Credentialing the Ayurvedic Profession

NAMA has been systematically building a credentialing program based on the belief that credentialing is one of the most important ingredients to the advancement of the Ayurvedic profession and a key component to the goal of licensing. There are many steps toward credentialing and NAMA has been hard at work over the past twelve years laying the groundwork. We are now ready to establish viable and fair National Exams for the Ayurvedic Health Counselor and the Ayurvedic Practitioner and will eventually create one for the Ayurvedic Doctor level.

Here we answer some questions you may have about the certification process, its impact on you and why NAMA’s certification program will be recognized nationally as the gold standard for competency in the field of Ayurveda.

Why Credentialing?

Credentialing facilitates standardized practice across a wide variety of treatment settings. Most importantly it assures ethical professionals are available to clients, families and their communities. Certification serves the following purposes:

  • It gives the general public a basis for evaluating a service provider
  • It helps employers judge the skills of existing or potential employees
  • It allows those who are certified to differentiate themselves from others in the profession and to advance their career

What is NAMA doing in the certification process?

First, NAMA had to identify the competencies an individual must possess to perform his/her job functions competently at various levels. NAMA identified Scopes of Practice required for these various levels of professionals. Additionally, we looked at educational guidelines required to meet the scopes of practice and took into consideration the value of experience needed to successfully complete a competency-based exam. These steps have been completed.

The next step was to find an experienced and appropriate partner to assist in creating the exams. After evaluating a number of proposals, we have teamed up with an outside consulting firm to provide expertise in psychometrics to ensure a valid and rigorous competency exam. A well-designed examination avoids the pitfalls of developing test questions that are not legally defensible or valid, thus resulting in poor data, and potential legal challenges.

Why develop a certification process?

According to the Center for Association Leadership, certification programs have become increasingly popular during the last few years. There have been many cases of organizations setting up certification programs and credentialing examinations without the proper rigor, judgment and stakeholder buy-in. For some organizations, it is seen simply as a quick revenue stream.

NAMA has chosen this rigorous path of certification in order to foster increased recognition of the profession nationally. However, creating and then maintaining a certification program requires planning and close attention to several important steps. NAMA is committed to a thorough and comprehensive process that includes the use of an experienced organization skilled in the creation and implementation of fair and legal examinations. The costs and time are significant in developing, marketing and administering a certification program and must be thoughtfully planned and implemented.

What are the biggest mistakes that some organizations make?

Underestimating the support needed in creating a defensible rigorous certification program. The support of the Ayurvedic community from the practitioners to the schools is paramount to its success.

>>NAMA has long worked with representatives of Ayurvedic schools, practitioners, and other key members of our community. In the cases where this is not done there tends to be many issues that arise around fairness and even legality of the exam itself. Thus creating a weak and indefensible component to the future licensing ingredients.

Underestimating the time needed. The variables included in the exam process include identifying the job tasks (competencies), identifying the exam objectives, the subject matter expert availability, and obtaining a good sample of beta candidates. If shortcuts are taken here, they usually come back to haunt the program in poor test items, unsatisfied test takers, and unreliable data.

>>NAMA has thoughtfully been working on the entire process over the past 10 years and is now entering the phase of the actual exam creation with a target date of December 2016 for implementation.

Failure to account for recertification. Few organizations certify for life without at least requiring some sort of skills maintenance. You should be skeptical of any organization that does not have a recertification process.

>>NAMA is making a long-term commitment by assuring a process for recertification through a continuing education program that will require those certified through the grandfathering process, or ultimately through the examination process to maintain and/or improve their skills on a regular basis. Developing side-by-side with the examinations, the Professional Ayurvedic Continuing Education (PACE) requirements provide evidence that our organization is continuing to invest in the credential that will maintain its value in the health field.

Failure to have a certification revocation process. This involves two steps: developing and distributing a “Code of Ethics” and confirming that all Professional Members have agreed to adhere to this standard, and creation of a “States of Professional Conduct” plan to establish a process by which complaints can be lodged and investigations conducted.

>>NAMA has a “Code of Ethics & Professional Conduct” in place and all professional members agree to follow the code when they submit their membership application. All professional members are also required to take a short Ethics Exam every two years as a part of their Professional Ayurvedic Continuing Education requirements. NAMA’s Ethics Committee reviews any complaints or breach of the code of ethics by professional members. The next step in the development of a certification revocation process is to take great care to ensure a disciplinary process is applied consistently and fairly. This process must also allow for a mechanism by which disciplinary actions can be appealed.

Failure to design a rigorous and fair exam that has both internal and external validity. When looking at a certification exam ask if it’s an exam that’s criterion based. That means it provides an objective reference standard. In a nutshell, this means that the candidates taking the exam are evaluated on how they perform relative to a fixed set of criterion, and not judged relative to their peer group’s performance.

>>NAMA is engaging experts in the field to work with us to assure this validity.

Failure to use experts in the exam development. Creating a fast and easy quiz or test without attention to the details of the exam process can result in invalidating any credential offered for everyone who has taken the exam.

>>NAMA has recognized few people are trained in rigorous test development. We’ve acknowledged that to provide a rigorous exam it needs guidance and expertise in exam development. We have teamed up with a psychometrical team of experts who are working closely with us to provide the necessary tools and guidance to help ensure our certification exam is:

Useful: Achieves our professional goals

Credible: Has perceived value and holds up under the scrutiny of others in the healthcare field

Reliable: Consistently measures whatever the test is measuring

Valid: The scores provide meaningful information based on the purpose of the test(s)

Legally Defensible: Has followed best practices to help ensure the test scores are fair, reliable, and valid

A lot boils down to the integrity of the exam. If the certification exam is too easy, too hard, or does not measure what it’s supposed to, then everything else will fade over time.

It is not enough to just offer a certification program for its own sake. We must raise the bar for the profession and follow through with a certification process that identifies and supports the best practitioners in our profession - those that practice to a well-defined and excellent standard of practice. NAMA is committed to offering a rigorous, valid and fair certification exam and has spent the last 12 years creating the groundwork to put it all in place.

NAMA has taken on this challenge for its members and ultimately for the viable future of Ayurveda in the United States. State organizations that adopt NAMA’s credentialing process, including the certification examinations, will have a strong and fully developed program to present to their legislatures in the efforts toward licensure. With a strong, thoughtful, and well-designed process, everyone wins.



Institute for Credentialing Excellence (2010). Defining features of quality certification and assessment-based certification programs. Retrieved from:

Kryterion. Test development Analysis: retrieved from:

Lenora G. Knapp, Ph.D., Joan E. Knapp, Ph.D. (2014). Business of Certification: A Comprehensive Guide to Developing a Successful Program. Center for Association Leadership. Retrieved from:

Institute for Credentialing Excellence (2010). Defining features of quality certification and assessment-based certification programs. Retrieved from:

Reed A. Castle, PhD. (2002) Developing a Certification or Licensure Exam. Schroeder Measurement Technologies, Inc. Retrieved from:

Patient Encounter Guidelines

Definition of Patient Encounter (PE)

A patient encounter is defined as a combination of the following, a substantial percentage of which should involve direct, hands-on contact. A patient encounter refers to each encounter: initial or follows up. Schools are encouraged to provide the opportunity for long-term follow up by which students can experience outcomes.

a) Experience history and/or outcomes of patients in order to build an internal database of clinical knowledge and experience. This internal database can be built by a variety of experiences whether it is observation, internship, externship, small group work or apprenticeship (working under and alongside the practitioner in a graduated responsibility model).

b) Carry out procedures such as history taking; prakṛti and vikṛti assessment; pulse, tongue and nail diagnosis; as well as other appropriate methods in order to gain assessment fluency. This cannot be accomplished by passive observation but can be attained in a variety of settings including intern, small group work or apprenticeship (working under and alongside the practitioner in a graduated responsibility model). 

c) Carry out the clinical application of Ayurveda as per category designation. *Refer to the Scope of Practice for the Ayurvedic Profession, Ayurvedic Health Counselor: Educational Outline for Competency, Ayurvedic Practitioner: Educational Outline for Competency and Ayurvedic Doctor: Educational Outline for Competency documents for specific details.

Three Settings for Patient Encounters

1) Observation: Observing the teacher/clinician working with a client in a classroom setting.

2) Student/client encounter with direct supervision of a teacher. This includes working one-on-one or in small groups of two or three.

3) Student/client one-on-one, in a more intimate setting with the student doing complete intake, recommendations, and follow-up; to be supervised directly or via externship.

Patient Encounter Requirements by Category

Ayurvedic Health Counselor

Requires a minimum of 50 patient encounters with at least 25 in the first two settings as indicated above and 25 one-on-one*.

Ayurvedic Practitioner

Requires a minimum of 100 patient encounters over and above the 50 of the AHC category. Twenty-five observation, 25 under direct supervision onsite and 50 completely one-on-one* with direct or indirect supervision.

Ayurvedic Doctor

Requires 250 client encounters that will include the 100 client encounters from the AP category with the additional 150 as mainly one-on-one sessions reviewed by senior faculty or senior Doctor of Ayurveda.

*One-on-one typically means one client, per one student/intern. However, some schools have found that students learn better when working with a client in groups of two or three students, all of whom are fully engaged in all aspects of diagnosis and chikitsa. This is an acceptable substitution for one-on-one encounters, provided students also gain experience working with patients one-on-one before graduating.

Definition of Supervised/Supervision

Each and every patient encounter a student has is supervised by one or more of the methods outlined below. Schools offer a variety of valid methods of supervision, including but not limited to:

a) Supervisor present during consultation

b) Onsite supervisor checks students’ work after student has seen patient

c) Live Internet supervision via a HIPPA-compliant telemedicine platform, e.g. VSee (

d) Roundtable discussions

e) Use of approved local mentors

“Six months of supervised clinical practice” should read “Equivalent to six months of supervised clinical practice.” While some school formats would deliver this in a six-month block, others might be interspersing it throughout the training. A student might see only a few patients in six months. Hence, the number of clinical patient encounters is of more importance than the time taken to accrue them.

Recording Patient Encounters

For schools with onsite clinics, students can fill out a form or worksheet that is signed by the clinic for verification. For schools where the students are being mentored from a distance, an online recording system could be used. Some schools may choose to retain the patient encounter forms, while others might record the patient encounters on spreadsheets and return them to the students for their portfolio.

When the student applies for NAMA professional membership, the school informs NAMA that they have completed the required patient encounters, just as the school informs NAMA that they have completed the other educational requirements.

Recommended Roll-out of Increased Patient Encounter Criteria by 2016

Ayurvedic Health Counselor 50 PE

Ayurvedic Practitioner 100 PE