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This is a heads up for all you acupuncture students out there. Once you graduate from four years of studying Chinese Medicine and Acupuncture, you aren’t done. Depending on where you plan to practice, you either need to pass the California Acupuncture License Exam or the National Certification Commission for Acupuncture and Oriental Medicine’s (NCCAOM) Oriental Medicine Certification. Unless you are absolutely certain you won’t ever practice in California, it is strongly recommended that you take the California Boards. These exams aren’t cheap and you want to make sure you have money set aside to pay for them. Here’s the break down in costs:

California Acupuncture License Exam (CALE)

Application Fee: $75 — One time fee.
Examination Fee: $550 — Per exam. Try not to fail.
Certification: $325 (prorated based on max 2 years) — Once you pass, this is what you pay to get your license.

CALE Initial Total: $950

NCCAOM Oriental Medicine Certification

You will need to take 4 exam modules: Foundations of Oriental Medicine, Acupuncture with Point Location, Biomedicine, and Chinese Herbology.

Oriental Medicine Application Fee: $550 — One time fee.
Foundations of Oriental Medicine Module Exam: $300 — Per exam.
Acupuncture with Point Location Module Exam: $300 — Per exam.
Biomedicine Module Exam: $200 — Per exam.
Chinese Herbology Module Exam: $300 — Per exam.

NCCAOM Initial Total: $1650

Grand Total for CALE and NCCAOM: $2600 

This total assumes that you only have to take everything once. If you have to take one or more of these exams multiple times, it’s going to get painful quick. The last thing you want to do is graduate but can’t practice because you can’t afford to pay for the exams. If you have to travel to Sacramento to take the California Boards, factor in travel and hotel expenses. Good news is that they will be having exams in the Southern California area in the near future.

Acupuncture is found to work better than drugs like aspirin to reduce the severity and frequency of chronic headaches. A team at Duke University recently reviewed studies involving nearly 4,000 patients with migraine, tension headache and other forms of chronic headache and found that 62 percent of the acupuncture patients reported headache relief compared to 45 percent of people taking medications.

Acupuncture works by triggering the release of the body’s natural painkillers without the side effects of drugs. Common side effects of Aspirin include heartburn, nausea and upset stomach. Chinese Medicine is also much more nuanced in its diagnosis of headaches. We don’t treat it with a one-size-fits-all pill. We treat headaches differently depending on what area of the head, whether the pain is sharp or dull, and other accompanying signs and symptoms. This is why Acupuncture, combined with Chinese herbal medicine is so effective.

Other studies have shown that acupuncture helped alleviate pain in patients who had surgery for head and neck cancer, can relieve hot flashes and other menopausal symptoms and can reduce chemotherapy-induced nausea.

Link to full article at Reuters: Acupuncture Beats Aspirin for Chronic Headache

There’s currently a lot of sensational news in the media surrounding this new swine flu. The media is reporting triple digit deaths and increasing spread of infection throughout the world. The World Health Organization is calling it a pandemic, meaning that it is a new influenza virus that we humans have no immunity to and it has the potential to spread rapidly and cause a lot of deaths.

In Egypt, the government plans to slaughter the country’s 250,000 pigs. Wild boars are being killed in Iraq. Concerts and public events are being cancelled in Mexico. Hundreds of tourists are being quarantined in Hong Kong. Here in the U.S. Lawmakers are talking about closing our border with Mexico.

Let’s cut through the mass hysteria and get some perspective on this new strain of influenza.

1. It is a strain of influenza. You’ll experience the same symptoms as normal flu. Fever, cough, body aches, sore throat, chills, fatigue. Some people have also reported diarrhea and vomiting.
2. There is no evidence that this new strain was spread from pigs to humans. You will not get it from eating pork. The World Health Organization has stopped using the term “swine flu” late last week to avoid this confusion. It is now called H1N1.
3. As of April 29th, the World Health Organization has only confirmed 7 deaths due to swine flu. The 152 deaths reported by media outlets at the time are false.
4. Each year around the world, 500,000 people die from the flu. 36,000 of those deaths are in the U.S. 7 deaths out of hundreds of infections are hardly cause for widespread fear about this virus.
5. There are no vaccines for this new influenza strain. Even for strains that we already have vaccines for, effectiveness is questionable. Look at how many people still die from the flu. You also need to have the right vaccine for the right strain. In addition, beware of their side effects, which include diarrhea, nausea, sinusitis, nasal signs and symptoms, bronchitis, cough, headache, dizziness, and ear, nose, and throat infections. That’s right you may get flu like symptoms taking a vaccine! With viruses constantly evolving, vaccines cannot be a permanent solution. There will always be a threat of new strains.
6. Health officials are recommending Tamiflu. Its most common side effect is nausea and vomiting. Japan and Korea banned this drug, linking it to an increase in suicidal behavior of influenza patients aged between 10 and 17.
7. During the swine flu outbreak in 1976, 25 people died from flu inoculation while 1 person died from the flu itself.

The best thing you can do is to wash your hands regularly. The proper way to wash your hands is scrubbing them under warm soapy water for at least 15 seconds. That, along with getting plenty of rest and Chinese medicine, can take care of the flu.

Yes, Chinese medicine and acupuncture are effective against the flu. There are herbs with broad antiviral and antibacterial properties that, unlike vaccines, can treat a broad spectrum of diseases, not just 1 specific strain of 1 disease. The exact combination of herbs prescribed is not one size fits all but tailored to an individual’s unique needs. In addition, acupuncture can address sign and symptoms and boost the immune system.

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I’m about to finish my last clinical hours as a Chinese Medicine and Acupuncture intern at Yo San University. I put together these ten tips to help make the transition smoother for future acupuncturists preparing to go into their final year in clinic. Interns past and present, please feel free to chime in with your suggestions.

1. Manage Your Time.
Time management is probably the toughest issue for most new interns. If there’s one thing you should focus on first, this would be it.

Wear a wristwatch and always be aware of how you are doing on time. Know when in the hour you need to get certain things done by. You have 1 hour for each patient and that hour includes intake, diagnosis, treatment plan, put in needles, leave them in, fill herbal prescription, take out needles, and clean up. It can be a little overwhelming at first, especially if something doesn’t go smoothly. You have to factor in if the patient comes late, if your supervisor is busy with another intern, if the patient has a complex condition that requires a more lengthy intake, if the patient needs to change, if you are doing cupping/moxa/tuina/Qi Gong, etc.

Getting your time management down will make everything else easier. You won’t feel as rushed. You have more time to think, relax and be who you are in the treatment room. And since you aren’t fighting against time, if something unexpected comes up, it’s not going to be a meltdown.

Intake and needling were the 2 things that slowed me down in the beginning. It’s important to focus during the intake and ask relevant questions. Read the patient’s file ahead of time, either before the shift starts or while you still have the previous patient “cooking” with the needles. Once you start seeing regulars, their intakes can be done very quickly.

As for needling, I used to take one needle at a time, insert, and repeat. It would take me 10-15 minutes to finish. When I started gripping the spare needles between the pinkie and ring fingers of my off-hand I cut my time by more than half. Free handing instead of using guide tubes also helped speed things up. As I became more familiar with locating points on the body, that also made things go faster.

2. Ask Questions.
You are going into your final year and this may be the last opportunity you get before you graduate and go off on your own. Don’t be afraid to ask questions. Take notes. Figure out for yourself what works great and what don’t.

3. Trust your Intuition.
Work on your intuition while you are in the clinic. Our medicine is more than just treating the symptoms that are present. Sometimes the patient leaves out an important piece of information. Something tells you to needle a certain point. Practice seeing beyond what’s “there.” Use all your senses, including your 6th sense, to help you.

4. Look Professional.
As a medical professional, patients look to you to help take care of their health. This is a big responsibility. Be respectful of yourself and your patients by dressing the part. Looking professional helps leave a positive impression and builds trust. Have good hygiene, wear clean non-wrinkled clothes, and follow a professional looking dress code. Check out some of my tips in this blog for help.

5. Take Care of Yourself.
Eat well. Do self-cultivation. Get enough sleep. Have a life outside of school. You want to serve as a positive role model for your patients. If you are taking care of your health and your life, it will show. No words are needed to convey that to your patients. Your patients will respect you and be more compliant with your recommendations. You won’t get sick as easily. You’ll be more present. And when things do go crazy, you are able to stay centered and grounded.

6. Be fully present and confident.
Patients don’t get better with just your kickass acupuncture skillz alone. The energy you project and emanate is equally, if not more important. When you are able to connect with your patients, they will be more relaxed and open to the healing process. The last thing anyone wants when they are sick is a healer who is uncaring, not confident, or closed off.

Maintain a positive attitude, a good sense of humor, and a smile. Practice being compassionate, fully present and dedicated. Work on your listening skills. Maintain good eye contact. Your positive energy will raise theirs as oppose to theirs bringing yours down.

7. Get a good hand moisturizer.
You are going to be washing your hands a lot. They’re going to get dry. Invest in a good, travel size hand moisturizer that you can keep in your lab coat at all times. Whole Foods has a good selection. They have samples you can try. Find one that’s not too oily but also not too light. It shouldn’t be too fragrant either. I like the Kiss My Face stuff. EO is good too.

While you’re at it, get some good breath mints. I like the Tao of Wellness’s Frosties Crystals. Strong, effective and made with Chinese herbs!

8. Stay on top of your new patients.
Interns have trouble getting their new patient requirements done on time. We need 60 to graduate. I recommend getting started right away since it will only get harder and harder later when more repeat patients want to come back and see you.

If you are doing 5 shifts, block out at least 2-3 new patient slots per week. Get people you know to come in and see you. Call in those favors from friends. Practice promoting yourself. Start talking to anyone and everyone about the benefits of acupuncture and Chinese Medicine. Then close the deal. Give out your business card. Hand out discount coupons. Remember to have them come in to see you specifically.

It’s truly amazing the amount of pain and discomfort so many people put up with while not knowing what our medicine can do for them. It can dramatically improve people’s lives. With that in mind, why wouldn’t you be excited talking to other people about our medicine?

9. Do Externships
Externships are a great way to experience different settings in which we practice our medicine. You see patients you may rarely see at our clinic. For example, at Being Alive you treat HIV positive patients. Many of them have a history of drug use and other serious diseases. You also get to work with a really gifted supervisor. Carolyn Leigh is amazing. Intuitive, compassionate, and smart.

Over at the Venice Family clinic and the Venice Pain clinic, you treat a lot of pain cases. Dr. Kord uses mostly distal and scalp acupuncture to almost miraculous results. I’ve had patients with pain scales of 7-8 out of 10 walk out with pain completely gone. Dr. Wing brings a more balanced approach to acupuncture with excellent results as well.

You also get a lot of new patients through these externships, and you get to work on your time management as these environments are much faster paced. You’ll learn how to treat 2-3 patients an hour.

If you plan on working in a complementary environment with medical doctors, nurses, chiropractors, etc., experience at this externship sites will look great on your resume. These clinics are established and more easily recognized by other medical professionals than a place called “Yo San Clinic”.

10. Don’t Stress
Don’t expect to get everything right, especially on your first day or your first week. To take some of the stress away, I recommend asking your friends to book you when you first start.

Learning this medicine is a life long practice. Going into clinic as an intern is only the beginning. You will know what you know. Rely on your supervisors to help you. That’s why they are there. Be ok with not knowing an answer to a patient’s question. You will make mistakes. The most important thing is that you continue to learn, improve, and grow.