Naturopath Education: Still Replete With Bollocks

CCNM Canadian College of Naturopathic Medicine CCNMNaturopaths are allowed to call themselves doctors in Ontario, placing them alongside Physicians, Dentists, Psychologists, Optometrists, and (regrettably) Chiropractors as a statutorily-legitimized and protected class of healthcare provider.

When someone is given the right to call themselves a doctor, we expect a very high level of medical training and expertise. So it’s fair to ask just what Naturopaths learn during their education. About 2.5 years ago, John did just that, looking at the curriculum of the Boucher Institute in Westminster, BC and finding it riddled with pseudoscience. This article is intended to update John’s work by breaking down the curriculum of the country’s largest naturopathic college, the Canadian College of Naturopathic Medicine (CCNM) in Toronto.

Admission & Program Reqirements

Entry into the CCNM requires at least a 3-year bachelor’s degree in any field of study, a minimum GPA of 2.7 (B-), at least one full year course (6 credits) in each of Biology, Physiology, and Humanities, as well as one half year course (3 credits) in each of Chemistry and Psychology. But for the lack of MCAT scores, this is not dissimilar to the minimum requirements for entry into an MD program, though due to competition, pre-med does tend to be much more rigorous than those minimum requirements. Still, it sets a bar grounded in science, and that’s a good thing.

The program itself is also clearly modelled after Canadian MD programs — two years of academic study, two years of clinical practice, and a two-part certifying exam. The main difference seems to be the lack of a residency requirement, but it’s nonetheless hard to fault ND’s for not putting in the time.

The question, then, is what they’re putting in that time learning. There are three primary areas of study: Biomedical Sciences, Clinical Sciences, and the Art and Practice of Naturopathic Medicine. I won’t cover Clinical Sciences, as it’s mostly about application of the other two, but here’s a breakdown of the rest of the curriculum.

Biomedical Sciences

Coursework in anatomy, physiology, biochemistry, immunology and clinical pathology seems promising. While we can’t be certain of what’s taught in these courses, let’s give CCNM the benefit of the doubt and assume they’re the same as they would be in an MD program, and that they provide a firm grounding in life sciences.

I’m less inclined to grant such leeway to the courses in environmental & public health, given that so many ND’s come out of these programs anti-vaccination, and that alternative medicine has been found to be significantly associated with reduced adherence to vaccine schedules. Yes, there could be self-selection confounding both of these findings, but if this were the case, a science-based curriculum should disabuse students of these biases, and it clearly isn’t. Something seems to be going on in these courses; for further proof, just look at the top titles available in the school’s library. (h/t Scott).

Similarly, the decoupling of courses in pharmacology from those in pharmacognosy (study of natural medicines) is perhaps not surprising, but nonetheless troubling. If a natural medicine works, it does so by pharmacological means, rendering the distinction meaningless — except, that is, to provide ground for the naturalistic fallacy (“natural = safe”) and arguments from antiquity (“old practices = trusted wisdom”) to take root.

Take-away: while there’s likely much science being taught in the biomedical portion of the CCNM program, there are also areas that are likely laced with pseudoscience. When it’s all presented as if it’s “of a piece”, it’s reasonable to be concerned about ND’s ability to tell fact from fiction.

Art and Practice of Naturopathic Medicine

And it only gets worse from there, as the coursework covers the six major modalities of naturopathic medicine:

    • Homeopathic Medicine – Homeopathy is an elaborate placebo system with no basis in science. That it forms a fundamental part of the naturopath’s curriculum is shameful, and further indication of the casual way in which science is blended with pseudoscience in the curriculum.
    • Asian Medicine/Acupuncturecovers “Yin and Yang theory, the meridians and channels system, the five-element theory and the symptoms and signs involving the 12 master meridians.” This is pure vitalism, the belief that living things possess an animating energy or life force, and that such energy can be manipulated for therapeutic benefit. In other words, bollocks. Acupuncture in particular has been extremely well studied, and consistently shows no benefit beyond a placebo in the highest quality trials.
Robert Schad Naturopathic Clinic CCNM

Of course it’s fertile. It’s packed in manure.

  • Botanical Medicine – as discussed above, treating botanical medicines as different from other medicines is an artificial distinction that only serves the naturalistic fallacy. Nature of course produces many useful compounds, but unfortunately they’re only occasionally safe enough and effective enough to be useful in their native form.
  • Clinical Nutrition – includes “prescriptive therapeutic strategies” like detoxification (bollocks), supplementation (bollocks), and orthomolecular therapy (bollocks).
  • Physical Medicine – includes hydrotherapy (bollocks) and naturopathic manipulation (almost certainly bollocks)
  • Health Psychology and Lifestyle Counselling – not much to say here, other than presumably the counseling includes guidance in applying the other 5 modalities.

Take Away: any good done by the science courses in the biomedical track is completely undone by training in naturopathic modalities. If there’s a pseudoscientific treatment out there, it’s probably taught at the CCNM.

The Statutory Whitewash

Even if we accept the basic notion that natural treatments are somehow better than other medical treatments, the presence of homeopathy, detoxification, and energy therapies in the Canadian College of Naturopathic Medicine’s curriculum is a healthcare travesty. Though CCNM’s ND program is structurally modeled after Canadian MD programs, its substance is so divorced from reality as to render its graduates incapable of science-based practice. That they’re allowed to call themselves doctors is a testament to a flawed regulatory structure, not the training standards of the profession.

7 Responses to “Naturopath Education: Still Replete With Bollocks”

  1. And what are you going to do about it?
    We have just lost a court case about the wrong use of titles by a chiropractor. How can patients know if the person in front of them is a real MD or a ND?

    • Erik Davis says:

      Catherine, what case are you referring to?

      An ND can’t call themselves an MD, and I haven’t seen any trying to do so…they’re typically proud of the distinction.

  2. Dave Bailey says:

    “Still, it sets a bar grounded in science, and that’s a good thing.”

    Obviously not good enough to steer them away from their career choice. Perhaps, in the courses mentioned, there should be a greater emphasis on things that would highlight the flaws in alt-med. Maybe even an all-out attack.

  3. Gary says:

    What’s “two years of clinical practice”? Just watching an ND “treat” “customers” (elsewhere called “patients”)?

    • Erik Davis says:

      They typically work in clinics like the one in the ad above, which is run by CCNM. Could be quite rigorous for all I know, but as those clinics practice naturopathic nonsense, it hardly matters.

  4. Jeremy Chunick says:

    Hi,

    I come here infrequently to check out the articles and this is the first time I’ve posted. It just so happens that I had recently checked out the CCNM website when my brother told me he had sent his daughter to see a naturopath. I wanted to show him the kind of crap they peddle and I ended up finding this gem on their website under RESEARCH.

    http://www.ccnm.edu/research

    The slide show presentation shows a study they did titled, “Naturopathic Treatment for the Prevention of Cardiovascular Disease: A Randomized Pragmatic Trial”. They claim to have worked with Canada Post, who employs about 72,000 employees, but ended up screening just 1125 CUPW member of which only 246 participants were chosen. These participants had the highest relative risk of cardiovascular disease (CVD).

    Right off the bat I have a problem with this. You see, if these people are at the one extreme end then it stands to reason that any change will likely be in the positive direction (ie. an improvement).

    If you go on to read what they consider Naturopathic Interventions, you would possibly be surprised – or not – to find out that they include things like eating raw almonds, fruits and vegetables, and fish; taking supplements such as fish oil, plant sterols, fibre, cinnamon and CoQ10; and also doing a combination of breathing exercises, aerobic and resistance exercises, and weight loss counselling. I don’t know about you, but the last time I checked eating healthy, exercising and losing weight were not exactly what I would call alternative therapies/medicine. I thought that stuff was firmly grounded in science and “western” medicine.

    So, it comes as no surprise that there were positive results for the “Naturopathic Interventions” working better than just the “usual care” alone. By “usual care” I assume they meant going to the doctor and taking their medication which probably involved either cholesterol pills, blood pressure pills or a combination of both.

    It’s funny that my doctor, who is just a plain old regular MD, has suggested on many visits that I lose weight, eat healthier and exercise more in order to help reduce my blood pressure and cholesterol more than just my medication does alone. Hmmmm… I wonder if he’s getting these pearls of wisdom from those amazingly insightful naturopaths and their special naturopathic interventions?

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  • Erik Davis

    Erik is a technology professional based in Toronto, focused on the intersection of the internet and the traditional media and telecommunications sectors. A reluctant blogger, he was inspired by the great work Skeptic North has done to combat misinformation and shoddy science reporting in the Canadian media, and in the public at large. Erik has a particular interest in critical reasoning, and in understanding why there’s so little of it in the public discourse. You can follow Erik's occasional 140 character musings @erikjdavis