Acupuncture and Chinese Medicine Clinical Student Handbook

Clinical Herbal Education

The Accreditation Commission for Acupuncture and Chinese Medicine (ACACM) requires that all CM interns receive specific training and clinical experience in herbs. Eventually all CM students may be required to have two herbal internship shifts. However, currently, only one herbal internship shift is required before graduation. These shifts are part of the total intern hours required and are not in addition to those hours. Herbal Internship may be done in terms T7, T8 or T9. One additional herbal internship may be done if time and supervision permit but this is at the discretion of the ACM clinic education chair, pending review of the overall internship needs for all of the clinic internship sites during a trimester.

The Herbal Dispensary Assistant will conduct an herbal intern orientation during the first week of each term for new herbal interns.

Herbal interns must complete separate timecards and Patient Note forms for all shifts spent as an Herbal Intern. These forms are turned in at the end of each term to the Clinic Coordinator. These forms may be found in the Clinical Education Department.

Herbal interns will shadow the clinic supervisor. If the treating intern during a given shift is not an CM student and a patient desires herbs, the herbal intern will formulate an herbal diagnosis, discuss it with the supervisor and provide a prescription to the Dispensary Assistant for filling. If the treating intern is also an CM student, s/he will talk with the supervisor and the herbal intern about the diagnosis and possible herbal prescription. The herbal intern will be able to count any patient for whom s/he has created a formula approved by the clinical supervisor as part of total patient numbers.

In addition to the above duties, the responsibilities of the Herbal Intern will include, but are not limited to:

  • Instructing patients on use of formula
  • Demonstrating a basic understanding of the potential side effects of a formula given, as covered in the didactic courses on Materia Medica and Formulas and Strategies
  • Applying didactic knowledge in potential interactions of herbs and pharmaceuticals.

Herbal Resources

The Clinic Dispensary dispenses a variety of herbal products in various forms. Chinese medicine interns, under clinical supervision may recommend these herbal products for patient use, including:

  • bulk medicinal substances, dried plant, animal and mineral substances for use in decoction, poultices, and washes
  • medicinal granules (substances which are in granular or powdered form for patient convenience)
  • Chinese patent medicines (a wide variety of prepared herbal formulas in pill, liquid concentrate, capsule and liniment forms).

Writing Prescriptions

The supervisor must always approve herbal prescriptions. Since interns are at different levels of herbal training during their clinical experience, levels of independence and complexity regarding herbal prescriptions will vary.

With all prescriptions written in NWHSU on-site clinics, the intern must fill out the Centricity medications box to add an herbal prescription with the guidance of clinic supervisor.

Forms will automatically include:

  • Patient Name
  • Current Date
  • Date of Birth

The intern should include the following information on the prescription form:

  • Herbal formula(s) and/or single herb(s) and quantity easily identifiable. Always note if raw herbs are prescribed.
  • Note any special preparations, or if specific herbs are to be separated from the bulk herbs in one bag (e.g. Fu Zi, E Jiao, Bo He, other herbs that should be separated and added at different times, etc)
  • Dosage
  • Refill information including number of refills or refills allowed to a specific date not to exceed 6 months from first prescription
  • Allergies/drug interactions

**Intern must route the patient file to supervisor for signature before faxing to Herbal Dispensary.

Patient Prescription Requirements

Patients will receive written dosing instructions. It is important to give the patient explicit written instructions on administration of all raw herbal decoctions and herbal formulas with unusual requirements. With the guidance of the clinic supervisor, it is the intern’s responsibility to ensure that the patient is aware of the details regarding use and potential side effects and/or precautions of their prescriptions.