Development of a Comprehensive Acupuncture Training Curriculum at an Academic Medical Center in Southwest Virginia

Abstract

Background:

Acupuncture is an ancient practice that involves fine needle insertion into specific points on the body to regulate the flow of energy (qi), alleviate pain, and promote healing. In the United States, acupuncture education and training mainly occur within schools for acupuncture and oriental medicine (AOM). However, more and more academic institutions are now adopting acupuncture and providing it to patients. In this manuscript, we discuss an acupuncture training curriculum devised by Carilion Clinic in Southwest Virginia.

Materials and Methods:

In accordance with Virginia’s medical board's requirements, trainees will complete 200 hours of training, including 50 hours of in-person instruction. Training is administered in four phases, two of which include two 3.5-day in-person hands-on training opportunities. The other two phases include 150 hours of self-instruction through various educational assignments and online modules. Topics covered include acupuncture theory, acupoints system, acupressure, TCM theories/therapies, evidence-based practices, and the integration of TCM into a comprehensive healthcare approach. Regular surveys and feedback forms will be used to follow up with alumni, their employment status, areas of specialization, continued education, and professional achievements.

Results:

Our new acupuncture training program has launched its inaugural class of 28 trainees, consisting of practicing physicians, residents, and medical students. Comprehensive statistical data will be collected on the career progression of our graduates and frequency of acupuncture services offered to patients.

Conclusion:

This new acupuncture training program offers a comprehensive and integrative approach to acupuncture and traditional medicine, drawing from a variety of Eastern medical theories. The training program is open to physicians, fellows, residents, and medical students and is currently in its inaugural year training 28 individuals. Future studies will analyze acupuncture service provision by our graduates and the potential of our training program to meet the growing demand for acupuncture therapy within our area.

INTRODUCTION

Acupuncture, a form of alternative medicine based on traditional Chinese medicine (TCM), uses meridians and the flow of energy (qi) as a guide to treat various medical conditions.¹ This ancient practice involves fine needle insertion into specific points on the body to regulate the flow of qi, alleviate pain, and promote healing.² In recent decades, numerous investigations have been conducted to verify the effectiveness of acupuncture in managing chronic pain, headaches, anxiety, insomnia, and many other medical conditions.^3–6 The growing body of research supporting the efficacy of acupuncture has also sparked discussion on how to effectively integrate acupuncture into conventional medicine through evidence-based practice.⁷

In the United States, the education and training of acupuncturists occur within schools for acupuncture and oriental medicine (AOM). As of 2018, there were 62 active and accredited AOM schools, with about 40% located in California, Florida, and New York.⁸ Although most medical schools and hospital institutions may not have structured curricula for the training of acupuncturists, some schools, such as Uniformed Services University of the Health Sciences, have successfully introduced integrative health and acupuncture lectures to medical students in preclinical education.⁹

According to the American Academy of Medical Acupuncture (AAMA), acupuncture is within the scope of practice of physicians in most US states but certain states may have restrictions or additional requirements.¹⁰ There are a handful of programs that provide acupuncture training to doctors, which may include a list of currently approved acupuncture programs by the AAMA as listed on their website.¹¹ Course fees, travel time, and expenses as well as accommodation limit attendance of acupuncture programs by physicians. Many physicians who completed such training also do not incorporate it into clinical practice due to time constraints and lack of support from practice managers or hospital employers. Additionally, only limited indications of acupuncture such as low back pain are being covered by Medicare and other insurance providers. CMS only covers acupuncture for chronic low back pain, as per the guidelines published in January 2020. The Center for Medicare and Medicade services (CMS) National Coverage Determination (NCD 30.3.3).

Until recently, only physicians in private practice could incorporate acupuncture into their clinical practice, with most payments coming directly from patients. In some cases, worker’s compensation, auto insurance, and federal/state insurances would cover acupuncture.

Increasingly, academic institutions are now adopting acupuncture and providing it to patients. This trend is supported by organizations such as the Academic Consortium for Integrative Medicine & Health, which has documented an increase in integrative medicine programs that include acupuncture as part of patient care. Several large institutions, including Harvard Medical School and the University of California, San Francisco, have established acupuncture training programs, which reflects this growing trend.^12,13

The Carilion Clinic in Southwest Virginia, for instance, has established at least two acupuncture clinics, one in Family Medicine and another in Physical Medicine and Rehabilitation (PM&R). Carilion Clinic also believes that creating hospital training programs for acupuncture can enable providers to effectively apply acupuncture techniques while broadening their scope of practice. To this end, Carilion Clinic has established a comprehensive acupuncture training program available to physicians, residents, fellows, and medical students, with the vision to expand it to physicians at other parts of the country. Here, we detail the various components of the acupuncture training program and discuss the objectives and anticipated outcomes.

RATIONALE FOR CURRICULUM DEVELOPMENT

The decision to establish the acupuncture training program at Carilion Clinic was driven by the growing interest of current providers, patients in acupuncture, and the growing body of evidence supporting its efficacy. There was also a significant need to train providers in the practice of acupuncture, as there were only two trained physicians able to administer acupuncture to patients. This demand for training is highlighted by the immediate enrollment of 28 individuals in the inaugural year of this program, including 23 practicing physicians, 2 residents, and 3 medical students.

The patients seeking acupuncture at our medical center come from a diverse demographic background, with ages ranging from 18 to 85 years. Most patients present with chronic pain conditions, such as back pain, osteoarthritis, migraines, and fibromyalgia. Additionally, we see a growing number of patients with anxiety, insomnia, and other stress-related conditions seeking acupuncture as part of a comprehensive care plan.

The participating physicians in the program represent a diverse array of specialties, including primary care (family medicine and internal medicine) ENT, emergency medicine, OB-GYN, neurology, and dentistry. This diversity underscores the broad applicability of acupuncture across different fields of medical practice, as the training prepares physicians to integrate acupuncture into their respective specialties, addressing a wide range of patient complaints.

The demand for acupuncture has steadily increased in our medical center, driven by both patient interest in nonpharmacologic treatments and physician referrals for pain management, stress reduction, and adjunctive care in rehabilitation. Surveys conducted among our patients indicate a high level of satisfaction with acupuncture treatments, particularly for chronic pain and anxiety management. This increased demand has prompted us to integrate acupuncture into more service lines, such as cancer care and sports medicine.

The program is designed to produce practitioners who will integrate acupuncture into their clinical practices within our medical center and beyond. Upon completion, these trained practitioners will be able to offer acupuncture as part of a multimodal treatment approach, increasing access to this service within our system. From a financial perspective, offering acupuncture is advantageous as it can reduce reliance on more expensive treatments, such as surgery or long-term pharmacotherapy. By improving patient outcomes and satisfaction, acupuncture also enhances the value-based care model, making it a cost-effective addition to our clinical services.

PROGRAM SETUP AND COMPONENTS

This new acupuncture training program within Carilion Clinic aims to provide comprehensive education in acupuncture and integrative medicine. The curriculum will cover a wide variety of topics including disease assessment, diagnosis, treatment based on TCM theories/therapies, holistic concepts of healing and health, evidence-based practices, and the integration of TCM into a comprehensive health care approach. A sample course timeline has been added as an appendix to provide readers with a clear structure of the program. This timeline outlines the topics covered in each module, from foundational acupuncture theory to practical sessions on needling techniques and safety (Appendix A).

Except for medical students, participants are expected to hold an active, unencumbered medical license to practice in their respective state. The inaugural class of this training program started its training in April 2024 and is projected to complete their training by March 2025.

To justify Carilion Clinic and the VA medical board’s requirement to add acupuncture to Delineation of Privileges (DOP), participants need a minimum of 200 h of continuing medical education (CME) activities in acupuncture, of which at least 50 h must be live. Accordingly, our training program will be administered over 200 h with four phases, two of which include two 3.5-day in-person hands-on training opportunities. The other two phases include 150 h of self-instruction through various online modules and educational assignments within our learning platform. Learners will be able to obtain additional CME credits as listed on AAMA website for relevant acupuncture courses.¹⁴ Participants can shadow the course director in his acupuncture clinic for one-to-one teaching. Participants will also be given guidelines to establish an acupuncture clinic, how and from where to procure their supplies, billing codes, documentation templates, and marketing techniques.

The primary instructor for this new acupuncture course is S.K.J., MD, who is board-certified in PM&R, Pain Medicine, and Brain Injury Medicine. He has completed a fellowship in Integrative Medicine and is member of the AAMA. Dr. Jain has also undergone specialized training in acupuncture and has over 25 years of experience integrating acupuncture into clinical practice. The hands-on workshops are overseen by faculty members with training and experience in medical acupuncture, including a practicing acupuncturist. In addition to Dr. Jain, Dr. Weppner and Dr. Apfel have completed at least 300 h of acupuncture training from various training programs. These workshops involve intensive training in acupuncture point location, needling techniques, safety protocols, and treatment strategies for various conditions. The two 3.5-day workshops include supervised clinical practice to ensure learners gain confidence in acupuncture techniques.

Criteria have been established for successful module completion, including:

Demonstrating competency in labs and practicums under the supervision of the course director/delegates, following the criteria set by the course director and CME committee.

Achieving a score of 80% or higher on module exams and tests.

After completing this training program, participants will:

1. Acquire a strong understanding of practical skills to safely administer acupuncture.

2. Recognize and follow an integrative approach to care guided by the principles of TCM.

3. Demonstrate competency in labs and practicums of acupuncture.

PHYSICIAN ACUPUNCTURISTS TRAINING

Physician acupuncturists undergo training equivalent to that of medical students. The distinction lies in physicians being eligible for 200 h of CME postcourse completion, while medical students, residents, and fellows may also request and receive a certificate of participation. Physicians must complete a mandatory 200 h of training, including 50 h of in-person instruction, to practice acupuncture as per Virginia’s medical board’s requirements. There is a vision to expand our current curriculum to 300 h, with a minimum of 100 h of in-person training. Efforts are also underway to obtain approval from the AAMA, ensuring alignment with acupuncture training standards across states where physicians are permitted to practice acupuncture in the United States.

While the Carilion Clinic acupuncture course incorporates elements from the AAMA, and Textbook on acupuncture by Helms, the curriculum is primarily original, developed to meet the needs of our learners and patient population. This course is developed to meet VA medical board’s requirements to include acupuncture in the DOP for medical doctors. In future years, the course may be revised to ensure that the course meets the guidelines required by AAMA before we submit it for their approval.

INTEGRATION OF MEDICAL STUDENTS

The Carilion Clinic acupuncture training program is open to all practicing physicians, fellows, residents, and medical students. Residents, fellows, and medical students are strongly encouraged to participate, and discounted prices are available to encourage enrollment. Medical students can participate in the online components of our acupuncture training alongside their standard Western medicine education. They must, however, obtain prior approval from their medical school and adjust their rotations to accommodate hands-on training sessions.

There are two medical schools close to Carilion Clinic, one MD and one DO school, and flyers were distributed on their campuses to bring awareness about the training program. Future training sessions can attempt to make collaborations with educational offices within the nearby medical schools to increase medical student participation.

ACUPUNCTURE THEORY AND ACUPOINTS SYSTEM

The curriculum is designed to provide a comprehensive education in acupuncture and energetic flow, integrating classical theories with modern microsystems to offer a well-rounded understanding of the practice. Students are trained in the variety of techniques and approaches below to prepare them for diverse clinical applications. The primary acupoints used in TCM, cover the 14 major meridians: 12 primary meridians (Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Burner, Gall bladder, and Liver) and the two extraordinary vessels (Ren Mai and Du Mai).

MICROSYSTEMS IN ACUPUNCTURE

• Auricular Acupuncture (Ear Acupuncture): Microsystem: The ear as a microsystem reflecting the entire body.

Commonly Used Protocols: Such as the National Acupuncture Detoxification Association (NADA) protocol for addiction treatment, Battlefield acupuncture (BFA), advanced BFA, modified BFA, and Acute trauma protocol (ATP).

• Scalp Acupuncture: Microsystem: Zones on the scalp corresponding to various parts of the body and brain functions.

Techniques and Applications: Used for neurological and systemic conditions, particularly effective in stroke rehabilitation.

USE OF EASTERN MEDICINE THEORIES AND INTEGRATION OF WESTERN AND TRADITIONAL MEDICINE

Our program offers a comprehensive and integrative approach to acupuncture and traditional medicine, drawing from a variety of Eastern medical theories. Since participants are from different specialties, acupuncture protocols of interest to various specialties not limited to neurology, psychology, gastroenterology, gynecology, and rheumatology will be included. Modalities including acupuncture with and without electricity, use of moxa, cupping, power pointer, laser pens, etc. will be included. A list of all the specific health conditions explored in the curriculum as well as best practice for their acupuncture management is available upon request. Below is a detailed overview of the theories and principles our curriculum covers.

The term “power pointer” refers to an electronic auricular point locator used to identify acupuncture points in the ear. This device emits an audible tone or a light when an active acupuncture point is located, facilitating precise point identification, particularly for beginners.

Traditional Chinese Medicine:

• Yin-Yang Theory:

Fundamental concept describing the dual nature of all things.

Focuses on balance and harmony between opposing forces within the body and the universe.

• Five Element Theory (Five Phases):

Elements: Wood, Fire, Earth, Metal, and Water.

Correspondences: Each element is linked to specific organs, tissues, emotions, seasons, and natural phenomena.

Cycles of Interaction: Generating (sheng) and Controlling (ke) cycles, explaining the dynamic relationships between elements.

• Zang-Fu Theory:

• Organ System: Detailed study of internal organs (Zang: solid organs like Heart, Liver, Spleen, etc.; Fu: hollow organs like Stomach, Large Intestine, etc.).

Functions, Pathologies, and Interrelationships: Understanding how organs interact and contribute to overall health.

• Qi, Blood, and Body Fluids:

Vital Substances: Roles and relationships of Qi, Blood, and body fluids in maintaining health.

Pathologies: Imbalances and stagnations leading to disease.

• Eight Principles:

Diagnostic Framework: Categories like Interior/Exterior, Heat/Cold, Excess/Deficiency, and Yin/Yang used to diagnose and treat conditions.

Integrative Medicine Principles:

• Holistic Approach:

Treating the whole person: Mind, body, and spirit.

Emphasizing balance and harmony in all aspects of life.

• Evidence-Based Practices:

Integrating modern scientific research with traditional practices.

Using clinical evidence to inform and enhance traditional treatment methods.

• Preventive Care:

Focus on maintaining health and preventing disease through lifestyle modifications, diet, and regular treatments.

• Personalized Treatment:

Individualized diagnosis and treatment plans are based on each patient’s unique constitution and health status.

Using a combination of traditional diagnostics (pulse, tongue) and modern assessments.

BEST PRACTICES AND RECOMMENDATIONS

It is essential to develop a comprehensive acupuncture curriculum that integrates both traditional theories and modern scientific research. This curriculum should include a diverse range of acupuncture techniques, such as TCM, auricular, scalp, and Japanese styles. Practical, hands-on training is crucial, with many opportunities for supervised clinical practice to ensure students gain necessary skills and build their confidence. Interdisciplinary learning, incorporating subjects like herbal medicine and nutrition, can provide a more holistic understanding of patient care.

Employing qualified and experienced instructors with strong academic and clinical backgrounds is vital, and these instructors should engage in continuing education to stay current with the latest advancements and research in acupuncture. Instructors should employ student-centered learning approaches, using interactive methods such as case studies, group discussions, and practical demonstrations. Providing individualized support through mentorship and personalized feedback helps in nurturing student development. Regular assessments, accompanied by constructive feedback, are crucial for tracking student progress and encouraging growth. Additionally, integrating evidence-based practices into the curriculum teaches students to combine traditional acupuncture techniques with modern research findings, fostering critical thinking and a balanced approach to treatment. Moreover, continuous curricular improvement through regular feedback from students, patients, and community members is essential for refining educational and outreach programs. Encouraging continuous professional development for practitioners through courses and certifications fosters a culture of lifelong learning and excellence in acupuncture.

Finally, modern technology plays a pivotal role in expanding the reach of acupuncture education and services. Developing online courses and resources can make learning more accessible to a broader audience. Implementing telemedicine services allows for remote follow-up consultations and patient education, ensuring continuous support. Encouraging interdisciplinary collaboration through workshops, seminars, and research projects can further integrate acupuncture into comprehensive health care strategies, highlighting its benefits in conjunction with other therapeutic modalities. By following these best practices, acupuncture educators and practitioners can enhance the quality and impact of their work, contributing to the broader acceptance and integration of acupuncture as a valuable health care modality.

ACUPRESSURE TRAINING

Recognizing the importance of a comprehensive approach to traditional medicine, our curriculum ensures that students gain a fundamental understanding of acupressure techniques. However, the time allocated for acupressure training is limited. These sessions cover the basic principles of acupressure, highlighting its similarities and differences compared to acupuncture.

Our acupressure training includes an overview of key acupoints, teaching students how to locate and stimulate these points using manual pressure. We emphasize the therapeutic benefits of acupressure, such as pain relief, stress reduction, and overall wellness, making it a valuable complementary skill for acupuncturists. Students learn practical applications, including techniques for self-care and patient education, which can be particularly beneficial in settings where needle-based acupuncture may not be feasible. Participants will learn the use of acupuncture beads as well that can be used in body acupuncture and auricular acupuncture.

The selection of body and auricular points provides a well-rounded acupuncture approach for treating a variety of conditions such as pain, emotional disorders, digestive issues, stress, and immune function. In particular, the auricular points complement body acupuncture by addressing central nervous system regulation, emotional balance, and pain management. Points like Shen Men, Thalamus, and the Sympathetic Point offer potent relief for both physical and psychological stressors.

• LI4 (Hegu): Located on the back of the hand, between the thumb and index finger. Indications: pain relief, stress reduction, immune system boost.

• GB20 (Fengchi): At the base of the skull, on either side of the neck. Indications: headache, neck pain, improved circulation, vision clarity.

• SP6 (Sanyinjiao): Inside of the lower leg, four finger-widths above the ankle. Indications: menstrual cramps, digestive issues, relaxation.

• CV17 (Shanzhong): Center of the chest. Indications: anxiety, depression, improved breathing.

• HT7 (Shenmen): On the wrist, on the little finger side. Indications: insomnia, anxiety, relaxation.

• LV3 (Taichong): On the foot, between the first and second toe. Indications: headaches, menstrual cramps, digestive issues.

• PC6 (Neiguan): Inside of the wrist, two finger-widths from the wrist crease. Indications: nausea, motion sickness, calm mind.

• GB34 (Yanglingquan): Outside of the lower leg, below the knee. Indications: knee pain, digestive issues, circulation.

• LI11 (Quchi): Outside of the elbow, at the end of the crease when bent. Indications: pain relief, digestive issues, immune boost.

• UB40 (Weizhong): Center of the back of the knee. Indications: back pain, knee pain, circulation.

• GV14 (Dazhui): On the back of the neck, below the skull base. Indications: neck pain, headache relief, mental clarity.

• KD3 (Taixi): Inner ankle, in the depression between the ankle bone and Achilles tendon. Indications: fatigue, lower back pain, kidney function improvement.

• LI10 (Shousanli): Outer forearm, two finger-widths from the elbow crease. Indications: shoulder pain, neck pain, digestion.

• SP10 (Xuehai): Inner thigh, three finger-widths above the knee. Indications: menstrual cramps, skin conditions, circulation.

• BL67 (Zhiyin): Outside of the pinky toe, outer nail corner. Indications: breech presentation, labor induction, headache relief.

• LU7 (Lieque): Inside of the wrist, above the wrist crease. Indications: respiratory issues, wrist pain, immunity.

• ST44 (Neiting): Top of the foot, between the second and third toes. Indications: digestive issues, foot pain, relaxation.

• SI3 (Houxi): Back of the hand, between the fourth and fifth metacarpals. Indications: shoulder pain, neck pain, circulation.

• ST36 (Zusanli): Lower leg, four finger-widths down from the kneecap. Indications: digestive issues, fatigue, immune boost.

• BL60 (Kunlun): Outside of the ankle, between the ankle bone and Achilles tendon. Indications: ankle pain, lower back pain, relaxation.

• GV20 (Baihui): Top of the head, center. Indications: headache relief, stress reduction, improved concentration.

• CV6 (Qihai): Lower abdomen, three finger-widths below the belly button. Indications: menstrual cramps, urinary issues, relaxation.

Some of the auricular acupuncture points included in the course:

• Shen Men (Ear): Often used for calming the mind, stress reduction, pain relief, and sleep improvement. This is a master point for treating anxiety and trauma-related conditions.

• Sympathetic Point: Helps regulate the autonomic nervous system, balancing organ functions and providing pain relief.

• Point Zero: A homeostatic point balancing the body’s energy and regulating the sympathetic and parasympathetic systems.

• Prefrontal Cortex (Auricular Region): Targets cognitive and emotional regulation, beneficial for reducing anxiety, depression, and improving decision-making and focus.

• Cingulate Gyrus (Auricular Region): Focuses on emotional regulation, helpful for treating chronic pain, and addressing issues related to mood disorders like depression or obsessive-compulsive disorder.

• Thalamus (Auricular Region): Influences both sensory and emotional pain control. Also beneficial for sleep regulation and stress management.

ACUPUNCTURE SAFETY

The acupuncture training program at Carilion Clinic prioritizes patient safety and well-being. To this end, we emphasize the use of strict sterile precautions tailored to the specific requirements of acupuncture in various parts of the body. This includes the proper handling and disposal of needles, maintaining a clean and hygienic environment, and using sterilized equipment to prevent infections and cross-contamination. Moreover, students are taught to adapt their needling techniques based on the individual patient and the specific area of the body being treated. This includes understanding the appropriate depth and angle of needle insertion to avoid injury to vital structures such as blood vessels, nerves, and organs. Participants learn to respect and appreciate the underlying tissue. Forbidden points during pregnancy are discussed. Furthermore, our curriculum also covers the identification and management of potential adverse reactions, such as fainting, hematoma, or infection, and equips students with the skills to respond appropriately in such situations.

The curriculum also emphasizes the importance of thorough patient assessment and communication via detailed medical histories, understanding contraindications and cautions for acupuncture, and discussing potential risks and benefits with patients to obtain informed consent. By incorporating these safety protocols into our training, we aim to cultivate practitioners who are not only skilled in their techniques but also deeply committed to maintaining the highest standards of patient care and safety.

ANTICIPATED OUTCOMES AND CAREER PROGRESSION

This training program aims to successfully train physician-acupuncturists who can integrate acupuncture into their practice and offer it to interested patients. As this is the inaugural year of our training program, we do not yet have statistical data on the career progression of our graduates. However, we plan to gather comprehensive data on their career trajectories, frequency of acupuncture services offered, and whether the demand for acupuncture therapy within our area is being met through the training program.

Regular surveys and feedback forms will be used to follow up with alumni, their employment status, areas of specialization, continued education, and professional achievements. An alumni network will facilitate ongoing communication, mentoring opportunities, and resources for professional development. As we continue to build and refine our program, we look forward to sharing detailed statistical data on the successful career progression of our students in the coming years.

While the inaugural class is still in progress, the program’s initial success has been measured through a combination of enrollment numbers, positive feedback from participants, and institutional support. We have seen increased demand for future course offerings, which indicates that the program is meeting an important need within the academic and medical community. Additionally, the program has secured continued funding and administrative backing, further supporting its sustainability and potential for growth.

CHALLENGES FACING THE PROGRAM

Currently, there are only two trained physician acupuncturists within the Carilion Clinic and only one is available to provide this training, which requires a considerable time commitment on his behalf. As this is the first year of the acupuncture training program, the course director needed to design a new curriculum and create several learning materials without being offered any dedicated time to develop the course. Another significant challenge facing the program has been pushback from program directors who did not allow their fellows, residents, and medical students to participate in the program. There were also several physicians within the Carilion Clinic health system who were hesitant to learn about acupuncture and dissuaded others from utilizing this training opportunity. Finally, this program neither have any seed money nor financial support provided by the institute. The Carilion Clinic provided space and promised to use the funds raised from registration to provide meals for the participants.

Appendix A: The Acupuncture Training Program for Physicians at Carilion Clinic

This program offers a comprehensive path to earn a Certificate of Training for Acupuncture and Integrative Medicine. Successful completion of all four modules, including hands-on practicums, will equip participants with foundational skills to safely administer acupuncture and practice an integrative medicine approach to care in line with TCM principles. We also recommend completing 100 h of clinical observation to enhance your knowledge. The program is structured as a two 3.5-day immersion, supplemented with online coursework. The program covers various aspects, including disease assessment, diagnosis, treatment based on TCM theories and therapies, holistic concepts of healing and health, evidence-based practices, and the integration of TCM into a comprehensive health care approach, with personalized therapies promoting well-being and healing.

Target Audience: Physicians licensed to practice medicine in Virginia, looking to incorporate medical acupuncture techniques into their practice. Residents, fellows, and medical students can participate and can request a certificate of attendance. 

Identification, mitigation, and disclosure of Financial Relationships: 

Planning Committee Members, Speakers, and Facilitators: Sunil K Jain, MD, Justin L Weppner, DO, Chad DeMott, MD, Lisa S Apfel, MD, Victoria Taylor, L.Ac, Elizabeth Russo-Stringer, MD, Lisa A. Uherick, MD, Katherine Coffey-Vega, MD, Carol Gibson, Emily Cundiff, Krystle Pickerel, Chris Blake, Tara Wiedeman, Rhona Blankenship, and Rachel Kniceley, reported no relevant relationship with any entity producing, marketing, reselling, or distributing health care goods or services consumed by or used on patients.

Objectives: After completing this program, participants will:

1. Acquire a strong understanding of practical skills to safely administer acupuncture.

2. Recognize and follow an integrative approach to care guided by the principles of TCM.

3. Demonstrate competency in labs and practicums of acupuncture.

Prerequisites: Participants must hold an active, unencumbered medical license to practice in their respective state. 

Certificate of Training Requirements: To receive a Certificate of Training, participants must demonstrate competency by completing all four modules within this program. The Institute, CME committee, or the course director reserves the right to withhold a Certificate of Training from any student who does not fulfill the program or module requirements.

Professional Credit: The Medical Society of Virginia is a member of the Southern States CME Collaborative, an ACCME Recognized Accreditor. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Southern States CME Collaborative (SSCC) through the joint providership of Carilion Clinic’s CME Program and Carilion Clinic Physical Medicine. Carilion Clinic’s CME Program is accredited by the SSCC to provide CME for physicians. Carilion Clinic’s CME Program designates this live activity for a maximum of 200 AMA PRA Category 1 Credits.™

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Planning Committee Members and Facilitators: Sunil K Jain, MD, Justin L Weppner, DO, Chad DeMott, MD, Lisa S Apfel, MD, Carol Gibson, Emily Cundiff, Krystle Pickerel, Chris Blake, Tara Wiedeman, Rhona Blankenship, and Rachel Kniceley.

Speakers/Presenters: Sunil K Jain, MD, Justin L Weppner, DO, Chad DeMott, MD, Lisa S Apfel, MD, Victoria Taylor, L.Ac., Elizabeth Russo-Stringer, MD, Lisa A. Uherick, MD, and Katherine Coffey-Vega, MD.

CME credits will be granted upon the successful completion of the entire course. Medical students, residents, and fellows can also attend. They may request and receive a certificate of participation. Criteria have been established for successful module completion, including:

Demonstrating competency in labs and practicums under the supervision of the course director or his delegates, following the criteria set by the course director and CME committee. Achieving a score of 80% or higher on module exams and points tests for each module. The learning experience is divided into 4 phases, and participants will have to complete them in sequence for proper learning. To justify Carilion and the VA medical board’s requirement to add Acupuncture to DOP, participants need a minimum of 200 h of CME activities in acupuncture, out of which at least 50 h must be live. 

Recommended reading and references:

• Helms, Acupuncture Energetics

• American Academy of Medical Acupuncture - medicalacupuncture.org 

• Society for Acupuncture Research (SAR) - acupunctureresearch.org 

• NIH—National Center for Complementary and Integrative Health—nccih.nih.gov 

• Helms Medical Institute—www.hmieducation.com/published articles The course is designed to be both descriptive, in that theories and concepts are presented, and application oriented. Course Materials: Course materials will be accessible through online modules. Course Approach: Reading Assignments, Online quizzes, and Practicum.

Online examinations: There will be multiple online examinations during this course. The examinations will be open-book quizzes. All quizzes and discussions will open on the first official day of the unit. This allows participants the flexibility to work ahead if they wish. Due dates for assigned reading and quizzes are the last day of the unit. Participants may only proceed to the next unit after completing units in succession. 

Schedule: 

Phase 1 (Online Module 1): 60 contact hours, May 1, 2024 to September 15, 2024

Unit 1: May 1, 2024 to May 30, 2024–10 hours

1: Introduction to Acupuncture, Evaluation of Acupuncture in the West, Indications and Potential Complications of Acupuncture, and Theories of Acupuncture. 

2: All about Acupuncture needles, Moxa, TENS units, Laser Acupuncture, and Cupping 

Needling techniques and Energetics

Reading assignments: 

• Review chapters 1, 2, and 3 from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: What is the best way to explain how acupuncture works? 

• Case example: Case of a patient with an ankle sprain sustained in an MVA.

Unit 1 Quiz 

Unit 2: June 1, 2024 to June 30, 2024–15 hours

3: Evaluation of a patient for Acupuncture: Pulse diagnosis, Tongue diagnosis, Biopsychotypes

4: Yin and Yang concept, Five Elements theory, and Mu Shu points 

Reading assignments:

• Review chapters 8, 9, 10, 11, and appendix A from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: Think about somebody you know, or a fictional or historical character based on their favorite color, season, food flavor, etc. Think about their boiopsychotype and the diseases they are prone to have. 

• Case example: Case of a patient with a mixed picture of biopsychotypes.

Unit 2 Quiz

Unit 3: July 1, 2024 to August 15, 2024 (6 weeks)–20 hours

5: Kidney, Heart, Small intestine, and Bladder meridians

6: Liver, Master of the heart, Triple heater, Gallbladder meridians

7: Spleen, Lung, Large intestine, and Stomach meridians 

Reading assignments: 

• Review chapters 12, 13, 14, 15, 16, 17, and appendix C from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: Think about the most important points and what is the significance of your favorite meridian. 

• Case Example: Case of firefighter with headaches.

Unit 3 Quiz

Unit 4: August 16, 2024 to September 15, 2024–15 hours

8: Introduction to Microsystems and Auricular acupuncture

Reading assignments: 

• Review chapter 5 from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: Is auricular acupuncture complementary to body acupuncture or stand-alone treatment? 

• Case Example: Case of a patient with central pain syndrome responding to BFA.

Unit 4 Quiz

Phase 2 (Live Session 1): 25 contact hours September 25, 2024 to September 28, 2024

Conference room 5, second floor. ION building. 2331 Franklin Road, Roanoke, VA 24014

No parking at the ION building for this event. Shuttles will be available to transport participants from Riverside 3 parking lot to ION building at 7:20 AM and 7:40 AM, and back in the evening.

Day 1: Wednesday, September 25, 2024–7.5 hours

Morning Session:

7:30 AM–8:00 AM: Registration 

8:00 AM–9:30 AM: Taylor/Jain−1.5 hours

• Five Elements Theory

• Breakfast while attending the lecture at 8:30

 9:30 AM–11:30 AM: Taylor/Jain–2.00 hours

• Intake skills (To ask, feel, hear, see)

11:30 AM–12:30 PM: Lunch break

Afternoon Session:

12:30 PM–2:30 PM: Jain/Taylor–2.00 hours

• All about Acupuncture needles, TENS unit, MOXA, Pointer plus, and Cupping

2:30 PM–3:00 PM: Afternoon Refreshment Break

3:00 PM–5:00 PM: Jain/Taylor–2 hours

• Acupuncture meridians and point location.

Day 2: Thursday, September 26, 2024–7 hours

Morning Session:

7:30 AM–8:00 AM: Registration 

8:00 AM–10:00 AM: Jain–2 hours

• Evaluation of a patient for Acupuncture, Biopsychotypes, Labs, Imaging

• Breakfast while attending the lecture at 8: 30

10:00 AM–10:30 AM: Morning break

10:30 AM–12:00 PM: Jain–1.5 hours

• Common acupuncture points

12:00 PM–1:00 PM: Lunch break

Afternoon Session:

1:00 PM–2:00 PM: Russo-Stringer–1 hour

• Interdisciplinary pain management

2:00 PM–2:30 PM: Afternoon refreshment break

2:30 PM–5:00 PM: Jain–2.5 hours

• Needle insertion techniques and practice

Day 3: Friday, September 27, 2024–7 hours

Morning Session:

7:30 AM–8:00 AM: Registration 

8:00 AM–10:00 AM: Jain/Taylor–2 hours

• Auricular Acupuncture: NADA, ATP, and BFA protocols

Breakfast while attending the lecture at 8:30

10:00 AM–10:30 AM: Morning break

10:30 AM–12:00 PM: Weppner–1.5 hours

• Acupuncture for TBI

12:00 PM–1:00 PM: Lunch break

Afternoon Session:

1:00 PM–2:30 PM: Apfel–1.5 hours

• Japanese Acupuncture techniques and Electroacupuncture

2:30 PM–3:00 PM: Afternoon refreshment break

3:00 PM–4:00 PM: Uherick–1 hour

• Integrative Medicine, Acupuncture, and Wellness

4:00 PM–5:00 PM: Jain/Taylor–1 hour

• PENS protocol

Day 4: Saturday (Half Day), September 28, 2024–3.5 hours

7:30 AM–8:00 AM: Registration and breakfast

8:00 AM–10:00 AM: Jain–2 hours

• Live demonstration and competency check

10:00 AM–10:30 AM: Morning break

10:30 AM–12:00 PM: Jain–1.5 hours

• Q&A, Wrap up, and close

 Phase 3 (Online Module 2): 90 contact hours, October 1, 2024 to February 28, 2025

Unit 5: October 1, 24 to October 31, 24–18 hours

9. Research in Acupuncture

10. Research Methodology

11. Acupuncture for Musculoskeletal Pain 

12. Meridian Regulatory Acupuncture

Reading assignments:

• Review Chapter 19 from Helms, Acupuncture energetics.

• Review articles and notes. 

• Question to ponder upon: How does acupuncture work for pain?

• Case example: Case of a patient with trigeminal neuralgia responding to auricular acupuncture.

Unit 5 Quiz 

Unit 6: November 1, 2024 to November 30, 2024–18 hours

13. Tendino-muscular Meridians 

14. Distinct Meridians 

15. Curious Meridians 

16. Acupuncture Yoga

Reading assignments: 

• Review Chapters 4, 7, and 20 from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: How can you integrate acupuncture into your medical practice?

• Case example: Case of a patient with glaucoma responding to a distinct meridian with central module.

Unit 6 Quiz

Unit 7: December 1, 2024 to December 31, 2024–18 hours

17. Scalp Acupuncture

18. Sixty command Points 

19. Ming Men, and 7-needle protocol 

20. Acupuncture for stroke and other neurological disorders 

Reading assignments:

• Review chapter 18 from Helms, Acupuncture energetics.

• Review articles and notes.

• Question to ponder upon: How can acupuncture help with neurological disorders?

• Case example: Case of a patient with cervical dystonia and head tremors benefiting from Botox and scalp acupuncture.

Unit 7 Quiz

Unit 8: January 1, 2025 to January 31, 2025–18 hours

21. Acupuncture for Mental Health: anxiety, depression, and fatigue

22. Acupuncture for Headaches 

23. Acupuncture for Gastritis and other GI disorders 

Reading assignments:

• Review articles and notes.

• Question to ponder upon: What is the role of acupuncture in mental health treatment?

• Case example: Case of a patient with irritable bowel syndrome and anxiety responding to acupuncture.

Unit 8 Quiz

Unit 9: February 1, 2025 to February 28, 2025–18 hours

24. Common Chinese Herbs and their Integration with Acupuncture

25. Natural Supplements used in patients undergoing Acupuncture treatments 

26. Practical approach to Integrative practice 

Reading assignments:

• Review articles and notes.

• Question to ponder upon: What and how Chinese herbs or natural supplements can you integrate with acupuncture in your practice? 

• Case example: Case of a patient with chronic fatigue syndrome responding to a combination of acupuncture and lifestyle modifications including natural supplements.

Unit 9 Quiz

Phase 4 (Live Session 2): 25 contact hours; March 5, 2025 to March 8, 2025

Day 1: Wednesday, March 5, 2025–7.5 hours

Morning Session:

7:30 AM–8:00 AM: Registration

8:00 AM–10:00 AM: Jain/Taylor–2 hours

• Advanced Acupuncture techniques

• Breakfast while attending the lecture at 8:30

10:00 AM–12:00 PM: Jain/Taylor–2 hours

• Special protocols and their applications

12:00 PM–1:00 PM: Lunch Break

Afternoon Session:

1:00 PM–2:00 PM: Coffey-Vega–1 hour

• Myofascial and Orthopedic Issues with Acupuncture and Complementary Therapy

2:00 PM–3:00 PM: Jain–1 hour

• Scalp Acupuncture

3:00 PM–3:30 PM: Afternoon Refreshment Break

3:30 PM–5:00 PM: Jain/Taylor–1.5 hours

• Integration of Microsystems with Body Acupuncture

• COVID-19 Rapid De-Stress Protocol

Day 2: Thursday, March 6, 2025–7 hours

Morning Session:

7:30 AM–8:00 AM: Registration 

8:00 AM–10:00 AM: Jain–2 hours

• Microsystems and Advanced Auricular techniques: Advanced BFA, Modified protocols

• Breakfast while attending the lecture at 8:30

10:00 AM–10:30 AM: Morning Refreshment Break

10:30 AM–12:00 PM: Jain/Taylor–1.5 hours

• NADA

12:00 PM–1:00 PM: Lunch Break

Afternoon Session:

1:00 PM–2:30 PM: Jain–1.5 hours

• Auricular Allergy Treatment

2:30 PM–3:00 PM: Afternoon Refreshment Break

3:00 PM–4:00 PM: DeMott–1 hour

• Incorporating Acupuncture in Medical School curriculum

4:00 PM–5:00 PM: Jain–1 hour

• Q&A

Day 3: Friday, March 7, 2025–7 hours

Morning Session:

7:30 AM–8:00 AM: Registration

8:00 AM–10:00 AM: Jain–2 hours

• Incorporating Acupuncture in Clinical Practice/ Integrative Medicine 

• Breakfast while attending the lecture at 8: 30

10:00 AM–10:30 AM: Morning Refreshment Break

10:30 AM–12:00 PM: Jain–1.5 hours

• Business of Acupuncture, Billing codes, and Documentation

12:00 PM–1:00 PM: Lunch Break

Afternoon Session:

1:00 PM–2:30 PM: Jain–1.5 hours

• AAMA, Board Certification in Medical Acupuncture, Review course, and Resources

2:30 PM–3:00 PM: Afternoon Refreshment Break

3:00 PM–5:00 PM: Jain–2 hours

• Case presentation by participants

• Revision - Putting Everything Together

Day 4: Saturday (Half Day), March 8, 2025–3.5 hours

7:30 AM–8:00 AM: Registration and Breakfast

8:00 AM–10:00 AM: Jain/Taylor–2 hours

• Live demonstration and competency check

10:00 AM–10:30 AM: Morning Refreshment Break

10:30 AM–12:00 PM: Jain/Taylor–1.5 hours

• Live demonstration and competency check

• Wrap up

AUTHORS’ CONTRIBUTIONS

All authors contributed to conceptualization, drafting, and reviewing of the article.

DISCLOSURE STATEMENT

The authors do not have any conflicts of interest to report.

FUNDING INFORMATION

The authors do not have any funding to report.