Editor's Note: This is the second in a series exploring acupuncture care in China. In October, I traveled to Tianjin and Beijing for a glimpse into where acupuncture is headed and what practitioners in the United States can learn from the latest innovative treatments abroad. This installment examines the TCM educational system in China.
Tianjin, China - During the Han Dynasty, Chinese physician Zhang Zhongjing built his legacy in Traditional Chinese Medicine by attending to the needs of his sick peers and studying the masters who came before him.
By following his ancestor's footprints, Zhang Zhongjing paved his own path and to this day is celebrated by the Chinese for his contributions in the treatment of infectious diseases with TCM.
Fast-forward to 2012: Practitioner and student Alex Chen, LAc, DAOM from San Francisco, Calif. is also trying to learn from the masters by completing an educational fellowship in China to better equip himself for his patients back home and aspires to also build his own legacy among his patients and peers much like Zhang Zhongjing.
"We all know to learn a language it is important to immerse yourself in that environment," said Chen, who was completing a fellowship at the First Teaching Hospital in Tianjin, this past fall. "It is also true that a practitioner immerse himself/herself into the TCM environment. There are plenty of masters than you can learn from."
Although much has changed since Zhang Zhongjing's era (150-219 A.D.) clearly many things remain the same. TCM professionals continue to build on the education from the masters of the past, whose skillful techniques have been preserved for thousands of centuries.
In China, these techniques are golden. Today, the Chinese are not only holding on to the treasures of the past, but also using them to pave the way to the future.
Preserving Legacies
TCM education in China is strongly rooted in the masters and there is a constant demand to ensure their work and knowledge about the human body makes its way into the future.
In China, the history of TCM education has been well documented along with a surplus of treatments. Treatment protocols designed by early masters like Zhang Zhongjing are easily accessible to the new generations who have openly embraced TCM in addition to modern medicine. China is a country that honors its past, while also speeding head on into the future and nowhere is it more evident than in the TCM education system. Proof can be seen in education hubs all over China.
At the China Academy of Chinese Medical Sciences (CATCM) in Beijing, there is an extensive collection of books and journals on Traditional Chinese Medicine – 20,000 volumes of books there are recognized as rare editions.
Some of the top historical relics of TCM are also stored at the Academy's Traditional Chinese Medical History Museum. TCM students in China today are focused on furthering research of many of material medica that has been stored.
Currently, there are more than 480 research projects at the Academy in Beijing, including 200 national projects and 258 ministerial and bureau projects, according to Academy officials.
Around China, TCM academic institutions are busy working with the government to make preservation of the classics a top priority.
"There is an effort to preserve the ancient methods, and to recognize old masters. As well as to be progressive with a more modern style of development," said Michael Berger, who studied in China extensively for over three years for his M.S. in Medicine, Acupuncture and Tuina.
The goal is to not only preserve TCM's past significant achievements, but also to use them to further TCM in prevention and treatment of a wide range of diseases today. In order to do this, the Chinese have been heavily involved in using the academic institutions to further scientific research.
"China continues to do research and make acupuncture a more measurable, tangible medicine. They understand and study how acupuncture affects the blood and brain and the central nervous system," said Kristy Stecker, an Arizona-based TCM student who has studied in Tianjin, China. "This is incredible valuable information for the future of the medicine, especially when pertaining to gaining acceptance from Western medically trained doctors."
In Beijing, CATCM officials along with their student body have completed nearly 900 research results, among which nearly 300 projects won the national and ministerial awards.
Officials at the academy said scientific research has been the leading mission for TCM education in recent years and has enabled its students to be on the cutting edge of the latest TCM treatments coming out of China.
"Students in China do research to understand the measurable quality's of acupuncture, of which we have no concept of in the US," said Stecker. "As an example in China students may work on lab rats and utilize a popular acupuncture point known as Zu San Li (St 36). They draw blood from the rat before and after using this point and get to see the difference in red blood or white blood cell count. This type of research gives measurable data in what is seemed to be an immeasurable area of medicine. It also gives further understanding of what is happening within the body from a Western perspective, which then gives a practitioner a clear idea of when and why to utilize certain points on their patients."
The ability to do extended research and training is part of the overall TCM education model in China. The degree system in the country differs greatly from programs in the states.
Getting a TCM education in China requires an extended amount of time in a dual system of medicine – Eastern and Western. This model of education offers students the ability to delve into the teachings of masters from the past and deeper into diagnosis, TCM theory and herb compatibility.
Leading the Way
In China the first requirement is to complete a Bachelors degree in medicine and receive an MD. Then you must complete your acupuncture degree after you have a complete understanding of western medicine. You can choose to continue studying and receive a PhD in acupuncture if you wish.
Most Chinese acupuncturists have a total of 8-9 years in learning and understanding Western medicine and acupuncture by the time they begin to practice. In the U.S. students receive three to four years (if they study Chinese herbs) of training and a master's degree.
One of the most significant differences in education lies in the clinical training offered by many of the TCM hospitals in China.
"The clinical aspect of training is much different between the US and China," said Stecker. "In China, a student must observe for years before they get to assist in patient treatment, students are also taught in a hospital setting where they can observe 100 treatments each day. In the U.S. we see four patients each day at the most."
While training in Tianjin, Alex Chen's typical day included doing clinical rounds, observation of treatments for patients with a wide range of maladies from hypertenstion to facial paralysis and insomnia.
Chen said in a typical day he would observe up to 100 patients. He would also take part in thorough discussions on the various conditions and treatment plans. His most valuable teachings have been in group settings when stroke patients have been treated.
"Many ancient TCM masters told us our patients are our teachers," said Chen. "The TCM hospitals here in China are great settings where practitioners can easily share their experiences with lots of supervisors and peers to support them in seeing how TCM can help different types of diseases."
TCM education in China has also been able to offer aspiring TCM doctors who come to study from abroad many valuable teachings that have yet to hit stateside. Some of them involve the wider range of needles that are used.
Students as well as practitioners have access to needles such as the hypodermic needle, small needle scalpel and fire needle – needles that are not yet available in the United States. Herbal medicine also has a better range in China, due to the better understanding of the variety of herbs and modalities, according to Chen.
"Although TCM herbal treatment is accessible in the States, the variety is still limited because its not as well understood by Americans," said Chen.
While studying in China, Berger said he found being able to study in clinics at various hospitals priceless. During his time training and learning in China, Berger said he was required to learn unique and esoteric methods with special teachers.
"I studied both the Ling Gui Ba Fa ( Turtle Method), and the Jiu Gong Ban Fa (9 Palaces method), both of which are very classical methods mentioned in the Zhen Jiu Da Chang. I studied Jin's 3 Needle technique, the Silver Needle technique, and a lot of other methods that I don't think I would ever have had a chance to study in the USA," said Berger. "I was able to see a huge number of patients in many hospitals, had the chance to do my own clinical trial and write and defend a thesis, and was an elected Council Member (WFCMS) and speaker at some International TCM Conferences. I am not sure I would have had those same opportunities in the U.S."
Studies with cadaver/dissection anatomy as well as training in reading of X-rays and MRIs are also part of the education in China that have been able to offer students a greater understanding of what the masters had found before them.
Bridging the Gap
Stecker said education in China has a number of great advantages for those willing to learn from the motherland of TCM, but the lessons can also be a way to form a heftier education model in the U.S. as well.
"I feel we need to bridge the gap in the knowledge of western medicine and how clinical rounds are completed. If students could get a better grasp on western medicine and clinic could be run through local hospitals students would be able to get better results," she said.
In recent years, Chinese academic institutions have worked hard to make this kind of rigorous TCM education more accessible to foreigners, by both developing programs taught in English and by publishing more books in English, said Berger.
"In English speaking countries we don't have access to even a fraction of the very important books published in Chinese," said Berger. "Some of these are extremely important, so efforts are being made to translate them."
Educational hubs such the CATCM in Beijing have also made major efforts to solidify their relationships with U.S. TCM schools such as Harvard, Stanford and many others. The collaborative relationships are what many TCM students see as key to strengthening the development of the medicine abroad.
CATCM officials said multi-lateral relations and collaborations have been established between their academic institution and international research institutions as well as organizations such as WHO (World Health Organization) and UNDP.
"I hope we can leverage the strengths (in China) to help more U.S. patients," said Chen. "The public's education of TCM is also critical for TCM practitioners success as well."
During his time, Zhang created one of thoses masterpieces - the "Shanghan Zabing Lun" focused on curing infectious diseases that caused fevers. His studies made breakthroughs, and today practitioners on both sides of the world strive to do the same. Luckily, Zhang's work has been preserved to offer some guidance.
"You don't really get to know how impactful a medicine is until you see it in its birthplace," said Stecker who plans on more training in China in the near future. "Seeing it firsthand, asking questions and applying it is much better than learning it from a teacher at school who learned it from their teacher who learned it from a professor in China."
This trip was sponsored by Jing Liu & Eastern Medicine Center.
To read the first part of AT in China: Part I click here. The final part of the AT in China series will debut next month. For questions, email me at bduran@mpamedia.com
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