My primary care and medical acupuncture clinical rotation

I recently wrote an article for The DO about my experience doing an away rotation at the NIH Clinical Center. Now I’d like to talk about another unique fourth-year rotation that I did: a clinical rotation in primary care and medical acupuncture.

My interest in integrative medicine

I have always been interested in combining integrative medicine treatment modalities and philosophies into my clinical practice. Because I am a psychiatry resident, the practice of mindfulness — one of the more popular topics in integrative medicine — lends itself nicely into what I do as a psychiatrist on a daily basis. There are other interesting aspects of integrative medicine as well. For instance, it draws upon techniques from traditional Chinese medicine, including the use of acupuncture and acupressure.

 In my article last month, I commented on how you can make your medical education whatever you want it to be; I definitely took this philosophy to the next level! Before beginning my fourth year, I actually spent a year doing a predoctoral research fellowship at University of California – San Francisco in integrative medicine.

One of the projects I worked on involved seeing how acupressure given at the bedside can benefit children undergoing active chemotherapy or bone marrow transplants. This was particularly a cool project to do as a DO, given that I was also studying osteopathic manipulative medicine (OMM), another manual, hands-on intervention that involved touch and manipulation of body tissues.

How I set up this rotation: The art of cold-calling and expressing your interest

Every medical school has different requirements for graduation. I attended Touro University College of Osteopathic Medicine in California, which required one four-week primary care rotation during fourth year. When considering how I would meet this requirement, I decided to seek out an experience that was unique and “me.”

Although there were several available rotation sites in the community where I could have completed this requirement (such as the clinic where many of our faculty worked), I wanted to look for something on my own that would fit my own interests in integrative medicine.

I started Google-searching around the area and found a clinic called Hana Holistic Medical Center in downtown Berkeley, California. I contacted the medical director, Anas Hana, MD, and expressed my interest in learning from him during a clinical rotation. Thankfully, he agreed to take me on! (Warning: This may not always work because physicians in the community are always very busy, and they may not necessarily have the time, bandwidth or interest to take on a medical student. But it definitely helped that I was very interested in what he did, and that this clinical rotation aligned with my prior research work and interest in integrative medicine.)

What I learned

Dr. Hana trained in internal medicine and worked at San Francisco Kaiser Permanente Medical Center for years before starting his own clinic. In addition to practicing standard primary care medicine (which I helped with by taking histories and doing supervised physicals), he also provides medical acupuncture to his patients, and I shadowed him on many sessions.

His clinic also has a yoga studio where Dr. Hana hosts myriad wellness sessions for the public, including yoga and tai chi classes and fitness and nutrition workshops.

Dr. Hana studied traditional Chinese medicine (TCM) in addition to his MD training, including training in delivering Tui Na (a hands-on traditional Chinese body treatment) and medical acupuncture (using needles). Dr. Hana also taught local premeds how to deliver Tui Na during his off hours. I joined these sessions and had a lot of fun comparing and contrasting Tui Na techniques to OMM techniques.

What was also interesting about learning primary care medicine incorporated with perspectives from TCM is its diagnostic system, which is based on a patient’s reported symptomatology combined with systematic examination of the person, including physical palpation of the body. This was quite similar to how we diagnose structural abnormalities in osteopathic medicine.

Dr. Hana and I would sit after appointments and discuss how one would diagnose or think about the patient’s symptoms through the lens of TCM. The idea that internal organ systems may interact with musculoskeletal components and how your palpated findings of the musculoskeletal components may represent something about the internal organs is quite similar to osteopathic principles.

Beyond these unique clinical experiences, seeing how Dr. Hana combined his rigorous medical training with his personal healing philosophies in his private practice was a valuable learning lesson in and of itself. Your career is your oyster!

Related reading:

Why med students should consider rotating at an NIH clinical center

Rejection, redirection and resilience: How I found success after so many ‘no’s’