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Natural Medicine is the Best Medicine: May 2011

Thursday, May 19, 2011

"So you're going to be, like, almost a doctor, aren't you?"

I talk about Bastyr and naturopathic medicine a lot.  By now all of my friends and most of my family's friends are well-versed in naturopathic medicine, our role as primary care providers, and my educational level.  I was having one of these conversations with a family-friend (my parent's generation) who finally asked me "so, you're going to be, like, almost a doctor, aren't you?" Ouch.

After nearly four years of medical school, dozens of 12-hour days, hundreds of patients seen, and more information than I can possibly fit in my brain, I certainly hope I will become a doctor.  This brings up a common misconception: that naturopaths are quacks who get online degrees and don't know what they are talking about.

So what is our educational training? 

Naturopathic physicians attend four-year graduate schools that are nationally accredited by the Council for Naturopathic Medical Education (CNME).  The CNME is recognized by the U.S. Department of Education, which classifies the ND degree as a Doctorate-Professional degree, on par with MD and DO.  Currently 6 schools in the US and Canada are accredited through the CNME to provide naturopathic medical education.

The naturopathic program consists of at least 4 years of study with over 4,100 clock-hours in the classroom or clinic.  A minimum of 1,200 hours are spent in clinical education with direct patient contact under supervision.

The first two years of the ND program are very similar to an allopathic program.  We learn all the basic sciences including anatomy, biochemistry, immunology, microbiology, histology, pathology and physiology.  Here is a breakdown of the curriculum:

University of Washington medical students average over 70 credits per year (72 and 78 credits for the first and second years), which is similar to Bastyr's ND program (74.5 and 77 credits for the first and second years, respectively).

The main difference in education between allopathic and naturopathic physicians in the the area of specialization.  By definition naturopathic physicians are specialists in natural treatment of primary care conditions.  From the beginning of our education we focus on primary care - diseases and conditions that a practitioner would encounter in an outpatient clinic.  We touch upon emergency medicine, surgery and high-force pharmaceuticals (like chemotherapeutic drugs) in the context of referrals and co-management.  However, unlike allopathic students we do not go through rotations in these areas.  While MD students do rotations in specialty fields in their 3rd and 4th years (like Oncology, Obstetrics, Surgery, etc), ND students do clinical work in naturopathic primary care only*.   We see people in an out-patient setting, directly managing the care of "our" patients under the supervision of a licensed naturopathic physician.

Also, naturopathic medical education differs in that we have a broad scope of practice with multiple modalities that we can offer our patients as treatment.  Throughout our education we have multiple courses in pharmacology, botanical medicines, homeopathy, counseling, nutrition, and naturopathic manipulation. In the state of Washington naturopathic physicians can prescribe most medications, perform minor surgery, offer counseling services (just like a licensed mental health counselor), offer nutritional advice (like a dietician), and perform osseous manipulations of the spine and extremities (like a chiropractic physician).

Naturopathic medical students also take board exams comparable to the USMLE boards taken by allopathic students.  These tests are called the NPLEX exams - naturopathic physician licensing examinations, and are governed by NABNE.  Only students from accredited schools of naturopathic medicine are eligible to sit for these exams.  Students must complete two sets of examinations, one after the first two years of the ND program (the basic science boards), and one after graduation (the clinical science boards).  Just for a comparison, our basic science boards are similar to USMLE Step 1 exam, and the clinical science boards are similar to the Step 3 exam.  The USMLE Step 2 exam, which evaluates physical exam and clinical skills, is similar to our Clinical Entry exam, which is governed by the school (Bastyr) itself - we must do a complete intake, physical exam, and differential diagnosis on a standardized patient (actor), graded by a member of the clinical faculty.  We must pass this exam (after our 2nd year) in order to see patients in the clinical setting. 

Only after completing all 4,100 hours, passing both sets of board exams, and getting a diploma is a naturopathic student eligible for licensure.  This is in contrast to some so-called "naturopaths" who receive online or distance-learning degrees. In all 17 states that license naturopaths, only those who graduated from an accredited 4-year school can call themselves naturopathic physicians or doctors.

So to clarify, YES, I am going to be a doctor! A naturopathic doctor, that is. 

Source: "Basic Science Curriculum." UW Medicine.  University of Washington, 2011. Web. 19 May 2011
Source: "Program Tracks and Curricula for Doctor of Naturopathic Medicine." Bastyr University.
Bastyr University, 2011. Web. 19 May 2011. 
Association of Accredited Naturopathic Medical Colleges. AANMC, 2011. Web. 19 May 2011.

(*with a few exceptions - we can do adjunctive care for cancer patients, but not primary treatment). 

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Monday, May 2, 2011

Lobbying in DC!

This morning I am in Washington DC preparing to speak with my senators and representative about naturopathic medicine.

Every year the American Association of Naturopathic Physicians, the AANP (, hosts an event called the DC FLI, where hundreds of naturopathic medical students and naturopathic physicians travel to DC to support federal legislation for ND's.

Naturopathic physicians are primary care and preventive medicine specialists. ND's are fully trained primary care providers, completing 4-years of medical school and over 1,200 hours in direct clinical patient contact.   In fact, the U.S. Department of Education considers the ND degree as a First Professional Degree, on par with MD and DO.  Naturopathic students, including myself, receive federal funds for student loans, yet somehow do not qualify for federal loan repayment programs.  We also are excluded from the Public Health Service Act, and are not eligible for residencies paid by the federal government (the majority of residencies that MD and DO graduates participate in).

With the enormous healthcare disparity in this country, naturopathic physicians (including myself in just 13 months) are willing and qualified providers of primary care.  Considering the fact that less than 4% of medical students plan on pursuing primary care, it is essential that naturopathic physicians be utilized to fill the gap.

In the state of Montana, where I plan on practicing, 40 out of 56 counties have a Health Professional Shortage Area (HPSA) designation, meaning there are not enough primary care providers to fill the need for the county.  Additionally, 12 of the counties in Montana are absent of a single primary care provider.  I am an eager and willing future physician who could fill a very real need in the state of Montana.

Please consider contacting your members of Congress to support me, my profession, and a solution to the current healthcare crisis.  Patients have a right to have access to healthcare.

Follow this link to send an e-mail to your members of Congress, it is incredibly easy and takes less than two minutes (come on, you know you have 120 seconds to spare).

In Health,

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