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Q: I am going to be a master next summer. I received my bachelor degree of Chinese medicine 3 years ago,and I got TCM doctor qualification this year. How can I be an acupuncturist in the United Kingdom?
A: Practitioners have to be registered with local authorities for health and safety purposes, and most of these now check to make sure that someone is properly trained. This is commonly interpreted as a degree level training, so your qualifications are probably likely to be acceptable.
It is difficult to judge from your address whether you are already UK-based. If you are, or are a permitted resident within the European Union, this should make the position about work permits much easier. If you are outside the European Union or United Kingdom, there are quite strict rules for entry, and you would have to meet one of the categories applied by the UK Borders Agency which can be found here:
Most practitioners in the UK belong to professional associations like the BAcC or ATCM. The BAcC has a clearly defined entry procedure for people who did not train in a UK teaching institution, the rules for which can be found here:
Some bodies, like the Association of Traditional Chinese Medicine (ATCM at www.atcm.co.uk), recognise qualifications from China as an entry standard.
However, in the first instance, if you are not a UK resident it would be important to see whether you would qualify for a work permit, without which you would probably not be granted residence in the UK. In the past years there were several large chains of chinese shops which employed TCM doctors and were able to get them permits to enter, but two of the largest chains of these collapsed three years ago, and there are few opportunities from this avenue now.
A: We have produced factsheets on both of these areas:
which give some cause for optimism, as does a heavily publicised research trial by BAcC member Hugh Macpherson and colleagues published very recently
There is also a link on our home page today to a new study about anxiety
However, we could do worse than reproduce the text of a piece we provided for Anxiety UK some months ago.
ANXIETY AND ACUPUNCTURE
Anxiety is more than just being anxious. Just as migraine sufferers get righteously indignant when someone claims to be a fellow sufferer but can still get to work, eat and stand the daylight, so anxiety sufferers know that they bear only the slightest resemblance to people who feel a bit nervous or have ‘butterflies in the tummy.’ Clinical anxiety is a crippling affliction which can sometimes defy all of the medications and talking therapies that someone can throw at it.
Why, then, has acupuncture been found to be successful in treating it? The main reason is that in conventional medicine, there is no single treatment for each sufferer as each person has differing symptoms. However, in traditional acupuncture every patient is considered to be unique, and this means that the practitioners will be looking and listening very carefully to everything that the patient says to establish a diagnosis and find the specific keys to unlocking the patterns of the symptoms the patient is suffering. They will aim to identify the imbalances which cause the symptoms of anxiety, not just treat the symptoms themselves. This whole ‘package’ – taking the patient’s individual story seriously and giving them time to tell it, trying to hone precisely the diagnosis, and selecting the optimum way to use the least needles to achieve the greatest effect – has been found to be very effective.
The theory of traditional acupuncture is very straightforward. The free flow and internal balance of energy (Qi) is seen in eastern medicine as essential for good health. Any prolonged exposure to extremes or intense situations, be they physical, mental, emotional or spiritual, will cause the flow and balance to be affected. This disruption in balance then ripples through the whole system, causing symptoms which sometimes bear little apparent relation to the underlying causes. An acupuncturist’s skill lies in making sense of seemingly unconnected symptoms and understanding the unique nature of someone’s energies in such a way as to restore balance. A treatment plan may simply involve needles and moxibustion, the use of a warming herb, and tui na, a form of traditional Chinese massage, but can extend to address issues in someone’s diet, their exercise patterns and their lifestyle.
People sometimes ask why, if acupuncture is so successful, there isn’t much research to back up its claims and make it more freely available within conventional care. A major reason for this is the unique nature of treatment which resists putting people in pigeon holes and which changes as the person’s balance begins to improve. Both of these confound attempts to organise research according to western models where a named condition receives a single treatment and all other variables are taken out of the equation. In Chinese medicine the variables are called patients!
Where do our patients with anxiety come from? Word of mouth still remains the most common and most reliable form of referral, and more people have had acupuncture than you think. If you ask around your support groups you are almost certain to find someone who has tried acupuncture and found that it works. Perhaps this time it’s your turn!
People also usually want to know whether the treatment will ‘stick’, whether they have to keep on having acupuncture. Some don’t – a single course of treatment can set them on a good path which, as long as their life remains well-balanced and relatively stress-free, means that they will stay anxiety-free. Many, though, like to keep ‘tuned up’, and realise that spending a fraction of what they spend on keeping their cars roadworthy keeps the driver in good shape too.
As always, though, we still think that the best advice we can give is that you contact a BAcC member local to you to see if acupuncture would be appropriate for your own unique circumstances.
Q: Since breaking an elbow in late 2009, followed by a frozen shoulder in early 2010, I have suffered chronic neuropathic pain in my hand and fingers.
I have see a pain management specialist and after various investigations, it has been concluded that the only problem is nerve irritation at the C6/C7 level - assumed to be related to posture and tight scalenes. I have undertaken a wide number of injections, pulsed radio frequency and taken both Pregabalin and Duloxetine. None of the injections or PRF helped; I couldn't tolerate Pregabalin and Duloxetine was only of limited help so I stopped taking it. Physiotherapy helps to some extent (primarily focuses on trigger points) and I have been taking clinical pilates sessions to help with posture. Capsaicin applied topically to my hand gave some relief.
Since it is now nearly 4 years that the problem has been ongoing, I am becoming somewhat despondent. Is there any evidence that acupuncture might help resolve the problem or at least offer some pain relief? If so, could you recommend an acupuncturist in London.
A: When someone has tried, or been treated with, as many of the standard treatment options as you have and without lasting effect, we would be reluctant to make encouraging noises about the value fo acupuncture treatment where all else has failed. However, it is perfectly true to say that acupuncture in Chinese medicine is premised on an entirely different theoretical basis, and symptoms such as neuropathic pain are understood as disruptions in the flow of energy, or 'qi' as it is called in Chinese medicine. The skill and art of the practitioner lies in determining whether this disruption in the flow arises as a consequence of a local blockage or weakness in the flow, or whether it is the tip of a much larger iceberg, and is local evidence of a systemic problem. When there has been local damage, especially where there has been a broken bone, it is not uncommon to find that from a Chinese medicien perspective there has been a local restriction which, until unblocked as best possible, will continue to generate symptoms 'downstream.'
We do have a factsheet on neuropathic pain
but this does not really address the issue with which you are dealing. Our best advice to you, because of the very specific nature of the problems you have, is to visit a BAcC member local to you and let them have a look at the problems. Nothing can replace a face to face assessment in cases like yours, and we are confident that you will be given an honest view of how beneficial acupuncture treatment may be. If you were to present in our clinic we would also have in mind that cranial osteopathy might well have something to offer. The kinds of subtle disruption to the flow of energy which injuries can cause is often treated well by this form of intervention.
As for personal recommendations, we don't make them because there is no need to. All of our members are equally well equipped to deal with any patient who visits them, whether this involves treatment or referrals on to other forms of treatment if they judge the problems to be best treated in other ways.
We hope that after your long journey so far that you find something which helps to bring the symptom under control.
Q: My husband has had chemo and radiotherapy to treat throat cancer. Treatment finished 12 weeks ago and he is suffering with severe pain in his throat following the radiotherapy. Can acupuncture help?
A: This is a very difficult question to answer. While acupuncture has always been used for pain relief, as our factsheet shows
there is a considerable difference between a chronic back pain or chronic headache and the sorts of tissue damage which radiotherapy can create. We do have a factsheet on postoperative pain,
but this does not have anything specific to say about radiotherapy.
As far as other research is concerned, there is a systematic review
which summarises the results from all studies in this area, and seems to show a number of potential positive outcomes. These reviews will always conclude, however, that 'more work needs to be done' because the sample sizes are usually too small to generalise from - acupuncture research is not high on the agenda of mainstream medicine. There are a number of encouraging studies for the treatment of xerostomoa (dry mouth) resulting from radiotherapy in throat cancer, and insofar as these point to a return to normal function, there may be some hope that acupuncture might work with servere pain in the same area.
Each case is individual, however, and we would recommend that your husband would be best advised to visit a BAcC member local to you (you can find one by using the search function on our home page) and see if they will offer a face to face assessment of what may be possible. Most practitioners, if they took on a patient with a problem such as yours, would set some fairly tight review periods to make sure that treatment did not continue if there were no tangible benefit; it is very easy for the patient to want to keep going when there has been no discernible improvement.
We hope that your husband does find a way to reduce the pain. We know from our own experience of treating similar cases just how debilitating it can be.
Q: i wonder if ther is any data on this website about guidance for the acupuncture graduates and how to open their own business and what are the next steps after graduation? Also. is there any data available about employability of acupuncture graduates in UK? For example what percentages of graduates stay in business after graduation?
A: There is information about what to do when setting up a business and when dealing with the transition from study to practice, but this is one of the benefits of student membership for which someone needs to be studying at a British Acupuncture Accreditation Board accredited teaching institution. We produced a very helpful booklet called Bridging the Gap and have placed a great deal more information on the student website. If you are a student at a BAAB course, then this material will be made available to you. In certain exceptional circumstances students at other courses are allowed to become student affiliates which allows them access to the same materials. This is granted at the discretion of the Student Services Officer and the Admissions Manager.
As far as statistics about people remaining in practice is concerned, we have undertaken a few rudimentary surveys over the last few years to determine whether the recession is causing a greater dropout rate than previously. We were always concerned that teaching institutions were giving a slightly over-optimistic picture of how easy it was to establish a practice, and we reckoned that two years was probably the minimum time necessary to become free-standing. We have found that there has been a slight but not very significant increase in the dropout rate from membership, but of course this means only that someone ceases to belong to the BAcC. We have no idea, for example, how many people find even the heavily discounted subscriptions of the first two years something of a luxury after the cost of training, and leave the BAcC to save money. This is probably more common than leaving practice entirely, especially since the average student has spent or committed themselves to £20K or more to become a practitioner.
There is no more data than that. However, many of the teaching institutions, who can be found on the main BAAB site, maintain alumni groups for cohorts of graduates, and you may find that they can give you a better view. Of course, it may not be in their interests to tell you if the drop out rate is high.....!
As for employability, the majority of UK practice is self-employed business, so the successful transition to business is very much in the hands of the individual. There are a small number of employment opportunities in the NHS, but too few to merit anything.