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{Authors note: I wrote this post in May 2011 when I was a fourth-year naturopathic medical student at Bastyr University.  Since that time the curriculum of both University of Washington and Bastyr have changed significantly.  As of 2012, Bastyr’s ND program has switched to a systems-based approach, similar to the 2011 curriculum of University of Washington (except of course with more emphasis on natural, whole-person treatments).  I haven’t updated the statistics in this article due to the incredible amount of time it takes to research and compare credit-by-credit the curriculum of the two schools. For updated references, visit www.bastyr.edu/academics/areas-study/study-naturopathic-medicine/naturopathic-doctor-degree-program#CurriculumYou can also e-mail a student ambassador in the naturopathic medicine program at admissn@bastyr.edu for more information comparing the curriculum.}

I talk about Bastyr and naturopathic medicine a lot.  By now all of my friends and most of my family’s friends are well-versed in naturopathic medicine, our role as primary care providers, and my educational level.  I was having one of these conversations with a family-friend (my parent’s generation) who finally asked me “so, you’re going to be, like, almost a doctor, aren’t you?” Ouch.

After nearly four years of medical school, dozens of 12-hour days, hundreds of patients seen, and more information than I can possibly fit in my brain, I certainly hope I will become a doctor.  This brings up a common misconception: that naturopaths are quacks who get online degrees and don’t know what they are talking about.

So what is our educational training? 

Naturopathic physicians attend four-year graduate schools that are nationally accredited by the Council for Naturopathic Medical Education (CNME).  The CNME is recognized by the U.S. Department of Education, which classifies the ND degree as a Doctorate-Professional degree, on par with MD and DO.  Currently 6 schools in the US and Canada are accredited through the CNME to provide naturopathic medical education.

The naturopathic program consists of at least 4 years of study with over 4,100 clock-hours in the classroom or clinic.  A minimum of 1,200 hours are spent in clinical education with direct patient contact under supervision.

The first two years of the ND program are very similar to an allopathic program.  We learn all the basic sciences including anatomy, biochemistry, immunology, microbiology, histology, pathology and physiology.  Here is a breakdown of the curriculum:

University of Washington medical students average over 70 credits per year (72 and 78 credits for the first and second years), which is similar to Bastyr’s ND program (74.5 and 77 credits for the first and second years, respectively).

The main difference in education between allopathic and naturopathic physicians in the the area of specialization.  By definition naturopathic physicians are specialists in natural treatment of primary care conditions.  From the beginning of our education we focus on primary care – diseases and conditions that a practitioner would encounter in an outpatient clinic.  We touch upon emergency medicine, surgery and high-force pharmaceuticals (like chemotherapeutic drugs) in the context of referrals and co-management.  However, unlike allopathic students we do not go through rotations in these areas.  While MD students do rotations in specialty fields in their 3rd and 4th years (like Oncology, Obstetrics, Surgery, etc), ND students do clinical work in naturopathic primary care only*.   We see people in an out-patient setting, directly managing the care of “our” patients under the supervision of a licensed naturopathic physician.

Also, naturopathic medical education differs in that we have a broad scope of practice with multiple modalities that we can offer our patients as treatment.  Throughout our education we have multiple courses in pharmacology, botanical medicines, homeopathy, counseling, nutrition, and naturopathic manipulation. In the state of Washington naturopathic physicians can prescribe most medications, perform minor surgery, offer counseling services (just like a licensed mental health counselor), offer nutritional advice (like a dietician), and perform osseous manipulations of the spine and extremities (like a chiropractic physician).


Naturopathic medical students also take board exams comparable to the USMLE boards taken by allopathic students.  These tests are called the NPLEX exams – naturopathic physician licensing examinations, and are governed by NABNE.  Only students from accredited schools of naturopathic medicine are eligible to sit for these exams.  Students must complete two sets of examinations, one after the first two years of the ND program (the basic science boards), and one after graduation (the clinical science boards).  Just for a comparison, our basic science boards are similar to USMLE Step 1 exam, and the clinical science boards are similar to the Step 3 exam.  The USMLE Step 2 exam, which evaluates physical exam and clinical skills, is similar to our Clinical Entry exam, which is governed by the school (Bastyr) itself – we must do a complete intake, physical exam, and differential diagnosis on a standardized patient (actor), graded by a member of the clinical faculty.  We must pass this exam (after our 2nd year) in order to see patients in the clinical setting.

Only after completing all 4,100 hours, passing both sets of board exams, and getting a diploma is a naturopathic student eligible for licensure.  This is in contrast to some so-called “naturopaths” who receive online or distance-learning degrees. In all 17 states that license naturopaths, only those who graduated from an accredited 4-year school can call themselves naturopathic physicians or doctors.

So to clarify, YES, I am going to be a doctor! A naturopathic doctor, that is. 

References:
Source: “Basic Science Curriculum.” UW Medicine.  University of Washington, 2011. Web. http://uwmedicine.washington.edu/Education/MD-Program/Current-Students/Curriculum/Basic-Sciences-Curriculum/Pages/default.aspx. 19 May 2011
Source: “Program Tracks and Curricula for Doctor of Naturopathic Medicine.” Bastyr University.
Bastyr University, 2011. Web.  http://www.bastyr.edu/education/naturopath/degree/curricula.asp. 19 May 2011. 
Association of Accredited Naturopathic Medical Colleges. AANMC, 2011. Web. http://www.aanmc.org/. 19 May 2011.


(*with a few exceptions – we can do adjunctive care for cancer patients, but not primary treatment). 

Dr. Erika Krumbeck
Dr. Erika Krumbeck
Hello! My name is Dr. Erika Krumbeck (or “Dr. K” to my littlest patients). I am a naturopathic doctor and licensed primary care physician in the state of Montana. I specialize in pediatrics, infertility and postpartum women. Most importantly - I am a Mom! I am passionate about providing accurate, helpful medical information for you and your family. I love sharing the latest research in medicine, debunking health myths, and providing an unbiased voice for controversial topics. This blog is also full of natural ways to safely heal yourself and your children.