Integrating Medical and Traditional Acupuncture Education in the United States: Enhancing Patient Care Through Combined Expertise

Abstract

Background:

In the United States, acupuncture education is divided into two primary pathways: medical acupuncture for licensed physicians and traditional acupuncture rooted in Traditional Chinese Medicine (TCM) for nonphysician practitioners. These pathways reflect the distinct educational needs and historical development of acupuncture in the United States.

Objective:

To compare medical and traditional acupuncture educational systems, highlighting their strengths, weaknesses, and the potential for integration to enhance patient care.

Methods:

This narrative review utilized comprehensive literature searches, analyzing peer-reviewed articles, institutional reports, and accreditation documents. The study focused on programs approved by the American Academy of Medical Acupuncture and accredited by the Accreditation Commission for Acupuncture and Herbal Medicine.

Results:

Medical acupuncture programs are shorter and emphasize evidence-based practice, allowing physicians to integrate acupuncture into conventional medical treatment. These programs focus on Western medical terminology and concepts but may lack depth in TCM principles. Traditional acupuncture programs offer extensive training in TCM principles and practices, including herbal medicine, with comprehensive clinical training but may lack emphasis on modern medical science and research-based evidence. There is a significant workforce disparity between licensed traditional acupuncturists and the much smaller number of medical acupuncturists in practice.

Conclusions:

Integrating both educational pathways can enhance patient care through comprehensive treatment approaches. Successful integration examples demonstrate improved patient outcomes. Future efforts should focus on developing joint training programs, promoting research collaboration, and increasing hospital-based internships to foster interdisciplinary learning and practice.

INTRODUCTION

The growing acceptance and utilization of acupuncture in U.S. health care has led to two distinct educational pathways: physician acupuncture education and nonphysician acupuncture education.^1–6 These parallel systems reflect the unique historical development of acupuncture in the United States and present both opportunities and challenges for the future growth of the field. However, so far, few studies in the literature have discussed and compared these two parallel education systems under the theme of integrative medicine. It is critical to compare these educational models not to establish superiority but to clarify the strengths and weaknesses of each approach, thereby fostering mutual appreciation and complementarity among graduates and optimizing training efforts toward better patient outcomes and safer practice. Furthermore, as acupuncture becomes more integrated into mainstream health care and individual acupuncturists increasingly develop subspecialties, the composition of the workforce trained by these distinct educational pathways will greatly affect interprofessional collaboration, scope of practice, and quality of care. By analyzing and comparing physician versus nonphysician education in acupuncture, we can deal more clearly with the difficulties and opportunities ahead for acupuncture as an integrated component of U.S. health care. This narrative review aims to compare acupuncture training programs in the United States, focusing on programs approved by the American Academy of Medical Acupuncture (AAMA) and those accredited by the Accreditation Commission for Acupuncture and Herbal Medicine (ACAHM).^1,7 A comprehensive literature search was conducted using electronic databases, mainly PubMed. Both peer-reviewed articles and gray literature, such as institutional reports, accreditation documents, and relevant websites, were reviewed and analyzed. The results of this analysis will be used as instrumental tools to form policies, guidelines, and educational strategies that ultimately benefit practitioners, patients, and the system at large.

WHAT ARE MEDICAL ACUPUNCTURE AND TRADITIONAL ACUPUNCTURE?

Medical acupuncture is a specialized practice in which licensed physicians, already trained in conventional Western medicine, integrate acupuncture into their existing medical practices.^2,8 It emphasizes evidence-based methods and serves as a complement to traditional treatments. Physicians receive additional training through programs, such as those approved by the AAMA.^1,9–12

Traditional acupuncture, rooted in Traditional Chinese Medicine (TCM),¹³ a major component of East Asia Medicine,¹⁴ involves a comprehensive understanding and extensive training of TCM philosophies, acupuncture points, meridian pathways, and the use of herbal medicine. Programs accredited by the Accreditation Commission for ACAHM are intensive, often spanning several years and thousands of study hours.⁷ Certification typically involves passing exams from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).^9,10,15–17

These distinct but complementary approaches to acupuncture highlight the diversity within the field and underscore the potential for integrative health care practices that draw on the strengths of Western medical science and traditional Eastern healing arts.

OVERVIEW OF EDUCATION SYSTEMS OF ACUPUNCTURE IN THE UNITED STATES

Educational Pathways for Medical Acupuncture

Overview of Medical Acupuncture Programs

Medical acupuncture programs in the United States are designed specifically for licensed physicians (MDs and DOs) who wish to integrate acupuncture into their medical practice.¹ Table 1 presents AAMA-approved medical acupuncture training programs in the United States, summarizing program characteristics including didactic and clinical training hours (Table 1).

Table 1.

Overview of American Academy of Medical Acupuncture-Approved Medical Acupuncture Programs in the United States, Detailing Program Characteristics, Didactic Hours, and Clinical Training Requirements

Program	Host organization	Location	Course content	Duration	Unique features
Medical Acupuncture for Physicians	Helms Medical Institute https://hmieducation.com/	Berkeley, CA	- Fundamentals of acupuncture theory - Channel/point locations and functions - Chinese diagnostics and therapy approaches - Needling techniques - Patient management - Practice setup and billing	6–7 months part-time, 300 h: - Three 3.5-day live sessions - Home study between live sessions with videos, readings, quizzes - Small group virtual meetings	- One of longest-running programs, training 90% of U.S. physicians practicing acupuncture - Chosen by U.S. military for training physicians - Combines classical theory with neuroanatomical approaches - Prioritizes hands-on clinical activities
Acumed—Integrated Structural Acupuncture	University of New England, College of Osteopathic Medicine https://acumed.org/	Biddeford, ME	- Point verification system for optimal diagnosis and treatment - Integrates nutrition, exercise, manual therapies - Musculoskeletal, neurological, and internal medicine applications	8 months, 300 h: - Two streamed weekend webinars - Two 4-day live hands-on sessions - Web-based material access	- Results-oriented, easy-to-learn style - Diagnoses and verifies treatment efficacy through palpation - Limited class size for high student–teacher ratio
Acupuncture Course	Academy of Pain Research https://www.acupuncturecourse.org/	San Francisco, CA	- Fundamentals of acupuncture theory - Channel and point locations/functions - Chinese diagnostics and therapy approaches - Needling techniques - Patient management for common conditions - Herbal medicine	300 h including minimum 100 clinical hours	- One of the first U.S. acupuncture courses for physicians (since 1979) - Comprehensive herbal medicine training - Covers management of both painful and nonpainful conditions
Medical Acupuncture at Downstate	State University of New York Downstate Medical Center https://www.downstate.edu/education-training/continuing-medical-education/acupuncture/index.html	Brooklyn, NY	- Acupuncture theory fundamentals - Channel/point locations and functions - Chinese diagnostics and therapy concepts - Needling techniques - Patient management for prevalent conditions	300 h: - Didactic seminars - Clinical workshops - At least 100 h of supervised clinical activities	- Qualifies participants for NY state acupuncture certification - Prepares physicians to employ acupuncture skills in practice - Clinical rotations at state-of-the-art NYC facilities a
UCLA East–West Integrative Medicine Fellowship Program	University of California, Los Angeles Center for East–West Medicine https://www.uclahealth.org/medical-services/east-west-medicine/medical-education/east-west-medicine-fellowship	Los Angeles, CA	- Integrative East–West medicine - Acupuncture - Trigger point injections - Nutrition - Herbs and supplements - Mind-body techniques - Evidence-based research	1 year full-time: - Continuity clinic 1–2 days/week - Specialty clinics 1–2 days/week - Didactics, case conferences, journal club - Research project	- Comprehensive training in integrative medicine - Incorporates acupuncture with other Eastern and Western modalities - Strong focus on research - Broad clinical exposure in renowned UCLA health system b

NYC: New York City.

UCLA: The University of California Los Angeles.

These programs provide physicians with the necessary training to incorporate acupuncture into their practice, focusing on both the theoretical and practical aspects of acupuncture within a medical context.^3,18 B.

Structure and content of the curriculum

The curriculum for medical acupuncture programs typically covers the following areas: TCM theory and philosophy, location and functions of acupuncture points, diagnosis and treatment planning in TCM, needling techniques and safety, integration of acupuncture with Western medicine, and clinical applications for various medical conditions (Table 1). C.

Training requirements

Didactic hours: The minimum didactic training requirement for medical acupuncture programs is typically 200 h. However, many programs offer more comprehensive training, some providing up to 300 h of didactic instruction.

Clinical practice hours: Clinical training requirements vary between programs but generally range from 100 to 150 h. This hands-on experience allows physicians to apply their knowledge under supervision and develop practical skills in acupuncture treatment.

Licensing and certification processes

The licensing and certification process for medical acupuncturists in the United States involves several steps: 1.

Complete an approved medical acupuncture training program:

Graduation from a recognized training program is the first step toward certification.

Obtain certification from the American Board of Medical Acupuncture (ABMA)⁸:

Certification requirements include: ▪

Graduation from an accredited allopathic or osteopathic medical school in the United States or Canada.

▪

Hold a current, valid, and unrestricted license to practice medicine.

▪

Completion of at least 300 h of acupuncture education, including 100 h of clinical training.

▪

Passing the ABMA written exam.

State license:

State licensure requirements vary. Many states recognize ABMA certification but may not require it to practice. Many states allow physicians to practice acupuncture under their existing medical licenses.¹⁹ Other requirements might involve completing a specific number of clinical hours, securing malpractice insurance, and passing a state-specific examination.¹⁹

Maintain certification through continuing education:

The ABMA requires recertification every 10 years, which involves documenting ongoing acupuncture practice and continuing education.

It is important to note that the requirements can vary by state, and physicians should consult their state medical board for specific regulations regarding the practice of medical acupuncture.¹⁹

In conclusion, medical acupuncture education for physicians in the United States offers a structured path to integrate acupuncture into conventional medical practice. With comprehensive training programs and a clear certification process, physicians can acquire the necessary skills and credentials to incorporate this ancient healing art into their modern medical toolkit.

Educational Pathways for Traditional Acupuncture

Traditional acupuncture programs in the United States are designed for nonphysician practitioners and offer comprehensive education in acupuncture and TCM. These programs are typically offered at the master’s or doctoral level and are accredited by ACAHM (Table 2) presents representative traditional acupuncture schools in the United States. Schools were selected based on accreditation status and geographic distribution. Overall, there are 49 ACAHM-accredited and preaccredited programs in the United States as of 2024 (Table 2).

Table 2.

Representative Traditional Acupuncture Schools in the United States, Selected by Accreditation Status and Geographic Distribution (49 Programs as of 2024)

Name	Host organization	Location(s)	Course content/programs	Web address	Features
Emperor’s College of Traditional Oriental Medicine	Independent	Santa Monica, CA	Master’s and doctoral programs in Acupuncture and Oriental Medicine	www.emperors.edu	- Extensive clinical training - Experienced faculty - Located in health-conscious Southern California
Pacific College of Health and Science	Independent	San Diego, CA; New York, NY; Chicago, IL	Acupuncture, Chinese Medicine, Holistic Nursing, Massage Therapy, Medical Cannabis Certificate	www.pacificcollege.edu	- Multiple campus locations - Diverse program offerings - Integrative approach to health sciences
Bastyr University	Independent	Kenmore, WA	Doctor of Acupuncture, Master of Science in Acupuncture, Master of Science in Acupuncture and Oriental Medicine	bastyr.edu	- Integration of Eastern and Western healing traditions - Hands-on training at Harborview Medical Center - Focus on research in natural medicine
Five Branches University	Independent	Santa Cruz, CA; San Jose, CA	DAcHM, MAcHM, DAOM, PhD in China	www.fivebranches.edu	- Specializes in Traditional Chinese Medicine - Offers study abroad programs in China - Faculty includes experienced TCM practitioners
New England School of Acupuncture	Massachusetts College of Pharmacy and Health Sciences (MCPHS)	Worcester, MA	Master’s and doctoral programs in Acupuncture and Oriental Medicine	www.mcphs.edu/academics/schools/new-england-school-of-acupuncture	- Nation’s first professional acupuncture school (est. 1975) - NIH-supported research center - On-campus NESA Acupuncture Treatment Center

Length of Study

Traditional acupuncture programs in the United States typically require students to complete a master’s or doctoral program lasting between 3 and 4 years. ACAHM has approved 49 accredited and preaccredited programs and institutions as of 2024.⁷ These programs are intensive and comprehensive, often exceeding 2500 h of combined classroom and clinical training.²⁰ Table 3 presents ACAHM-approved degree programs at traditional acupuncture schools, detailing program duration and clinical training components (Table 3).

Table 3.

ACAHM-Approved Degree Programs at Traditional Acupuncture Schools, Summarizing Program Duration and Clinical Training Components

Degree	Description	Course requirements	Hours	Length of program	Features	Accreditation	Licensure preparation
Master of Acupuncture (MAc)	Focuses on theoretical and practical aspects of acupuncture, including traditional Chinese medical theory, diagnosis, and treatment techniques.	Core courses in acupuncture theory, techniques, biomedical sciences, and clinical practice.	Approximately 2500 h	3–4 years	Focuses on acupuncture with a strong clinical component.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for the NCCAOM exams required for licensure in most states.
Master of Acupuncture and Chinese Herbal Medicine (MAcCHM)	Combines acupuncture training with extensive education in Chinese herbal medicine, preparing practitioners to integrate both modalities.	Core courses in acupuncture, herbal medicine, biomedical sciences, and clinical practice.	Approximately 3000 h	4 years	Integrates herbal medicine with acupuncture training.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for both acupuncture and Chinese herbal medicine certification exams by NCCAOM.
Doctor of Acupuncture (DAc)	An advanced degree emphasizing clinical skills, integrative approaches, and research in acupuncture.	Advanced courses in acupuncture theory, techniques, biomedical sciences, integrative medicine, and research.	Approximately 3500 h	4–5 years	Emphasizes advanced clinical skills, integrative approaches, and research.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for advanced clinical practice and may include research and integrative approaches; eligible for NCCAOM exams.
Doctor of Acupuncture and Chinese Herbal Medicine (DAcCHM)	Includes comprehensive training in both acupuncture and Chinese herbal medicine, with a focus on clinical practice, research, and integrative health care.	Advanced courses in acupuncture, herbal medicine, biomedical sciences, integrative medicine, clinical practice, and research.	Approximately 4000 h	5 years	Comprehensive training in both acupuncture and herbal medicine, with an emphasis on research and integrative health care.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for advanced clinical practice in both acupuncture and Chinese herbal medicine; eligible for NCCAOM exams.
Master of Science in Oriental Medicine (MSOM)	Provides a comprehensive education in Oriental Medicine, including acupuncture, herbal medicine, and other Traditional Chinese Medicine practices.	Comprehensive courses in acupuncture, herbal medicine, biomedical sciences, clinical practice, and additional Traditional Chinese Medicine modalities.	Approximately 3000 h	4 years	Broad education in Oriental Medicine practices, including acupuncture and herbal medicine.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for the NCCAOM exams required for licensure in most states.
Master of Acupuncture (MLA)	Focuses on the theoretical and practical aspects of acupuncture, similar to the MAc but may vary in curriculum specifics.	Core courses in acupuncture theory, techniques, biomedical sciences, and clinical practice.	Approximately 2500 h	3–4 years	Similar to MAc but may vary in specific curriculum and focus areas.	Accredited by ACAHM Recognized by the U.S. Department of Education	Prepares students for the NCCAOM exams required for licensure in most states.

ACAHM, Accreditation Commission for Acupuncture and Herbal Medicine; NCCAOM, National Certification Commission for Acupuncture and Oriental Medicine.

Types of Courses

The curriculum in traditional acupuncture programs is designed to provide a deep understanding of the principles and practices of TCM. Core courses typically include TCM principles and philosophy, acupuncture techniques, herbal medicine, and extensive clinical practice.

Certification Requirements

To practice as a licensed acupuncturist in the United States, graduates must meet certification and licensure requirements set by various accrediting and regulatory bodies.

Accreditation: ACAHM accredits acupuncture programs, ensuring that they meet established educational standards. Graduating from an ACAHM-accredited program is often a prerequisite for certification and licensure.⁷

Certification exams: Graduates must pass certification exams administered by NCCAOM.¹⁵ These exams test knowledge and skills in areas such as acupuncture, biomedicine, and Chinese herbal medicine. Successful completion of the NCCAOM exams is required for licensure in most states.¹⁵ Recertification is required every 4 years.

State License: In addition to national certification, acupuncturists must obtain licensure in the state where they intend to practice. State licensure requirements vary, but generally include proof of graduation from an accredited program, passing the NCCAOM exams, and meeting any additional state-specific exams or continuing education.¹⁵ Licensed acupuncturists are typically required to complete periodic continuing education for recertification; requirements vary by state, with many mandating renewal every 2–4 years along with a specified number of continuing education credits.

The combination of a comprehensive educational curriculum, extensive clinical training, and rigorous certification processes ensures that traditional acupuncturists are well prepared to provide high-quality care rooted in the principles of TCM.

STRENGTHS AND WEAKNESSES

Strengths of Medical Acupuncture Education

Integration with conventional medical training and familiarity with Western medical terminology

One of the main strengths of medical acupuncture education is its integration with conventional medical training and familiarity with Western medical terminology. Physicians trained in medical acupuncture can seamlessly incorporate acupuncture into their broader medical practice and facilitate effective communication with other health care professionals, enhancing holistic patient care. This integration also allows for a comprehensive approach to patient treatment that addresses not only symptoms but also underlying conditions.^21,22

Focus on evidence-based practice

Medical acupuncture programs emphasize evidence-based practice, ensuring that treatments are scientifically validated.^23,24 This focus aligns acupuncture with the rigorous standards of Western medicine, promoting the use of acupuncture techniques that have been proven to be effective through clinical trials and research. This evidence-based approach improves the credibility and acceptance of acupuncture within the medical community, encouraging more physicians to consider it as a viable treatment option.

Weaknesses of medical acupuncture education

While medical acupuncture programs provide valuable training, they often offer a shorter duration compared to traditional acupuncture programs. Yeh found that half of physicians after training in an acupuncture program did not enter actual practice.²⁵ Kalauokalani found that physician acupuncturists often have a diverse training background and use a blend of acupuncture styles in practice.²⁶ Major barriers that prevent physicians from getting into an acupuncture practice include time constraints, inconsistent insurance reimbursement, lack of confidence, and insufficient institutional support, all of which hinder its integration into clinical care.^25,27 There are huge differences in the available workforce of practicing acupuncturists between physician acupuncturists and traditional acupuncturists. Based upon the data from AAMA, ABMA, and Helms Medical Institute websites,^1,8,28–30 the estimated total number of medical acupuncturists—comprising both ABMA-certified and non-ABMA-certified practitioners—is significantly smaller than the number of NCCAOM-certified and non-NCCAOM-certified traditional acupuncturists in the United States, limiting the impact of medical acupuncturists in the U.S. health care system^15,31 (Fig. 1).

FIG. 1.

Comparisons of the number of acupuncturists in the United States. The number of licensed acupuncturists includes the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certified and noncertified practitioners. The estimated number of medical acupuncturists includes the American Board of Medical Acupuncture (ABMA) certified and noncertified practitioners. Date sources: Fan et al.³¹; websites of ABMA, the American Academy of Medical Acupuncture (AAMA), and Helms Medical Institute (HMI).

This abbreviated training can also result in a superficial understanding of the TCM principles. For example, medical acupuncture programs might not provide extensive training in the use of Chinese herbal medicine, a critical component of TCM that complements acupuncture treatments.^32,33 Furthermore, traditional diagnostic techniques such as tongue and pulse diagnosis may receive less emphasis in medical acupuncture curricula.^34,35 Consequently, physicians trained in medical acupuncture may not fully appreciate the holistic approach of TCM, potentially limiting the effectiveness of their acupuncture treatments in addressing the root causes of health problems.

In addition, physician acupuncturists often limit their acupuncture practice to their own medical specialty, resulting in a narrower range of treated patient populations. This can lead to less diverse clinical experience with acupuncture compared to nonphysician practitioners.

Strengths of Traditional Acupuncture Education

Comprehensive training in TCM principles

One of the significant strengths of traditional acupuncture education is its comprehensive training in TCM principles. Programs provide a deep understanding of holistic health, covering theories such as yin-yang balance and the five elements. This foundation allows practitioners to diagnose and treat patients based on a holistic view of the body, mind, and spirit, which is central to TCM philosophy.^36,37

Extensive clinical practice

Traditional acupuncture education places a strong emphasis on extensive clinical practice. Students often complete hundreds of hours of supervised clinical training, which provides significant hands-on experience. This practical training is critical to developing the skills needed to diagnose and treat patients effectively using acupuncture and other TCM modalities. Clinical practice in these programs typically starts early and continues throughout the education period, ensuring that graduates are well prepared for real-world practice. Dong reported that long-term trained acupuncturists showed a larger volume of gray matter in areas of the brain related to touch sensation, fine motor control, and emotion regulation compared to nonacupuncturists, indicating structural changes being correlated with the duration of their acupuncture practice.³⁸

Holistic approaches

The holistic approach to traditional acupuncture education is another strength. TCM emphasizes treating the root causes of ailments rather than just the symptoms. This approach involves a detailed understanding of the patient’s overall health, lifestyle, and environment. By focusing on the root causes, practitioners aim to restore balance and promote long-term health and wellness. This holistic perspective is a key advantage that offers patients a more integrated and comprehensive form of health care.^36,39

Weaknesses of Traditional Acupuncture Education

Gaps in understanding modern medical science

One of the weaknesses of traditional acupuncture education is the gaps in understanding modern medical science. Traditional programs often focus heavily on TCM principles and may not provide extensive training in contemporary medical research and Western biomedical sciences such as physiology, pathology, pharmacology, and diagnosis. Li found that the accreditation manual of the Accreditation Commission for Acupuncture and Oriental Medicine, the predecessor of ACAHM, the entry-level acupuncture programs mandate that over 70% of the curriculum should concentrate on Chinese medicine, while only 20% or more should be dedicated to Western medical subjects.⁴⁰ This can limit practitioners’ ability to fully integrate their practice with modern medical approaches and understand the latest scientific developments in health care. Enhancing training in these areas could improve interprofessional communication and better prepare practitioners for managing complex health conditions.

Less emphasis on research-based evidence

Traditional acupuncture programs may also place less emphasis on research-based evidence compared to medical acupuncture programs. While TCM has been practiced for thousands of years, many of its techniques and principles lack extensive scientific validation through modern clinical trials. However, Anderson reported that acupuncture students often receive limited training in research methodologies, leading to a lack of confidence and interest in pursuing research-related activities.^41,42 This reliance on traditional knowledge rather than evidence-based practice can be a disadvantage, particularly in health care environments that prioritize scientifically proven treatments.³⁹

These limitations highlight the need for ongoing education and collaboration between traditional acupuncture practitioners and those trained in Western medical approaches. Integrating the strengths of both systems can enhance patient care and improve health outcomes.

Influence of training systems on acupuncture practice

As discussed earlier, the training systems for traditional and medical acupuncture reflect their distinct philosophical and educational foundations, shaping their respective approaches to clinical practice. Traditional acupuncture, grounded in TCM principles, emphasizes holistic treatment, addressing systemic imbalances and incorporating adjunct therapies like herbal medicine and lifestyle changes. In contrast, medical acupuncture focuses on specific conditions, often integrating needling techniques into conventional Western medical care with an emphasis on evidence-based practices.

These differences result in varied diagnostic methods, treatment goals, and patient interactions. Traditional acupuncturists often provide highly individualized care aimed at restoring overall balance, while medical acupuncturists tend to target defined conditions, such as pain, using streamlined and standardized approaches. This divergence can limit the scope of care in one system and reduce the depth of understanding in the other.

The need for integration is clear. A combined training model that incorporates the holistic and preventive strengths of traditional acupuncture with the research-driven precision of medical acupuncture could bridge these gaps. For example, interdisciplinary collaboration can be fostered through cotraining workshops, joint clinical rotations in hospital settings, and collaborative research initiatives that bridge Western and TCM diagnostic approaches. A joint practice model integrating medical and traditional acupuncturists offers another approach to collaboration. Such integration would enable practitioners to offer comprehensive care that is both patient-centered and scientifically validated, enhancing outcomes and expanding the potential of acupuncture within modern health care systems.

Integration of educational systems: Combined knowledge enhancing patient care

Recognizing the limitations of traditional acupuncture education, efforts have been made to integrate traditional acupuncture into the mainstream health care system. By combining the strengths of both approaches, practitioners can develop more comprehensive treatment plans that address a broader range of patient needs.

Hospital-based student internships at traditional acupuncture schools

There are numerous examples of integrating Eastern and Western clinical experience and training at traditional acupuncture schools. One notable example is the hospital-based internship programs offered by traditional acupuncture schools. These settings include general hospitals, cancer centers, family practices, and pain clinics. These programs allow students to work alongside Western medical professionals, applying their acupuncture skills in a hospital setting.⁴³ Such experiences not only enhance the students’ clinical skills but also demonstrate the practical benefits of integrating acupuncture with conventional medical treatments. Table 4 presents hospital-based internships offered by select traditional acupuncture schools, listing available clinical training opportunities in hospital settings (Table 4).

Table 4.

Hospital-Based Internships Offered by Traditional Acupuncture Schools, Listing Available Clinical Training Opportunities in Hospital Settings

School name	Student internship opportunities	Hospital-based internships
Emperor’s College of Traditional Oriental Medicine	- On-campus clinic - Off-site clinical externships - Integrative medicine centers	- Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center (Burbank, CA) - Venice Family Clinic (Simms/Mann Health and Wellness Center)
Pacific College of Health and Science	- On-campus clinic - Off-site clinics - Community partnerships	- Rady Children’s Hospital (San Diego, CA) - UCSD Medical Center (Owen Clinic, HIV care) - UCSD RIMAC (treating student athletes) a ^, b
Bastyr University	- Hospital-based clinical training - Pain medicine internship	- Harborview Medical Center (Pain Medicine and Anesthesiology Department)
Five Branches University	- Hospital-based clinical training program - Integrative medicine residency	- Sutter Bay Hospitals/Alta Bates Medical Center (Oakland and Berkeley, CA) - Highland Hospital (Oakland, CA)
New England School of Acupuncture at MCPHS	- On-campus NESA Acupuncture Treatment Centerc - Off-site clinical placements - Integration with pharmacy and health sciences programs	- Boston Medical Center (Family Medicine department, Pediatric Pain Clinic, and Adult Pain Clinic) - Cleveland Clinic (Affiliate Program)

UCSD: The University of California San Diego.

RIMAC: The Recreation, Intramural, and Athletic Complex.

NESA: The New England School of Acupuncture.

Training new generation of hospital-based acupuncturists

The emergence of hospital-based acupuncturists represents a transformative direction in acupuncture education and practice.^44,45 By integrating medical and traditional acupuncture knowledge, educational programs aim to equip practitioners with the skills necessary to thrive in hospital environments. This approach enhances patient care by developing more comprehensive treatment plans that draw from the strengths of both medical and traditional approaches. A clinical manual treating inpatient cancer-related pain with acupuncture is a new example of the effort.⁴⁶ Hospital-based acupuncturists are becoming integral to multidisciplinary health care teams. Their role is to provide nonpharmacologic therapies for pain management and other conditions, reducing the reliance on opioids and enhancing overall patient care. These practitioners serve as a bridge between conventional and traditional medicine, utilizing a deep understanding of both systems to address complex health issues. This dual expertise enables them to contribute to integrated care models that prioritize holistic patient management.⁴⁶

Benefits of interdisciplinary collaboration

The benefits of interdisciplinary collaboration are significant. By working together, medical acupuncturists and traditional acupuncturists can offer more well-rounded and effective care. This collaboration can lead to improved patient outcomes, as practitioners can draw on a wider range of techniques and knowledge.^47,48 This comprehensive care model ensures that all aspects of the patient’s health are addressed, leading to better overall outcomes. This collaboration is particularly beneficial in educational settings, where students can gain exposure to various medical philosophies and practices, preparing them to work in diverse and integrative health care environments.^42,49

CONCLUSION

Summary of Key Points

The comparison between medical acupuncture and traditional acupuncture education in the United States reveals distinct pathways, strengths, and challenges. Medical acupuncture, integrated with conventional medical training, emphasizes evidence-based practices and Western medical terminology, while traditional acupuncture focuses on comprehensive TCM principles and extensive clinical practice. The workforce distribution shows a larger number of licensed acupuncturists compared to medical acupuncturists, reflecting the established presence of TCM. However, the integration of both educational systems can enhance patient care by combining their unique strengths.

Importance of Collaboration

Collaboration between medical and traditional acupuncture practitioners is crucial for improving patient outcomes. By integrating their knowledge and skills, practitioners can offer more comprehensive and holistic treatment plans. This interdisciplinary approach can address various health issues more effectively, combining the precise, evidence-based techniques of medical acupuncture with the holistic, root-cause-focused methods of traditional acupuncture. Such collaboration can lead to better health outcomes, improved patient satisfaction, and a more inclusive health care environment.

Future Directions

Future integration efforts should focus on enhancing mutual learning between the two educational systems. Developing joint training programs and collaborative research initiatives can bridge the gap between traditional and medical acupuncture. Increasing the availability of hospital-based internships and integrative clinics can provide valuable hands-on experience for students and practitioners to develop hospital-based acupuncturists. Additionally, promoting public and professional awareness about the benefits of combining these approaches can foster greater acceptance and utilization of integrated acupuncture therapies, ultimately advancing patient care and health outcomes.

By embracing these future directions, the field of acupuncture can evolve into a more cohesive and effective component of modern health care, benefiting both practitioners and patients.

AUTHORS’ CONTRIBUTIONS

W.L. conceptualized the manuscript, conducted the literature review, drafted and revised the article, and approved the final version for publication.

Footnotes

AUTHOR DISCLOSURE STATEMENT

The authors have no conflicts of interest to declare.

FUNDING INFORMATION

There are no funders to report for this submission.

References

AAMA. Training Programs - American Academy of Medical Acupuncture (AAMA). 2024.

White

, Editorial Board of Acupuncture in Medicine. Western medical acupuncture: A definition. Acupunct Med, 2009; 27(1):33–35; doi: 10.1136/aim.2008.000372

Guerrera

, Goetz

. Incorporating acupuncture into medical school curriculum: An innovative, successful model. Medical Acupuncture, 2007; 19(4):175–180; doi: 10.1089/acu.2007.0558

Helms

. An overview of medical acupuncture. Altern Ther Health Med, 1998; 4(3):35–45.

Tian

, Shang

, Tian

, et al. Apprenticeship system of American NCCAOM Certification of acupuncture and oriental medicine. Zhongguo Zhen Jiu, 2019; 39(4):429–432; doi: 10.13703/j.0255-2930.2019.04.022

Tian

, Tian

, Li

, et al. Recertification and continuing education of NCCAOM Diplomates of Acupuncture and Oriental Medicine. Zhongguo Zhen Jiu, 2017; 37(5):537–540; doi: 10.13703/j.0255-2930.2017.05.022

ACAHM. Accreditation Commission for Acupuncture and Herbal Medicine. 2024. Available from: https://www.acahm.org

ABMA. American Board of Medical Acupuncture®. 2024. Available from: https://www.dabma.org/ [Last accessed: July 28, 2024].

Sierpina

, Frenkel

. Acupuncture: A clinical review. South Med J, 2005; 98(3):330–337; doi: 10.1097/01.smj.0000140834.30654.0f

10.

Ledford

CJW

, Crawford

3rd . Integrating medical acupuncture into family medicine practice. Am Fam Physician, 2019; 100(2):76–78.

11.

Crawford

, Helms

. Outcomes of “think acupuncture first”: An acupuncture-training program during family medicine residency. Explore (NY), 2019; 15(6):429–431; doi: 10.1016/j.explore.2019.07.007

12.

Tait

, Cummings

. Education, training and continuing professional development in medical acupuncture–a contemporary overview. Acupunct Med, 2004; 22(2):75–82; doi: 10.1136/aim.22.2.75

13.

Kaptchuk

. Acupuncture: Theory, efficacy, and practice. Ann Intern Med, 2002; 136(5):374–383; doi: 10.7326/0003-4819-136-5-200203050-00010

14.

Park

, Lee

, Shin

, et al. Traditional medicine in china, Korea, and Japan: A brief introduction and comparison. Evid Based Complement Alternat Med, 2012; 2012:429103–20121024; doi: 10.1155/2012/429103

15.

NCCAOM. NCCAOM Home. NCCAOM. 2018. Available from: https://www.nccaom.org/ [Last accessed: July 28, 2024].

16.

, He

, Zhao

. Introduction and analysis on acupuncture education and qualification examination system in U.S.A. Zhongguo Zhen Jiu, 2013; 33(12):1131–1134.

17.

Stone

. The status of acupuncture and oriental medicine in the United States. Chin J Integr Med, 2014; 20(4):243–249; doi: 10.1007/s11655-014-1776-0

18.

Wetzel

, Eisenberg

, Kaptchuk

. Courses involving complementary and alternative medicine at US medical schools. JAMA, 1998; 280(9):784–787; doi: 10.1001/jama.280.9.784

19.

Lin

, Tung

. The regulation of the practice of acupuncture by physicians in the United States. Med Acupunct, 2017; 29(3):121–127; doi: 10.1089/acu.2017.1235

20.

Bleck

, Gold

, Westhoff

. Training hour requirements to provide acupuncture in the United States. Acupunct Med, 2021; 39(4):327–333; doi: 10.1177/0964528420939576

21.

Rogge

, Helmer

, Icke

, et al. Effects of training oncology physicians advising patients on complementary and integrative therapies on patient-reported outcomes: 2-year follow-up of the multi-center, cluster-randomized KOKON-KTO study. Cancer Med, 2024; 13(14):e70008; doi: 10.1002/cam4.70008

22.

Subbarao

, Hayani

, Clemmens

. Complementary and integrative medicine in treating headaches, cognitive dysfunction, mental fatigue, insomnia, and mood disorders following traumatic brain injury: A comprehensive review. Phys Med Rehabil Clin N Am, 2024; 35(3):651–664; doi: 10.1016/j.pmr.2024.02.013

23.

Mao

, Ismaila

, Bao

, et al. Integrative medicine for pain management in oncology: Society for integrative oncology-ASCO Guideline. J Clin Oncol, 2022; 40(34):3998–4024; doi: 10.1200/jco.22.01357

24.

Qaseem

, Wilt

, McLean

, et al.; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med, 2017; 166(7):514–530; doi: 10.7326/m16-2367

25.

Yeh

, Ryan

, Phillips

, et al. Doctor training and practice of acupuncture: Results of a survey. J Eval Clin Pract, 2008; 14(3):439–445; doi: 10.1111/j.1365-2753.2007.00891.x

26.

Kalauokalani

, Cherkin

, Sherman

. A comparison of physician and nonphysician acupuncture treatment for chronic low back pain. Clin J Pain, 2005; 21(5):406–411; doi: 10.1097/01.ajp.0000125265.40304.c5

27.

Ledford

CJW

, Fisher

, Moss

, et al. Critical factors to practicing medical acupuncture in family medicine: Patient and physician Perspectives. J Am Board Fam Med, 2018; 31(2):236–242; doi: 10.3122/jabfm.2018.02.170381

28.

American Academy of Medical Acupuncture (AAMA). History - American Academy of Medical Acupuncture (AAMA). 2025. Available from: https://medicalacupuncture.org/about/history/

29.

Marshall

, Sager

. Article - Acupuncture Letter. Dr. Feely; 2025. Available from: https://www.drfeely.com/articles/acupuncture-letter/ [Last accessed: January 17, 2025].

30.

Helms Medical Institute. Acupuncture Training For Physicians | Medical Acupuncture Training. 2025. Available from: https://hmieducation.com/ [Last accessed: February 17, 2025].

31.

Fan

, He

, Sangraula

, et al. Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2023, during the late stage of the COVID-19 pandemic. J Integr Med, 2024; 22(4):379–384; doi: 10.1016/j.joim.2024.06.002

32.

Cao

, Li

, Lin

, et al. The clinical value of acupuncture for women with premature ovarian insufficiency: A systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne), 2024; 15:1361573; doi: 10.3389/fendo.2024.1361573

33.

, Wang

, Yu

, et al. Chinese herbal medicine and acupuncture for insomnia in stroke patients: A systematic review and meta-analysis of randomised controlled trials. Sleep Med, 2024; 120:65–84; doi: 10.1016/j.sleep.2024.05.006

34.

, Chen

, Chiang

, et al. Tongue diagnosis of traditional Chinese medicine for rheumatoid arthritis. Afr J Tradit Complement Altern Med, 2013; 10(5):360–369; doi: 10.4314/ajtcam.v10i5.24

35.

Wang

, Wang

, Li

, et al. Phlegm-dampness constitution: Genomics, susceptibility, adjustment and treatment with traditional Chinese medicine. Am J Chin Med, 2013; 41(2):253–262; doi: 10.1142/s0192415x13500183

36.

NCCIH/NIH. Traditional Chinese Medicine: What You Need To Know. 2024. Available from: https://www.nccih.nih.gov/health/traditional-chinese-medicine-what-you-need-to-know [Last accessed: July 28, 2024].

37.

Brett

, Brimhall

, Healey

, et al. Competencies for public health and interprofessional education in accreditation standards of complementary and alternative medicine disciplines. Explore (NY), 2013; 9(5):314–320; doi: 10.1016/j.explore.2013.06.001

38.

Dong

, Zhao

, Yuan

, et al. Length of acupuncture training and structural plastic brain changes in professional acupuncturists. PLoS One, 2013; 8(6):e66591; doi: 10.1371/journal.pone.0066591

39.

Caruso Ch. Exploring the Science of Acupuncture. 2024. Available from: https://hms.harvard.edu/news/exploring-science-acupuncture [Last accessed: July 28, 2024].

40.

, Karp

. Understanding the Challenges of U.S. Acupuncture Practice (Pt. 7) | Acupuncture Today. Acupuncturetoday; 2024.

41.

Anderson

, Kligler

, Cohen

, et al. Survey of Chinese medicine students to determine research and evidence-based medicine Perspectives at pacific college of oriental medicine. Explore (NY), 2016; 12(5):366–374; doi: 10.1016/j.explore.2016.06.002

42.

Wayne

, Hammerschlag

, Savetsky-German

, et al. Attitudes and interests toward research among students at two colleges of acupuncture and Oriental medicine. Explore (NY), 2010; 6(1):22–28; doi: 10.1016/j.explore.2009.10.003

43.

BMC. Program for Integrative Medicine and Health Disparities. Boston Medical Center; 2024. Available from: https://www.bmc.org/holistic-medicine-integrative-health [Last accessed: July 28, 2024].

44.

Hullender Rubin

, Veleber

. Hospital-Based acupuncture integration: access, reimbursement, and implementation. J Altern Complement Med, 2020; 26(5):356–359; doi: 10.1089/acm.2020.0133

45.

Vitek

, Bhagra

, Erickson

, et al. Optimizing delivery to meet demand for integrative medicine services in an academic hospital setting: A pilot study. Explore (NY), 2021; 17(4):340–343; doi: 10.1016/j.explore.2020.03.001

46.

Ashby

, Toveg

, Ye

, et al. The Assessment and Treatment of Inpatient Cancer-Related Pain with Acupuncture: Development of a Manual. Med Acupunct, 2022; 34(1):15–23; doi: 10.1089/acu.2021.0035

47.

Nedrow

, Heitkemper

, Frenkel

, et al. Collaborations between allopathic and complementary and alternative medicine health professionals: Four initiatives. Acad Med, 2007; 82(10):962–966; doi: 10.1097/ACM.0b013e31814a4e2c

48.

O’Reilly

, Sevigny

, Sabarre

, et al. Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility. BMC Complement Altern Med, 2014; 14:394–20141014; doi: 10.1186/1472-6882-14-394

49.

Wayne

, Pensack

, Connors

, et al. Increasing research capacity at the New England School of Acupuncture: Building grants management infrastructure. Altern Ther Health Med, 2008; 14(1):56–64.