When students elect to spend a month learning about integrative medicine at the University of Maryland, they study by working with the toughest, most frazzled patients: themselves.
In their fourth year of medical school, many of the students are exhausted and fighting to get good grades. They're tired; they experience headaches and back pain; and they don't feel as sharp as they'd like.
But these students aren't focusing on what drugs to prescribe. Instead, they're looking at integrative therapies in search of better health.
Under the direction of Dr. Delia Chiaramonte, University of Maryland Center for Integrative Medicine's director of professional education, the students make a values list, which Chiaramonte says helps them consider whether they might suffer from undue stress because they're not focusing on what's truly important to them. They also learn to consider how daily stresses and triggers are affecting their lives, and they practice yoga and tai-chi.
"By the end of the month, they almost always feel better themselves," said Chiaramonte. "They really learn viscerally for themselves that this stuff works."
The Maryland students aren't the only ones looking past the pill in search of better health. A growing number of Americans have embraced complementary or integrative medicine, which combines conventional, allopathic medicine with alternative therapies.
According to the most recent data from the National Institute of Health's National Institute for Complementary and Alternative Medicine, some 38 percent of Americans used some form of alternative medicine in 2007 -- up from 36 percent in 2002. Experts say such figures explain why a growing number of medical schools have embraced what critics deride as "woo-medicine," but proponents of the techniques say integrative medicine represents the future of health care.
"More and more students are interested in integrative medicine -- that's clear," said Dr. Mary P. Guerrera, a professor of family medicine and director of integrative medicine at the University of Connecticut. "There is greater awareness in the world-at-large. With that, students are coming to medical school already aware of what it is."
In the last decade, the National Consortium of Academic Health Centers for Integrative Medicine, which was formed to promote and support integrative medicine in medical schools, has ballooned from eight member institutions to 51. That list includes top academic names, like Harvard University, Johns Hopkins and the Mayo Clinic.
Last month, University of California-Los Angeles hosted the first-ever National Student Conference on Integrative Medicine, an event created by students looking to build upon the traditional medical school curriculum by exploring topics from what they dubbed an "integrative perspective." It drew more than 100 attendees, including some who don't have access to training in integrative medicine at their home institutions.
"I met a resident who wanted to incorporate some of these practices and who said it was so helpful to have physicians who he could talk to. ... It gave him hope that he can go out there and learn this," Guerrera said. "He felt very isolated in his training program, because there was no one he was able to identify to help him."
Among the institutions that do provide training in integrative medicine, that education takes many forms. Some medical schools offer month-long immersive electives, others simply offer several-hour-long lectures introducing medical students to areas they may not have considered before.
The University of Arizona has been at the forefront of incorporating integrative medicine into its programs: They've partnered up with like-minded residency programs and recently created a distinct program for medical students that lets them supplement their traditional training with a focus in integrative medicine over their four years.
"It's a really big step that the College Of Medicine was willing to say 'This is important. This is no longer fad, and we will recognize it,' " said Dr. Victoria Maizes, executive director at the Arizona Center for Integrative Medicine.
But some medical schools still lack a formal environment to learn integrative medicine, experts say, and not all institutions have faculty that's supportive of the techniques. That may in part stem from limited evidence testifying to the efficacy of alternative therapies. Even the National Institute for Complementary and Alternative Medicine acknowledges many complementary and alternative medicines lack the backing of trustworthy clinical trials.
But Maizes argued that many tenets of complementary medicine have already been independently verified. She noted, for instance, that there is significant scientific evidence supporting the role of good nutrition -- which is a major focus of integrative medicine -- in health, as well as the connection between the mind and body. What is lacking, she said, are clinical trials comparing integrative therapies to traditional medicine.
Which is why supporters believe incorporating integrative medicine in medical schools is important, so that students who apply integrative therapies and ideas are well-grounded in conventional training.
"We're not cutting anything out from traditional medicine," Chiaramonte said. "We're adding to the toolbox."