Members of our profession have been talking for a long time about being recognized as doctors of Oriental medicine and acupuncture. Chiropractors, naturopaths, even physical therapists, have the "Doctor" title, and our medical practices are at least at their level.Many health care professions, from nursing to audiology, have achieved this recognition. I believe we also need to achieve this recognition and now is the time for our profession to step up to the plate.
Four Possible Doctorals
This article reviews four different doctorals possibly involved in this transition and highlights the experiences of Five Branches University with the Doctor of Acupuncture and Oriental Medicine (DAOM) degree designation.
First, AOM students, after four (maybe five) years of study, will graduate with a first-professional doctorate as entry into the profession. Second, licensed acupuncturists might be offered a transition doctorate taking into consideration their experience and allowing them to earn the first-professional doctorate. Third, AOM education will continue to offer the present post-graduate doctorate (DAOM), focusing on specializations, integrative medicine, teaching and research. And finally, the state AOM boards can convert our license to Doctor of Oriental Medicine (DOM) or a similar title, as four states already have done. The difference is the first three doctorals have to do with educational degrees and the last involves state licensure.
First-Professional Doctoral Program as Entry Level Into the Profession
As readers might be aware, the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) facilitated a task force to review and develop standards to define the first doctorate for entry into the profession. The task force had wide representation from the profession including the AAAOM, the colleges and other affiliated organizations. After three years of development and public hearings, ACAOM published the standards on their Web site and again asked for public comment. Surprisingly, they received substantial feedback and published the following resolutions in their Winter 2008 newsletter (www.acaom.org/newsletter.asp):
"Be it resolved that the Commission urges the acupuncture and Oriental medicine communities of interest, as the primary conveners, to continue to seek consensus by whatever means deemed appropriate regarding the issue of a first-professional doctorate as entry-level into the profession.
Be it resolved that once consensus is reached within the profession, the Commission will renew its efforts to develop and subsequently pilot standards, policies and procedures for first-professional doctoral programs in AOM as entry-level into the profession."
The standards developed by the ACAOM-facilitated task force represent a reasonable compromise, based on the present four-year master's standards and adds a series of important professional competencies while maintaining the four-year program length. While some might wish for higher standards and a five year program (myself included), the recommended standards are a reasonable starting point. The standards increase the entrance undergraduate requirement to three years rather than the present two - the extra year allowing entering students to study natural sciences. An informal vote at the May 2008 Council of Colleges meeting showed more than 90 percent of the colleges present supported the acceptance of these standards as a starting point.
As the ACAOM so clearly reflects in their resolutions, we need general support and consensus from our profession and we need the ACAOM or the AAAOM to again create the forum for this discussion in order for us to move forward with a first-professional degree.
For licensed acupuncturists to convert their present degrees to the first-professional degree, the profession will need to study and develop a transition program allowing LAc's to fulfill the new increased requirements of the first-professional doctorate. It is not possible to grandfather practitioners into this. We need to begin discussing the development of this transitional program and determine the necessary steps.
In the fall of 2006, Five Branches University started the DAOM program. To date, we have had three entering classes and a total of 68 students enrolled, including faculty from the Five Branches' Master's program.
AOM Expertise. The DAOM offers the profession the platform to invite renowned AOM specialists and lecturers from the U.S. and China. These specialists offer licensed acupuncturists high-level clinical and theoretical expertise in AOM. Western Understanding. The DAOM offers a platform to study with highly knowledgeable Western medicine specialists. This will deepen their level of understanding of AOM and open the doors to interdisciplinary medicine, a major recommendation of the IOM (Institute of Medicine) in its publication, Crossing the Quality Chasm: A New Health System for the 21st Century.
Exposure to Chinese AOM Hospitals. The DAOM offers practitioners the opportunity to study in Chinese hospitals with specialized experts to experience working with a high volume of patients in a fast-paced environment.
Pedagogy. The DAOM offers pedagogy; bringing in professionals who teach students new learning theories and how to improve their teaching and clinical supervision skills. Besides specific lectures on pedagogy, the DAOM program offers some of the best examples of successful teaching. For example, one Stanford University teacher showed how stepping to the side of the classroom encouraged group discussion, but standing in the middle and front of the classroom encouraged teacher-oriented discussion.
Research. While not research-oriented by design, the DAOM brings to the profession knowledge and skills on how to find and evaluate research, and simple, yet effective, research designs to accumulate findings from individual practices. The research or capstone requirement of the DAOM allows practitioners to discover the world of research, an essential component as our profession grows. We anticipate a fruitful cooperation between DAOM programs, the Society for Acupuncture Research (SAR) and specialized committees in our national organizations such as the Research Committee of the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM) to develop and publish relevant research protocols for evidenced-based research.
Specialization. The DAOM brings our profession to the next level, teaching practitioners in-depth knowledge and skills in various specializations. These specializations might be categorized by department (such as gynecology) or by technique (such as Meridian Diagnosis). Establishing these specializations in the U.S. will support our leadership role in AOM education worldwide.
Cross-Pollination and Establishing Specialized Institutes. AOM experts share their expertise with DAOM students, providing our colleges the opportunity to utilize this expertise through the development of specialized medical centers. For example, inspired by the teachings of a diabetes expert from China, a group of Five Branches DAOM students are traveling to China to spend two to four weeks at the diabetes center located there with the intention of establishing a sister diabetes center in the U.S.
Opening Doors. The doctoral degree makes a definite positive impression on the medical profession. A few Five Branches students have accepted positions with major medical facilities, with one student reporting that being a doctoral student was the primary reason he was offered a position. The DAOM also assists graduates in obtaining teaching positions in American universities, and/or publishing articles in journals.
Licensed as Doctors of Oriental Medicine and Acupuncture
After establishing our academic credentials as a first-professional doctorate and offering a path for licensed acupuncturists and Oriental medicine practitioners to earn this doctorate through a transition program, we can go the last step and convert our licensure to DAOM. This is a political rather than educational issue and becomes a natural extension of having our entry-level degree be a first-professional doctorate. There are many intricacies involved to get to these destinations within the various contexts that each state presents. Four states have accomplished this transition, so we know it can be done.
Many of us were surprised when the ACAOM reported there was not consensus in our profession to move in this direction. This reflects the possibility we might need more time to integrate our diverse ideas before we can proceed. Our national organizations, especially the AAAOM and the ACAOM, need to create the roundtable around which we can all sit to discuss our destination and how we can cooperate to get there. I envision the process will be like a wave; certain states will be able to move faster than others, which will influence and assist other states to move forward as well.
The doctoral title is no longer reserved for MDs. There is a trend among allied health practitioners to be recognized as doctors. To date, approximately 20 health professions have their four-year training programs recognized as first-professional doctorates. To achieve this recognition for our profession will involve work, perseverance and patience, similar to the efforts necessary when we first established the AOM profession in the U.S. We can proceed diligently, one step at a time. Once we are there, we'll wonder why we worried so much about doing the obvious.
Bon voyage to all of us! And, esteemed doctor, I look forward to the day we all receive the recognition this noble, effective and safe tradition deserves.
Ron Zaidman is president and CEO of Five Branches University in Santa Cruz, Calif. He may be contacted at www.fivebranches.edu/default.taf.