Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley. In addition to their on-campus health clinics, both campuses have numerous free and low-cost community clinics, including on-campus veterans and community clinics, a substance abuse rehabilitation clinic at the Santa Cruz campus, and three off-campus free community clinics in gerontology, mental health, and HIV/AIDS for low-income and homeless individuals.
In January of 2016, FBU began offering an enhanced level of clinical training for its students through a hospital-based Traditional Chinese Medicine (TCM) residency program at Highland Hospital (located in Oakland Calif.), which is part of the Department of Medicine's Division of Integrative Medicine (DIM). With a longtime dream of establishing a TCM hospital, FBU co-founders Ron Zaidman and Joanna Zhao believe this opportunity is a momentous step towards realizing their shared vision. The formal TCM residency program fills the gap that TCM graduates encounter when compared to their MD/DO counterparts.
A New Era in Medical Training
Highland Hospital was built in 1927 to serve as a public teaching hospital and is currently Alameda County's only public hospital. Highland is known for being a groundbreaking educational institution and is a leader in training future physicians, surgeons, nurses, and nurse midwives. Now, Highland's visionary leaders are again advancing medical training by pioneering a TCM residency. The departments of emergency medicine, internal medicine, and general surgery residency and fellowship training programs at Highland are affiliated with the University of California, San Francisco, School of Medicine. The TCM residency program at Highland provides students with the opportunity to train side-by-side with practitioners of allopathic/osteopathic medicine, while also providing medical students, residents, attendings, and faculty exposure to the dynamism of TCM.
The two-year TCM residency with the DIM at Highland, which is open to current FBU DAOM fellows and senior master's level students, was established by the founders of the International Center for Integrative Medicine (ICIM). The goal is to provide the best of Eastern and Western Medicine, while promoting quality, holistic health care that is customized to the individual patient; conduct research on the efficacy and design for integrative medicine; and to educate practitioners with an integrative medicine paradigm. The founders of the program are Amy Matecki, MD, LAc, Chief, DIM; Craig Brandt, JD; Colin Feeney, MD, FACP, Chief, Pulmonary/Critical Care at Highland; and Alex Feng, PhD, OMD, LAc, Medical Director, ICIM.
In 2010, the ICIM team began working with doctors and nurses at Highland to educate them on the benefits of an integrative medicine approach, and more specifically how TCM can enhance the treatments currently being conducted at the hospital in both the inpatient and outpatient settings. At first, a conservative approach was taken by focusing on patients with pain related issues and referring them to the DIM team for consultation. This humble beginning soon resulted in an enormous number of consultation requests for the DIM team of physicians, residents, and nurses, who soon began to comprehend the broader scope of conditions with which the team could assist. Currently, there is a wait list of more than six months for patients to see the DIM team in the outpatient setting.
The DIM operates in three capacities: providing outpatient clinical treatments; responding to inpatient consultation requests received from various departments of medicine, including medical sub-specialties (e.g. neurology, critical care, pulmonary, etc.); and facilitating didactic trainings between the DIM team and the rest of the department of medicine residents, interns, and medical students. Didactic training includes inpatient and outpatient clinic rounds with the various medical sub-specialty chiefs and residents, which the DIM students follow during their rotations. In the Spring and Summer semesters of 2016, DIM students performed rotations in neurology, pulmonary, endocrinology, and hematology/oncology. In the Fall of 2016 these rotations expanded to include cardiology.
One most important aspects of this training program is increasing patient access to receiving TCM treatments. In California and the rest of the U.S., acupuncture has primarily been utilized by only a fraction of the population, with the highest prevalence amongst Euro-Americans, Asian-Americans, and those with higher levels of education.1, 2, 3, 4 As a public teaching hospital, Highland serves everyone within Alameda County, especially those most vulnerable to receiving substandard or even no medical care at all, including individuals who are low-income, homeless, and/or are undocumented immigrants. There are now patients that are receiving acupuncture at Highland who had previously never even heard of acupuncture, let alone TCM in its broader context. Because of this TCM residency program, thousands of individuals are able to receive the medical benefits of an integrative approach and are experiencing reduced pain and suffering, better health outcomes, and a higher quality of life.
As part of the mission to integrate Eastern TCM into Western medical practices, research has become one of the building blocks of this pivotal bridge, and facilitating research is also a core component to the didactic training. Recently, the DIM in cooperation with Dr. Feeney and the ICU, concluded a six-month feasibility study, utilizing 560 inpatients at Highland Hospital, to examine the efficacy of acupuncture within the department. The results of the study were presented at several medical conferences in Shanghai, People's Republic of China in May of 2016 by Dr. Matecki and Dr. Feeney, and are currently in press for publication within the next year. The DIM has several other research projects in development and has included research as a fundamental part of the program, adding to the vast number of research studies being carried out at the hospital to better inform evidence-based medicine.
In June of 2016, Mr. Xiayong Xiao, the Chinese Cultural Counselor from the Consulate-General of the People's Republic of China in San Francisco, visited the DIM team to tour the hospital's campus, meet with the pioneers of the program, and learn about the dynamics of the training and services provided. According to Sing Tao Daily newspaper staff writer, Mingyue Xu, Counselor Xiao expressed full support of the program and hopes it can serve as a model to establish similar programs at other teaching hospitals throughout the U.S.
Integrative Perspectives
On their second day of the program, after the resident's morning report, two of the TCM residents began their pulmonary rotation. After introducing themselves, one of the medical residents looked up from his research article on the latest procedures and standards for intubating patients in the ICU and said, "I didn't know we had Acupuncture residents here." "We are actually the first in the country," they replied. "Hmmm…well, welcome," he said, as he looked back down at his research.
One of the TCM residents further stated, "After the chief of pulmonary presented the day's patients who were in the ICU under our care, he looked at my fellow TCM resident and me and asked, ‘Can acupuncture help improve any of these patients' conditions?' My colleague and I looked at each other, smiled, and replied to him, ‘Yes.'" According to this resident, "It is a very rewarding experience to see the smiling faces of individuals being offered the much needed additional medical support necessary to carry on with their daily activities, especially because many of these caring people are socio-economically disadvantaged and would not otherwise be able to receive the benefits of TCM. I am very grateful to be at the forefront of medicine and participate in building the bridge between East and West by training and collaborating with medical students, residents, and tenured physicians."
Another Five Branches DAOM student described her second day as a Highland TCM resident: "This is the level of education I have been searching for. My request to our attendings and faculty is to continue to push me, hold me accountable for everything you wish me to know, and set the bar high. I spoke with Dr. Matecki today about the possibility of researching the effects of acupuncture on chemotherapy induced peripheral neuropathy. I would greatly appreciate support and direction in becoming involved in research at Highland. I cannot thank you all enough for your time and dedication."
References
TrA-2, my primary needle location, I needle 95% of the time and I think it works the best. You’ll know you have the right point location when you discover the muscle twitching when applying electric stimulation.
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