I’m not even sure that the Association of Accredited Naturopathic Medical Colleges (AANMC) actually thinks that they need to have residencies or make major curriculum changes. One of the sources that was
actually cited by the
AMSA ND Advisory Board FAQs page was a page about
“Comparing the ND & MD Curricula” on the AANMC site; the AANMC’s understanding of the basic structure of the MD curriculum seems flawed. One of the AANMC’s main arguments is that ND students don’t need to complete residencies because during their 3rd and 4th year, they have “increasing opportunities for hands-on clinical training and practice, often at their schools’ teaching clinics and offsite clinics,” but that MD students do need to complete a residency because MD students
only observe clinical activities during all four years of med school. 3rd and 4th year in Allopathic programs definitely involve more than just passive observation (links for the ND student:
Part 1 &
Part 2); additionally, the students at my school start learning basic clinical skills during 1st and 2nd year when they are also free to start volunteering in community clinics. Either way, a residency should be required to practice.
Also note that the AANMC made it look like ND programs had far more clinical experience than MD programs in the
bar graph by combining Clinical Training with Modality Training; the category of Modality Training includes the courses that cannot be compared to allopathic clinical training like homeopathy, botanical medicine, etc. Plus, contrary to what the AANMC was attempting to prove with numbers, if the total number of credit hours for the first two years of each program are nearly the same (150 vs. 151.5), then that doesn’t support the idea that the two programs are equivalent in terms of medical education/biomedical sciences. If ND programs also devote a significant number of their credits (N credits) to courses like botanical medicine and homeopathy, then ND students would have to take N+150 credits not 150 total credits in order to have a medical education that was equivalent to the MDs in terms of credit hours. It's an extraordinarily dumb argument. Anyhow, I posted most of the main excerpts below, but it’s probably worth it to read the
page in its entirety.
"The first two years: a string science background"
“[...] During the first two years, ND students’ credit loads are almost identical to those of MD students. In nearly every biomedical science, ND students are required to complete as many credits as, if not more than, MD students. Specifics vary by school, but a 2010 course comparison of the University of Washington’s (UW) MD program and Bastyr University’s ND program shows that during the first two years, UW MD students complete a total of 150 credits and Bastyr ND students complete 151.5 credits, most of them in comparable biomedical and diagnostic science courses. […] While many conventional medical schools use a systems-based approach to medical education, most naturopathic medical programs currently do not. In a systems-based approach, anatomy, physiology, pathology and diagnostic skills are each taught individually for each body system (i.e., respiratory, digestive, nervous system, etc.). And although some ND schools may be moving toward a more systems-based approach to education, classes in a typical ND program are not divided by system, but rather focus on how a symptom in one part of the body may affect the patient’s entire anatomy and well-being. Some ND school curricula also begin clinical training during the first and second years, just as some MD school curricula initiate observational shifts at that time.”
"Third and fourth years: hands-on experience via clinical training"
"After the first two years, both ND and MD curricula focus on applying medical knowledge to real-life situations; simultaneous classroom studies support this training. Both curricula strive to maximize the synchronization of classroom and clinical training during these key years, thereby improving the quality and practicality of the students’ educations. However, it is during these later years that MDs’ educations begin to differ noticeably from those of NDs. MDs complete clerkships, which are courses in various medical specialties, and although MD students see plenty of patients during these clerkships, their roles are primarily observational: they are not primarily responsible for patient care. Third- and fourth-year ND students have increasing opportunities for hands-on clinical training and practice, often at their schools’ teaching clinics and off-site clinics, which offer diverse patient populations. This period of clinical training goes well beyond the observation and is absolutely essential to NDs’ educations – so much so that clinical training is now being introduced during the first and second years of education at several AANMC-member schools. As a result, naturopathic medical students graduate prepared to begin practice and to diagnose and treat patients, whereas MD students are required to complete residencies after graduation in order to gain clinical experience."
"Post-graduation: residencies and shadowing"
"Examining third- and fourth-year clinical training brings up another major difference: medical residencies. MD residencies are mandated and regulated by conventional medical schools. As a result, an abundance of such opportunities exist at a wide variety of medical facilities all across North America. Every graduate of conventional med school must expect to complete a post-graduation residency. Naturopathic residency opportunities, on the other hand, are not nearly as common because unlike conventional medical residencies, they are not yet required or funded by the federal government. Only 5 to 10 percent of new NDs participate in formally approved residency positions, all of which are associated with colleges approved as residency sponsors by the Council on Naturopathic Medical Education (CNME). There are some naturopathic residency opportunities available, and the naturopathic medical community is working to create more all the time, but such programs are not required (except in Utah). In place of a residency, many new NDs choose to practice with or shadow an experienced ND before setting up their own practices. […]
Primary care physicians. When examining a naturopathic medical curriculum, especially in comparison with that of a conventional medical school, remember this important differentiating factor: all future NDs are in training to become primary care physicians. In other words, a naturopathic medicine program is by definition a specialization in primary care – a field of medicine in extreme shortage in the US today. The majority of conventional med school students opt for careers in particular specialties and receive further training in specific areas, such as emergency medicine, major surgery or oncology. While ND curricula do cover such specialty subjects, they are not studied in depth. ND students learn to recognize the symptoms of diseases that may fall outside of their scope of practice (such as cancer) so that they can refer patients to specialists as appropriate. This is not to say that some NDs don’t go on to expand their educations and develop specialty areas post-graduation. But the focus in naturopathic med school is on learning to treat those diseases that fall within the realm of general practice."
