There are many practitioners in the Southeast using the interchangeable titles “naturopathic doctor” and “ND.” As one of these practitioners, it is important to me to clarify the potential differences in our training. Consumers who understand these differences are better able to choose practitioners with whom they want to work. Some NDs, like myself, are trained at four-year naturopathic medical schools, and others through distance learning programs. The scope, rigor, and purposes of these approaches are vastly different.

Four year naturopathic medical colleges
There are five schools in North America that offer four-year, doctoral-level programs leading to the degree Doctor of Naturopathic Medicine. Their curricula are all similar. They require bachelor’s degrees for admission. They teach two years of basic sciences (anatomy, physiology, etc.) and diagnostic sciences (laboratory and physical exam, etc.), just like conventional medical schools. They also teach two years of naturopathic therapeutics, such as nutrition, homeopathy, herbal medicine, counseling, and physical medicine. At the same time, students are required to complete 1200 hours of clinical training under the supervision of licensed NDs, MDs, and DOs.

All five schools are accredited, or candidates for accreditation, with the same regional accrediting agencies that accredit major universities. Such accreditation ensures that the schools have facilities, faculty, and administrative personnel appropriate for doctoral level education.

The purpose of these programs is to prepare graduates for careers in private practice, research, and the natural health care industry. Graduates are eligible to sit for national board exams required for licensing. At this writing, twelve states license naturopathic physicians. Scopes of practice in these states approximate that of conventional primary care physicians, with the addition of the numerous natural therapeutic modalities, which are the cornerstone of naturopathic medicine. North and South Carolina do not yet license naturopathic physicians, so in this state, the use of the term “naturopathic doctor” or the initials ND is not limited to graduates of four-year programs. Generally, though, graduates of four-year programs who work in North Carolina hold licenses in other states.

Distance Learning Programs
There are also many distance-learning programs that offer a degree with a very similar title: Doctor of Naturopathy. These schools generally offer their programs to high school graduates. Their curricula include 25 to 30 courses which can be completed at home in a matter of months. Exams are written to demonstrate competency. The classes may include a basic science class or two, assessment techniques such as kinesiology and iridology, and several introductory classes to natural therapeutics such as herbs, homeopathy, and acupressure. Some require a consulting practicum for graduation.

Most distance learning programs say they are accredited and list their accrediting agencies in their marketing materials. These agencies are not institutional accrediting agencies, and they are not recognized by the U.S. Department of Education. In fact, they are organizations that “certify” naturopathic doctors. “Certification” has no legal meaning as “licensing” does; it is a means of providing credentials to those who don’t meet the standards required to be licensed. The “accreditation” of a distance learning program simply means that the agency will “certify” a graduate of that program.

The purpose of the programs, as stated in their literature, is to give students the knowledge necessary to live a healthier life. Some of the literature suggests that graduates may become comfortable enough with the material to eventually offer consultations to others. There are distance-learning graduates in private practice, authoring books, and bringing extra knowledge to established healing work such as massage therapy. Graduates of distance learning programs are not eligible to sit for national board exams, and are therefore not able to be licensed as naturopathic physicians in states with such licensing.

Conclusion
As a graduate of a four-year program, I am obviously biased in favor of such a course of study. However, my point here is not to make the choice for anyone about whom is best-suited to provide their health care. That is an individual decision. Without information, however, no one can make an informed decision. I believe I have presented factual information to create a context in which a person can better choose a naturopathic doctor when he or she chooses to work with one.

Dr. Coward is a graduate of Southwest College of Naturopathic Medicine. He practices classical homeopathy and naturopathy in Asheville, NC at Asheville Natural Health & Homeopathy. He can be contacted at drcoward@hotmail.com or 828-254-3004.

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