Now that nearly 40 percent of American adults swear by some sort of complementary and alternative medicine, or CAM, from nutrition and mental comfort to acupuncture, magnet therapy, and international healing systems like traditional Chinese medicine and Indian ayurveda, a growing number of medical schools have embraced functional medicine.
“Interest in teaching alternative strategies has exploded, especially this past year,” states Laurie Hofmann, executive director of the Institute for Functional Medicine, which will be based in Gig Harbor, Wash. The nonprofit institute educates healthcare specialists to look for underlying systemic imbalances as a cause of illness rather than focus on treating symptoms and, when possible, to correct with lifestyle changes and mind-body techniques.
The Consortium of Academic Health Centers for Integrative Medicine, which encourages the spread of CAM education, was founded in an initiative by eight academic medical centers; it now boasts 46 medical school members.
Traditional studies of surgery and drugs or medications, naturally, still dwarfs class discussion of complementary and alternative medicine. However, students want to add complementary, integrative and functional medicine methods because they “know their potential patients will be using them,” says Shelly Adler, director of integrative medicine education at the University of California, San Francisco School of Medicine, which has a history of teaching the subject.
“I could already see the limits of Western medicine, particularly when treating recurrent pain or other chronic problems. I thought other healing traditions could fill in some gaps,” says Carson Brown, a first year resident at San Mateo Medical Center in California. Spurred in part by the relief which acupuncture had provided her to get hip pain she took a two-week elective last year offered to UCSF students which covered topics from acupuncture to mind-body medicine.
A similar optional was started last spring in the Loma Linda University School of Medicine in California; the faculty is likely a second, more in-depth option on functional medicine for chronic conditions. An approach to handling, even reversing, diabetes, as an instance, highlights exercise and also a diet rich in foods that are whole, together with medication as a last resort, to provide overall health and wellness to future patients.
The colleges insist that they approach the subject with an eye toward the signs, advocating only approaches that have withstood scientific scrutiny even as they examine some methods patients frequently use. But critics charge that this is not necessarily the case. A 2009 review in the journal Academic Medicine of a couple of course curricula discovered a bias “in favor of CAM,” noting recommendations of acupuncture for ailments like asthma in which there’s “no credible evidence” and instances of ignoring research, for instance, studies linking chiropractic manipulation with stroke.
At the University of Arizona, where bestselling CAM guru Andrew Weil is a part of the school, a program overhaul five years ago expanded the discussion beyond the scope of an elective or two. Based on the growing body of research supporting a few holistic remedies, especially nutrition, and of smaller-scale studies on other treatments with limited risks, such as journaling to help rheumatoid arthritis, “it made sense to integrate these ideas into a variety of courses,” says Victoria Maizes, executive director of the Arizona Center for Integrative Medicine in the medical school.
As before, fourth-year students have the choice of a four-week elective on the subject. All students, in courses across the curriculum, recognized and now gain an understanding of the use of nourishment remedies in healing and prevention and of the body’s innate ability to heal itself. Members that have gone through the center’s full-fledged, two-year fellowship in medicine give pupils a window on how they could incorporate CAM into their practice.
One cardiovascular surgeon, for example, supplies surgical patients using pre-operative guided vision (shown in a lot of studies to decrease stress and aid healing), provides comprehensive nutrition guidance for heart health, and is researching the effectiveness of Reiki, an energy healing method that relies on touch, on surgical recovery.
There’s a fourth-year optional, too, that highlights the value of caring for the mind, body, and spirit of their physician in addition to the patients. Students not only learn about yoga and tai chi but they also practice these themselves to de-stress, Chiaramonte says. “Students recognize that, to be good healers, they need to facilitate their own wellness, that [it’s] is a part of healing a patient,” she says, a practice which can prove beneficial to them.
For medical schools which can’t locate the tools or the space in their packed curricula to include CAM, a current Institute for Functional Medicine (IFM) survey suggested that time, not lack of interest, is the prime impediment for the addition of such programs in their schools, where often an online education can fill the gap. The University of Arizona will establish a holistic course on wellness and prevention, open to medical students from different schools.
The IFM will debut Web-based modules on gastrointestinal health, the principles of functional medicine, and nutrition. (Time limitations are no doubt the reason a recent study in Academic Medicine found that only 27 percent of healthcare schools currently meet the minimum goal, set by the National Academy of Sciences, of 25 hours for course time.)
Whether or not pupils who know about alternative approaches ever include herbs or acupuncture in their own practices, believers say, they stand to gain from viewing medicine in a more holistic manner.
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By Dr. Alex Jimenez
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