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Certain alternative med. programming weak, study suggests

A new study of national data compiled by Boston University School of Medicine researchers found medical programs across the nation might be lacking in qualified faculty to lead programs in complementary and alternative medicine, as well as integrative medicine, according to an Oct. 10 press release.

BUSM professor of family medicine Paula Gardiner, leader of the study, said contemporary and alternative medicine and integrative medicine programs are important for medical schools’ curricula since many people use these treatments in conjunction with traditional medicine. As many as 40 percent of Americans use CAM, Gardiner said.

“That means that one out of every three or four patients that walks into your office is using complementary and alternative medicine,” Gardiner, who is also assistant director of integrative medicine at Boston Medical Center, said. “So it’s important that they [medical professionals] say, ‘yes this a topic that we should be talking about.’”

The survey, distributed via email by the Council of Academic Family Medicine, found that while 58 percent of residency directors said that CAM and IM are important to medical school curricula, 60 percent said they do not have set learning objectives in their curriculum.

Residency directors should establish set competency systems, faculty training courses and additional teaching models to improve CAM and IM programs, the study stated.

“In addition to a need of dissemination of the CAM/IM competencies to all program directors, faculty development programs, flexible curricular models and incorporation of existing communication and educational approaches could facilitate CAM/IM educational initiatives,” the study stated. “It is important to address barriers to implementation as CAM/IM has an important role in patient centered medical care.”

More than 200 residency program directors at various national institutions responded to the survey.

The National Center for Complementary and Alternative Medicine, which partially funded the study, considers CAM to be mind-body therapies such as yoga, meditation and dietary herbs and supplements. Manipulative therapies such as massage therapies, as well as whole system medicine, such as acupuncture and naturopathology, are also classified as CAM, Gardiner said.

“The original definition [of CAM] started out as things that were not traditionally taught in medical schools,” Gardiner said. “That definition has changed over the years, as things like probiotics, or mind-body medicine, are becoming more and more part of medical school curriculum.”

Integrative medicine is an evidence-based combination of CAM and allopathic medicine, or what is thought of as traditional Western medicine, Gardiner said.  Additionally, CAM and IM education could provide medical students with a wider skillset as practicing physicians, she said.

“These skills of integrative medicine — active listening, patient communication skills, being able to counsel about prevention and exercise, and eating right and mind-body — these are wonderful skills that they [students] can take into the future with them, which really emphasizes patient-centered care,” she said.

Boston Medical Center Integrated Medicine Clinical Services Coordinator Danielle Dresner said she is not aware of any changes currently taking place in the department.

“In terms of medical student education, everything right now is on an ad hoc basis,” she said. “So if students are interested in integrative medicine, we’re happy to take them on to let them shadow or do rotation with us. Our family medicine residents actually all spend time with the integrated medicine division during their family medicine residency.”

Demand for integrated medicine education is increasing amongst medical school students, Dresner said.

“We’re seeing a growing demand in interest in integrative medicine and integrative medicine curriculum for medical schools,” she said. “We have students on an individual level approach us with interests, also on a school leadership level we’re seeing a growing interest for integrative medicine curriculum into the standard medical student curriculum.”

CORRECTION: The article and headline originally implied BUSM was specifically lacking. However, the study reached similar conclusions for national programs and was compiled by BUSM researchers. The article has been updated to reflect this correction.

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