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Status & Development of Ayureda in U.S.

Written by Dr. Marc Halpern
(Delivered at a January 2000 Conference on Ayurveda in India)

This talk intends to update the Indian Ayurvedic community on the development of Ayurveda in the United States. As interest in Ayurveda grows, significant developments of this profession are occurring. This paper will be of interest to India's educational community and its Ayurvedic practitioners as they contemplate their relationships with Ayurveda abroad.

History of Ayurveda in the United States

Interest in Ayurveda in the United States began in the 1970's largely as the result of efforts by the Maharishi Mahesh Yogi organization of Transcendental Meditation. Interest continued to grow as Indian physicians came to the United States in the 1980's. Among these physicians were Dr. Vasant Lad, Dr. Sunil Joshi and Dr. B.D. Triguna. In the late 1980's Dr. Deepak Chopra wrote "Perfect Health", his famous introductory book on Ayurveda for the general public. This opened the door of India's ancient healing science for many Westerners. Furthermore, several American pioneers helped attract attention to Ayurveda and influence it's growth in the US. They include Dr. David Frawley of the American Institute For Vedic Studies and Dr. Robert Svoboda, a Westerner who completed India's BAMS program. As interest and awareness grew, training programs of various degrees emerged. 

The State of Ayurvedic Education in America

The quality of educational programs varies widely in the United States, and there is no national standard of required compliance for Ayurvedic colleges. Each institution creates its own guidelines for training and certifying practitioners.

Ayurveda training programs in the US fall into four categories: (1) correspondence programs, (2) correspondence with classroom training programs, (3) on-site training programs without state certification (4) on-site training programs with state certification.

Correspondence programs enable the student to study exclusively at home and correspond with questions to the school. Dr. David Frawley's course in New Mexico requires 250 hours of study to complete the program. Dr. Robert Svoboda administers a similar program via the Ayurvedic Institute in New Mexico. 

A few correspondence programs add one to two weeks of seminars where attendance is required. These programs are provided by the Florida Vedic College, the International Ayurvedic Institute in Massachusetts, and the Ayurveda Holistic Center in New York. 

On-site training programs require the student to be in class for a designated number of hours, completing requirements and exams. The most extensive on-site training program for self-healing is run by Dr. Vasant Lad at the Ayurvedic Institute in New Mexico. This program does not focus on training practitioners, but focuses on the student's self-healing experience. Dr. Deepak Chopra runs a shorter seminar program also teaching the science of self-healing. 

The only training program which currently offers state certification and practitioner training is the California College of Ayurveda. The format for our two year course includes three days a month on-site training for a year and a half, a six-month clinical internship, and independent study. Completion culminates in certification as a practitioner.

In addition, Ayurvedic training seminars are offered from time to time from the above-mentioned institutions. Many seminars are designed to probe specific Ayuvedic topics including pulse diagnosis, Pancha Karma, and Yoga and Ayurveda.

Practitioner Programs 

One type of practitioner program emphasizes basic principles and lifestyle counseling. Programs include those run by the Florida Vedic College, the International Ayurvedic Institute in Massachusetts, and the Ayurveda Holistic Center in New York. 

Notably, an independent college is moving in the direction of offering a Master's or Ph.D. program in Ayurveda. However, at this time the programs are not accredited and do not meet the academic standards of Masters or Ph.D. programs of accredited schools. 

The California College of Ayurveda exclusively offers a practitioner program which includes basic principles and lifestyle counseling, but specializes in a six-month clinical practice. We chose to follow a model set by the Allopathic, Acupuncture, Naturopathic and Chiropractic professions. This model develops a certification or degree that stands on its own. We created a certification as a Clinical Ayurvedic Specialist or C.A.S.. Furthermore, we support the development of a Doctor of Ayurveda degree (Ay.D.).

Development of Ayurvedic Associations

Two independent representative organizations formed to support the growth of Ayurveda in the United States. They are the National Association of Ayurvedic Medicine and the California Association of Ayurvedic Medicine. Both missions are to formalize Ayurvedic educational standards, attain licensing and set standards of practice. After going through a year long formative stage, both associations aim to become public non-profit organizations in early 2000. 

The national organization (CAAM) currently is supported by Ayurvedic Institute of New Mexico and the California College of Ayurveda. These schools are the largest, most established ayurvedic education institutions in the United States. Both schools are instrumental in the viability of the National Association. This joint effort marks the first collaborative effort in America of Ayurvedic centers for the benefit of establishing and formalizing the profession. While the association is still in a formative state, it will soon be inviting input and membership from the broader Ayurvedic community.

Regulation of Ayurveda in the United States of America

There is no current regulation of Ayurvedic practice or education in America. The Ayurvedic associations will create these standards.

In the United States, State laws regulate a profession and set its formal scope of practice. Strong state associations must advocate for the advancement of a profession. The only state association in the U.S. is the California Association of Ayurvedic Medicine, which plans to become public in early 2000.

Some schools, such as California College of Ayurveda, received formal state approval to operate and train practitioners. Graduates of such programs do have a legal basis to practice their vocations as taught in their school. The State of California grants state approval based on academic standards and financial stability; however, it does not review curriculum for authenticity or validate the competency of a program.

It is legal to practice Ayurveda in the U.S.; however, how it is practiced currently determines its legality. In the United States, no one can practice Allopathic Medicine without a license. Therefore, practice of Ayurveda must avoid allopathic diagnosis, use or altering of prescription medicines and surgery. For this reason, ayurvedic practitioners emphasize lifestyle counseling, sensory therapies and herbalism based upon the determination of prakruti and vikruti. Traditional Ayurvedic diagnosis according to samprapti is taught at the California College of Ayurveda and treatment addresses each component. However, no formal correlation is made between the Ayurvedic samprapti and a specific allopathic disease in clinical practice.

The Ability of Indian Trained Ayurvedic Practitioners to Practice in the United States

Indian Ayurvedic physicians who have immigrated or those with U.S. work visas may practice Ayurveda legally in the United States, as there are no laws which prevent this. However, the scope of practice, which is broad in India, must be narrowed in the United States to remain within the legal scope. I advise Ayurvedic physicians to receive additional training in America in order to apply their knowledge in a safe, effective, and legal manner. At the California College of Ayurveda we grant the Clinical Ayurvedic Specialist title to Ayurvedic physicians upon completion of exams and our internship program. This is designed to assist Indian doctors in learning how to communicate with Americans, how to meet their clients' needs, and learn the details of legal practice in America.

Cultivating An Ayurvedic Profession Within The United States

There are diverging viewpoints on this subject. One states that Ayurveda should be a subspecialty of allopathic medicine. In this scenario education and the ability to practice would only be available to medical doctors. 

The other view is that the Ayurvedic profession should remain independent and grow on its own, training its own practitioners. Separate schools would train Ayurvedic practitioners who would practice either independently or in a complementary/integrated manner with allopathy. As the director of the California College of Ayurveda, I support the independent profession viewpoint.

This view is based on the model set by Acupuncture, Chiropractic and Naturopathy in the US. These professions regulate their own development. In addition, if the professions are independent, those who are attracted to study a specific mode of alternative medicine do not need to become physicians to practice, and physicians do not need to re-train their way to thinking to incorporate ayurvedic medicine. 

In order to build a new profession, several pieces of the puzzle must develop. One piece is to form schools with the intention of training practitioners. An independent national association must play the role of guiding the development and making recommendations to the federal government. This association must also develop an accrediting agency for Ayurvedic schools and colleges, which would set minimum standards for curriculum. State associations must form to advocate for a specific scope of practice and state licensing. Communication tools need to develop to allow ayurvedic practitioners to share their knowledge.
In the United States today, programs vary widely according to the extent of education and vision for the future. Programs frequently seek affiliations with institutions in India to create the illusion of greater credibility. Both practitioners and institutions from India should closely evaluate the education and vision of any institution before offering support. 

While Ayurveda in the United States grows according to its own course, India's role is crucial in the development of Ayurveda abroad. Support for specific programs adds credibility in the minds of the American public. Institutions use this credibility to attract additional students. In America today, the more students an institution has, the greater its political clout. Hence, support for an institution isn't merely support for Ayurveda, but encompasses support for the institution's vision! Care should be taken in creating affiliations, as this shapes the political landscape.

Developing Ayurveda is a step-by-step process. Other alternative health professions developed these steps which can help us avoid obstacles.
• Interest develops.
• Early informal education begins for self-healing, which is unregulated and people may practice.
• Short formal training programs begin as academic schools open. Graduates practice.
• Associations form to advocate for the profession and open up internal dialogue.
• Education improves and expands.
• The government sets up formal scope of practice and licensing of practitioners.

In the United States of America today, our profession is in the middle stages, depending on the state and the institution. Only at the last stage does real official regulation exist. 

I believe the Ayurvedic profession will develop naturally as interest continues to grow, as schools compete for students, and more practitioners bring Ayurveda to their communities. The opinion of some Ayurvedic physicians from India is that we should exclusively have five and one-half year training programs in America. Unfortunately, this does not take into account the natural developmental process of a new profession. Currently, student interest and commitment are not strong enough, and such training programs would quickly encounter financial instability.

Conclusion

Ayurveda is growing rapidly in the United States of America. Educational institutions are forming to train practitioners and associations are forming to give the profession a voice and address regulation issues. In America, Ayurveda is an infant whose growth requires the diligent nurturing of both Ayurvedic communities in the United States and in India.