The Pedagogical Betrayal in BAMS and PG Curriculum

The Pedagogical Betrayal: How NCISM’s Curriculum Framework Violates Core Educational Principles

Dr Aakash Kembhavi MD, PGDMLS, MS (Counseling & Psychotherapy)

Author’s Note

The views expressed in this article are my personal opinions, developed through more than 25 years of experience in Ayurvedic education and clinical practice. I write this as a Double Gold Medalist and University Topper in BAMS, holder of MD from IPGT&RA Jamnagar, MS in Counseling and Psychotherapy. My credentials include international teaching experience at Thames Valley University London and Europe Ayurveda Academy France, recognition as RGUHS PhD Guide for Research Methodology and Bio Statistics, and editorial roles with multiple peer-reviewed journals including ARMARC, RJAS (RGUHS), and JONAM (MedWin Publishers, USA).

These perspectives emerge from decades of witnessing the gap between curriculum documentation and classroom reality, between institutional claims and graduate competency. I offer this critique not as an outsider, but as someone deeply invested in Ayurvedic education’s future.

Transparency note: **This article was developed in collaboration with AI assistance for research synthesis, structural organization, and editorial refinement. The analysis, arguments, and conclusions represent my professional assessment based on lived experience within the system being critiqued.

The Central Problem

The National Commission for Indian System of Medicine (NCISM) had undertaken and introduced the ambitious curriculum reform for BAMS education, claiming to adopt an “outcome-based curriculum” structured around Bloom’s Taxonomy and Miller’s Pyramid. The User Manual reads like a progressive educational manifesto, invoking all the right terminology: learning outcomes, competency-based education, progressive skill development, and integrated assessment.

Yet beneath this veneer of pedagogical sophistication lies a profound betrayal of the very frameworks it claims to embrace. The NCISM curriculum represents not the implementation of these educational frameworks, but their systematic misappropriation—a bureaucratic performance that checks boxes while fundamentally misunderstanding the transformative principles these frameworks were designed to achieve.

This is not a minor technical failure. This is an epistemological catastrophe that perpetuates rote memorization masquerading as understanding, surface learning replacing deep comprehension, and mechanical degree completion substituting for authentic competency development.

Understanding What Was Betrayed

Bloom’s Taxonomy (revised 2001) represents a theory of intellectual development recognizing learning as progressive mastery of increasingly complex cognitive operations—from Remember (lowest) through Understand, Apply, Analyze, Evaluate, to Create (highest). Each level builds on the previous; students cannot analyze what they don’t understand, cannot evaluate what they cannot analyze.

Miller’s Pyramid (1990) specifically addresses clinical education, recognizing that medical competence requires integrating knowledge, skills, and professional behavior in authentic practice contexts. Its four levels—Knows, Knows How, Shows How, and Does—demand progressive movement from factual knowledge through demonstrated performance in controlled settings to integrated performance in real practice.

Together, these frameworks provide a pathway from foundational knowledge to integrated clinical performance, recognizing that knowing facts does not equal clinical competency.

The Seven Fundamental Betrayals

Betrayal #1: Reducing Hierarchies to Checklists

NCISM treats taxonomy levels as administrative labels rather than developmental stages. Each learning objective gets tagged with a Bloom’s domain and Miller’s level, but this labeling doesn’t create development. Simply classifying objectives by taxonomy level doesn’t ensure students actually progress through those levels. It’s like believing that labeling foods as “carbohydrates, proteins, fats” constitutes nutrition education.

Betrayal #2: Stagnation at Lower Cognitive Levels

The overwhelming majority of learning objectives remain trapped at Bloom’s “Remember” and “Understand” levels. Assessment heavily emphasizes MCQs (primarily testing recall), with 75% of marks from MCQs and SAQs testing lower cognitive levels. Bloom’s entire purpose was to move education beyond memorization—yet this curriculum makes “Knowledge” (recall) the dominant objective.

Ayurveda desperately needs practitioners who can analyze individual patient constitutions, evaluate multiple therapeutic options, and create individualized treatment protocols. These require Bloom’s highest levels. Yet the curriculum keeps students memorizing Dosha characteristics and reciting treatment formulas.

Betrayal #3: The Miller’s Pyramid Misunderstanding

The document states that “lower three levels are useful in UG”—suggesting undergraduate education should NOT reach “Does” (actual clinical performance). This fundamentally misunderstands medical education. Objectives are labeled with Miller’s levels, but there’s no curriculum structure ensuring students actually progress through them. Most assessments (theory MCQs, SAQs, LAQs) only evaluate “Knows”—yet students are supposed to reach clinical competency?

Miller’s Pyramid was designed specifically to address medical education producing graduates who know facts but cannot perform clinically. NCISM’s curriculum maintains the very knowledge-practice gap Miller’s framework was designed to bridge.

Betrayal #4: The “Must Know / Desirable / Nice to Know” Category Error

This classification system conflates content importance with cognitive level and competency depth—three entirely different dimensions. Faculty interpret “Must Know” as “teach more content” rather than “ensure students reach higher cognitive levels with this content,” perpetuating content-coverage mentality instead of competency-development focus.

Betrayal #5: Teaching Methods Divorced from Cognitive Levels

The document lists 40+ teaching methods but treats them as interchangeable options rather than recognizing that different cognitive levels demand different pedagogical approaches. Faculty see an objective labeled “Cognitive/Application” and arbitrarily select a teaching method, defaulting to lectures—the least appropriate method for higher cognitive levels.

The manual provides zero guidance on which methods suit which cognitive levels or how to design activities ensuring progression through Bloom’s levels. This is pedagogical malpractice disguised as comprehensive documentation.

Betrayal #6: Assessment Methods Misaligned with Claimed Outcomes

The curriculum labels objectives at higher cognitive levels but assesses them with methods appropriate only for lower levels. It claims to develop clinical competency (“Does”) but relies heavily on written examinations (“Knows”). Students can score 60-70% by memorizing information and performing isolated skills demonstration—and be awarded BAMS degree—without ever demonstrating integrated clinical competency in actual practice.

Betrayal #7: The Integration Illusion

Topics are marked for “horizontal” and “vertical” integration, but the curriculum provides no mechanisms ensuring integration actually occurs—no collaborative teaching structures, no integrated assessments, no faculty development on integrative teaching. Departments remain siloed. The graduate cannot connect Dravyaguna knowledge to Roga Nidana diagnosis to clinical treatment decisions.

The Teacher Competency Crisis

The curriculum’s fundamental flaw is compounded by a brutal reality: the overwhelming majority of Ayurvedic faculty lack the pedagogical literacy to recognize these problems, much less correct them. Most have never studied Bloom’s Taxonomy beyond superficial exposure, never encountered Miller’s Pyramid, and never learned outcome-based education principles.

Most faculty cannot distinguish cognitive levels in practice. They might recognize that analyzing is “harder” than defining, but lack framework understanding to design progressive difficulty. They default to lecturing for 90% of contact hours because they’ve never experienced alternative methods as learners and don’t know how to design problem-based learning scenarios.

The NCISM Manual enables this ignorance—describing frameworks superficially, providing no worked examples, listing methods without guidance, and assuming competencies faculty demonstrably lack. It reads like it was written by educational consultants who never entered an Ayurvedic classroom.

Real-World Consequences

For Students: Five years memorizing information, reproducing it for examinations, never developing deep understanding or progressing to analysis, evaluation, or creation. They graduate believing medicine is knowing facts. First day of independent practice, they discover patients don’t present like textbook descriptions, classical formulations require adaptation, and they can recite Nadi Pariksha theory but can’t reliably interpret pulses.

For Patients: Practitioners who conduct perfunctory examinations, prescribe standard formulations without individualization, cannot explain treatment rationale, and switch to allopathic medicine when Ayurvedic approach requires actual thinking. Patients conclude Ayurveda doesn’t work—when actually the practitioner doesn’t know how to practice.

For Ayurveda: Graduates who never learned to question, analyze, or conduct research result in intellectual stagnation. Ayurveda becomes museum science—preserved but not advancing. Best students avoid Ayurveda programs, leave for other fields after graduation, or don’t pursue academic careers, perpetuating the faculty crisis.

The Path Forward

Immediate Actions:

  • Acknowledge the crisis—admit current curriculum implementation is failing
  • Pause and pilot—select 10-15 institutions, provide intensive faculty development, study what works
  • Emergency faculty development—minimum 120 hours covering framework understanding, assessment literacy, active learning methods, and supervised implementation

Structural Reforms:

  • Curriculum redesign with genuine vertical integration of Bloom’s Taxonomy across years
  • Assessment revolution—reduce theory exam emphasis, prioritize performance assessment, implement workplace-based assessment during internship
  • Faculty career reconceptualization—mandatory professional development, teaching portfolios, student outcomes as performance metrics
  • Institutional accountability based on student learning outcomes, not just inputs

The Choice Before Us

The fundamental problem is not the frameworks themselves. Bloom’s Taxonomy and Miller’s Pyramid are valuable pedagogical tools when properly understood and applied. The problem is superficial adoption without transformational implementation.

We borrowed impressive-sounding educational terminology. We created elaborate documentation. We mandate compliance with outcome-based education. But we never ensured anyone actually understood these frameworks, developed faculty capacity to implement them, created infrastructure supporting genuine transformation, or acknowledged when implementation was failing.

We performed pedagogical reform as theater. We wanted to appear modern and progressive. We satisfied accreditation requirements. But beneath the performance, nothing changed.

The betrayal is not that we tried and failed—it’s that we pretended to try while ensuring nothing would change.

If we are serious about Ayurvedic education, we must:

  • Admit the NCISM curriculum’s implementation is failing
  • Acknowledge teachers lack necessary pedagogical competencies
  • Accept that documentation is not transformation
  • Invest in authentic faculty development
  • Redesign curriculum with genuine framework application
  • Hold institutions accountable for student learning outcomes
  • Embrace the discomfort of real change

Bloom’s Taxonomy and Miller’s Pyramid are not failed frameworks. They are betrayed frameworks—adopted in name, violated in practice, and blamed when the predictable failures occur.

The recently introduced PG Curriculum from Semester 1 through 6 are based on similar pedagogical betrayal. It assumes that faculties are equipped to teach, train and create skilled post graduate scholars. My personal experience shows that this is not the case. The same set of faculties who teach at the undergraduate level teach the post graduates. If the undergraduate teaching and training itself is failing, then how can we expect the post graduate teaching to excel because post graduate teaching requires a far more analytical and reasoning skills and extensive clinical exposure. These remain handicaps in our system. **Are we ready to address these issues? **

The answer will determine whether Ayurveda survives as a living, vital medical science—or devolves into a museum artifact, preserved in rhetoric but dead in practice.

Choose wisely. Choose honestly. Choose now.

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