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How are Naturopathic Doctors Educated, Trained, and Licensed?

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Naturopathic doctors (NDs) are trained as primary-care physicians to diagnose, treat, and prevent illness. A licensed ND treats conditions like chronic pain, asthma, diabetes, and heart disease by identifying the underlying causes, minimizing factors that compromise good health, and supporting the body’s natural restorative process. Treatment modalities include nutritional counseling, lifestyle recommendations, and botanical, homeopathic, behavioral, and prescribed medicines.

How to Become a Naturopathic Doctor

NDs graduate from accredited naturopathic medical schools (four-year, in-residence, post-graduate medical programs). In addition to a standard medical curriculum, NDs complete four years of training in clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, physical medicine, and counseling. For at least the final two years of their medical program, naturopathic medical students intern in clinical settings under the close supervision of licensed professionals. NDs graduate with hands-on experience diagnosing and treating patients.

Differences Between MD, DO, and Naturopathic Training

The general educational structure1ND, MD/DO, NP: What’s the Difference? Association of Accredited Naturopathic Medical Colleges. for naturopathic doctors is comparable to that of conventional medical doctors (MDs) and osteopathic doctors (DOs). In all three medical programs, the first year emphasizes biomedical sciences such as anatomy and biochemistry. Second-year classes focus on the diagnostic sciences, including areas such as evidence-based medicine and physiological assessment. All programs progressively increase students’ problem-based learning and integrated coursework, enabling students to learn how different concepts affect one another.

After the first two years, the curricula of the three medical programs focus on applying medical knowledge to real-life situations with simultaneous classroom studies supporting this training. Third- and fourth-year naturopathic medical students have opportunities for hands-on clinical training and practice, often at their schools’ teaching clinics and off-site clinics. This period of clinical training is essential to these students’ education—so much so that clinical training is now being introduced during the first and second years of education at several AANMC-member schools. As a result, naturopathic medical students graduate with experience in diagnosing and treating patients, even before they begin formal practice.

During naturopathic medical school, students are educated in the biomedical sciences as well as the latest advances in science in combination with natural approaches to therapy. They also study disease prevention and clinical techniques.

Medical Residencies

A major difference between the training of the MDs and naturopathic doctors is medical residencies. MD residencies are mandated and regulated by conventional medical schools. As a result, many opportunities for residencies exist at a wide variety of medical facilities and are funded by the federal government.

There is a rising number of residency opportunities available to new NDs, with many completing 1-2 yr  Primary Care Physician (PCP) or specialty residencies each year. Naturopathic medical schools2Accredited Naturopathic Medical Schools. Association of Accredited Naturopathic Medical Colleges. that are part of the American Association of Accredited Naturopathic Colleges can apply for residencies for their students. The Institute for Natural Medicine is proud to augment this growth by hosting the INM Residency Consortium (IRC). This accredited program provides naturopathic medical school graduates two years of valuable clinical residency time, in addition to enrichment in practice management and other skills (learn more about INM-sponsored residency).

In Addition to Medical Residencies

Beyond this, in place of a residency, it is common for new naturopathic doctors to volunteer or work shadowing a practitioner in a hospital, private practice, or medical community center for hands-on patient experience. In Washington State, naturopathic doctors are helping to fill the shortage of primary care physicians by working alongside physicians in federally qualified health centers. Also, new integrative medicine residency opportunities are developing, like the integrative medicine residency program at the University of California, Irvine, led by Dr. Arvin Jenab, where NDs train alongside conventionally trained medical doctors.

Like MDs, a growing number of naturopathic doctors choose to specialize or focus their practices. Specialty associations currently exist for endocrinology, environmental medicine, gastroenterology, parenteral therapies, pediatrics, primary care, psychiatry, and oncology. In addition, while practicing Family Medicine, many naturopathic doctors choose an area of focus based on a therapeutic, condition, or population subset.


Prior to admission into an accredited naturopathic medical school, the typical student3Academic Prerequisites. Association of Accredited Naturopathic Medical Colleges. has completed three years of pre-medical training and earned a bachelor of science degree. Students are expected to have completed courses in English and the humanities as well as math, physics, and psychology, with a strong emphasis on chemistry and biology. In addition to prerequisite coursework, prospective students must demonstrate appropriate observational and communication skills, motor function, intellectual-conceptual abilities, integrative and quantitative abilities, and behavioral and social maturity.

Accredited Schools

Accredited naturopathic medical schools4Naturopathic Curriculum. Association of Accredited Naturopathic Medical Colleges. are four-year, in-residence, hands-on medical programs consisting of a minimum of 4,100 hours of class and clinical training.

There are currently seven accredited schools5Accredited Naturopathic Medical Schools. Association of Accredited Naturopathic Medical Colleges. with eight campus locations in the United States and Canada. A degree from an accredited medical school is required for licensure or certification by a state. The following accrediting institutions provide accreditation services for naturopathic medical schools:

  • College accreditation is issued by the U.S. Department of Education (ED). All AANMC member schools have been accredited or are in candidate status for accreditation by an ED-approved regional accrediting agency.
  • Programmatic accreditation is issued by the Council on Naturopathic Medical Education (CNME). All AANMC member schools have also been accredited—or are candidates for accreditation—by the CNME, the recognized accrediting body for naturopathic medical programs in North America.
  • The exam required to qualify for naturopathic doctor licensure is administered by the North American Board of Naturopathic Examiners. The Naturopathic Physicians Licensing Examinations (NPLEX) consist of two parts. Only students and graduates from accredited or candidate naturopathic programs are eligible to sit for the NPLEX. Passing the NPLEX is required before a doctor of naturopathic medicine can be licensed by a state.

Given the importance of hands-on, clinical experience for naturopathic medical students, the accrediting body for naturopathic medical colleges does not recognize degrees from online programs of study.

Licensure and certification

Licensure6Naturopathic Doctor Licensure. Association of Accredited Naturopathic Medical Colleges. and certification are the highest forms of regulation. They are designed to protect the public by ensuring that certain minimum competency requirements are met. They also set standards for the profession.

Currently, 20 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands offer licensure or certification for naturopathic doctors. The American Association of Naturopathic Physicians maintains a list of states and territories that license or certify naturopathic doctors.

The AANP and the INM would like to acknowledge the Association of Accredited Naturopathic Medical Colleges (AANMC) for its contributions to the content of this FAQ. The AANMC was established in 2001 to advance the naturopathic medical profession by actively supporting the academic efforts of accredited naturopathic medical schools.

Photo by Southwest College of Naturopathic Medicine.

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This article is provided by

The Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform health care in the United States by increasing public awareness of natural medicine and access to naturopathic doctors. Naturopathic medicine, with its person-centered principles and practices, has the potential to reverse the tide of chronic illness overwhelming healthcare systems and to empower people to achieve and maintain optimal lifelong health. INM strives to fulfil this mission through the following initiatives:

  • Education – Reveal the unique benefits and outcomes of evidence-based natural medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research on this complex and comprehensive system of medicine

About The Author(s)


Institute for Natural Medicine Staff

Our dedicated content team of professional staff writers represents decades of experience covering essential natural health topics in an accessible, evidence-based, and engaging way. Guided by a shared passion for holistic well-being, each and every one of our writers strives to empower our readers to take charge of their health.

Supported by a rigorous fact-checking and medical editing process from licensed naturopathic doctors that examines the latest in peer-reviewed research, our team brings their in-depth knowledge of natural health practices into every piece of content we produce. We strive to be the gold standard for evidence-based natural medicine, providing trustworthy information and inspiring narratives to help you live your best health, naturally.

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