This year, Chinese pharmacologist Tu Youyou was awarded the Nobel Prize in medicine for her work in developing a drug to treat malaria. The artemisinin-based treatment that she helped produce is based on ancient Chinese remedies dating back 1,600 years and has been administered to more than 1 billion patients since 2000, according to the World Health Organization.
[Above: Georgia State University graduate Gloria Rinomhota dressed as the emperor’s wife at the Summer Palace in Beijing, China]
Artemisinin compounds used in the drug are derived from sweet wormwood, a plant native to Asia that is commonly used in traditional Chinese medicine (TCM). This ancient tradition is generally considered an alternative practice in the U.S., but as Tu’s accomplishment illustrates, TCM can have far-reaching, positive effects. However, pharmacy curricula often lack information about alternative pharmaceutical methods.
“Patients are looking for non-drug solutions, but herbs are actually where drugs started,” says Lauren Schlesselman, associate clinical professor and associate dean for academic affairs at the University of Connecticut (UConn) School of Pharmacy. “In pharmacy, herbs make up a much smaller part [of the curriculum]; we teach much more about over-the-counter and prescription drugs than herbals. TCM is something that patients are really interested in and knowledgeable about, but faculty are not.”
Typically, easily avoidable drug interactions can occur when pharmacists are unaware of herbal medicines that patients are taking. That is why, with the increasing popularity of TCM, some pharmacy schools are recognizing the importance of teaching students about alternative medicines by taking them to the source — China.
Currently, only three universities offer such excursions: UConn, Purdue University, and Georgia State University (GSU).
This summer, Schlesselman says 20 UConn pharmacy students traveled to Beijing, China, for five weeks of study focused on herbal medicine, acupuncture, and Mandarin Chinese. Only one or two students went on the first trip in 2008.
In addition to knowing how western drugs can interact with herbal medicines, Schlesselman says pharmacists need to be knowledgeable about cultural differences to understand how best to treat all patients.
“When you know the cultural aspects of your patients and have a cultural understanding of alternative, traditional medicine, you as a pharmacist are better able to serve that patient population,” she says. “Being aware of what different cultures do and take to treat themselves will make you more aware of how drugs may interact.”
As with anything, there is a learning curve to becoming knowledgeable about a different culture, but for UConn student Connor Walker — a doctor of pharmacy candidate who went on this year’s Beijing trip — that was part of the appeal.
“Eastern culture was something that I had not known too much about before I went on this trip, and it was a wonderful experience to be able to be a part of a different culture,” he said in an email.
“I absolutely love the concept of [leaving] the safety of your comfort zone and just completely immersing yourself in an entirely different culture,” he added. “There is nothing better for making you grow as a person.”
Tonglei Li — associate dean of graduate programs, professor, and Allen Chao Chair in the Department of Industrial and Physical Pharmacy at Purdue University — also makes the case for the cultural knowledge and increased sensitivity pharmacy students can gain from studying abroad.
Li says that TCM has endured for thousands of years because a lot of its methods work, but it looks different from western pharmaceuticals in the way it is practiced. Exposing students to these different approaches was a driving factor behind Purdue’s College of Pharmacy offering study abroad opportunities to its students.
“Pharmacy students do not have many opportunities to study abroad,” Li says. “Exposing students to different perspectives makes them more appreciative of history and how other people handle healthcare issues.”
Unlike western medicine, which often treats a broad range of symptoms with a single pill, TCM examines how five different elements — fire, earth, water, wood, and metal — manifest in an individual. When a patient has an imbalance of elements, a unique combination of herbs is developed to treat that patient’s particular range of symptoms. TCM remains a very popular mode of healthcare in China, and Li says it makes up about 40 percent of the healthcare market share, compared with western medicine at 60 percent.
This coming spring, Li will lead about a dozen pharmacy and pre-pharmacy students on a trip to Shanghai, China, where they will visit hospitals, pharmacies, and medical gardens. He says they will also have time to mingle with local residents.
“Culturally, I think it’s a very good opportunity to get exposure — and to get a different perspective — about medicine, health, and about life,” he says.
At GSU, interest from chemistry and biology students was the impetus for developing a study abroad program in pharmaceuticals. Since 2012, the university has been offering a two-week program in Beijing. Bin Xu, professor of chemistry and study abroad program director at GSU, says the average group consists of eight or nine students.
“We wanted to give them the opportunity to experience a different way of life and culture and also focus on traditional and modern Chinese medicine,” Xu says. “China has a rapidly growing economy that cannot be overlooked.”
Prior to departure, students take noncredit courses in Mandarin, as well as Chinese culture and history. While in Beijing, they visit research labs, where they observe clinical trials. Xu says many pharmaceutical companies outsource this kind of research to countries with emerging economies because it is more cost effective.
“Students learn something that they can’t learn from lectures,” she says. “They learn the possible challenges that can occur during clinical testing, and when they are looking for a job, they will have already had some of these experiences.”
Gloria Rinomhota is one such student; she traveled to Beijing as an undergraduate chemistry major while at GSU and says the experience prepared her for success at the University of Maryland School of Pharmacy in Baltimore, where she is a doctor of pharmacy candidate. She says she saw firsthand how language and cultural differences can be barriers between patients and pharmacists.
“It’s helpful to see from the other side,” Rinomhota says. “If you can’t understand the community and appreciate different people and cultures, you won’t end up asking the right questions or making sure you both understand each other.”
While Xu and Schlesselman say they doubt the U.S. Food and Drug Administration will ever approve TCM formulas for use — because their makeup is so complex — they believe these international experiences still serve a valid purpose. As globalization continues, the need for pharmacists with an understanding of alternative medicines and the patients who use them will continue to grow.●
Rebecca Prinster is a senior staff writer for INSIGHT Into Diversity.