RESOURCES FOR THE STUDY OF CHINESE MEDICINE

SCHOOLS OF ACUPUNCTURE AND ORIENTAL MEDICINE-August 2002

Schools of Chinese medicine first appeared in the U.S. during the 1970s. It was not until the 1980s that a major expansion of this field took place, stimulated by new legislative bills licensing acupuncture as a health profession in numerous states and the opening of China, allowing visits to study Chinese medicine. There are now approximately 900 students graduating from professional Oriental medical schools each year, with licensing for qualified practitioners now available in 36 states and in the District of Columbia (see Table 1). Currently, over 14,000 acupuncture licenses are registered by those states (see Table 2), of which about 12,000 represent active practices.

Nearly all of the 70 school campuses in the U.S. and Canada have from 4 to 18 years of experience (maximum 26 years). The quality of the programs and teaching staff for the schools has varied over the past several years of development; therefore, it is worthwhile to speak with current faculty and students in order to make an evaluation of their suitability for your needs. General recommendations as to which are the "best schools" are difficult to make due to the ever-changing nature of the schools.

Duration of study in preparation for licensing examinations is typically three to four years-an increase from the original one or two-year programs. Contact the schools for catalogues and other information or contact the Council of Colleges of Acupuncture and Oriental Medicine (301-608-9175) for a pack of brochures and catalogues of accredited schools. Take particular note of clinical facilities available, how long they have been in operation, and range of subjects in the curriculum (including Western medical aspects of diagnosis and treatment, which is increasingly important in an era of integrated medicine). For those already licensed in another field of health care, some of the schools and institutes can provide short (non-accredited) courses that allow incorporation of specific techniques into the practice conducted under the original license.

It is advisable to apply early (i.e., winter for admission next fall) to gain admittance to acupuncture schools, as several of them must turn away potential students due to class size limitations. Most of the schools have 20 to 60 students in each year of the program. Accredited schools require two to four years of undergraduate college experience, including specific science courses. The tuition cost for full time students typically ranges from $3,500 to $10,000 per year (there are usually additional costs, such as texts and attendance at special seminars); evidence of financial capability for paying tuition must be shown to enroll. Federally-backed, low-interest student loans are available to attend accredited colleges. There are no foundations offering grants to attend acupuncture colleges.

The schools provide the education necessary for students to pass the licensing or certification examination appropriate for the state where the school is located. An examination administered by the National Commission for the Certification of Acupuncturists (NCCA) has been adopted by most states and now serves as a standard for students even in states that have their own exam (e.g., California), since practitioners are likely to encounter NCCA requirements if they decide to move to another state. The still controversial O.M.D. (Oriental Medical Doctor) designation can be obtained after graduation, usually through a short supplemental study program (the controversy is related to the lack of standards for granting the designation).

NCCA has also incorporated herbal medicine as part of its realm of testing-defining minimum standards for qualification to include recommending herbs as part of the scope of practice. The state of California has included herbs in its scope of acupuncture practice since 1979 and currently devotes about one-third of the state certification exam to questions about herbal medicine. For the study of Chinese herbal medicine, West coast and Southwest schools and institutes have the longest track record for teaching this subject and are situated in an environment that is more conducive to its study because practitioners in the community usually prescribe Chinese herbs in a supportive setting. Students frequently find that community resources (e.g., local practitioners, Chinese herb shops, or organizations involved with Chinese medicine) provide valuable additions to the school program they are enrolled in. Thus, for study of acupuncture or herbs, the nature of the surrounding community can be taken into account in selecting a school; community resources may compensate for deficiencies in classroom opportunities.

Schools in the U.S. and Canada receive accreditation from the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine. There are several schools that are candidates for accreditation; generally, these are newer schools. Some of these schools may become accredited soon; contact the National Accreditation Commission for details: 301-608-9680; fax: 301-608-9576. It is easier to transfer credits between accredited colleges than from a non-accredited to an accredited college.

Schools that are neither accredited nor currently candidates for accreditation are usually those which only recently developed a full program of studies that meets the minimum requirements necessary for its students to apply for licensing. Lack of accreditation or candidacy does not suggest that the school is inferior to others, but may suggest that it has less experience in graduating fully-trained students. However, schools with poor quality programs may be unable to successfully become candidates for accreditation.

Acupuncture Styles

There are two major trends in acupuncture styles taught at American colleges. The primary style is called "TCM" (traditional Chinese medicine), which is actually a standardized system that was developed over the past fifty years in China, based on the ancient system. To varying extents, some colleges may offer alternative perspectives on TCM based on older interpretations of Chinese medicine or the particular experience of the lead professors. The other approach is the "Worsley" or "Five Element" style, which places its emphasis on certain teachings of the ancient text Huang Di Nei Jing. This text referred almost exclusively to acupuncture; TCM is more heavily dependent on herb therapies and attempts to integrate acupuncture and herbs within a single theoretical system, relying heavily on modern developments. There are other styles as well: the one taught usually reflects the background of the school's founder.

What is a Career in Acupuncture Like?

According to a survey conducted by ITM, the typical acupuncturist sees about 35 patients per week (seeing patients for 3-4 days), charges an average of $50-60 per office visit (more for the initial visit), and maintains a pharmacy of herbs and other supplements that are prescribed and sold to the clients. Typical annual income (after paying business expenses), is about $50,000 (range is $20,000-80,000). It is becoming common practice for acupuncturists to share an office with other health professionals (chiropractors, massage therapists, medical doctors, naturopathic physicians), which makes it much easier to get cross-referrals, to take vacations or sick days without interrupting patient access to services, and to bill the services to insurance (with shared expenses for secretaries to handle the paperwork and phone calls). Licensing may eventually be extended to all states. The total number of actively practicing licensed or certified acupuncturists in the U.S. is growing at the rate of about 750 per year, with most new graduates prescribing herbs as part of their work. Attendance at the continuing education conferences held each year, subscriptions to journals, and membership in both state and national acupuncture organizations helps maintain contact with colleagues nationwide. Public health programs, utilizing acupuncture and herbs, such as drug detox and HIV treatment, are increasingly available and are sometimes funded by government or private grants.

TABLE 1: States that License or Register Acupuncturists

* Either a ruling by the Board of Medical Examiners, medical supervision, or referral from a medical doctor is required in these states that do not have formal licensing.

For complete information about requirements, scope of practice, and restrictions, contact the Board of Medical Quality Assurance in the state capitol for the state of interest.

TABLE 2: Acupuncture Licenses Per State

About 80% of the licenses belong to practitioners who are offering professional services to the public at least 2 days per week; the remaining 20% are held by practitioners who have retained a license despite limited or no public offering of services. Only the 20 states with over 100 acupuncture licenses each are listed in this table (data from Acupuncture Today, April 2002). In a survey conducted by ITM, most practitioners report that they have far fewer patients visiting them than they would ideally serve. This suggests that the profession is saturated with practitioners, relative to demand for services, at least in those states, as listed below, where the number of practitioners is already high. Colleges of Oriental Medicine encourage their graduates to move to areas not already served by an adequate number of practitioners.

LINKS TO SCHOOL LISTINGS

In the past ITM maintained a state-by-state listing of accredited acupuncture schools and institutes, as well as those awaiting accreditation. The continued proliferation of schools makes it difficult for ITM to maintain and provide the most up-to-date information on a regular basis.

Therefore, ITM will no longer be maintaining the listing of schools and institutes. In its place, we offer the following links, as they contain the most current information:

The Council of Colleges of Acupuncture and Oriental Medicine.

http://www.ccaom.org/Members3.asp

CCAOM provides a listing of their members with complete contact information.

www.naturalhealers.com

Natural Healers provides an excellent listings of schools with contact information and background information for each one.