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Ah, I've come to this group at the right time...

 

Having just found out I passed my CA board,

I am grappling with whether or not to go to

medical school (MD/DO)- and the main reason

is that I agree that the MSci level of training is insufficient.

 

I totally agree with raising the standard to PhD

and also implementing a residency. I think we

need a lot more apprenticeship, clinical experience

(doing and seeing)... in basic physical exam

to catch ominous signs, specific info about the

diseases we see (some of this is communicated in

the Master's level classes, but it sometimes vanishes

when you see real patients- thus the need for residency),

how modern CM practitioners treat these diseases...

e.g. the kind of medical herbalism demonstrated in

Volker Scheid's book (specifically the meniere's

formula).

 

I am frustrated with some of the other email

discussion lists because when I mention research- its

importance in improving the medicine, plus gaining

the interdisciplinary respect that Todd mentioned-

they go crazy. Some of our profession do not believe

in the value of research.

 

On this and many issues, I'm seeing that his is the most

divided profession I know!

 

I think that's another reason I don't have trouble

thinking about going for MD/DO- is that I am

deflated in my opinion of our profession when I

hear some of those things!

 

Any feedback, commiseration, or hope?

 

Thanks,

B

 

 

 

Brian Benjamin Carter

Editor, The Pulse of Oriental Medicine

Columnist, Acupuncture Today

 

The PULSE of Oriental Medicine:

Alternative Medicine You Can Understand

http://www.pulsemed.org/

 

The General Public's Guide to Chinese

Medicine since 1999... 8 Experts,

100+ Articles, 115,000+ readers....

 

Our free e-zine BEING WELL keeps

you up to date with the latest greatest

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, " Brian Carter " <

bbcarter@p...> wrote:

 

> On this and many issues, I'm seeing that his is the most

> divided profession I know!

 

Brian

 

I was thinking yesterday how many contentious issues there are in our field.

But rather than being disheartened, I am amazed at how well reasoned many

of the differing viewpoints are. sure, those who oppose research altogether

as somehow damaging the integrity of the medicine is not a position that I

have ever seen well argued. On the other hand, discussions we have here

on the importance of classical study, language, education, dosage, quality

control, etc. include many differing but often equally persuasive arguments.

We are still in the formative stages of TCM in america. We could perhaps

liken this period to the song-jin-yuan era, when a 100 schools of thought

flowered. In the ensuing 800 years, many of these ideas have bit the dust,

never having made much headway after their inception. I think we will see a

similar process in america, but it can be frustrating because the resolution of

many of these arguments may be decades away. At least, thanks to TCM,

we'll all live to 150 to see it through. :-)

 

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Brian,

I don't see where anyone is 'going crazy' over research in the field

or interdisciplinary communcation. I do think, at least speaking for

myself, that there are socio-economic issues around alternative

medicine that are being hammered by the media, and that a certain bias

has colored perceptions of studies done on acupuncture and herbal

medicine so far. I think research is a wonderful idea, if it is done

properly.

 

I personally have a problem with the perception that in scientific

research, 'double-blind' studies, are the 'gold standard'. There is a

myth that somehow such studies are unbiased, removed from the influence

of researcher's beliefs, or that of their sponsors. There are so many

possibilities of interpreting data that can color the outcome of

studies.

 

Vol 299, January 10th issue of Science Magazine (www.sciencemag.org)

has an article on ongoing clinical trials and screening of Chinese

medicinals. There are some interesting comments in this article. One,

by Wallace Sampson, a professor emeritus at Stanford University in

clinical medicine, says that screening plants for useful remedies

is'wishful thinking'. " These emperical observations on herbs (in

traditional texts) are unreliable, fanciful, false, and irrelevant. "

Observations by herbalists in the article point out the difficulty of

designing studies around prescriptions of many ingredients.

 

Getting decent research is a tug-of-war, with many pros and cons. I

don't oppose research, I oppose shoddy research that doesn't respect

the Chinese medical tradition and treats herbs as if they were drugs.

The value of herbal medicine is not merely in finding new drugs for the

pharmaceutical industry.

 

Finally, funding for such studies is expensive. Our profession

doesn't generate that kind of money to pay for it. It will take time

to develop.

 

Brian, congratulations on your licensure. I am sure whatever you

decide to do, it will be worth it.

 

 

On Thursday, March 6, 2003, at 06:43 PM, Brian Carter wrote:

 

> I am frustrated with some of the other email

> discussion lists because when I mention research- its

> importance in improving the medicine, plus gaining

> the interdisciplinary respect that Todd mentioned-

> they go crazy. Some of our profession do not believe

> in the value of research.

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Having just found out I passed my CA board,I am grappling with whether or not to go tomedical school (MD/DO)- and the main reasonis that I agree that the MSci level of training is insufficient.Hi Brian,

Nice to speak with you in this forum and congratulations on your credential. I decided to respond on list here so that others could see some details that I feel are worth knowning.

I think Todd and Z'ev did a beautiful job of responding to your issues for the most part. My two cents is why do you want to change paradigms (going to MD/DO)? Also do you really want to damage your health in America's idea of medical training? In my recent posting about spending entire residencies and parts of your 3rd and 4rth years in school doing cycles of 12, 12, 36 hour shifts means you miss 1/3 of your sleep for quite a few years. I saw a statistic that 60% of doctors who finish residency in internal medicine are clinically depressed from the physical rigors of their training. That means 60% have turned themselves in for psychotherapy or medication. In my opinion those 60% still have insight into their well being, while the other 40% are mostly in denial. The profoundly initiatory nature of American medical training has negative consequencies for both practitioners and patients and furthermore injures the paradigm of the training itself. When you've done a 7 AM to 7 PM shift and then worked the 7 PM to 7 AM shift, you're in the morning grand rounds getting beaten up by the attendings with no way to even speak coherantly. And you've still got twelve hours to go. You've actually got years to go, and you're already damaged goods.

An alternative that I'd consider if I were in your shoes (and as young as you are) is studying enough Chinese to attend school at Shanghai Medical University of TCM. Dr. Xie is the vice president of the university and is the chief of day to day operations. His program for foreign medical students and medical doctors is quite interesting. The school is a foreign language school for young Chinese people which means that when you attend a program there, you will have a personal translator. You can opt for a short program and follow master practitioners with the translator. You can also study Chinese first and try to work the programs from that perspective. Finally, you have options to do a series of short programs or try to enter the medical college program as a regular medical student.

As a full time medical student in that program, you do have some rigors to deal with but as an American you might be allowed to stay at a certain level despite a less than stellar performance. The Chinese medical students there discover life in the pharmacy if they don't do well enough in their clinical performance. The Chinese medical students experience another cut at the end of the program regarding where they do their residency. Those who get to stay in the city of Shanghai are what we would call here the AOA (Alpha Omega Alpha), top 10 to 15%. That's how it is in CA, too, for MDs. No one matches at a residency in San Francisco that I know of who is not AOA. The difference between getting into a residency in S.F. as compared to Oakland is night and day. It's the same at the Shanghai Univ. of TCM. So anyway, that would be a place to test your metal. It might not matter to you, but older applicants (over 30) to American MD/DO schools are not well considered and usually end up at a lesser medical school and then can't match in the city of their choice no matter what their grades. You would do well to get plenty of guidance from what ever community (MD or OMD) as to where you want to train.

Check with me off list if you want to know more about training in Shanghai.

Emmanuel Segmen

 

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My two cents is why do you want to change paradigms (going to MD/DO)? Also do you really want to damage your health in America's idea of medical training? In my recent posting about spending entire residencies and parts of your 3rd and 4rth years in school doing cycles of 12, 12, 36 hour shifts means you miss 1/3 of your sleep for quite a few years.

>>>>Emmanuel did you finish MD school in the US? I thought that is what you said.

Alon

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I personally have a problem with the perception that in scientific research, 'double-blind' studies, are the 'gold standard'. There is a myth that somehow such studies are unbiased, removed from the influence of researcher's beliefs, or that of their sponsors. There are so many possibilities of interpreting data that can color the outcome of studies.

Z'ev,

I also feel frustration with this within my own circle of colleagues ... in basic science as well as clinical MDs. I would enjoy a discussion with you regarding this on or off list.

Emmanuel Segmen

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