Jaded. That's how I felt that night. Beaten by unseen forces foiling my quest to learn about integrative medicine. It was April 2002, in my first year of medical school. I was sleep-deprived after six exams and I had just received another email about a talk on complementary and alternative medicine (CAM) at a New York medical school I would not be able to attend. Last time, tests. This time, I had already arranged to shadow a physician. So again, a serious academic discussion of CAM eluded me.
Then a simple solution occurred to me: find like-minded students and create our own CAM seminar series for Columbia University Health Sciences students. A flurry of emails brought nine of us together, and six months later we launched the Integrative, Complementary and Alternative Medicine (ICAM) Seminar Series under the co-sponsorship of the P&S World Medicine Club and the P&S chapter of the American Medical Student Association. Our goal was to organize monthly talks open to the whole Health Sciences community, especially students, to rigorously examine how CAM may play a role in our future careers.
Dr. Mehmet Oz, associate professor of surgery, and Dr. Constance Park, associate clinical professor of medicine, spoke to an audience of more than 100 students, faculty, and researchers at our first seminar on Oct. 1, the largest turnout I had seen for any event in Bard Main Lounge that didn't offer food or alcohol. One month later, Dr. James Dillard, associate clinical professor of rehabilitation medicine and staff acupuncturist, described the latest findings about acupuncture and pain management, and demonstrated his trade on ICAM team member Mason Bragg '05. On Nov. 19, Washington Heights community leader Milagros Batista explained Dominican home remedies and spiritual healing, then led us in dance to a Santera band. On Jan. 15, massage therapist Beacon OrShalom introduced students to craniosacral therapy, a relatively new technique that is gaining popularity. A March 4 talk will feature Dr. Richard Brown, associate clinical professor of psychiatry, speaking about CAM for depression and anxiety, and touching on drug interactions.
With the wealth of knowledge we have about conventional therapies proven by repeated randomized controlled trials, one may wonder why Health Sciences students are interested in alternative therapies. Based on an anonymous survey we did at the first seminar, a majority of attendees responded positively to having tried CAM instead of allopathic medicine, having tried it concurrently, and having a relative who had tried it, when each question was tallied separately.
In my case, experiences with yoga, martial arts, herbal medicine, and different nutritional approaches have drawn me to integrative medicine. A few of us organizing the seminar series already plan to practice this way. For others, the interest may come from realizing that a majority of patients use alternative therapies, whether they inform us or not. Their action poses the question of how alternative therapies may affect our own interventions, whether by adverse interactions, support, synergy, or by no effect at all. Moreover, until we are indoctrinated into our studies, many of us enter medical school with a fairly similar view toward CAM as the general publicit's interesting, mystifying, and accessible; it can also be philosophically or spiritually satisfying. And since so many people use it, anecdotally with success and with the increasing support of research, CAM is an important element in healthcare. Unfortunately, it is under-explored in the medical school curriculum.
Now in my second year, I am pleasantly surprised that two of the 12 elective seminars in Humanities and Medicine do cover CAM topics: acupuncture theory, and mindfulness meditation, and yoga. Two pharmacology lectures also address CAM for cancer and endocrine disorders. In the fourth year, a segment of the month-long clinical practice course looks at CAM for pain management. Kudos to the course directors. Exposing medical students to CAM ensures that future physicians and surgeons will not overlook its clinical efficacy merely because it is unfamiliar. Dr. Dillard said we can only control 65 percent of all chronic pain with our full pharmacological arsenal, and that acupuncture is now widely accepted in Western medical practices and backed by solid research for its efficacy in pain control. More than that, medical student exposure to CAM could open the door to improved physician-patient communication, cultural competence, and leadership in CAM research.
CAM, however, could be further introduced into the existing medical curriculum via several routes. In Clinical Practice I, students learn how to critically review journal articles; an exam could use a research study on a CAM modality. In Clinical Practice I or II, a lecture could focus on CAM, followed by a small group session or clinical assignment on interviewing patients about CAM use. Increasing mention of CAM in pharmacology lectures may just take a few minutes to briefly touch on other modalities. Beyond the existing framework, a wellness unit could add a dimension to medical education, since patient education and many CAM approaches address enhancing wellness. It is a tremendous gift to have the Rosenthal Center for Complementary and Alternative Medicine on our campus, and I hope students discover more ways to benefit from its presence.
Any readers who would like to support our effort and have resources, funding, or energy to contribute, please contact us. It has been a pleasure being part of this team that developed the ICAM Seminar Series and one of many powerful learning experiences I will take from Columbia.
Max Fischer is a second-year medical student at P&S. He can be contacted at firstname.lastname@example.org.