There are presently
five C.N.M.E. recognized naturopathic
medical colleges in the U.S. and Canada (Click here for more info
on the colleges):
Bastyr University - Seattle,
Washington also accredited by the Northwest Association
of Schools and Colleges and offers both undergraduate and graduate
studies, but undergraduate students may enter Bastyr only as juniors.
NCNM and SCNM offer only graduate studies.
National College of Naturopathic
Medicine - Portland, Oregon
Southwest College of Naturopathic
Medicine - Tempe, Arizona
University of Bridgeport College
of Naturopathic Medicine - Bridgeport, Connecticut
The curriculum of UBCNM
is modeled after the curriculum at professionally accredited schools
Canadian College of Naturopathic
Medicine, Ontario, Canada
BU, SCNM, NCNM, CCNM, and UBCNM each
offer a professional doctorate degree for completion of studies
in naturopathic medicine. A minimum of three years of undergraduate
premedical study is prerequisite for entry to a naturopathic medical
school. The first two years of naturopathic school emphasize the
basic sciences: anatomy, physiology, pathology, biochemistry,
organic chemistry, neurology, radiology, minor surgery, microbiology,
obstetrics, immunology, gynecology, pharmacology, pediatrics,
dermatology, lab diagnosis, clinical and physical diagnosis, and
other clinical sciences. Study of the bodily systems takes in
gastroenterology, pulmonary system cardiology, neurology, gynecology,
The second two years focus on clinic
skills and the range of natural therapeutics. NDs receive training
in naturopathic therapeutics including botanical medicine, homeopathy,
natural childbirth, acupuncture, hydrotherapy, naturopathic manipulative
therapy, therapeutic nutrition, and other therapies. Because coursework
in natural therapeutics is added to a standard medical curriculum,
naturopathic doctors receive significantly more hours of classroom
education in these areas than the graduates of many leading medical
schools, including Yale, Stanford andJohns Hopkins schools (Comparative
Curricula). Pharmacology and minor surgery are examples of other
conventional training recieved by NDs.
Clinical Internship consist of
1500 hours of treating patients under the supervision of licensed
naturopathic and conventional medical physicians.
After graduating from a college
of naturopathic medicine and passing the exam (NPLEX) required
by the accrediting agency for naturopathic medical programs; the
Council of Naturopathic Medical Education (CNME)
and other state tests, most NDs go into private or group practice
treating people with acute and chronic disease. NDs do not specialize
in the treatment of any one organ system (such as dermatology)
or any individual disease because they treat the body as an integrated
whole. This is what is meant by whole person health care.
Mail Order Schools
There are two primary reasons to license
a profession. The first reason is to protect the public from potential
harm. Obviously, in medicine, potential harm is a real concern.
A second reason is to protect the integrity of a profession against
charlatans and unqualified persons. When states license naturopathic
doctors, they require practitioners to have graduated from an
accredited program and to have completed all appropriate tests
and clinical training.
Without licensure, anyone can "hang
out a shingle" and practice with nothing more than a "mail-order"
degree or a home study course.
Because naturopathic medicine is
not regulated in 38 states, some individuals call themselves "naturopaths"
who do not meet the historical standards of the profession. Such
individuals sometimes have degrees or diplomas from correspondence
schools, weekend seminar programs without supervised clinical
training, extremely abbreviated courses, "certifying"
agencies that confer naturopathic credentials based on other kinds
of health education, poor "home study" schools without
state authority to grant degrees, and/or schools without naturopathic
programs or faculty. None of these programs qualify a candidate
to sit for board exams or to receive licensure in any state. In
some states, individuals call themselves "naturopaths"
simply by paying a fee for a business license requiring no evidence
of education at all. This license is not a license to be
a Naturopath but simply a license to sell products and services
of any kind.
How to Get the Degree You Want
by John Bear differentiates between traditional education; off-campus,
life-experience and correspondence courses; and outright diploma
mills. Regarding alternative medicine, Bear says: ".
. . There are no legitimate alternative schools of "near-medicine"
. . . The good schools in this category require three or four
years of study in residence, and cannot be considered non-traditional."
Diploma mills and mail order degrees
(witch are fraudulent and not legal) mislead, endanger, and actually
harm consumers as well as being damaging to trained and professional
naturopathic physicians who find themselves sharing the same title.
The Council of Naturopathic Medical Education (CNME)
accreditation helps state authorities to distinguish between such
degrees and legitimate medical education.
Consumers should know what they
are getting when they seek the services of a naturopathic physician.
Only licensure can guarantee the training and safety to which
consumers are entitled.
All physicians listed in our database
have been checked out by one of our editors to ensure they are
qualified naturopathic physicians.
Scientific Basis for Naturopathic Medicine
When expert and objective scientists,
educators, or regulators have examined the scientific basis of
naturopathic medicine, they have concluded that naturopathic medicine
as practiced by the licensable professionals in the U.S. is well
grounded in modern scientific method and practice.
Scientific studies of methods utilized
by naturopathic physicians not only validate naturopathic treatments,
but leads to their improvement.
The Textbook of Natural Medicine
includes over 10,000 citations of scientific studies on naturopathic
methods. Scientific studies and observations have not only held
up the validity of diet, herbal medicines, manipulation, and massage,
but also treatments including acupuncture, biofeedback, and homeopathy.
In many instances, the scientific investigation has not only validated
the natural method, but also led to significant improvements.
In herbal medicine, improved equipment
and techniques for chemical analysis have led to increased understanding
of how best to grow and harvest a plant, and how to extract and
concentrate the medicinal components of a plant for maximum benefit.
In each of the three main areas
of medicine - diagnosis, prevention, and treatment - naturopathic
medicine rests on a scientific foundation.
Diagnosis Using the Same Science
Naturopathic physicians use the same
methods of clinical, physical and laboratory diagnosis as conventional
general practitioners. These may be supplemented by quantifiable
naturopathic methods, which attempt to assess areas such as the
patient's vitality, the underlying susceptibility to disease,
or sub clinical weaknesses in systems.
In the area of prevention, naturopathic
physicians utilize the body of knowledge an MD uses in judging
the course a disease may be expected to take. They are trained
to give individual immunizations as needed with fully informed
consent when allowed by law.
Most important, naturopathic physicians
are highly trained in clinical nutrition and lifestyle modification
for the prevention of disease. In these areas, all thoroughly
supported by science, naturopathic physicians are better trained
than MD general practitioners (the majority of whom have not taken
a single course in nutrition), family practice specialists, or
registered dietitians. Naturopathic physicians are the only primary
care medical professionals in the U.S. meeting and exceeding the
recommendations of the U.S. Surgeon General for medical education
in nutrition and dietary counseling.
Each of the major therapies used by
naturopathic physicians is rooted in scientific literature and
long traditions of clinical use. Modern naturopathic medicine
incorporates advances in science into its traditional body of
The dietary approach to prevention and
treatment of chronic degenerative disease, championed for more
than a century by naturopathic physicians, has recently gained
the attention of orthodox medicine. Each of the seven dietary
guidelines in the 1988 U.S. Surgeon General's report on nutrition
and health is a traditional part of naturopathic practice. More
than 40 scientific journals worldwide are devoted to clinical
nutrition, and articles on the therapeutic use of diet or supplements
also appear regularly in conventional medical journals.
Most European countries recognize the
effectiveness of medicinal plants, include them in their official
pharmacopoeias and regulate them as drugs or over-the-counter
remedies. At least 14 scientific journals worldwide are devoted
to the study of botanical medicine.
Homeopathy is a system of medicine more
than two hundred years old and there aremore than one hundred
homeopathic medical colleges worldwide. A recent review article
in the British Medical Journal performed a meta-analysis of 107
controlled clinical trials of homeopathic substances, and found
positive evidence supporting their effectiveness (Kleijnen; see
also: Alibeu; Ferley; Gassinger; Gibson; Maiwald; Reilly; Vozianov;
Weisenauer). Various other in vitro or animal studies have also
demonstrated the effectiveness of homeopathic preparations (Bildet;
Poitevin; Sukul; Wagner).
The value of water treatments, fasting
and rest in treatment for chronic disease is recognized throughout
the developed countries in Europe. About half million French citizens
each year receive insurance reimbursement for medically prescribed
spa therapy (Payer).
Naturopathic manipulation of the muscles,
bones and soft tissues is collectively known as Naturopathic Manipulative
Therapy (NMT). Physical medicine also includes exercise therapy,
physiotherapy using heat and cold, electrical pulsation, ultrasound,
diathermy and hydrotherapy. Such techniques are regularly evaluated
in journals such as the Journal of Manipulative and Physiological
Therapies. A recent study in England found manipulative treatment
to be more effective than orthodox medical treatment for certain
kinds of back injuries (Meade). The value of such treatments is
recognized in other licensed professions such as physical therapy,
osteopathy, chiropractic, and massage therapy.
Naturopathic physicians are trained
in various psychological techniques, including basic counseling,
stress management, hypnotherapy, biofeedback, and methods of lifestyle
modification. A large body of scientific literature points to
the importance of treatment for psychological and somatic factors
and coping mechanisms in many illnesses and complaints.
All naturopathic physicians are trained
at an introductory level in the basics of Oriental medicine, and
about one in five receives further training and specializes in
it. Oriental medicine has been developed continuously for more
than three thousand years in Asia and coexists along with conventional
medicine today in China and Japan as a primary form of medicine.
Dozens of peer reviewed journals are devoted to the scientific
evaluation of Oriental methods, including both acupuncture and
Certain naturopathic treatment
methods are well supported by conventional science. However, naturopathic
physicians typically administer several treatments simultaneously,
on the principle that treatments acting through different mechanisms
may be more effective than any one of them used alone. They tailor
groups of treatments to fit the individual needs of the patient.
These complex protocols have only rarely been formally tested,
although many of the individual treatments have been subjected
to controlled trials. The orthodox approach of only testing single
agents and the need for controlled conditions comes into conflict
with the naturopathic practice of using protocols and adapting
them to the patients' needs. Financial constraints also make the
costs of evaluation of complex protocols prohibitive in some cases.
The naturopathic profession continues to develop appropriate modes
for outcomes analyses which include methodology acceptable to
NPLEX: Your Naturopathic Doctor IS Tested!
NPLEX (Naturopathic Physicians Licensing
Examinations) is an independent, nonprofit organization whose
purpose is to provide a sound examination that would be nationally
recognized and of such high quality and reliability that authorities
regulating the practice of naturopathic medicine may grant a license
without requiring further testing. Some jurisdictions require
jurisprudence and other exams in addition to the NPLEX.
Purpose of NPLEX
The purpose of the NPLEX exam is to
ensure that the candidate has the knowledge necessary to practice
safely. The NPLEX exam follows a blueprint based on a job analysis
of the profession. The job analysis was created based on the results
of a nationwide survey of naturopathic physicians to determine
the conditions they were seeing and the treatments used in their
Licensing exams are meant to do considerably
more than test what candidates learned in the classroom. Because
they are based on blueprints of what takes place in actual clinical
working conditions, NPLEX assesses what the candidate needs to
know to practice safely. Research by NPLEX into the practices
of the National Board of Medical Examiners (United States Medical
Licensing Examination for MDs), the National Board of Chiropractic
Examiners, and the National Council of State Boards of Nursing
indicates that NPLEX observes every national standard in the
development and scoring of health care licensing examinations.
Who is eligible to take the NPLEX
NPLEX consists of three sections, the
Basic Science exams, the Clinical Science exams, and the Add-on
exams. The requirements for eligibility to take the Basic Science
exams typically include completion of the second year of naturopathic
medical school. Requirements for eligibility to take the Clinical
NPLEX typically include completion of requirements for graduation
from an accredited naturopathic medical college. No candidate
will be permitted to sit for the NPLEX exams who has not been
approved by a licensing authority. To complete all 12 to 14 exams
takes four days. Failing to pass even one exam means a postponement
of practicing until the exam is successfully completed.
NPLEX study guide and tests
The NPLEX blueprint is available at
naturopathic medical school bookstores and is available for test
candidates' use. The NPLEX blueprint is a study guide. However,
the NPLEX exams test knowledge gained over a two to four-year
period and it would be impossible to specify all the information
needed to practice safely as a naturopathic physician. Therefore,
the exams may test for knowledge that is not specified in the
The NPLEX Basic Science exams are designed
to test the student's knowledge of anatomy, biochemistry, microbiology,
pathology, and physiology. Of the 11 states that license naturopathic
physicians, only CT and HI have elected not to require the Basic
Science exam. If a candidate is initially licensed in one of these
jurisdictions and later wants to become licensed in a jurisdiction
that does require them, s/he will be required to successfully
complete the Basic Science exams before being licensed.
The NPLEX Clinical exams are designed
to test the candidate's knowledge of the clinical sciences needed
to be a safe and effective naturopathic physician. The clinical
tests are required by every jurisdiction that provides for licensure
of naturopathic physicians.
Add-on exams (Homeopathy, Acupuncture,
Obstetrics, and Minor surgery) are not required by every licensing
authority. Different jurisdictions allow different specific physician
practices, and some jurisdictions require a state test to cover
these practices. The NPLEX exams are national exams and so candidates
are required to have the general knowledge to practice in any
jurisdiction, not just knowledge of the procedures which are allowed
in one particular jurisdiction.
Establish the Passing Score
Because NPLEX is a criterion-referenced
exam series, each exam has a passing score that is independent
of the passing scores of the other exams. The Angoff method is
used to establish the minimum passing score.
Naturopathic physicians rate the difficulty
of each item by answering the question, "What percentage
of minimally competent, entry level physicians would be expected
to answer this item correctly?" (for Clinical items) or "What
percentage of minimally competent students ready to enter the
clinical phase of training would be expected to answer this item
correctly?" (for Basic Sciences). This step is the key element
for setting the passing standard. Thus, substandard education
should not bring down exam standards as scoring on a curve would
do, and variation in item difficulty is controlled for, rather
than causing erratic passing rates as might be seen with an arbitrary
passing score. The ratings from the physicians are averaged to
get a cut score for an item. The cut scores for every item on
the exam are averaged to determine the cut score for that exam.
Scores are sent to the licensing authority
through which the applicant is taking the exams approximately
six weeks after administration of the exams.
Who Makes Up the NPLEX Board?
The NPLEX Board is comprised of one
representative from each jurisdiction giving the exams, one representative
from each of the colleges graduating physicians eligible for licensing,
one representative from the AANP, one from the Canadian Naturopathic
Association, and two unaffiliated members. The NPLEX Board oversees
the exam development process and provides input regarding jurisdictional
and constituent needs.
How Is the Exam Assembled?
Items for the exams are written by NDs
in the United States and Canada and by other qualified professionals.
These items are submitted on special forms detailing the source
of the items, the references for the correct answer, and information
about the item writer. Submitted items are added to a computerized
item bank, and the exams are assembled. A Central Exam Committee
reviews these assembled exams, substituting items as it deems
appropriate, and finalizing the content. The exams are then sent
to selected physicians for final proofreading. After corrections
are made, the exams are produced as test booklets and sent to
the exam sites for administration.
For further NPLEX information contact:
Christa Louise- Executive Director
PO Box 69657
Portland, OR 97201