Beginning April 27, 2014, the Canadian College of Naturopathic Medicine in Toronto, Ontario, is offering an efficient means through which international medical graduates can practice medicine in those Canadian provinces and states of the United States that regulate naturopathic doctors. The CCNM “Bridge Delivery” program offers a “compressed” naturopathic medical program of six terms in 24 months to candidates who have met stringent standards in prior medical education abroad. The pre-requisites for enrollment, for instance, include attaining a passing grade on the Medical Council of Canada Evaluating Examination (MCCEE) or a passing grade for United States Medical Licensing Examination Step I (USMLEI).
The CCNM site asserts that “many foreign trained medical doctors feel that the nature of a naturopathic doctor’s practice is much closer to their experience as a medical doctor.” The education of the naturopathic doctor at CCNM includes training in acupuncture techniques. The International Medical Graduate (IMG) Bridge Delivery application is here.
Comment: The phenomenon of a Chinese-trained medical doctor who practices as a non-doctoral licensed practitioner in acupuncture and Oriental medicine (AOM) is familiar in North America. The MD (China) attached to the LAc (licensed acupuncturist) fairly begs for a broader scope of practice than the AOM practitioner has in North American jurisdictions. Typically, western diagnosis is not in the acupuncturist’s scope of practice.
The MD (Russia) or MD (China) or MD (elsewhere) who chooses the CCNM 2-year program embarks on an interesting re-entrance to practice. The IMG becomes a “doctor” or, in most US jurisdictions, a “physician” such as he or she was accustomed to being. Yet at the same time, the IMGs will discovered the rude reality that in the heated politics of US medicine they might be scorned by polarizing forces in regular medicine as frauds and quacks.
Yet the naturopathic practice can be familiar to the IMG’s general practitioner experience at home. The ND’s patient population arrives with health issues typically as broad as are seen in conventional family medicine. In some US jurisdictions such as Vermont, Washington, Oregon, and Arizona, naturopathic doctors have broad prescribing rights including pharmaceuticals that require registration via the US Drug Enforcement Administration (DEA). Yet mainly the tools used by a naturopathic doctor are closer to what the IMG may know as traditional medicine back home.
Will a naturopathic practice satisfy an average IMG? No doubt, the right to practice in this case is yet the right to practice as a second class citizen. The ND is only partially included in the medical system. Yet change is afoot. CCNM, for instance, is an increasingly fertile bed for whole practice research that supports the profession’s claims. The Canadian Medical Association Journal recently published positive CCNM findings on naturopathic care for back pain. Major research grants related to cancer and diabetes were received this spring. A new CCNM cancer center in Ottawa has assumed a high profile in the community. Meanwhile, south of the Canadian border in the state of Vermont, for instance, naturopathic doctors are part of the primary care matrix and approved to run primary care medical homes (PCMHs) at clinics like Mountain View Natural Medicine. Across the country in Oregon, the Center for Natural Medicine is similarly pioneering such a role for naturopathic physicians under that state’s health reform.
In short, the decision of an IMG to re-enter the healthcare work force through the CCNM Bridge is yet a bit of a crapshoot but with the dice increasingly loaded for success. The CCNM site invites enrollees with: “If you are an internationally trained medical professional, you have significant training that is valuable to the Canadian health care system and to the health of Canadians.” This would be reassuring to an IMG if such a banner were posted on the Health Canada website. One suspects that, while the power relationships might not yet be what one wants, the content of the naturopathic education at CCNM is likely closer to the IMG’s less than fully industrialized medical education at home. There is likely something to the CCNM assertion that “the nature of a naturopathic doctor’s practice is much closer to their experience as a medical doctor.”