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How to Become a Naturopathic Doctor

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Traditional medicine is solution-oriented: Identify a problem; then treat the problem. Naturopathic medicine, like other alternative therapies, attempts to treat the whole person and eliminate the causes of illness rather than simply treat the symptoms. To paraphrase the old saying, naturopathic medicine focuses on the ounce of prevention rather than the pound of cure.

This focus on wellness and prevention and treatments based on natural remedies rather than conventional pharmaceuticals appeals to many aspiring practitioners and their potential patients. Becoming a naturopathic doctor is not a light commitment; however, it requires a full eight years of college.

Distinguishing Between Naturopaths and Naturopathic Doctors

If you spend time on the websites of naturopathic practitioners, you’ll notice a difference in how they describe themselves. Some self-identify as naturopaths or “traditional naturopaths” or simply speak of “operating a naturopathic practice and consultancy.”

Because those titles aren’t licensed and regulated by the state, practitioners can vary quite widely in training and competence. It falls to the patients themselves to do the research and choose a reputable practitioner.

Other caregivers use the term “naturopathic doctor” or “naturopathic physician,” which is an entirely different thing. Often abbreviated as ND, NMD or NP, these credentials are used in states that license and regulate naturopathic medicine. In order to be licensed as an ND or NP, caregivers must first earn a four-year bachelor’s degree, then complete an accredited four-year doctoral program at one of the handful of recognized naturopathic medical schools. Finally, graduates must pass a national licensing exam. It’s a rigorous process, similar to those followed by chiropractors, dentists, medical doctors, doctors of osteopathy and other professionals.

Naturopathic Medical School Requirements

As with other healthcare professions, your path to licensure begins in high school. The health sciences are science-based, so your course selection should skew that way. Biology and chemistry are especially important, because they’ll provide the foundation for your later coursework in anatomy, physiology and pharmacology. Don’t neglect the humanities, because they teach critical-thinking and communication skills that you’ll need in your practice.

After graduation, your next step is a four-year bachelor of science degree. Take the time to look at the admissions requirements for the naturopathic colleges you’re interested in attending. Most will be broadly similar, calling for specific numbers of course hours in biology and chemistry as well as math, psychology and English composition. Make sure the course load you settle on covers all of the necessary prerequisites.

Individual schools may have other requirements, from essays to community service to personal interviews. Your grade point average will also play an important role, so be diligent to keep it at 3.0 or higher. There are a limited number of accredited naturopathic schools and a growing interest in the field, so a high GPA can improve your chances of getting into your preferred program.

Schools Offering a Naturopathic Medicine Program

You can’t become a licensed naturopathic doctor unless you attend a program that’s accredited by the Council on Naturopathic Medical Education, or CNME. This is a short list, with just seven approved schools at the time of writing. These are Bastyr University, with campuses in Kenmore, WA and San Diego, CA; the National University of Natural Medicine in Portland, OR; National University of Health Sciences in Lombard, IL; Southwest College of Naturopathic Medicine and Health Sciences in Tempe, AZ; University of Bridgeport School of Naturopathic Medicine in Bridgeport, CT; and two Canadian schools: Boucher Institute of Naturopathic Medicine in New Westminster, BC; and the Canadian College of Naturopathic Medicine in Toronto, ON.

You’ll find the admissions requirements for each of these schools on its respective website.

Naturopathic Doctor Education

Once you’ve earned one of the limited number of spaces in an accredited program, the real work begins. The course load in a naturopathic doctoral program is very similar to those taken by mainstream physicians in a medical or osteopathic medical school.

These courses include anatomy, cellular biology, biochemistry, pharmacology, epidemiology and the neurosciences. Most programs also include courses on ethics and the legal issues facing healthcare workers. Clerkships and clinical rotations provide hands-on experience in the various branches of medicine, including family medicine, radiology, obstetrics and dermatology.

What makes naturopathic medicine distinctive is its focus on integrative, whole-person wellness. To serve that focus, aspiring NDs also receive hundreds of hours of instruction on botanical medicine, homeopathy, ayurvedic and traditional Chinese medicine, and other alternative therapies.

The total number of hours spent in training for a naturopathy degree is very similar to those required for an MD or DO.

If You’re Already a Healthcare Professional

If you’re already a healthcare professional and have an interest in adding naturopathic medicine to your credentials and skill set, you may be eligible for “advanced standing,” meaning you’ll be given credit for your existing training where it overlaps with naturopathic training. This is determined on a case-by-case basis, and it can dramatically shorten the time required for licensure.

After Graduation

After graduating successfully from your doctoral program, the next step is to take and pass the Naturopathic Physicians Licensing Examinations, or NPLEX, which are administered by the North American Board of Naturopathic Examiners, or NABNE. There are three separate NPLEX exams.

The Part I exam covers the core biomedical sciences portion of the curriculum. The Part II exam is, itself, divided into two separate tests. The first covers core clinical sciences, while the second tests applicants on their knowledge of elective and specialized material. Dates and eligibility requirements for each year’s NPLEX examinations are posted on the NABNE’s website.

After successfully passing the NPLEX, you may apply for state licensure if you live in one of states, provinces or territories that licenses and regulates naturopathic doctors. Depending on the state you choose to live and/or practice in, you may need to meet additional requirements.

Licensure and Scope of Practice

Healthcare professionals are governed by what’s called a “scope of practice,” which lays out in detail which forms of treatment they may legally provide. Physicians and surgeons have a very broad scope of practice, while nurses and advanced practice nurses, chiropractors, and other alternative care providers all face greater restrictions. The scope of practice varies by state.

Oregon has the most liberal scope of practice for NDs or NPs. Naturopathic doctors in that state are classified as primary care providers, and they are legally permitted to examine and diagnose patients on their own authority, order diagnostic tests, refer patients to medical specialists and even perform minor surgeries.

In states that do not license naturopathic doctors, NDs can practice freely but may find themselves in competition with traditional naturopaths and other alternative practitioners. In unlicensed states, NDs will also be unable to prescribe controlled medications or earn hospital privileges.

Naturopathic Doctor Salary

Naturopathic doctors don’t command the salaries enjoyed by some medical specialties, but your earnings would be comparable to those of many healthcare professionals. The U.S. Bureau of Labor Statistics doesn’t have a separate category for NDs, grouping them instead with “Health Diagnosing and Treating Practitioners, All Other.”

The average annual income for this classification is $85,600, while the median salary is $73,960, and the top 10 percent earn $141,330 or better. These figures coincide closely with those of other healthcare workers the BLS does track, including chiropractors, audiologists and speech-language pathologists. The Association of Accredited Naturopathic Medical Colleges cites average salaries of $80,000 to $90,000 for established practitioners and $20,000 to $30,000 for new residents, but with potential earnings of $200,000 or more.

As with other alternative practitioners, your income may ultimately be determined by your own ability to build a practice, through personal networking, savvy use of social and traditional media, and word-of-mouth referrals from existing patients.


Fred Decker is a prolific freelance writer based in Atlantic Canada. He was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology. Aside from CareerTrend, he's written career-related information for and the website of the Houston Chronicle.

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