Students discover my blog in various ways. Some accidentally stumble across it while researching naturopathic schools. Others are exploring the differences between naturopathy and medicine through my blog in order to gain an alternative perspective.
Regardless of how they found naturopathicdiaries.com, they are all usually considering a career in naturopathic medicine. After reading through my posts, the most common question students ask me is, “Should I go to naturopathic school?”
My answer is always the same. No.
(Actually, my answer is always “NO!”)
Students do not like this response. Inevitably, I end up in lengthy email exchanges explaining the many reasons to avoid naturopathy like the plague. It was through these conversations that I realized important information needed by students to answer this question themselves may not be accessible, or clear, within my blog.
This post aims to provide an explanation of the reasons I believe students should not pursue an education or career in naturopathic medicine under any circumstances. In my opinion, naturopathic school is overpriced, provides poor training with limited job opportunities, and appeals to a flawed ideological mindset.
Naturopathic education lacks medical training
As I have written before, naturopathic education and training is not as the profession presents.
Naturopathic schools present their programs as rigorous, innovative and comprehensive medical programs that are nationally recognized and prestigious. The schools also state that their naturopathic curricula are “on-par” with conventional medical school curricula.
Accredited naturopathic schools are disguising the naturopathic education of nonsense as a distinct, and better, form of primary care medicine. Sadly, these schools are getting away with what I consider to be education fraud. The truth is that naturopathic education is riddled with pseudoscience, debunked theories, and experimental medical practices.
This notion is presented by all the accredited naturopathic schools (Bastyr University, National College of Naturopathic Medicine, Southwest College of Naturopathic Medicine, University of Bridgeport, Canadian College of Naturopathic Medicine, Boucher Institute of Naturopathic Medicine, and National University of Health Sciences) in North America to attract students. The specific rhetoric used to create this facade is very similar to that used by the American Association of Naturopathic Physicians (AANP) for political advancement of the profession within the United States.
An interesting visual aid used by naturopathic schools and professional organizations is an education chart that compares naturopathic education to that of a medical doctor or doctor of osteopathic medicine. In a post from March 13th, 2015 on ScienceBasedMedicine.org, I scrutinized my own education from Bastyr University in order to understand how my naturopathic schooling truly compared to conventional medical school. The original post can be found here, along with my Bastyr University transcript.
In this post I concluded that, compared to medical doctors, my naturopathic education severely lacked both the quantity and quality of medical training necessary in order to practice as a competent physician. Additionally, it lacked the application of medical standards of care within a hospital setting.
Based on my transcript, course syllabi and academic handbook, I calculated that I received 561 hours of training in “direct patient contact” at Bastyr University. This number is far less than the 1,224.5 hours advertised by Bastyr University and other naturopathic schools. The 561 training hours really seem dismal, though, when compared to the number of training hours in patient care completed by students in conventional medical school and throughout their mandated residency programs. Naturopaths are not required to complete residency training in order to practice medicine (except in Utah where a one-year residency is required.)
A medical doctor recently wrote to me stating, “One of the biggest differences between ND school and med school is that med students are NOT considered competent to practice after graduation. They are considered competent to advance to post-graduate training (residency, in other words). You will never find a modern MD or DO who is practicing who did not complete a residency. Med school provides the foundation. Residency provides the true education and experience.” I completely agree.
It is illogical and risky to practice primary care medicine after four years of classes, two years of minimal patient contact hours in a non-hospital setting, and no clinical experience in urgent care or emergency medicine. Yet, this is exactly what happens. Naturopaths graduate from school, pass a licensing exam that includes questions in homeopathy, and then set-up shop to diagnose and treat patients.
In my opinion, the education and training provided by accredited naturopathic schools does not prepare students to practice any form of medicine.
(For a thorough breakdown and detailed description of my naturopathic education and training, read this post.)
The cost of naturopathic education is overpriced
The Bastyr University website states the average cost for the first year of the Doctorate of Naturopathic Medicine Program is $39,235 per year, not including living costs. In Kenmore, Washington CollegeData.com estimates living expenses of $15,550 per year. Thus, four years of naturopathic school at Bastyr can easily reach $220,000!
As a comparison, in March of 2015, USnews.com reported that graduates from public medical schools averaged $167,763 in student loan debt. Private medical school graduates typically borrowed $190,053. On the surface, it appears that a naturopathic education costs the same as a real medical education. Besides obvious differences between the quality of the two school systems, there are a few other important differences to point out.
First, naturopathic schools charge students to learn fake medicine. Pseudoscience is widely incorporated into the naturopathic curriculum. Besides taking basic science and “regular” medical classes like Cardiology, I also took classes on homeopathy, naturopathic manipulation, hydrotherapy, Chinese medicine, botanical medicine, and naturopathic theory and philosophy. How much did these classes cost me?
I took an average of 24 credits per semester while at Bastyr University. According to Bastyr’s current fee schedule, it costs $8,066 to enroll in up to 16 credits and $322 for every additional credit thereafter. This means I spent $10,642 on average per semester. I actually paid a bit less than this, as tuition fees have increased since I graduated.
Using my transcript, I tallied the credits for the following courses:
- 17.5 credits in hydrotherapy, naturopathic manipulation and myofascial analysis
- 11.0 credits in botanical medicine
- 7.0 credits in homeopathy
- 8.0 credits in naturopathic theory
- 4.0 traditional Chinese medicine
TOTAL CREDITS: 47.5
TOTAL COST: $20,831.60
I spent over $20,000 on fake medical courses that are widely regarded by the medical community to be ineffective, unscientific, and in some cases, dangerous.
I decided not to add up the cost of courses taught by fake experts, such as my embryology course taught by a “doctor of naprapathy.” These course appear on paper to be “on-par” with medical school, but in reality, are superficial, deficient, and a front for teaching pseudoscience and anti-medical ideology.
I did calculate the cost of patient care shifts which included scant medical training and the reinforcement of dubious diagnostics and made-up diseases. (For more information on patient care shifts at Bastyr University, read this post.) I completed 21 shifts in patient care. Each shift was worth 2.00 credits. In total, I spent about another $20,000 learning to practice naturopathy by practitioners who believe in chiropractic medicine, therapeutic touch, homeopathy, flower essences, and many other magical treatments.
Much more of my total tuition expenses were spent on courses that had some real medicine but also had a lot of fake medicine and mystical philosophy packed in.
The second important point to make about the cost of naturopathic school is that the graduates are not eligible for all of the same federal loan repayment programs as medical doctors. Whether or not a naturopath’s debt qualifies for loan repayment depends on the specific program and the state. For example, naturopaths working at National College of Natural Medicine in Oregon might qualify for the Public Service Loan Forgiveness program but do not qualify for the Oregon Medicaid Primary Care Loan Repayment Program or the Oregon Partnership State Loan Repayment program. Overall, naturopathic graduates have far fewer opportunities to reduce their student loan debt through state and federal programs.
In a discussion about finances, I think it is important to note that naturopaths on average earn less money than MDs and DOs. My first year residency salary was about $30,000 per year plus health insurance and liability coverage. According to a 2014 report by Medscape.com, the average first year salary for a medical resident is $53,000 plus benefits. In the following two years of practice, the most I made was about $42,000. I was able to pay my student loans (with an income-based repayment plan), my bills and live a comfortable, yet frugal, life on this salary. However, I would have been more financially comfortable making between $54,000 and $59,000, which is what the average third to fourth year medical resident earns.
The average naturopathic doctor makes $60,000 per year in private practice. Primary care medical doctors, in comparison, earn about $186,00. While this income is not nearly as high as other medical specialties, I think it is enough to be comfortable, especially given the student loan debt reduction options for medical doctors. In my opinion, the high debt to income ratio and limited student debt repayment options makes an investment in naturopathic education a poor decision.
Job prospects for naturopaths are limited
There are serious career challenges as a naturopath.
Aside from working at one of the accredited universities or opening up your own naturopathic practice, there are not many job opportunities for naturopaths. Naturopaths do not have hospital admitting rights and are therefore not eligible for hospital-based positions.
While some students dream of working in an integrative medical setting, it may be difficult to find an MD or DO willing to work with you. Not all medical doctors or DOs are willing to work with naturopaths for a wide variety of reasons.
In a private practice setting, it can be very difficult to make naturopathic services affordable and accessible to patients. One issue is not all states accept insurance for naturopathic services. When naturopathic services are covered by insurance, the reimbursement is usually comparable to what a company may pay for the services of a nurse.
Another major drawback to the ND degree is limited state licensure. Currently, naturopaths are only licensed to practice in 20 states and territories. Within these 20 U.S. jurisdictions, the legal scope of practice differs widely. Some permit naturopaths to order exams and write prescriptions. Others strictly limit the scope to nutrition and lifestyle advice. Practicing in an unlicensed state may be tricky for liability and legal reasons and not a risk many would want to take.
Unlike the MD/DO degree, the naturopathic doctorate does not qualify an individual to work for government organizations like the Centers for Disease Control or the Food and Drug Administration. In order to work in the fields of public health or health policy, one usually needs a PhD in a relevant field or to have completed a medical residency and hold an active medical license. Since naturopaths are not eligible for the same medical residencies as MDs/DOs, they do not qualify for these positions involving research, policy, or public health.
On a global scale, the naturopathic degree does not easily translate in other countries. Based on personal research, I have found that an ND degree will not get you hired at international organizations such as UNICEF or the World Health Organization.
You may not be able to practice naturopathy in other countries either. Despite homeopathic medicine being widely accepted in Germany, I cannot practice naturopathy with my ND degree here. I once had a brief email exchange with a Canadian ND who runs a private practice in Singapore. She is only legally allowed to make nutritional, lifestyle, and homeopathic recommendations. Obviously, the scope of practice varies widely in other countries, but I would not expect abundant or easy-to-access job opportunities.
If you are looking for a stable career with diverse and meaningful job opportunities in the fields of health policy, research, or medicine, a doctorate in naturopathy is not for you.
A flawed perspective
Many students who contact me are afraid that conventional medical school will turn them into harried doctors, pill pushers, and uncaring, terrible people. In contrast, they believe naturopathic school will cultivate empathy, open-mindedness, and reciprocal healing relationships with their patients. Neither assumptions are true, but I can relate to both of them.
I went to naturopathic school in hopes of finding a better medical system than the one I experienced. I wanted to change health policy and improve the way medicine is practiced in the United States. As a result, I spent many years and a lot of money on fake subjects and therapies that I believed would help patients and inspire fundamental changes within medicine. I spent far more time learning bogus therapies than real medicine, like pharmacology. As a result, I accidentally duped patients into wasting their time and money on naturopathy.
With the privilege of hindsight, I now know my investment in naturopathic school did not make me open-minded or provide me with the tools to be a good physician. Instead, my naturopathic education impaired my independent and critical thinking skills. And it gave me a false sense of self. I thought I was a real primary care doctor. In reality, I was someone who paid a lot of money for a degree in quackademic medicine and was tricked into believing I could diagnose and treat patients competently.
Since my departure from naturopathy, I have had an important realization. I would not have turned into a stressed and indifferent drug peddling doctor had I gone to medical school. I would have become the doctor I always wanted to be.