The Current Status of Acupuncture Education and Clinical Practices in Taiwan

INTRODUCTION

Approximately one-fourth of the population in Taiwan utilizes Chinese medicine, ¹ leading the government to actively cultivate talents in this field. Currently, five universities in Taiwan are dedicated to training traditional Chinese medicine (TCM) practitioners. Among these, China Medical University (CMU-Taiwan) stands out as a pioneer, having established its Department of TCM in 1966, which marked the beginning of formal academic education in TCM. ² Furthering its commitment, the university founded in 2005 an institute focused solely on acupuncture research. ³ In addition, the Continuing Education Center at CMU-Taiwan offers acupuncture workshops, enabling Western medicine physicians and dentists to earn credits for acupuncture practices. This article highlights the teaching and training at CMU-Taiwan to explore the comprehensive education and training of acupuncturists, as well as their future prospects in clinical practice after graduation.

TEACHING CHARACTERISTICS

The curriculum at CMU-Taiwan is well-planned. Students must complete either a 7-year training program in the Department of TCM or a 5-year post-bachelor training TCM program to earn a Bachelor of Chinese Medicine degree. The TCM curriculum in both programs is broadly divided into foundational and clinical courses. Acupuncture, a vital component of the TCM curriculum, is also subdivided into foundational and clinical courses. Basic acupuncture courses focus on meridian theory and acupoints throughout the body, and clinical acupuncture courses emphasize disease treatment and clinical skills, totaling 2,376 study hours. This curriculum design aims to give TCM students a comprehensive understanding of both the theoretical and clinical aspects of acupuncture. In addition, students undergo 1,386 hours of clinical practice in hospitals. The course content is detailed in Table 1. ⁴ Western medicine physicians and dentists can acquire professional acupuncture knowledge and skills through specialized acupuncture workshops, which include 60 hours of clinical practice in hospitals. After completing acupuncture workshops, Western medicine doctors and dentists can practice acupuncture.

The teaching methods are diverse, including classroom lectures and problem-based learning, which involves discussions that encourage students to demonstrate their learning outcomes. This approach creates a supportive learning atmosphere and enhances student autonomy. In addition to teaching TCM theories, the curriculum encompasses modern medical knowledge and the latest scientific research findings, with a strong emphasis on clinical skills training. Diagnostic aids such as tongue diagnosis instruments and pulse diagnosis instruments are introduced to help students more easily grasp the basic principles and techniques of TCM diagnosis and gain more experience during their internships.

Aside from the comprehensive mastery of TCM theories, the adoption of advanced information technologies in instruction is a highlight. For example, the Virtual Reality (VR) Acupuncture System has been in use since 2023. ⁵ This interactive system allows students to independently learn acupoints and simulate needling through repeated practice. It offers various acupuncture positioning postures that meet clinical scenario requirements and enhance the accuracy of locating acupoints. By visualizing human tissue meridians and three-dimensional acupoints, students gain a clearer understanding of anatomical structures and point locations. In addition, the system’s interactivity enables acupuncture instructors to record the needling process, allowing students to study it repeatedly. This creates an efficient and immersive acupuncture learning experience.

Through the simulated clinical scenarios provided by the VR Acupuncture System, medical students or residents can engage in more extensive training and practice. Moreover, the system supports multi-user remote connections, free from the constraints of people, time, or location, rendering it a powerful tool for future education.

ACUPUNCTURE HIGHER EDUCATION AT CMU-TAIWAN

In order to promote the science of acupuncture and cultivate professional acupuncture practitioners, teachers, and researchers, CMU-Taiwan established the Graduate Institute of Acupuncture Science (GIAS) in 2005 and expanded it with a doctoral program in 2015. GIAS aims to develop acupuncture talents with independent thinking, problem-solving, professional research capabilities, language expression skills, and international vision. The mandatory courses in GIAS are categorized into common and specific ones. For example, courses such as lectures on TCM, molecular medicine, seminars, and theses or dissertations are required for both the master’s and doctoral programs. Courses specifically for master’s students are seminars on meridian and seminars on acupuncture education. The required courses for doctoral students include advanced acupuncture treatment and advanced acupuncture channel medicine. A total of 30 credits (540 hours) are required for the master’s program, and 32 credits (576 hours) are required for the doctoral program. Thus, comprehensive training for students in both the master’s and doctoral programs is provided.^6,7

CLINICAL DEVELOPMENT

The clinical training of TCM students in both the 7-year TCM education program and the 5-year post-bachelor TCM program is well-structured. Before graduating, they must complete a 1-year “Clinical Internship in TCM” course to develop the clinical skills and professional attitude essential for TCM practitioners through hands-on practice and training. After graduating and passing the TCM qualifying exam, they officially become TCM practitioners and may choose to participate in a 2-year chief physician training program at TCM medical institutions. This program is designed to establish a systematic clinical training system that enhances and ensures the quality of TCM health care services. The training content is outlined in Table 2. ⁸ The basic training courses involve medical ethics, medical regulations, evidence-based medicine, infection control, medical administration, medical quality, medical document writing, health policy, and first aid training. Professional subjects such as Chinese internal medicine, integrative medicine in obstetrics and gynecology, integrative medicine in pediatrics, acupuncture and moxibustion, integrative medicine in Orthopedics, traumatology and rehabilitation, and Chinese medical pharmacology are mandatory in the first year. In the second year, physicians must take TCM family and community medicine and Western clinical medicine. In addition, they can select at least one elective course from the curriculum based on their interests.

To guarantee that TCM practitioners continuously refine their professional medical knowledge and skills, they are required to regularly participate in the continuing education (CE) overseen by the Ministry of Health and Welfare in Taiwan. ⁹ During each 6-year practice cycle, all TCM practitioners must earn 120 CE credits accredited by medical authorities. CE courses emphasize advancing medical applications and research and are available in various formats, such as conferences, paper publications, workshops, seminars, lectures, and distance learning. Upon acquiring the required credits within the designated period, TCM practitioners can maintain their practicing qualifications.

THE ACUPUNCTURE SPECIALIST SYSTEM IN TAIWAN

The acupuncture specialist system proposed by the Ministry of Health and Welfare in Taiwan is actively being promoted to ensure the quality of acupuncture treatment. Referring to the six core competencies set by the Accreditation Council for Graduate Medical Education (ACGME) in the United States, the system exclusively focuses on patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, systems-based practice, and professionalism. ¹⁰ It aims to bolster the clinical medical capabilities and academic research of acupuncturists in various fields, and to foster acupuncture specialists’ modern medical expertise and holistic medical mindset. All TCM-certified practitioners who have graduated from either the 7-year TCM education program or the 5-year post-bachelor TCM program are eligible to train as prospective acupuncture specialists through a 2-year training program. Information about the training is listed in Table 3. ⁸

In the future, the acupuncture specialist physician system will be continually promoted to enhance practitioners’ clinical skills and academic research capabilities. This training will primarily focus on patient care and integrate clinical teaching with evidence-based research to advance the development of TCM. Currently, there are few TCM practitioners with expertise in evidence-based research and specialized teaching. Efforts will be ongoing to cultivate such talent and further strengthen the specialist physician training system.

CONCLUSION

The cultivation of acupuncturists in Taiwan involves a comprehensive and solid educational and clinical training system. This system is dedicated to integrating traditional and modern medicine, aiming to develop professionally qualified acupuncturists. Consequently, Taiwan’s acupuncture education and clinical training system serve as an applicable model that effectively integrates traditional Chinese and Western medicine.