A Review of Functional Medicine Training. Why you should care.
I see and hear from my patients about seeing other Functional Medicine practitioners before they came to me, and I am often disappointed in what I learn. Don’t get me wrong, there are some serious rock stars in the field of training other doctors in functional medicine. This isn’t my opinion, it’s the opinion of thousands of doctors.
And I know and have worked with many of these stars. My experience level in functional medicine is at the highest level.
But because Functional Medicine is still in its infancy and because it isn’t regulated yet, patients may not know what they are getting into, so I hope this essay will help you to identify the best from the rest. I want to help some of you avoid practitioners who lack the background to know what they are doing, while still advertising as functional medicine practitioners when they may only have a weekend seminar.
There is a difference. Unfortunately, the same is true in the field of Naturopathic Medicine as there are some who lack clinical training but make the claim that they do. The market is getting better and more transparent and honest, but it’s not there yet. I’ll discuss that in a later blog.
There are many types of functional medicine practitioner training programs and I thought it worth laying out the history and development of the field so those of you exploring your medical care options have a bit of an understanding. At the same time, I’d like to share my experience as to what I think are the best functional medicine practitioner degree and training programs out there.
These range from doctor-centered Functional medicine degree programs to functional nutrition programs designed for non-doctors, to coaching programs (more focused on the psychology of lifestyle change), and clinical nutrition programs that delve into physiology. Some programs specialize in cancer patients, cognitive decline, or autoimmunity. There are plant-based conferences and Paleo conferences. There are the classic yearly meetings in person in New York (IHS) and San Diego (AIHM). There are the larger teaching institutes, IFM and A4M, and there are some that are all practical and skill acquisition-oriented.
We don’t have a single, official functional medicine doctor degree program that everyone in practice is required to follow. Someday the field will consolidate around a single functional medicine doctor degree program but that is likely farther in the future.
History: back in the 1980’s much of what we now call functional medicine was just beginning and Functional medicine doctor degree training programs were in a formative stage. Although if you want to trace the theories and practices to their origins one could go back several thousand years when physicians and healers in all cultures throughout the world used diet and herbal treatments to great effect. In my mind what separates functional medicine from the larger field of natural medicine is more than just that we are offering non-drug, non-surgical treatments, the unique thing we have is the development of functional medicine lab testing. Jeff Bland, the grandfather of Functional Medicine borrowed the healing philosophy of Naturopathic Medicine and melded it with Allopathic diagnostic testing.
While a typical functional medicine patient plan might include a diet change, breathing exercises, the use of Nutraceuticals (supplements, herbs, homeopathic, etc.) along with human connection and therapeutic relationships. What makes functional medicine new and special is the ability to determine what food changes, herbs, and vitamins you may need based on lab tests. Another unique and super cool aspect of functional medicine is the ability to use the labs to see exactly how the patient's physiology is disturbed so you can treat people based on dysfunction and not solely on symptoms.
In the 1980s, only a handful of lab testing companies specialized in functional testing, Great Smokies, Diagnotechs, Genova, and Metametrix. There are now more lab companies offering more lab tests with improved and better information at less cost. This is especially true in terms of bundled panels of labs offering dozens to hundreds of tests at a lower cost and genetic testing which is now vastly improved (factoid: although we have the human genome mapped we only know what about 4% of it is for so there is room to improve)
There was not yet an “Institute for Functional Medicine” or much of any organization heading up the educational efforts. Back then it was all individual teachers teaching individual students.
IFM (the Institute of Functional Medicine) was the first education-only group, and they continue to this day to have the best functional medicine training and live-in-person courses. The IFM lectures are all taught by experienced clinicians, many of whom have been teaching for 30-plus years. They incorporate all the latest science, and the lectures are updated year to year to reflect the growing body of evidence showing clinical efficacy and treatment rationales that people in practice so desperately need.
The lectures tend to be densely packed with information and are best absorbed by people who already have some type of advanced degree in the health sciences as there is a fair amount of assumed knowledge and someone without advanced education in physiology and pathology might easily become lost. IFM classes are also excellent introductions to functional medicine for those now in conventional medical practice who are considering a move into the field.
As a functional medicine training experience, I think of IFM as the “medical school” of functional medicine. In-depth courses, world-renowned faculty, fast-paced and with a steep learning curve. For many years they were only available as in-person events which required a decent amount of travel and lost time away from work, now much of their curriculum can be done via live stream and online.
I am an IFM Certified Practitioner having completed the vigorous IFMCP program, a 3-year process that includes course work, case presentation, clinical research and presentation, 3 years of classes, and peer review. I learn more each time as each year the information is updated. I continue to attend IFM and have recently been also attending the Klinghardt academy to study directly with Dr. Dietrich Klinghardt.
IFM is for the most serious practitioners.
There is also a group called A4M which started as an educational group focused on anti-aging medicine. As the anti-aging moniker implies, they are more focused on aesthetics and prevention and many A4M doctors combine their services with plastic surgery or other beauty-enhancing type treatments like skin treatments and so on. A4M is a much larger group and where IFM in my mind has always attracted the doctors focused on chronic illness, chronic fatigue, anxiety, fibromyalgia, and autoimmune type patient base, A4M has focused more on patient practices prescribing hormones and more youth-enhancing, anti-aging approaches to health care.
Over the years I’ve seen A4M embrace a much more “functional” approach in their course offerings responding to the greater interest in functional medicine from both the public and practitioners. A4M also has focused primarily on in-person conferences, also like IFM they teach “modules” and have a core curriculum you can go through, or, any many doctors chose to, you can just attend the modules that interest you and not complete the whole program. I don’t consider A4M to be as vigorous as IFM but it is a good solid grounding.
In contrast, IFM’s modules include hormones, GI, detoxification, immune, energy, and cardiometabolic and they have an excellent broad one-week course they call AFMCP which is the first step to achieving IFMCP certification.
There are other online programs, the two most popular that I hear about all the time are Chris Kresser’s course and Functional Medicine University.
FMU (Functional Medicine University) goes way back and is 100% online with no live webinar or case review. It’s a pre-recorded curriculum. I hear generally positive feedback about FMU as a good introduction/background course. I think FMU would be a good starting point for doctors new to functional medicine, but I certainly wouldn’t stop there as their peer review and updates are not cutting edge.
There are lots of doctors, especially Chiropractors, who start and stop with FMU and I think they miss out on the clinical aspects. If you are interested in and would benefit from set programs that aren’t personalized to your needs (about 75 - 80% of the population may benefit from this type of approach), then this level of education might be what you are looking for. But I would caution you to ask questions and compare their costs to more qualified doctors.
The reason I am writing this review is because of the experiences a new patient of mine had with a series of FMU grads who put her on programs that did NOT help and sucked a lot of money out of her savings. I have no issue with a doctor charging a reasonable rate for their services, but not if it doesn’t come with good measurable results for patients.
Further down there is also functional diagnostic nutrition training and associated functional diagnostic medicine training. The functional diagnostic nutrition training title is typically associated with practitioners that are not MDs or NDs but are licensed in other ways. Again, nothing wrong here depending on your needs.
There are other courses out there I am not going to get into detail on because they are all more niche-oriented and not in the category of clinical training. These doctors offer courses that are great: Nalini Chilkov on cancer, David Brady on fibromyalgia, Ben Lynch on genomics, Nathan Morris built Pure Genomics, Sam Yanick on autoimmune/immune, Michael Ruscio on the gut (he has a book worth checking out), Sachin Patel does business and practice building (disclosure: he’s a friend of my husband), Kara Fitzgerald has a mentorship course, Isabella Wentz and Amy Meyers on thyroid, Mark Hyman teaches everything, Datis Kharrazian teaches everything, Dale Bredesen and Nate Bergman on cognitive decline, everything Mark Menolascino or Kristi Hughes (disclosure: she’s my old colleague and friend, a sweet person and a great teacher who is now local to MN) touch is gold, and of course, Jeffrey Bland, known as the grandfather of functional medicine, is still leading the field.
Not to toot my horn, but I’m honored to have studied with many of the people on this list over the years. I am well qualified, and I can prove it. And this is the point of this essay, that not all functional medicine providers are the same.
Why do I mention all of this? Because qualifications and education matter in choosing your health care provider. So does experience. The organizations listed above are a sampling of the ones that are good, but it isn’t all the places that are advertising functional medicine training and some of them allow certification after a single weekend online seminar. No testing, no case presentation, no peer review, no research papers. Nothing. It isn’t the same.
But from your point of view, their web pages or ads may look the same as a practice where the doctor may have much more education and experience. I hope this essay gave you some tools to help make good decisions about your health care.
If you are looking for basic advice, then any number of practitioners can do a perfectly good job for you. But if your case is more complicated or long-standing, then see someone whose education and experience match your needs.
Do yourself a favor and investigate the training of any functional medicine doctor you will see, especially if your case is long-standing, complicated, or not resolved no matter whom you see. Ask questions about their education and clinical training as well as their post-doctoral training. A good open practice will have a mechanism for you to discover this for free. We post some things on our webpage, but we also offer a free 10-15 minute phone conversation directly with our doctors so you can ask these questions.
A few minutes of research could save you thousands or more. I can’t tell you how many patients I see who tell me they have spent 10s or 100s of thousands of dollars with 5 or 10 or more doctors without good results. This is wrong.
The right doctor for you gets you results that you can measure and feel. If you don’t feel better, then ask why. A good doctor will be able to tell you and guide you toward optimal health.
If you have any questions you can schedule an online chat with me or Dr. Liza. We are always glad to answer questions and provide advice.
Dr. Lee Aberle, ND, IFMCP, FSM, ART (in process)