The development of first professional doctorate degrees in Chinese medicine
I must confess that the issue of accreditation of programs, levels of education within the acupuncture and Chinese herbal medicine profession(s) and all related issues sometimes evade my understanding. While the degree that I will get at the end of my training is a Masters of Science in Oriental Medicine, I will obtain a certification that will give me the title of Licensed Acupuncturists (LAc). At this point, further education is possible in accredited DAOM (Doctorate in Acupuncture and Oriental Medicine) but it brings with it no further licensure benefits. At this point, all Doctorate programs require the student to have their Masters degree and have some amount of clinical experience before they are considered for entry. The standards vary as to how much clinical experience is required. The Doctorate is clinically based and generally requires some amount of clinical research to be done.
NCNM, the school I attend in Portland, OR, has been working to create a first professional doctoral degree that focuses on Classical Chinese Medicine. I’m unclear as to whether other schools are seeking something similar. It’s been a long road, one that was started down long before I came to the school. Students, faculty, staff and community practitioners have been involved in the creation and refinement of the program. Most of the students currently in the MSOM program had high hopes that ACAOM (the Chinese medicine accreditation organization) would create a set of standards for first professional doctorates in time for us to complete our “first professional doctorates.” To that end, we have been taking the extra coursework necessary for our proposed Doctorate program. Some of us have been quite active in the process, attending committee meetings and submitting comments to the ACAOM in support of a certain set of standards.
On February 8, ACAOM released their recommendation - which is essentially that they feel they can make no recommendation because of lack of consensus in the community. If you would like to read the official document, read it at ACAOM’s website. I’m unclear what, exactly, this means for our program at NCNM. Almost certainly those of us in our third or fourth year that were hoping to graduate on time with our Doctorate will not be able to do so. That’s not my biggest concern - I’m simply interested in understanding what the essential disagreement is in the community.
So, I would like to hear from my readers. What is your stance on First Professional Doctorates? What do you feel needs to be in place before a program like that goes through? Do you have other thoughts about how education and licensing works in the Chinese medicine profession in the United States? Let us know in the comments.
Eric
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Tags: acaom, Acupuncture, chinese-herb, classical-chinese-medicine, doctorate program, education, licensed acupuncturists, licensing, ncnm, organization, professional doctorates, studentsRelated posts
Increasing safety of Chinese medicine without killing its soul
Every morning I read through the Chinese medicine news available on the Internet. It always makes me happy to be blogging about what I blog about. Today I ran across this article for a second time discussing the continuing efforts of Chinese researchers to modernize TCM.
The main point in the article, along with most articles like it, is that TCM must modernize in order to be viable in the 21st century. Surely not the first time in Chinese medicine’s history that this argument has been made. Modernization is supposed to progress on two fronts. First, modernization means safety through tighter regulation of herbal products and tougher licensing standards for practitioners. Second, modernization means adopting rigorous materialist worldview based testing of treatments with the eventual goal of reshaping the medicine as a whole to come into line with that materialist worldview.
Regarding modernizing for safety: I can respect this, as I’ve discussed already. If this means that practitioners and patients will be less likely to get herbs tainted with pesticides, herbicides and heavy metals - I’m all for it. Of course, companies have already risen up to take care of this problem and they are growing in popularity every day. Scrupulous practitioners will seek out clean sources for their herbs. This may be a case where the market is going to be a better regulator than any governmental body could be.
With regards to licensing standards - they should definitely exist. Everyone seeking to practice as a Chinese medicine physician should be expected to have a certain amount of theoretical and clinical education as well as basic training in rescue medicine and doctor-patient relationships. That being said, the exact composition of that educational mix should be left to a governing body composed of experienced Chinese medicine docs! The method currently used in Oregon and many other US states seems to work fine - in our program at NCNM we learn basic Western medicine principles so we can effectively communicate with other physicians, we learn rescue medicine, we learn doctor-patient relationship, we learn TCM and then we learn the real medicine - Classical Chinese Medicine. Our program is fully accredited and we will be eligible for licensure upon graduation. It seems to work out ok.
The latter part of modernization is what I’m not so sure about. Chinese medicine is not based on a materialist worldview. It is not based on either/or logic, for the most part. Chinese medicine seeks to honor the complexity of the human being, the humans’ environment, the herbs. Rather, Chinese medicine RECOGNIZES the complexity of the human being, environment and herbs and does not shy away from it. It’s true that a treatment that works in one individual will not necessarily work the same way in another, and for Western medicine this is a serious problem. One major goal in that system is replicability. It seems for that system if you’re not capable of exactly replicating something, you must be misunderstanding something. For instance, the effect could be due to “placebo effect” or you could just be failing to understand some component of the system and thus not setting up the experiment properly. Thus, by this theory, if you do more research you will understand it better and, thus, be able to replicate the effect you are seeking.
This philosophy has become so ubiquitous that most people don’t even seek to challenge it in any substantive way.
But this way of seeing things is not the basis for Chinese medicine. It doesn’t mean that the ancient Chinese thought that things could never be replicated. The four gates treatment of acupuncture, for instance, has a similar and powerful effect on nearly everyone it is used on. Ma Huang will make almost everyone sweat when in the right formula at the right time. A red tongue almost always indicates heat in the body. These principles are just as fixed, just as replicable as any in Western medicine. But that’s not the basis of the medicine. The basis of the medicine is interaction, is interplay, is changeability, is a great balancing act. That’s why it needs skilled, deeply educated practitioners that aren’t busy trying to isolate compounds from Yang tonifying herbs to act as a competitor for Viagra. It needs practitioners who spend their time reading the classics, refining their diagnostic and treatment techniques, dwelling on the qualities of nature and working on their own self-cultivation.
Changing the way herbs are processed, making sure that doctors are trained, holding ourselves to high standards of cleanliness and propriety - all of these things are boons of modernization and I welcome them with open arms. But we simply must not allow the incessant drumbeat of scientific materialism to tell us how our medicine must dance. We can exist side by side, treating what we treat best. A world in which Classical Chinese Medicine and Western medicine both seek to serve patients and not ideological or political masters would be a beautiful world indeed.
Eric Grey
Tags: Acupuncture, Blogging, chinese-medicine, licensing, medical-safety, safety, traditional-chinese-medicineRelated posts
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