A mixed methods study to explore employment status, financial wellbeing and career progression among Ayurveda graduates in Kerala, India

In 2019, Ayurveda doctors with a Bachelor of Ayurveda Medicine and Surgery (BAMS) account for 16% of doctors in India. However, limited literature has investigated the employment status, financial wellbeing and career progression among BAMS graduates. A sequential explanatory mixed-methods study was conducted through a survey of a random sample of 370 BAMS graduates registered during 2016 to 2019, followed by in-depth interviews of 15 purposively sampled respondents. Information on socio-demographics, employment status and financial wellbeing was collected and analysed in the survey. Qualitative interviews explored career progression. Binary logistic regression analysis was done to identify factors associated with employment status and financial wellbeing. Thematic analysis was employed to analyse in-depth interviews. Around 43% (n = 160) of graduates were employed, and 31.9% (n = 118) had satisfactory financial wellbeing. Type of college (adjusted odds ratio [AOR]: 4.30; confidence interval [CI]: 2.17–8.50), employment status (AOR: 3.00; CI: 1.75–5.16) and satisfaction with the BAMS programme (AOR: 4.11; CI: 2.35–7.19) were significantly associated with financial wellbeing. Thematic analysis yielded 191 codes and 18 subthemes, which further yielded seven themes reflecting dimensions influencing the career progression of BAMS graduates. The themes include (i) individual goals and aspirations, (ii) support from family and workplace, (iii) migration opportunities and job security, (iv) low salaries and limited opportunities, (v) lack of respect and recognition, (vi) opportunities in an alternate career, and (vii) gender roles. The BAMS graduates face significant challenges with respect to employment and financial wellbeing. Our findings highlight the need for interventions that strengthen employment opportunities, improve professional recognition, and support career development to enhance the financial wellbeing of Ayurveda graduates.