Title 16, Article 3.5 Acupuncture Training Programs
1399.434. Criteria for Approval of Acupuncture and Oriental Medicine Curriculum (effective 5/24/2017)
To be approved by the Board, an acupuncture and Oriental medicine educational and training curriculum shall consist of at least 2,050 hours of didactic and laboratory training and at least 950 hours of supervised clinical instruction. The curriculum shall include the following coursework that contains the following criteria:
(a) Basic Sciences 350 hours
The curriculum in basic sciences shall prepare students to enter postsecondary upper division biomedical and clinical science courses and shall consist of at least 350 hours of didactic and laboratory instruction in the following basic science courses:
(1) General biology;
(2) Chemistry, including organic and biochemistry;
(3) General physics, including a general survey of biophysics;
(4) General psychology, including counseling skills;
(5) Anatomy-- a survey of microscopic, gross anatomy and neuroanatomy;
(6) Physiology-- a survey of basic physiology, including neurophysiology, endocrinology, and neurochemistry;
(7) Pathology and Pathophysiology-- a survey of the nature of disease and illness, including microbiology, immunology, psychopathology, and epidemiology;
(8) Nutrition and vitamins;
(b) Acupuncture and Oriental Medicine Principles, Theories and Treatment 1,255 hours
The curriculum in acupuncture and Oriental medicine principles, theories and treatment shall consist of at least 1,255 hours of didactic instruction in the following principles, theories, prescription, and treatment procedures of acupuncture and Oriental medicine:
(1) Acupuncture and Oriental Medicine Principles and Theories
(A) Oriental Medicine Principles and Theory;
(B) Acupuncture Principles and Theory;
(C) Oriental Massage (e.g., Tui Na or Shiatsu) Principles and Theory;
(D) Chinese Herbal Medicine Principles and Theory, including relevant botany concepts (This subject area shall consist of at least 450 hours of instruction);
(E) Acupuncture and Oriental Medicine Diagnosis;
(F) Acupuncture and Oriental Medicine Specialties, including dermatology, gynecology, pediatrics, ophthalmology, orthopedics, internal medicine, geriatrics, family medicine, traumatology, and emergency care;
(G) Classical acupuncture and Oriental medicine literature, including Jin Gui, Wen Bing/Shang Han, Nei Jing;
(H) Modern acupuncture and Oriental medicine literature.
(2) Acupuncture and Oriental Medicine Treatment
(A) Integrated acupuncture and Oriental medicine diagnostic and treatment procedures;
(B) Acupuncture techniques and treatment procedures, including electroacupuncture;
(C) Oriental massage (e.g., Tui Na or Shiatsu), acupressure, and other techniques utilizing manual therapy and mechanical devices;
(D) Exercise therapy, including breathing, qi gong and taiji quan;
(E) Herbal prescription, counseling and preparation;
(F) Oriental and Western clinical and medical nutrition, dietary and supplement prescription and counseling;
(G) Cold and heat therapy, including moxibustion and ultrasound;
(H) Lifestyle counseling, and self-care recommendations;
(I) Adjunctive acupuncture procedures, including bleeding, cupping, gua sha, and dermal tacks;
(J) Acupuncture micro therapies, including auricular and scalp therapy;
(K) Hygienic standards, including clean needle techniques. The clean needle technique portion of this subject shall use the "Clean Needle Technique Manual 7th edition" (rev. January 2016), published by the Council of Colleges of Acupuncture and Oriental Medicine, which is hereby incorporated by reference. Students shall successfully complete the clean needle technique portion of the hygienic standards subject prior to performing any needling techniques on human beings;
(L) Equipment maintenance and safety;
(M) Adjunctive acupoint stimulation devices, including magnets and beads.
(c) Clinical Medicine, Patient Assessment and Diagnosis 240 hours
The curriculum in clinical medicine, patient assessment and diagnosis shall consist of at least 240 hours of didactic instruction and shall prepare the student to possess the knowledge, skills and abilities necessary to utilize standard physical examinations, laboratory and imaging studies, and International Classification of Diseases (ICD) diagnostic principles to improve treatment efficacy, patient safety, referral, and continuity of care; to improve communication and collaboration of care with all other medical providers; to assist in the evaluation and documentation of patient progress; and to improve the acupuncturists understanding of biochemical etiology and pathology. Clinical medicine, patient assessment, and diagnostic skills curriculum shall include the following:
(1) Comprehensive history taking;
(2) Standard physical examination and assessment, including neuromusculoskeletal, orthopedic, neurological, abdominal, and ear, nose and throat examinations, and functional assessment;
(3) Pharmacological assessment, emphasizing side-effects and herb-drug interactions;
(4) Patient/practitioner rapport, communication skills, including multicultural sensitivity;
(5) Procedures for ordering diagnostic imaging, radiological, and laboratory tests and incorporating the resulting data and reports;
(6) Clinical reasoning and problem solving;
(7) Clinical impressions and the formation of a working diagnosis, including acupuncture and Oriental medicine diagnoses, and the World Health Organization's International Classification of Diseases (ICD-910);
(8) Awareness of at-risk populations, including gender, age, indigent, and disease specific patients;
(9) Standard medical terminology;
(10) Clinical sciences--a review of internal medicine, pharmacology, neurology, surgery, obstetrics/gynecology, urology, radiology, nutrition and public health;
(11) Clinical medicine--a survey of the clinical practice of medicine, osteopathy, dentistry, psychology, nursing, chiropractic, podiatry, naturopathy, and homeopathy to familiarize practitioners with the practices of other health care practitioners.
(d) Case Management 90 hours
The curriculum in case management shall consist of at least 90 hours of didactic instruction and shall prepare the student to manage patient care as a primary health care professional, and shall include instruction in the following subjects:
(1) Primary care responsibilities;
(2) Secondary and specialty care responsibilities;
(3) Psychosocial assessment;
(4) Treatment contraindications and complications, including drug and herb interactions;
(5) Treatment planning, continuity of care, referral, and collaboration;
(6) Follow-up care, final review, and functional outcome measurements;
(7) Prognosis and future medical care;
(8) Case management for injured workers and socialized medicine patients, including a knowledge of workers compensation/labor codes and procedures and qualified medical evaluations;
(9) Coding procedures for current procedural and diagnostic codes, including Curren Procedural Terminology (CPT) and International Classification of Disease ICD-10 diagnostic codes;
(10) Medical-legal report writing, expert medical testimony, and independent medical review;
(11) Special care/seriously ill patients;
(12) Emergency procedures.
(e) Practice Management 45 hours
The curriculum in practice management shall consist of at least 45 hours of didactic instruction and shall include the following subjects:
(1) Record keeping, insurance billing and collection;
(2) Business written communication;
(3) Knowledge of regulatory compliance and jurisprudence (municipal, California, and federal laws, including OSHA, Labor Code, Health Insurance Portability and Accountability Act of 1996 (HIPAA);
(4) Front office procedures;
(5) Planning and establishing a professional office;
(6) Practice growth and development;
(7) Ability to practice in interdisciplinary medical settings including hospitals;
(8) Risk management and insurance issues;
(9) Ethics and peer review.
(f) Public Health 40 hours
The curriculum in public health shall consist of at least 40 hours of didactic instruction and shall include training in the principles of public health, including the following subjects:
(1) Public and community health and disease prevention;
(2) Public health education;
(3) A minimum of eight (8) hours in first-aid and adult/child cardiopulmonary resuscitation (CPR) from the American Red Cross, American Heart Association or other organization with an equivalent course approved by the board;
(4) Treatment of chemical dependency;
(5) Communicable disease, public health alerts, and epidemiology.
(g) Professional Development 30 hours
The curriculum in professional development shall consist of at least 30 hours of didactic instruction and shall prepare the student with the skills to continue to expand their knowledge, including instruction in the following subjects:
(1) Research and evidence based medicine;
(2) Knowledge of academic peer review process;
(3) Knowledge and critique of research methods;
(4) History of medicine.
(h) Clinical Practice 950 hours
The curriculum in clinical practice shall consist of at least 950 hours in clinical instruction, 75% of which shall be in a clinic owned and operated by the school, which includes direct patient contact where appropriate in the following:
(1) Practice Observation (minimum 150 hours)--supervised observation of the clinical practice of acupuncture and Oriental medicine with case presentations and discussion;
(2) Diagnosis and evaluation (minimum 275 hours)--the application of Eastern and Western diagnostic procedures in evaluating patients;
(3) Supervised practice (minimum 275 hours)--the clinical treatment of patients with acupuncture and oriental medicine treatment modalities listed in the Business and Professions Code Section 4927(d) and 4937(b).
(4) During the initial 275 hours of diagnosis, evaluation and clinical practice, the clinic supervisor shall be physically present at all times during the diagnosis and treatment of the patient. Thereafter, for a second period of 275 hours the clinic supervisor shall be physically present at the needling of the patient. The clinic supervisor shall otherwise be in close proximity to the location at which the patient is being treated during the clinical instruction. The student shall also consult with the clinic supervisor before and after each treatment.
NOTE: Authority cited: Sections 4927.5 and 4933, Business and Professions Code. Reference: Sections 4927.5, 4938, 4941 and 4944, Business and Professions Code.
An acupuncture and Oriental medicine training program approved by the board shall adopt the following procedures for its program effective January 1, 2005:
- (a) Candidates for admission shall have successfully completed at least two (2) academic years (60 semester credits/90 quarter credits) of education at the baccalaureate level that is appropriate preparation for graduate level work, or the equivalent from an institution accredited by an agency recognized by the U.S. Secretary of Education
- (b) The training program should be located in an educational institution approved under Article 4 (commencing with Section 94770) of Chapter 7 of Part 59 of the Education Code, or in the case of training programs located outside California, in an institution which is approved by the appropriate governmental accrediting authority or an accrediting agency recognized by the U.S. Department of Education.
- (c) The training program shall develop self study evaluation process to determine the effectiveness of its theoretical and clinical program.
- (d) Coursework shall carry academic credit.
- (e) The director and supervisor(s) of the clinical portion of the training program shall be a licensed acupuncturist in the state where the educational institution is located and with at least 5 years of licensed clinical experience in the practice of acupuncture and Oriental medicine.
- (f) All instructors shall be competent to teach their designated courses by virtue of their education, training and experience. All faculty credentials shall be equivalent to the course and degree level being taught.
- (g) Each training program shall develop policies and procedures to evaluate and award transfer credit to students for coursework and experience which is equivalent to current coursework and clinical instruction required Such policies and procedures shall be defined in the school's catalog and shall include the following
- (1) Credit shall only be awarded for actual coursework.
- (2) Where the coursework and clinical instruction were completed at an acupuncture school not approved by the board, the evaluation shall include an examination administered and retained by the school in the subject area(s) in which transfer credit may be awarded.
- (3) Up to 100% transfer credit may be awarded for coursework and clinical instruction completed successfully at another acupuncture school or college which is approved by the board.
- (4) Up to 100% transfer credit may be awarded for courses completed successfully in basic sciences, clinical medicine, case management, practice management, public health, and professional development at a school which is approved under Article 4 (commencing with Section 94770) of Chapter 7 of Part 59 of the Education Code or by an accrediting agency recognized by the U.S. Department of Education.
- (5) Up to fifty percent (50%) credit, by transfer or challenge exam, for clinical practice coursework and instruction in acupuncture and Oriental medicine principles, theories and treatment procedures completed successfully at a school which is not approved by the board may be awarded by a school approved by the board, provided that at least 50% of the course hours in individual subjects are completed successfully at a school approved by the board.
- (6) The entire record of the evaluation and award of the student's transfer credit shall be included in the student's academic file and shall be made an official part of the student's transcript which shall be filed with the board upon request.
- (7) All students shall receive upon matriculation a copy of the school's policies and procedures for evaluating and awarding transfer credit.
(a) Each educational and training program seeking board approval of its curriculum shall submit an "Application for Board Approval of Curriculum" (rev 4/15), hereby incorporated by reference. The application shall be accompanied by the following information and documentation:
(1) Educational and training program legal name, current address, phone number, website, contact person, and program(s) requested for board curriculum approval;
(2) A completed course-by-course list for each course that meets the board required coursework with course number, clock hour, and course unit to document that the curriculum meets the requirements for Section 1399.434;
(3) A list of all courses in the program requested for board approval of curriculum with course hours, course units, course number and course title;
(4) A copy of all course syllabi for program(s) requested for board curriculum approval; and
(5) A copy of the current course catalog.
All information and documentation submitted under this section shall be in English.
(b) An "Application for Board Approval of Curriculum" shall be deemed received and complete pursuant to Business and Professions Code Section 4927.5, subdivision (b), when the board has received a complete application, including the form and all information and documentation, as defined in subdivision (a) of this regulation.
(c) An educational and training program whose "Application for Board Approval of Curriculum" is incomplete shall be notified, in writing, that the application is incomplete, and of the reasons the application is incomplete and instructions for how to address the incomplete application. An educational and training program's incomplete application shall be deemed abandoned if the educational and training program does not submit a complete application to the board within 30 days of the mailing of the written notification that the application is incomplete.
(d) An "Application for Board Approval of Curriculum" submitted subsequent to the abandonment of a prior application shall be treated as a new application.
(e) Any changes to coursework as listed in Section 1399.434 after Board approval constitutes a new curriculum and requires Board approval pursuant to Business and Professions Code Section 4927.5. The approval shall be attained prior to implementing the new curriculum.
NOTE: Authority cited: Sections 4927.5 and 4933, Business and Professions Code. Reference: Sections 4927.5, 4937 and 4938, Business and Professions Code.
The board may deny, place on probation, suspend or revoke the approval granted to any acupuncture training program for any failure to comply with the regulations in this article, the Acupuncture Regulations or the Acupuncture Licensure Act.
- (a) Every approved acupuncture school shall be required to submit to the board within sixty (60) days after the close of the school's fiscal year a current course catalog with a letter outlining the following: 1) any courses added/deleted or significantly changed from the previous year's curriculum; 2) any changes in faculty, administration, or governing body; 3) any major changes in the school facility; and 4) a statement regarding the school's financial condition, which enables the board to evaluate whether the school has sufficient resources to ensure the capability of the program for enrolled students.
- (b) If determined necessary an on-site visit by representatives of the board will be made to the school to review and evaluate the status of the school. The school will be required to reimburse the board for direct costs incurred in conducting such review and evaluation.
- (c) All student records shall be maintained in at least English.
- (d) Each approved acupuncture school shall report to the board within 30 days any substantial changes to the facility and/or clinic(s), and curriculum required in this section.