In a devastating decision, the U.S. Department of Education [Education Department] found that the Council on Naturopathic Medical Education [CNME], the sole accreditor of naturopathic educational programs in the U.S., failed to demonstrate
it has standards that are sufficiently rigorous enough to ensure that [CNME] is a reliable authority regarding the quality of education or training provided by the programs it accredits.
In other words, no one should believe that graduation from a CNME-accredited school is a reliable indicator of a graduate’s fitness to practice naturopathic medicine. This is hugely problematic because it is a primary metric states use to evaluate the quality of naturopathic education and training in licensing decisions.
On pain of having its recognition as an accreditor pulled for the second time, the Department gave CNME one year to correct critical deficiencies noted in the Department’s decision letter, accompanied by unequivocal proof that it had done so. During this time, CNME is deprived of its authority to accredit any new naturopathic program.
On top of all this:
- New Education Department student loan regulations exclude naturopathic students from previously available loans for doctoral-level educational programs.
- New debt-to-earnings ratio tests will likely hamper the eligibility of naturopathic schools for other federal student loans due to graduates’ astronomical debt-to-earnings ratios. This could drastically reduce the pipeline of taxpayer dollars flowing to naturopathic programs.
- Naturopathic school grads are taking advantage of a federal program called borrower defense that allows student debt relief when schools have lied to, deceived, or misled students. Successful claims can result in the feds seeking recoupment of the loan money from schools.
- Just days ago, Florida’s governor vetoed a much-ballyhooed naturopathic licensing bill, meaning that moving to the country’s third most populous state for a fresh start is no longer an option for all those naturopathic doctors oppressed by low earnings and high student loan debt. (The veto caused anti-vaccination propagandist Del Bigtree to whine that Gov. DeSantis was being insufficiently obedient to MAHA.)
- Bridgeport University has shuttered its naturopathic program due to declining enrollment.
- The crown jewel of naturopathic education, Bastyr University, nearly lost its accreditation recently from not just one, but two, accrediting agencies due, in part, to financial instability. It is currently on CNME probation.
Which brings us full circle, because the CNME’s failure to make Bastyr address its financial and 19 other accreditation issues figured in the Department’s decision on CNME’s status as an accreditor.
Today we’ll take a deeper dive into that decision, including some damning facts and figures about naturopathic education and practice gleaned from the Department’s review.
But first, a bit of background, for context.
Background
In this country, the federal government farms out accreditation of institutions of higher education to private agencies which, by law, are supposed to ensure that the institutions meet “acceptable levels of quality.” Toward this end, agencies are to
develop evaluation criteria and conduct peer evaluations to assess whether or not those criteria are met.
To be clear, a science-based education is not a criterion for the Department’s “acceptable levels of quality”. Hence, the ability of naturopathic, chiropractic, and acupuncture schools to teach rank pseudoscience.
CNME is currently the sole accreditor recognized by the Education Department for five U.S. schools granting a doctorate in “naturopathic medicine”, representing a relatively tiny student population of around 1,500. (For comparison’s sake, there are 162 MD and 42 DO programs in the U.S., enrolling around 140,000 students.)
“Naturopathic medicine” is an attempt to adopt the nomenclature and organizational structure of “conventional” (that is, reality-based) medicine while retaining the field’s disdain for science and evidence, as demonstrated by the many pseudoscientific diagnoses and treatments naturopathic “doctors” and “physicians” use in their practices, a subject we’ve covered many times on SBM. In fact, over a decade ago, former naturopathic doctor Britt Hermes exposed many of the weaknesses in naturopathic education and training, as well as huge student debt, catalogued by the Education Department.
CNME is a critical component in state licensing of naturopathic doctors, via the magic of Legislative Alchemy. This is because state licensing laws incorporate CNME accreditation of naturopathic programs as the standard for whether their graduates are eligible for licensing: No CNME, no accredited programs, no licenses.
Recognized accreditors are re-evaluated every few years by the Department. Prior to making a decision, Department staff conducts an investigation and issues a report on their findings, along with a recommendation. This goes to the National Advisory Committee on Institutional Quality and Integrity (NACIQI), a group of educational experts and others who, in turn, meet to review and discuss pending renewals. NACIQI then advises the Education Department on whether an accreditor deserves continued recognition.
In CNME’s case, the staff issued a 28-page report documenting the many ways in which CNME was deficient as an accreditor and recommended continuing recognition for one year only (as opposed to the requested five years) to give CNME the opportunity to clean up its act.
NACIQI rejected this recommendation after a meeting that included a Q&A with CNME’s Executive Director and hearing further testimony. On March 25, 2026, NACIQI voted unanimously to deny CNME continued recognition.
On June 23, the Education Department issued its scathing 26-page rejection of NACIQI’s recommendation, instead allowing CNME to hang on for another year, although without the authority to accredit any new program.
Lack of rigorous student achievement standards
As quoted above, the Department found that CNME lacks student achievement standards rigorous enough to ensure that it is a reliable authority regarding education and training in naturopathic medicine.
CNME’s standards set a 75% graduation rate and a 70% NPLEX I and II (the naturopathic medicine licensing exam) pass rate as minimum benchmarks for accreditation. Yet, the Department found that CNME had repeatedly allowed schools to elide those requirements and failed to set forth clear expectations for remedying their deficiencies.
For example, Universidad Ana G. Mendez [UAGM] (Puerto Rico) consistently failed licensure exam passage rates for five years. At Bastyr, fewer than 70% of students passed the NPLEX exam in four out of a five-year period. National University of Natural Medicine [NUNM] (Portland) had a 48% graduation rate one year and 67% another.
This raised
significant, substantive concerns with the agency’s [CNME’s] lack of response to poor program performance and seeming reluctance to investigate or enforce compliance with [its own] criteria . . . .
Regardless of the low pass rates, one NACIQI committee member questioned the very utility of the NPLEX as a reliable measure of student achievement. He commented on the “lack of transparency around the NPLEX”, which is a written, multiple-choice exam and does not test actual clinical skills on modeled patients.
I don’t think that NPLEX is necessarily preparing people for thriving careers if we look at actual career information, which is their earning, their wages, their ability to pay back debt.
CNME’s response was essentially to blame COVID and its student population, described as working people and moms. This blame-the-victim attitude incensed NACIQI, which used it as one basis to recommend denial of recognition at all. As one NACIQI member, quoted approvingly in the Department’s letter, said
When an [accreditor] allows schools to saddle students with insurmountable debt . . . [w]hile routinely excusing their inability to meet licensure standards because of the population they serve or global pandemics that we all had to live through I have to wonder who the accreditation system is serving.
Which brings us to the schools’ misleading recruiting practices and said “insurmountable debt”
Misleading students
Department staff found that
[CNME] does not require its accredited programs to clearly explain and disclose data-driven information on typical employment opportunities, average starting salaries, federal student aid debt levels and the availability of conventional medical work for its program graduates.
As well, the Department’s decision letter said that neither CNME nor its accredited programs had collected “reliable data” on student debt and graduates’ earnings and job opportunities, calling CNME “remiss and apathetic” to the need to collect data.
It is around this issue that some truly disturbing information was revealed about the schools’ recruiting practices, as well as the education and training of naturopathic doctors, contained in the Department’s letter, the staff report, and the NACIQI meeting transcript.
- The top three schools with CNME-accredited programs have 400 pending borrower defense claims, likely mostly ND graduate claims; conservatively, about 100 million dollars of taxpayer money.
- One commenter was told by the admissions director that the program was “equal to or better than traditional medical schools” and that a graduate would be “qualified to work as a primary care physician”; graduates were “in high demand” and there would be “no trouble” repaying a student loan. All of this proved to be false.
- A student employee of the American Association of Naturopathic Physicians, “a marketing and public relations arm of the ND schools”, “repeatedly saw messaging” that graduates “commonly work as primary care physicians”, while “in reality” employment “is severely limited and inconsistent across states”.
- CNME-accredited schools do not “provide accurate information on financial earnings and job prospects”. One commenter reported that “four CNME programs are in the top six worst debt-to-income ratio graduate program[s] in this country with a staggering median debt of over $263,000 and a median income of just $34,000”, a “765 percent debt-to-income ratio.”
The Department concluded that
Not only does it appear that students are perpetually provided with inflated earnings or job prospect narratives in admissions practices, it appears that, given the failure of many of the CNME recognized institutions to meet the NPLEX pass-rate benchmarks, that many of these graduates are also saddled with significant, life-altering student loan debt.
It is this combination of terrible debt and abysmal earnings that could hamper naturopathic programs’ eligibility for future student loans under the Education Department’s new debt-to-earnings ratio tests.
Confessions
In addition to a withering rebuke of CNME and accredited ND programs, the review process yielded interesting further insights into naturopathic education and practice.
CNME’s Executive Director actually admitted what we all know: that naturopathic practice is not science or evidence-based. He told the NACIQI:
Certainly, with traditional practices, you have the case experience, the over decades or centuries, sometimes millennia of different types of interventions and how they can solve certain issues. That doesn’t mean that they are necessarily, you know, truly efficacious . . . [I]t isn’t that there was a scientifically based basis for all of these practices. Quite the contrary, they developed over time through the practice of [naturopathic] physicians and the clinical results that they achieved through those [practices]. [Emphasis added.]
In sum, we don’t know if “naturopathic medicine” is safe or effective for patients, but we do it anyway.
Remarkably, one NACIQI committee member recommended that CNME put some actual scientists on its board.
Additional disturbing testimony came from students and graduates. At the NACIQI meeting, they focused on lack of clinical training, inadequate faculty, and unpreparedness of practitioners. From them we learn:
- Classes are taught by NDs who are not content experts in the field they are teaching. Nor do these teachers have training in medical pedagogy. This “failure to provide sufficiently rigorous education by sufficiently prepared medical educators is one of the major contributors to the low NPLEX pass rates.”
- From a practicing ND who was on the Sonoran University of Health Sciences (formerly the Southwest College of Naturopathic Medicine) staff: “Clinical training did not consistently provide the level of rigor, supervision, or patient volume necessary to prepare students for independent practice.”
- A former NUNM student reported “many clinic shifts where week after week I would see zero patients.” In two 12-week clinical rotations, he had “between 10 and 20 patient contacts total”, including “fabricated scenarios” where we would discuss a “made up” case and “check that off as one patient contact.”
- “Repeated discussions in licensed naturopathic professional forums illustrate gaps in clinical competence that are consistent with inadequate clinical training.” For example, a licensed ND was uncertain whether parental notification or emergency intervention was required after a minor disclosed ongoing suicidal ideation with a specific plan. “I could provide dozens more examples of this type of scary clinical decision-making.”
To be sure, there were those who testified they believed their education and training were adequate and that they had satisfying careers, although none actually refuted the alarming statistics or the damning testimony of others. And, unfortunately, the Department made some gratuitous statements about naturopathic medicine’s contributions to combating chronic disease that were both unsupported by any evidence and outside its purview.
CNME’s Catch-22
CNME doesn’t appear to have gotten the message. After being hammered by the Education Department about lack of transparency, a press release begins:
[CNME] is pleased to announce that the U.S. Department of Education has continued CNME’s recognition as the specialized accrediting agency for naturopathic medical education programs.
The press release does admit that CNME will need to address “specific [but unspecified] compliance items” and that it has been “directed to pause” accreditation of new programs for one year.
No summary of the Department’s findings is provided, nor are there links to the staff report, NACIQI transcript, or Department’s letter.
Despite the appearance of being insufficiently concerned about its precarious position, if CNME actually complies by beefing up its accreditation standards and enforcing them, it seems implausible that several poorly-performing programs can survive, thereby further depleting the ranks of naturopathic programs. If CNME can’t, or won’t, do what the Department mandated, and do it all within one year, it risks losing recognition as an accreditor, thereby leaving all five U.S. naturopathic programs without the accreditation status needed for state licensure of their graduates.
It’s a Catch-22 for CNME. And along with a myriad of other problems, part of a growing crisis in naturopathic medicine.
