Viewpoints: Advice on Choosing an Acupuncture School

• A Comparison of Acupuncture Schools in North America
• Acupuncture Viewpoint: Message from the Front Lines
• How To Choose an Acupuncture and Chinese Medicine Program
• Q&A Letter About Choosing a School of Chinese Medicine

Comparison of Acupuncture Schools in North America
By Lauren Stomel

For thousands of years, there were no schools of Chinese Medicine as we know them today. To understand the development of Acupuncture and Chinese Medicine as it is taught today in the west requires a brief look at Chinese history.

Well over 2000 years ago, Chinese Medicine existed within the body of knowledge known as the Taoist Healing Arts. As healers, the ancient Taoists did not make a distinction between science and spirit. They saw the human body as a combination of physical matter, spirit, and Qi (which can be roughly translated as vital energy). By focusing on balancing one’s Qi, one can develop the ability to synchronize oneself with the balanced Qi of nature, which serves to restore and preserve one’s health. The oldest book known to describe Chinese medicine in detail is the Yellow Emperors’s Classic of Medicine, which dates back to at least 200 years BCE. Acupuncture is first described here as a practice that restores the normal flow of Qi through the channels (meridians) by stimulating acupuncture points.

As the Taoist Healing Arts were refined over thousands of years, the secrets were passed down orally and through hands on experience within a student-master relationship. Medical universities, as such, did not exist. In some cases there were families of master healers who amassed a great body of special healing techniques and integral practices. Generation upon generation were taught and, in turn, contributed to the wealth of healing knowledge. By the 20th century, there were several outstanding lineage-based styles of Chinese Medicine whose depth of knowledge and styles of treatment went far beyond what is taught today as Traditional Chinese Medicine.

The Great Divide:
Chinese Medicine undertook a drastic change in the 1950’s. In an effort to standardize a national medicine of the Marxist state, The People’s Republic of China stripped the ancient teachings and practices of its spiritual dimension, which was deemed “superstitious”. In turn, the government created a single form of teaching that more closely emulated the western biomedical model and censored much of the knowledge gained over thousands of years within the lineage-based styles of Chinese Medicine.

The resulting form of Traditional Chinese Medicine is taught today in Universities throughout China. This is also the model taught in most acupuncture schools in North America. Although it is based on traditional models of Chinese Medicine, it is only a small portion of the wealth of technique developed by healing masters and handed down during the past 2,000 years

Types of Acupuncture Schools
Today, there are roughly 3 styles of accredited acupuncture schools in North America:

• TCM schools that follow the standardized curriculum of state run universities developed in Maoist era China. The curriculum is vital, but homogenized to produce western style practitioners.
• Complementary and Alternative Medicine schools that teach an abbreviated form of acupuncture for those who use it as an adjunct to their primary practice. Primarily M.D.’s and D.O.’s may practice acupuncture with as little as 300 hours of formal training.
• Lineage-based Schools of Chinese Medicine that teach both the standardized curriculum required for national TCM accreditation plus the ancient teachings and healing techniques that require a spiritual dimension to understand and practice.

About TCM Schools:
While it may seem a harsh judgment, most of the TCM schools represent an Americanized version of Chinese Medicine that bears a growing resemblance to western biomedical training. As Mark Seem (President and CEO, Tri-State College of Acupuncture) notes in the article below, "acupuncture is about to be lost and scattered to the four winds of the health care world." He continues, "The Oriental medicine or TCM style of acupuncture taught at most schools and practiced by most practitioners (especially on the West Coast, where TCM had its biggest influence) is a watered down version of acupuncture in which informed touch plays virtually no role at all."

More to the point, the study of Qi is fundamental to Chinese Medicine. While Qi is not a religious concept, it does have a spiritual dimension—simply defined as the energy of nature that also exists in the human body. Practitioners who have balance and mastery of their own Qi will be better healers, and most TCM schools do not recognize or emphasize this. (For more information, read "What is Qi?" by Dr. Maoshing Ni, Co-founder of Yo San University of Chinese Medicine)

When you evaluate a TCM school, look into the tradition and teachings of the founder and senior instructors, as well as the curriculum. If the founder is a western businessman, the school is less likely to teach healing technique from ancient Chinese masters. If the curriculum does not include some form of Qi cultivation for its students, it will most likely be limited to the western biomedical model of Chinese Medicine which does not recognize the body of teaching developed from ancient times.

About Complementary and Alternative Medicine Schools:
Complementary and Alternative Medicine (CAM) Schools primarily represent an effort to bridge and blend both eastern and western healing arts. In most cases, they do not offer the curriculum that meets the national standards for certification to practice acupuncture, unless you already have an M.D. or D.O. license.

One notable exception exists, however, in Tai Sophia, Institute, Maryland. Tai Sophia Institute is a graduate school for the healing arts offering three graduate programs in Acupuncture, Herbal Medicine and Applied Healing Arts. Under the guidance of Bob Duggan, M.A., M.Ac, the Institute has been recognized as an anchoring academic institute for the nation's emerging wellness system, and sets the standard in the field of CAM study, as well as an excellent acupuncture program.

(For more information on CAM, read "Complementary and Alternative Medical Therapies: Implications for Medical Education" by Miriam S. Wetzel, PhD; Ted J. Kaptchuk, OMD; Aviad Haramati, PhD; and David M. Eisenberg, MD)

About Lineage-based Schools of Chinese Medicine:
While the lineage-based schools encompass all of the modern medicine required for national accreditation and licensing individuals to practice acupuncture, they also include ancient wisdom that is essential for self-development of the healer. Their approach differs from the western biomedical model in that “The essential art of Chinese medicine is the foretelling and prevention of disease rather than the treatment of illness after it has manifested as painful or distressing physical and mental symptoms”. Their teaching is more focused on Qi Cultivation and the subtle laws of energy response. In the ancient tradition, the healer must become the medicine. In addition to learning the appropriate clinical skills, the student must refine their personal energy before one is qualified to practice.

In a study called Tracing the Contours of Daoism in North America published by the University of California Press, Louis Komjathy says, “The connection between Daoism and health in North America finds its culmination in the establishment of Yo San University of Traditional Chinese Medicine (Los Angeles) by Ni Hua-ching and his sons; and Liu Ming’s (then Charles Belyea) involvement in the founding of Five Branches Institute of Traditional Chinese Medicine (Santa Cruz)."

He further identifies all of the lineage based teachers active in North America, including Jeffery Yuen who is currently the academic dean of acupuncture at Swedish Institute of Acupuncture and Oriental Studies (New York). Other teachers are active at schools focusing on the teaching of Taiji quan, Qigong, Daoist meditation,
Daoist philosophy, and traditional Chinese healing methods, however they are not accredited to license acupuncturists.

(For more information on lineage-based schools, read "Tracing the Contours of Daoism in North America" by Louis Komjathy)

Differences in Curriculum:
While the lineage-based schools draw from a greater body of knowledge and tradition than other TCM schools, one can also expect to find a slight difference in curriculum. For example, the student handbook of Yo San University of Traditional Chinese Medicine states, “At Yo San University, Taoism is a guiding philosophy, not a religion.” It further states, “Yo San’s Qi Development curriculum emanates from our belief that practitioners who have balance and mastery of their Qi will be better healers. The study of Qi is not just an academic exercise but is cultivation through daily practice, The program is designed to provide students the opportunity to heal and cultivate themselves and also to directly experience the balance and harmony that underlie Taoism and the medicine that has developed from it.”

Acupuncture Viewpoint: Message from the Front Lines
By Mark D. Seem, PhD, LAc Founder, President and CEO, Tri-State College of Acupuncture

With over two decades of being actively involved full-time as a school head, educator, practitioner and activist in the acupuncture profession in the tri-state region of New York City, I feel as if I have been on the front lines in the development of the American acupuncture and Oriental medicine profession.

As happened for so many of us who were instrumental in making this profession happen in the United States, we grew tired of the political realm and moved back to a more focused life of educating and practicing what we love so much. It is therefore with great sorrow that I look at our profession today from a more pragmatic perspective, and am compelled to sound the alarm: acupuncture is about to be lost and scattered to the four winds of the health care world. Scattered, I hasten to add, because very few in this profession today have the passion for acupuncture, for what acupuncture might do for a health care world in which informed touch is disappearing rapidly, and because the new thrust is for Oriental medicine and the doctorate.

This thrust sees acupuncture as a mere part of Oriental medicine, in which Oriental medicine is a code word for herbal practice. In this perspective, born when traditional Chinese medicine (TCM) hit the U.S., acupuncture is reframed as internal medicine akin to herbs, rather than a hands-on therapy designed as a physical medicine that, through informed touch, can restore integrity not only to the body, but to the body, mind and spirit as a whole.

Acupuncturists that I know, including all of the senior clinical faculty at the Tri-State College of Acupuncture, practice what Bob Flaws once termed “an acupuncturist’s acupuncture”: that is to say, acupuncture from an acupuncture or meridian point of view. The Oriental medicine or TCM style of acupuncture taught at most schools and practiced by most practitioners (especially on the West Coast, where TCM had its biggest influence) is a watered down version of acupuncture in which informed touch plays virtually no role at all. In TCM, practitioners do what everyone else in the health care world does: they administer an intake, analyze the data, arrive at a diagnosis in their own terms (not the patient’s), and treat a formula of acupoints by inserting needles or applying moxa to exact textbook locations, as if those points had therapeutic properties of their own like herbs. The inevitable result is that the TCM style of acupuncture has done to acupuncture what Western medicine has done to itself - removed informed touch from the therapeutic encounter.

In direct contract, hands-on meridian acupuncture styles, including those practiced in Japan, view informed touch as a central guide to treatment. Informed touch is utilized as a means of validating the patient’s experience of suffering while connecting directly with the patient’s living pattern of distress. To those who would counter that such hands-on meridian-based perspectives downplay acupuncture and relegate it to the realm of a mere physical therapy, I would respond that acupuncture practiced from an acupuncture point of view is physical medicine par excellence. No other physical medicine perspective I am familiar with has as comprehensive and systematic a therapeutic approach, nor as comprehensive a therapeutic effect.

In its failure to recognize that acupuncture itself, independent from herbology, has caught the attention of both the public at large and the Western medical world, the Oriental medical profession is in essence allowing acupuncture to be taken out of the hands of the profession. In the last few years, we have witnessed the proliferation of a far inferior “medical acupuncture” (acupuncture practiced by medical doctors with merely 200-300 hours of training) and now, more frequently, a “chiropractic acupuncture,” often practiced with only 100 hours of study.

To me, this signals that the inherent value of acupuncture as a treatment is its own right is in serious jeopardy. Unless our profession reclaims acupuncture for itself, acupuncture may be diminished by our Western counterparts to a mere part of treatment - one more billable modality to hike the overall price of a visit. Unfortunately, the public remains ill-equipped to distinguish between practitioners with abridged versus comprehensive acupuncture educations.

It is my prediction that if the acupuncture and Oriental medicine profession does not begin to develop variable training programs for physicians and chiropractors in excess of the 100-300 hour courses now available, patients will suffer. Oddly, acupuncture schools recently opted to refrain from teaching abbreviated courses to physicians or chiropractors, thereby leaving these professionals with no choice but to find other options - usually enterprising individuals with relatively limited resources. It is my belief that acupuncture schools have a responsibility to the public to actively seek out and attract serious-minded physicians and chiropractors by developing training programs that satisfy our profession’s standards.

The question I raise to our profession is: Who will work for an acupuncturist’s acupuncture, a practice of acupuncture in all its depth and breadth? An acupuncturist’s acupuncture, anyone? The public certainly seems to want it. I believe they deserve it.

Mark D. Seem, PhD, LAc
Tri-State College of Acupuncture
New York, New York

How To Choose an Acupuncture and Chinese Medicine Program
by Changzhen Gong, PhD

Today, a growing number of patients routinely receive acupuncture and Chinese herbal medicine treatment, creating a continually increasing demand for practitioners. As a result, more and more people are interested in studying Traditional Chinese Medicine (TCM). However, as with all things, there is a wide range of choices available to the prospective TCM or acupuncture student. Across the US there are many schools, most of them advertising their “TCM” curriculum. In fact, however, many schools offer courses and systems which widely diverge from genuine TCM as developed and practiced over thousands of years in China. These include Japanese, Korean, Vietnamese, and French styles and systems, to name a few.

Graduates of such programs often flounder when the time comes to establish and manage a successful practice, simply because they are not grounded in real TCM principles and practices. Only a solid TCM education can truly prepare students for a successful practice in the real world.

A school which offers such a program should focus on a core TCM curriculum as presented and practiced today in China but adapted for the adult American students. A core TCM curriculum means that the program’s curriculum is built on the TCM pattern-based approach, with traditional Chinese medicine theory as the foundation, meridian theory, TCM pathology, TCM diagnostics and TCM treatment principle as the base, acupuncture, Chinese herbology, dietary therapy, and Tui Na as the leading techniques, students are gradually led to TCM internal medicine, TCM Gynecology, TCM Pediatrics, TCM Dermatology and other clinical medicine. Students should be introduced to other off-shoots of TCM systems (such as Japanese, Korean and French acupuncture systems), but the emphasis always remains on the core TCM curriculum. This integrated and progressive approach ensures that the student is fully grounded in all aspects of TCM theory and practice. In addition, the school should maintain the integrity of the traditional Chinese medicine curriculum. An independent school with a solid financial basis and strong, cohesive and committed TCM faculty is the only choice for a real TCM education.

Class sizes should be small and dialogue between instructors and students encouraged, so that students learn quickly and easily in a supportive environment. And when it is time to prepare for critical examinations, the school should routinely offer review classes for students preparing for such examinations. Some TCM schools rely entirely on outside tutors to assist students in consolidating and strengthening their knowledge for comprehensive preparatory examinations and for the National Board Examination.

The school should have a comprehensive TCM library, an essential resource to facilitate and enhance study, and this should include not only all available English and Chinese TCM and health-related books, but also a complete collection of all of the major English and Chinese-language TCM journals, as well as TCM and Chinese culture-related videos. The library will also contain the works of the school’s highly trained and experienced teachers and practitioners in both English and Chinese.

In all schools, Clinic Observation is the first stage of clinical practice. Be sure that students at this stage observe and assist real TCM practitioners - most schools only have students observing more advanced students. Only experienced TCM practitioners can provide students with the necessary depth of information regarding diagnosis and treatment which is necessary to develop the student’s understanding and abilities. Students should also begin clinical work in their first trimester, and the school’s clinics should be capable of providing a steady flow of patients.

Establishing a successful TCM practice depends on the ability of the graduate to successfully diagnose and treat a wide range of conditions and to compete in the marketplace. The school should not only prepare its students to make a good living in their TCM practice through a thorough and comprehensive pattern-based TCM education, but should also include how to establish and manage a successful clinic practice through hands-on experience while in the program. To further insure the success of graduates, the school should also offer a consultation service after graduation. In such a program, graduates can consult with the school’s instructors at any time regarding patient diagnosis and treatment, and staff doctors are available to visit the graduate’s facility to more directly assist with diagnosis and treatment.

The American Academy of Acupuncture and Oriental Medicine (AAAOM) can satisfy all these requirements. AAAOM offers a Masters degree program in acupuncture and Traditional Chinese Medicine, and students begin their studies throughout the year at the beginning of the Winter, Summer, and Fall Trimesters. Applications are accepted all year around.

Changzhen Gong, PhD, MS, is the President of the American Academy of Acupuncture and Oriental Medicine and executive director of TCM Health Centers. Dr. Gong came to the United States on a Fulbright Scholarship and is the author of many papers on traditional Chinese medicine. He can be reached at 651-631-0204.

Dear Brian,

I may pursue training in Chinese medicine after my Ph.D. and I was wondering how one finds out what schools are strong academically (besides word of mouth).

Are there any rankings of the accredited schools? I notice that if you graduate from certain schools such as one in Houston you are licensed to practice in several states? How exactly does that work?

Thanks!
William A.

William,

That’s a great question for prospective students!

Education and licensing are separate. The latter depends on the state. Most states use the national exam to license their acupuncturists, but a few states (like California) have their own exams.

The California Acupuncture Board lists pass rates for its exam. When you look at these stats, make sure not to look just at the pass rates but also how many students they sent to the exam. Some schools have 100% pass rates, but only sent one student. I think a better question is, “Which schools that are educating a lot of students get the best pass rates?”

The National Certification Commission for Acupuncture and Oriental Medicine doesn’t appear to release those stats about their test, at least not on their website. You might try calling them at 703-548-9004.

In thinking about the best schools for you, I’d start with where you plan to practice, or what subjects you want to emphasize- if herbs are important, think California. The CA test is more difficult, and herbs are required (most states only require the national acupuncture license and ignore the national herb license - some practitioners who are qualified to do herbs do not get the herb license for that very reason).

Programs are pretty standard, but you can get more details about each school at the Council of Colleges of Acupuncture and Oriental Medicine.
Some questions you may want to ask prospective schools are:

• How much do you teach about Chinese herbal medicine?
• What styles of acupuncture do you teach?
• What are the required classes?
• What electives does financial aid not pay for?
• How do you teach the classics (Do you teach the classics)?
• What clinical and externship opportunities are available?
• Are there OM conferences and events local to the college’s area?
• How long has the college been around?
• What kind of experience and credentials does the faculty have?
• What kind of English language and public speaking abilities do the faculty have?
• Is the college involved in any scientific research, especially NIH funded?

These should get you a lot more information. You may want to prioritize the above list - figure out which of these questions is most important to you.

No school is perfect, and to some extent, your education is up to you. You’ll find that when you graduate, your continuing education is somewhat legislated, but still essentially dependent on your own commitment and discipline.

All the best!
B