“As a person and future naturopathic doctor, I hope to better communicate and educate patients and colleagues with increased cultural sensitivity, awareness and empathy. I have an understanding of how to separate beliefs that differ from mine, which will allow me to work without bias or discrimination to provide patients with the best possible care.”
Hailing from Kingsville, Ontario, Sarah Denotter is a second-year naturopathic medical and Master of Science in Nutrition student at National University of Natural Medicine (NUNM). She shares her path to naturopathic medicine, global health experience, and excitement in being awarded the John Milner Nutrition and Cancer Prevention Research Practicum.
Why did Sarah choose naturopathic medicine?
Sarah always knew she wanted to go into medicine, but had not heard of naturopathic medicine until a high school career survey suggested she may be interested in it. With that in the back of her mind, she pursued her undergraduate degree and began traveling the world.
“In Morocco, I noticed how much the population lacked medical technology and advancements compared to North America but still had a relatively the same age of mortality and prevalence of chronic disease. They focused on nutrition and natural therapies before resorting to pharmaceuticals and other conventional measures. I saw similar trends throughout my travels. I always knew I wanted to go medicine, but something did not feel right to me about the allopathic field for me personally – and I think this was it. There are ways of using nutrition and lifestyle modifications to address the root cause or physiological imbalance in a person and enhance the body’s ability to heal itself and prevent disease from occurring. I think there is a time and a place for conventional and naturopathic medicine depending on a patient’s medical and family history, lifestyle, etc. What is best for a patient may be to combine and individualize a treatment plan that is a combination of multiple modalities. This is what naturopathic medicine is – an approach to health that considers every aspect of a person as whole and utilizes the least invasive methods first. It is what I dreamed of doing my whole life and could not wait to become a part of the growing field filled with incredible people and opportunities.”
How did you prepare for ND school?
“I think the best thing I did was shadowing multiple naturopathic doctors – you really get to see the career you are working towards; how much you are able to make it personalized and decide your patient population.” Sarah says those experiences were of significant benefit when interviewing and applying for naturopathic medical school. She also attended an AANMC virtual fair and contacted current students.
As an undergraduate student, Sarah completed the naturopathic medical school prerequisites and earned a certificate in business. “I remember learning from NDs in practice how they wished they had more business experience. My baseline business knowledge as well as my science background allowed me to stand out. Another thing ND schools look for is your ability to maintain a work-life balance, which becomes an even more vital skill medical school. To demonstrate my ability to do this I volunteered at a local hospital and with a health promotion club on campus, had a part-time job and exercised regularly. I also studied abroad which exposed me to many different cultures and people where I learned how to communicate and respect alternative views, became more open-minded and consider situations with a new perspective that allowed me to be more innovative and flexible.”
Why did you choose NUNM?
Ultimately, it was the wide variety of electives available for ND students that led Sarah to NUNM. “I have an underlying interest in nutrition and the benefits it has in healthcare, so I was excited to learn more in the nutrition-based electives. NUNM also allows you to complete your Master of Science in Nutrition (as well as other Masters degrees) in the same four years as your ND degree. Because of the graduate programs, I was able to take courses in Ghana, Guatemala, and Peru as a part of my education. I cannot begin to emphasize how important those courses have been in shaping myself as a person and future physician. Oregon also has one of the largest scopes of practice for NDs in North America. Which means that when I am a medical intern in my third and fourth years, I will be able to apply everything I am learning.”
What is your favorite thing about school? What surprised you?
“I did not expect that I would have to re-learn how to learn. Coming to NUNM from my Bachelor’s degree, I thought that I knew how to study but those mechanisms were no longer effective. It took a while to finally figure out what techniques worked for me to be successful. I struggled with realizing that what worked best for me was not the same as my new friends. It is interesting how this concept of re-learning how to learn keeps reoccurring. Now with the global pandemic, I have to learn how to learn in my home instead of in the company of my peers in a classroom. I suspect this will keep happening when I begin to intern and enter a clinical practice. I will learn from different patients, colleagues, residents, physicians and friends in many different aspects. It is about being adaptable and open-minded to whatever situation you are faced with and understanding that what works best for you may not be what works best for everyone else.”
I love what I am learning and how challenging it is. Learning becomes so much easier when you really like the topics. The program is teaching me to think in completely different ways than the way I was raised. For instance, we learn to take a completely new perspective about a patient’s medical condition by incorporating all aspects of their life. It is even more exciting acquiring these approaches with people who are like-minded to you. It is incredible how diverse experiences all of my cohort had, yet it led to us embarking on the same medical program. The support we receive from teachers, residents and attendings is remarkable. We all have something to learn from each other and will be able to use each other as resources in the real-world.”
This past spring, Sarah was accepted into the National Cancer Institute’s (NCI) annual five-day intensive John Milner Nutrition and Cancer Prevention Research Practicum – a very competitive research-focused opportunity fully supported by the National Institutes of Health (NIH). The practicum was cancelled due to the COVID-19, but Sarah hopes to attend in 2021.
“Naturopathic medicine focuses on treating a physiological imbalance within the body. Through my education, travels and clinical experience so far, I have learned that this imbalance is more often than not a result of lack of proper nutrition. By addressing a patient’s nutrition early, it can be preventative for disease progression, especially cancer. Other than nutrition there are many other avenues that cancer can develop from such as environmental toxins, social history and psychological, physiological or physical stress. However, I have seen a lack of research in nutrition or prevention in general as it is extremely difficult and expensive to obtain accurate and credible results. I hoped the practicum would further identify how to fill the research gaps and formulate ideas on how to overcome them with impactful experimental methods with others who have a similar drive.
In my future, I dream of working in an integrative healthcare research center focused on oncology. I hope to discover and amplify what nutrients are needed to mediate symptoms and progression, but most importantly fill the gaps in nutritional research that can help patients can fight cancer before it even begins. What if curing cancer isn’t treating it but preventing it from occurring?”
Experience in Global Health
While in naturopathic medical school, Sarah has had three global health experiences to date. Her first experience was to Ghana where she shadowed physicians in a local hospital and observed deliveries, C-sections and hysterectomies as well as rounds of patients with malaria, parasites and various gastrointestinal diseases – things that are very uncommon in the United States. “Each night we were taught dances and had a local family create traditional meals for us. We then traveled and toured the Cape Coast Castle where Ghanaians were held before they were shipped to the ‘New World’ as slaves. Other activities included staying with a tribe, herbs walks, visiting a local fish farm, exploring local markets and touring a community healthcare clinic. This was one of my most humbling experiences as I was introduced to the concept of power and privilege between different races and cultures. It was the realization of how privileged we are in our society today to have accessibility to resources such as clean, running water or medical care. And the most remarkable thing is how hard Ghanaian’s worked, how much less they had, but were so much happier.”
Sarah’s second trip was an intensive One Health/Farm to Table course at a Permaculture Institute on Lake Atitlan, Guatemala. “Two other students and I were introduced to the concepts of permaculture and one health by exploring many local farms and communicating with local people. These farms included cacao and bee farms, coffee co-ops, food forests, and a women’s textile co-op. I learned the importance of one health as it identifies the health hazards and risks that arise at the interfaces between humans, animals and the environment.
In August 2019, I attended Dr. Stansbury’s Ethanobotany course in Peru. This course involved exploring and learning about medicinal uses of plants in the Sacred Valley and the Manu region of the Amazon basin. We also stayed at Villa Carmen Biological State and Reserve and traveled and lodged with the Queros Wachiperi tribe. This trip allowed me to see first-hand traditional uses for specific plants in the Amazon while experiencing the amazing Peruvian culture, food, and landscape.
All of these experiences lead to a greater understanding of the importance of relationships between humans, animals and the environment and that one will not be able to thrive if they are not mindful of the health of others. Learning to understand these relationships is only the beginning to grasping the inequalities between and among them. I would recommend every medical student have at least one global health experience – it is truly humbling recognizing how much more I have to learn and understand outside of my comfort zone. Global health experiences enhance cultural competence, awareness, appreciation and overall humility by a realization of where your bias and misconceptions lie. As a person and future naturopathic doctor, I hope to better communicate and educate patients and colleagues with increased cultural sensitivity, awareness and empathy. I have an understanding of how to separate beliefs that differ from mine, which will allow me to work without bias or discrimination to provide patients with the best possible care. In my future, I hope to continue being involved at a global level such as with Naturopaths Without Borders and Natural Doctors International.”
How do you maintain a school/life balance?
“In my undergrad my school/life was very balanced. However, once I started med school that began to change. During the first term it was very difficult to adapt to the intense in workload with 30-40 hours of class per week and multiple exams. Eventually you begin to grasp what concepts are more important to know, what questions may be asked, and you get into a comfortable routine. Exercise was always a huge stress reliever for me, though, I struggled to find time to do it as I was often too exhausted. I found that even going to the gym and biking while reading over notes on my phone/tablet, was a way that I could exercise without feeling guilty. After learning this, I realized that I needed to step away from the books every once in a while. After taking a couple weekends off, I saw my grades jump 5-10%.
Now that I am in my second year, I have learned the importance of taking time away from school is almost as important as being at school. This includes doing little things once a week or a ‘bigger’ excursion once a month. I also missed doing research and wanted more experience in a hospital setting as it may be helpful in my future, so I applied to Oregon Health and Science University. I went through the rigorous process of getting volunteer positions with healthcare practicitioners in the Family Medicine division and research in the neonatal intensive care unit.”
What advice do you have for prospective ND students?
“Step away from the academics and talk to NDs who are practicing, find a mentor, go to conferences, community and school events. Ask everyone about their path, their favorite part of their job and what they wish they would have done differently. These conversations and learning experiences remind you of what you are working towards. It may even give you the motivation you need to keep moving forward.
Find your people. The naturopathic medical program is very challenging, and you will not be able to do it alone. Although everyone in the program is working towards the same goal, we are all successful in different ways. Understanding that there is so much to learn from each other will not only create a strong community in school but also when you are practicing. I have found balance in keeping in finding a community outside of NUNM. It is so easy to get sucked into the school-eat-sleep routine and forget about the outside world. If you fall into that pattern you may drain yourself. Take breaks to allow yourself to thrive.”
Click here to learn about other naturopathic doctors’ paths to naturopathic medicine.