Abstract
Objective: Chinese Medicine (known as acupuncture and Oriental Medicine (AOM) in the United States), has spread far and been utilized in more than 183 countries or regions. It has played an important role in the health care systems of many countries. Licensed acupuncturists' contribution to the U.S. market alone is more than 3.5 billion dollars. The aim of the current study was to determine the ranking status of Chinese Medicine schools on the global or international level in 2020.
Materials and Methods: Databases of PubMed.gov, wanfangdata.com.cn, cnki.net, and google.com were searched, using the keywords: university or college or school, Chinese Medicine or acupuncture and Oriental Medicine, global ranking or international ranking, 2020 both in English and Chinese. If the ranking did not show up in the results directly, the authors moved on to find global or international higher education (universities or colleges) ranking agencies or institutions. Then the authors used the websites of ranking agencies or institutions to conduct more research, using the keywords: 2020, Chinese Medicine, or acupuncture and Oriental Medicine.
Results: U.S. News & World Report is the only recognized authority that reported the ranking status of universities of Chinese Medicine in its 2020 edition, in which the best global universities were ranked. A total of 1500 universities in 81 countries and regions were included. Based on the overall academic strength of each university, Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as numbers 1376, 1390 and 1440, respectively. In clinical medicine, 750 universities were ranked among the strongest in the world; Nanjing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as 688th, 734th, and 738th, respectively. In pharmacology and toxicology, 250 universities were among the strongest in the world; Shanghai University of Traditional Chinese Medicine and Nanjing University of Chinese Medicine were ranked as 153rd and 209th, respectively. In oncology, 250 universities were ranked as strongest in the world; Nanjing University of Chinese Medicine was ranked as 243rd in the world.
Conclusions: Chinese Medicine schools are more accepted and more highly ranked than they had been in the past.
Keywords: Chinese Medicine, acupuncture, educational institution, ranking, best global universities, 2020
Introduction
Traditional Chinese Medicine (TCM)* (or acupuncture and Oriental Medicine [AOM], as it is known in the United States), has evolved over thousands of years.1 It has spread far and been utilized in more than 183 countries or regions. Chinese Medicine has played an important role in the health care system in China, as well as in many countries and regions around the world, such as the United States, United Kingdom, Canada, and Australia.2 In addition, with its unique theory, treatment strategies, and perspectives on the nature of illness and disorders, Chinese Medicine incorporates practices of the mind and the body. Such practices include acupuncture, herbal therapies, tuina (an Eastern style, chiropractic and massage like therapy), and tai chi to address health problems.1,3
For the last 20 years, the number of academic articles on acupuncture published in the English language, in the PubMed/MEDLINE® database, has increased. Publication of randomized clinical trials (RCTs) performed on acupuncture is much higher than those in biomedicine.4 Acupuncture articles were mainly published in journals of complementary and alternative medicine; however, in recent years, the high-impact journals on mainstream medicine, led by the Journal of American Medical Association (JAMA), also started to publish articles on acupuncture.5–7 This indicates that Chinese Medicine, at least in terms of acupuncture, is gradually entering the mainstream medical field.
In 2017, the National Cancer Institute and National Center for Complementary and Integrative Medicine published a White Paper to urge the transformation of acupuncture studies into clinical practice.8 Thirteen national organizations in the AOM professions and academic institutions published a White Paper on acupuncture's role in solving the opioid epidemic, which played a very important role in supporting acupuncture therapy listed in the Package H.R.6 Act; so much so that it became law. The full title of the H.R.6 Act is “Support for Patients and Communities Act,” also known as “Substance Use—Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.”9,10
Behind all of these, there were some important contributions from the graduates of Chinese Medicine schools, the Chinese Medicine doctors. In the beginning of 2018, there were 37,886 actively licensed acupuncturists (the current authors note that this number includes ∼6000 Chinese Medicine doctors educated in mainland China) and 62 active and accredited AOM schools in the United States.11 Licensed acupuncturists' contribution alone to the U.S. market is more than $3.5 billion.12
In a Congressional Briefing on Capitol Hill, held on November 8, 2017, on acupuncture's role in solving the opioid epidemic, Chinese Medicine doctors, including current author Arthur Yin Fan, MD (China), PhD, LAc, spoke about the education and training of Chinese Medicine doctors in China while Jun Xu, MD, reported on the practice of TCM in mainland China today.13
The aim of the current study is to look for the ranking status of schools (including colleges or universities) in Chinese Medicine (i.e., AOM) at the global or international level for 2020.
Materials and Methods
Search Strategies
Two authors searched the databases of PubMed.gov, wanfangdata.com.cn, cnki.net, and google.com, using the keywords: university or college or school, Chinese Medicine or acupuncture and Oriental Medicine, global ranking or international ranking, 2020, both in English and Chinese. If the ranking did not show up directly in the results, the authors moved on to find global or international higher-education (universities, or colleges) ranking agencies or institutions; the authors then used the websites of ranking agencies or institutions to conduct further research, using the keywords: 2020, Chinese Medicine, or acupuncture and Oriental Medicine. The searches were conducted in October of 2019.
Judgement Strategies
All related results, such as ranking in national (domestic) and international (global) schools, were displayed in the search results. However, the focus was kept on the results at the global or international level in 2020.
Results
Main Findings
There were no results from a search of the PubMed.gov, wanfangdata.com.cn, or cnki.net databases. However, on google.com, some news articles were found stating that some of the Chinese Medicine universities had been listed in the best universities' ranking, but there were no specific details given. The authors then found that there are 4 well-known authorities (agencies or institutions) focused on ranking the best global (or international) universities; these authorities are: Quacquarelli Symonds, QS (UK)14; Times Higher Education World University Ranking, (THE, United Kingdom)15; U.S. News & World Report Global Best Universities Ranking, U.S. News (United States)16; and Academic Ranking of World Universities (ARWU; by Shanghai Jiao Tong University, China; now called ShanghaiRanking).17
U.S. News & World Report is the only authority that included universities of Chinese Medicine in its 2020 edition ranking the best global universities. This year, a total of 1500 universities in 81 countries and regions were included—an expansion from the 1250 universities in 75 countries and regions ranked the year before. Based on the overall academic strength of each university, Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as numbers 1376, 1390 and 1440, respectively.16
In clinical medicine, 750 universities were ranked among the strongest in the world, in which Harvard University ranked as first. Nanjing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as 688th, 734th, and 738th, respectively.18
In pharmacology and toxicology, 250 universities were among the strongest in the world, and Harvard University ranked as first. Shanghai University of Traditional Chinese Medicine and Nanjing University of Chinese Medicine were ranked as 153rd and 209th, respectively.19
In oncology, 250 universities were ranked as the strongest in the world. Harvard University was number 1. Nanjing University of Chinese Medicine was ranked as 243rd in the world.20
Other Findings at The Global Level
In 2018, U.S. News & World Report listed the universities of Chinese Medicine as some of the best universities in the world. Shanghai University of Traditional Chinese Medicine was ranked at number 1231, and Nanjing University of Chinese Medicine was ranked at number 1249.21 ARWU ranked Beijing University of Chinese Medicine as a Best University in the World for 2018 and 2019 (within numbers 901–1000).17 There were no globally ranked listings of university or colleges of Chinese Medicine (or acupuncture and/or Oriental medicine) in either QS or THE for the year 2020 or in previous years.14,15
Other Findings at the National Level
In China
There were 6 universities of Chinese Medicine listed in “Double-Top Universities Plan List,” a ranking of 42 world-class comprehensive universities and 95 world-class universities in specific specialties by the Chinese central government in 2017, including: Beijing University of Chinese Medicine; Tianjin University of Chinese Medicine; Shanghai University of Traditional Chinese Medicine; Nanjing University of Chinese Medicine; Guangzhou University of Chinese Medicine; and Chengdu University of Chinese Medicine.22
In ARWU Ranking,23 “The Best Chinese Medical Universities Ranking—Overall Ranking 2019” listed 71 best medical universities in China based on ARWU criteria; among the choices, there were 22 universities of Chinese Medicine listed.
The criteria for ARWU ranking are based on four aspects: (1) Quality of Incoming Students (Average Score of Incoming Freshmen in National College Entrance Exam); (2) Education Outcome (Employment Rate of “Bachelor Degree in Medicine” Recipients); (3) Outstanding Alumni (Accomplished Medical Experts); and (4) Reputation (Income from Donations).
The Chinese medicine universities in the ranking list were:
-
(1)
Shanghai University of Traditional Chinese Medicine, ranked at number 8 of 71, in “Best Chinese Medical Universities Ranking”
-
(2)
Beijing University of Chinese Medicine, ranked number 11
-
(3)
Nanjing University of Chinese Medicine, ranked number 16
-
(4)
Guangzhou University of Chinese Medicine, ranked number 19
-
(5)
Tianjin University of Traditional Chinese Medicine, ranked number 24
-
(6)
Heilongjiang University of Chinese Medicine, ranked number 29
-
(7)
Hunan University of Chinese Medicine, ranked number 30
-
(8)
Hubei University of Chinese Medicine, ranked number 32
-
(9)
Changchun University of Chinese Medicine, ranked number 33
-
(10)
Liaoning University of Traditional Chinese Medicine, ranked number 38
-
(11)
Chengdu University of Traditional Chinese Medicine, ranked number 39
-
(12)
Fujian University of Chinese Medicine, ranked number 40
-
(13)
Henan University of Traditional Chinese Medicine, ranked number 42
-
(14)
Guangxi University of Chinese Medicine, ranked number 46
-
(15)
Anhui University of Chinese Medicine, ranked number 47
-
(16)
Hebei University of Chinese Medicine, ranked number 49
-
(17)
Shaanxi University of Chinese Medicine, ranked number 49
-
(18)
Shandong University of Traditional Chinese Medicine, ranked number 49
-
(19)
Jiangxi University of Traditional Chinese Medicine, ranked number 59
-
(20)
Yunnan University of Traditional Chinese Medicine, ranked number 63
-
(21)
Gansu University of Traditional Chinese Medicine, ranked number 68
-
(22)
Guiyang University of Traditional Chinese Medicine, ranked number71.
In the U.S
ProspexDigital LLC listed “Best Colleges with Traditional Chinese Medicine and Chinese Herbology Degrees in the U.S.”24:
-
(1)
University of Bridgeport
-
(2)
American College of Traditional Chinese Medicine
-
(3)
East West College of Natural Medicine
-
(4)
Yo San University of Traditional Chinese Medicine
-
(5)
Colorado School of Traditional Chinese Medicine
-
(6)
Emperor's College of Traditional Oriental Medicine
-
(7)
Northwestern Health Sciences University
-
(8)
American Institute of Alternative Medicine
-
(9)
Midwest College of Oriental Medicine-Racine
-
(10)
Maryland University of Integrative Health
-
(11)
Midwest College of Oriental Medicine-Chicago
-
(12)
Bastyr University
-
(13)
Arizona School of Acupuncture and Oriental Medicine
-
(14)
New York College of Traditional Chinese Medicine
-
(15)
Tri-State College of Acupuncture (authors' note: recently closed)
-
(16)
World Medicine Institute (authors' note: recently closed)
-
(17)
New England School of Acupuncture (Massachusetts College of Pharmacy and Health Sciences)
-
(18)
Daoist Traditions College of Chinese Medical Arts.
Thebestschools.org ranked “The Best 20 Acupuncture schools in the U.S.”25:
-
(1)
Oregon College of Oriental Medicine
-
(2)
Emperor's College School of Traditional Oriental Medicine
-
(3)
New England School of Acupuncture (Massachusetts College of Pharmacy and Health Sciences)
-
(4)
American College of Traditional Chinese Medicine
-
(5)
AOMA Graduate School of Integrative Medicine
-
(6)
Bastyr University
-
(7)
Five Branches University
-
(8)
Maryland University of Integrative Health
-
(9)
Northwestern Health Sciences University
-
(10)
Pacific College of Oriental Medicine-San Diego
-
(11)
American College of Acupuncture & Oriental Medicine
-
(12)
Atlantic Institute of Oriental Medicine
-
(13)
Pacific College of Oriental Medicine—New York
-
(14)
Tri-State College of Acupuncture (authors' note: recently, closed)
-
(15)
Texas Health and Science University
-
(16)
American Academy of Acupuncture & Oriental Medicine
-
(17)
New York College of Traditional Chinese Medicine
-
(18)
National University of Natural Medicine
-
(19)
Seattle Institute of Oriental Medicine
-
(20)
Finger Lakes School of Acupuncture & Oriental Medicine of New York Chiropractic College.
ACE Acupuncture Continuing Education listed “Top 10 Acupuncture & Oriental Medicine Schools in the U.S.” (in no particular order)”26:
-
(1)
American College of Traditional Chinese Medicine
-
(2)
Pacific College of Oriental Medicine
-
(3)
Maryland University of Integrative Health
-
(4)
Emperor's College – School of Traditional Chinese Medicine
-
(5)
AOMA Graduate School of Integrative Medicine
-
(6)
Southern California University of Health Sciences
-
(7)
Northwestern Health Sciences University
-
(8)
Won Institute
-
(9)
Oregon College of Oriental Medicine
-
(10)
New England School of Acupuncture (Massachusetts College of Pharmacy and Health Sciences).
There are no best (or top) universities (or colleges) of Chinese Medicine (or AOM) in other countries found in the search.
Discussion
The fact that the universities of Chinese Medicine are ranking among the best universities in the world is a milestone for the academic field of Chinese Medicine; it signifies Chinese Medicine's entrance into mainstream health care, especially for clinical medicine, pharmacology and toxicology research, and oncology research.
One potential factor for being listed in the best global universities ranking is the number of universities included in the ranking system. The number of universities included in each ranking system is different. QS,14 THE,15 U.S. News,16 and ARWU17 include in their lists 800, 1400, 1500, and 1000 schools, respectively. Before 2019, U.S. News Rankings included 1250 universities, while ARWU only included 500–800 before 2018. Universities of Chinese Medicine were listed in U.S. News and ARWU; “the best global universities” might be related to these two ranking systems including more universities. However, it is noted that THE did not include any school of Chinese Medicine.
In the U.S. News 2020 Ranking, the top 5 countries with the most numbers of ranked universities were the United States, China, the United Kingdom, Japan, and Germany, with 249, 188, 86, 82, and 66 universities, respectively. The Top Ten universities are located in the United States and the United Kingdom. They are: Harvard University (United States), Massachusetts Institute of Technology (United States), Stanford University (United States), University of California–Berkeley (United States), University of Oxford (United Kingdom), California Institute of Technology (United States), Columbia University (United States), Princeton University (United States), University of Cambridge (United Kingdom), and University of Washington (United States).16
The methodology in university rankings is based on analyzing perspectives and calculating methods. The U.S. News Ranking of the Global Best Universities is based primarily on the academic information from Web of Science, a company that ranks academic journals' impact factors. There are 13 aspects to the methodology for the 2020 Ranking: Global research reputation, weighted at 12.5%; Regional research reputation, 12.5%; Publications, 10%; Books, 2.5%; Conferences, 2.5%; Normalized citation impact,10%; Total citations, 7.5%; Number of publications that are among the 10% most cited, 12.5%; Percentage of total publications that are among the 10% most cited, 10%; International collaboration, 5%; Percentage of total publications with international collaboration, 5%; Number of highly cited articles that are among the top 1% most cited in their respective fields, 5%; Percentage of total publications that are among the top 1% most highly cited articles.27
In the 2020 Ranking, there might have been several factors that influenced the objectivity of analysis and calculation, such as the perspectives of the analysts, languages of the publications, and whether the publication of the articles in academic journals with impact factors (the SCI Journals) can influence the objectivity of the Global Best University Rankings significantly. It does not cover many non-English publications and the nonacademic aspects of universities. It does not have a specific ranking in the field of Chinese Medicine, and so this ranking methodology does not cover the colleges of Chinese Medicine in large medical universities or comprehensive universities. At the same time, this methodology seems to be more inclusive of articles published in English, which will be more-beneficial for universities in English-speaking countries, such as in Europe and the United States. The actual strength of universities in non-Western traditional academic fields, such as Chinese Medicine, might have been undervalued.
There are currently 24 universities of Chinese Medicine and 18 colleges of Chinese Medicine within comprehensive universities in mainland China, for a total of 42. They provide 5–7 years of medical professional education in the different majors of Chinese Medicine—acupuncture, herbology, tuina, and rehabilitations—as well as extensive biomedical courses. The graduates of such schools have gone on to become Chinese Medicine doctors in China (a kind of medical doctor, while other kinds of medical doctors from non-Chinese Medicine schools are the same as in Western countries), with about a half-million in population, or 15%–16% of the whole population of medical doctors.28,29 These Chinese Medicine doctors work in various medical departments similar to the structure of the U.S. medical field, in different levels of hospitals. While the majority of these doctors practice herbology, acupuncture, and tuina as routine modalities to treat patients, these doctors are also eligible to prescribe medications, perform surgical procedures and biomedical examinations.
Many universities of Chinese Medicine have been listed in the best medical universities' ranking in China, and 6 of them were listed as best universities, in the “Double-Top University Plan List,”22 by the Chinese central government. Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine, as well as Beijing University of Chinese Medicine, are among the 5 earliest established public universities of Chinese Medicine (another one was Chengdu University of Chinese Medicine) in China. The education standards of 28 such schools—listed in the World Directory of Medical Schools—were accepted by the American Medical Association, and the graduates from these schools are eligible to sit for the U.S. Medical Licensing Examination.30 At the same time, all graduates of these schools are eligible to participate in examinations in acupuncture and/or oriental medicine held by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).31
The majority of the abovementioned 6000 Chinese Medicine doctors currently in the United States are licensed acupuncturists (LAc, or called “acupuncture physicians” in Florida, and “Doctors in Oriental Medicine” in some states), with the others serving as medical doctors, teachers and researchers.
In the United States, there are currently 56 colleges or universities of AOM (or Chinese Medicine), accredited by the Accreditation Commission for Acupuncture & Oriental Medicine (ACAOM).32 Compared to universities of Chinese Medicine in mainland China, these colleges or universities have much-less-extensive education in biomedicine, clinical specialties, and internship training. They have not yet been ranked among the best global universities by ranking authorities, although there are several non–well-established agencies within the United States that have ranked these institutions.24–26 They enforce important education requirements for their graduates, most requiring them to pass the NCCAOM examination to receive the NCCAOM certificate. This certificate is a basic requirement for obtaining acupuncture (or Oriental medicine) license in the majority of states, or to work in hospitals and in the veteran healthcare system in the United States.
Acupuncture and Oriental medicine (Chinese Medicine), as a major form of integrative medicine, is entering the mainstream medical system in the United States. The Joint Commission—the accreditation agency for the U.S. health care system, especially for hospitals—has started to advise that all health care systems and providers offer nonpharmacologic treatment options to patients.33 As a form of nonpharmacologic therapy, acupuncture is a most heavily evidence-based and immediately available option to fulfill these calls.9
On June 19, 2018, Rep. Jackie Walorski's (R–IN) and Rep. Judy Chu's (CA–D) Opioid Alternative bill passed unanimously in the U.S. Congress. The bill states that acupuncture is a major alternative to prescription pain medication. On October 24, 2018, President Donald J. Trump (R-NY) signed the historic Opioid Package H.R.6 Act (i.e., Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act) into law, which includes the abovementioned Opioid Alternative bill. Both the House and Senate overwhelmingly passed this final package, which endorses acupuncture as one of the most-important and promising integrative methods in pain management and for ending the opioid epidemic. 34 Since 2018, the Veterans Administration has started to cover acupuncture for all military veterans and their family members,35 and Tricare, a medical insurer for military service members, is going to start covering acupuncture for treating certain pain conditions in early 2020.36 Following the requirements of the H.R.6 law, Medicare plans to implement step-by-step coverage for acupuncture for seniors and disabled people.10
These developments are very encouraging for U.S. acupuncture and Chinese Medicine professionals, especially so as the authors' American TCM Association (ATCMA), mainly formed by Chinese Medicine doctors mentioned above, is one of the major sponsor organizations for Rep. Judy Chu's acupuncture bills.10
Conclusions
From the perspective of education assessment, the Chinese Medicine or AOM profession has developed significantly in recent years. Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine were recognized as some of the best global universities in 2020 by legitimate international ranking organizations. Their ranking shows that the improving reputation of these schools is being noticed. It indicates that Chinese Medicine schools are more-accepted and more highly ranked than in the past.
Acknowledgments
This article was written by the team of the Acupuncture Profession Survey Project, of the American TCM Association. Part of the information was presented on November 8, 2017, by Dr. Fan on Capitol Hill, in a Congressional briefing on acupuncture's role in solving the opioid epidemic. The authors would like to express thanks to David Miller, MD, LAc for double-checking information on Chinese Medicine doctors and schools in China. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.
Author Disclosure Statement
No competing interests exist.
Funding Information
No funding support from any agency or institution was received for this article.
TCM, broadly, refers to the medicine originated from ancient China, and has been widely practiced in East-Asian countries, with many schools academically. Narrow TCM mainly refers to the traditional medicine taught by current universities or colleges of Chinese Medicine in China and some other countries; some scholars believe that it does not cover Five Elements acupuncture, a classic school of acupuncture developed in the United Kingdom and the United States.
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