Medical education since 1910

Mainly as a result of reforms following the Flexner Report of 1910^[81] medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.^{[n 11]} Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.^[83] Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,^[84] and engaging in complex clinical reasoning medical decision-making.^[85] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center in which education, research and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions which were not well understood in mechanistic terms and were not effectively treated by conventional therapies.^[56]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.^[86] Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine a member entity of the Cochrane Collaboration.^[87][88] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine MD.^[89] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam USMLE.^[89]

The British Medical Association, in its publication Complementary Medicine, New Approach to Good Practice 1993, gave as a working definition of non-conventional therapies including acupuncture, chiropractic and homeopathy: "those forms of treatment which are not widely used by the orthodox health-care professions, and the skills of which are not part of the undergraduate curriculum of orthodox medical and paramedical health-care courses".^[90] By 2000 some medical schools in the UK were offering CAM familiarisation courses to undergraduate medical students while some were also offering modules specifically on CAM.^[91]