Yogya in shalya tantra: revisiting an ancient simulation-based paradigm of surgical skill acquisition and its relevance to contemporary surgical education

Background: Surgical competence in Ayurveda has traditionally been understood as the integration of theoretical erudition (Shastra Jnana) with practical dexterity (Kriya Kaushalya). Acharya Sushruta, regarded as the father of surgery, insisted that no practitioner should attempt an operative procedure on a living patient without prior training on substitute models. This preparatory training methodology, described in the Sushruta Samhita under the term Yogya, constitutes one of the earliest documented frameworks of simulation-based surgical education in world medical history. Objective: To critically review the classical concept of Yogya as described in Shalya Tantra and to correlate its principles, materials, and pedagogical structure with modern simulation-based surgical training methodologies. Materials and Methods: A narrative literary review was conducted using classical Ayurvedic texts, commentaries, and contemporary peer-reviewed literature on simulation-based medical education. Thematic comparison was performed between Yogya practice models and modern simulation modalities such as mannequins, virtual-reality simulators, and cadaveric training. Results: The classical description of Yogya identifies specific organic and inorganic substitute materials — such as pumpkins, bottle gourds, leather bags, lotus stems, and worm-eaten wood — each selected for its biomechanical resemblance to particular human tissues, enabling trainees to rehearse core operative actions (Shastrakarma) including Chedana, Bhedana, Lekhana, Vedhana, Eshana, and Aharana before clinical application. Conclusion: The pedagogical logic underlying Yogya - graded, repetitive, low-risk skill rehearsal prior to patient contact - anticipates, by more than two millennia, the core rationale of present-day simulation-based surgical curricula. Structured revival of Yogya-based training, integrated with modern simulation technology, offers a cost-effective and culturally rooted supplement to surgical pedagogy, particularly in resource-constrained settings.