The Difference Between a Licensed Naturopathic Doctor and a Traditional Naturopath in North America

A naturopathic doctor with a patient

Guest Post by Valerie Gettings, NMD, CISSN, originally published on January 19, 2020 and updated on August 22, 2023.

Having a career as a licensed naturopathic doctor (ND) is exciting and rewarding. However, it can be difficult for many potential students to choose which naturopathic doctor program to enroll in, since there are different types of naturopathic doctor and naturopathy programs available.

How Do You Choose the Right One for You?

Some schools offer online or correspondence programs, while others are accredited four-year, in-residence medical schools. With all of the natural medicine programs out there, it is important to know that not all naturopathic doctor programs are created equal, and that graduates of these programs leave with varied degree/certificate titles and professional training, which can create confusion for patients. This is especially true when it comes to knowing the difference between a traditional naturopath and a licensed naturopathic doctor/physician (ND) in North America.

What is the Difference Between a Licensed Naturopathic Doctor and a Traditional Naturopath?

While both traditional naturopaths and licensed naturopathic doctors aim to help the body heal through natural substances such as food, herbs, and water, their education is very different, and their scope of practice and regulatory status vary from state to state and province to province—and in some states and provinces there are not yet any regulations pertaining to any types of naturopathic practice. Thus, traditional naturopathy or health coaching, differs from the practice of naturopathic medicine.

The titles “traditional naturopath” and “naturopathic doctor” (or “naturopathic physician” and/or “naturopathic medical doctor”) are not interchangeable. A licensed naturopathic doctor (ND/NMD) is a primary care physician who is trained to diagnose and prescribe, while a traditional naturopath is not licensed to do either. In some states where naturopathic medicine is not yet a regulated medical profession, a traditional naturopath may, on their own, choose to use the title “naturopathic doctor,” which is confusing to patients looking for a licensed ND. AANMC has fielded reports of cases of harm over the years due to this confusion—as well as heard from many upset students who didn’t realize the distinction until they were out thousands of dollars in tuition.

Infographic: What's the Difference Between a Licensed Naturopathic Doctor (ND) and a Naturopath?

What is the Education of a Licensed Naturopathic Doctor?

After obtaining a bachelor’s degree, a naturopathic medical student in the United States or Canada attends a four-year, professional, in-residence doctoral program accredited by the Council on Naturopathic Medical Education (CNME). The CNME is recognized as the only accrediting body by the U.S. Department of Education for naturopathic medical programs in the U.S. and Canada. This accreditation qualifies graduates to take the Naturopathic Physicians Licensing Examination (NPLEX) or College of Naturopaths of Ontario (CONO) exams for licensure/regulated practice.

Students from accredited naturopathic medical schools complete more than 4,100 contact hours of instruction, including at least 1,200 hours of supervised, hands-on clinical training. A recent change to curriculum and technology has resulted in some schools offering first-year curriculum online before introducing in-person clinical learning in second year. Moreover, supervised telemedicine has been implemented in clinical rotations for a small percentage of patients where this route of care is indicated. In this way, students can learn how to reach patients in remote areas or cities with heavy traffic in order to provide care to those patients who would otherwise not have access to it.

The schools’ evidence-informed curricula consist of biomedical sciences—including anatomy (with cadaver lab), physiology, biochemistry, microbiology, immunology, and embryology—similar to conventional medical school, as well as clinical medicine, homeopathy, botanical medicine, lifestyle management, nutrition, pharmacology, radiology, and physical medicine, to name a few. Additionally, the curriculum includes specialized classes in such areas as pediatrics, fertility, fibromyalgia, oncology, and sports medicine. All students also learn drug-herb interactions as well as critical red-flag health issues and proper referral channels. Some schools also offer the option of studying Traditional Chinese Medicine and acupuncture, which enables graduates to become a licensed acupuncturist in addition to a licensed ND.

In order to become licensed, naturopathic medical graduates must also pass the two-part national board exam, NPLEX, which consists of biomedical science and clinical medicine portions, or CONO exams. Typically, NPLEX 1 is taken after year two and NPLEX 2 is completed after year 4 of study. Some licensed ND students go on to complete post-doctoral residencies in healthcare facilities across North America.

Currently, AANMC represents five accredited naturopathic medical programs across seven North American campuses. NDs across North America are regulated in 26 US jurisdictions and 6 Canadian provinces, including the District of Columbia, U.S. Virgin Islands, and Puerto Rico. In some of these states and provinces, licensed NDs are able to prescribe pharmaceuticals, administer vaccinations, and perform minor surgery, as well as order labs, diagnostic imaging, and food sensitivity tests. NDs follow different career paths and work in a variety of settings such as integrative oncology care, private practice, medical schools, and government organizations.

What is Taught at a Traditional Naturopathic School?

Online and correspondence traditional naturopath degree or certificate programs do not have a standardized curriculum or accreditation of their programs as recognized by the U.S. Department of Education. These programs are not accredited by the Council on Naturopathic Medical Education.

They may teach a variety of classes that help students understand the healing power of nature and the innate ability of the body to heal itself. The classes may consist of botanical medicine, the history of natural medicine, homeopathy, orthomolecular nutrition, introductory anatomy, reflexology, and iridology, among others. Program length can vary from weeks to months or years to complete, depending on the speed of self-study by the student.

Since classes are mostly offered online in traditional naturopathic programs, these programs lack standardized, on-site, clinical training in treating patients under the supervision of experienced licensed NDs. Also, faculty in traditional naturopath programs are not required to be licensed NDs, which is in contrast to CNME-accredited four-year naturopathic medical programs where naturopathic faculty must have an ND degree and other faculty must have terminal degrees in their professional fields (e.g., MD, DO, DC or PhD). Some traditional naturopath programs are entirely online, and students in these programs may never interact with faculty in person.

In addition, traditional naturopaths are not eligible to write the NPLEX or CONO board exams or obtain licensing. For that reason, many traditional naturopaths choose to practice in unregulated states and provinces, and use their knowledge primarily to help family and friends, or for their own personal health use. Some individuals trained as traditional naturopaths, like myself, subsequently choose to attend a four-year, CNME-accredited naturopathic medical program in order to become licensed.

Which Program Should I Attend?

1. Determine Your End-Goal

The first step is to determine what you want to do with your education. If you want to be trained as a primary care physician, prescribe, and act as a partner in health with your patients, then becoming a licensed ND may be the career for you. However, if you want to learn more about botanical medicine, nutrition, or homeopathy, and use that education to help yourself or family, there are many other programs that may fulfill that desire.

*Practicing medicine without a license is considered a felony in the US.

2. Do Your Research

Find out what the degree you are considering will allow you to do. Each state and province are different in terms of scope of practice and regulation of both naturopathic doctors and traditional naturopaths. Additionally, the term “accredited” can cause confusion. Many online or correspondence naturopathic programs state they are “accredited”. However, the organizations they list lack recognition from the U.S. Department of Education. The CNME is the only agency to accredit four-year, doctoral-level ND programs. Only graduates from CNME-accredited schools are eligible to obtain licensure or write NPLEX/CONO examinations. Always carefully research your options before deciding.

3. Fall in Love with the Curriculum

Whatever program you decide to attend, make sure you fall in love with the curriculum, and that it will enable you to reach your desired end-goal.

Do you know the difference between a naturopathic doctor and a homeopath? Learn about that on our page “Naturopath vs. Homeopath: What You Need to Know.”

About The Author

Dr. Valerie Gettings, NMD, CISSN, is a practicing naturopathic doctor in the state of Arizona and is a graduate of the Canadian College of Naturopathic Medicine, Toronto campus. Dr. Gettings is a Past President of the Naturopathic Medical Student Association (NMSA), a 501(c)3 non-profit representing over 2,200 naturopathic medical students across North America. She is also a traditional naturopathic doctor graduate from Trinity School of Natural Health, Warsaw, Indiana. Prior to her path in naturopathic medicine, Dr. Gettings was a public affairs specialist and director for community outreach for the U.S. Navy Medicine. She received her B.A. in public communication and international relations from American University, Washington, D.C.

Valerie Gettings guest post photo


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