According to the Canadian Association of Naturopathic Doctors (ND), there are approximately 1500 NDs practising in Canada. The Council on Naturopathic Medical Education (CNME) is the accreditation body for NDs and lists the following schools:
- The Boucher Institute of Naturopathic Medicine (New Westminster, British Columbia)
- The Canadian College of Naturopathic Medicine (Toronto, Ontario)
- The National College of Naturopathic Medicine (Portland, Oregon)
- Bastyr University (Seattle, Washington)
- The University of Bridgeport College of Naturopathic Medicine (Bridgeport, Connecticut)
- Southwest College of Naturopathic Medicine and Health Sciences (Scottsdale, Arizona)
- The Council on Naturopathic Medical Education has granted candidacy for accreditation to the National University of Health Sciences (Lombard, Illinois)
Identifying the schools gives us the opportunity to examine the curriculum requirements to become accredited as a ND in Canada. For an example we will look at the Boucher Institute of Naturopathic Medicine. For convenience sake, they have their full Academic Calendar available on line (PDF). First of all, the entrance requirements are defined on page 9:
Biology: one full-year (6 credit hours). This may be fulfilled either by one year of general biology or by one semester of cell biology plus one semester of an appropriate biology, such as botany, ecology, genetics, microbiology or zoology.
Psychology: half-year (3 credit hours). This requirement must be filled by introductory or general psychology. It is strongly recommended for the 2011 intake that applicants have an additional 3.0 credits of psychology in any discipline.
English / Humanities: one full-year (6 credit hours). This requirement may be fulfilled by courses such as:
General Chemistry: one full-year (6 credit hours)
Organic Chemistry: half-year (3 credit hours)
Biochemistry: half-year (3 credit hours)
In addition, prospective students would benefit by completing additional courses in some or all of the following areas showing a final grade of at least 73% or ‘B’: Business/Marketing, Calculus, Community/Cultural/Global/International Studies, Cell Biology, Ecology, Environmental Science/Sustainability, Genetics, Leadership, Management, Microbiology, Nutrition, Philosophy, Physics, Religious Studies, Research, Sociology, Statistics
The actual minimum requirements add up to one year of undergraduate study, but I assume that the majority of applicants would complete most or all of an undergraduate degree. By comparison, medical schools generally require an undergraduate degree and most require applicants to write the MCAT exams.
Once accepted into Boucher, courses are divided into five broad categories: Biomedical Sciences ; Professional Development; Naturopathic Therapeutic Modalities ; Clinical Science ; and Clinical Practice and Integration .
The language of the course descriptions is a mingling of the scientific and the pseudoscientific. In the sections that comprise the biomedical sciences, there is a definite vitalistic slant to the descriptions. However, the topics of biochemistry, anatomy, physiology, neuroanatomy, microbiology, and diagnostic imaging are difficult to criticize with the amount of information in the syllabus.
Within the component of Naturopathic Therapeutic Modalities are the following:
Botanical Medicine I–V
This series of courses provides an in-depth study of the botanical materia medica and the clinical use of whole plants and extracts.
This is a four-part sequence that prepares the student to prescribe homeopathic remedies in an acute and classical manner.
The Nutrition series examines the physiological functions, metabolism, and requirements for all macro- and micro- nutrients, as well as the pharmacological effects of individual nutrients…. The psychological meaning behind foods and food habits is also investigated.
Physical Methods and Agents Program
The Physical Methods and Agents Program provides hands-on training in physical assessment and physical medicine modalities. Included are the evaluation of soft tissue pathologies, orthopaedic testing, structural analysis, gait analysis, and examination and assessment of the vertebral column, pelvis, and peripheral joints. The principles and practice of goniometry and manual muscle-testing are introduced. Various systems of soft- tissue and osseous manipulation are taught such as Swedish massage, manual lymph drainage, trigger point therapy, neuromuscular technique, muscle energy, strain/counterstrain, craniosacral manipulation, fascial release therapy, and joint mobilization. Training in preventive and therapeutic exercise provides a foundation in the principles, techniques, and therapeutic application of exercise and stretching for improved strength, co-ordination, balance, posture, ergonomics, relaxation, and cardiovascular training.
The following eight courses comprise the Physical Methods and Agents Program.
NeuroMusculoSkeletal Medicine III provides an in-depth course outlining methods to accurately assess axial (spinal) dysfunction. Electrotherapy surveys the electrotherapeutic modalities and their application in a variety of conditions, including musculoskeletal disorders and pain management.
Exercise and Rehabilitation focuses on the rehabilitation of injured tissues as well as the maintenance of healthy tissues.
Hydrotherapy provides an education in the physiological principles and proper application of various, as hydrotherapy is at the root of naturopathic treatment.
NeuroMusculoSkeletal Medicine I allows the student to determine or identify pathological dysfunction in the muscles or joints of the body. hydrotherapeutic procedures
Massage describes the various techniques for soft tissue manipulation.
Naturopathic Manipulation is a four-part series of courses that provides a solid basis for the practitioner to determine the need for, and perform specific, spinal and peripheral adjustments of joints in the body. The primary focus is the spinal column.
NeuroMusculoSkeletal Medicine II investigates the standard orthopaedic examination techniques.
From these descriptions, it becomes obvious that the study of naturopathy contains some scientific practices such as physiotherapy. However, most of the courses involve unproven, useless, or dangerous techniques.
Homoeopathy, which makes a mockery of the basic laws of physics, chemistry and biology, plays a large part in naturopathy. Craniosacral manipulation is considered useless by Dr. Stephen Barrett at Quackwatch.
Spinal manipulations are the hallmark of chiropractic, a practice that is deconstructed in great detail by Dr. Barrett, and was dealt a serious credibility blow in England following a failed lawsuit against Dr. Simon Singh.
Hydrotherapy is merely baths of differing salts and temperatures that are recommended for such diverse conditions as hypertension, climacteric problems, and neurosis (a term that went out with Freud and Woody Allen). Despite the fact that most of us have used a bath for relaxation of pain relief, there have been a number of deaths in spa bath treatments, as reported by a team from Russia.
Botanical, or herbal medicine, involves the use of plant extracts, that may or may not have therapeutic value, but most of which are not regulated or tested in any way.
Another course area is Mind/Body Medicine
Mind Body Medicine examines a variety of topics in psychobiological healing, including bio-feedback, hypnosis and auto-suggestion, visualization and guided imagery, neurolinguistic programming, belief and the placebo response, prayer and meditation, shamanic healing, and focused healing intention.
This one paragraph deserves an entire blog post, but I will merely say that this entire section is best summed up by the words ‘placebo response’, which in scientific studies means that the placebo treatment is the equivalent of no-treatment.
Traditional Oriental Medical Systems I–V
This series of courses provides a working knowledge of the philosophy, theories of diagnosis, and therapeutic concepts and techniques of traditional oriental medicine. It emphasizes and demonstrates the use of acupuncture, tongue and pulse diagnosis, five-element theory, and the basic use of oriental botanicals.
Acupuncture is one of the most popular alternative treatments, but serious questions remain about its efficacy and safety. In fact, sham acupuncture, or acupuncture that ignores ‘proper’ placement of needles works just as well as ‘real’ acupuncture.
Tongue diagnosis relies upon the concept that parts of the tongue will show alternations based upon disorders of various organs. Pulse diagnosis is related in that the depth and strength of the pulse reveals specific details of a person’s health. I think it goes without saying that these concepts are not based upon any physiological knowledge.
According to the Canadian Association of Naturopathic Doctors website, one of the guiding principles of naturopathy is First Do No Harm (Primum Non Nocere), this includes as part of the elaboration—Your naturopathic doctor chooses remedies and therapies that are safe and effective. By this statement, every ND is in violation of their principles.
As of the day I wrote this post, the Standards and Ethics page of their site states <currently being updated>. That seems appropriate.