Learning to doctor on the margin of medicine: the socialization of naturopathic medical students

This research explores the socialization and culture of naturopathic students. Naturopathic physicians are a rapidly growing group of health care providers with a different ideology than conventional physicians. At present they work on the margins of the division of labor in health care. Only 15 U.S. states explicitly recognize, regulate, and license their practice, although the number is increasing. Therefore, the professional socialization of naturopathic students is framed within a context of a changing division of labor in health care. The recent growth of naturopathic physicians reflects the American public's increased interest and use of complementary and alternative medicine (CAM). However, these practitioners are not yet accepted as legitimate physicians by most conventional physicians. This research investigates how the professional socialization of students at a naturopathic medical school prepares them to assume their role as CAM providers in a division of labor that is dominated by conventional physicians. The research examines their choice to attend a naturopathic school, formal and informal socialization at the school, and the student culture. The main research site is a four-year, accredited naturopathic medical school where participant observation, intensive interviews, and a survey were used to collect data. Additional data are presented from observations at a national conference of the American Association of Naturopathic Physicians. Results indicate that the student culture and socialization process at the naturopathic medical school differ in some important ways from the previously documented socialization process at conventional medical schools. The average age of naturopathic students is much older than conventional medical students, and a much larger percentage are women. Unlike conventional medical students, who rely heavily on role models and previous knowledge of what it takes to become a medical doctor, naturopathic students select a career path based on values and beliefs that are more aligned with their own than conventional medicine. The formal and informal training and culture of naturopathic students prepares them to work alongside, rather than within, mainstream medicine. The documentation of how a group of CAM practitioners is created contributes to a better understanding of the ever-changing ideology and division of labor in health care.