California Acupuncture Board Decreases Herb Portion of Exam

[Guest guest]

What I see is that students don't even know what a formula is until they are in

the clinic (and this is after most of their formula classes are over). By this I

mean, how does one decide to use a formula, when and why do you modify, what are

the goals: short term and long term when using a particular formula?

 

As is often stated, Westerners need to see the big picture first in order to

understand the details. So we begin teaching that " this herb is for XYZ symptom "

and then a year later that this " formula fits this zang-fu " . Somehow students

are supposed to both retain individual herb information and integrate formula

usage together just as they are asked to implement it in the clinic.

 

No wonder it doesn't work.

Doug

>

> Just memorizing 350 herbs and then memorizing 250 formulas is not effective.

> Understanding how 100 herbs create 90% of the formulas should be the focus.

> As Huang Huang has written, 50 medicinals are the building blocks

> for almost the entirety of the Shang han za bing lun.

>

> Maybe we should learn herbs through formulas and not separate them by a

> year.

> Isn't that how it's taught in some places in China?

>

> K

>

[Guest guest]

Cliff,

I completely understand your dilemma. Most schools teach over 200

formulas,

because of the content on the National Boards herbs section.

 

Over 200 formulas within 9 months is understandably difficult to grasp in

its entirety.

The CA state boards only tests on 63 formulas,

so if you want to change the way the institutions teach,

then we need to change the licensing tests themselves.

 

If it was up to me, Z'ev's proposed class is the best way to teach formulas.

 

K

[Guest guest]

Thank you for a clear and brutally honest message. I really look forward to your

ideas in the next years as to the educational changes that could be made to this

process. Because you seem to be an " experienced " student I am sure you would

find Bob Flaws response of interest.

Doug

 

 

, " cliffrae2004 " <cliff wrote:

>

> Dear Folks and Mr. Stone especially,

>

> Thank you so much for writing your email. I am currently struggling in my

first Formulas class. As a student of educational theory and former math

teacher, I have to say that my school's current approach (8 to 13 new formulas

each week) is probably the best way to ensure that whatever CAN be memorized

successfully for short-term test taking will probably quickly be forgotten,

because, in most cases, it is not used and/or practiced immediately. I am

currently so over-whelmed that the class sometimes feels to me to be little more

than memorizing nonsense syllables; formulas differentiated in use by subtleties

of diagnosis which, as a novice, I only marginally comprehend. Frankly, it is a

nightmare. Instructors and administration members defend the status quo based

on... I don't know WHAT theory of educational success! To me, the focus in this

process is all on passing the Licensing Exam, and then afterward " you can do

what you want, " which is not really a basis for becoming a good practitioner or

building a successful practice. Other students I talk to about strategies for

getting through it admit TO A PERSON (!) that they don't remember most

formulas/formula classes already tested.

>

> Mr. Stone, where do you teach? I may be in the market for a new school!

>

> Thanks for listening,

> Cliff Rae

>

[Guest guest]

I think that's a pretty standard experience. You can try " reverse cueing "

as a memorization method.

The Chinese themselves have a great emphasis on memorization, but they

memorize the stuff in their native language. I think that makes a huge

difference.

 

 

 

-

" cliffrae2004 " <cliff

 

Friday, July 24, 2009 7:28 PM

Re: California Acupuncture Board Decreases Herb Portion of

Exam

 

 

> Dear Folks and Mr. Stone especially,

>

> Thank you so much for writing your email. I am currently struggling in my

> first Formulas class. As a student of educational theory and former math

> teacher, I have to say that my school's current approach (8 to 13 new

> formulas each week) is probably the best way to ensure that whatever CAN

> be memorized successfully for short-term test taking will probably quickly

> be forgotten, because, in most cases, it is not used and/or practiced

> immediately. I am currently so over-whelmed that the class sometimes

> feels to me to be little more than memorizing nonsense syllables; formulas

> differentiated in use by subtleties of diagnosis which, as a novice, I

> only marginally comprehend. Frankly, it is a nightmare. Instructors and

> administration members defend the status quo based on... I don't know WHAT

> theory of educational success! To me, the focus in this process is all on

> passing the Licensing Exam, and then afterward " you can do what you want, "

> which is not really a basis for becoming a good practitioner or building a

> successful practice. Other students I talk to about strategies for

> getting through it admit TO A PERSON (!) that they don't remember most

> formulas/formula classes already tested.

>

> Mr. Stone, where do you teach? I may be in the market for a new school!

>

> Thanks for listening,

> Cliff Rae

>

> , Al Stone <al wrote:

>>

>> I'm actually with Ben on simplification of the number of herbs and/or

>> formulas.

>>

>> This isn't about lowering the bar, this is about setting the bar at a

>> height where we can actually clear it!

>>

>> Memorizing 350 some-odd herbs in a year results in a skill set that has

>> no benefit to the clinical practice of Chinese medicine. The skill set

>> you obtain is how to memorize information to be regurgitated on a test.

>>

>> I find that simplification allows people to actually create a skeleton

>> upon which all the other organs, tissues and whatnot can be added in

>> time. However when we're given every single body part all at once, fat

>> chance on us ever putting it together.

>>

>> I used to write radio commercials and two points are commonly recognized:

>>

>> 1. For people to remember the content of a commercial, they must be

>> exposed to it five times.

>> 2. If you want to something to be remember from a commercial, focus on

>> ONE thing. That's it.

>>

>> Applying this to herb studies, as Z'ev mentioned, you gotta start out

>> with a limitiation. Isn't that an application of five phase thinking?

>> Nourishing and controlling phases need to be harmonious. Force-feeding

>> too many herbs at once is over-nourishing and under-controlling. Limit

>> the number of herbs and you'll increase their ability to actually use

>> them in clinic and later on in practice. As time goes on, we can (and do)

>> add to that framework.

>>

>> --

>> , DAOM

>> Pain is inevitable, suffering is optional.

>>

>>

>>

[Guest guest]

As a student in a NY school, our training is a little different - acupuncture

and herbs are separated (I am currently a practicing acupuncturist going to

school for herbs). In my school, we have a Kanpo formula class and a TCM

individual herbs class at the same time. Initially it's a little confusing to

learn formulas and individual herbs together. And yes, it's easier to learn the

formulas than the entire Materia Medica. But what starts to happen is that the

individual herbs aren't just these abstract things to memorize; instead, the

herbs connect with formulas which connected to stories of our instructors'

patientsan and eventually I have a relationship with the individual herbs. As a

student who has never been able to memorize well, and not for lack of trying,

this way of teaching was very useful.

 

So far we have learned 75 formulas, and will know 150 formulas by the time

school is done. 150 is way less than the 300 formulas I keep reading about on

this forum; but, I will have a closer relationship with the 150 formulas than if

I learned 300 formulas. True, I will have to do more study after school is out

(but that's what we OM practitioners do anyway).

Jennifer

Sent from my Verizon Wireless BlackBerry

 

 

" "

 

Sat, 25 Jul 2009 06:31:25

 

Re: California Acupuncture Board Decreases Herb Portion of Exam

 

 

What I see is that students don't even know what a formula is until they are in

the clinic (and this is after most of their formula classes are over). By this I

mean, how does one decide to use a formula, when and why do you modify, what are

the goals: short term and long term when using a particular formula?

 

As is often stated, Westerners need to see the big picture first in order to

understand the details. So we begin teaching that " this herb is for XYZ symptom "

and then a year later that this " formula fits this zang-fu " . Somehow students

are supposed to both retain individual herb information and integrate formula

usage together just as they are asked to implement it in the clinic.

 

No wonder it doesn't work.

Doug

>

> Just memorizing 350 herbs and then memorizing 250 formulas is not effective.

> Understanding how 100 herbs create 90% of the formulas should be the focus.

> As Huang Huang has written, 50 medicinals are the building blocks

> for almost the entirety of the Shang han za bing lun.

>

> Maybe we should learn herbs through formulas and not separate them by a

> year.

> Isn't that how it's taught in some places in China?

>

> K

>

 

 

 

 

 

 

[Guest guest]

In a real clinic, you can probably get by with knowledge of 100 Rx's, and

unless you're having to fulfill orders by fulfilling them yourselves,

you'll, in time, forget the ingredients...

 

On Sat, Jul 25, 2009 at 5:12 AM, <jmm752003 wrote:

 

>

 

 

--

Robert Chu, PhD, L.Ac. QME

chusauli

 

See my webpages at: www.chusaulei.com

 

 

 

[Guest guest]

I wondered if there would be any benefit to restructuring things so that

board exams could be taken periodically throughout one's education, not just

all at the end. Naturopaths take their basic science boards half way

through, and then boards in various therapeutics at the end of their

schooling.

 

 

 

Sean

 

 

 

 

[Guest guest]

Bill,

 

Fair enough, but I still think there is a problem with information and

passion retention when it comes to herbs in the groups of students supported in

their education. While I've heard many students call Five Branches - " Herbs, and

the other four branches " with a great line up of Chinese trained

physician-herbalists and impassioned teachers such as yourself laying down a

solid foundation to work with herbs, I can honestly say that I found less than

5% of students in their last year to have a real personal investment in

herbalism. It is my disappointment at this that has me offering up what I view

as questions rather than opinions.

 

Ben

 

 

 

 

 

 

 

 

plantmed2

Sat, 25 Jul 2009 05:00:47 +0000

Re: California Acupuncture Board Decreases Herb Portion of Exam

 

 

 

 

 

Well stated, Joey.

 

Ben and Al, I have to disagree. Ben, you're my friend and I respect your

opinion, but as a teacher of two materia medica classes, I don't see students

having a problem with learning the material if they are willing to do the work.

Very few of them fail to do it right. I didn't have a problem learning all the

herbs when I was a student, either. Did it take up about 30% - 40% of my

studying time? Yes. Do I think it was worth it? Absolutely. Do I forget info and

have to relearn it periodically? Of course. This is a lifetime endeavor, part of

what makes herbal medicine so interesting.

 

I do see a problem with students spending a huge portion of their time studying

for cumulative exams and exam preparation classes.

 

A pared-down version of materia medica will give them an incomplete foundation

in herbs. By the time they get around to studying the rest of them, they will

have failed to integrate those herbs into their understanding of the disease

patterns and the formulas. IMO, knowing how to modify formulas is at least as

important as understanding the formulas themselves. Without the entire arsenal

of herbs, this understanding will be incomplete.

 

- Bill

[Guest guest]

, " Bob Flaws " <bob wrote:

>

> Eric,

>

> I hope you don't mind if I continue devil's advocating.

 

Bob, these are excellent questions, and I must confess that I don't really have

the answers. However, I have a few observations that I feel might be useful.

 

You mentioned that most people studying Chinese medicine in China are fresh out

of high school, whereas many students in the West have already had developed

professional lives in separate, often unrelated fields. Western students are

often older and, as you said, have marriages, lovers, mortgages, children, etc.

To their credit, many of these older students turn out to be some of the best

practitioners because they have a lot of life experience and are incomparably

more mature than a student fresh out of high school or college.

 

Overall, our training in the U.S. is entirely geared towards becoming a

clinician in private practice. Some of the best clinicians use very few

formulas, very few medicinals, very direct logic, and very simple yet profound

treatments. A practitioner can achieve excellent results with their patients

regardless of whether they have mastered 40 points or 400 points, 40 formulas or

400 formulas. Academic development (scholarship) is a totally separate thing

from clinical practice. The problem is that both aspects are needed in our

community, and currently the " practical clinician " track and the " preparation

for post-graduate study " track are the same.

 

The schools need to have a program that is effective at training people in the

core herbs, the core points, and the core clinical decisions they need to help

their patients. Many students attend school while working full-time, while

raising children, or while planning for a future home and grounded life. These

people can't just flake off and spend 10 years of their life living like a broke

student studying with a teacher in Asia. Many of these people go on to become

awesome doctors to their patients and pay off their house in the process. They

apply the core principles of Chinese medicine well and they help endless

patients while simultaneously being a good parent or working on some other noble

pursuit. This group accounts for the majority of students, and would be well

suited to a " practical clinician " track of education.

 

A practical clinician track could focus on herbal medicine, acupuncture, or

both, and it could have classes of different levels of depth and intensity, like

a normal and honor's program. Those who planned to have herbal medicine as a

more background feature of their life could focus on learning 50 formulas and

the basic principles of herbal medicine, without having to suffer through

needless cramming that they neither enjoy nor retain.

 

A parallel track in education, the " preparation for post-graduate study " track

could draw a different type of student. Someone who wants to dive into a 20

year career of learning could use this track as a starting point. It could have

only students that want to study hard, that really want to know how to use 400

herbs. Currently, the problem is that students only have one class to choose

from, so the people that wanted the honor's class have to have their curriculum

pared down to prevent the people that want the basic class from complaining

about the difficulty. At this point, I think there is adequate demand for both

an honor's class and a basic class.

 

Bob asked the question about whether or not teachers could be found to teach the

honor's classes. To this, I would first mention that good teachers, whether in

China or the West, are relatively rare gems. (There are more in China because

the scale of the medicine and population is larger, but language remains a

critical barrier to accessing most of the best teachers over there.) Good

teachers are rarely motivated by money. Teachers are relatively poorly paid,

but teachers choose teaching for the love of it. As a teacher, it is easy to

lose the love for it if most of your students don't really have any interest in

learning about advanced herbal medicine or whatever it is that you teach.

Teachers would be more motivated and easier to recruit if they could simply

teach the students that WANT to be there, rather than all the students that HAVE

to be there.

 

Many potentially good teachers get frustrated when all the students care about

is the test. Some of the students truly want to learn as much as possible and

want to go as far as possible, but we can't really target the class towards

these students because they are in the minority. Most students just want to be

basic, safe, and generally competent practitioners, and frankly Chinese medicine

is not rocket science nor is it generally dangerous. Students that want to get

through school, get their license, and focus on their practice and their family

should have a mellow, interesting, and relatively easy education available.

 

For the students that really want to excel, giving them an honor's track would

foster a lot of growth in the field. It would help to attract young, bright

minds and it would give a slightly elite environment that would encourage people

to think of a more advanced education as a privileged opportunity that is worth

working for. Some of the best teachers around would love to teach such a

cohort.

 

Bob mentioned that there are few good teachers out there that could teach the

honor's course, but actually I think that there are many good teachers that

could come out of the woodworks if they really stood behind what the school was

doing. Consider teachers like Marnae Ergil and Kevin Ergil, at the Finger Lakes

school associated with NYCC. They are true experts and great professional

teachers. They work in an institution with amazing facilities, endowments, and

even a reasonable salary. They are one step outside of the office-complex

acupuncture school model, they are more like faculty in mainstream academia.

The more we have excellent teachers and alliances with the scientific and global

academic communities, the more we can think outside the box of what is possible

at an acupuncture school in America.

 

While most teachers aren't such lucky souls to teach at an institution with the

resources that NYCC has, there are a lot of people in the early generation who

have spent their lives studying and advancing their knowledge. Let's face it,

none of us have had a stellar starting education. It doesn't matter if you

graduated 5 years ago or first started studying 30 years ago. It doesn't even

matter if you went to China and studied there. At the beginning stage of TCM

knowledge acquisition, we are all beginners and most of the basic training is

mediocre. Some have better foundations and starting resources, but the thing

that really matters is what one does after graduation.

 

People like Bob Flaws or started out in a time when good

materials were scarce, but they dedicated their lives to learning as much as

they could over decades. On the flip side, there are younger people like

Suzanne Robidoux or Charlie Thomson, who began their studies in the better but

still imperfect modern acupuncture schools and went on to travel to China for

extensive advanced training. Good potential teachers from both the old and new

generations of practitioners could come out in droves if there were highly

motivated classes of students to teach. Plus, we cannot forget that motivated

students would inspire some great Chinese teachers, like Yuan Wang in San Diego

or Xiao Tian-Shen in Austin.

 

The problem is the one-size-fits-all model that forces students who really don't

want to use herbs into the same class as the students that want to excel in

herbs. It isn't satisfying for the students or the teachers, and it isn't

effective as an educational strategy. If students could tailor the difficulty

of their program to their goals, skill, and preferences, it would be greatly

improved.

 

I am all for having a pared-down, relatively easy route of training, I just

don't think it should be the only thing we have. At the end of the day, you

can't say that a high-performance scholar is any better than a busy parent that

remembers only 10 formulas but has an incredible gift with healing. By nature,

people with more going on in their lives cannot devote as much time to studying

formulas as someone with nothing else to do. But a professional field cannot be

defined exclusively by those who can only devote 40% of their life to the field.

 

To make an analogy about clinicians vs. scholars in TCM, let me use the example

of music. Some people just want to play an instrument, while others want their

life to revolve around being a musician. Anyone should be able to play and

practice an instrument as much or as little as they want; it can be played with

great skill or just for fun, and doesn't necessarily require advanced classroom

training. The recently famous musical performance of Susan Boyle was a perfect

example of the brilliance that can come through even in the absence of strong

formal training. But in the world of the educated and elite musicians, the

field of music can be intensely deep for the small minority of people that truly

live for it. Some of the music professionals understand it to a crazy degree

that I cannot even comprehend, and the field of music needs to have an

environment that fosters the development of these artists. I think the TCM

field needs this high threshold of encouragement as well.

 

A few short answers to some of Bob's well-phrased dilemmas below:

 

> 1. Where are these post-graduate teachers you are referencing? Certainly such

exist in China, but how many of our graduates can spend meaningful time in China

post-grad when amny of them are $100K in debt?

 

Yes, I am referring to China. Without a doubt, finances and timing hold back

many possibilities in life for everyone. Regardless of whether the limiting

factor is family, money, or whatever, post-graduate stuff is not for most

people. It isn't even really necessary in Chinese medicine if one doesn't care

about being on the cutting edge. As I said before, the best doctors still use

the same 40 formulas.

 

However, post-graduate stuff is FUN. It expands your world. Those few people

that do go on to study Chinese and do post-graduate stuff invariably love it if

they groove with the culture and the experience of being abroad. They have a

safe and guaranteed route to professional success, and the temporary pain of

learning Chinese grammar, like the temporary pain of memorizing herbs, quickly

wears off once the skills are acquired and the doors open up. The problem is

that not enough people know how many opportunities exist just by making the

simple decision to look at the post-graduate world. If more people realized how

many opportunities there are in Asia, people would flock to learn Chinese, tons

of new material would come back with them, and virtually all of the problems

that this thread discusses would be greatly improved in just one or two

generations.

 

 

> 2. While I agree that we are just as smart as Chinese students, there are some

important differences that must be taken into account:

>

> A. We are asking our students to learn two forms of medicine (albeit related

and somewhat overlapping) in three years, each of which take four years to learn

in China.

 

This is true. There is a problem in that most students are trained in both

acupuncture and herbs, but do not necessarily have a strong interest or strong

training in both. Either field takes much longer than four years to learn well,

but Western students don't yet think of acupuncture school graduation as a

starting point, they see it as an ending point.

 

> B. Chinese students start TCM education at 18 and then study full-time in a

live-in environment. Our students typically have jobs (at least part-time),

lovers, families, and other impedimenta that Chinese students do not, at least

not when I was a student there.

 

True, as mentioned above.

 

As an aside, if there is one thing that Westerners bring to TCM that is a unique

and valuable contribution, it is our communication style, which is well-suited

to our patient population. We learn to communicate through our personal and

work relationships, so we often see beginning students in the West that have a

better degree of self-actualization and expression than an 18 year old can

typically start with. (Mind you, starting at age 18 is part of what makes it

possible to have a mentor with 50+ years of experience in China.)

 

> C. Chinese students are studying in their own language taught by teachers

speaking their own language and have access to the full literature of our

profession in their own language, the language this medicine was created in.

 

Very good point here. Another not trivial feature of this argument is the fact

that Chinese people can memorize formulas with songs. Even a Westerner that is

fluent in Chinese can rarely use the songs well, and without the songs true

memorization of all those formulas is virtually impossible for most people. The

simple fact that Pinyin is foreign to most students is a huge hurdle with herbal

medicine. I think knowing Pinyin alone helped me to be a better herbs student,

because I didn't need to waste energy on remembering seemingly random syllables.

(Ironically, it was actually just an offhand comment from the admissions adviser

about learning Chinese that made me study it before TCM school in the first

place. It was the best thing I ever did, at least for my particular interests

and lifestyle.)

 

 

> D. Teachers in China are professional, full-time teachers taught to teach this

material. Clinical mentors in China have 10-50 years experience.

 

I agree about the clinical mentors. However, there are some really lousy

teachers in China that really don't know how to teach. Droning lectures is the

norm. But get an awesome doctor over a meal of Peking duck, and you can learn a

ton.

 

> These are practically meaningful differences, and any solutions offered to our

profession's current academic problems need to take these factors into account.

In other words, it's one thing to come up with ideal solutions, but another to

implement those solutions in the world as lived and experienced.

 

I get it, says the idealistic youth.

 

Eric Brand

[Guest guest]

Eric,

 

Good answers.

 

As for the poor teachers in China, no surprise there since this is how most

Chinese teachers teach here. If one is not taught how to teach, one teaches how

they themselves were taught. But, is it not true that, in the udnergraduate

programs in China, all the teachers teach to the same standard in terms of

material? I'm interested in hearing your feedback about this since, here, the

way we hire faculty results on a very " eclectic " situation (to put it nicely)

with few standards and little quality control that I can see.

[Guest guest]

The problem I see is this. There may be a few gifted healers that can get

amazing results with limited amount of knowledge, but this is the exception

not the rule. I find that the majority of graduating students do not have

enough training to effectively practice herbs. Consequently, they do not get

the results they expect and end up doing less and less herbs over time,

replacing them with or other therapies. I am surrounded with graduating

students / practitioners and even the most gifted healers struggle with

herbs (and usually phase it out). One needs to study hard to get it (herbs)

even if they have a gift.

 

 

 

Training 'want to be clinicians' with a simplified curriculum is no

guarantee that they are going to get better or even equal results.

Furthermore I did find your comment funny, something along the lines of, we

can make a program for students that don't want to study hard. Hhmmm. I

wonder if a potential patient would think that the practitioners I want to

see is the one that didn't want to study hard.- Back to the music. Of

course there are a few gifted musicians that have no training and with

little practice can actually make decent music. However, being inundated in

the music world since birth, I can tell you that most of the time these

people just make noise. So it is all about the percentages. We need tp

maximize our graduates odds for success in treating disease. It is my

opinion that most people need structure and rigorous study. Otherwise I

would see herbalists everywhere that were rocking and that did not study, I

don't really see these people. Not to put down anyone, but maybe these type

of people are best suited for acupuncture. Just an idea.

 

 

 

So I completely disagree that one should be able to study as hard (or

little) as one wants and still be licensed to practice herbs. To me, this is

unethical. Herbs are hard and take time. Acting like one can learn a few

formulas and treat everything is IMO not very likely. But the point Eric I

think is missing is that yes there are great doctors that use 40-50

formulas, but they usually know many more formulas than that, and they know

how to modify these formulas for the individual. They use ideas from other

formulas (e.g. dui yaos). Or as in Taiwan will combine many formulas

together based on the individual. All of this on the surface may look easy,

but almost all of them have lots of study and experience behind them.

 

 

 

-

 

 

 

 

 

 

On Behalf Of Eric Brand

Saturday, July 25, 2009 1:18 PM

 

Re: California Acupuncture Board Decreases Herb Portion of

Exam

 

 

 

 

 

 

<%40> , " Bob Flaws " <bob wrote:

>

> Eric,

>

> I hope you don't mind if I continue devil's advocating.

 

Bob, these are excellent questions, and I must confess that I don't really

have the answers. However, I have a few observations that I feel might be

useful.

 

You mentioned that most people studying Chinese medicine in China are fresh

out of high school, whereas many students in the West have already had

developed professional lives in separate, often unrelated fields. Western

students are often older and, as you said, have marriages, lovers,

mortgages, children, etc. To their credit, many of these older students turn

out to be some of the best practitioners because they have a lot of life

experience and are incomparably more mature than a student fresh out of high

school or college.

 

Overall, our training in the U.S. is entirely geared towards becoming a

clinician in private practice. Some of the best clinicians use very few

formulas, very few medicinals, very direct logic, and very simple yet

profound treatments. A practitioner can achieve excellent results with their

patients regardless of whether they have mastered 40 points or 400 points,

40 formulas or 400 formulas. Academic development (scholarship) is a totally

separate thing from clinical practice. The problem is that both aspects are

needed in our community, and currently the " practical clinician " track and

the " preparation for post-graduate study " track are the same.

 

The schools need to have a program that is effective at training people in

the core herbs, the core points, and the core clinical decisions they need

to help their patients. Many students attend school while working full-time,

while raising children, or while planning for a future home and grounded

life. These people can't just flake off and spend 10 years of their life

living like a broke student studying with a teacher in Asia. Many of these

people go on to become awesome doctors to their patients and pay off their

house in the process. They apply the core principles of Chinese medicine

well and they help endless patients while simultaneously being a good parent

or working on some other noble pursuit. This group accounts for the majority

of students, and would be well suited to a " practical clinician " track of

education.

 

A practical clinician track could focus on herbal medicine, acupuncture, or

both, and it could have classes of different levels of depth and intensity,

like a normal and honor's program. Those who planned to have herbal medicine

as a more background feature of their life could focus on learning 50

formulas and the basic principles of herbal medicine, without having to

suffer through needless cramming that they neither enjoy nor retain.

 

A parallel track in education, the " preparation for post-graduate study "

track could draw a different type of student. Someone who wants to dive into

a 20 year career of learning could use this track as a starting point. It

could have only students that want to study hard, that really want to know

how to use 400 herbs. Currently, the problem is that students only have one

class to choose from, so the people that wanted the honor's class have to

have their curriculum pared down to prevent the people that want the basic

class from complaining about the difficulty. At this point, I think there is

adequate demand for both an honor's class and a basic class.

 

Bob asked the question about whether or not teachers could be found to teach

the honor's classes. To this, I would first mention that good teachers,

whether in China or the West, are relatively rare gems. (There are more in

China because the scale of the medicine and population is larger, but

language remains a critical barrier to accessing most of the best teachers

over there.) Good teachers are rarely motivated by money. Teachers are

relatively poorly paid, but teachers choose teaching for the love of it. As

a teacher, it is easy to lose the love for it if most of your students don't

really have any interest in learning about advanced herbal medicine or

whatever it is that you teach. Teachers would be more motivated and easier

to recruit if they could simply teach the students that WANT to be there,

rather than all the students that HAVE to be there.

 

Many potentially good teachers get frustrated when all the students care

about is the test. Some of the students truly want to learn as much as

possible and want to go as far as possible, but we can't really target the

class towards these students because they are in the minority. Most students

just want to be basic, safe, and generally competent practitioners, and

frankly Chinese medicine is not rocket science nor is it generally

dangerous. Students that want to get through school, get their license, and

focus on their practice and their family should have a mellow, interesting,

and relatively easy education available.

 

For the students that really want to excel, giving them an honor's track

would foster a lot of growth in the field. It would help to attract young,

bright minds and it would give a slightly elite environment that would

encourage people to think of a more advanced education as a privileged

opportunity that is worth working for. Some of the best teachers around

would love to teach such a cohort.

 

Bob mentioned that there are few good teachers out there that could teach

the honor's course, but actually I think that there are many good teachers

that could come out of the woodworks if they really stood behind what the

school was doing. Consider teachers like Marnae Ergil and Kevin Ergil, at

the Finger Lakes school associated with NYCC. They are true experts and

great professional teachers. They work in an institution with amazing

facilities, endowments, and even a reasonable salary. They are one step

outside of the office-complex acupuncture school model, they are more like

faculty in mainstream academia. The more we have excellent teachers and

alliances with the scientific and global academic communities, the more we

can think outside the box of what is possible at an acupuncture school in

America.

 

While most teachers aren't such lucky souls to teach at an institution with

the resources that NYCC has, there are a lot of people in the early

generation who have spent their lives studying and advancing their

knowledge. Let's face it, none of us have had a stellar starting education.

It doesn't matter if you graduated 5 years ago or first started studying 30

years ago. It doesn't even matter if you went to China and studied there. At

the beginning stage of TCM knowledge acquisition, we are all beginners and

most of the basic training is mediocre. Some have better foundations and

starting resources, but the thing that really matters is what one does after

graduation.

 

People like Bob Flaws or started out in a time when good

materials were scarce, but they dedicated their lives to learning as much as

they could over decades. On the flip side, there are younger people like

Suzanne Robidoux or Charlie Thomson, who began their studies in the better

but still imperfect modern acupuncture schools and went on to travel to

China for extensive advanced training. Good potential teachers from both the

old and new generations of practitioners could come out in droves if there

were highly motivated classes of students to teach. Plus, we cannot forget

that motivated students would inspire some great Chinese teachers, like Yuan

Wang in San Diego or Xiao Tian-Shen in Austin.

 

The problem is the one-size-fits-all model that forces students who really

don't want to use herbs into the same class as the students that want to

excel in herbs. It isn't satisfying for the students or the teachers, and it

isn't effective as an educational strategy. If students could tailor the

difficulty of their program to their goals, skill, and preferences, it would

be greatly improved.

 

I am all for having a pared-down, relatively easy route of training, I just

don't think it should be the only thing we have. At the end of the day, you

can't say that a high-performance scholar is any better than a busy parent

that remembers only 10 formulas but has an incredible gift with healing. By

nature, people with more going on in their lives cannot devote as much time

to studying formulas as someone with nothing else to do. But a professional

field cannot be defined exclusively by those who can only devote 40% of

their life to the field.

 

To make an analogy about clinicians vs. scholars in TCM, let me use the

example of music. Some people just want to play an instrument, while others

want their life to revolve around being a musician. Anyone should be able to

play and practice an instrument as much or as little as they want; it can be

played with great skill or just for fun, and doesn't necessarily require

advanced classroom training. The recently famous musical performance of

Susan Boyle was a perfect example of the brilliance that can come through

even in the absence of strong formal training. But in the world of the

educated and elite musicians, the field of music can be intensely deep for

the small minority of people that truly live for it. Some of the music

professionals understand it to a crazy degree that I cannot even comprehend,

and the field of music needs to have an environment that fosters the

development of these artists. I think the TCM field needs this high

threshold of encouragement as well.

 

A few short answers to some of Bob's well-phrased dilemmas below:

 

> 1. Where are these post-graduate teachers you are referencing? Certainly

such exist in China, but how many of our graduates can spend meaningful time

in China post-grad when amny of them are $100K in debt?

 

Yes, I am referring to China. Without a doubt, finances and timing hold back

many possibilities in life for everyone. Regardless of whether the limiting

factor is family, money, or whatever, post-graduate stuff is not for most

people. It isn't even really necessary in Chinese medicine if one doesn't

care about being on the cutting edge. As I said before, the best doctors

still use the same 40 formulas.

 

However, post-graduate stuff is FUN. It expands your world. Those few people

that do go on to study Chinese and do post-graduate stuff invariably love it

if they groove with the culture and the experience of being abroad. They

have a safe and guaranteed route to professional success, and the temporary

pain of learning Chinese grammar, like the temporary pain of memorizing

herbs, quickly wears off once the skills are acquired and the doors open up.

The problem is that not enough people know how many opportunities exist just

by making the simple decision to look at the post-graduate world. If more

people realized how many opportunities there are in Asia, people would flock

to learn Chinese, tons of new material would come back with them, and

virtually all of the problems that this thread discusses would be greatly

improved in just one or two generations.

 

> 2. While I agree that we are just as smart as Chinese students, there are

some important differences that must be taken into account:

>

> A. We are asking our students to learn two forms of medicine (albeit

related and somewhat overlapping) in three years, each of which take four

years to learn in China.

 

This is true. There is a problem in that most students are trained in both

acupuncture and herbs, but do not necessarily have a strong interest or

strong training in both. Either field takes much longer than four years to

learn well, but Western students don't yet think of acupuncture school

graduation as a starting point, they see it as an ending point.

 

> B. Chinese students start TCM education at 18 and then study full-time in

a live-in environment. Our students typically have jobs (at least

part-time), lovers, families, and other impedimenta that Chinese students do

not, at least not when I was a student there.

 

True, as mentioned above.

 

As an aside, if there is one thing that Westerners bring to TCM that is a

unique and valuable contribution, it is our communication style, which is

well-suited to our patient population. We learn to communicate through our

personal and work relationships, so we often see beginning students in the

West that have a better degree of self-actualization and expression than an

18 year old can typically start with. (Mind you, starting at age 18 is part

of what makes it possible to have a mentor with 50+ years of experience in

China.)

 

> C. Chinese students are studying in their own language taught by teachers

speaking their own language and have access to the full literature of our

profession in their own language, the language this medicine was created in.

 

Very good point here. Another not trivial feature of this argument is the

fact that Chinese people can memorize formulas with songs. Even a Westerner

that is fluent in Chinese can rarely use the songs well, and without the

songs true memorization of all those formulas is virtually impossible for

most people. The simple fact that Pinyin is foreign to most students is a

huge hurdle with herbal medicine. I think knowing Pinyin alone helped me to

be a better herbs student, because I didn't need to waste energy on

remembering seemingly random syllables. (Ironically, it was actually just an

offhand comment from the admissions adviser about learning Chinese that made

me study it before TCM school in the first place. It was the best thing I

ever did, at least for my particular interests and lifestyle.)

 

> D. Teachers in China are professional, full-time teachers taught to teach

this material. Clinical mentors in China have 10-50 years experience.

 

I agree about the clinical mentors. However, there are some really lousy

teachers in China that really don't know how to teach. Droning lectures is

the norm. But get an awesome doctor over a meal of Peking duck, and you can

learn a ton.

 

> These are practically meaningful differences, and any solutions offered to

our profession's current academic problems need to take these factors into

account. In other words, it's one thing to come up with ideal solutions, but

another to implement those solutions in the world as lived and experienced.

 

I get it, says the idealistic youth.

 

Eric Brand

 

 

 

 

 

 

[Guest guest]

In regard to the statement " no one retains it anyway " I have a few things to

say.

 

 

 

Studying herbs in school is just the first pass. I do not think anyone

expects the students to memorize and retain all the information contained

within the formula/herbs descriptions. This is just a foundation and

exposure to the topic. It teaches one the ideas and methodology in learning

how to study the topic. One must study for years reviewing the information

and building upon the core ideas. One should never have the illusion that

one just studies the material in the classes and then should be able to

practice a high level medicine. However, if one is never is exposed to the

majority of formulas or medicinals while in school, the chance of them

branching out in the future is slim. I cannot count the number of times that

I've reviewed fundamental/basic information. Although one may have forgotten

something from a class, when reviewed, it quickly comes back and you then

can make new connections, based on new knowledge, and learn that material on

a deeper level. This is just the basic learning process.

 

 

 

Furthermore, one should not have to read Chinese to effectively teach this

topic. There is enough translated material to present the foundation. One's

teaching skills is what actually counts at this level. However, one actually

should have a good working knowledge of herbs to actually teach herbs. I

think what people are pointing out is that some teachers are not teaching

the core material and teaching other ideas related to herbs, possibly not

related to mainstream Chinese medicine. This is of course problematic. I see

this as just a curriculum issue related to the school, not a language issue.

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

On Behalf Of ben zappin

Saturday, July 25, 2009 10:58 AM

chineseherb academy

RE: Re: California Acupuncture Board Decreases Herb Portion

of Exam

 

 

 

 

 

Bill,

 

Fair enough, but I still think there is a problem with information and

passion retention when it comes to herbs in the groups of students supported

in their education. While I've heard many students call Five Branches -

" Herbs, and the other four branches " with a great line up of Chinese trained

physician-herbalists and impassioned teachers such as yourself laying down a

solid foundation to work with herbs, I can honestly say that I found less

than 5% of students in their last year to have a real personal investment in

herbalism. It is my disappointment at this that has me offering up what I

view as questions rather than opinions.

 

Ben

 

 

<%40>

plantmed2 <plantmed2%40gmail.com>

Sat, 25 Jul 2009 05:00:47 +0000

Re: California Acupuncture Board Decreases Herb Portion of

Exam

 

Well stated, Joey.

 

Ben and Al, I have to disagree. Ben, you're my friend and I respect your

opinion, but as a teacher of two materia medica classes, I don't see

students having a problem with learning the material if they are willing to

do the work. Very few of them fail to do it right. I didn't have a problem

learning all the herbs when I was a student, either. Did it take up about

30% - 40% of my studying time? Yes. Do I think it was worth it? Absolutely.

Do I forget info and have to relearn it periodically? Of course. This is a

lifetime endeavor, part of what makes herbal medicine so interesting.

 

I do see a problem with students spending a huge portion of their time

studying for cumulative exams and exam preparation classes.

 

A pared-down version of materia medica will give them an incomplete

foundation in herbs. By the time they get around to studying the rest of

them, they will have failed to integrate those herbs into their

understanding of the disease patterns and the formulas. IMO, knowing how to

modify formulas is at least as important as understanding the formulas

themselves. Without the entire arsenal of herbs, this understanding will be

incomplete.

 

- Bill

 

 

 

 

 

 

[Guest guest]

Cliff,

 

I've been following this discussion thread with interest, as designing

software for TCM herbal education has been a central focus of our

efforts at RMHI for the past 10 years.

 

I'm gratified that someone sees the relevance of modern educational

theory and research to this problem. I've written several articles on

this topic, so I won't belabor them here:

 

 

http://www.rmhiherbal.org/review/2002-2.html

Computer-aided instruction in TCM clinical analysis and decision-

making skills

 

http://www.rmhiherbal.org/review/2004-2.html

Why TCM Herbology needs to become an independent profession, separate

from acupuncture

 

http://www.rmhiherbal.org/review/2008-1.html

The history behind HerbalThink-TCM software - why it was developed

 

 

---Roger Wicke PhD

Rocky Mountain Herbal Institute

website: http://www.rmhiherbal.org/

email: http://www.rmhiherbal.org/contact/

 

 

 

On 2009.Jul.25, at 15:43, wrote:

 

> 2.3. Re: California Acupuncture Board Decreases Herb Portion of Exam

> Posted by: " cliffrae2004 " cliff cliffrae2004

> Fri Jul 24, 2009 11:10 pm ((PDT))

>

> Dear Folks and Mr. Stone especially,

>

> Thank you so much for writing your email. I am currently struggling

> in my first Formulas class. As a student of educational theory and

> former math teacher, I have to say that my school's current approach

> (8 to 13 new formulas each week) is probably the best way to ensure

> that whatever CAN be memorized successfully for short-term test

> taking will probably quickly be forgotten, because, in most cases,

> it is not used and/or practiced immediately. I am currently so over-

> whelmed that the class sometimes feels to me to be little more than

> memorizing nonsense syllables; formulas differentiated in use by

> subtleties of diagnosis which, as a novice, I only marginally

> comprehend. Frankly, it is a nightmare. Instructors and

> administration members defend the status quo based on... I don't

> know WHAT theory of educational success! To me, the focus in this

> process is all on passing the Licensing Exam, and then afterward

> " you can do what you want, " which is not really a basis for becoming

> a good practitioner or building a successful practice. Other

> students I talk to about strategies for getting through it admit TO

> A PERSON (!) that they don't remember most formulas/formula classes

> already tested.

>

> Mr. Stone, where do you teach? I may be in the market for a new

> school!

>

> Thanks for listening,

> Cliff Rae

[Guest guest]

I agree with Jason. If somebody doesn't want to put in the extensive work it

takes to learn herbs, they should probably just study acupuncture. Ben's point

about many graduating students being unmotivated to use herbs confirms this. In

California, that's not an option, though.

 

I think we all can agree that learning herbs by rote memorization alone will

kill motivation and understanding. Memorization is necessary, but there are

other things we can do to help enhance understanding and interest. Maybe this

should be a new thread, but I would be very interested to hear some ideas that

herb teachers have for achieving this. I'll start with a few things that I do in

this regard:

 

1. Show slides of the actual plants, along with the herbs as they appear in

commerce. Discuss the habitat and how to cultivate it, if I have that info. Show

them sources of seeds and live plants to grow the herbs. Mention local plants

that are related.

 

2. Since I teach theory as well as herbs, whenever I teach a new pathology, I

ask them which herbs can be used for that pattern or condition.

 

3. I haven't taught formulas for 12 years, but when I did, I would put samples

of a dozen or so different herbs on the table and ask them to construct two

classical formulas and make up one of their own, explaining why they chose each

herb.

 

4. When I have a student who is completely sensory with no memorizing ability, I

take them into the herb room, have them close their eyes, and let them smell and

feel the herbs, while they say the name over and over. That seems to help it

stick.

 

5. When teaching materia medica, I always show them the formulas that the herbs

go into and show them where the herbs tend to be in " real life " .

 

6. They are only responsible to know pinyin, but I give them a little extra

credit for Latin or Chinese characters.

 

7. Mention instances of using the herbs successfully from cases in my clinic.

They really seem to remember stories.

 

Those are a few ideas. I would be interested to hear ways that other teachers

present herbs to supplement the memorization.

 

- Bill Schoenbart

 

 

 

 

 

, " " wrote:

>

> In regard to the statement " no one retains it anyway " I have a few things to

> say.

>

>

>

> Studying herbs in school is just the first pass. I do not think anyone

> expects the students to memorize and retain all the information contained

> within the formula/herbs descriptions. This is just a foundation and

> exposure to the topic. It teaches one the ideas and methodology in learning

> how to study the topic. One must study for years reviewing the information

> and building upon the core ideas. One should never have the illusion that

> one just studies the material in the classes and then should be able to

> practice a high level medicine. However, if one is never is exposed to the

> majority of formulas or medicinals while in school, the chance of them

> branching out in the future is slim. I cannot count the number of times that

> I've reviewed fundamental/basic information. Although one may have forgotten

> something from a class, when reviewed, it quickly comes back and you then

> can make new connections, based on new knowledge, and learn that material on

> a deeper level. This is just the basic learning process.

>

>

>

> Furthermore, one should not have to read Chinese to effectively teach this

> topic. There is enough translated material to present the foundation. One's

> teaching skills is what actually counts at this level. However, one actually

> should have a good working knowledge of herbs to actually teach herbs. I

> think what people are pointing out is that some teachers are not teaching

> the core material and teaching other ideas related to herbs, possibly not

> related to mainstream Chinese medicine. This is of course problematic. I see

> this as just a curriculum issue related to the school, not a language issue.

>

>

>

> -

>

>

>

>

>

 

> On Behalf Of ben zappin

> Saturday, July 25, 2009 10:58 AM

> chineseherb academy

> RE: Re: California Acupuncture Board Decreases Herb Portion

> of Exam

>

>

>

>

>

> Bill,

>

> Fair enough, but I still think there is a problem with information and

> passion retention when it comes to herbs in the groups of students supported

> in their education. While I've heard many students call Five Branches -

> " Herbs, and the other four branches " with a great line up of Chinese trained

> physician-herbalists and impassioned teachers such as yourself laying down a

> solid foundation to work with herbs, I can honestly say that I found less

> than 5% of students in their last year to have a real personal investment in

> herbalism. It is my disappointment at this that has me offering up what I

> view as questions rather than opinions.

>

> Ben

>

>

> <%40>

> plantmed2 <plantmed2%40gmail.com>

> Sat, 25 Jul 2009 05:00:47 +0000

> Re: California Acupuncture Board Decreases Herb Portion of

> Exam

>

> Well stated, Joey.

>

> Ben and Al, I have to disagree. Ben, you're my friend and I respect your

> opinion, but as a teacher of two materia medica classes, I don't see

> students having a problem with learning the material if they are willing to

> do the work. Very few of them fail to do it right. I didn't have a problem

> learning all the herbs when I was a student, either. Did it take up about

> 30% - 40% of my studying time? Yes. Do I think it was worth it? Absolutely.

> Do I forget info and have to relearn it periodically? Of course. This is a

> lifetime endeavor, part of what makes herbal medicine so interesting.

>

> I do see a problem with students spending a huge portion of their time

> studying for cumulative exams and exam preparation classes.

>

> A pared-down version of materia medica will give them an incomplete

> foundation in herbs. By the time they get around to studying the rest of

> them, they will have failed to integrate those herbs into their

> understanding of the disease patterns and the formulas. IMO, knowing how to

> modify formulas is at least as important as understanding the formulas

> themselves. Without the entire arsenal of herbs, this understanding will be

> incomplete.

>

> - Bill

>

>

>

>

>

>

[Guest guest]

Interesting and important topic

 

There are many, many challenges to teaching/learning this

medicine in the West. Some of it falls on the schools, some on

the teachers and some on the students.

 

Jason said:

One should never have the illusion that one just studies the

material in the classes and then should be able to practice a

high level medicine.

 

 

I think that this touches on one of the " institutional "

weaknesses that schools need to address. There is a huge

disconnect between the didactic and practical portions of

learning. This is apparent in the diagnosis, acupuncture and

herbs.

It's difficult to expect even great memorizers to retain

information that is not applied for some indeterminate amount of

time. The first formula we all learn is Ma Huang Tang....but many

students NEVER use it...how, then, could we expect them to

remember and understand?

I think that this problem is complicated by the fact that most

schools offer Tea Pills and many students rely on them more and

more. How does a student develop a relationship with herbs when

all they do is hand over a plastic bottle? At least with granules

there could be modification which would require review of the

formula on some level.

 

I think that there is a valid argument for limiting the number of

formulas. IF a student really and truly knows say, 100 formulas

they create a model in their mind on how formulas are structured,

work and are applied. From there, new formulas can be understood

and assimilated fairly easily. If a teacher only gets 2 semesters

with a student in the midst of studying theory, acupuncture and

biomedicine, maybe the single most important achievement would be

to inspire the student to love herbs and provide guidance on

pursuit of greater learning.

Still, without practical application our brain will de-prioritize

that information that you haven't thought about much for the last

9 months.

 

Stephen Woodley LAc

 

--

http://www.fastmail.fm - Email service worth paying for. Try it for free

 

 

 

 

[Guest guest]

, " Bob Flaws " <bob wrote:

>

> Eric,

>

> Good answers.

>

> As for the poor teachers in China, no surprise there since this is how most

Chinese teachers teach here. If one is not taught how to teach, one teaches how

they themselves were taught. But, is it not true that, in the udnergraduate

programs in China, all the teachers teach to the same standard in terms of

material? I'm interested in hearing your feedback about this since, here, the

way we hire faculty results on a very " eclectic " situation (to put it nicely)

with few standards and little quality control that I can see.

 

Yes, very true. The difference is that in China, there is a common consensus on

what constitutes a solid foundational curriculum and a basic standard of

professional care. The field gets progessively more advanced and diverse at the

higher levels, but the starting point is well-established, cohesive, and

consistent across instructors and universities.

 

This consistency is lacking in the West, because many people simply don't know

what the standard knowledge in our field is. The students don't get a clear,

consistent message and there is little quality control because the " eclectic "

views are interspersed without being clearly identified as idiosyncratic views

that lack support in primary sources. Students thus get a feeling that

" anything goes " and they don't feel the need to base their views on reliable

primary sources and professional consensus. Then they end up selling something

to patients as Chinese medicine even though there is no evidence that such a

perspective ever existed in Chinese medicine.

 

As an aside, it is worth noting that the common consensus in Chinese medicine is

not some product of whitewashing from the 1950s in the PRC. The core consensus

in Chinese medicine is similar to the PRC in places like Hong Kong and Taiwan,

which lacked the PRC cultural revolution. Despite the rabid marketing against

" TCM, " establishing consensus has been something that has slowly developed for

hundreds of years.

 

We have a blog about TCM and the cultural revolution here:

http://www.bluepoppy.com/blog/blogs/blog1.php/2008/12/17/chinese-culture-extends\

-far-beyond-the-c

and here:

http://www.bluepoppy.com/blog/blogs/blog1.php/2008/12/11/the-cultural-revolution

 

 

The lack of awareness of standards and consensus in the West is a testimonial to

the power of money and advertising at reaching non-informed consumers. A few

people make vast sums of money by training students in systems with no

historical basis, all under the auspices that " TCM " has somehow lost touch with

all its real knowledge. Yet Chinese medicine never had a guru-based system that

lacked historical references and academic support until it arrived in the West,

where eager consumers buy up whatever it is that someone is advertising.

 

Eric Brand

[Guest guest]

, " " wrote:

>

> The problem I see is this. There may be a few gifted healers that can get

> amazing results with limited amount of knowledge, but this is the exception

> not the rule.

 

Jason, I agree with all of your points completely. I don't really think that

someone with minimal training will ever be a good herbalist. The problem is,

most of the people in a program just want to be acupuncturists, they don't have

any ambitions to be herbalists and generally don't overextend themselves or bill

themselves as herbal practitioners. Most of these practitioners know that their

clinical limit and their interest doesn't go beyond xiao yao san, so they should

not be filling the herbal classrooms and holding back the students that truly

want to be herbalists. I'm not advocating lower educational standards for

herbalists so much as I'm saying that the people that don't want to learn herbs

should get out of the way of the students that have the potential to really do

something with it.

 

Eric