Finally! Indian Health Services includes ND's in Loan Repayment Program

Way back in May I wrote a blog post about my experience lobbying for naturopathic medicine in Washington DC.  Every year a group of naturopathic physicians and naturopathic medical students gather in Washington DC to talk to their state representatives about naturopathic medicine, primary care, and our role in the national health crisis.  The last nine years our list of "asks" to our representatives has included a request to ammend the Indian Health Services Loan Repayment Program to include naturopathic physicians as eligible providers.

Finally, finally, our request has been granted - naturopathic physicians are now listed as one of the "priority health professions," paving the way for inclusion in many loan-repayment programs.  Awesome news for our profession and for patients who want access to naturopathic physicians!

For the full press release from the American Association of Naturopathic Physicians (AANP), read here.  You can also read the full announcement from the Department of Health and Human services here.  If you're confused as to why this is important, I highly recommend reading my blog post from May (hyperlinked at the top of this post). 

Congratulations ND's!

"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. 

References:
Source: "Basic Science Curriculum." UW Medicine.  University of Washington, 2011. Web. http://uwmedicine.washington.edu/Education/MD-Program/Current-Students/Curriculum/Basic-Sciences-Curriculum/Pages/default.aspx. 19 May 2011
Source: "Program Tracks and Curricula for Doctor of Naturopathic Medicine." Bastyr University.
Bastyr University, 2011. Web.  http://www.bastyr.edu/education/naturopath/degree/curricula.asp. 19 May 2011. 
Association of Accredited Naturopathic Medical Colleges. AANMC, 2011. Web. http://www.aanmc.org/. 19 May 2011.


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

My story...

I have had several requests to speak a little about myself and how I came to Bastyr and the ND program.  I would love to share with you my journey to naturopathic medicine...

I was born and raised in a Swedish-American family in the Pacific Northwest.  My relationship with nature grew at an early age, and thanks to the encouragement of my parents much of my childhood took place outdoors.  I spent my summers picking blueberries and wild strawberries in Sweden, swimming and playing in Lake Washington and hiking to alpine lakes in the Cascade mountain range.  Winters were dominated by my love of snow, with plenty of adventures by skiing, snowshoeing and sledding.  These activities laid the foundation for my appreciation of nature, and eventually led to my decision to become a naturopathic physician.

As a right-brained child, I gravitated to various art and music classes.  At age 6 I joined an internationally touring children’s choir, and at age 8 I began learning classical piano.  I took drawing, painting and ceramics classes throughout my youth to feed my desire for creativity. 
Music and art became my therapy during adolescence, a healing power that I still value.

As a teenager I retained my love of the arts but also discovered the pleasure of solving puzzles, especially in math and science.  I followed both of these passions throughout my undergraduate education at Gonzaga University where I finished my bachelor’s degree with a double major in visual arts and biology.  Originally I planned to become a medical illustrator but soon realized that a career in an isolated cadaver lab was not for me. I realized that I love people and that I thrive in an environment where I can develop relationships with others.  Because my biology degree closely mirrored the premedical curriculum, I started thinking about attending medical school to pursue a field where I could help and heal others.  Taking some time off of school, I moved to Nashville after graduation to participate in an AmeriCorps program in a low-income health clinic.

In 2005 my family and I had our lives dramatically changed when my father had a major stroke.  After weeks of hospitalization and months of physical therapy, his insurance stopped paying for rehabilitation.  At this point my parents turned to several alternative therapies, including acupuncture, warm-water physical therapy and Feldenkrais.  On one weekend home I had the opportunity to take my father to his acupuncture appointment with Dr. Yuanming Lu, who also happened to be a professor at Bastyr University.  My parents, wanting me to move back home to Seattle, encouraged me to check out the naturopathic medicine program at Bastyr.  In 2006 I visited Bastyr and immediately fell in love with the campus, the community, and the philosophy of naturopathic medicine.  My eyes were opened to a completely new type of medicine - a natural, holistic and truly patient-centered model of practice. 

At the same time it was becoming apparent that I had my own health issues that were getting progressively worse.  After multiple rounds of imaging and medication trials to find the cause of my stomach pain, I was finally diagnosed with Irritable Bowel Syndrome and was told by my medical doctor that there was nothing more I could do.  Being a motivated patient, I searched for answers on my own, and learned of the link between food sensitivities and IBS.  After my doctor refused to do the testing, I called the Bastyr Center for Natural Health, and the year before I began the ND program I had my first experience as a naturopathic patient.  I learned that I had multiple food sensitivities, including gluten, soy and dairy.  Eliminating these foods from my diet, in addition to other naturopathic therapies, changed my health and changed my life.  I am happy to report that I am now 99% symptom-free, and my health continues to improve year after year. 

In 2007 I began my education at Bastyr University in their Doctor of Naturopathic Medicine program. The journey continues to amaze me, and every day that I am in school I fall more deeply in love with this incredible medicine.  I am excited to become a Physician, a Counselor and a Healer, and I am honored to be a part of the lives of patients as they are transformed.