MSHS in Integrative Medicine: Curriculum

Would you like to diminish the burden of non-communicable, chronic diseases such as type II diabetes, obesity, heart disease, and their related comorbidities? Could yoU.S.ee nutrition as the foundation of your integrative approach to health? In Nutrition I, you will learn the risk factors for malnutrition in macronutrients (protein, fat, carbohydrates), micronutrients (fat versus water-soluble vitamins), as well as those due to environmental exposures including medications. Together we will think critically about nutrition, nutrition research, and their application to health care. Through this, we hope you will develop a passion for nutrition and keeping up with emerging research We will work to prepare you to be able to motivate others to care about nutrition (academically and as part of their lifestyle) and to spread the practice of preventative care with an emphasis on nutrition and lifestyle.

Now that you have developed a foundation in the Dietary Reference Intakes (DRIs) from Nutrition I, we will delve deeper into nutrition requirements by examining how they change across the lifespan. You will hone your critical thinking in nutrition, nutrition research, and application to health care at each unique stage in the lifecycle Along the way, we will expand upon the Nutrient Summary Table you created with your Nutrition I class to aid you in counseling patients of all ages in your integrative nutrition practice.

INTM 6201 provides a framework for developing a patient-centric approach to evidence-based care. The course provides an overview of the historical, sociocultural, and professional evolution of INTM in the United States Competing models of therapeutic approaches, the ascendancy of biomedical reductionism, and a re-envisioned medical system based upon a personalized, therapeutic paradigm are explored. The role and identity of the INTM provider and review of basic professional competencies, including fundamental attitudes, knowledge, and skills, are analyzed. The course will focus on four domains in detail with a focus on evidence-based, patient-centered practice: communication skills and behavior change, lifestyle medicine, personalized medicine, and traditional medical systems. The structure of the INTM Programs allows students to master didactic coursework, while simultaneously applying that content in the practical application of concepts and clinical reasoning to address health care needs. The INTM Programs are designed for students to complete all coursework and work with faculty in an online environment. Many faculty members are clinicians and professionals who practice in the INTM field and thus are available for direct telephone consultation by appointment only.

Burnout is more prevalent among health care professionals than among their education-matched peers in the general US population. They are more susceptible to depression and anxiety and are at increased risk of job dissatisfaction leading to potential adverse patient outcomes (Koinis et al. 2015). Evidence has shown that discussing and reflecting on wellness topics in small groups has positive effects, including increased engagement and empowerment in the workplace, as well as decreased emotional exhaustion, depersonalization, and burnout (Arnold et al. 2018). Evidence-based themes for wellness such as sleep, nutrition, financial health, support networks, and mindfulness have the potential to make a profound impact on health care provider wellness (ibid). In this Self-care Methods course, you will gain a better understanding of health care provider wellness and develop strategies to address the biological and psychological domains of personal and clinical care. You will engage in online discussions surrounding health care provider wellness and burnout and have the opportunity to further develop an awareness of their own wellness and identify areas for improvement. Topics for wellness strategies will focus on sleep hygiene, nutrition, physical fitness, financial health, mindfulness, support networks, workplace wellness, and medical error coping.

We will evaluate diseases of the gastrointestinal, immune and nervous systems and analyze the interconnectedness of these body systems in the context of chronic disease states Assessment of symptomatic, functional and disease markers and the development of integrative treatment plans will be emphasized. You will synthesize summary cases and submit to faculty and students for review.

You have completed the first course in this set of courses (INTM 6203) and will now extend and practice that knowledge. You will continue to evaluate diseases of the gastrointestinal, immune and nervous systems and analyze the interconnectedness of these body systems in the context of chronic disease states with an emphasis on assessment of symptomatic, functional and disease markers and the development of integrative treatment plans.

Students will evaluate the legal and ethical considerations in decision making related to patient care ● Review the legal environment in which the Integrative Medicine physicians operate, how to assess risk and mitigate malpractice events ● Understand common ethical issues that arise in medical practice today ● Understand what is PHI, HIPAA Privacy Rule, HIPAA Security Rule, and the Patient Safety Rule ● Understand what is able to be disclosed, to whom, for what reason and what is needed for disclosure ● Review physician risk for referral to non-traditional providers ● Discuss agency relationships and duty to supervise ● Discuss ‘health freedom laws’ and state medical board regulatory powers ● Review the Federation of State Medical Boards model guidelines governing CAM therapies ● Review consumer rights to access versus states rights for regulation and licensure of medical practices ● Discuss the caveat of DSHEA as consumer right for dietary supplements ● Define non-FDA approved drug category ● Review access to CAM therapies in hospital setting ● Discuss special populations: children and infants ● Review third party reimbursement issues and mandated covered therapies ● Discuss financial risk with regard to departure from insurance guidelines ● Define advanced beneficiary notice and opting out for Medicare and Medicaid

Would you like to work in a healthcare environment where integrative person-centered care is the medical/ health care model utilized, and collaborative teams come together to support the patient’s holistic health? Is this what you envision for yourself as we move into an era where health promotion and disease prevention are the foundational tenets from which we understand health care, healing, and medicine? The first step in developing such an enterprise requires business competence and health care leadership skills. This course will focus on sound business strategies and practices that drive the development, management, and implementation of practical programs and processes that support your patients, providers, and your entire team. Starting with integrative health care principles, you will create a business plan that incorporates learned business models, leadership approaches, and team development methods. You will integrate professional and personal resiliency strategies to manage and grow your business through successes and setbacks. This course is aimed to position you and your enterprise for success.

INTM 6210 is the first of two Practical Application courses within the Integrative Medicine curriculum. This course is designed for students who have already taken INTM 6201, and INTM 6202 Content from those courses is applied to clinical cases, and students are given the opportunity to formulate integrative care plans demonstrating competence with the relevant foundational material. The readings and assignments throughout this course are designed to take you directly into a practical application of the concepts, tools, and guidelines. We recognize that there is a wide variation of experience within the class. Follow the assignments carefully, and the structure of the course will lead to significant learning and professional development.

In this course, we will work to build skills for developing rigorous study designs and critiquing those in the literature to address questions surrounding integrative medicine. This will help you develop the ability to understand and pose evidence-based research questions and to identify appropriate designs and methods, preparing you to use the literature to provide a context for clinical questions. You will be able to serve as a translator of knowledge and disseminate information to individual patients/clients, professional and interprofessional groups, potential funders, and policymakers. This course kicks off with basic training: National Institutes of Health (NIH) Good Clinical Practice (GCP). Training and your initial search for your literature review. You will identify gaps in the literature, propose research questions and methods to address those gaps, and suggest research questions grounded in integrative medicine. You will organize your literature review and evaluate the five levels of evidence. All of this is done with a focus on specific aspects of research design week by week. Each week will serve as practice and time for improvement. Discussion Boards will entail designing effective methods for translating knowledge to everyday practice and for communicating information to clients and peers. The feedback you get during these will be useful in completing each Assignment, which builds on the Discussion Boards Each. The assignment also relies on the previous Assignment, so, despite this being a challenge, you will have ample time to iterate with and learn from the faculty along the way.

The student will apply the disciplines of clinical genomics, proteomics, and metabolomics to clinical practice with special attention to [1] the scientific problems involved in the post-‘omics clinical research, [2] how to access and interpret the immense volumes of -omics data, [3] perform pattern recognition and simple analysis of this data, and [4] apply these research tools to personalized clinical care. Various topics include: genomics, transcriptomics, proteomics, metabolomics, phenomics, bioinformatics, pattern recognition, metabolic network assessment, targeted vs non-targeted analysis, laboratory methods and experimental design. Students will review the emerging disciplines of clinical genomics, proteomics, metabolomics, bioinformatics and the role of technology with Integrative Medicine Expert faculty will help students understand the promise, complexity and challenges related to ‘omics, current application and future trends. Students will apply evidence-based ‘omics and technology towards prevention, predictive analysis, and patient-centered care.

Integrative Medicine requires either INTM 6211 or 6213 This course provides students with the practical and in-depth application of learned principles of integrative medicine for each of the 18 therapeutic domains required for competency in the current ABPS ABOIM board exam. The student is required to draw upon traditional healing systems and lifestyle approaches while demonstrating leadership skills, team building competencies and respectful collaboration with professionals from allopathic and complementary disciplines. Students will incorporate health promotion and disease prevention and advocate for healthy lifestyles and preventive medicine practices in patient care plans with emphasis on care plans that require synthesis and integration of conventional clinical care for specific diagnoses. Development of clinical reasoning through an evidence-based approach to the evaluation and management of problems commonly encountered in outpatient settings.

(Formally: Practical Application II for Non-clinicians) Integrative Medicine requires either INTM 6211 or 6213. This course provides a foundational understanding of complementary and integrative health (CIH). Terminology is defined, and core concepts in CIH are explained. The course introduces commonly used CIH approaches and discusses them within the larger framework of determinants of health Current U.S. healthcare reform efforts are outlined with an emphasis on emerging integrative care models. During the last part of the course, we will explore Integrative Medicine (INTM) in the context of a conventional medical system under increasing economic and social pressure, and evaluate the clinical effectiveness of some of the most popular INTM therapies and explore plausible mechanisms to explain their observed health effects. Finally, we will consider to what extent individuals and the public would benefit from a truly integrated model of health care, and observe how actual healers practice their professions.

Required for Nutrition Specialization In Advanced Nutrition, we will explore intermediary metabolism with a special emphasis on the interrelationship of nutrients, metabolic pathways, health, and disease. This builds on the foundation of Nutrition I and II, exploring more advanced and complex issues surrounding normal and abnormal metabolism of nutrients. Students will review dietary inputs from molecular, biochemical, and integrative perspectives.

Required for Nutrition Specialization. The grocery stores see about 20,000 novel food products every year. What are these products made of, and how do they get made? In this course, we will survey food technology processes and how your food gets made. We will learn about the health benefits of foods beyond macronutrients and micronutrients — namely of phytochemicals and explore the depths of our gut microbiome. Through this, you will build your fluency in trends in food processing, refine your communication as a practitioner, and hone your critical thinking skills in evaluating these new technologies.

Nutrition is an ever-evolving discipline with important considerations for health promotion. Research efforts regularly supplant existing recommendations and shed light on new aspects of human nutrition and metabolism with clear implications for dietary policy, nutrition education, and individualized patient care. In this survey course, we will investigate current topics in nutrition, based on the latest findings in the scientific literature, interest from the health care community, and public inquiry. Developing an appreciation of topics in the forefront among the minds of consumers, patients, media outlets, and fellow clinicians will help students ensure they stay abreast of the most recent topics relevant to their work with patient education and their own acumen with the nutrition care process.

Required for Nutrition Specialization You are now well-grounded in nutrition, but did you realize that many nutrients are crucial for the function and regulation of the immune system? We will explore the immunoregulatory and immune-related nutrients, focusing on micronutrients, which will also develop a basic understanding of the immune system. This will help you identify risk factors in your patients and develop a more complete Integrative Nutrition Care Plan.