SHISHIKSHA (Internship Orientation Program) – New for Ayurveda Internship (Form BAMS 2021 Batch)

SHISHIKSHA (Internship Orientation Program) Manual, which is a uniform manual for a mandatory, six-day orientation program prescribed by the National Commission for Indian System of Medicine (NCISM) for UG (BAMS) students entering their compulsory rotatory internship.

The overall purpose of this program, subtitled “(Bench to Bedside),” is to smoothly transition newly graduated doctors from academic learning to hands-on clinical practice.

Here is a detailed explanation of the program’s components in easy-to-understand language.

Program Overview

This is a mandatory six-day orientation totaling 42 hours (7 hours per day) that interns must attend before starting their internship³. The teaching methods include lectures, audio-visual classes, demonstrations, and hospital rounds.

The teaching institution is responsible for conducting the orientation. A core part of the program is the mandatory attendance and maintenance of an E-logbook.

Main Objectives

The program aims to prepare interns for practice by:

• Familiarizing them with hospital policies, goals, and NABH standards.
• Enhancing skills in diagnostics, therapeutics, communication, and professional conduct.
• Providing essential knowledge on medical records, medico-legal aspects, ethics, and pharmacovigilance.
• Training them in the Hospital Information Management System (HIMS) for efficient patient data management.
• Cultivating soft skills like empathy, professional communication, and etiquette.
• Introducing them to entrepreneurial opportunities in the field of Ayurveda.

The Six-Day Curriculum

The curriculum is structured across six days, covering a mix of administrative, clinical, and professional development topics.

Day 1: Introduction, Hospital Orientation & Professional Readiness

This day focuses on setting the stage for the internship.

• Assessment: It begins with an Inaugural Function and a Pre-Test (30 questions) to assess baseline knowledge and identify learning gaps. A post-test will be given on Day 6.
• Rules & Duties: Interns learn the hospital’s general rules, regulations, leave policies, code of conduct, and their specific duties in OPD (Out-Patient Department) and IPD (In-Patient Department).
• Quality Standards: A significant portion is dedicated to the NABH standards (National Accreditation Board for Hospitals & Healthcare Providers) to ensure interns are prepared to deliver care on par with national and global benchmarks.
• Safety & Waste Management: Includes training on Biomedical Waste (BMW) disposal, hospital infection control, patient safety goals, and hands-on training for handwashing and gloving.
• Records & Personality: They are also introduced to the Medical Records Department (MRD) and its importance for medico-legal compliance and receive training on communication, critical thinking, and soft skills.

Day 2: Kayachikitsa, Panchakarma & Clinical Records

This day is focused on core clinical departments and documentation²⁰.

• Kayachikitsa (Internal Medicine): Hands-on training for writing OPD cards and IPD notes, which includes detailed examination, grading of symptoms, and writing prescriptions for ASUS (Ayurveda, Siddha, Unani, Sowa Rigpa) medicines. They also practice writing discharge cards and participate in mock drills for emergencies like shock.
• Panchakarma: Learning to write therapy notes, daily assessment notes, and perform documentation of procedures. Hands-on training or demonstrations for various procedures like snehan (oleation) and swedan (sudation) are included.
• Pharmacy & Pharmacovigilance: Training on drug dispensing, labeling, storage, interpretation of drug labels, and reporting of Adverse Drug Reactions (ADR).
• Laboratory & Communication: Hands-on training in sample collection, storage, and lab etiquette. The day concludes with sessions on patient counseling, cultural sensitivity, and teamwork.

Day 3: Shalya, Shalakya & Medico-Legal Orientation

The focus here is on surgical aspects and legal compliance.

• Shalya Tantra (Surgery): Training on clinical examination and management of common surgical disorders, OT (Operation Theater) etiquette, and hands-on practice for writing surgical notes and discharge summaries. They are also familiarized with procedures like Ksharasutra and Agnikarma.
• Shalakya Tantra (Eye, ENT): Similar training for OPD/IPD notes specific to Eye and ENT, as well as hands-on training for Kriyakalpa procedures (like Nasya and Shirodhara).
• Medico-Legal Aspects: Detailed orientation on NCISM ethics regulations, the rights of practitioners, handling medical certificates, informed consent, and the Drug and Magic Remedy Act.
• HIMS: Hands-on training on the Hospital Information Management System for patient registration, unique ID generation, and prescription writing.

Day 4: SRPT, KB & Emergency Preparedness

This day covers specialized fields and crisis management.

• Stree Roga evam Prasuti Tantra (Gyn/Obs): Training on labor theater etiquette, writing ANC (Antenatal Care) cards, writing birth notes, and hands-on practice of gynaecological examinations and procedures.
• Kaumarbhrutya (Pediatrics): Training on NICU (Neonatal Intensive Care Unit) etiquette, cold chain maintenance for vaccines, anthropometric measurements for growth, and prescription writing for children.
• Emergency Management: Sensitization and demonstration of common protocols for the Casualty section, including first aid, use of emergency medications, and procedures for referring trauma cases.
• AYUSH Regulatory Bodies: Information about the AYUSH Ministry and bodies like NCISM and State ISM registration councils.

Day 5: Public Health, PHC Training & Digital Health

The focus shifts to community medicine, technology, and career preparation.

• Swasthavrutta & Yoga: Role-playing and small-group activity for preparing diet charts and understanding Dinacharya (daily regimen) and Sadvritta (ethical conduct).
• Primary Health Care (PHC): Orientation on PHC routines, managing diseases prevalent in rural areas, participating in National Health Programmes, and maintenance of various registers (patient, family planning, etc.).
• Ayushmaan Bharat Digital Mission (ABDM): Hands-on training in digital health tools like Telemedicine, E-Sanjeevani, and the HPR (Healthcare Professionals Registry) portal.
• Professional Development: Includes Team Building Activities and sessions on Medical Value Travel and the AYUSH VISA to broaden the interns’ perspective on global healthcare opportunities.
• E-Logbook: A crucial session on the NCISM-mandated electronic logbook system, its structure, integration with HIMS, and penalties for incomplete documentation.

Day 6: Research, Career Pathways & Valedictory

The final day focuses on future careers, professional excellence, and program closure.

• Career: Orientation on Entrepreneurial opportunities in AYUSH, including startups and MSME schemes, to empower interns to explore non-traditional career paths.
• Academics: Training in Scientific presentation skills, case series presentation, research aptitude, clinical audits, and publication skills to bridge traditional knowledge with modern communication.
• National Exams: Information about NCISM’s National Examinations, such as NExT and NTET, to prepare them for postgraduate study or teaching.
• Assessment & Feedback: The program concludes with a Post-Test (the same questionnaire as the pre-test) to measure learning outcomes. The results must be compared, and any weaknesses must be addressed.
• Valedictory: A formal closing function that includes feedback on the orientation program and an interaction with Heads of Departments.

Short Summary

The SHISHIKSHA Internship Orientation Program is a mandatory, six-day (42-hour) NCISM-prescribed training module for new BAMS interns. Its goal is to provide a smooth “Bench to Bedside” transition by moving students from academic theory to competent clinical practice.

The comprehensive curriculum covers administrative protocols (hospital rules, NABH, BMW disposal), core clinical skills (case-taking, prescription writing, surgical etiquette in Kayachikitsa, Panchakarma, Shalya, Shalakya, SRPT, and Kaumarbhrutya), legal and ethical compliance (medico-legal aspects, Drug Act), digital health (HIMS, ABDM, E-logbook), and professional development (communication, entrepreneurship, research). The program is monitored by mandatory attendance and the maintenance of an E-logbook, and its effectiveness is measured by comparing pre-test and post-test scores.