Implications of Low Admission Standards in Naturopathic Education

Studying for MCAT

Britt’s Note: My husband recently suggested that I investigate the admissions standards for naturopathic schools.

I said, “You should!”

He replied, “Okay, I will.”

I welcome Taylor, my husband, archaeologist, general skeptic, and part-time dog trainer to NaturopathicDiaries.com with his article comparing the admission standards of naturopathic schools with nearby medical schools.


Naturopaths claim to be competent health care providers who can practice independently as primary-care physicians. In state legislatures around the country, NDs argue they should be granted wide latitude in diagnosing and treating diseases and be able to prescribe pharmaceuticals without supervision. Britt’s recent post on ScienceBasedMedicine.org begins to debunk this political platform by supporting the claim that naturopaths who practice medicine are dangerously underqualified.

Naturopathic Education: Admissions Rate Profile

Bastyr University’s naturopathic medicine program is one of the seven ND programs accredited by the Council on Naturopathic Medical Education (CNME). Britt’s education at Bastyr should be similar to any other ND student’s experience in any of these programs. Therefore, given her evidence, all students of naturopathic medicine are not qualified to practice medicine.

Yet, it is unfair to assume this statement is true without more data on the other six programs.

Until other ND students or alumni report on their education, this claim can only be tested by critically examining publicly available documents, like student handbooks and course catalogs, and counting hours as written. Even still, without course syllabi and testimony from individuals, the hypothesis that all NDs are under qualified to practice medicine is still difficult to test.

Let’s formulate a new research question in light of data that is comparable across ND programs:

Do the CNME-approved programs maintain rigorous admission standards for acceptance to study for a doctorate of naturopathic medicine?

Here is a table showing the enrollment size, acceptance rate, average undergraduate GPA, and percent female of the student body for each of the CNME-approved naturopathic programs:

MD acceptance rates

Immediately, the very high acceptance rates of naturopathic programs is striking. On average, nearly three out of four applicants to any program will be awarded admission. What stands out the most to me is that at University of Bridgeport all applicants are welcome to study. In any year, it would seem that there are a great deal of successful applications out of the total number of applicants, and those who chose to enter a program have an average GPA of about 3.3-3.4.

Curiously, there is a wide gender gap at ND schools. Besides National University of Health Sciences (whose ND numbers are combined with DC students), women typically outnumber men five to one. This is below the gender difference seen in primary education teachers in the United States, which is about seven to one, but it is still pretty elevated. There’s always value in putting thought into the social forces behind gender gaps, but I’ll leave it up to someone else to sort that out for the naturopathic profession.

To really understand these statistics on ND students, they need to be compared to students in MD programs. The following table presents the same statistics as the table above but now for the geographically closest medical school to each ND program:

MD acceptance rates table

MD programs are 20 to 30 times more selective than ND programs.

Undergraduate GPAs are much higher as well. (ND students are not required to take the MCAT or GRE for admission.)

The gender gaps are nearly even. (For now, I’m not getting into a detailed critique of the gender issues.)

The results are clear: Compared to medical schools, naturopathic schools do not have selective admissions nor do their students have better or equivalent undergraduate GPAs. I’d argue that in light of these data, naturopathic schools do not apply rigorous admissions standards.

The naturopathic education system appears to be drawing from an academically un-selective portion of the undergraduate population.

The implication of this finding is significant: Students of naturopathic medicine do not seem equipped to embark on an intensive course of study that will lead to the practice of medicine. The practice of medicine is one of the highest honors endowed to individuals in society. Our health and welfare depend on health-care providers, and especially physicians, being selected from the most intellectually competent slice of the population. Statistically, there are hundreds of NDs who could also have gotten into or did get into medical school, but it seems that the CNME-approved schools are not selecting from the same measures of ability as medical schools that serve to train physicians with a full license to practice medicine.

Image credit: Flickr user fvrt birdwhen yu sing under a CC License

 

Taylor is a doctoral candidate in archaeology at Kiel University.

  • http://motherfigure.com Meredith

    This is really interesting. The gender gap thing is striking. Could be lots of reasons, but I’m going to speculate (based on my experience in the women’s health world) that women are more encouraged to embrace the “spirit” within, to find their inner harmony, to align with the light. Or something like that. That kind of babble seems to coincide with images of women as more nurturing, as mother figures. If naturopathic means embracing the whole body, the root causes, while traditional medicine means clinical cold rationalism, the stereotypes align neatly (it’s like the stereotypes are writ large in ND school). Heck, I even found myself drawn to that language when I was pregnant, but my skeptical temperament eventually squashed it. Don’t even get me started on the natural childbirth language. The trust your body nonsense. I “trusted” my body and the repercussions aren’t pretty. As a feminist (aren’t we all), I’m actually disheartened by the disproportionate numbers. This means women are buying and selling more woo.

    • Beth

      I “trusted” my body and the repercussions aren’t pretty.

      If you’d care to share…

      As a feminist (aren’t we all), I’m actually disheartened by the disproportionate numbers. This means women are buying and selling more woo.

      There is actually some tendency for women to more often have various pseudoscientific beliefs, although it’s not as drastic as the ND numbers suggest. I’m not sure why that is.

      • Farikh

        I don’t see how you got to this “noteworthy conclusion” either. I know a lot of MDs that went to restorative school in the Carribeans because of low GPA and MCAT scores (have you taken a gander at the affirmation rates for Ross and SGU??) and I trust these MDs are impeccably fine clinicians. Ability is all the more firmly attached to passing your courses and board exams, less on your entering GPA. Sorry however this was an extremely powerless contention. click her http://zahanat.com/ecat-entry-test-preparation-2015

        • starri

          The washout rate for the Caribbean medical schools is astronomical. Only a certain percentage survive long enough to take USMLE, only a certain percentage of those pass and are able to enter the Match, only a certain percentage of those actually do match. And the Match is weighted heavily against Caribbean students, so in order for them to be even close to getting into GME, they have to have much more competitive scores than US grads.

  • Beth

    given her evidence, all students of naturopathic medicine are not qualified to practice medicine

    There are people who get ND training who already are MD’s or nurse practitioners.

    • Taylor Hermes

      I question how many people enter ND school who already have an MD degree. My guess is that these numbers are low. I’ve seen a few individuals advertise themselves on the internet who have an MD degree from a sketchy school, like University of Health Sciences Antigua or St. Matthew’s University, Grand Cayman, and also an ND in addition to other cryptic abbreviations after their names. Such international schools are specifically disapproved by the California Medical Board. As for nurse practitioners who then enter ND school, I still suspect these numbers are low, and the few cases are probably explained by falsifying credentials or having to depart their previous profession for failure to meet licensing requirements.

      • Ian

        Yes keep questioning everything especially conventional medicine. On this topic, there are also surgeons that undergo ND training. This should not be a surprise as ND training is legit and is overseen not only by NDs but also members of the public. For example, the licensing bodies must have 1/3 of representatives from the public appointed by the health minister. Unless you believe in conspiracy theories, thinking that the health minister is trying to fool the public, it becomes clear as day that naturopathic medicine is legit and worth investing in.

        • Beth

          ND training is legit and is overseen not only by NDs but also members of the public. For example, the licensing bodies must have 1/3 of representatives from the public appointed by the health minister. Unless you believe in conspiracy theories, thinking that the health minister is trying to fool the public, it becomes clear as day that naturopathic medicine is legit and worth investing in.

          Using similar reasoning – we have democratically elected politicians in the USA who think global warming isn’t caused by humans.
          Does that imply that global warming isn’t caused by humans?

          • Ian

            I’m not sure what global warming, which is an outdated term as there is cooling in some places, has to do with this topic.

            Do you believe global warming is solely caused by human activity?

            • Beth

              Then, could you tell me a non-mainstream, non-establishment, “fringe” idea that you do NOT believe in?
              Homeopathy?
              Bigfoot?
              UFO visitations?
              Astrology?
              Ghosts?
              etc. etc.
              What are you a skeptic on?

              • Ian

                What I just mentioned is an example of my non-mainstream skepticism. That humans are not solely the cause of climate change. This is because I consider North Amercian mainstream as fringe when compared to the world mainstream.

                My mainstream skepticism would have more to do with conventional medicine and its disappointing results in chronic disease.

                What is YOUR mainstream skepticism? And you still have not answered my first question that is do you believe we are solely respoinsible for climate change?

              • Beth

                “My mainstream skepticism would have more to do with conventional medicine and its disappointing results in chronic disease. ”
                OK, in THAT case:
                Suppose I told you that the health minister appointed representatives of the public to oversee mainstream medicine and that implies that mainstream medicine is legit and worth investing in.
                What would you think of THAT argument?

              • JGC

                Ian, no one I’m aware of has argued that that humans are the sole cause of climate change–who is it that you’re being skeptical of here?

              • Ian

                I’m not sure how the threads on this website work but for some reason I can’t reply to Beth’s last remark without having to her previous one.

                Beth: At some point I hope you also start answering my questions. It seems your strong suite is in asking questions and never wanting to engage in a conversation which shows your motivation.

                Regardless, to answer your question, I would give anyone the health minister has approved the respect they deserve as a primary care practitioner. Even if I find them misguided I would not belittle the entire profession who have members dedicated to helping humanity by calling them frauds or quacks.

              • Beth

                @Ian
                Do you feel that if a profession is regulated by the government, that means its treatments generally work?
                That seemed to be what you were claiming, by saying that naturopathy is “legit and worth investing in”.
                Do you think that if a large number of people see naturopaths, that means their treatments generally work?
                Or do you just think naturopaths may be well-intentioned? I agree with that.
                With the global warming question, I was only trying to translate your reasoning into another area, for purposes of illustration.

            • Taylor Hermes

              The current trend in warming is (extremely) (most likely) caused by people, but not all warming is caused by people.

            • JGC

              The IPCC has found that neither natural forces acting alone nor human activity of itself are sufficient to account for the observed rise in global mean temperature over the past 4 to 5 decades.

              The evidence also supports the conclusion that of the two, human activity represents the most significant contributor to the rise in GMT. (Human activity is also the only one we have the ability to alter.)

        • JGC

          “Unless you believe in conspiracy theories, thinking that the health minister is trying to fool the public, it becomes clear as day that naturopathic medicine is legit and worth investing in.”

          Actually, the only evidence that would demnstrate naturopathic medicine was ‘legit’ would be clinical sufficiently well designed, scaled and controlled clinical studies demonstrating naturopathic treatments perform as well or better than current standard-of-care science based medical treatments for the same indications.

          Got any, Ian?

          • Ian

            Got any money to fund these studies JGC?

            Should we stop and wait for studies and let people suffer or go by clinical observations and patient response?

            • JGC

              By what rational argument would it be my responsibility to underwrite the cost of studies which might demonstrate naturopathy was ‘legit’?

              Surely you’re not suggesting that just because it’s expensive to conduct the necessary studies naturopaths should be held to a far lower or absent standard of proof that their treatments are safe and effective than we require of all other providers of medical interventions (physicians, surgeons, drug developers, the manufacturers of medical devices, etc.)?

              • Ian

                I would like studies on conventional medicines showing proof that they can eliminate the cause of disease.

                • Taylor Hermes

                  Are you familiar with vaccines?

              • JGC

                Ian, first I’ll note that you’ve avoided answering my questions:

                Is it not the responsibility of the ND’s prviding treatment to fund and conduct studies demonstrating the treatments they provide (at a cost) are safe and effective?

                Shouldn’t ND treatments be held to the same standard of proof that all other metdical interventions are held?

                As for “studies on conventional medicines showing proof that they can eliminate the cause of disease”, how do you think antibiotics and antifungals work other than by eliminating the pathogens which cause bacterial and fungal infection, or statins other than by eliminating excessive circulating LDL resulting in cardiac events?
                Perhaps you’re using some non-standard definition of the word ‘cause’ here?

            • Beth

              Should we stop and wait for studies and let people suffer or go by clinical observations and patient response?

              Indeed, why bother doing research at all, if clinical observations and patient response are just as good for evaluating a method?
              Why not just try out ideas on the patients?

              • Ian

                LOL you’re so naive as to think this is not already happening with conventional medicine. Where is the art of medicine if doctors are not trying different methods based on patient response.

                You want cookbook medicine instead? The only relevant evidence for an individual patient comes from clinic observations and yes experimentation.

                Again dont be naive on this matter. Experimentation is what practice is all about.

              • Beth

                Ian,
                Do you think that clinical observations and patient response are just as good as scientific studies to determining the usefulness of a treatment?
                If that’s what you think, why bother with the research?
                Why not just try the treatment out on patients?

        • Brenda Hill

          Your black and white options betray a woeful lack of critical thinking skills. There are other possibilities. Consider that Ministers of the Crown are elected officials, politicians who may or may not have an appropriate level of science literacy. It need not involve a “conspiracy”, as you put it; the Minister will do what it takes to get re-elected, and there are plenty of naive voters who embrace all sorts of pseudo-scientific balderdash.

  • Beth

    Also, in some states nurse practitioners are allowed to practice on their own.
    If one believes this is OK, then ND training should be compared to nurse practitioner training.
    I don’t like the idea of NP’s practicing on their own, although it may be necessary in some areas where there aren’t enough MD’s.

    • Beth

      A nurse practitioner’s practice would have some similarities to an ND’s practice, in that people who are seriously ill tend to have the sense to go to MD’s instead.
      From what I’ve read, most of the people who go to ND’s are relatively healthy, and they don’t often see cases where emergency treatment is needed.
      For that reason also, comparing ND training to NP training is perhaps more just.
      There seems to be more deception involved in being an ND, more pretending to be a real doctor – and perhaps it’s more likely that seriously ill patients will go to them and be misdiagnosed and mistreated.
      And seriously ill people don’t always know they’re seriously ill.
      That’s a big “perhaps” – ND’s as primary care providers really make me shudder, and I also don’t like the idea of a NP practicing on their own.

      • Jennifer

        From what I’ve read, most of the people who go to ND’s are relatively healthy, and they don’t often see cases where emergency treatment is needed.

        Where did you read that? It would be interesting to explore this more — how do ND patients compare to NP patients compare to PCP (MD) patients? I imagine there are actually quite a few different ways to compare them. I suspect that there is a higher proportion of patients with chronic conditions seeing NDs, but I wonder about healthier. (I doubt PCPs “often” see cases where emergency treatment is needed, for a few different reasons, but honestly I don’t know.)

        Also, why does the idea of independent NP practice bother you? It’s based on solid standards, unlike ND practice.

        • FunknJunk

          Yeah, I don’t get this type of response you replied to … Taylor has done some solid little basic research here based on the premise, which I have heard many, many times, being a Seattleite, that NDs are just as educated as MDs and sometimes even have MORE training! Now, the goalposts have been moved? We should compare NDs to NPs? I . Don’t. Think. So. That’s not the BS line I’ve been handed … “We have just as much training as NPs@!!” Nope. But, let’s add that to the list of tasks for Taylor and Bree! Go for it, guys. Let’s compare NDs and NPs as well .. I’ll bet money on where that comparison lands …

          • Beth

            If the point is to rebut the claim that ND’s are trained as well as MD’s, I agree.
            If the point is to evaluate whether ND’s are qualified to do primary care at all, perhaps they should be compared to NP’s, because a NP is (at least for routine problems and for most patients) able to do primary care on their own.

            • JGC

              The scope of practice for NP’s is determined by state law, but I don’t believe that in any state it comes close to the scope of practice for licensed MD’s.

              Correct me if I misunderstand, but I believe also that NP’s are educated to provide care for a specific client population selected on entry into their NP training program (e.g., as a Pediatric NP, Geriatric NP, Acute Care NP, Neonatal NP, etc.). As their entire didactic and clinical training is devoted to the clinical area in which they intend to practice they’re actually not trained to proivde care–primary or otherwise–for routine problems or most patients. ND’s, on the other hand, are arguing for the ability to provide care for a far broader client base, similar to that of an MD.

          • Beth

            I wonder if studies have been done on the outcomes when similar patients go to MD’s, NP’s, ND’s, DC’s for primary care.
            Is the treatment effective? for example for a patient with high blood pressure?
            Do they refer appropriately and recognize when a situation is an emergency?

        • Beth

          Where did you read that? It would be interesting to explore this more — how do ND patients compare to NP patients compare to PCP (MD) patients?

          Not in a research study, although perhaps there has been some such research.
          Just comments here and there, have given me that impression. For example a naturopath responding to one of Dr. Lipson’s “Primary Care Challenges”, said that it would be a very exciting month when he saw one person similar to the “challenge” case.

          why does the idea of independent NP practice bother you?

          MD’s get a lot more training, and hopefully that makes them more likely to get the less common diagnoses right.
          And based on my experience seeing NP’s, I think they’re OK for routine problems, not so much otherwise.

      • Suzanne

        I think this is the real issue! I don’t think naturopaths should have the ‘ND’ title as it is confusing for the public. Naturopaths should work in the same way that physiotherapists or occupational therapists do, to support the work of a primary care physician.

  • Nanea

    Thanks for enlightening me further about ND vs MD!

    I think there’s something wrong though with the admission numbers: the ND table says U of Bridgeport takes everyone who applies, but in the text it’s Boucher. Not nitpicking, just pointing out…

    • Taylor Hermes

      Fixed! Thank you.

  • Dale Smith

    This is a great start, but there is another level to consider.

    If you compare the actual requirements between MD and ND programs, the MD programs require more coursework that is more challenging, and more of it. So these tables are not comparing apples to apples.

    For example, at Southwest College of Naturopathic Medicine, students are only required about half the chemistry required for most MD programs. At the National University ND program, they don’t even specify how many courses are required in each area.

    If ND programs had the same requirements as MD programs, their students would likely have even lower GPA because of the harder coursework.

    • Cruz

      Or not, during my pre-med years I met many students that did very well in the basic sciences (General Chem, Organic Chem, Physics and Bio); they just did not want to take the MCAT and/or were really swayed by the philosophy of Chiropractic or Naturopathic ‘medicine’. Most of the people that went in the chiropractic direction believed that they could start making money after four years of study with a DC degree and the ones that went into Naturopathy were kinda crunchy, health-obsessed, yoga-obsessed, ‘spiritual’ seeking people. Most of them were actually really good students, bright otherwise, just very irritating with their contrived enlightenment.

      • Jane

        When you are enamoured by biomedical sciences and besotted by food, that is when the allure of naturopathy works! It is such a pity that at the end of course work and ‘clinical’ rotations, you wake up to realise that your scope of practice and capacity to help others is minimal. That those years of work, and often hard work, could have been put to better use.
        I am going back to study, this time taking the MD route, and hopefully the thorough understanding I do have of CAMs won’t make all those years such a waste.

        I would like to say though, not many naturopaths in Australia agree with homeopathy and very few practice it. I do despair when naturopathically trained people cannot see how poor the evidence for the ‘intervention’ is. Not to mention how aggressive said people become in their defence.

        It makes no sense! How can less than 1o^23 of a substance be therapeutic? By that logic, everything we come in to contact with has some drug effect. I mean, what dose of homeopathics are we getting when we swim in the ocean?!?! I just don’t understand.

        • JGC

          A useful exercise when evaluating the evidence supporting alternative medical treatments is to ask yourself “If all Merck or Glaxo-Smith Kline or Novartis could offer in support of their next new product (chemotherapy agent, antibiotic, anti-depressant, etc.) was the same tyoe and quality of evidence (anecdotal accounts, personal testimonials, small inconclusive studies) would you accept that it should be approved by the FDA/EMEA? or would you insist they do more-actual phase I,II, and III clinical trials–to demonstrate its safety and efficacy?

          I can think of no rational reason why naturopathy’s claims should be held to a lesser standard of evidence.

  • David

    Even more telling would be an analysis of which undergraduate schools people are applying from. Those applying to md with those high grades are getting them at distinguished schools whereas those applying to naturopathy and chiro often seem to do half their schooling at community college or non competitive schools. It is a big difference getting a 3.9 gpa at an Ivy League school versus a 3.1 at a state school or college.

    • Cruz

      That’s why we have the MCAT! Not everyone can or will go to a ‘name’ university… I went to a State University versus a name because of cost; I went to community college first and then transferred to a State school (something many medical school students (MD and DO) do – I did not want to have debt for my bachelor degree and I had to work (mommy and daddy did not pay for my education, I financed most of my undergraduate); Medical School is expensive, so I only want that as my student debt. The MCAT is supposed to be the true equalizer between school variances – To do well on the MCAT you need to understand the physical and biological sciences well and you need to show reading comprehension at high academic levels – so someone from a State University that scores a 39 with a 3.5 GPA can readily compete with a 3.9 GPA but a low 32 MCAT from Yale.

      • David

        Point well taken! I am coming from canada (although I did do some university in the US). Here the prices of community college versus university are pretty well the same.

      • David

        Furthermore Cruz, I commend you on getting in to med school without the advantage of rich parents or a named school. Unfortunately , the admissions process does not take this into consideration. Even the mcat which you say is an equalizer, still favours the rich and advantaged. For example, not many peope have the luxury of spending 4 months studying for the mcat full time with numerous prep courses (as many of my classmates did).

    • Petticoat Philosopher

      There are many extremely intelligent and hardworking people who go to those schools that you disparage and community colleges are a “way in” to college education for a lot of people. Although the more well-heeled elite schools can be fairly generous about scholarships for low-income students, your socioeconomic status is still the biggest predictor of where (and if) you go to college. I’ve spent years working with at-risk and low-income students who go to inner city public schools and, for most of those kids, the Ivy League is not an option, even though I’ve known some exceptionally brilliant kids. They struggle just to be the first in their families to go to college at all. Some of them have made it and, if they decide to become doctors, we will all be better for it.

      A friend of mine who is an MD came from not particularly “distinguished” school–it was the option that was available to her at the time–and worked extremely hard. I’m glad her medical school (which incidentally was Ivy League) didn’t have the same snobbish attitude towards colleges as you do.

      • Beth

        c’mon, David already said he’s in Canada and the price of community college is similar to a university. Maybe in Canada, students who are bright and dedicated but poor, don’t go to a community college.

        • Petticoat Philosopher

          I posted this comment before that other exchange took place. I’m glad to see that David is receptive to the idea that, in the US, class background plays a major role in who gets to go to an elite undergraduate institution. Canada is a much more equitable society and it probably is hard to understand the depth of social inequality here if that’s your experience.

  • David

    I will tell you a story illustrating my point. I was near the top of my class in high school and went on to go to one of the best universities in North America. I got grades and was able to get into medical school. When I returned to my high school 10 year reunion I was talking to a classmate who said “did you know joe and mike are doctors like you”. I thought to myself, how is this possible. Joe and mike could not even get into university and went to the local community college. Apparently, they were able to transfer their community college credits to some university and then one applied to chiro and one to naturopathy. To rub it in, both had dr on their name tags whereas I used my first name only.

    • Beth

      I don’t use “doctor” for other than MD’s, DO’s or vets.
      Modern medicine has made such huge improvements in human and animal health, and we respect it for that reason. When ND’s, DC’s etc. call themselves doctors, they’re trying to steal that respect.

  • DANIEL GAUTREAU

    The notion that science and mathematics are masculine influences women towards unscientific beliefs. Most people of each gender have no knowledge of what science is or what scientists do. Many think it it is an attitude or a cult. If it were either, and if it were masculine, women would naturally be dis-inclined to join it. Of course it wouldn’t have any record of success either….. Two centuries ago when science was less influential and much less valued, men often asserted that women were innately better-equipped for it, and men were better at language and communication (And hence deserved to run all the government).

    • Rachel

      That is so interesting that it used to be thought that women were better at science/math and men better at language. Do you have a reference that discusses this? I’d love to read more. I was very impressed a couple of years ago by the Harvard implicit bias test, which shows that today’s attitudes are quite the opposite.

  • http://www.openmindedhealth.com Rose

    Interesting. As a medical student (MD), would love to see a further breakdown. We have a number of requirements beyond GPA, including MCAT scores, required coursework (2 years bio, 1.5 years chem, 1 year physics, and so on), extra curricular activities (research, volunteering…), shadowing experiences, and letters of recommendation. Do NDs have anything that is at all comparable?

    • John O’Malley

      My experience with ND admission was exactly that, all of that. Except the MCAT. All the requirements of MD medical school except for the MCAT. Which I hear they is some consideration about instituting in 2017. I even took the MCAT but they didn’t want the score. I did all my undergraduate pre-med at UWash, a very competitive program, tons of shadowing, volunteering, extra curricular activities, and so on.

  • Don

    I’d be interested in the graduation rate. I appreciate schools will give students all the help they can, but a 100% graduation rate would be suspicious

  • http://tzafrir.org.il Tzafrir Cohen

    I’m not sure I understand your conclusion. There is a big demand for medical studies. There are limited seats. Hence the great competition. It doesn’t mean that those who were not accepted couldn’t be good (enough) doctors had they been accepted.

    Those programs are more selective. This may mean that there is less of a demand for studying for ND or that it’s cheaper to create a new place for an ND student to study in and hence there are more places. The limited resource is access to a hospital or whatever .

    I truely suspect that thoseschools are somewhat shoddy. It is just not the conclusion of your data.

    • Taylor Hermes

      The conclusion is simple: naturopathic programs are not selective.

      The conclusion is not that the schools are shoddy. The implication is that students who study in a naturopathic program are not prepared to study as physicians in medical school. Therefore, they are probably not receiving the “same sciences training as an MD.” This statement is advertised by many ND schools and professional organizations. The statement is likely false.

      • John O’Malley

        Anyone who has a 5th grade education knows that percentages in this case mean nothing without (total accepted / total applicant) numbers. If Bastyr only had 200 applicants while the University of Washington had 50,000 or 60,000, then you are comparing apples to oranges here Britt. Apples! Oranges! 😉

        • Taylor Hermes

          Actually, the percentages already reflect total accepted / total applicants. I think you meant to suggest that a missing figure in my analysis is the matriculation rate. I would argue if the acceptance rate between ND and MD schools were more similar, then the matriculation rate would help explain the differences. Yet, in this case, with a 20-30 times higher acceptance rate for ND programs, your suggestion is irrelevant. The numbers speak for themselves.

          • John O’Malley

            Actually Taylor, the numbers do not speak for themselves. There are only 8 ND doctoral programs in the entire country. The majority of the population doesnt even know they exist. The average medical student doesnt know they exist. If every medical student who is applying to the hundreds of MD/DO programs knew about ND programs and had equal opportunity to consider applying to these programs, then you could use that logic. But the ND schools are drawing their applicants from a much smaller pool due to the fact that there are literally invisible to the mainstream medical student applicant population. I have many MD/DO medical student friends who didn’t even know about ND when they were applying to their programs….. Honestly, in all seriousness, you are grasping here. You are drawing conclusions about the selectivity of ND programs based on some real shaky “logic”. The conditions under which ND admission operate are not comparable to the conditions under which MD and DO programs operate. How can you and Britt not see that?

            • John O’Malley

              Also Taylor, According to AAMC, American Association Of Medical Colleges,

              https://www.aamc.org/newsroom/newsreleases/358410/20131024.html

              in 2013 – 48,000 people applied to about 150 different MD/DO programs around the country. I did some research and found the matriculation number for University of Washington is roughly 240 per year. They have a 4% acceptance rate. It is likely that just about everyone who is accepted to the program will matriculate because it is an excellent school, but not all… so lets say accepted is around 340. So total applications for just that one medical school is about 9,000 applicants. If we take 9000/48,000 then we see that about 20% medical school applicants applied to UW. Or about 1 in every 5 pre-med students applied to go to medical school at University of Washington. That is a lot. This tells me that student are applying to more than just one or two schools in their application process (which is what the case is for the ND applicant). I know for a fact the average pre-med students apply to 15-20 As an ND student, I had only 8 choices, and only 3 of which I considered to be good fit for me and I applied to just two. So how again are these numbers NOT comparing apples and oranges? Simple math buddy.

              918

              • Reasonable Roger

                John O’Malley
                Let’s say that, hypothetically the MD medical schools had a 90% acceptance rate just for the sake of argument, meaning, they accepted even more % of students than ND schools, even when you took into consideration that one student applied to more than 15 MD schools on average vs. an ND student who only applied to 2 or 3. Let’s just say MD schools were much much easier to get into.

                …OK. Are you imagining this?

                OK. So first of all this says NOTHING about the difference in education between the two types of schools. Likewise, MD schools attract MD caliber students and ND schools attract…students who don’t need to take the MCAT, who may not exactly be serious science majors, etc.

                Forget about the acceptance rates. Look at the DROP OUT RATES.
                MD schools have a 96% graduation rate. People who enter those schools, finish.
                AAMC posted a bulletin on their site a few years ago (https://www.aamc.org/download/102346/data/aibvol7no2.pdf) Over 80% of students in the cohort they followed graduated in 4 years and that came up to 96% if you followed out over 10 years.

                At ND schools you have huge drop out rates. It’s a result of poor selection of students. It’s a result of the schools knowing that the more people they can accept, the sooner, the better for them. They KNOW 30% or so will be gone by the end of year one but that’s just more money in the bank.
                That’s how it works. I would know. I’ve seen it. Multiple years.

                But beyond all that…that’s not the real issue. The real issue is that ND students are not prepared properly with a sensible education to be primary care physicians.

                The acceptance statistics and the details are just that, details.

                Don’t try and make the ND profession look like it is not in need of major overhauls.

              • John O’Malley

                Roger, It won’t let me reply to your below post for some reason so I am replying to this one instead…. I appreciate the response but where did you get this 30% drop out rate for ND first years? That is laughable, ridiculous, and sounds completely made up. I would attest that it is more like 5-10% in the first year and less than 3% each subsequent year. Those who do leave their program generally are just transferring to another ND school to be closer to home. At least that is the case at Bastyr. ALSO, in the above article I posted from American Medical School Association, the total rate of matriculation among “first time applicants” (which I think is a better data set, was 20,055/35, 727 or 56%. So what can we draw from this data? That 56% of first time applicants ended up 1. being accepted to any number of schools, and 2. enrolled in one of those programs. 56%…. That means that 44% of first time applicants either were accepted into a program and didn’t go to any (which seems highly unlikely) OR they were not accepted anywhere. I would assume that pre-med students, either ND or MD/DO bound would, at then end of the day, chose to enroll in a program, even if it wasnt their top choice. So of those students who desired to receive a MD/DO education 56% were deemed worthy to both do it…and did it. Within the ND realm, I dont have exact numbers of total first time applicants because no one tracks that….but based on total enrollment numbers and acceptance rate we can surmise it is somewhere in the realm of 65-70%. You can definitely debate me on this because I am making an assumption here, but its one based on available data. So the selectivity of entrance into ND vs. MD/DO medical programs is not equal but it is also not so far off as represented above in the data charts. I completely agree with you Roger that ND schools need to be more selective, but that is a luxury that these niche type of programs currently do not have, but the trend is towards it

  • Marty

    The grade point average is telling, of course. But something I noticed 30 years ago is that the people in naturopathic school were not necessarily college graduates in the first place. There was a track that an interested person could follow to get into naturopathic school that didn’t require a college degree. Naturopathy is a modern remnant of the pre-scientific world known as “natural philosophy”.

    And the thing that binds the extremely diverse and even seemingly mutually exclusive philosophic practice choices of the graduates is that they agree to comport themselves as modern natural philosophers. Oh, and they love to play doctor.

  • Reasonable Roger

    I would like to remain anonymous. But for the record I am in the naturopathic profession.
    I, like Mrs. Hermes, am so very disappointed and concerned about the quality of education that naturopaths receive.

    Naturopathy attracts low-quality applicants (doesn’t mean everyone in an ND school is lower quality, but the general rule of thumb is very true).

    Naturopathy mixes some really great principles with some really poor principles devoid of any evidence. But medical school shouldn’t be about getting it kinda right. It shouldn’t be about finding a “healthy balance” of bullshit and effective therapies. DO AWAY WITH THE BULLSHIT.

    Osteopathic medicine used to be in the same camp as naturopathic. But D.O. schools require an MCAT. They have relatively good residencies. They have relatively good quality students. They promote evidence-based medical diagnosis and treatment. And yet, they also have this philosophy of “treating the patient as a whole person, not as a name with a disease.” They have a slight stress placed on physical manipulation techniques.

    In the same way, naturopathic schools should do this too. There’s nothing wrong with “treating the whole person.”
    What’s wrong is using unproven methods like homeopathy, acupuncture, applied kinesiology, and so on.
    The field of naturopathy needs to be either done away with, or revamped. And this is coming from someone in the field. I’m able to look objectively at the picture as an insider too and I agree with Mrs. Hermes and her husband 100%.

    When you spend entire chunks, course after course teaching homeopathy, acupuncture, hydrotherapy, etc…you do so with the expense of teaching something that isn’t useful AT ALL (like homeopathy), or, it is minimally useful and of very very dubious benefit (acupuncture, hydrotherapy). Not only that but that time spent wasted on those methods draws away from time that could have been spent on a more useful area of education!

    This is a disgrace.

    • darwinslapdog

      Enjoyed your comment. I often wonder which of my many MD’s over the years (I’m old) didn’t bother to “treat the whole person”? What does that phrase even mean? Not much beyond a feeling of being cut short by a doc too busy to listen to your interminable stories of vague unease, I suspect.

      • Ken Phelps

        “Sell the sizzle, not the steak”.
        I suspect that the thinness of alt med’s intellectual steak accounts for their emphasis on the sizzle of patient relationships.

    • Petticoat Philosopher

      I’ve had MDs (and NPs) that I felt did “treat the patient as a whole person” (if we mean the same thing by that–it’s a nebulous concept) and MDs who didn’t. That’s about the ability to empathize, listen, make the patient feel comfortable discussing sensitive information etc. Now I’ve mostly worked in non-profit youth development and will be going back to school for my MSW this fall (with the intention of continuing my work with youth) so far be it from me to downplay the importance of these skills and talents–and that is absolutely what they are. But that skill set is not a replacement for medical expertise, even if they ought to be a companion to it, and it is not the sole province of naturopathy. The doctors I have have seen who have excellent bedside manners and are actually real doctors at the same time demonstrate that.

      Also, medical schools train all kinds of doctors and for some, the “soft skills” (I hate that term but for lack of a better one…) you are talking about matter more than others–think of what being, say, a pediatrician requires vs. a radiologist. So it would not make sense for medical schools to actually screen applicants for these abilities because some people will need them more than others, depending on the area of medicine they go into. One just has to hope that people who are gifted in forming relationships where people feel cared for and feel safe sharing high-stakes personal information will gravitate towards the specialties where those gifts are important. Obviously, that doesn’t happen all the time but what’s the alternative? Not seeing “doctors” who aren’t actually doctors, that’s for sure.

      • Petticoat Philosopher

        Er, that should be “even if IT ought to be a companion to it.” I’m lost without an “edit” button after a long day…

    • John O’Malley

      Roger, Homeopathy comprised roughly 3% of the total didactic hours of the curriculum and Acupuncture is a dual track degree, not mandated. Believe me, the majority of time is spent leaning biochemistry, anatomy, physiology, pathology, immunology, infectious disease management, and systems medicine. Herbal medicine and physical medicine comprise about 15-20%. Counseling is about 5%. Thats great you are “in the field” but you are not in the ND field and thus you dont know what you are talking about my friend.

      • Mildly Confused

        If NDs study homeopathy and real drugs on the same course, how come their heads don’t explode at the contradictions in dosage?

    • WL

      Thanks. Always good to hear from someone with skin in the game.

      Question: I’m in complete agreement that all medicine should be as evidence based as possible, but if so, what would be the point of retaining ND schools at all? They seem to strongly object to any science that contradicts the woowoo, and howl like banshees at the idea of standards of care.

      If you do away with the bullshit, what remains that isn’t properly covered by a team of MDs, RNs, and techs?

      • Beth

        If you do away with the bullshit, what remains that isn’t properly covered by a team of MDs, RNs, and techs?

        Doctors don’t tend to do very well with illnesses that aren’t well understood by science. They often just treat the symptoms in that case, or think the patient is imagining things and don’t treat them at all.
        Perhaps because doctors are reluctant to think (or practice) out of the box, because it might lead to a malpractice suit.

        • Alain

          Doctors don’t tend to do very well with illnesses that aren’t well understood by science

          Why should they? The scientific method & data is enough to cover a royal bunch of illness that cover the world’s population and while you may prove me otherwise, please do so using science methods & data, not something that isn’t rooted in science because all of the illness not found using scientific methods are being devised by lower reliabilities methods which is relied upon by practitioners of alternative “medicine” who are not using science to find out if their methods work.

          The scientific method == find your best hypothesis, usually from a literature review but could be anything else and then, test out the 20, 30, 50 or 90 alternative methods for which your treatment work to find out if you have the best hypothesis or else, it’s something else that provide a better explanation for your treatment method work, or does not work. This is philosophy science (not invented by scientist btw). Can you find a better method? if so, apply for a philosophy PhD.

          Alain

          • Beth

            Why should they? The scientific method & data is enough to cover a royal bunch of illness that cover the world’s population

            Have you heard of illnesses that aren’t well understood? Such as chronic fatigue syndrome?
            Many people do suffer from illnesses and go to doctors for decades, without finding any real answer.

            • JGC

              The doctors are not now able to provide “real answers” doesn’t argue these clients might benefit by going to naturopaths, given that ND’s have not demonstrated an ability to real answers either.

          • Beth

            Sometimes when people have illnesses and aren’t helped by MD’s, they turn to naturopaths.
            Do you think they never get help from the naturopaths?

            • JGC

              If they are getting help from naturopaths, shouldn’t there be a body of evidence demonstrating that ND interventions are safe and effective?

              And if there isn’t, is there any reason to believe they are getting help?

              • Beth

                If they are getting help from naturopaths, shouldn’t there be a body of evidence demonstrating that ND interventions are safe and effective?

                How does that follow?
                Perhaps such people sometimes get help from naturopaths and sometimes they don’t.
                Perhaps such people are sometimes harmed by the naturopaths they seek help from.
                My question was, do you believe that such people never get help from the naturopath that they go to?
                Plenty of them tell us they do; do you think they are all kidding themselves?

              • Beth

                is there any reason to believe they are getting help

                If you ask whether such people (who don’t get help from mainstream medicine and then go to a naturopath) are on average helped – how could we even know the answer to that?
                I don’t know what naturopaths do on average.
                If we ask whether some people in this situation are helped by the naturopath – I do think so. It would be very surprising if the naturopath’s intervention never helped.

              • JGC

                “How does that follow?”
                Is that a serious question? If a medical intervention is effective–i.e., some people ‘get help’ from it–we’ll see evidence this is the case: outcomes in people who have received the intervention will be superior to outcomes in those who have not.

                “Perhaps such people sometimes get help from naturopaths and sometimes they don’t.”
                We would still see evidence that some get helped. For example, in childhood ALL some people “get help” from the current standard of care chemotherapy while some do not, but the likelihood you will be one of the ones it helps is measurable (70% 5 year survival rate, I believe)

                “My question was, do you believe that such people never get help from the naturopath that they go to?”
                I don’t believe that people who go to ND’s get help if they receive only treatment modalities that are embraced by naturopathy but also common to evidence based medicine. They may benefit from nutritional counseling for example (as long as it is evidence based) but demonstrably will receive no benefit from homeopathy or acupuncture that is superior to placebo treatments.

                “Plenty of them tell us they do; do you think they are all kidding themselves?”
                I believe they are wrong.

              • JGC

                “If you ask whether such people (who don’t get help from mainstream medicine and then go to a naturopath) are on average helped – how could we even know the answer to that?”

                If we can’t ‘even know the answer to that’—if naturopaths can’t know whether or not the medical interventions they provide their clients are more likely than not to result in improvements to their health—how can could possibly be considered ethical to charge clients for services rendered?

              • JGC

                Typo clarification: should have read “I don’t believe that people who go to ND’s get help if they receive only treatment modalities that are embraced by naturopathy but not also common to evidence based medicine.”

              • Beth

                If a medical intervention is effective–i.e., some people ‘get help’ from it–we’ll see evidence this is the case: outcomes in people who have received the intervention will be superior to outcomes in those who have not.

                No – maybe the naturopaths sometimes help people and sometimes harm them.
                It could be that on average people are not helped or even on average harmed – and yet, some people are helped.

              • Beth

                I don’t believe that people who go to ND’s get help if they receive only treatment modalities that are embraced by naturopathy but not also common to evidence based medicine

                Does that mean you believe that people who go to ND’s do NOT get help if they receive only treatment modalities that are embraced by naturopathy but not also common to evidence based medicine?
                If so – what is the basis for your belief?

              • Beth

                I don’t believe that people who go to ND’s get help if they receive only treatment modalities that are embraced by naturopathy but not also common to evidence based medicine.

                It’s not so black and white as that, a lot of the time. With some approaches, ND’s might be more likely than MD’s to try them.
                As I pointed out earlier, MD’s seem to be much more vulnerable to malpractice suits than ND’s, and this has a downside: they may omit some treatments that would help a patient, out of fear of a malpractice suit.

              • JGC

                If naturopath’s “sometimes help people and sometimes harm them” with the numbers working out so close to even there’s no detectable benefit, then you’re as likely to be harmed as helped if you seek treatment.

                And in that case–unless there’s some reliable way to identify prior to treatment whether someone will be helped rather than harmed–it’s unethical for ND’s to provide these treatments.

                Agreed?

              • JGC

                “If so – what is the basis for your belief?”

                The lack of any evidence that either those treatment modalities help anyone or the existence of evidence that they do not help anyone (e.g., acupuncture and homeopathy).

                Again: if treatments work there’d be evidence. Even if they only helped some people there’d be evidence (consider herceptin). There is none for many of the modalities embraced by naturopathy.

            • JGC

              “It’s not so black and white as that, a lot of the time. With some approaches, ND’s might be more likely than MD’s to try them.”

              The fact that they might be more likely to try some forms of treatment doesn’t argue those forms are likely to be effective or that ND’s are likely to help people that MD’s cannot.

              Being open to trying new things isn’t of itself a virtue, if there’s no reason to believe whatever new thing you’re trying will be beneficial.

        • Beth

          Doctors don’t tend to do very well with illnesses that aren’t well understood by science. They often just treat the symptoms in that case, or think the patient is imagining things and don’t treat them at all.
          Perhaps because doctors are reluctant to think (or practice) out of the box, because it might lead to a malpractice suit.

          In other words, the standard of care in medicine has a downside as well as an upside. It means that doctors are vulnerable to malpractice suits, which leads to CYA medicine, both in terms of not giving care the doctor might otherwise reasonably give; and also in terms of doing testing and giving treatment the doctor might otherwise not think justified.

          • Alain

            US doctors are vulnerable to malpractice suit. Elsewhere in the world is a different story (and yes, they can be vulnerable to malpractice suit but much less compared to US based doctors).

            The thing is, they have the necessary education to deal with really rare condition affecting at most 1 out of a million peoples and at the least, 1 out of a billion peoples, they are equipped with the clinical skill to arrive at the most correct diagnosis while assuming they might be wrong about that diagnosis but then again, as one of my infectious disease here, his motto os: always wrong, never in doubt; which also apply to naturopath. They key difference is that the doctor ask the right questions to arrive at a correct diagnosis while the naturopath does not.

            Keep in mind that this for clinical situation, for research, the research method which I used previously does apply, even for a single patient with an unknown aetiology for which she or he represent a good case study to carry further research and find more accurate answer. This is the very reason some medical treatment has been abandoned, some diagnostic criteria have been devised (CFS for exemple but it remain a work in progress).

            My opinion (which is informed) is that, we need to digest through all the science data that have been collected to arrive at better diagnostic test and treatment available but it start at one point, the money given to research & translational scientists which is a political issue; not the scientific method which is good enough as a method of inquiry.

            Remember, if the diagnostic isn’t devised using the scientific method, it’s of no use because no one on this planet devised a better method despite centuries of research.

            Alain

          • Alain

            Oh and btw, for medical doctor to carry clinical trial on any modalities, you and I need 4 or 5 years of medicine training (US and Canada, in Europe and Asia, it might be different), a 3 or 4 years bachelor degree in science or more (engineering), an optional master degree and a mandatory PhD degree (could be replaced by the Master if the board of medicine in provinces or states allow it but they recommend a PhD).

            ND === 4 years of naturopathic college as written by Britt here on many of her posts.

            In both case, it is possible to study anything but in the case of MD’s, they are bound by the hippocratic sermon and the geneva convention which I don’t know about ND but I can ask Britt, is this the case at Bastyr?

            Alain

            • Alain

              I think I lost my previous post.

              Will be back tomorrow.

        • WL

          Beth, you are correct that docs “don’t tend to do well with illnesses that aren’t well understood…” but then why on earth would a naturoquack do any better? Pretending to understand an illness, doing placebo treatments, and just generally making stuff up doesn’t strike me as a reasonable alternative.

          For a real doc to practice “outside the box” (at least very far out) would indeed be legally dangerous–that’s because real medicine has standards of care, which the various quackopaths do not. The quacks don’t get sued as often for that very reason, i.e. it’s kind of hard to prove that, say, “orthogonal qi meridian magnetoquantum energy therapy” caused harm when it doesn’t exist on this actual planet and has no standards associated with it.

  • Reasonable Roger

    Naturopathic schools should ideally function like this:

    1. Require an MCAT
    2. Absolutely get rid of teaching homeopathy
    3. Turn acupuncture into an optional part of the education (for instance have an ND program and have an optional ND+ program that is slightly longer or more intensive that incorporates acupuncture but by no means makes it an integral part of the education)
    4. Focuses everything on evidence and science. Botanical medicine needs to be based on high quality studies. Physical medicine needs to be based on the best available data, etc.
    5. Stress needs to be placed on pharmacology (ALL naturopaths are severely lacking here, it is only the ones who go out of their way to study this area on their own that may have good knowledge, but if they do it is in spite of their education, not due to it). Also stress needs to be placed in major pathology such as cardiology, cancer, pulmonology, etc. The education in these areas is often embarrassingly poor.
    6. The entire idea of the “us vs. them” mentality needs to be dropped. From the top down. Nobody should be speaking ill of MDs, instead it should be a partnership and a cooperative, which cannot occur when the ND’s are acting like martyrs or like they have the “right” medicine and it’s all being suppressed by “allopaths.” That very term “allopathic” is so idiotic.

    Just like D.O. schools, which are very similar to standard MD schools only with a slight emphasis placed on physical manipulation and some other minor areas, so too should ND schools be just like MD schools, only with slight emphasis placed in botanical medicine/physical medicine/nutrition etc.

    Medicine is medicine. There’s no such thing as alternative medicine. There’s just things that there is evidence for (we call this medicine) and things which the evidence indicates are harmful (which is fraud and malpractice) and things which there is no evidence or neutral evidence for (which is useless/harmful).

    It’s a sad state of affairs.

    • Beth

      Ironically, I think that when alt-med does do good that mainstream medicine doesn’t, it’s sometimes because they’re willing to treat based on valid clinical observations that haven’t been thoroughly researched.
      Often DO’s seem to be more willing to be experimental and try novel techniques. For exampled, there’s an osteopathic gastroenterologist online who’s science-based but more experimental than most MD’s.
      But certainly if the revised naturopaths you envision were to act as doctors, their treatments need to meet the medical standard of care.

    • John O’Malley

      Reasonable Roger, I absolutely love all these ideas and I just want you to know that as a current ND student, I can attest to the fact that items 3 and 4 already are the status quo and reality. Item 1 (MCAT) ideally should and will be implemented soon. Item 2 would make me really happy, but instead of getting rid of homeopathy completely, I would just make it an elective or optional certificate or some crap like that. In regards to item #5… here we should talk a bit. Yes, the pharmacology training we receive has been historically lacking, but I think that is because many ND’s dont have prescriptive rights in their state…which is really besides the point because you need Rx knowledge to safely and effectively manage patients, but I am happy to report that atlas at my school the pharm curriculum has greatly expanded and clinical pharmacology is becoming more central to the curriculum. Cardiology, Gastroenterology, Respiratory etc…is actually very comparable to MD and we even have a few MD’s and PHD’s teaching the courses…. Our anatomy professor taught at University of Washington medical school until she transferred to us two years ago… Saying that we are “poor” in pathology and systems is just not true. Im not sure why you think this is the case, have you experienced any of the curriculum first hand? I have the exact same pathology books that UW medical school uses for its courses so I dont know where you think the difference is here. And….. lastly, item #6 Us vs. Them… I mean are you really going to tell me that it is NDs with this mentality and not MDs as well? I think most NDs would be perfectly happy to work along side MD’s and they do. I have consulted many MD specialists during my clinic rotations re: patient care and coordination. I think here in the pacific northwest we have a more enlightened MD culture that has realized the value NDs bring to their patients and we work together to great effect.

  • JGC

    I think if you’re going to embrace evidence and science as you recommend in 3, you’ll need to toss out acupuncture along with homeopathy. After all, there is no evidence that meridians exist or that acupunture generates better outcomes than placebo treatments, and there is nsubstantial evidence that faux acupuncture (where needles are inserted at the wrong meridian points, retractable needles that don’t penetrate the skin are used, etc.) performs just as well as ‘genuine’ acupuncture.

    • Reasonable Roger

      I completely agree. I’m just saying separate it from the requirements. I couldn’t care less if acupuncture was done away with entirely. I do not believe meridians exist, I don’t see evidence of “qi” or “vital energy” or any of that nonsense.

      One could make a mild argument that acupuncture can lead to some degree of pain relief. It cannot deal with severe pain at all, and I don’t know why someone would want to study for 2 years to use it, but, nevertheless, it should at the very least be completely optional and ideally, done away with.

    • John O’Malley

      Actually acupuncture has been validated by EBM. Where have you been? Geez, are you guys not keeping up with current research? I practically live on PubMed.

      • JGC

        Citations needed, John

      • Lawrence

        “Validated?” Exactly how and when?

      • Ken Hamer

        And the walls come crashing down.

        • John O’Malley

          Ill happily post some studies when I get back from vacation. Until then, you can easily just hop on PubMed and see for yourself….but if that is too much work, stay tuned and I will post some.

          • JGC

            John, I’ve searched on Pubmed. I have not found any credible studies indicating that acupuncture performs better than placebo or sham acupuncture.

            Tell you what–to make it as easy as possible for you to defend your claim that studies have ‘validated’ acupuncture, why don’t you post a citation to the single study you personally believe offers the most credible and compelling evidence acupuncture is effective (i.e., perfomrs better than placebo’s or sham acupuncture) at treating non-self-limiting injuries or illness, for our examination?

          • Ken Hamer
          • NH Primary Care Doc

            I think you’re showing some selection bias in what studies you’re reading.

  • Law of Scimitars

    In 1988, I enrolled as a mature-age student in the part-time Bachelor of
    Applied Science (Naturopathy) then offered by the “longest established school of
    its kind in Australia and has played a leading role in the development of complementary medicine both in our part of the world and internationally”.

    In the last 25 years, SSNT has gone from a private school to attaining government accreditation as an educational provider and offering FEE-Help to all eligible students. In 1988, the admission criteria was ‘bums-in-pews’ and there was zero support for the part-time mature age students attending evening classes while juggling jobs and family obligations.

    By 1991, so many of the ‘naturopathic’ modalities offered in the evening were cancelled so often due to ‘low enrolment’, that I gave the whole thing away as a bad joke. I withdrew from my final semester 12 hours past the ‘cut-off’ date and for the next two years the SSNT administration doggedly pursued my for the fees. They were not at all compassionate or accepting of my (then) acute medical condition of Panic Disorder with Agoraphobia.

    It was all about the money. I can’t believe I spent 15 years regretting that I didn’t fulfill my study/caree goals. Now I am proud to call myself a naturopathic college drop-out.

    PS: I effected a full recovery from Panic Disorder with Agoraphobia using Stillness Meditation developed by the Australian psychiatrist, Ainslie Meares. He was considered a quackdoctor by his peers. Now the mainstream has embraced meditation. Go figure.

    • darwinslapdog

      Perhaps your “full recovery” was from any one of several alternate explanations–much as in any other testimonial. Just sayin…

      • Law of Scimitars

        Without the blood, sweat, tears and damn hard work and determination on my part; neither GP, psychiatrist, ‘fish-slapper’, or fairy-godfather would have been of any use. The buck stopped with me!

  • Beth

    Death by naturopath – one of the “well-trained” naturopaths – licensed, with a ND degree from Bastyr.
    Su Wilson found her 16-year-old daughter, Megan, lying in bed, … her chest heaving. “Megan, get up! You have to use your medication,” Su recalls telling her daughter, who suffered from chronic asthma. … Megan rose from her bed and used a device called a nebulizer, which transmitted a medicinal vapor to her lungs. When that didn’t work, Su called Megan’s primary care physician, a Kirkland naturopath named Lucinda Messer. …
    http://www.seattleweekly.com/2005-06-08/news/death-by-natural-causes/

    • NH Primary Care Doc

      Holy shit. She treated status asthmaticus with acupuncture, B12 and an herbal tincture.

      And she’s a Bastyr graduate.

      • Beth

        Holy shit. She treated status asthmaticus with acupuncture, B12 and an herbal tincture.

        And she didn’t have the sense to call 911.
        She claims that the girl’s mother refused to take her to the hospital.
        But even if so, she should have called 911.

      • Beth

        Yes, and she’s still practicing!
        She had to pay a settlement, but that’s all so far as I know.

  • Mildly Confused

    Taylor, I am mildly confused. John O’Malley above has written exactly what I was thinking. If an MD course has 500 spaces and those 500 spaces are filled from 5000 applicants then 10% acceptance rate. If an ND course has 500 spaces but those spaces are filled from 500 applicants then 100% acceptance rate. Unless you know how many people are applying for how many spaces, I don’t see how the comparison is valid. A 4% acceptance rate to a good MD course might be a sign of high standards, or just that massively more people have applied than there are available spaces.

    I should point out that I do believe your conclusions. A belief in homeopathy or energy healing doesn’t require high intelligence and critical thinking abilities. I just don’t understand how your figures prove this.

    • Taylor Hermes

      I do concede that theoretically your point is valid. Yet, it is quite clear from the numbers I present that ND schools do not have rigorous admissions standards. Perhaps you should look at the acceptance rates of the MD programs which are the easiest to get into.

    • Ballena

      If you assume that 1-intelligence follows a normal distribution, 2-that the the baseline social and cognitive demographics of those applying to both centres is similar , and 3-that lower admission rates work by selecting only the best candidates, then it is obvious that at the end of the proccess you will have in naturophatic schools average people (with 100% of admission the exact distribution as in the application population), whereas in the medical schools you will get as students a non representative sample of the application population consisting in those subjects more intelligent or prepared.

      So yes, 100 % admission rates tends to indicate less prepared or intelligent students.

  • Reasonable Roger

    One doesn’t even need to consider the acceptance rates anyway. What’s more important is the acceptance criteria along with the quality of the education.

    The troubling aspect is that ND schools essentially attract poor quality students. I remember one of my first days at school I remember talking to new classmates. One of them didn’t even know what glycogen was. Many students had zero science backgrounds. I was astounded how they could have fulfilled the prerequisite courses and be so lacking in background education.
    Compound this low quality of student with a low quality medical education and your result is NOT competent primary care physicians. Not to mention the tests are often curved, sometimes so much that it’s the difference of two entire grades (i.e. what was actually a D is graded as a B).

    The board exams are curved as well and I’m not sure this is the case in MD schools. I’m curious about that actually.

    I have to laugh at anyone in the ND profession who thinks their medical education is on par with an MD’s medical education.
    Some aspects of an ND education resemble an MD education. But I would highly advise not making such a comparison.

    And then there is the ND arrogance, conspiratorial thinking, victim mentality and general disregard of science.

    This is huge. The lack of scientific literacy within the entire profession is a sickness, and there is no doubt in my mind it harms the public.

    It doesn’t help at all that there are well respected people in the field who deny evolution, or view MDs as adversaries. Its completely cookoo.

  • Not convinced Keep Trying

    I don’t understand how you got to this “significant conclusion” either. I know plenty of MDs that went to medical school in the Carribeans due to low GPA and MCAT scores (have you looked at the admission rates for Ross and SGU??) and I believe these MDs are perfectly fine clinicians. Competence is more closely tied to passing your courses and board exams, not so much on your entering GPA. Sorry but this was a very weak argument.

    • Ballena

      ” I know plenty of MDs that went to medical school in the Carribeans due to low GPA and MCAT scores […] and I believe these MDs are perfectly fine clinicians” is only a useless anecdote, and the fact that you know “plenty” is irrelevant as the plural of anecdote is not data. Moreover, believing something does not make it so.

      MCAT, GPA, or any other intelligence and or personality test is used in the selection process because it partially predicts “passing your courses and board exams” and more generally competence. The fact that it is not a perfect predictor does not invalidate their use.

      Nevertheless, I would concede that the best comparator would be an exam after graduation common to all doctors from different universities…. but until there is one, acceptance % can be used as another valid measure to compare NDs and MD programs.

      • John O’Malley

        See my comment above as to why acceptance rate % is completely useless. Do the math. I did.

        • Ballena

          See my comment above as to why acceptance rate % is completely useful. Learn some basic epidemiology/statistics, I did.

    • NH Primary Care Doc

      I think you’ll find that the dropout rate for Caribbean schools is extremely high. The pass rate for the USMLE is low. The acceptance rate into residency is very low. So, those that actually make it through school, pass the USMLE and get a residency may be fine clinicians, but they are the ones that have made it through an extensive weed-out process. Ross has a 27% dropout rate and only a 55% Match rate.

  • Mildly Confused

    The GPA seems to indicate this too but I don’t really know how much of a difference that this is as I’m on the other side of the Atlantic. Don’t know what goes into a GPA and how significant the difference is.

  • David

    I really do not understand how ND And chiro can claim to have the same education. As an MD, the majority of our training is in the hospital dealing with sick people with multiple diseases. Naturopaths and chiros read about these diseases in a book!! They never see this diseases. When an MD sets up practice, they are often terrified because they know all the things that they can miss, and they know that there is so much they do not know. ND and chiro seem to have this insane confidence that they can CURE all (a word which MD almost never uses. Patient comes in with abdominal pain and all these terrifying diagnosed go through the young md mind that they must rule out like ectopic pregnancy, ischemic bowel, appendicitis, diverticulitis and on and on. All the diseases that they have seen first hand and helped managed in the hospital. The chiropractor is like bring it on, I will cure that with an adjustment, and the naturopath can give a gluten free diet, or treat for the dreaded systemic candidiasis.

  • Mildly Confused

    Why are DOs getting an easy ride in some of these posts? In the UK, osteopathy is pretty similar to chiropractic. Equally limited and quacky. Or does DO mean something else in America?

    • Mildly Confused

      Never mind. Apparently it does. American DOs are much more widely trained.

      • Cruz

        The medical training of a DO in the U.S. is the same as an MD candidate – DO students do the same rotations as MD students in their 3rd and 4th years; while visiting one of chicago’s major hospitals I met both MD students and DO students doing their rotationsat said hospital. DO students do get taught manipulation techniques but it’s not that many hours- it’s basically a relic- most DO physicians do not practice osteopathy – they practice medicine – DOs and MDs also both do ACGME accredited residencies – neither MD or DO would ever proclaim themselves ready to be a bona fide primary care physician upon graduation from medical school – they need to do either a family, internal medicine, pediatrics or ob-gyn residencies (the former three taking three years, the latter four years) in order to practice as a primary care physician.

        Unlike NDs who believe that upon graduation they are full-fledged primary care physicians. They also have a silly one-year residency working for a naturopath collective or at their silly schools. They do not do rotations in hospitals followed by standardized exams due upon finishing said rotation like DO/MD have to do.

  • Chiro-Skeptic

    I do not know where to find these kinds of number (admission rates, number of applicants, average GPA). Would you be able to provide a similar table for Chiropractic Schools, or if you cannot, point me to the appropriate sources? Thank you so much.

  • Suzanne

    With all of this in mind, what then is the view of readers on naturopaths as allied health providers?
    As a BPharm, I do see a place for nutrition and some herbs in chronic disease management. An example is in ulcerative colitis/crohns where there is increasing evidence for the efficacy of turmeric in prolonging remission and reducing steroid dose. Is this still considered naturopathy or once there is evidence it is medicine?

    In Australia, homeopathy is not associated with ‘natural medicine’ at all. Indeed, any health care provider who advocates homeopathy should be condemned for promoting sickness behaviour. It is a pity that such esoteric practices degrade public opinion of evidence for nutrition and herbal interventions.

    That said, the real issue is that naturopaths are claiming to be primary care providers when in fact they provide allied health care. Diet and herbs alone cannot be entirely beneficial for patient outcomes.

    • JGC

      “Is this still considered naturopathy or once there is evidence it is medicine?”

      Adminsitering herbal tumeric for ulcerative colitis would be ‘medicine’ to the same extent treating a headach with willow bark tea (rather than aspirin) would be, I suppose.

      It isn’t tumeric itself but the specific molecule curcumin, one of three curcuminoids the tumeric plant produces (curcumin, desmethyoxycurcumin and bis-desmethyoxycurcumin) that shows potential efficacy in ulcerative colitis and Chrohn’s. Curcumin is seen inhibit the STAT3 signaling pathway, reducing expresion of TNF-alpha and interleukin 1B.

      Co-administration of curcumin falls within the sphere of science based medicine (pharmacognosy)-feeding patients ground tumeric containing some undetermined amount of curcumin along with ithe two other curcuminoids and whatever non-curcuminoid molecules–again in undetermined amouts– the plant produces would fall within naturopathy’s herbal treatments..

  • Alanna

    I too am a skeptic. I have become very skeptical of the modern, mainstream practice of medicine with all of its snobbery. I do not believe that only those who score the highest GPAs are fit to help us heal. Intelligence and competence can be measured by more than text books, tests and recall. My best and most effective medical practitioner is a acupuncturist. Some people call her a quack, but acupuncture produces results beyond what science can understand yet. I don’t care what her GPA was, but I do care about the results she created – ended my lifelong pain and helped me to conceive a child. After thousands of dollars down the drain, the best trained MDs were unable to produce those results for me.

    MDs treat symptoms and often and ignore the underlying causes. Also, mainstream medicine has not caught up with viewing organisms as a whole. I am immensely grateful for people who are being trained as NDs and in related fields. It
    is not quackery to understand that our minds and bodies are connected, that plants, whom have guided our evolution, have medicinal properties that do not need to be isolated to be effective, or that adequate nutrition is vital to disease prevention. MDs have their place, but I personally will never stop with an MDs advise again. When they diagnose me, I will turn the knowledge of old for my healing.

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