Section 1: Overview of the NUNM Teaching Programs

1.1 Fulfillment of Mission

The mission of the NUNM academic medical clinics is to provide quality health care to the public and quality clinical education to medical students and residents. The mission and the clinical training objectives of both the ND and CCM programs are fundamentally aligned with NUNM’s overall mission: “to educate and train physicians, practitioners and preprofessionals in the art, science and research of natural medicine.” In addition to the school’s global mission, the College of Classical Chinese Medicine has the specific mission of “transmitting the art, science and spirit of Chinese medicine to cultivate clinical practitioners rooted in the ancient tradition of the medical scholar.

ND Program

The university provides training that allows graduating students to become well-versed in the underlying principles and philosophy of naturopathic medicine as it applies to supporting the healing process. This training allows students to obtain skills necessary to be able to perform as competent entry-level primary care physicians with sole responsibility for patient care as demonstrated through proficiency in demanding clinical and academic programs. Students are given the opportunity to master entry-level knowledge in differential diagnosis, laboratory and diagnostic imaging interpretation, preventive medicine, botanical medicine, homeopathy, clinical nutrition, physical medicine, musculoskeletal therapies, hydrotherapy, minor surgery, lifestyle counseling, and the use of pharmaceutical medications. Graduating students are given the opportunity to become well prepared for the national licensing exams.

CCM Programs

In accordance with the CCM mission, students receive lineage-based training that emphasizes transmission and mentoring as major methods for promoting personal and professional cultivation. They have the opportunity to become well-versed in the principles, philosophy, and practice of classical Chinese medicine. Graduates will have demonstrated proficiency of knowledge and skills in Chinese diagnostic techniques, acupuncture, herbal medicine (DSOM and MSOM only), Asian massage, qigong, Chinese dietetics and lifestyle counseling. Students also receive instruction in biomedical pathophysiology and recognizing clinical red flags.  Graduating students have been trained to assume sole responsibility for patient care, and are given the opportunity to become well-prepared for the national licensing exams, as well as collaborate with other medical providers.

1.2 Clinical Faculty

NUNM Health Centers host both adjunct and full-time faculty members. Each has completed a rigorous application and hiring process, and has been selected based on their clinical acumen measured by their level of experience, patient care, expertise and passion for natural medicine, as well as their commitment to NUNM’s patients, students and education. The practitioners in the CCM program have also been recruited and selected on the basis of their commitment to training students in the art, science and spirit of classical Chinese medicine.

1.3 Student Participation in Clinical Training

Attendance at, or participation in, clinical training is permitted only for those students who are in good standing at NUNM. Any student who is suspended or expelled from NUNM is not permitted to attend clinical training sessions or have contact with NUNM’s clinical patients. Any student for whom clinical privileges are suspended is also excluded from attending clinical training sessions or having contact with NUNM’s clinical patients.

1.4 Stages of Clinical Training – ND Program

Students assume the role of patient care provider gradually as they progress through well-defined stages with increasing levels of responsibility.

Clinical Observation – year one

Clinical observations provide students with observational learning experiences under the mentorship of licensed physicians in practice. During this first-year series, students are assigned to NUNM clinic shifts where they will observe the application of routine clinic policies and procedures, communication between doctors and students and between students and patients, diagnosis and treatment discussions, application of therapeutic modalities, and referral management.

Hydrotherapy/Massage Technician – year two

In the second year, students are assigned to the role of hydrotherapy/ massage technician. At this stage of clinical training, students administer hydrotherapy and massage to clinic patients. This stage provides students with their first hands-on experience treating members of the patient population at our academic medical clinics, and provides an important introduction to certain aspects of responsibility for patient care. Students continue in this role while a vigorous academic schedule prepares them for the next formal stage of clinical training, that of the secondary.

Secondary – year three

Students become secondaries at the beginning of their third year after passing their OSCE 1 exam. A secondary functions as an integral member of a patient’s treatment team, formed when the attending doctor, and the primary and secondary students join the patient in the healing process. The secondary’s main responsibility is to observe and learn about all aspects of patient care, under the direction and supervision of the physician and in cooperation with the primary, who leads the student team. Secondary duties include, but are not limited to, scrubbing charts for health maintenance; reviewing medications, allergies and problem lists with the patient; enrolling the patient in MyChart; assisting the primary intern during patient visits; contributing to discussions regarding patient assessment and management; and taking vital signs.

Primary – year four

The final formal stage of clinical training begins after the third year when the student assumes the role of primary, after passing the OSCE 2 exam. With a fourth-year course load focused on clinical readiness, students are able to devote much of their time to providing naturopathic medical care to patients in the NUNM Health Centers. Primary duties include taking a patient history; performing an appropriate physical examination and diagnostic evaluation; developing differential diagnoses and a working diagnosis; and composing an individualized treatment and management plan that includes appropriate preventive recommendations and anticipatory guidance (in conjunction with the clinical supervisor and secondary). Students receive expert guidance from a diverse group of skilled naturopathic physicians during their primary rotations. Although patient care is coordinated and organized by the primary, the attending physician oversees each case. As fourth year progresses, students are expected to develop greater clinical skills, to act with more confidence and, in keeping with the clinic’s mission, begin to assume a role of responsibility with regard to the delivery of naturopathic health care. At no time does the primary act independently without formal authorization from a supervising licensed naturopathic physician. 

Community Experience Preceptorships (ComEx) – all years

ComEx preceptorship rotations afford students the opportunity to follow healthcare providers in practice, providing students with additional exposure to naturopathic medicine, conventional medicine and allied health fields in the surrounding community. Students meeting ComEx program requirements are eligible to begin their preceptorships the summer after their first year. Requirements for the ComEx component of clinical education are reviewed annually.

Entrance Into and Advancement through Clinical Training

In order for ND students to advance through clinical training, they must meet the following requirements:

  1. To enter the clinic as a clinical observation student, students must:
  • Pass the urinary drug screen (completed upon matriculation)
  • Have all required immunizations as outlined in the Oregon Revised Statutes.
  • Maintain annual HIPAA certification
  • Maintain current CPR/BLS certification
  1. To become a hydrotherapy technician, students must:
  • Maintain current CPR/BLS certification
  • Maintain annual HIPAA certification
  • Pass Clinical Observation I and II
  • Pass Therapeutic Modalities I
  • Complete Epic training for hydrotherapy technicians
  • Students on academic probation must have passed the above requirements and have completed a valid academic contract
  1. To become a secondary, students must:
  • Maintain current CPR/BLS certification
  • Maintain annual HIPAA certification
  • Pass all first-year courses
  • Pass Introduction to Clinic
  • Complete hydrotherapy clinic hour requirement (48 hours)
  • Complete Epic training for secondaries
  • Complete all mandatory clinic orientation meetings
  • Successfully pass the Clinic Secondary Entrance Exam (OSCE 1) within 6 months of starting secondary rotations
  • Students on academic probation must have passed the above requirements and have completed a valid academic contract
  1. To become a primary, students must:
  • Maintain annual HIPAA certification
  • Maintain current CPR/BLS certification
  • Complete musculoskeletal, cardiology, gastroenterology and urology system blocks
  • Complete all secondary clinical hours
  • Complete mandatory primary orientation
  • Successfully pass the Clinic Primary Entrance Exam (OSCE 2) within 3 months of starting primary rotations
  • Students on academic probation must have passed the above requirements and have completed a valid academic contract

Proficiency Examinations

ND students are required to pass an Objective Structured Clinical Examination (OSCE) before moving forward in each stage of clinical training. The OSCE 1 examination (clinic entrance examination) is taken and passed no more than 6 months before the student may be allowed to begin secondary rotations. The OSCE 2 examination (primary status examination) must be passed no more than 3 months before a student is allowed to begin primary rotations, and successful completion of the OSCE 3 examination (exit examination) is required to graduate from the program. A student is eligible to take the OSCE 3 exam after successful completion of eight (8) primary clinic rotations if they matriculated prior to fall 2015, or after successful completion of six (6) primary clinic rotations if they matriculated in fall 2015 or after.

1.5 Stages of Clinical Training – DSOM and MSOM Programs

The goal of CCM clinical training is for students to transform into competent practitioners through the following components of the clinical program. The timing described below assumes that the student is on the four-year track. Clinical Observation starts in the third year of the five-year track.

Introduction to Clinic – year one

In the spring quarter of their first year, students are introduced to the fundamentals of working in the CCM clinics. Topics include HIPAA compliance, clinic policies and procedures, hygienic standards including Clean Needle Technique, charting protocols, patient confidentiality and multicultural awareness. Students learn how to create a patient timeline as preparation for writing patient case reports.

Observation – year two

In clinical observation five students per rotation learn as they watch seasoned faculty supervisors treat clinic patients. Over the course of the year, students become more familiar with clinic policies and procedures, practice the diagnostic skills learned in the first year of the program, and relate their classroom learning to the clinical situation. Through their observation of patient-practitioner interactions and their involvement in discussions regarding patient diagnosis and treatment, students build their clinical knowledge, skills and attitudes, and become familiar with the different styles and interests of the clinic faculty. At the discretion of the faculty supervisor, students may participate in the delivery of certain aspects of patient treatment, including moxibustion, massage, cupping and/or needle removal. Students create at least one patient timeline on each of their observation rotations.

Clinical Mentoring – year three

In the third year of the program, students continue to gain clinical experience and become more familiar with the different lineage styles of the clinical faculty. Participating in two clinical mentoring rotations per quarter, students become more involved in the process of diagnosing and treating patients under the direction and supervision of the clinician. Students write case reports on patient cases they have followed in the clinic.

Pre-Internship – year three

In spring quarter of the third year, students begin the pre-internship rotation, where they learn the role and responsibilities of the intern by shadowing the current interns.

Clinical Case Presentation I-III – year three

Students apply their didactic learning to clinical scenarios through case-based discussion and presentation.

Internship – year four

In the final year of the program, students become interns and assume a gradually increasing level of responsibility for direct patient care. They continue to refine their clinical skills and understanding, and build their confidence as proficient practitioners. They become more fully involved in the diagnosis of increasingly complicated cases, and in the creation and delivery of integrated treatment protocols that typically include needle insertion and the prescription of herbal formulas. Students receive training and guidance from a diverse group of skilled practitioners of classical Chinese medicine and are encouraged to choose a clinical mentor, with whom they do at least one rotation per quarter during the fall, winter and spring quarters. At no time does the intern act independently without formal authorization from a supervising licensed practitioner. By the end of the year, each student will have created a case report on one of their patient cases.

Internship Case Presentation I-III – year four

Students present their clinic cases to fellow interns and a faculty supervisor for discussion and feedback.

Entrance Into and Advancement through Clinical Training

In order for DSOM and MSOM students to advance through clinical training, they must meet the following requirements:

  1. To advance as a clinical observer (Clinical Observation I-III), students must:
  • Pass the urinary drug screen (completed upon matriculation)
  • Complete annual HIPAA training, mandatory reporting, and blood borne pathogen training
  • Achieve CPR certification for healthcare professionals and attain the Certificate of Completion for the CCAOM Clean Needle Technique course
  • Have completed Palpation and Perception I-II, Chinese Diagnostic Techniques I-II, Acu-Moxa Points and Techniques I-III, Herbs I-II, Evidence-Informed Practice, and Introduction to Clinic (including EPIC training)
  • Make satisfactory academic progress as a second-year student, and be enrolled in/complete Chinese Pathology I-III, Acu-Moxa Points and Techniques IV-VI, Herbs IV-VI, Biomedicine I-III, and Practitioner Cultivation I
  • Students on academic probation must have passed the above requirements and have completed a valid academic action contract
  1. To advance as a clinical mentoring rotation student, (Clinical Mentoring Rotation I-VI), students must:
  • Complete annual HIPAA training
  • Maintain current CPR/BLS certification
  • Complete 144 hours of clinical observation
  • Maintain satisfactory academic progress as a third-year student and enroll in/complete Biomedicine IV-V, Clinical Medicine I-III, Clinical Case Presentation I-III, and Clinical and Physical Diagnosis
  • Students on academic probation must have passed the above requirements and have completed valid academic action contract
  1. To advance to pre-internship status, students must:
  • Maintain current CPR/BLS certification
  • Complete at least two Clinical Mentoring Rotations, Biomedicine IV, Clinical Medicine I, and Clinical Case Presentation I
  • Students on academic probation must have passed the above requirements and have completed a valid academic contract
  1. To advance as an intern, students must:
  • Complete annual HIPAA training
  • Maintain current CPR/BLS certification
  • Complete 288 hours of clinical mentoring
  • Complete Biomedicine VI, Clinical Medicine III, Clinical Case Presentation III, and Clinical and Physical Diagnosis
  • Pass all portions of the clinic entrance examination
  • Complete all mandatory clinic orientation meetings
  • Students on academic probation must have passed the above requirements and have completed a valid academic contract

1.6 Stages of Clinical Training – MAc Program

The goal of CCM clinical training is to transform students into competent practitioners through the following components of the clinical program. The timing described below assumes that the student is on the three-year track. Clinical Observation starts in the third year of the four-year track.

Introduction to Clinic – year one

In the spring quarter of their first year, students are introduced to the fundamentals of working in the CCM clinics. Topics include clinic policies and procedures, hygienic standards including Clean Needle Technique, charting protocols, patient confidentiality and multicultural awareness.

Observation – year two

Students become more familiar with clinic policies and procedures as they progress through observation. They have the opportunity to practice the diagnostic skills learned in the first year of the program and to relate their classroom learning to the clinical situation. Through their observation of patient-practitioner interactions and their involvement in discussions regarding patient diagnosis and treatment, students build their clinical knowledge, skills and attitudes, and become familiar with the different styles and interests of the clinic faculty. At the discretion of the faculty supervisor, students may participate in the delivery of certain aspects of patient treatment, including moxibustion, massage, cupping and/or needle removal. As they progress, they continue to gain clinical experience and become more familiar with the different styles of their clinic supervisors.

Clinical Mentoring – year two

During the final quarter of their second year, students become more directly involved in the intake, diagnosis and treatment of patients, under the full guidance of their clinical supervisor.

Internship – year three

In the final year of the program, students become interns and assume a gradually increasing responsibility for direct patient care. They continue to refine their clinical skills and understanding, and build their confidence as proficient practitioners. They become more fully involved in the diagnosis of increasingly complicated cases, and in the creation and delivery of integrated treatment protocols that typically include needle insertion. Students receive training and guidance from a diverse group of skilled practitioners of classical Chinese medicine and are encouraged to choose a clinical mentor, with whom they do at least one rotation per quarter during the fall, winter and spring quarters. At no time does the intern act independently without formal authorization from a supervising licensed practitioner.

Internship Case Presentation I-III – year four

Students present their clinic cases to fellow interns and a faculty supervisor for discussion and feedback.

Entrance Into and Advancement through Clinical Training

In order for MAc students to advance through clinical training, they must meet the following requirements:

  1. To advance to clinic observation status, students must:
  • Pass the urinary drug screen (completed upon matriculation)
  • Complete annual HIPAA training, mandatory reporting, and blood borne pathogen training
  • Attain CPR certification and pass the CNT course
  • Complete Foundations of CCM III, Palpation and Perception I-II, Acu-Moxa Points and Techniques I-III, and Introduction to Clinic
  • Complete the first-year basic science courses and be enrolled in the second-year basic science courses
  • Students on academic probation must have passed the above requirements and have completed a valid academic action contract
  1. To advance to internship status, students must:
  • Complete the annual HIPAA training
  • Maintain current CPR/BLS certification
  • Complete the Acu-Moxa Points and Techniques series, Syndrome Differentiation and Treatment I–II, and Clinical and Physical Diagnosis
  • Complete all observation rotation requirements
  • Students on academic probation must have passed the above requirements and have completed a valid academic action contract.