Funding and attitudes of health care commissioners:

A luxury we cannot afford.Name: Not surprisingly, many think the RLHH is

exclusively homeopathic. But changing name difficult. Inthe UK, integrated often means integration betweenprimary and secondary care.

10.1016/j.eujim.2009.08.149

Educational initiatives in integrative medicine: The imperative

for change

A. Haramati

Georgetown University School of Medicine, Departments of

Physiology & Biophysics and Medicine, Washington, DC,

USA

As the public’s use of complementary and alternativemedical (CAM) therapies has increased, and as researchinto the safety and efficacy of these modalities hasintensified, medical schools are faced with the challengeof determining how best to integrate this information intothe curriculum. Over the past decade, there has beenincreased interest and activity at many medical schools toincorporate complementary, alternative and integrativemedicine (CAM) into the 4-year-undergraduate medicalcurriculum, as well as to graduate medical educationprograms. Beginning in 2000, the National Center forComplementary and Alternative Medicine (NCCAM) atthe National Institutes of Health in the US funded 15institutions for multi-year grants (R25 awards) to fosterthese types of educational initiatives. The efforts of thisgroup have been documented in a series of articlespublished in Academic Medicine and other key journals.Another important development has been the formation in2002 of the Consortium of Academic Health Centers for

Integrative Medicine, a group of now 43 medical schools inNorth America dedicated to helping transform healthcarethrough rigorous scientific studies, new models of clinicalcare, and innovative educational programs that integratebiomedicine with the rich diversity of various therapeuticsystems and modalities. The Consortium published asuggested list of core competencies in integrative medicinethat all graduates of medical school should possess (Acad.

Med. 79:521–531, 2004), and also compiled a series ofmodules for teaching elements of Integrative Medicine. InCanada, efforts are underway, through the CAM in UME(Undergraduate Medical Education) Project, to broaden theawareness of CAM practices, products and perspectives inan evidence-based manner across the various curricula. Inthis plenary presentation, Dr. Haramati will outline theimperative for moving medical education in this direction. A

variety of approaches will be highlighted in which materialfrom the thematic thread of Complementary and Integrative

Medicine, that is the blending of conventional and non-conventional therapies, can be used to advance bothscientific curricular objectives and also to help studentsattain proficiency in competencies related to professional-ism, such as self-awareness, self-care and personal growth.

10.1016/j.eujim.2009.08.150

Systematic reviews — Benefits and pitfalls

K. Linde

University of Technology, Institute of General Practice,

Munich, Germany

Systematic reviews have considerable impact on the discussionof complementary therapies in the scientific community, themedia and on health care decision making, as they areconsidered to be the most reliable tool to summarize andassess the available evidence on a defined question. Thislecture will discuss strengths and limitations of systematicreviews, both in general and in relation to complementary andalternative medicine (CAM). Well-performed systematic re-views clearly define the questions addressed, use systematicmethods and describe them carefully, assess the quality of theprimary studies and summarize their findings in a transparentmanner. However, review questions in CAM tend to be broadwhich often leads to results which leave wide room forsubjective interpretation. For searching the literature compre-hensively it is sometimes necessary to go far beyondconventional electronic databases, but the quality of thematerial identified in other sources seems often doubtful.Small changes in selection criteria can influence strongly whichstudies are actually included. Publication bias, insufficientreporting in primary studies and problems related to qualityassessment apply to both conventional medicine and CAM. Inconclusion, while systematic reviews are (at least currently)without alternative, they have to be read and interpreted withcaution. And in many cases, particularly in the area of CAM,they will leave a lot of room for controversial discussions.

10.1016/j.eujim.2009.08.151

ARTICLE IN PRESSInvited lectures / European Journal of Integrative Medicine 1 (2009) 167–171168