Experts criticise 'pseudo-scientific' complementary medicine degrees

Ernst and Singh wage a campaign against CAM in the name of science. They do not much to further the cause of science, because they blur the lines between quack-busting activities and dispassionate research. <p>Speaking as the Programme Leader for the homeopathy course at Thames Valley university, I can only say that our course is properly validated, and that it is a rigorous process to get the course developed and validated (it took us more than 2 and a half years). The course has a double focus of training practitioners and to study the discipline critically. There is no contradiction here. On the contrary, a critical attitude makes for good and responsible practitioners.The real issues in CAM are proper regulation and training. The BSc. courses are helping in this process.If Ernst and Singh were serious about CAM (and science), they should welcome such moves. I suspect their motives are different.

I thought it was generally accepted that homeopathy has no basis in science. It is an art. Let's not dilute our science faculties out of existence.

"Critical thinking" and "validation", proclaimed by Ralf Jeutter as being part of degrees in homeopathy, are meaningless if they take place in a parallel reality where none of the known laws of physics and chemistry apply. All you can critique is minor degrees of bullshit <p>For instance, Ralf Jeutter et al. teach the theories of people like James Tyler Kent, who was denying that germs cause disease in the 1920s, fifty years after Robert Koch had essentially proved that they do. Tyler Kent believed all disease was "disturbance of the vital force", and viewed illness as being resulting from spiritual problems. <p>So how, one might ask, do degrees like Dr Jeutter's teach students to be "critical" of this kind of thinking? By pointing out that all known science and medicine shows it to be the purest nonsense? I severely doubt it. <p>What we are dealing with here is a belief-based ideology that exist in rejection of the laws governing the physical universe. Nothing more and nothing less.You may be able to teach people to "critique" it strictly within its own framework of belief-based reality, in the way that theology students are taught to debate theology. But that is not a science degree. Call it a BA in the "sociology, theory and practise of homeopathy" if you must; but it is not science by any acceptable definition. <p>As David Colquhoun often says, what next? A Bachelor of Science degree in astrology? <p>All that Edzard Ernst - who trained in and used homeopathy as a doctor in Europe - and Simon Singh are asking CAM to do is to accept that if must be judged by the same standards set for any other therapy in medicine - "Does it actually work better than a placebo? - yes or no". If it does, it is medicine. If it doesn't, it is "stealth" talking therapy (at best) or just plain Snake Oil (at worst).

Sterling work from Ernst and Singh, but possibly only the tip of the iceberg. Web-blurb for the Transpersonal Psychology and Consciousness Studies MSc at the University of Northampton notes "that it is required that students take up and regularly (ideally daily) practice some spiritual discipline, such as meditation or contemplation, Tai Chi, Chi Gong or Yoga". Meanwhile over at the "parapsychology" research unit a postgraduate student appears to be studying to be a spiritualist medium.

I am pleased to hear that David Colquhoun is disappointed that these universities will not make their course materials available for review. I would love to have a look at the materials for the courses run at UCL, so please David can you arrange for a full copy of the course materials for the Pharmacology department at UCL to be made available for public consumption as soon as possible, and save me the bother of submitting a Freedom of Information Act request. I won't hold my breath. <p>You can actually look at the structure for any reputable course by looking at an institutions website or by ordering their brochure. It is not difficult to ascertain the requirements for a degree in acupuncture to be validated by the British Acupuncture Council (which all of the acupuncture degrees mentioned are). These courses have to contain a significant amount of study of Western sciences, specifically anatomy, physiology and pathology. They also teach students to critically assess research papers written on acupuncture from a wide variety of sources. Please remember that acupuncturists need to be able to understand patients who may only be able to explain their symptoms from a Western perspective, and we need sufficient knowledge to be able to cope with this. <p>Acupuncture has been proved for a variety of conditions using scientific methods and has been reported in well-regarded journals. Indeed, I do believe scientists from Professor Colquhoun's own institution reported in NeuroImage in 2005 that acupuncture is more than placebo. Maybe you need to get your own house in order Professor Colquhoun before you start criticising others. <p>I also think mentioned crystal therapy and acupuncture together is ridiculous. I imagine the reporting of this study has been somewhat sensationalised, rather than reporting it's actual contents, so if anyone can post a link to the full report I would be very grateful (or do we need to buy the book? In which case this seems like some wonderful free promotion.....)

Genuine researchers into CAM and those with a vested interest or bias can be distinguished by the way they present evidence on CAM (and in particular homeopathy). The former will come at least with an open verdict, if not an admission that the research trend is in favour of homeopathy, the latter will want to close the book on homeopathy (by hook or by crook). The evidence is based on ultra-high dilution trials, which have shown repeatedly the physiological effects of those dilutions; on meta-analyses (of which there are quite a few), which show homeopathy to be more effective than placebo (if that was assessed), and very importantly (because this is closer to clinical realities) clinical outcome studies, which produce conistently favourable results for homeopathy. The case aginst homeopathy has to be watertight and irrefutable, otherwise we risk to miss a great opportunity to reserach further into what is clinically so clearly an effective therapeutic intervention. One can also tell genuine researchers by the fact that they don't use words like 'nonsense', 'bogus' and 'dangerous' in order to describe homeopathy. I don't know of any embarrassment of bio-medical collegeues. We seem to get on fine. I agree with David Coloqhoun that we should always make sure to raise standards and to make sure that our profession is safely regulated. Being part of a university environment helps on both counts.

As a mature student currently on a foundation degree course in Complementary Therapy I can assure everyone that we are not lightweights when it comes to studying. We are constantly reviewing research into the therapies and are encouraged to have an open mind and to look at all of the research whether it reflects well on CAM or not. Currently we are studying chemistry, botany and pathology and have already completed an advanced anatomy and physiology module which we will revisit in our second year. I am really disappointed that Prof Ernst, a real hero of mine, seems to be so damning of the whole degree idea. There is a place for complementary therapy within the medical profession, all we are trying to do is to earn some respect as therapists. I meet plenty of people who really benefit from the therapy's they receive emotionally and as a result physically.

I would not want any casual reader here to think that what Ralf Jeutter says about scientific evidence for homeopathy is true. If you read `Trick or Treatment?' (I have a copy in front of me) you will see how Ernst and Singh describe in detail the methodology of meta-analyses and in particular the issue of study quality. Jeutter's assertion is based on analyses that ignore study quality. I have examined in some detail the `ultra-high dilution trials' and frankly the effect sizes are so small that they could easily be the result of confounding factors, and in particular of data dredging (the harder you look the more you find). After 200 years why are we even arguing about whether homeopathy works? It should be obvious. <p>I am prepared to believe that BSc courses in quackery include some science, but unless the universities overcome their embarrassment it's hard to know how much. But that doesn't excuse the simultaneous teaching of idiotic anti-science. Why teach students on one day that pharmacological effects are usually dose-related, and the imaginary `law of infinitesimals' the next? Charging fees to tell students lies is fraud.

Thank you for the link David. It is interesting to note that you would also require an FoI for 'most' of the UCL teaching material to be made available. You are in fact no different to the universities who have been criticised for not disclosing upon request (and who also have a right to commercial interest). But thank you for the Powerpoint that you have authored and therefore have the discretion to release - I am sure there are many lecturers of complementary therapies who will also be happy to distribute presentations they use in their teaching too. And well done for evading all the other points I raised. Any complementary therapy that makes claims which it cannot support is of course totally irresponsible, however this is not the issue here. Should a course in acupuncture be a BSc? Yes, absolutely, because the content of the course contains enough Western medicine for it to be classified as such (in the same way for example that some Geography degrees are BSc, for example at UCL, because it has been decided they contain enough scientific content). Certainly at the college I attend (not appearing in the hit list) all of the Western medicine subjects are taught by people trained in that discipline. The BSc classification does not however mean that acupuncture is necessarily a science or is claiming to have been universally tested using Western methods, but there is mounting evidence that it is effective for certain conditions, that it cannot be down to placebo, and shock-horror, for certain conditions is MORE effective than the Western medical alternative where one exists.

Perhaps Tim Gough will now reciprocate by posting his notes that explain the principles of acupuncture. <p>I should respond also to his comment about imaging. The report to which he refers tells us that sticking a needle into somebody produces a signal in the brain. Not much surprise there. It is only a slight advance on what any sensory physiologist could have told you decades ago. What the report does NOT tell you is whether acupuncture is any good for helping patients. Thus far the responses here have, very obligingly, emphasized the validity of concerns that we have for academic standards in the alternative medicine business.

Gimpy - Homeoprophylaxis is indeed a legitimate field of research, and has been around for 200 years, esp. in preventing and treating epidemic diseases like cholera. Research is ongoing: there are meningitis studies, small scale studies on malaria; a university validated study on prevention of childhood diseases; a study on the prevention on influenza etc. We would have not this discussion if conventional vaccinations were infallible. I am aware in your interest of my website, and I respect your concern for public health. You have surely seen that I do not 'sell' homeopathic vaccines, but that they are only dispensed after a thorough consultation, which involves making sure that risks and benefits of this way of protection are understood. Those opting for homeopathic immunisations have to sign a consent form and take partin research in order to assess effectiveness and possible side-effects of this method. The wording of my website has been checked with the Advertising Standards Agency and the Committee of Adverstising Practice to make sure no misleading information is on my website. As a point of principle, I usually do not respond to anonymous bloggers, because in my experience they often cannot resist the temptation to become offensive and personal and to go rather over the top in their pronouncements. So, please, don't see it a sign of rudeness if I don't respond to any of your further comments. I am happy to communicate with the person behind 'gimpy'.

Let's have a quick look at Western medicine then. Very often brilliant - there is no debate there. Also, frequently useless (anyone care for a discussion on the effectiveness of anti-depressants?), often with horrendous iatrogenic consequences (even those available over the counter), and very often non-existent. As I said before, it is totally irresponsible for any practitioner, of any discipline, to suggest that the treatment they offer is going to cure someone. This applies to 'mainstream' and 'complementary' therapies. However, are you going to deny the opportunity to someone suffering from multiple sclerosis to dare to make up their own mind whether they wish to try a therapy which may offer some relief? A study published in Multiple Sclerosis found that from a sample of over 20,000 people with MS, 54% had made use of complementary therapies - and why? despair with the care they have received from Western practitioners? the side-effects of medication? Or that fact that what is being offered isn't working? I must reiterate that I am not saying that acupuncture is going to cure them and I would never suggest that to someone - but people have a right to make up their own mind about whether to seek alternative therapy, which is increasingly available on the NHS, and is frequently funded through private health schemes. We are taught to work alongside Western medicine - we know our place, and we know when it is imperative that people are referred to GPs or A&E, and we look forwards to providing integrated treatment wherever possible. <p>Regarding posting presentations on acupuncture - I am not a teacher of acupuncture. However I am a graduate of biological sciences from a well-regarded university (and I am not the only one in my class), and I can assure you that the content of our Western science classes is certainly science. And posting any presentations on acupuncture would be pointless as you would only take great enjoyment in ridiculing it. <p>Anyway I have gone massively off-topic again. Is it science? Maybe not. Does it matter? No, not when people are free to make a fully informed choice about the treatment they wish to receive. Do we try and shun Western medicine? No, we look forwards to seeing more quality studies which demonstrate the effectiveness of acupuncture, and which help to have it take more seriously. However, we also know that 'you' have an issue with the unexplained, so even when it is demonstrated to be effective, you just switch your argument to 'how?' <p>Please be assured, and I sincerely hope this never happens, that if you are ill and Western medicine fails you, the doors to our clinics will always be open. And if it makes you feel better, I don't suppose you will be looking in the Lancet to check if you are allowed to feel this improvement.

Tim, I wouldn't bother searching the UCL website for course materials, or bother making a FoI request for them. Your time would be far better spent asking which pharmaceutical companies provide funding for research in UCL's pharmacology department, and how impartial this allows Research Professor Colquhoun to be when commenting on alternative therapies.

David Colquhoun Thanks for taking the time to try and make me look stupid but I really feel that a comparison to 17th century blood-letting physicians is a bit strong! Prof Ernst's recent article, extracts of which were published in the times intimated that we were all as bad as each other. That sceptics who are emotionally opposed to to CM ignore evidence relating to the field. Mainstream journals rarely publish positive findings whereas CM journals rarely publish negative ones. <p>The therapy's that I am studying are actually aromatherapy, therapeutic massage and reflexology. Yes because I have a brain I do question the efficacy of concentrating on a particular part of the foot which is supposed to relate to a part of the body. I have great difficulty with some of the 'spirtual' therapies on offer. We need people like you to make us question what we are doing but I am still sure that ther is a place for us and that we can make a difference if we work with and not against each other.

Lorraine, I'm glad you do question the premises of the material you are studying. Perhaps there is indeed 'a place' for complementary therapies alongside mainstream medicine: I think that a range of skilled practitioners who are sincere, of high integrity, and empathetic can provide genuine help to many people who are in emotional turmoil, stressed by their job, frightened of getting old, etc. They may offer the time, attention, emotional support and comforting treatment (massage, aromas, maybe just listening) that mainstream medics find it harder to deliver because of all the obvious constraints of time and money. Done with integrity, there could be genuine reasons to call the training of such people a 'science degree'. There could be an honest complement to general practice - and indeed some practices do collaborate with such therapists to help distressed patients for whom pills are not the solution. <p>What is unacceptable is when students are deceived, and go on (knowingly or not) to deceive patients/clients. It is dishonest to present myth, superstition and fiction as if it were non-fiction. It is dishonest to claim that treatments 'work' when the evidence does not show that. It is dishonest to tell people they are being trained as scientists if they do not acquire essential scientific skills, knowledge and insight and perhaps above all, if they do not learn how to deal with finding out that the observations do not match what they thought was going on. <P>Does the divergence of views on what constitutes scientific understanding really matter? Yes it does matter; because it can be directly dangerous to vulnerable people in need of effective treatment; because students can be betrayed and misled into bogus careers; and because it influences the maturity of the society we live in.

Diana's comment about David Colquhoun's department is that old Alt Medicine favourite the "Phama-Shill Gambit”. <p>This line relies on trying to persuade - or more accurately, scare - people into believing that the drug companies have bought and paid for all the people who point out the scientific fallacies of Alternative Medicine. <p>David Colquhoun has stated for the record many times that he has never had any funding from a drug company. For what it is worth, neither have I. We do this stuff out of a desire to not see people get mislead and bilked by an industry – for that is what Alternative Medicine is – that rejects any attempt to make it produce real scientific evidence for its claims.

There is a much deeper reason for knowing that 'alternative' medicine such as homeopathic dilution is unscientific which has not been mentioned above. Although several of the pro-alternative people quote their scientific training I am afraid that training did not go deep enough. Trying to relate cause and effect when you have no physical understanding of the possible connection is one of the most dificult things in science. History shows it to be intrinsically error prone. In the 200 years since homeopathy was mooted, any possible physical basis has diminished to zero with the development of physics to the quantum mechanical level. Real science is about understanding what happens not about belief systems you would like to be true.

A number of questions need to asked before one can make sense of these pseudo science degrees. Before doing so, isn't it sensible to recognise that a course is introduced when a demand is made or seen? <p>Where, when, did the demand (by gender) for these degrees enter the mainstream of offerings from some uni's? What, now, is the gender balance attending these courses? Answers to these questions may shed some light on the present and possibly growing demand.

An addendum to my last. Some academics will always travel an easy pathway toward a greater student enrollment regardless of the frivolous nature and usefullness of the courses offered. This attitude has now become endemic within higher education in N. America (Canada and the USA) and shows signs of filtering down to the grade schools and kindergarten. We have certainly reached the age of endarkenment.

This whole debate is quite revealing. having read the whole interchange, arguments and counter-arguments about Alternative Medicine, I have had to break with the main stream of this discourse to shed some light on why this debate should not even exist. <p>For beginners, those against alternative medicine suffer from a simple historical bias: the denial of non-western (especially non-whitened) forms of knowledge. To this school of thought, there is a constant struggle to mock and hence invalidate anything that has no 'scientific' qualities. <p>There is more to science than the exact sciences. what the west appropriated for itself and therefore calls 'western medicine' was long practiced in pre- and dynastic eqypt. There is nothing 'alternative' about these timetested ways of healing, and those in the 'mainstream western' scientific field have nothing to worry from these disciplines that have for long been invalidated, erased, suppressed and rubbished.

Are there not just two types of medicine ? <p>Those that work and those that do not ,quite simple for myself as a lay person to understand . <br>If it works show the proof ,seems a reasonable request. <br>If your only response is conspiracy and "big pharma" then go and join the "we did not land on the moon brigade" <br>By the way where does "western medicine" start Istanbul? never been quite sure about that. <p>Oh and why do wealthy Chinese people use "Western medicine " and the poor use traditional remedies ?

I notice that Professors Colquhoun and Ernst have their professional status reported as does Dr Singh. Whilst Dr Tim Duerden is named just as Tim Duerden. Is this bias due to him going over to the dark side. It would be interesting to find out how many medically trained personnel have joined him..

In response firstly to Tekkens' comment Why do wealthy Chinese people use 'Western Medicine'? Possibly the same reason wealthy Indian people use it, it's a quick fix, but an expensive one in China and India! For instance if you have back pain due to being over-weight, are you going to resist taking pain killers? If you have a job and need to get back to work even if you are ill , quick fix or traditional fix? Or are you truthfully telling me that you are going to patiently reverse the cause and diet until the pain naturally ceases? Same thing goes for migraine and headache caused by stress or allergies. The thing is, have you considered the long term side- effects, or do you just trust what your peers have to say. Do you ask your pharmacist for evidence and proof when you collect your prescription? Do you read the leaflet inside that tells you of the possible illnesses your medicine can cause or will cause with long time use? Proof is always a reasonable request if you have access to funding and supplies. Traditional medicines have been used for centuries in countries that have used what is available. Centuries of trial and error is probably all the adequate proof some nations require. In most cases these happen to be natural resources, it would be ideal for poorer countries to have access to unlimited funding, equiptment and trained researchers and dare I say it 'scientists' but guess what? This is the real world, open your eyes and look around, poverty really exists. perhaps when world poverty has been conquered we can all sit down and quibble over whose medicine is most effective. Western medicine is not necessarily the answer to health because it does not always work, it sometimes causes long term difficulties and in some cases actually causes further complications. Different things work for different people, choice of medicine and treatment should be a fundamental right for every autonomous person. I know for a fact that Middlesex University Complementary degree courses involve 66% study of western medicine and general degree modules. The specific CAM subject is taught in a way that encourages students to constantly criticise and compare with that of western medicine and research published in a wide variety of scientific journals. These graduates are examined to a level where medical emergencies and safety procedures are recognised, alternative or complementary medicine is not prescribed along side western medicine unless research says it is safe, if in doubt students are taught not to issue medicine unless they are sure it is safe. how many times do G.P.s prescribe and issue drugs that are unsafe to consume with current mediciation? How often do the G.P.s check whether patients are under supervision of other medics? From personal experience and reports, not always. the NHS is over run and over crowded. Pressure is needed to be relieved by the help of other medics, and that should include graduates that have reached a safe and acceptable standard of training such as that of middlesex. If the public are requesting CAM, then at least let it be of a certain regulation and standard. If it is thought that a science degree is not appropriate to some CAM therapies, sort out which ones, don't label health alternatives to 'Western Medicine' under one umbrella, they are really very different, that is a little like using the word 'foreignor'. One final word, and that is, have you checked the content of each CAM degree, if not, what gives you the right to criticise them, and if you have, have you compared them alongside todays NHS funded courses such as nursing and the rather hurried GP course? A lot of CAM courses actually share the same lectures as these students, are these courses worthy of graduating with a BSc?