Looking at the differences of ND and DNM or any other designation boils down to three main considerations: qualifications, regulation and designation.
Qualifications, or educational standards ensure that the practitioner has been adequately trained. Licensed naturopathic doctors are required to complete a minimum of three years of pre-medical studies at a recognized university followed by four and a half years of full-time naturopathic medical education at an approved naturopathic medical college. There are only six of these schools in North America, one of which is the Canadian College of Naturopathic Medicine in Toronto, Ontario. These schools have been accredited by the Council on Naturopathic Medical Education (CNME). The CNME is a member of the Association of Specialized and Professional Accreditors and abides by ASPA’s code of good practice. The U.S. Secretary of Education recognizes the CNME as the national accrediting agency for programs leading to degrees or diplomas as a Doctor of Naturopathic Medicine. The CNME is recognized as the accrediting body by all the approved schools as well as the professions national associations in both the U.S and Canada. This schooling involves training in the same medical sciences as medical doctors, as well as, training in natural forms of healing such as clinical nutrition, botanical medicine, Traditional Chinese Medicine and acupuncture, homeopathic medicine, naturopathic manipulation, physical medicines and lifestyle changes. Approved naturopathic colleges give students a thorough knowledge of diagnostic techniques that can only be acquired through contact with a patient. All of the approved naturopathic colleges also require 1,500 hours of supervised clinical practice with patients.
All licensed naturopathic doctors in Canada and the United States write board exams that are standardized for North America. These board exams are called the Naturopathic Physicians Licensing Exams (NPLEX) and are administered by the North American Board of Naturopathic Examiners (NABNE) which is similar in structure to the National Board of Medical Examiners. While NPLEX creates the exams, NABNE sets policy regarding the qualifications of applicants to take NPLEX, sets policy regarding the administration of NPLEX, verifies the qualifications of applicants to sit for NPLEX and administers the NPLEX at testing sites in the U.S. and Canada. The successful completion of the NPLEX is just one part of the requirements to become a licensed Naturopathic Doctor and NPLEX does not guarantee that the examinee will be licensed. Licensure is granted by the regulatory boards in the province or state where the Naturopathic Doctor practices.
To become a licensed Naturopathic Doctor in Canada you have to attend one of the approved naturopathic medical colleges (visit www.cnme.org for more information), write and pass NPLEX and write and pass any add-on examinations required by the provincial regulatory boards. As far as I am aware, there are no full-time programs or schools that train people to become a Doctor of Natural Medicine and correspondence programs do not prepare students for practice as licensed practitioners.
Regulations have to do with whether or not a provincial government recognizes and has approved a scope of practice for a specific practitioner group, such as Naturopathic Doctors, Chiropractors or Midwives. The main purpose and value of regulation is that it is an outside appointed group that protects the public. This provides them with a comfort level that there are standards of education and a defined scope of practice. It is because of the lack of regulation in many modalities that there is so much confusion for the public.
Naturopathic Medicine is regulated currently in four provinces in Canada: British Columbia, Manitoba, Saskatchewan, and Ontario. Alberta’s regulations are scheduled to be completed by the end of 2004 or early 2005. In a regulated province only those practitioners that have completed the appropriate training and obtain licensure are able to practise. Regulation also ensures title protection which helps identify qualified practitioners for the public.
The regulatory board for Naturopathic Doctors in Ontario is the Board of Directors of Drugless Therapy — Naturopathy (BDDT-N) see www.boardofnaturopathicmedicine.on.ca/. This board is a government-appointed board that is independent of any of the naturopathic associations and its job is to protect the rights of the public and to ensure a standard of patient care.
Doctors of Natural Medicine, Homeopaths, Herbalists and many other modalities are not currently regulated in any province in Canada. This means that there is no independent regulatory body that ensures that these individuals have appropriate training, or that standards of practice are being maintained. It also means that if a patient/client has any concerns their only recourse is a court of law. Most insurance companies only cover practitioners that are licensed.
Designations can be very confusing. In all provinces practitioners that have completed the required training and licensure are granted the title of Naturopathic Doctor (ND). For confirmation on qualification of any practitioner claiming to be a naturopathic doctor feel free to contact the CAND at www.cand.ca.
A naturopath or a Doctor of Natural Medicine is not a naturopathic doctor. When you looking for a practitioner in a non-regulated province or you are dealing with a non-regulated modality, such as Doctor of Natural Medicine it doesn't really tell you anything. There may be ideals of educational standards or ideals of practice, but when anyone can use a designation without an outside, independent regulatory body overseeing each applicant and ensuring standards it leaves room for a lot of confusion.
Naturopathic Medicine is a primary health care profession that focuses on prevention and uses non-invasive methods and natural substances to enhance healing. Naturopathic doctors are trained to examine, diagnose and treat patients, emphasizing support and stimulation of the body’s natural healing mechanisms. Their treatment programs are tailored to each patient's individual health condition and integrate dietary protocols, clinical nutrition, botanical medicine, acupuncture, Oriental medicine, homeopathic medicine, physical therapeutics and lifestyle counselling.
Doctors of Natural Medicine are not regulated in Canada. Therefore, you can’t compare a Naturopathic Doctor to a Doctor of Natural Medicine.
The best advice is to be informed. Verify the qualifications and licensure of any practitioner and check with your insurance company to confirm that they are providing coverage.
Iva Lloyd, ND
Doctor of Naturopathic Medicine and Chair of External Communications of the CAND