Overseas TCM Internship Experiences

Formal acupuncture and Oriental medicine or traditional Chinese medicine education has been established in the U.S. for more than 30 years. There are more than 60 schools and colleges with accredited or candidacy status with the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM). Even though ACAOM and state agencies have defined the educational standards for AOM schools, the majority still follow a curriculum modeled on schools in China, Taiwan, Japan or Korea.

According to ACAOM guidelines, accredited internship training for students in the U.S. must be completed in a clinic owned or managed by the AOM/TCM school. In California, state regulations prohibit schools from granting credit for overseas internship training (ACAOM guidelines do not contain specific language about overseas internship training). Despite the prescriptive nature of the regulations, most U.S. students firmly believe that an overseas internship experience in an Asian AOM/TCM school or hospital will assist their learning and enhance their clinical experiences.

The College of Acupuncture and Oriental Medicine at Southern California University of Health Sciences (SCU) believes that the overseas internship experience is a remarkable opportunity for our students and a high point of their educational experience. In 2006, SCU signed affiliation agreements with Chang Gung University (CGU) and China Medical University (CMU) in Taiwan. The affiliation agreements provide for exchange of faculty and students, and joint research. So far, three SCU student groups have visited Chang Gung Memorial Hospital (CGMH) and one student has visited CMU hospital. This article is about our students' experience in CGMH.

CGMH was established in 1976. Since that time, the hospital has grown in terms of facilities and number of patients, and the quality of services has also improved to meet international standards. CGMH has Keelung, Taipei, Linkou (including Taoyuan), Chiayi and Kaohsiung Hospitals. It also has two special hospitals: Children's Hospital and Rehabilitation Hospital. Today, CGMH has a total of 6,800 beds and serves 27,000 outpatients each day. It also has outstanding clinical teaching and research. It also has approximately 490 full-time and 340 part-time faculty members and more than 6,100 students.

SCU students may apply to CGMH as exchange students for two to three weeks during our college's term break. Students stay at a dormitory during their training. Rotations are conducted at CGMH Taipei and Taoyuan hospitals. Students are divided into four groups and rotate through the following departments: Chinese Internal Medicine, Chinese Traumatology, Chinese Acupuncture, and Chinese Gynecology. Students attend the daily morning meeting, clinical morning shift and outpatient clinics. They have the opportunity to observe 100 to 150 patients per day, including many conditions and treatments that are not typically seen in an AOM outpatient clinic in the U.S. Students are assigned to CGU interns in the same team to enhance mutual understanding and exchange learning experiences. Communication is easy because the majority of doctors and interns at CGMH speak English.

Student feedback about the experience has been uniformly positive. Even though students do not receive internship credit, they affirm that their internship is a unique and valuable experience. In addition to the number and variety of patients they are able to observe, they especially appreciate the in-depth exposure to herbal prescription and preparation. They are also enthusiastic about the chance to learn about TCM research conducted at CGMH.

Several students told me that they gained more confidence from their studies at CGMH. Before, they felt that what they learned in our program was not the same as in China or Taiwan. During their trip, they came to understand how much they had learned as students at SCU. When they compared themselves to the interns at CGU, they found that their knowledge and skills were at a similar level. Our students were especially appreciative of the early hands-on acupuncture internship experiences they had at SCU when they found out the majority of the CGU interns were merely observing treatments. In these cases, SCU students had more clinical needling skills and experience than the CGU interns.

The following comments come from one student who completed the internship: "I must say this has to be one of the most eye-opening experiences ever. The exams and treatments are a true interdisciplinary approach. The consultations have the medical history that contains medications, past care and all the information that the TCM doctor needs to make appropriate care recommendations. We have a great group of students, I have sat with a few residents and they are impressed with our knowledge of TCM. This hospital is beautiful, and the facilities are as nice as any four-star hotel. The most obvious observation is that TCM and acupuncture work. They see hundreds of patients a day. The stroke ward is fascinating."

In summary, I strongly encourage AOM/TCM students to pursue an internship experience in China, Taiwan or Korea. This is a great chance to verify what you have learned in your U.S. program. You will get to observe the advanced standing of TCM in the Western Medicine Hospital and the integration between Western medicine and TCM that may be a model for the future of AOM/TCM in the U.S. I encourage all U.S. schools to sign affiliation agreements with major TCM schools/hospitals in China, Taiwan and Korea. Affiliations between institutions create extensive opportunities to improve the quality of teaching and research at our schools. Our college's next goal is to send our faculty or doctoral students to major TCM universities and hospitals for short-term (one to three month) specialty training. I look forward to reporting the success of this program in the months to come.