Future medical doctors need to be informed about CAM to ensure safe and competent patient care

Complementary and AlternativeMedicine (CAM) remains a controversial topic. Despite its widespread use by patients [1], its provision by a large number of physicians and substantial student interest [2], [3], it is rarely taught by medical schools in Europe. By contrast, in the United States (US) 82 medical schools have included CAM-related content in their compulsory curriculum [4] and special educational methods are used to teach about CAM [5]. In a discussion on the teaching of CAM at universities, it is important to clarify which methods are designated by the term CAM. CAM covers a broad variety of treatment methods that are not part of conventional medicine (http://nccam.nih.gov/health/whatiscam/ and http:// www.nhsdirectory.org/default.aspx?page=HLReport). These methods comprise whole medical systems, such as naturopathy, Chinese medicine and homeopathy, as well as single interventions such as aromatherapy [1], [6]. The National Centre for Complementary and Alternative Medicine (NCCAM) in the US defines whole medical systems as systems that are built upon complete systems of theory and practice. Such systems have evolved prior to and separate from conventional medicine (http:// nccam.nih.gov/health/whatiscam/overview.htm). Although survey data show that decision-makers at German medical schools are indeed interested in CAM, CAM is integrated in medical curricula to a very limited extent only [7]. This is underscored by the fact that all chairs in CAM at medical schools are endowed chairs. A possible explanation for this is that medical schools feel bound to scientific medicine and that scientific evidence for many CAM treatments is scarce. However, some universities have been involved in CAM research for many years and offer lectures on CAM [8], [9], [10]. Since 2003, naturopathy treatments (German: Naturheilverfahren) have been included in the mainstream medical curriculum in Germany, but the number of teaching hours and the content taught varies greatly between universities. In Germany, naturopathy is defined as a combination of lifestyle medicine and mind-body medicine (German: Ordnungstherapie), hydrotherapy, herbal medicine, exercise therapy and dietetic treatment. It is used either as a preventive measure or therapeutically. It depends on the university whether naturopathy alone is taught or whether other CAM treatments, such as homeopathy and Chinese medicine, are also included in the curriculum. In addition some universities offer optional courses on complementary medicine. In the spring of 2009, a conference on CAM education in German Universities was organized by the Carstens Foundation, offering a platform for discussion about experiences, cooperation and standardization in relation to CAM courses. In Switzerland and Austria CAM is not included in the core medical curriculum. Lectures are mainly optional and depend on initiatives of individual universities. At Vienna medical school, for example, a lecture series on the fundamentals and the practice of CAM is offered by the Institute of General Medicine. Additional, more specialized, courses are offered in homeopathy, acupuncture and hypnosis. All medical students at Vienna medical school have to attend a compulsory case-based course on interdisciplinary patient management and this course addresses treatment options from both conventional medicine and CAM (e.g. homeopathy, osteopathy, herbal medicine, acupuncture, neural therapy). Another example is the medical school of Graz in Styria, which offers an optional lecture series in CAM with the main focus on homeopathy. In Switzerland, at the medical schools of Bern and Zürich, several courses are taught including lectures and practical courses in naturopathy, homeopathy, Chinesemedicine, anthroposophical medicine and neural therapy. Most of these courses are offered as electives for interested students and they are run by the Kollegiale Instanz Komplementärmedizin (KIKOM) in Bern