Chinese medicine, and any true course of study, is a lifetime of study. Even if you don’t pursue formal Chinese medicine for future licensure and practice, you can still study it for pleasure, historical value, and quality of life improvement. This article is for those who hope to formally embark on this Chinese medicine journey, who inquire about my experiences at the three Chinese medicine schools I attended, the seven I visited, and the numerous others that I researched before committing to this education.
Graduate level Chinese medicine education, usually to earn a Master’s degree, is required for licensure to practice acupuncture in most places in the USA. A few states provide licensure without a degree, fewer don't even require licensure. See the NCCAOM website (our licensing board) for the laws for your state. Here, I write about picking a suitable graduate level Chinese medicine program in the USA for licensure, as my experience has been thus.
It is a bittersweet investment, and exhausting, challenging, rewarding, and life-changing journey. It is only the formal beginning of this journey. I hope that this article is useful and helpful. Enjoy.
Note: I started writing this article when I left NUNM last spring. Over a year later, it is still unfinished. I’m still in school, and keep adding to it, but I want to share it now, as we're approaching application time for fall 2018 matriculation in most schools. Perhaps I’ll publish a more polished version in the future, but here it is, for now. Pardon the unpolished bits.
Key to a few terms, before we begin
AFEA= Academy for Five Element Acupuncture (my 1rst school, in Florida)
NUNM= National University of Natural Medicine (my 2nd school, in Oregon)
AMU= Alhambra Medical University (my 3rd and current school, in CA
ACAOM=Accreditation Commission for Acupuncture and Oriental Medicine (they approve schools)
You
What do you want?
Get clear about your goals, needs, desires, strengths, and weaknesses. What are you willing or not willing to give up or compromise for this education? This includes home/ location, current job/ career, financial commitment, etc. If you want the best education and are able to commit time, money, home, and likely even career, then move to China or Taiwan, and commit to learning Chinese first, then studying for another 6-7 years, there. However, USA acupuncture licensure requires that you study in the USA. Students who study abroad have to take a certain number of classes here in the USA, and then take the USA acupuncture board exams for licensure. I decided not to study abroad for that reason, and also for reasons of time and comfort. I can always return to China/ Taiwan after I graduate and into my future for supplemental studies.
Every school has its strong and weak points. Decide what’s most important to you. If herbs are your priority, then choose a school with a strong herbal program. If saving money is your priority, then choose the cheapest school. If you want to focus on a certain style of acupuncture, modality, demographic, or condition, then pick a school that excels in that area. Otherwise, pick a school that provides a solid foundation of the basics (diagnostics, points, and herbs), with a strong clinical program, and at a reasonable price. Be idealistic, yet realistic. No school is perfect.
What kind of learner are you?
Do you prefer small classes, or large lecture halls? Are you more of an introvert or extrovert?
What are your goals?
If you’d like to be a clinician, then choose a school with a strong clinical component: many hours observing practitioners with over 10 years of experience. Some people are fantastic clinicians, but terrible teachers. See what you can learn best with, and what you can simply “put up” with. If you’d like to be an academic, then attend a didactic school with excellent philosophical lecturers, and perhaps go for a doctoral program in classical Chinese, like what I started off doing at NUNM. If you are attending school for self enrichment, and don’t want to pursue it as a career, then simply pick a school with a style and cost that you resonate with, like some students do at AMU.
Location
Where do you live, now? Where do you want to live, in the future?
Pick a school where you’ll happily live for 3-5 years, and likely after graduation. Students form life-long relationships with fellow students, professors, patients, and local community. After graduation, most students remain local to school. Choose a place where you could live long-term, where the cost of living, landscape, weather, human population, and work availability all suit you. Research the acupuncture laws in your desired state(s) of practice. Do those state(s) have their own board exams or requirements? Will you live/ work in a state that requires both herbal and acupuncture board exams for licensure? Does your school cover herbs, if it’s required by your state laws? Is your school accredited by ACAOM and your desired state(s)?
Money
“Pick the cheapest school where you can get out the fastest,” said one of my mentors as I was researching schools, “You learn everything after you graduate, anyhow.” “Don’t worry about the money,” said another, younger friend, “it’s an investment.” I picked my first school, AFEA, because it fit my nomadic lifestyle, focused on a style of acupuncture that I liked, and was reasonably priced. However, I found focusing on just one style of acupuncture to be limited in perspective, and decided to change to the most expensive school in the country (NUNM), to better fit my academic goals. After 1.5 years there though, I felt like the cost of my education was not commensurate with the quality of my education, and decided to leave again, this time to one of the cheapest schools in the country (AMU), to just put my nose to the grindstone and finish my education as elegantly and cheaply as possible.
How much are you willing or able to pay? Do you have a family to support, or pre-existing debt? There are almost no scholarships available. Most students go into heavy debt of over $100,000 including all expenses, depending on the school, and location. Some schools offer negligible in-school scholarships. Government-funded financial aid is available at most larger schools, but at cut-throat rates that begin accruing immediately upon withdrawal of funds. At NUNM, our government loan rate was around 6%. Some schools offer low-paying work-study. I juggled a few work-study jobs at NUNM, which included filling herbal prescriptions in the school medicinary, assisting at school events, and caretaking plants in the school garden. These were relaxing jobs that paid minimally, but were wonderful learning opportunities. AMU and AFEA are both too small to offer work-study, but allow flexibility and a lower price tag, so students can still work part-time and emerge with less debt.
Does tuition cost remain consistent through school, or does it increase yearly? At NUNM, our tuition increased every year. When I left, it was $420 per credit, with costs rising as much as 4% each year. Most students left NUNM with $150,000 to $200,000 (and up) in debt, depending on what program(s) they did. A friend who is a father and primary provider of his household started off getting enough financial assistance for NUNM but once the tuition increased, was no longer able to make ends meet. Most NUNM students are enrolled full time, taking out full loans. Few hold part-time jobs, as NUNM has a demanding program that requires full focus and time commitment. AMU is a quarter of the cost, at $125 per unit. Most classes occur in evenings or on weekends, so students can work full or part time while attending school, accruing less or no debt.
What are you willing to sacrifice, or invest in, for this education? Total cost of education includes cost of living (ie. food, rent, clothes), associated student costs (ie. expensive textbooks, clinical gear), and other unforeseen expenses. After graduation, expenses include board exams, starting a business, etc. We are not guaranteed jobs upon graduation, but need to be creative entrepreneurs. It can take 2-3 years to build a practice, depending on your location, business skills, practitioner skills, and luck. Research your local Chinese medicine market, and talk with seasoned practitioners. This is a big investment.
Time
Do you want to work part time, and graduate in 5 or more years? Or do you want to fully commit to school, and graduate in 3-4 years?
Business
Business skills are an integral part of “making it” as an acupuncturist. Most schools have a weak business program, if it exists at all. Invest in business classes as you get close to graduation, pick up books at the library on this topic, notice how things are run in the school clinic, and ask fellow acupuncturists in your desired practice location. School will not provide all the tools that you need to begin a practice. We must develop strong business skills and become creative entrepreneurs on our own.
Style
What’s your personal experience with Chinese medicine? What brings you to this medicine? What style of acupuncture do you enjoy, or has been effective for you, as a patient? Are herbs effective for you, or not?
Schools usually offer electives that expose students to a variety of Chinese medicines styles or techniques. Other schools offer specializations, such as in sports medicine, geriatrics, or gynecology. Five element acupuncture and Eight extraordinary channels studies usually lend themselves well to more psychologically focused work. Craniosacral, lymph massage, shiatsu, or other forms of bodywork are helpful for those who enjoy physical contact with patients. Shen-Hammer pulse system and Applied Channel Theory provide more detailed diagnostic tools. Most of these skills can be studied after school, for CEU’s. At NUNM, many professors offered workshops outside of school. My anatomy professor taught various bodywork classes outside of school. My foundations teacher taught sound healing in Chinese medicine. Being an ancient form of art and medicine, each professor and clinician has their own relationship with and approach to the medicine. Don’t be discouraged if a school doesn’t offer an elective you’re interested in. Take CEU’s after graduation, and make your business pay for it, through tax write-offs!
Half of our educational content includes western medicine, although it’s far less emphasized, with mostly take-home exams, and professors of fluctuating skill levels and often no understanding of Chinese medicine. Take these classes online, if possible. Nonetheless, Western medicine allows us to communicate with other healthcare professionals and patients in a shared language, and offers alternate perspectives to support or refute diagnostics or treatment principles. The more tools the better, though sometimes it can get messy.
There is always more to learn. With a plethora of options, don’t get bogged down in options, or water down your education. Pass your board exams. Enjoy the journey, too. Be well informed, yet focused. “Your best teachers are your patients,” said Dr Wang Ju-Yi.
Master’s vs “First Professional Doctorate” degree
Chinese medicine practitioner scopes of practice varies by location. In the USA, each state has its own rules. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) administers the national board exam, which includes four parts: Foundations of Oriental Medicine, Biomedicine, Acupuncture, and Chinese Herbology. The first three portions are required for most states, while the Herbs portion varies by state. Some states require both Herbs and Acupuncture certification to become a licensed acupuncturist (LAc), while other states only require Acupuncture certification to practice. A few states include other tests. California has its own State Boards, instead of the National Boards (this will change next year). New Mexico has an additional practical exam, to take after passing the National Boards. After passing both tests in New Mexico, Chinese medicine practitioners are given the title of “Doctor of Oriental Medicine” (DOM), and are primary care physicians (PCP). In California, acupuncturists are also PCP’s. In most states, we are just “Licensed Acupuncturists” (Lac), sans PCP rights/ privileges/ responsibilities
In first professional doctorate programs, students concurrently take the doctoral program with the Master’s program. Our field is rapidly changing, moving more towards a doctorate being required, instead of optional. Some older practitioners think that directly going for the first professional doctorate makes more sense, to save time and money. Others suggest finishing up the Master’s, starting a practice, and getting more experience and focus first, before embarking on the next stage of education. I started off doing a dual degree, found it to be too much work and in a program that was more academic than clinical (I am more interested in clinic than academics), so changed back to completing my Master’s, first.
Post doctorate (Ph.D) programs also exist in Chinese medicine, though students usually pursue this after a few years of practice. This course of study can be engaged in either the USA or abroad.
When Visiting Schools
Speak with as many different students as you can. Get diverse views on the school. A few important questions:
What are your favorite and least favorite classes and professors?
Who are the primary professors for core classes, such as foundations, points, diagnostics, herbs, and formulas?
What do you most like and dislike about the school, in general?
What are the strong and weak points of this school?
Notice what each individual has to say, and pay particular attention to patterns across differing individuals.
Ask the Dean this question, too.
- Do professors and administration respond to student requests? How? How quickly? What's the procedure for voicing grievances, and conducting school-wide changes? Get solid examples of this.
Be bold, and ask professors the above questions. Many professors teach at different schools, and can offer perspectives from the different schools that they currently teach at, have taught in the past, or their own journey as a student.
Do not just speak with administration. Admin is necessary for processing paperwork, money, and other logistics, but don’t affect or understand course content, and can sometimes be rude or disorganized. (I had bad experiences at most schools that I visited and attended). Don’t let a bad experience with an administrator ruin your feeling about a school. Ask to speak with the Dean of the Chinese medicine program and again, speak with professors, clinicians, and students.
Remember that each person you speak with has their own opinions, biases, and personal experiences. What resonates for another might not resonate for you. But if you piece together enough of others’ experiences, it helps create an outline for you to fill in the blanks with your own experiences, perspective, and judgment.
Notice who the other students are
Who are your professors? What’s the ratio of men to women professors? Are there Chinese professors? Do your professors speak or read Chinese? Do they cite the classics, and their clinical experience?
Sit in on classes with topics that you care most about.
Get a complimentary treatment in the clinic.
Ask students and clinical supervisors about clinical progression. Notice the cleanliness and professionalism of the clinic, and how supervisors interact with students.
Do students seem happy, confident, relaxed, professional, and knowledgeable?
- Once you begin formally engaging with a school, keep well-organized records of everything, ideally digitally, especially payments and agreements. If they lose your paperwork (it's happened to me a few times), then you have it.
The Curriculum
Make sure that topics that most interest you are emphasized in the program if possible, or at least included.
Remember that this is only the beginning of your education. No school can offer everything. Your schedule, including school, possible work, and a life outside of school to integrate and rest, will be packed.
I found more richness in my life outside of school than my life in school, such as educational opportunities, people that I want to study with, etc.
Even if you don’t resonate with your professors, you can find mentors, inspiration, and continuing education opportunities outside of school. Ask around in local clinics and in your communities, either in person or online.
You can take such classes as qigong and other electives outside of school or for CEU’s after graduation, usually for cheaper than in school.
At NUNM, a 1.5 unit qigong class and weekend-long qigong retreat are part of every quarter. This looks great on the curriculum, and sounds romantic and lovely, but adds up to around $1000 every three months. Most schools only require two qigong/ taiji classes. Then, there’s also personal connection: I don’t enjoy this particular qigong form, and don’t want to spend $1000 every three months on it.
Clinic
Who are your supervisors in clinic? How many years of clinical practice do they have? Do you resonate with their teaching style? How large are clinic groups? What’s clinical progression like? How soon do you enter clinic, upon matriculation at that school? What population does the clinic serve? Does it serve a diversity of people with differing conditions, ages, income levels, etc? What kind of patient population or conditions do you hope to work with in the future, and does your school clinic reflect that?
At AMU, students observe other students practicing. We usually have two teams of students working at once, with a presiding supervisor over the entire shift. First level students observe second or third year students needling. Our supervisor only enters to double check tongue, pulse, and other diagnostics, and help form a treatment plan. Then, treatment is conducted entirely on our own. Second level students needle together. Third level students can needle solo. Most schools have this system. My current opinions, based off of my first quarter in AMU’s clinic:
Pro’s of watching fellow students
- I am sometimes more comfortable asking my peers simple repetitive questions (“stupid” questions) than high-level practitioners
- We have to take initiative and develop prowess in our work, as no one holds our hand
Con’s of watching fellow students
- Lack of experience
- It can sometimes get chaotic or messy
At NUNM and SIEAM, students start by observing clinicians with 10+ years of experience. As they progress in clinic, they have a closer relationship with their supervisors. Watching someone practice who has years of experience is very different than watching fellow students: it looks like a graceful dance, rather than a technical act. I find it inspiring and beautiful, and sometimes daunting, in a “this is a lifetime of learning” way. It’s rare to find a school where you can observe seasoned clinicians. Opportunities exist outside of school to observe excellent practitioners though, either via serendipity, self-created opportunities, or established programs with seasoned practitioners (usually more expensive).
Self-study
School can only teach you so much. It is only the beginning. The rest is up to you.
Some Schools
California has a plethora of Chinese medicine schools, particularly in the Bay area and Los Angeles, due to the abundance of Asians, here. I now attend Alhambra Medical University (AMU) in Los Angeles, which is one of the cheapest schools in the country, as it’s run and attended predominantly by immigrants, who will not pay the exorbitant fees that westerners are more willing to pay. This is reflected in the education itself, which is just straightforward and practical: traditional Chinese medicine (TCM) with no esoteric decorative flowers, and certainly no exoticism. TCM tends towards biomedical allopathic perspectives, which is the direction that Chinese medicine education in China and Taiwan focus on, more and more. This can be reductionist yet well organized. A deeper investigation of the classics and other styles or traditions can be engaged in during or after school, or upon graduation.
Los Angeles
My school. A small, cheap, immigrant-run TCM school that teaches to the Boards, with classes in English or Chinese (you choose). A DAOM program was just added, for people who have graduated, already. I am glad to be here, and am happy to share my experiences, if you have questions.
Other small, cheap, immigrant-run TCM schools that teaches to the Boards:
Larger TCM schools here at a slightly higher cost, with more westerners than Asians:
Located in a strip mall in west Los Angeles
Qigong is a required class through the entire course of study. They call themselves as a “family style” school, but the founders of the school rarely teach.
Has a first professional doctorate program, and no Master’s program. A small cohort-based TCM program in a much larger chiropractic school on a large beautiful campus in Whittier.
Bay Area (CA)
Well organized. I got a good feeling visiting this school, but did not like the location in super urban San Francisco. Recently partnered with California Institute of Integral Studies (CIIS), which has a transpersonal psychology, somatic psychology, and other interesting programs.
Small select staff and students. Warm environment. Seems like an excellent hands-on program. I was not a fan of Oakland (high crime, crowded).
A gorgeous campus and location, right next to the ocean in progressive Santa Cruz with redwoods and fun community. Has English or Chinese classes.
Colorado
Boulder was one of my favorite places to live, at the base of the beautiful Rockies, and in a progressive community with many Universities in a small town, including Tibetan Buddhism Naropa University. SWAC has a campus in Boulder, CO and in Santa Fe, NM. It has an affordable education, with excellent professors in a standard TCM education, with options for specializations in other areas, such as Japanese acupuncture.
Portland, Oregon
The cheapest option for studying Chinese medicine, but controversial, and only acupuncture, no herbs. No Master’s degree, just licensure. Some dogmatism around community acupuncture, but otherwise great principles.
Seattle, Washington
New England
“Classical Chinese medicine” schools (instead of “TCM”)
“TCM,” or “traditional Chinese medicine,” is a post Communist revolution modernized version of Chinese medicine, as synthesized by doctors under Mao Ze Dong. “Classical Chinese medicine” (CCM) refers to pre-Communist Chinese medicine.
I’ve heard great things about this school, and met some wonderful practitioners that graduated from here. It’s a rigorous education, with a lot of information folded into three years, a small cohort, the best professors, and reasonable tuition. If you’re willing to completely dedicate your life for three years to one of the best yet toughest schools, then come here. SIEAM doesn’t allow for transfers, and Seattle is cold and rainy, which is why I didn’t come here. The only school in the USA that teaches students to read and write modern and classical Chinese as part of its curriculum. You start observing in clinic immediately, then learn tuina to start practicing in clinic, before needling.
An emphasis on classical texts, with an idealistic yet thoughtful curriculum. Professors often ramble off in inspired yet disorganized ways, leaving students excited yet confused. The most expensive school in the country which is, in my opinion, not worth the cost. Clinic with experienced clinicians who each have their own style. A plethora of diverse Chinese medicine styles and techniques presented. Juicy, but can lead to lack of depth. Qigong and retreats every quarter which increases cost of education.
Founded by Jeffrey Yuen. More on that, another time.
Five Elements schools:
These schools are focused on “Five Element Acupuncture,” a style of acupuncture compiled by JR Worsley from a variety of approaches to Chinese medicine he learned in his East Asian travels. Students focus on this style of acupuncture, and are not exposed to much else. Pro’s with this kind of focus include graduating with an ability to perform one thing very well. Con’s include not knowing other modalities… but those can always be learned, later. Herbal medicine is not an inherent part of the Five Element approach, but a very basic herbal overview can be added onto the curriculum for an additional cost. Neither school is recognized by California or New Mexico (perhaps other states as well). Five Element style is not emphasized in the Board exams, so students have to prepare for the Boards on their own. Both schools offer a module-based program, which allows students to hold part-time jobs outside of school for the first two years of their education, before a full year of clinical residency in the final year.
Supplemental online education
Studying in Taiwan/ China
Another perspective on this topic from Andrew Nugent-Head, a professor and practitioner that I greatly respect and admire:
Related Blog Posts
- NUNM year 1: a review (09/2016)
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Other Ideas
A quick idea- sketch of future potential additions to this article, as it’s not finished, and will likely never be, as the field continues changing rapidly, and I do, too.
