Reimagining integrative medicine fellowship core competencies with a health equity lens

Vincent Minichiello; Melinda Ring; Shelley R Adler; Suhani Bora; Ann Marie Chiasson; Taryn De Sio Garber; Anand Dhruva; Katie Hu; Mikhail Kogan; Wendy Kohatsu; Tieraona Low Dog; Darshan H Mehta; Adam Rindfleisch; Jill Schneiderhan; Scarlet Soriano

doi:10.1016/j.amjmed.2025.07.013

Reimagining integrative medicine fellowship core competencies with a health equity lens

Am J Med. 2025 Dec;138(12):1716-1723.e20. doi: 10.1016/j.amjmed.2025.07.013. Epub 2025 Jul 16.

Authors

Affiliations

¹ Osher Center for Integrative Health at the University of Wisconsin-Madison, University of Wisconsin Osher Center for Integrative Health, Madison, WI, USA; University of Wisconsin-Madison School of Medicine and Public Health, Health Sciences Learning Center, Madison, WI, USA. Electronic address: vincent.minichiello@fammed.wisc.edu.
² Osher Center for Integrative Health at Northwestern University, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: mring@nm.org.
³ University of California, San Francisco, Osher Center for Integrative Health, San Francisco, CA, USA; UCSF School of Medicine, San Francisco, CA, USA. Electronic address: shelley.adler@ucsf.edu.
⁴ Lawrence Family Medicine Residency, Lawrence, MA, USA; Tufts University School of Medicine, Boston, MA, USA. Electronic address: suhani.bora@glfhc.org.
⁵ Andrew Weil Center for Integrative Medicine, University of Arizona, College of Medicine, Tucson, AZ, USA. Electronic address: chiasson@arizona.edu.
⁶ Academic Consortium for Integrative Medicine and Health, Oswego, OR, USA. Electronic address: taryn.desiogarber@imconsortium.org.
⁷ UCSF School of Medicine, San Francisco, CA, USA.
⁸ UCLA Center for East-West Medicine, Santa Monica, CA, USA; UCLA David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: khu@mednet.ucla.edu.
⁹ GW Center for Integrative Medicine, Washington, DC, USA; George Washington University School of Medicine, Washington, DC, USA. Electronic address: mkogan@gwcim.com.
¹⁰ Sutter Santa Rosa Family Medicine Residency, Santa Rosa, CA, USA; UCSF Dept of Family and Community Medicine, San Francisco, CA, USA. Electronic address: wkohatsu@gmail.com.
¹¹ University of California-Irvine, Irvine, CA, USA; Susan Samueli Integrative Health Institute, Irvine, CA, USA. Electronic address: tlowdog@hs.uci.edu.
¹² Osher Center for Integrative Health, Brigham & Women's Hospital, Chestnut Hill, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: dmehta@mgh.harvard.edu.
¹³ Osher Center for Integrative Health at the University of Wisconsin-Madison, University of Wisconsin Osher Center for Integrative Health, Madison, WI, USA; University of Wisconsin-Madison School of Medicine and Public Health, Health Sciences Learning Center, Madison, WI, USA. Electronic address: adam.rindfleisch@fammed.wisc.edu.
¹⁴ University of Michigan - Ann Arbor, Ann Arbor, MI, USA. Electronic address: jillsch@med.umich.edu.
¹⁵ Duke Health & Well-Being, Duke Integrative Medicine Center, Durham, NC, USA. Electronic address: scarlet.soriano@duke.edu.

PMID: 40681011
DOI: 10.1016/j.amjmed.2025.07.013

Abstract

Integrative medicine (IM) fellowships have grown significantly over the past decade. This review examines gaps in the original IM competencies and key revisions aligned with the Accreditation Council for Graduate Medical Education (ACGME) domains, informed by a multi-phase stakeholder engagement process. A task force from the Academic Consortium for Integrative Medicine and Health conducted a systematic review of existing IM competencies, ACGME core competencies, and relevant Diversity, Equity, and Inclusion (DEI) frameworks. A survey was sent to 23 IM fellowship programs, yielding a 96% response rate. Competencies were revised and refined through stakeholder input via conferences, focus groups, and surveys. Thematic analysis in December 2024 identified priorities for final revisions. Key updates include inclusive language and integration of underrepresented areas such as health equity, trauma-informed care, clinician well-being, interprofessional collaboration, and planetary health. Cultural humility and epistemic inclusivity are emphasized throughout, with health equity principles embedded across all domains. These updates mark a shift toward an inclusive, equity-centered model of whole-person care. Future efforts will focus on implementation, faculty development, and standardized assessment to support adoption in IM fellowship programs.

Keywords: Competency-based training; Fellowship training; Health equity; Integrative medicine; Medical education; Whole-person care.

Publication types

Systematic Review

MeSH terms

Clinical Competence* / standards
Education, Medical, Graduate* / standards
Fellowships and Scholarships* / standards
Health Equity*
Humans
Integrative Medicine* / education
Integrative Medicine* / standards