy student, while reading for a post graduate degree at the University of Oxford, and in conferences in various parts of the world. I have sensed the scepticism in the room when i introduce myself many, many times.

No one, however, has ever managed to arrive at the conclusion that i will simply not understand what is being taught or said because i am a homeopath. This seems to be the presumption being made by those opposed to the proposed bridge course. In the absence of details of the specific nature of this course, how is it being opposed, if not for this reason? When the training of both allopathic and homeopathic courses is so similar, i fail to understand the logic to this opposition.

The most facile argument concerns the dual registration of homeopaths in another national register once they complete the bridge course. Apparently, this is ‘neither permissible nor open’. I’m not sure what this means but maintaining a register of homeopaths who have completed the bridge course seems to be both ‘possible’ and ‘not a big deal’ to me.

It is time that the opponents relax this perceived sanctity around the medical profession and become more sensitive to the healthcare needs of India. There are large parts of the country where no medical practitioner is present, and none are willing to go. This is despite changes in regulations like making rural internships compulsory and enforcing of bonds for graduates of government colleges, preventing their departure from the country. Homeopaths are well positioned to shoulder the disease burden of the nation. Only in India, because of the stellar training provided to homeopaths, is such a move even possible.

If providing a bridge course can make them better equipped to handle at least some illnesses that they couldn’t earlier and spread healthcare services to far flung areas of the country, what can possibly be the problem? If ignorance of the structure and scope of the training of a homeopath was the problem, i hope this has helped. If prejudice is the problem, the nation will do well to rise above it.

Here is my rebuttal…

I was amused to read Dr. Kushal Banerjee’s take on, the bridge course for homeopaths to practice modern medicine (erroneously referred to as Allopathy). I am a qualified homeopath but having concluded that it is nothing less than pseudoscience, gave it up, studied for the all India entrance and got into modern medicine. I therefore have seen all of both the worlds and stand uniquely qualified to comment on the issue.

What surprises most is that he begins by firmly stating that Homeopathy is a, ‘complete science and is in no way limited by the inability to prescribe allopathic medicine’. If this is so why don’t our worthy Homeopaths simply practice this panacea of a pathy and provide solace to the beleaguered Indian masses? Why seek something that they have learned to debunk, deride and despise?

The fact remains that Homeopathy goes against the very basic scientific dogma, has never been able to produce good, strong evidence in support of its claims of magic cures, has been rightly dubbed as quackery in many countries and banned in several others.

Homeopathic colleges have thrived in India, simply because such qualification provides back door entry to the world of medicine. Plug this loop hole and these colleges will wilt, sooner than toadstool post monsoon. Day by day the law is becoming more stringent, enforcing agencies more threatening, patients armed with the CPA, are more belligerent and cross-pathy practice is becoming hazardous. It is on this back ground that the idea of a bridge course is being mooted with the ostentatious purpose of filling the gaps in the Indian healthcare system.

Agreed, that any person with average intelligence can become a doctor with appropriate training. But the contention that a bridge course in Pharmacology alone will do the trick for homeopaths is hollow.

Homeopaths do learn ‘all’ the subjects that are taught in colleges of modern medicine but the depth of understanding that is expected is far less. Auxiliary nurses and midwifes too learn about normal labor and delivery and so does a person appearing for post graduate degree in Obstetrics. Although it’s the same subject, the expected level of understanding is totally different. Thus what is needed is a complete course than a bridge course.

Just a bridge course won’t suffice because the Homeopathic doctrine simply does not believe in the current clinical-pathological correlation. Homeopaths believe in a ‘vital force’, deny the germ theory, believe that ‘miasms’  explain chronic conditions, think that dilution potentiates a drug’s action and that drugs work in absentia.  Given this total alienation from science and evidence based thinking, most that homeopaths do in college is pick up some jargon, some terminology with hardly any insight into what exactly is meant by it. Not that it is necessary to know, since homeopathic practices are not based on evidence at all. Take for example cancer cervix, which is staged into nine different stages; since modern therapy and the expected outcome hinges on this. Homeopaths will hear about this, will read this too but will not know its application, since homeopathic therapy is not based on this at all.

If at all such bridge course is mooted, then apart from a lot of learning homeopaths will have a lot to unlearn. Homeopaths are taught about 25 disadvantages and shortcomings of Allopathy, that a person, who practices Allopathy in spite of homeo training, be called a mongrel, that couples practicing contraception are doomed to suffer chronic maladies…! Thus just a sprinkling of pharmacology will not do. Extensive teaching will be needed.

Such a course will endorse a system that bypasses the correct one, will mock at the efforts of the students who have slogged it to get into modern medicine and what one completely fails to understand is how do the authorities keep tab on whether this ‘bridge course’ed doc is practicing within permitted limits?

Such a shrill demand for a bridge course from homeopaths means that these graduates aren’t equipped to earn their livelihood with whatever they are taught. They are in need of rehabilitation. The university has failed them, taken them for a ride. So what is the point in continuing with the homeopathic colleges? What is the point in providing rehabilitation, if more in need of rehab will be incessantly churned out?  Why not stop Homeopathic teaching and convert all these colleges into colleges to train paramedics since that is the segment that our health care woefully lacks?