DENVER—The University of Colorado’s Department of Family Medicine is boldly going where no medical school has gone before: residency training in holistic medicine.
Owing to the continued public interest in natural medicine, most medical schools around the nation have developed introductory elective coursework in “complementary and alternative medicine.” Many teaching hospitals now have integrative medicine clinics. This has kindled a strong and vocal interest among graduating medical students wishing to pursue further practical training in caring for the whole person while learning to apply complementary therapies.
But to date, there has been nowhere for them to turn. None of the nation’s medical schools yet offers a residency in holistic medicine, and for MDs and DOs, acquisition of clinical skills in nutrition, herbal medicine, acupuncture, Chinese medicine, homeopathy, mind-body techniques and the like remain largely the province of post-graduate continuing medical education.
Though some academic leaders in conventional medicine have expressed interest in “someday” developing residency programs, it seems that everybody is waiting for somebody else to make the first move. University of Colorado’s Robert Ivker, DO, and Tim Dudley, MD, are stepping forward as the “somebody else.”
Dr. Ivker is president-elect and one of the founders of the American Board of Holistic Medicine, which was established several years ago to create a comprehensive curriculum and certification exam for MDs and DOs interested in holistic medicine. He believes the ABHM curriculum, based upon Dr. Robert Anderson’s comprehensive “Scientific Basis of Holistic Medicine” database, will serve as a strong foundation for a residency program.
In an interview with Holistic Primary Care, Dr. Ivker said the plan is to create a Holistic Family Medicine track within a new 4-year residency program, which would maintain the existing 2.5 years of conventional family medicine training, but integrate an additional 18 months of didactic and clinical work in holistic medicine. This will be a longitudinal program throughout the 4 years of training.
“We will introduce the holistic curriculum right away, not as an ‘add on’ at the end,” said Dr. Ivker, who will serve as director of the holistic track. Initially, the program will be designed to accommodate 4 candidates, though this could expand once the program is established. He is expecting to have the first residents begin their training by June 2004.
Medical students around the country have already gotten wind of the possibility. “At the American Holistic Medical Association meeting in Toronto last May, I had a 3rd year medical student give me his card, asking that I keep him in mind. And I recently got an email from a 2nd year student asking what she could do now to increase her chances of being accepted into the program.”
The plan has the support of Frank DeGruy, MD, who is chairman of the Department of Family Medicine. He and others within the department believe creation of a holistic track within a new 4 year curriculum will strengthen UC’s family medicine residency program as a whole, and make the program far more attractive to recent medical school graduates. “They felt that family practice training needed to change, and this made perfect sense,” said Dr. Ivker.
Recently, he and Dr. Dudley, director of the UC Family Medicine Residency training program, met with representatives of UC’s existing Integrative Medicine Clinic, which was opened roughly one year ago. An important part of their mission is post-graduate medical education, so there will be a strong correlation with the proposed residency training program.
Dr. Ivker believes a holistic training program will thrive within the department of family medicine in large measure because family medicine already embraces a biopsychosocial model of health care. UC’s family medicine department opened the door in 1996 by sponsoring a conference which soon thereafter evolved into the ABHM’s board certification review course.
In 2000, UC co-sponsored the first ABHM course and exam. “We had 425 physicians attend the first review course, and while every medical specialty was represented, 51% of them were family physicians. That made a big impression on the Department of Family Medicine,” Dr. Ivker said.
The key to garnering support from leaders at UC was in presenting them with Dr. Anderson’s database, which documents the scientific research for commonly used non-pharmacologic, non-surgical approaches.
The ABHM curriculum encompasses 6 core topics: nutritional, environmental, exercise, behavioral, spiritual and social medicine, as well as 6 specialty areas: biomolecular therapies, botanical medicine, energy medicine, ethnomedicine (Traditional Chinese Medicine, Ayurveda, Native American medicine), homeopathy and manual medicine. It offers practical, condition-specific approaches, teaching physicians how best to apply holistic medicine to treat and prevent the most common clinical conditions including cardiovascular disease, back pain, sinusitis, asthma, headache, depression, hypertension, inflammatory bowel disease, osteoarthritis, osteporosis and menopause management.
The third annual ABHM course, entitled The Art, Science, and Practice of Holistic Medicine, and board certification exam, will be held on Nov. 17–20, 2002, at the Adam’s Mark Hotel in Denver. (For more information on the ABHM course and exam, call 509-884-1062 or visit: www.amerboardholisticmed.org.)
Far beyond the specific disease treatments and modalities addressed, the ABHM course and the residency program now being developed are intended to teach a new philosophy, one that recognizes that illness is not simply a physiologic phenomenon, and that health is far more than the absence of diagnosable disease.
Dr. Ivker believes a lot of eyes in academic medicine will be turned toward Denver in the coming years. If the UC Holistic Family Medicine residency program proves successful, it is highly likely that other medical schools will follow soon and establish programs of their own.
