I’m a 3rd year MD student trying to figure out what I want to do. It might be tunnel vision, but I’m constantly questioning why I’m even continuing if I might not like conventional clinical medicine. I know I want to pursue traditional, complementary, and alternative medicine (TCAM) / oriental medicine / acupuncture, but I’m just trying to figure out how much more training is worthwhile for me. There’s a lot more layers to uncover, so I’m just trying to keep it short here. Would love to get your perspective.
My overarching thought on your general situation is this:
Use your conventional medical training to your advantage. Having an MD gives you a huge leg up and sets you apart from probably 99% of people practicing any sort of traditional or alternative “medicine.” Your MD provides you with:
- The knowledge needed to critically evaluate therapies and treatments,
- Credibility with professional communities as well as the general public,
- The ability to obtain a license to prescribe medications,
- Many more career options within the healthcare industry than most other degrees.
It’s okay to question your decision to pursue conventional medicine. And it’s okay to pursue a career path that’s out of the ordinary. But don’t get so frustrated or exasperated that you put your valuable and hard-earned medical training to waste.
Consider traditional/alternative medicine to be an avenue through which you use your medical training, rather than thinking about yourself quitting conventional medicine. Some doctors would disagree with me on this, but I believe you can practice medicine as an MD and effectively implement principles of TCAM.
That said, below are some thoughts that more specifically answer your question.
How much more training is worthwhile to pursue TCAM or an alternative medicine career?
Finishing up medical school and completing a residency are definitely worthwhile. Resist the urge to skip residency in favor of pursuing TCAM-specific training. Residency opens up many doors for MDs. Even if you choose not to obtain a medical license or board certification, it’s helpful to have these as options in case your plans change.
One thing that you can do right now as a 3rd year medical student (if you haven’t already) is see if your school offers any 4th year electives in TCAM. If not, look into whether you can do an away rotation or even design your own elective. This may help your further define your interests and career goals.
Residency and fellowship options for an alternative medicine career
In terms of what residency to pursue, there are several options that can lend themselves nicely to a career in TCAM and will also allow you to get an American Board of Medical Specialties (ABMS)-recognized board certification. CAM itself isn’t an ABMS-recognized board certification.
Family medicine or internal medicine
Look for primary care programs that have an elective offering in TCAM or that are run by an institution that has a TCAM, integrative medicine, or similar department through which you could get involved in research or other endeavors.
Many preventive medicine programs incorporate training in CAM, integrative medicine, holistic medicine, and functional medicine.
Lifestyle medicine is a burgeoning field that aims to use evidence-based lifestyle therapeutic approaches to sustain health and improve health care. The American College of Lifestyle Medicine offers a certification specifically for physicians with ABMS or AOA board certification. I believe that their long-term goal is for lifestyle medicine to be recognized as a subspecialty by the ABMS. Some residency programs, including preventive, family, and internal medicine programs, have implemented lifestyle medicine into their curriculums. While lifestyle medicine is obviously not the same as CAM, there is overlap in ideology and certain principles.
Hospice and palliative medicine
Hospital and palliative care training programs often include aspects of CAM in their curriculum. This is a sub-specialty, so it requires that you first complete a residency in either anesthesiology, family medicine, internal medicine, pediatrics, psychiatry, or radiation oncology.
Principles of CAM arise frequently in the management of pain, so training in pain medicine might be something for you to consider. Like palliative care, pain medicine is a fellowship, so you’ll need to complete another residency first. Also like palliative care, there are several different primary specialty options – you can pursue pain medicine after completing a residency in anesthesiology, neurology, or physical medicine & rehabilitation.
Post-graduate training programs that aren’t ACGME-accredited
There are some fellowships that aren’t ACGME-accredited, but are specifically focused on CAM or integrative medicine, such as the Clinical Fellowship in Integrative Medicine at Northwestern.
The American Board of Physician Specialties (ABPS) recognizes integrative medicine as a certifiable specialty. ABPS certification doesn’t carry the same weight as ABMS certification; however, it may be helpful in certain contexts.
For an alternative medicine career, focus on training that is geared toward medical doctors
All the options mentioned above are geared toward medical doctors. There are also a ton of options for CAM-related training that don’t require an MD. These include general programs as well as specific certifications, such as acupuncture, homeopathy, or aromatherapy. In most cases, I don’t recommend these over MD-specific training, because they tend not to be as widely recognized or held to as high of a set of standards. The majority are not evidence-based, and some aren’t even evidence-informed.
There are a couple reasons you might want to pursue this type of training:
- There is a specific skill that you want to learn (ie, acupuncture)
- Training is required in order for you to implement a desired treatment or therapy into your practice.
But if those reasons don’t apply to you, rather than spend your time and money on this type of program, I recommend spending time and money on learning principles of business and on starting and growing a thriving, reputable practice. If you want to offer a type of therapy that you don’t personally have the necessary skills to administer, you can always hire staff with specific CAM-related experience and training to fill a need within your practice.
You might find that certain CAM concepts and skills can be learned on your own, as you go. As a medical doctor, you have the ability to excel at self-directed learning. The NIH National Center for Complementary and Integrative Health site is a great place to start in for self-directed education.