Important Factors in Naturopathic Professional Formation (part 4 in a series)
Canadian naturopathic doctors faced a bumpy road in trying to position their naturopathic college in the higher education landscape.
Understanding and defining the formation of naturopathy as a heterodox system of naturopathic medicine exhibits some of what Geiger (1991) means when he describes how peripheral private sector institutions evolve during the formational processes of particular groups or professions. He explains, “private institutions will tend to be closely associated with a sponsoring group or a specific clientele, and thus particularly responsive to the needs of those sponsors or clients” (Geiger, 1991, p. 223). At the same time as they are busy responding to those needs, though, private institutions such as the naturopathic colleges affiliated with the CNME are unlikely to have the resources to compete academically with public sector institutions that they aspire to emulate. Thus, the five colleges and one university offering naturopathic programs in North America find themselves traveling through complicated terrain.
Within this reality, every established, accredited naturopathic program in North America has found a niche just outside and parallel to the academic mainstream. That niche is also occupied, though, by self-interested professional naturopathic associations and groups who, just as the educational institutions that formed the foundation of their growth were finding their way, had been equally busy trying to establish themselves as a profession. It is in this complex interplay among the naturopathic medical practitioner, the emerging naturopathic medical academic, and the associations charged with scouting the terrain of professional formation and mapping a successful route across it, that the scholars of higher education and the sociology of the professions find much fascinating subject matter to explore.
This dynamic creates an ongoing connection between the practitioner in the field and the academic in the college. To capture the significance of that important link between education and clinical practice in the CAM field, though, we have to go far back, even prior to 1978 when Bastyr and OCNM were launched. In fact, the scene was set as far back as the late 1950s for what accumulated into a renewed effort to move naturopathic medicine into the mainstream. Important to note is that up until those first graduates from NCNM, JBC, and OCNM became registered in the United States and Canada as NDs, both Canada and the United States had depended almost entirely on a number of American chiropractic and related naturopathic programs for a virtual trickle of new, qualified naturopaths. This American source of trained naturopathic practitioners had disappeared with the closing of naturopathic programs such as those at National College of Chiropractic in Chicago (1951) and Western States College in Portland, Oregon (1955). The naturopathic program at Western States, one of a large group of chiropractic colleges and universities that had for decades offered joint chiropractic and naturopathic programs, had been the last surviving school with an accredited naturopathic program in the United States, closing its doors to naturopathic students in 1955.
In the late 1970s, however, a burst of activity arising from an interest in holism (Baer, 1987, 2001) took place. It was aimed squarely at repositioning the naturopathic profession in the higher education sector. Realizing that the basis of establishing and growing their profession meant that naturopathic doctors needed to have an educational platform of high quality resulted in the establishment of five different schools within the same three-year period: the Arizona College of Naturopathic Medicine, the American College of Naturopathic Medicine [Oregon], the Pacific College of Naturopathic Medicine [California], John Bastyr College [Washington], and the Ontario College of Naturopathic Medicine [Ontario, Canada]. Of these five, only two survived the 20th century in a world dominated by biomedicine—John Bastyr College and the Ontario College of Naturopathic Medicine. The former is now a university with a variety of programs; the latter is now called The Canadian College of Naturopathic Medicine (CCNM), with a singular program focus.
The naturopathic profession in Canada and the United States had been alarmed for years by the vulnerability that not having viable training institutions entailed, because the cohort of registrants was tiny and inconsistent. NCNM was key to providing a platform for the reestablishment of the naturopathic profession in North America. Fred E. Parsons, president, and Dr. Ross Skaken, secretary-treasurer, respectively of the Canadian Naturopathic Association, wrote an extensive report for the 1956 convention, in which they announced the newly formed National College of Naturopathic Medicine, describing it as “only one small college hanging on to existence with nothing to spare” (Canadian Naturopathic Association Executive Report on the State of the Profession, 1956, p. 3). As the chiropractic schools in the United States, and the only existing chiropractic school in Canada, located in Toronto, distanced themselves from naturopathic medicine, the modalities and practices of which were seen as too controversial, the preparation of new graduates became increasingly difficult to sustain.
National College of Naturopathic Medicine (NCNM) limped through the 1950s and 1960s graduating tiny classes. However, from these modest beginnings, by the early 1970s, NCNM had spawned a satellite campus in Seattle, Washington. By 1978, though, NCNM was a single-campus institution once again, in Portland, Oregon, and its satellite campus became John Bastyr College, alluded to earlier. In that same year, cited above, OCNM was established in Ontario based on the NCNM model. NCNM was the parent, then, of CCNM not only in that CCNM emulated its curriculum and clinical education standards, but also in light of NCNM’s impact on the development of John Bastyr College, later to become John Bastyr University. Bastyr University, in turn, influenced the institutionalizing of naturopathic medical education at CCNM by modeling an institutional development process that led directly to the higher education realm.
Bastyr was from the outset more focused on establishing a full-time program tied into federal and state accreditation process than OCNM. Indeed, Bastyr had the institutional memory and support of NCNM to generate that momentum. In Ontario, OCNM would take many years before positioning itself in the nonprofit sector and taking aim at higher education more systematically. In any case, 1978 became a pivotal year for naturopathic medical education in North America as new organizations jockeyed in their jurisdictions for a place to grow securely. Even though the Ontario college earnestly tried to affiliate with the province’s higher education sector as part of that naturopathic medical education surge in the late 1970s, it lost its fragile university link by 1980 and did not offer a full-time undergraduate program until 1983, relying instead on attracting already licensed primary health care practitioners, such as chiropractors and dentists, to its part-time intensive course.
The leaders of OCNM did not fully appreciate the serious limitations that their early proprietary model imposed on their institutional identity. The University of Waterloo could affiliate with the early OCNM program only inasmuch as Waterloo’s undergraduate kinesiology program was a useful preparatory program for naturopathic medicine. There were no transfer credits and no sharing of resources, standard articulation paths for institutions operating in the same framework.
Within this kind of evolution, it is important that we look at the institutional nature of naturopathic colleges particularly in terms of their commitment to being part of the higher education world, tucked as they are between the private and the public sectors. National College of Naturopathic Medicine, Southwest College of Naturopathic Medicine, Bastyr University, and the Faculty of Naturopathic Medicine of Bridgeport University were all heavily influenced in their institutional development by NCNM’s early focus on a location in the higher education framework of its state. Interestingly, it was John Bastyr College, the original offspring, that persisted most successfully in this focus and was the first of the modern day naturopathic colleges to achieve university status within a state regulatory framework, and within a (federal) regional accreditation context.
An understanding of what the organizational pathways for naturopathic medical education in Canada and the United States were modeled on is an important aspect of the actual institutionalizing of naturopathic medical education in North America. Strong U.S. roots in the formation of the naturopathic profession, the higher education contexts of the schools themselves in both countries, and the steady influences of the voluntary, nonprofit, third-sector (nonprofit) characteristics of these institutions’ respective early formation are key areas of interest for us. The developments in the United States influenced the formation of the naturopathic profession in Canada very directly.
For example, beginning in 1956, as mentioned above, National College of Naturopathic Medicine in Portland, Oregon, was the only recognized source of new naturopathic doctors eligible to practice in regulated states and provinces in North America for the next two decades. While American-trained naturopathic doctors were politically active in jurisdictions such as British Columbia, the NDs and drugless practitioners in Ontario had experienced numerous setbacks between the creation of the Drugless Practitioners Act (1925) and the creation of OCNM in 1978. Dr. Skaken of the Canadian Naturopathic Association (1956) reported:
(Extract)In the Province of Ontario, there has been considerable agitation and dickering with the Minister of Health, with the object of having a separate board and definition of Naturopathy set up under the regulations of the Drugless Practitioners Act. The Ontario attempt has finally ended in disappointing defeat and the whole issue has been abandoned. (Skaken, 1956, p. 19)
There were numerous smaller institutes in Ontario and British Columbia during this period where training and practice in some of the naturopathic modalities occurred; however, OCNM was the first of its kind focused on a comprehensive, eclectic, naturopathic medical education including all the modalities, as well as on clinic services integrated into a full-time, post baccalaureate four-year curriculum. During the 1920s and 1930s Dr. A.W. Paskin’s Associated Nature Cure & Physiotherapy Institute in British Columbia, for example, did provide preceptorships for Canadian students studying naturopathic medicine, but offered no cumulative sequence of courses or training programs itself of the sort contemplated by the founders of OCNM almost 50 years later (CNA Archives, newsletter, August 1931).
By the late 1970s, in any case, a group of chiropractors and an American-trained Ontario naturopathic physician initiated a pre-naturopathic curriculum informally affiliated with the science-stream kinesiology program at the University of Waterloo. To speed up the supply of qualified naturopathic doctors, these same founders also launched an abbreviated fast-track 850-hour postgraduate program alluded to above as “part-time intensive.” This course of study was composed of a series of weekend seminars lasting three years. Using the only incorporating vehicle available to them at the time (the Ontario Corporations Act), the founders of OCNM eventually designed and financed a brick and mortar school privately owned by a small group of NDs and chiropractors. The school’s mandate was to train naturopathic practitioners for the province of Ontario and Canada. The location of the school in civil society, though, as a privately held business, proved as confusing to other institutions as it did to the students whom the school initially attracted.
The curriculum of the preprofessional program was aimed directly at satisfying a postgraduate standard for entry to the ND program itself. The intensive postgraduate program was designed for health care professionals already qualified in a primary health care occupation such as dentistry or chiropractic. Some early drugless therapists also participated, hoping to upgrade quickly their qualifications and skills in natural therapies.
The overall goal of those who launched the new naturopathic school was to quickly increase the number of NDs in the province, and in Canada to avoid a looming threat of deregulation recommended in 1970 by the government of Ontario’s Report of the Committee on the Healing Arts. The urgency to stimulate numbers, though, was tempered from the beginning by the “dream of a full-time undergraduate program with links to a university” (ONA, February 3, 1979). A full-time four-year program was added in 1983, but it was stand-alone, and at that point not linked to any public sector program or university in the province.
The school’s initial and informal links to the University of Waterloo’s kinesiology program proved to be unsustainable. The original goal of affiliating with a university was in part driven by the impossibility of operating as an approved program of the Ministry of Colleges and Universities, and in part by understanding the “location” of the proposed naturopathic program as “post-graduate” in nature, or at the very least, “within a first professional degree category” (ONA, February 22, 1976).
In Canada, and more particularly in Ontario, the postsecondary and higher education public policy and regulatory frameworks of this period were geared to affiliation, and the early naturopathic college felt compelled to seek, as the chiropractic college had been trying to do for more than a decade, formal affiliation with a public sector university. Indeed, at the very point when the first full-time naturopathic undergraduate program was established, the Ontario government passed the Degree Granting Act in 1983, the provisions of which made it necessary to have authorization from the Legislature in order to grant degrees or at the very least, to be affiliated with a university that already did have those powers. It was the policy of the Ontario government, in fact, not to bring in legislation for any new, private degree-granting institutions, but instead to encourage aspirants to seek affiliation with a publicly supported university. CCNM’s founders and early leaders understood this preferred route to degree-granting ability and higher education respectability. However, from their organizational location as a private, career college, the affiliation route was fraught with barriers. These developments are entirely different from what was occurring in the United States during this same period. The American higher education sector is constructed differently and manifests differently.
Meanwhile, as a backdrop to these ambitious beginnings in Canada, there was the influence of the report called the Ontario government’s Report of the Committee on the Healing Arts (1970), which considered the naturopathic profession as marginal and likely disappearing. This attitude on the part of policymakers and Ministry of Health officials in Ontario persisted into the 1980s despite the presence at that time of over 140 drugless practitioners in the province who operated under the earlier mentioned 1925 Drugless Practitioners Act. Gort and Coburn (1988) have discussed how three major commissions, one federal and two provincial, were charged with charting the course for health professions in Ontario in this period. CCNM developed as an educational institution within this political and legislative context and, along with the naturopathic profession itself, was affected negatively in each case.
By the winter of 2001, that early vision of a bona fide, government-endorsed postgraduate higher education program resurfaced. Ontario’s Bill 132, passed into law in December 2000, was greeted by the naturopathic profession and its now thriving school with considerable enthusiasm. They were confident that the intentions and the provisions of Bill 132 would finally make it possible for the profession to have a naturopathic college with degree-granting status. Thus, the parallel goals of forming a profession with broad, societal acceptance and privileges, and accrediting a degree-granting educational platform for that profession, were seen to be converging at long last.
Just as National College of Naturopathic Medicine, Bastyr University, Southwest College of Naturopathic Medicine, and the Faculty of Naturopathic Medicine at Bridgeport University were relying on regional accreditation to establish their presence in higher education, so too the Canadian College of Naturopathic Medicine was committed to earning government recognition to take its place as an institution of higher learning. A related, parallel process was occurring for the profession itself in its attempts to be included under the more comprehensive and modern Regulated Health Professions Act (RHPA, 1991). After its enactment, the naturopathic profession had twice (1995, 2000) presented its proposals for inclusion under the act in the Province of Ontario without success. However, at the time of this writing, and significantly after CCNM had achieved CNME accreditation and had upgraded its instructional and research resources, the Ontario naturopathic profession is now on the cusp of regulation within the same act as other mainstream health care professionals in that province.
Baer HA: Biomedicine and Alternative Healing Systems in America: Issues of Class, Race, Ethnicity and Gender, Madison, 2001, University of Wisconsin Press.
Baer HA: Divergence and convergence in two systems of manual medicine: osteopathy and chiropractic in the United States, Med Anthropol Q 4:176-93, 1987.
CNA Newsletter, mimeograph, August 1931.
Geiger RL: Private higher education. In Altbach PG (ed): International Higher Education: An Encyclopedia, New York, 1991, Garland Publishing, Vol. 1, pp 233-46.
Gort EH, Coburn D: Naturopathy in Canada: changing relationships to medicine, chiropractic and the state, Soc Sci Med 26(10):1061-72, 1988.
Government of Ontario: Report of the Committee of the Healing Arts, Ontario Legislature, 1970, Toronto, Ontario.
Ontario Naturopathic Association (ONA): Meeting Minutes, February 3 and February 22, 1976.
Skaken R: Unpublished mimeograph. 1956.Canadian Naturopathic Association Executive Report on the State of the Profession. Distributed at the annual exhibition and general meeting of the Canadian Naturopathic Association, Calgary, Alberta, October 14-16.
David Schleich, president of Truestar Health, is the former CEO and president of Canada’s accredited Canadian College of Naturopathic Medicine, where he served from 1996 to 2003. His previous posts have included appointments as vice president academic of Niagara College, and administrative and teaching positions at St. Lawrence College, Swinburne University (Australia), and the University of Alberta. His academic credentials have been earned from the University of Western Ontario (BA), the University of Alberta (MA), Queen’s University (BEd), and the University of Toronto (PhD).