Two of the country’s leading naturopathic medical schools are planning to merge and become a single institution, a move that surprised many in the field.
In June, the presidents of National University of Naturopathic Medicine (NUNM) and Bastyr University jointly announced a non-binding letter of intent to come together under one banner some time in 2024. The two schools, headquartered in Portland, OR, and Kenmore, WA, respectively, are the oldest modern naturopathic colleges in the country.
Founded in 1956, NUNM (then called National College of Naturopathic Medicine) represented a rebirth of naturopathic medicine in the US at that time. The school has a long legacy of training excellent clinicians, researchers, and thought leaders, some of whom went on in 1978 to found Bastyr University. That school was named for John Bastyr, a teacher and early advocate of modern naturopathy.
Both institutions have grown considerably since their founding. Bastyr in particular has expanded quickly over the last 20 years, opening a second campus in San Diego in 2012. But despite the growth, the schools are still small by contemporary university standards. NUNM currently trains around 360 students, and Bastyr has around 750 between its two campuses.
Strength in Numbers
Leaders at both schools believe there’s strength in numbers, especially in today’s economic environment which is generally hostile to small institutions.
In an online “town hall” meeting announcing the proposed merger, Melanie Henriksen, ND, NUNM’s president, says that by joining forces Bastyr and NUNM will create a combined student body of well over 1,000–an important threshold. “Higher education research shows that a lot of things improve when a school has more than 1,000 students,” she said.
The new institution, which has yet to be named, would have a combined faculty of 388 members teaching 35 distinct program tracks. It will offer a total of 18 naturopathic residencies, and its three teaching clinics will have a combined capacity to provide nearly 60,000 patient visits.
The merger would also allow faculty clinicians and students to use a common electronic health record system, creating opportunities to easily share information across the three campuses and to pool data for research projects.
Devin Byrd, PhD, president of Bastyr, says small higher education institutions like his and like NUNM have faced stiff demographic and economic headwinds in recent years: an overall decrease in the younger population driven by a longstanding decline in the US birth rate; a stagnant economy especially for many prospective; a relentless push toward online education; surging overhead and operating costs; and an aging faculty.
These challenges are not unique to naturopathic training programs; all institutions of higher learning face similar trends, to varying degrees. But they are especially problematic for a small profession like naturopathy, which remains on the margins of healthcare at large, and which has a limited base of financial and structural resources.
By joining together, NUNM and Bastyr will be able to pool financial resources, eliminate curriculum redundancies, and provide a wider spectrum of learning opportunities to the combined student population.
“This merger improves access for students while offering more flexibility in how they learn, more interdisciplinary program options, and expands research and clinical practice opportunities,” says Byrd.
One major advantage of the merger is that it will permit faculty members to concentrate on their true areas of expertise.
“Both of us are small institutions. Many of our departments are departments of 1 or 2 teachers,” said Henriksen. “We ask our staff to be jacks-of-all-trades. By coming together, we can allow people to focus more on their strengths, while maintaining adequate staff across all three campuses.” The administrators envision a broader range of elective courses available to all students, based on the wide expertise of the combined faculty members.
Harmonizing the Curriculum
Though the two schools share many core principles and common objectives, they are unique and distinct, each with its own culture and legacy. No one is under the illusion that a merger will be easy.
Byrd and Henriksen both emphasized that administrators are soliciting input from everyone connected with the schools, including current students, alumni, and faculty members.
“We need to understand what’s working, what’s not, and where the opportunities rest. We want to bring forward all the ideas that people may have been sitting on for a long time but not speaking about,” says Byrd. “We are seeking guidance from all the programs, and we’ll make those decisions based on that. We’ll do that with everyone around the table.”
Currently, NUNM operates on a block-based curriculum, in which students progress through a sequence of in-depth organ system block courses, one at a time. Bastyr has a more conventional curriculum, with students taking multiple courses at the same time.
This is a major difference that has made it difficult for students at one school to transfer to the other if they so desire. One of the main objectives of the merger—and one of its biggest challenges—is to harmonize the two approaches and create a unified curriculum.
Another challenge is the differences in permitted scopes of practice in the three states where the schools are located. Washington, Oregon, and California all recognize naturopathic medicine, and have licensure for NDs, but they differ in their authorized scopes.
Kristina Connor, ND, dean of naturopathic medicine at Bastyr, says “We will prepare students to operate at the highest level that they can, so grads can be successful in any state that they go to. The combined curriculum will be keeping this in mind, so students can work within different states, different jurisdictions.”
Byrd and Henriksen both stressed that the plan is to maintain all three campuses and all current faculty positions.
A formal timeline for the merger has not yet been set, though the leaders say the effort of gathering input from their respective faculty, students, and alumni communities is already underway. The process of creating a new name and identity for the new school will begin this Fall.
A Win for Students & Faculty
Paul Mittman, ND, EdD, the president and CEO of Sonoran University of Health Sciences (formerly Southwest College of Naturopathic Medicine (SCNM), sees the Bastyr-NUNM merger as a win for students, teachers, and for the profession at large.
“I know many of the faculty at both schools. You have these extraordinary faculty members, and they won’t be place-bound anymore. It’ll be a school with 3 campuses, and the programs will be able to draw on each others’ faculties, which will enhance the quality of the educational experience.”
A graduate of the former National College of Naturopathic Medicine, Mittman took the helm of SCNM 22 years ago, and has steered the institution through many changes including its recent rebranding as Sonoran University. He told Holistic Primary Care that he well understands the economic and demographic forces that moved his peers at NUNM and Bastyr to consider a merger.
“Schools everywhere are looking to collaborate and create new economies of scale. The headwinds facing higher education are real. The inflationary costs, the escalating costs of information technology, they’re outpacing all other expenses. Even before the recent surge of inflation, costs were escalating. Schools are seeking all sorts of ways to meet those challenges. A merger is one type of collaboration along a spectrum of options.”
Mittman acknowledged that he and his team are feeling many of the same pressures as other institutions, though he added that there are no plans at Sonoran to undertake a merger with any other schools.
Online learning, which accelerated during the Covid pandemic, is changing the very nature of all medical education, not just in the naturopathic field. Mittman says that in many ways it is liberating. Schools can draw on a wider range of non-local teaching expertise, and a lot of basic didactic work can be pre-recorded for students to view at home. This frees up in-person interactive time with faculty for in-depth discussions, case reviews, and practical application of knowledge, rather than rote lectures.
Strengthening the Core
Joseph Pizzorno, ND, who trained at National College of Naturopathic Medicine in the 1970s, and who was the founding president of Bastyr University, says the news of the merger took him by surprise.
In an interview, he said he is agnostic about it. “All I care about is that the institutions and the professions will be stronger. And I believe that multiple strong schools will make the profession stronger.”
Like Dr. Mittman at Sonoran, Dr. Pizzorno has decades’ worth of experience in medical school administration. While he, too, recognizes the broader demographic and economic shifts, he sees two additional factors that underly the unique challenges confronting NUNM and Bastyr.
One is the fact that many of the core principles and practices of naturopathy have been incorporated into functional medicine and holistic/integrative medicine, and are now more widely available outside of naturopathic circles. The other is the gradual shift within the naturopathic field toward a “green allopathy” approach. He is concerned that the naturopathic profession has lost some of the distinctive features that made it unique and appealing to many young would-be healers.
Across the entire naturopathic field, new student enrollment is down, and program administrators need to figure out why.
Pizzorno holds that, merger or not, the administrators at NUNM and Bastyr need to look closely at recruitment and application patterns, and to pay attention to the aspirations of prospective students who inquire about naturopathic training.
A merger will, no doubt, give the schools greater economic efficiencies and increased capability to meet the demands of a new tech-enabled learning experience.
But Dr. Pizzorno emphasized that the profession as a whole needs to re-commit to the basic principles of naturopathy, and to increase efforts to raise public awareness of what makes naturopathy unique and valuable.