There’s a countdown going on among the intern class. In less than two weeks, they hit the road for spring break, and it’s clear how much they’re looking forward to spending time with their friends and families. With this in mind, I’d like to return to the discussion of the realities of clinical year. Or, rather, what the families and friends of each intern do for the 12-month residency that completes the Master of Acupuncture training.
Prospective students ask all the time how students with families and familial responsibilities manage moving to Gainesville and getting through the clinical year. For some students, getting the time off from work and family to attend the intensive sessions during the first two years of the program is the hardest part. But for most, it’s the year-long commitment of working in the on-site acupuncture clinic that influences their decision to attend the Academy most. And everyone handles the situation differently. Here are some of the most common ways to manage family and clinic during the last year of the acupuncture program.
If you’re one of those students whose sole responsibility is yourself, the transition is much easier. Choosing your housing may be your biggest challenge, and there are plenty of affordable options (living along, or rooming with a classmate, etc.) depending on your preferences. And most pets make the transition to Gainesville relatively easily, too (did I mention there’s a dog park in town? It’s a great way to meet people, or possibly recruit patients). That doesn’t mean that leaving home and your friends behind is easy. It simply means that there are slightly fewer factors to take into consideration when it’s time for clinical year. If you’ve been living in the same place for some time and have an established community, it’s hard to leave that community even for a year (no matter how fast that year goes). But luckily, you have a welcome place to visit on break and eventually to return to.
For those of you with partners, kids, or family members that you’re caring for, you may have some harder choices to make.
If you have a partner, what do they do for an entire year while you’re away? The answer to this question depends on the partner’s job. Can they work remotely? Those who can, will actually come to Gainesville too, renting out their homes for the year, or putting their things in storage. In this way, couples can share the year together, and it’s refreshing for the intern to be able to come home and share their day with their partner. Again, this path depends on the flexibility of the partner’s job, but it is a possibility to consider.
Those partners who can’t work remotely or take a year off, visit as often as they can. No one in a committed relationship wants to be apart for a year, but those visits are very sweet respites during a crazy year. I’ve seen a number of surprise visits on anniversaries that have brought tears from anyone who gets to see the reunion. It’s not the same as being together continuously, but, for some students, not having their partner with them allows them to focus on their work in a way that they wouldn’t have been able to otherwise. I know some interns who felt like they had to do it on their own. That doesn’t mean they don’t miss their partners and that the upheaval is easier. So it’s important to keep the end goal constantly in mind: remember there is a very good reason you’re doing this.
I’ve seen entire families move to Gainesville so that the student-parent can attend clinic. That’s right. The entire family, partner and kids, moves. Gainesville is an exceptionally family/kid friendly town. Kids go right into the school system and there are a lot of after-school activities to take part in. It becomes a family adventure. And I love hearing kids talk about being proud of their parents’ endeavors.
On the surface, it almost sounds easy, to just bring family along. But I won’t sugar-coat it. Uprooting everyone is hard, and it means that your kids and your partner have to make new friends in a new community while you’re ensconced with your cohort. Additionally, having your partner, or your kids with you, can add a significant amount of pressure. You have to constantly juggle the roles that you’re playing. It’s hard, but I’ve watched families make it work. Jumping into the Gainesville community is the best way to combat homesickness. Kids can be incredibly supportive, even if mom or dad isn’t as available. It depends on the willingness of each family member to do what’s best for you and your family.
For those students who are single parents, it’s their support system that becomes essential to their success in clinic. Some have family members who stay with their children and then they go home as frequently as the schedule allows. This works best if home is close to Gainesville and the travelling distance requires a car and not an airplane. Most single parents, though, bring their children with them (some even end up staying in town after graduation). As a student once told me, it’s not easy, but it comes down to finding members in the community whom you trust. Getting your child into an activity and meeting other parents, or meeting the parents of your kids classmates is the key so that you have people you can turn to. Support is there if you look for it. And you shouldn’t forget about your classmates. Students whose older children come with them will sometimes babysit the younger children. And it has happened where I’ve walked into the student lounge in the afternoon and seen kids quietly coloring, or chatting away with their parents’ classmates while mom or dad is treating a patient. The more flexible you and your kids can be, the easier the year is.
Again, I didn’t say it was “easy,” I said it was “easier.” The point here is to show that you have options, and that there are many students in situations similar to yours who have had very, very successful clinical years.
The hardest situation that I have come across is when students are caregivers for their parents or other family members. It’s not really a question of bringing them with you and asking them to be flexible. If you’re within driving distance and they are not solely dependent on you, there are ways to arrange one’s clinical schedule so that going back and forth most weekends is possible. I’ve seen one or two students do this, but it is much harder than any other scenario because there really is no downtime at that point. And there are plenty of weekends where you won’t be able to go home for the entire weekend.
In the end, the best advice that I can give prospective students is to be flexible and realize that many obstacles to the clinical residency are only as insurmountable as one makes them. It’s also important to remember that timing is everything. Sometimes, you have to be patient and wait for a better window. We welcome all prospective students to talk with the Admissions office about their family situations and concerns for clinical year. We can put you in touch with graduates or current interns in similar situations so that you can hear a first-hand account of overcoming the obstacles.
I’ve seen students with infants successfully finish clinic, watched whole families enjoy a year in Florida while mom or dad is in class, met many supportive partners during visits, and enjoyed seeing the interns come back recharged from break because of the quality time they’ve just spent with friends and family. A few months ago I wrote about how it’s really the people in our students’ lives who support them through the program, and I reiterate that here. Love and support can mean more to mental fortitude than having the natural ability to be a good student. So while figuring out what’s best for your family while you’re embarking on your dream, the best way to approach the obstacle is to think of your family as your support system, and not your obstacle. Chances are, they’re willing to do whatever they can to see you succeed.
And to the families and friends of our students out there, we thank you for loaning them to us during their training. We know that you, too, are making sacrifices, and we appreciate all that you do!
The interns seem to have arrived at THAT time of clinic. And I’m not talking about “senioritis.” I’m talking about that moment when the big hurdles of clinic have been conquered and the reality of life after clinic and school suddenly comes into focus. And what does that reality look like? BIG, SCARY BOARD EXAMS.
I don’t know exactly why it happens around this time. They’ve established a routine in clinic and seminar. Their first acupuncture patients are now ensconced in their care, referrals are coming in, they’ve begun treating new patients in the herb clinic. And yes, there’s still the final point location exam and the herbal studies final to contend with, but both are still months away. They should be able to relax into the routine. But each year, when the interns are just over the halfway point, someone rings the board exam alarm bell and the early nerves set in.
To be clear, many of the interns have completely relaxed into the flow of the clinical year. And no matter what they may be feeling internally, they’ve been trained to leave their anxieties at the clinic room door and focus on their patients’ needs. But on the academic side, we start to get peppered with questions about when they can take exams, how to study, and how other classes have fared. They’re already looking ahead to the next hurdle, sometimes forgetting that to be in the present moment is the best preparation for those exams. The more they learn from their patients and their teachers now, the better they’ll do.
Staying in the present moment is, of course, easier said than done. So I would like to sprinkle some good news into this mix of preparation and worry for the intern class, as well as for those prospective students who are already thinking that far ahead. I’ve written about the technical aspects of the NCCAOM exams before. For information on the exams themselves and how the Academy’s program prepares its students, please read Passing the NCCAOM Exams for some helpful suggestions and answers to the basic questions. The information there is still extremely current and relevant.
In the meantime, there is some additional information that I want to pass along to bolster everyone’s confidence. We get regular word from our graduates that they are passing their exams and getting licensed. It seems lately like each week brings another email about a recent graduate’s success story (the emails are usually filled with lots of exclamation points. I can practically see them jumping up and down). We’re very proud of all of them, and it tells the administration that our students are well-prepared once they graduate. I’ve heard so many prospective students tell me that the TCM schools they have visited tell them not to go to a Five Element school because we can’t prepare them to pass their national exams. I would like to officially negate that statement here. It’s simply untrue. If Five Element acupuncture is calling you, don’t let fear of an exam stand in your way. You will be ready.
I say this as a reminder to our current intern class as well. I know you don’t always feel like you know “enough.” But your patients are getting better. That isn’t luck, that’s YOU and your ability. Remember that your patients are your guides, and working with them in clinic is real knowledge. They are helping to prepare you for your exams, and for your practice after graduation. So when you start getting nervous or overwhelmed I encourage you to talk to your friends from the classes before you. They’ve either already navigated the process successfully, or are in the midst of it. While they are a huge source of information, they’re also a huge source of comfort. Remember the community that you are a part of. Remember that they are there for you when you need them.
I’m not saying that these exams are easy, or that everyone will breeze through them. You’re not supposed to. My point is that they’re not the insurmountable obstacle that they sometimes appear to be. The success of your upperclassmen is proof enough of that. So take your time, focus on what’s in front of you. There will be plenty of time for exam nerves AFTER you graduate.
It seems a little insensitive, if not indecent to talk about the coming spring when each succeeding week in February has brought a new storm-turned-blizzard warning for the majority of the country. But while we’ve had our own share of fluctuating temperatures and disrupted patterns this winter, spring is already in the air down here in Gainesville. You can see it in the angles of the sun and the buds on the trees. Students have been sharing pictures of their gardens greening up with flowers and herbs. I’m waiting for the communal fruit offerings from the fruit trees in the interns’ yards to start appearing in the student lounge.
And you can definitely smell spring in the air. You just have to be careful how deeply you inhale, because with the buds on the live oak trees also comes the pollen from the live oak trees. Oh yes, the green stuff is everywhere now. Even so, it’s a good time of year to come and visit the Academy if you’re thinking of applying to the acupuncture program. The interns are busy in the acupuncture and herb clinics and Class 2016W will be back for Session 2 at the end of March for those interested in sitting in on a class.
This is also a good time to talk about what’s happening in nature through the lens of the Five Element cycle. Hopefully, the Five Element perspective will provide some understanding and reassurance to those of you unhappily (and happily) blanketed in snow . And I’d like to ask our student readers to post some of their pictures here to give the rest of you something to look forward to once that snow finally melts.
In the Five Element cycle, the Water element, associated with winter, brings forth Wood and springtime. All winter long, we’re supposed to rest, to replenish our reservoirs so that the seeds of life underneath the frozen surface have the strength to break through the ice and frozen crust. Water feeds the birth of spring, quietly nourishing natural life even though all looks dead. What looks barren is actually teeming with potential life. But that potential needs to store up its energy before it can begin the process of (re)birth. Pushing too hard against the natural flow of the Water element can leave us tired and out-of-balance for the rest of the year. Lao Tzu describes Water as soft, flexible and yielding, yet able to wear away the rocks in its river bed. Water has power over what is seemingly unbreakable. The message is that it is better to be flexible and soft rather than adamant and rigid.
Growing up in New England, I used to hate snow storms because it brought life to a standstill. You couldn’t go anywhere or do anything but sit with yourself. But that was exactly the point: I needed to sit with myself, to slow down and refill my reserves. Maybe snow storms aren’t such a bad thing if it means we take a moment to stop and look around at nature, at our families and our selves. They’re nature’s way of forcing us to rest. I’ll say it again, you can’t push too hard against the flow of Water without extreme depletion. Better to go with the flow- because there are rejuvenating benefits and ways to enjoy 3 feet of snow in your yard. You just have to be flexible enough to see them.
Which brings me to the promise of springtime: the return of birds and birdsong, green buds, the smell of the still-damp earth. Spring brings clarity to thought. Life suddenly seems full of possibility and new projects and ideas flood our brains. That’s healthy Wood energy. I’ve always thought that New Year’s should be celebrated in March on the equinox, because it feels like an actual rebirth. You shed the layers of clothing necessary in the dead of winter and experience freer, less encumbered movement. The emerging springtime energy of Wood makes us a little restless to get outside and DO, rather than hunker down and be still.
Think of a strong, upward movement, like the sound of a shout that forces air up and out of the body. That’s the movement of Wood energy. It enables growth, which, for humans, takes the form of planning and execution of ideas. We now possess the clarity to see our vision for the future. We can dream of goals and then take the steps to reach them. Healthy wood energy drives us forward. Exciting, wouldn’t you agree?
Looking at the world from the Five Element perspective provides understanding of the natural cycle, which in turn allows us to follow that cycle rather than fighting against it. For those of you bracing for another storm, I urge you to soften that stance. Your daily life may come to a standstill because the plows haven’t cleared your street. I know it’s hard when you can’t get to work, or fulfill your obligations outside of the home. But, my question to you is, what good does bracing do? Does worry and stress keep the storm from coming? Not usually. I give you the words of Lao Tzu:
Men are born soft and supple; dead they are stiff and hard. Plants are born tender and pliant; dead, they are brittle and dry. Thus whoever is stiff and inflexible is a disciple of death. Whoever is soft and yielding is a disciple of life. The hard and stiff will be broken. The soft and supple will prevail.
So, I encourage you to turn off the news and weather reports and take the time to rest and replenish, rather than further depleting your energy. Let go of the worry about the weather so that you can focus on something you can control. Spring is literally around the corner. The more rested and alert you are, the sooner you’ll see the beginnings of it.
The January flurry has come and gone. The Class of 2016 has finished their first intensive and they have headed home to begin integrating what they learned into their directed study. The interns of Class 28 returned from their winter break, refreshed and ready to hit the ground running. In addition to their acupuncture patients, they are now taking on patients in the herbal clinic (hint, hint. If anyone is interested in addressing their health needs through herbal medicine, call the clinic!). They have also spent the last week with renowned Botanist, 7Song, learning the fundamentals of Botany and plant science. Meanwhile, Class 29 arrived for their third session of herbal studies and the long fifth session of acupuncture training. By the end of their time with us they had taken (and passed) a point location exam on the CV/GV meridians and had their first clinical skills assessment.
Whew! Not exactly the peaceful stillness of winter that our Water element needs to replenish its stores. But hopefully, that’s what February is for.
As the herb students in Class 28H headed for Paynes Prairie on Wednesday for a day of plant study in nature, they reminded me of a central admissions question. Most prospective students call with their interest in the acupuncture program and ask about the herbal studies program like an afterthought. They want to know if the herbal program is a requirement and how many students take both the acupuncture and herbal programs simultaneously. A few are already definite in whether or not they are going to take the program and so the conversation moves forward quickly. But for those who have not made up their minds, the herbal program requires sincere consideration.
Herbal studies is not an afterthought, or something that we “tack onto” the acupuncture program. It is an ancient form of healing that was meant to be used as a complement to acupuncture treatment. It adds considerable breadth to one’s practice. The Academy’s program is 27 months long, taught in the intensive format just like the acupuncture program. The two programs are scheduled together because they are intended to be taken concurrently. Students graduate with their Master of Acupuncture degree and their Certificate in Herbal Studies at the same time, making it easier to move forward in the exam and licensing process. While the herbal and acupuncture clinics are technically separate (they run on different days of the week), they take place at the same stage of training so that students come down for one clinical year. Interns who get to treat a patient with acupuncture and herbs learn valuable information on the complementary nature of both systems of medicine. It also does wonders for furthering patient/practitioner rapport.
I’ll talk about the reasons to take the herbal studies program in a moment, but it is also important to consider reasons not to. There is the added tuition cost and the extra time students have to be in Gainesville for intensives. Herbal study also requires a LOT of memorization (you are essentially learning a new language with herbs), which few choose as their preferred learning style. Our Academic Dean always recommends studying 15 minutes of herbs every day. It sounds like so little, but when you’re already balancing one academic program with the daily demands of work, family and life, 15 minutes becomes a luxury.
So again, why study herbs? First and foremost, there may be a technical reason to do so. The state you want to practice in may require herbal training. Many states, Florida included, require practitioners to have studied herbs in order to become licensed. And several states are entertaining new regulations that will require successful passage of the NCCAOM Chinese Herbology exam. Put simply: herbal study might be a necessity if you want to practice acupuncture. Every state is different, though, so it’s important to contact your state acupuncture board to be certain. Keep in mind also that regulations change. If the state is leaning towards requiring herbal training when you start the program, legislation may go through in the 3 years it takes you to graduate. Additionally, 10 years after you graduate and get licensed you may find yourself moving to a state that requires herbal training. There is no license reciprocity between states. So, it’s best to be prepared from the beginning.
Additionally, our herbal program is an 8 Principle-based program that goes into greater depth on the patterns of disharmony that are fundamental to TCM theory. Students who take both the acupuncture and herbal program have an easier time studying and passing their NCCAOM exams because they’ve been working with and integrating the practice of TCM theory in a clinical setting. That isn’t to say that our Five Element acupuncture students don’t pass their boards. I can happily report that they DO pass their exams with the same regularity that TCM students do. But clinical experience goes a long way in helping to understand the concepts you’re studying for a test.
But there’s a better reason to take the herb program: you may love it. Students who were hesitant at first about taking the program often come back to me and tell me how much they love studying herbs. They never could have guessed before hand that memorizing the names and indications of each herb can be just as beautiful and poetic as studying the associations of the Five Elements. Herbal study asks students to think about the body, its systems and functions in a different way. Herbs are nature’s pharmacy after all, and discovering the different interactions, connections and correlations is absolutely fascinating. As a result, students have a better understanding of how the body falls out of balance and the various ways practitioners can right that balance.
Herbal studies interns will come to me and gush (literally gush) about how much they love being in the herb dispensary, how working with the herbs, smelling, touching and tasting them brings them to life. It broadens their prospective of what “natural” medicine is, how what we consume is so important to our health. It provides reverence for nature and the workings of the human body. The Botany class got to see that up-close and personal this week as they collected plant samples and learned about natural first aid remedies.
We have something of a tradition here at the Academy. Into each class is born the Herb Nerd. It is, admittedly, an unfortunate nickname but it is a compliment of the highest order. The Herb Nerd is crowned by the class as the member who seems to have a sixth sense about herbal study and usage. They are the ones who find the amazing organizational system for studying that enables the rest of the class to catch on. They are the ones who spend those extra hours with their herb kits, reading Bensky for fun and signing up for extra shifts in the dispensary. They do it for the love of herbs and what herbs can do for health and well-being. As I said, there’s one in every class. You never know, it might be you.
For more information on our Certificate in Herbal Studies, please contact Admissions directly or visit the program page of our website, www.acupuncturist.edu. For current students and practitioners seeking to delve further into the world of herbs, sign up for our two upcoming workshops with Thea Elijah on March 2nd and March 3rd.
“He who is not satisfied with himself will grow; he who is not sure of his own correctness will learn many things.”Posted: January 8, 2013
Yesterday we welcomed to newest cohort to Academy for Five Element Acupuncture. The winter class of 2016 began their first acupuncture intensive this week, starting Monday with a day of welcome and orientation. If you’ve been following our blog for awhile, you’ve read about (or maybe even experienced), the mixture of emotions that envelope staff, faculty and student alike. It’s a day of beginnings, of rememberings, of nerves, of joy. New people, new friends, and sometimes old friends or acquaintances finding themselves once again on the same path. It can be hard to settle into the nuts and bolts of orientation after the Opening Circle, but this cohort jumped right in and are well on their way as the newest members of the AFEA family.
The class will now spend several days with senior faculty member, Gary Dolowich learning the fundamentals of Five Element theory. Even though Gary literally wrote one of the books on Five Element theory, some of this material may seem too introductory, too shallow for some. Some of it may feel redundant if they’ve been reading or studying on their own before they decided to commit to a program. In recent years I’ve seen a trend of students finding practitioners who will mentor them before they start school. But there are some questions that have to be deferred until later, some ends that won’t be tied up until clinic. The basics are essential in this tradition of acupuncture. So, while the dedication to learn as much as possible beforehand is impressive, I should point out that such preparation is not necessary to succeed. There are many traits that go into making a student’s time at the Academy successful, but I think clarity of purpose is actually more important that academic preparation. That sense of knowing that the Five Element way of life is your path helps ground students when life and school get complicated beyond that exciting first day.
Many of our students don’t spend years waiting to start their acupuncture training. Many choose to jump right in when that sense of purpose comes to them. And yet they’re in class next to the students who have previous knowledge. Those of you who haven’t been through the first intensive may ask yourselves how this works with differing levels of knowledge. There’s a reason everyone starts at the same point (many reasons actually), but there’s one in particular that needs to be stated here.
No matter where you’re starting, it’s important to find a way to stay in the Beginner’s Mind. To revel in the new information and way of seeing the world; to let go of preconceived notions and ideas, letting them inform but not hinder new discoveries. Staying in the Beginner’s Mind allows students a chance to acclimate, but more importantly it promotes openness. Those students who can’t revel in Beginner’s Mind often have a harder time remembering that the world of Chinese medicine is gray. Two seemingly opposite ideas can be true at the same time, which is a hard lesson to reconcile for our Western brains. Those who are more open can accept the simultaneity of opposites and realize that they don’t have to choose one practitioner’s version over another. Instead, they can file both versions away and determine which one might work better for the specific patient they are seeing.
So, I refer you now to the Chinese proverb in the title of this blog post. The cohort that began their training today will grow because they were not satisfied with their paths. They have chosen to grow. That was clear when they initiated the admissions process. But now, it’s important to remember the second part of the proverb: “he who is not sure of his own correctness will learn many things.” Remember that no matter how much preparation you have, you can never be sure of your own correctness. Stay open, stay in the Beginner’s Mind and you will learn many things. It all starts today.
Please join me in welcoming this newest group of acupuncture students to the AFEA community. We’re excited to watch your journey.
The series “Clinical Impressions” will recommence in the new year.
My original post last week was supposed to share with you an acupuncturist’s guide for getting through the holiday season. A number of our students and graduates had been sharing the article and its suggestions were atypical and useful compared to most similar articles about holiday stress. However, in light of last Friday’s shootings in Newtown, CT I held back from posting something that seemed irrelevant and almost irreverent under the circumstances. And so I must diverge.
As a native of Connecticut, married to a man who grew up in Newtown and went to elementary school at Sandy Hook, this tragedy is personal. I got married in Newtown and I know the community. I’ve heard it described in recent days as storybookish, quiet, rural. It is all of those things. But the tragedy isn’t worsened by the fact that something so violent and shattering happened in such a quiet, out of the way place. It’s that it happened at all. And so, we grieve.
Grief in Five Element theory falls under the jurisdiction of the Metal element, which is associated with the season of Autumn. Autumn is the natural world’s representation of the process of grief, of letting go, sifting through what is most important and letting the unimportant fall away. This process calls for self-reflection and retrospection, inviting a search for meaning and providing space for us to receive wisdom and inspiration. We find ourselves bowing to the weight of grief now, with inspiration the farthest of hopes.
Nowhere in Five Element theory does it say that this process is quick or easy, or painless. It is simply natural, and one that we do not have to fight against. We must go through it and find the wisdom in the end as best we can. Together. Grief does not have to be isolating.
While it is not in the scope of this blog-space to enter into the political debates now swirling in the media, it is in the scope to offer love and support. I am uncomfortably aware of how little words can do in times of sorrow, but I offer them anyway in the hopes that they can provide a little solace. The more I think about the original article that I had planned to share last week, the more I think that some of the suggestions might be helpful in dealing with the shock and grief our nation is trying to cope with. So, I am sharing it with you to read whenever you’re ready to click here.
I urge you: get out into nature, forget the “shoulds” racing around in your brain, and go about your life with purpose. More importantly, love your loved ones a little harder, a little more expressively. Share that love with those you don’t know as intimately. Be kinder. Be gentler. Be more forgiving. And let these emotions be the light that guides you.
And so, I am taking this moment to reach out to the AFEA community and tell you that when we in the administration think of our loved ones, we include you in our thoughts and hearts. You are training yourselves and your senses to work with grief, sorrow and pain. Your skills are deeply needed in our society and the work that you do to spread healing in this world is of monumental value. Whether you are a practitioner, student, prospective student, or interested bystander, your positive, healing energy is what we need. Let it shine.
Welcome back everyone! I hope you enjoyed your Thanksgiving recesses. Here at Academy for Five Element Acupuncture, we welcome back our intern class, as well as the Class of 2015 who began their second intensive this week. The building is once again humming with energy. And, in Admissions, we’re in the final phases of putting together the Class of 2016. One more push to the end of the year for all of us!
In the meantime, it’s a good time to address one of the biggest sources of questions that I get from prospective students: the clinical residency in the third year of our master of acupuncture program. I’ve touched on the schedule slightly when I discussed the intensive structure, but this post will be the first of a series that provides greater detail on what to expect and how to prepare for the clinical year. Today, I’ll start generally by outlining how the structure of the program changes and what it means to be an intern in the student clinic. Subsequent posts will address clinic from the supervisors’ point of view, the interns’ point of view, and what the year means for an intern’s family.
So, let the demystification begin.
The clinical residency at AFEA, and other acupuncture schools, is the final stage of graduate training, where students treat patients under the guidance of licensed supervisors. The clinical residency is 12 months long, a full calendar year treating patients and continuing didactic work in the classroom. It is also a residential year, which means that those students who aren’t already living in the Gainesville, FL area, must relocate for the duration of the program.
One of the questions I get a lot is whether the clinical year can be broken up and finished over a longer period of time. For many students, our intensive session structure attracts them because they can go back and forth between school and home more easily. The relocation for the third year becomes the sticking point because they might not be able to conceive of how to be away from home for a full year. Every student handles this issue differently (and we’ll talk about that in a later post). But, for these students, it would be easier if they could continue commuting. Some want to know if they can complete their clinical training elsewhere, at another school* or through an apprenticeship-like arrangement with a local private practitioner. The short answer to each of these proposals is: No. The clinical year must be done on-site and cannot be broken up over a longer period of time.
While there are several reasons as to why, one the most compelling is patient rapport. Five Element practitioners focus heavily on developing rapport with their patients as it’s essential in being able to treat them on the deepest levels. This relationship of trust and acceptance is built over the treatment cycle. If an intern were to be in Gainesville for a month of clinic, go home and come back several months later for another month, or some other such schedule, this would cause an insurmountable disruption to the patient/practitioner relationship. Not to mention the loss of focus and skill in the intervening time periods. So, no, the residency is one, continuous year-long period of training that must be done in the Academy’s student clinic.
Before I wear anyone out with the details of the clinical year schedule, let me also say our schedule is typical of any acupuncture program. To learn the skills required to become a safe and effective practitioner, to pass one’s national exams, and to have the confidence necessary for starting one’s own practice, many, many hours must be dedicated to study. While daunting, the year is also one of the most rewarding. At no other time in a practitioner’s career will they be surrounded with the knowledge, love, and support of their classmates and their supervisors and teachers. That’s an immense amount of wisdom and experience to draw on throughout the learning process. This is important to keep in mind.
Students don’t arrive for the start of the year and jump into the clinic immediately. They go through several weeks of Internship Preparation. This includes everything from patient paperwork to how the clinic actually runs. The students are responsible for running the clinic- they greet patients, check on supplies, and keep the patient flow moving throughout the day. It’s the best way to give them a foundation to draw from when they’re in their own practices. So, rather than throwing students right into this, the first few weeks of the residency are spent learning the processes and procedures of the clinic. They also see their first patient in the Grand Rounds Style of observation, where supervisors join them in the treatment room for the first TD (traditional diagnosis). That first treatment is nerve-wracking enough, so it’s helpful to have as much support as possible. We give the students time to get their feet underneath them before they start seeing their own patients.
So once Internship Prep is complete, the interns do jump into scheduling their own patients, assisting their classmates, and treating. The clinic is open three days a week with the first appointment starting at 9 am and the last appointment ending at 8 pm. This is a long day with a lot of movement. Treating patients requires absolute focus and can be draining energetically in the beginning as interns learn the best ways to interact with each individual. This is one reason that we require students to live in Gainesville. Even the students who come from the Jacksonville area of Florida, which is only an hour and a half away, move. Going home after a clinical day, only to return for class at 9 am the next morning is tough enough without adding on a lengthy commute.
I should note that interns are not required to be in clinic from 9 am to 8 pm. In fact, it’s not recommended at all. But over the years, we’ve noticed a tendency for interns to hang around longer and longer. Sometimes, it’s easier to catch up on paperwork and updating files by just staying at school when they’re not treating. Interns must complete a certain number of treatments where they are the primary practitioner, and they also must complete a number of treatments where they are the assist for a classmate. If they stay on campus for the entirety of a clinical day, an assist slot might open, or a primary slot might become available and they can get in an extra treatment. While this demonstrates dedication and initiative, it also means less time to recuperate. So, with our most recent intern class we’ve instituted a policy where they have set days and times to sign up for primary treatments and set days and times when they can sign up for assists. We’re building in rest periods this way.
You might have noticed that I mentioned class as well as clinic. The clinic provides the hands-on experience of diagnosis, treatment planning, and needling. But in conjunction with that experiential learning is the processing of that experience. Every week the interns attend clinical seminar in which they can discuss their patients’ response to treatment and possibilities for future treatment. When an intern has a difficult patient (and difficult can mean many different things), they can work through strategies with their classmates and instructors. Instructors also teach more advanced concepts in clinical seminar that the interns are now able to consider and use in their treatments. And of course, every week brings more point location study. After all, you can never have enough point location practice.
So, with three days of clinic and a day of class, we’re already up to four days a week that the interns are on campus for some length of time. If the intern is also in the Chinese Herbal Studies program, they have a day of either class, or herbal clinic that they must attend each week. That’s a five day schedule right there, and to it, we can also add several weekend seminars that are scheduled throughout the year. We try to space the weekend classes out as much as possible to give students those much needed days to recharge. But no matter when they are scheduled, it still means being in class on a Saturday and Sunday, with clinic starting a new week on Monday. Being able to go home for lunch on these days is extremely helpful in being able to decompress for even an hour or so.
One last note: the administration has been scheduling the clinical year for many classes. They know what they’re doing and the teachers and supervisors have all been in the interns’ shoes. Our graduates look back on their clinical experience as the best part of their education. I try to remind the interns to soak up the experience while they are going through it because there is immense wisdom and support surrounding them that they can use to their betterment. It takes patience and perseverance, but in the end, their patients go home healthier and happier, and that is the best reward.
Stay Tuned for Part II: Clinical Impressions from the Intern Perspective.
It’s the week of Thanksgiving, and the interns have all headed for the hills to enjoy some much needed and well-deserved restorative time with their friends and families. Hopefully they will be able to replenish their Kidney stores over these next few days.
So, the general hum of purpose and activity inherent in intern classes has ceased. Administration is quiet, too, as we try to catch up on projects that were pushed aside to help with more immediate concerns. And soon, we’ll be on our way towards our own Thanksgiving restoratives.
In the lull of this week, I wanted to leave a short rumination on Thanksgiving, but as I began to write, I realized I couldn’t summarize the various kinds of holidays people will be sharing this week. Not everyone has family to go to. Not everyone likes turkey and mashed potatoes (and the general over-consumption of rich foods over the course of the day tends to fly in the face of what our students learn about dietary therapy). And as we hear more often at this time of year, food and warmth are in short supply for many.
So, I invite you to take a moment and embrace the humility of moments like these- where we have the opportunity to think about what is around us and what others are doing. And I’m going to let Rumi, that mystic master of eloquence, send a message of thankfulness to the universe.
Happy Thanksgiving everyone.
What Was Told, That
By Jalal al-din Rumi, translated by Coleman BarksWhat was said to the rose that made it open was said to me here in my chest. What was told the cypress that made it strong and straight, what was whispered the jasmine so it is what it is, whatever made sugarcane sweet, whatever was said to the inhabitants of the town of Chigil in Turkestan that makes them so handsome, whatever lets the pomegranate flower blush like a human face, that is being said to me now. I blush. Whatever put eloquence in language, that’s happening here. The great warehouse doors open; I fill with gratitude, chewing a piece of sugarcane, in love with the one to whom every that belongs!
Copies of this poem can be found at http://www.poetry.org
With the celebration of Veterans Day this past weekend, there has been a lot of attention paid to veterans in the last week or so. We take one day out of the year to specially honor their service and sacrifice. But many families are living with the war in their homes on a daily basis, either with partners overseas or partners who have returned injured or are unable to assimilate into their old lives. Veterans Day is a day of recognition, but it can also be about awareness. It should prompt us to ask, “What are we doing for these men and women the rest of the year?”
Most of us leave that question to the government, the doctors in the VA hospitals, and the other groups created to look out for veterans’ interests, the VFWs and American Legions. But here in Gainesville, we have a large number of veterans in the community and a large VA hospital that can’t always manage all of the men and women who need attention. The question of what more we can do to serve this important population doesn’t go away so easily. And so, in 2007 with the help of a Veteran who was also a patient in the student clinic, Academy for Five Element Acupuncture started a free veterans clinic. This dedicated clinic offers free acupuncture treatment to veterans and their immediate family members who are seeking more treatment options than the VA can offer them.
Every Thursday evening from 6:30 pm to 7:15 pm, we invite veterans to come to our clinic for treatment. The service is free and no appointments are necessary. Service members simply need to show military ID. Treatment is provided in a safe and comfortable group setting. No undressing is necessary. Talking is optional. Patients sit down, let the student practitioner insert several very thin acupuncture needles in their ears, close their eyes, and relax. The needles will do the work. We have vets who come every week, and those who only come occasionally. It’s free and voluntary, but it has created a wonderfully supportive community for those who participate.
The student practitioners follow what is called the NADA protocol, which uses five acupuncture points in the patients’ ears to help energy flow throughout the entire body. The protocol was designed to help people with addiction problems, but it’s scope is much larger than that. The veterans who have come to our clinic report being able to sleep for the first time in years. They have more energy, less anxiety and stress, an improved ability to focus, and their chronic pain decreases or goes away altogether. Most importantly, treatment helps to alleviate the sense of hyper-vigilance PTSD sufferers deal with and decreases the number of flashbacks they experience. Anyone who has watched a veteran deal with flashbacks or nightmares, unable to control them or tell reality from the scenario their brain is replaying, knows how amazing these last two outcomes are.
Our veterans clinic has grown since its inception in 2007. Articles in the Gainesville Sun have helped raise awareness of the service, and the VA hospital has begun recommending it to their patients. This partnership is essential in ensuring that those who need treatment are made aware of it. The VA has, by far, the largest reach. However, I began this blog post asking the question, “What more can we do?” This is where the rest of Gainesville can answer that question: tell the veterans in your life about the clinic. Tell them there is safe, effective, and non-invasive treatment available to them at no cost. Help us spread the word. Or, give someone a ride. Let the smallest ripples spread out to the larger pools of the population.
I’m posting this on Thursday, November 15th. Our student practitioners and their supervisors will be on hand in the veterans clinic tonight starting at 6:30 pm. Come see what it’s all about. And bring a friend.
The clinic at Academy for Five Element Acupuncture is thriving. This community isn’t spending much time worrying about how acupuncture works because they experience it firsthand, and then they share that experiences with others. Patients have questions in the beginning, they may be skeptical, but their conditions soon convince them to see for themselves what the talk is about. And then, all skepticism vanishes as they start to feel better after years of looking for relief through Western medicine that kept pushing them to take new pills. It’s a beautiful site to walk downstairs to the clinic reception desk and see patients hugging their interns after treatment. Everyone always looks so vibrant and rested when they leave.
Acupuncture has been continuously practiced for over 3,000 years. And yet skepticism persists in the Western world as to its efficacy, due mostly to its perceived lack of discernible cause. Clinical studies designed under the Western scientific framework have not been conclusive in finding out a biological explanation for how acupuncture works. As a result, many have dismissed positive outcomes as the placebo effect.
And yet, acupuncture is steadily gaining ground as a valid complement/alternative to traditional medical approaches regardless of what the scientific community reports. Why? Because too many people are experiencing results. They don’t necessarily need to know why or how. They feel better. Experience speaks louder than a controlled experiment in this case.
A lot of our patients come as referrals from family, friends, or other patients. These are trusted resources. But for those of you who haven’t had the pleasure of having your skepticism turned into curiosity, and that curiosity turned into an appointment, I’d like to share two recent articles with you.
The first article appeared in The Atlantic on September 11, 2012. Titled, “Biological Implausibility Aside, Acupuncture Works,” it was written by Lindsay Abrams. The article details a new study conducted by the Memorial Sloan-Kettering Cancer Center that studied the effectiveness of acupuncture for pain management. It included 18,000 patients and 29 randomized control groups. The results concluded that acupuncture was more effective than the controls in treating pain. Furthermore, “real” acupuncture was found to be more effective than “sham” acupuncture in treating pain (“real” acupuncture refers to practitioners needling acupuncture points, whereas “sham” acupuncture refers to when practitioners needle randomly on the body to simulate acupuncture). So, regardless of how it works, this study concluded that acupuncture is more than the placebo effect: it works.
The second article picks up where the first article leaves off, questioning why the Western scientific community remains so hostile and reluctant to admitting there’s more to acupuncture than they’ve been willing to allow. Written for the Huffington Post by Mark Schulman, president of Saybrook University, “What Acupuncture Can Teach Us About Science” questions that hostility. According to Schulman, that hostility stems from preconceived notions about science and biomechanics, as well as from the idea that “We don’t know how it works, therefore it must not.”
Schulman calls for an unleashing of the “scientific imagination” that he says gets strangled out of graduate students early on in their training. He says “there is still plenty of room for [the world] to surprise us.” Maybe it’s time for scientists to observe a little more closely what happens in a treatment room, and leave room for the fact that they may discover something completely outside of the standard paradigm. And maybe, maybe all of those studies linking the body and the mind aren’t so “alternative” after all.
Compassion and empathy are two qualities that science cannot afford to diminish in health care as they have been (those are “alternative” qualities). There is much to be said for a patient feeling cared for, heard and understood, in a word: believed. That’s part of the reason there’s hugging after appointments in our clinic. Patients appreciate the care they have received and there is trust between patient and intern.
As a new patient, I know I asked my intern dozens of questions about their thought process, point selection, what to expect, etc. I was intensely curious (and most likely a tad annoying). But now, I don’t ask questions. I let them work, and enjoy the fact that the health of my body, mind, and spirit are in capable hands. And I wish that experience for you, however you choose to find it.