Recently I read a discussion between a number of professional Chinese medicine (CM) practitioners, which included teachers and administrators about the education of Western students (and Chinese students) in the field of Chinese medicine. There were questions about the direction the education has taken, e.g. more and more emphasis on Western/bio medicine and comments that proclaimed the benefits of students learning Chinese language, at least enough to read Chinese medicine books. There were many other comments, but instead of talking about that, especially since it was in a closed group, I would like to offer some thoughts and opinions about the direction I think education should take in the West.
After living in China for the past 3 1/2 years I have learned a fair bit, about CM, Chinese language, and most of all about Chinese culture. That said, much of what I will say here began to ferment 4 or 5 years ago while teaching in a Chinese medicine college.
Practicing CM on a high level is not easy, in fact most would say it is very difficult. Of course, that is true of most disciplines. However, in this case we are talking about healthcare, and as such low level practice is not something we should be satisfied with both as individuals and as a profession. The current system of education lacks much of what it takes to become a “high level” practitioner, but that is also true in China. Schools teach the basics, and many of them do it quite well. However, as noted above, the issue of language creates a barrier for those who want to get to that high level. I am not suggesting that this task is impossible without Chinese language skills, but there is no doubt that access to the vast amount of literature in Chinese about CM compared to the meager, yet ever growing amount available in English, give the practitioner who can at least read medical Chinese a significant advantage. But this is just part of the picture.
Chinese medicine is a cultural relic. Like all forms of medicine, it is based on the culture it arose from. The very theories of CM are embedded within the language of Chinese culture. As an example, if you ask any Chinese person if they know what qi (氣) is they can give you a basic, although not necessarily medical, idea of what it is. If you ask them about the 5 phases (五行) they can give you a basic, and again not necessarily medical, idea of what these is, and the list goes on. My point is that these ideas are neither foreign nor peculiar to the average Chinese person. Thus, when they enter Chinese medicine school and read a text about these concepts, they already have a frame of reference; a head-start, if you will, relative to Western students. Ideas like ingesting cold drinks or foods is not good for one’s 脾胃 (spleen/stomach) have been drilled into them by their grandparents and parents from the time they were very young children, it is merely part of their cultural construct. They may not REALLY understand why, or how it is not good, but they don’t really need to be convinced of this. While Western students openly debate this and question it a great deal, Chinese students are learning the mechanisms for how and why from a CM.
These are just a few examples of the cultural context that all Chinese students have when entering CM university.
Language is an obvious advantage. Getting the basics is now pretty doable with the quality of many (certainly not all) of the textbooks that are available now. And, although there are also a number of very good advanced books there is a limit, and that limits, or at least inhibits, an advanced student’s ability to grow and a practitioners ability to attain the aforementioned “high level” of practice. Without access to the language there is no way to compare what different doctors said about treating a particular illness. There is no way to do research on literature to forward the field by using sound research methodology. It is simply limiting.
Rather than talking about what schools could do better, I would like to talk about an entirely different model; a model that resolves the above issues and also solves some other problems that I have not mentioned.
I propose that CM be taught in the same 3 stages that any other profession is taught, namely Baccalaureate, Masters, PhD (Doctorate). The same basic model that is used in other disciplines can be used, however the first 4 years would offer a student a degree that could be applied to other professions if they decided they didn’t want to further pursue CM and become a practitioner. This program would give them the following:
- Chinese language and literature (with a focus on CM)
- Chinese studies (history, anthropology, etc. specific to China/Asia, particularly CM)
- Pre-med sciences (at least as much as they would need under the current rules for CM)
- General studies (focusing on Chinese studies but wide enough to satisfy rules for regional accreditation)
Students who graduated from this course of study could continue on to different schools of medicine if they chose, other Chinese or Asian studies programs or work that is related to these fields, but of course the goal would be to prepare these students for the more serious study of Chinese medicine.
At the Masters level (required for a license) students would embark on the study of CM only, with language continued from the first 4 years. This would be a three year program designed to produce not merely competent practitioners who are unlikely to hurt anyone, but practitioners who are dedicated students who understand the underpinnings of Chinese medicine as well has how to research material, write/publish (required), and apply the medicine in at what I personally would call an entry level.
Those who wanted to continue, who found the need to do specialization or research could continue on to the PhD program and would be required to do real and original research, present at conferences, publish their findings, and eventually probably teach. These people would have continued their language study as well as other class work that would give them a well rounded education allowing them to go out into the field of academia and work at non-CM universities if they so chose.