As before, fourth-year students have the option of a four-week elective on the topic. All students, in classes across the curriculum, now gain an understanding of the role of nutrition and recognized alternative remedies in healing and prevention and of the body's innate ability to heal itself. Faculty members who have gone through the center's full-fledged, two-year fellowship in integrative medicine often give students a window on how they may eventually incorporate CAM.
One cardiovascular surgeon, for example, provides surgical patients with pre-operative guided imagery (shown in numerous studies to reduce stress and aid healing), offers detailed nutrition guidance for heart health, and is researching the effectiveness of Reiki, an energy healing method that relies on touch, on surgical recovery.
Educators at the University of Maryland School of Medicine in Baltimore are similarly inserting a discussion of integrative therapies wherever in the basic physiology and therapeutics curriculum "there is reasonably good evidence that CAM is helpful, or where there is widespread use by the public for those conditions," says Delia Chiaramonte, director of education for the school's Center for Integrative Medicine.
There's a fourth-year elective, too, that emphasizes the importance of caring for the mind, body, and spirit of the physician as well as the patients. Students not only learn about yoga and tai chi, for example, but also practice them to de-stress, Chiaramonte says. "Students recognize that, to be good healers, they need to facilitate their own wellness, that [it's] is a part of healing a patient," she says.
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Medical schools that can't find the resources or the space in their packed curricula to add CAM—a recent Institute for Functional Medicine (IFM) survey indicated that time, not lack of interest, is the prime impediment—may find that online education can fill the gap. Next year, the University of Arizona will launch a 16-hour Internet-based holistic course on prevention and wellness, open to medical students from other schools.
The IFM will debut Web-based modules later this year on gastrointestinal health, the principles of functional medicine, and nutrition. (Time constraints are no doubt the reason a recent study in Academic Medicine found that only 27 percent of medical schools currently meet the minimum target, set by the National Academy of Sciences, of 25 hours for class time about nutrition.)
Whether or not students who learn about alternative approaches ever incorporate herbs or acupuncture in their practices, believers say, they stand to gain from viewing medicine in a more holistic way. Maizes recalls one cancer doctor who some years ago took the University of Arizona elective. He later told Maizes that the main takeaway he incorporated in his practice was a determination to spend time getting to know his patients as people.
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