Are Naturopathic doctors clinically trained and have they gone to medical school?


Preface before addressing this question: There was a recent negative news special in Dallas, TX raising concerns and warnings to the public about Naturopathic doctors. As someone who is a Naturopathic doctor, these concerns were valid, but they should have been discussed with NDs themselves, versus posed to the American public in the way that they were, because the American public is not knowledgeable about healthcare in the same way as MDs and NDs are. It was obvious that this coverage was intended to be negative. Furthermore, it was directed at NDs and ignores the fact that there are many MDs who are now taking certifications to become more knowledgeable in holistic medicine like NDs, but calling themselves by a different name - Functional Medicine. If there was no benefit to what NDs do, MDs would not seek it out. With that, let's get to the heart of this article based on the title:

Licensed Naturopathic Physicians attend an accredited 4-year Naturopathic medical school. They have to be on site the whole time. It is medical school. Anatomy with cadaver lab, Physiology, Biochemistry, Pharmacology, Pathology, Gynecology, Urology, Cardiology, Pulmonology, EENT, etc. are included in the curriculum (please check our curriculums for more information. They can be found on each school's website - aanmc.org). They have two years of clinical shifts in the 3rd and 4th years, which is when the holistic therapy classes start to increase. They then take board exams to obtain the license to practice medicine. After that, they can start seeing patients.

As a Naturopathic doctor who has not been to traditional (allopathic) medical school and gone through residency and fellowship, I decided to speak with 4 of my classmates who came from the allopathic model: MD, Respiratory Therapist, and 2 nurses.

All of them had hospital training, and stated that NDs did not. They said NDs have not had extensive training with very very sick people, such as major ascites, gangrene, or very bad jaundice. Certain specialties like OBGYN and prolotherapy, had to be sought out by the student if they wanted to become a specialist in it. It was not a set part of the curriculum (We did have Obstetrics class though, but clinical training was something you had to request). It was also mentioned that we only learn mainly one way to do physical exams, whereas there are actually multiple ways to do it.

One classmate mentioned that procedures and conditions like wound care, ventilator management, and diabetic ketoacidosis were not covered well. We also don't see as many patients in our training as MDs, so they are able to pick up pathologies and diagnose quicker. But NDs spend more time with each patient, so we get to the root cause of what is going on. That can be way more helpful in achieving results vs only spending an average of 7 minutes with each patient.

In some settings, MDs get paid $125 per hour, regardless of whether you live, die, or stay sick. NDs are usually entrepreneurs in a clinic setting on their own (or with maybe a few other NDs) and do not take insurance (some do though). NDs also made a definitive choice to stray from the traditional allopathic model and commit to a different, but still very rigorous 4 year long path (and often accruing massive loans via the government), because they saw the issues with strict allopathic medicine and wanted better for their patients. Thus, there is way more incentive to get you better.

NDs are willing to work with MDs. We are able to do that because NDs are taught allopathic language. We can communicate in it, understand it and utilize it in our own work. We are trained to be physicians. We are the ones who can also best explain the herbs and other supplements we have placed patients on, in the midst of them also being monitored and being on medications prescribed by an MD. It is MDs who often do not want to work with NDs. MDs are also not knowledgeable on holistic medicine. So when MDs discourage patients from being on any supplements, they are usually speaking from a non-educated fearful (but also out of concern) perspective in terms of how those supplements will interact with the medications. They are probably not asking who suggested them to the patient, nor taking the time to call the ND to understand it. I have noticed that they now ask on their forms which supplements you are taking, but this extra beneficial leg work afterwards may not happen. So this breeds an environment where patients do not tell MDs when they try holistic therapies.

In terms of pharmacology, one of my classmates said that our in-class training was pretty close, but again, not as much clinical experience. But NDs are usually not trying to use them as much. It is part of our training and we have to understand them because patients do come in already on medications. I take the time to do an interaction checker between my clients' medications and the herbs and other supplements I want to place them on. When clients are on many medications, I usually find more interactions between the medications than with any supplement. I also tell my clients that I will not take them off or wean them from any medication that an MD has placed them on. I do not have prescriptive rights in the state I reside. I tell them that through the therapies that we do, overtime as you get better, you can start having conversations with your doctor about whether and when the weaning process can begin.

After school, MDs have years of residency and fellowship training, and then they can stand alone as an MD. NDs can start practicing right out of school. Although Naturopathic residencies exist, there are not enough for everyone yet, so it is not required. However, one of my classmates felt that right out of school, NDs are more prepared then MDs. It is through training that MDs start to become good at what they do.

Despite these areas where we lack, we make up for it in other ways: we emphasize physiology and biochemistry, and our holistic therapies are what sets us apart. It is not atypical for someone having a particular condition for years (and being monitored by one or multiple MDs during that time) to start seeing improvements in less than 3 months. It is a different dynamic of healthcare.

NDs often intervene when allopathic medicine overlooks certain things. For instance, even if thyroid levels (TSH) are in the normal range, we may start addressing what appears to be a hypothyroid case based on symptoms and a more narrow range of what we see as normal.

Although many of us are not hospital trained, in the opinion of one of my classmates, all we need is to seek it out if that is something we want to do. The idea that natural medicine cannot work in a hospital setting is not the best opinion. It has to be tried. Successes come through trial and error. That's why both MDs and NDs are 'practicing' medicine. Two of my classmates have noticed that they are getting better results applying allopathic and naturopathic together.

In states where the license of NDs is not recognized, they do not practice medicine, treat, diagnose, or prescribe medications. Does that mean they are not effective in helping people get better? As someone in this situation, I can tell you the answer to that is No. NDs are thriving in unlicensed states using the basics of what we have learned. That is how powerful holistic medicine can be.

If you decide to try Naturopathic medicine, it is highly recommended that you do not wait to do it as a last resort. There is hope we can still change things around at that level, but holistic medicine can really shine when you are operating in the early stages or seeking prevention.

As you shop around, get to know what your potential ND is good at, what their specialties are, and if their personality is a good fit for you. Patients often get second opinions in the allopathic world, but can shy away after one bad experience with their very first ND. It was a new experience and was thus judged as that is how all NDs are. That is not the case. If you don't like one, try another. It is like this in any profession.

Learn to understand what you need at the time you are searching: ND or MD, or both. Sometimes it may be someone with a completely different set of skills and title. ;-) I want you to get better, period.

To conclude, yes Licensed Naturopathic Physicians have actually gone to medical school and we are clinically trained but there are differences that set us apart.


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