• Overview
  • Forms of Treatment
  • Prevalence and Use in the U.S.
  • Costs and Coverage
  • Licensure and Credentials
  • Transmission of Chinese Medical Thought
  • East Asian Medical Theory and Diagnosis
• Interventions
  • Acupuncture
  • Chinese Herbal Medicine
  • Meditative Exercises
• Conditions
  • Acupuncture and Smoking Cessation
  • Acupuncture in the Treatment of Hypertension
  • Tai Chi and Cardiovascular Health

Licensure and Credentials

This section explores educational requirements, licensure, scope of practice, and the diversity of clinicians who practice acupuncture and Oriental medicine.

Education, Accreditation and Degrees

Students interested in Chinese medicine can study either acupuncture alone or Oriental medicine, which includes the field of Chinese Herbal Medicine (CHM). There are over sixty colleges of acupuncture and Oriental medicine in the United States; approximately forty of these schools are accredited by or in candidacy status with the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM).

ACAOM accredits two master’s degree programs: a Master’s in Acupuncture (M.Ac.), and a Master's in Oriental Medicine (degrees conferred include M.A.O.M. or M.Ac.O.M.). Minimum requirements for accreditation for an acupuncture program state that the program must be a 3-year program of 1905 hours. The current minimum for a master's program in Oriental medicine is a four-year program totaling 2625 hours. Both curricula must comprise at least 705 hours of Oriental medical theory, diagnosis and treatment techniques; 660 hours of clinical training; 360 hours of biomedical clinical sciences; and for Oriental medicine programs, an additional 450 hours of CHM studies. Master's level programs currently are the entry-level degree for practicing acupuncture in the US. In May of 2000, ACAOM approved standards for doctoral level programs of Oriental medicine. Approved colleges will offer either a Doctor of Oriental Medicine (DOM) or a Doctor of Acupuncture and Oriental Medicine (DAOM).

There has been considerable debate among professional acupuncturists about whether the entry-level standard for licensure and practice should be upgraded to the doctoral level. The number of required hours for accredited acupuncture and Oriental medicine degrees is on the rise. As of July 2004, OM programs hours specific to biomedicine increased from 360 to 510; acupuncture and Oriental medicine hours increased to 2115, up from 1815 hours. The minimum hours for Master's of Acupuncture degree increased from 1725 hours to 1905 hours. Of those hours, the credits specific to biomedicine increased to 450 from 360 and Oriental medicine-specific hours increased to 1455 hours.

Licensure

The length of education required for licensure differs from state to state. Most states require graduation from an ACAOM-approved OM college. In addition to formal education, professional acupuncturists are required by most states to pass the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) exam. NCCAOM is the national certifying body for acupuncture and Oriental Medicine. Upon passing their exams, acupuncturists and Oriental Medicine practitioners are certified as diplomates and use the designation Dipl. Ac., Dipl. CH. and Dipl. OM. The NCCAOM offers certification examinations in both acupuncture and CHM to graduates from ACAOM accredited schools, or from foreign schools that meet ACAOM equivalent program requirements, e.g., many medical schools in China. NCCAOM has an online directory of all clinicians who have passed the national exams and are licensed to practice acupuncture and Oriental medicine.

In the US all but five states regulate and license acupuncturists. Most jurisdictions grant the licensure title Licensed Acupuncturist (L.Ac or Lic. Ac.), or Acupuncturist. Arkansas, Nevada and New Mexico grant the title of Doctor of Oriental Medicine (DOM). Rhode Island grants the licensure title of Doctor of Acupuncture (D.Ac.) and Florida grants the title Acupuncture Physician (A.P.). A few states grant a licensure title such as Licensed Acupuncturist but allow the use of DOM, OMD, Dr., or doctor under certain circumstances. Most of these states require a doctorate from an approved or accredited college in order to use the title. For more information on state regulations see the Acupuncture and Oriental Medicine Alliance website and the book Acupuncture & Oriental Medicine Laws. [1]

Scope of practice

Beyond practicing acupuncture, acupuncturists may also practice various forms of bodywork, CHM and offer nutritional advice. At this time, nineteen states specifically include CHM within their scopes of practice. Of these, six (Arkansas, California, Florida, Nevada, New Mexico and Texas) mandate training and/or examination in CHM for all applicants. Massachusetts has a separate requirement for L.Ac.'s who use herbs and other states are considering adopting a similar requirement. Current regulations are under development at both state and national levels for limiting the use of specific herbs to licensed acupuncturists who have passed national exams in CHM and hold diplomate status.

Two states, Florida and New Mexico specify that acupuncture or Oriental medicine providers are primary care providers. In California L.Ac.'s are primary care practitioners under Workers' Compensation. This trend is expected to continue.

Diversity of practitioners

The American Association of Oriental Medicine (AAOM) is the oldest professional association for acupuncture and Oriental medicine practitioners in the United States. AAOM reports that there are 15,000 to 17,000 practicing professional acupuncturists in the US.

In addition to professional acupuncturists and OM practitioners, a variety of clinicians incorporate acupuncture into their practices, including chiropractors, dentists, medical doctors, naturopaths, osteopaths, physical therapists, podiatrists and veterinarians. National estimates indicate that there are between 12,000 and 30,000 practitioners who are not professional acupuncturists who incorporate acupuncture in their practice.

State legislation determines who can practice acupuncture and with what training. Throughout the US, only a medical doctor's scope of practice uniformly includes acupuncture. Some ten states require 200-300 hours of acupuncture training to extend a medical doctor's scope of practice to include acupuncture. [1] The American Academy of Medical Acupuncture (AAMA) certifies member medical doctors and osteopaths in medical acupuncture. Their requirements include 200 hours of acupuncture specific training and 100 clinical hours. AAMA instructs physicians in a specific style of acupuncture, referred to as the French energetic system and does not train nor certify physicians in CHM.