Abstract:

Background:
Integrative Medicine (IM) is a new public health term and a modern interdisciplinary category. IM brings together conventional (allopathic, mainstream, orthodox) medicine, complementary and alternative medicine (CAM), lifestyle and biopsychosocial approaches to health. Global and European surveys show a significant increase in the demand of individualised medical services. There is expanding interest of using CAM-methods or nonconventional treatments. Therefore, the needs for IM-knowledge, skills and competences of the medical personnel are growing. Most of the nonconventional methods have centuries-old traditions. However, they are an innovation as academic disciplines in Europe and particularly at the higher education area in Bulgaria.

Aim:
To define and describe the IM as philosophy, clinical practice, research and academic field. Further, to analyse the current threats and opportunities for the introduction of IM in higher medical education in Bulgaria.

Methods:
Mixed methods including systematic internet search, literature review of IM-related textbooks and studies from database PubMed since the year 2000. SWOT-analysis is conducted in higher educational and public health context. Herewith, SWOT is a tool for understanding the strengths and weaknesses of IM, and for identifying both the external opportunities and threats in order to build sustainable higher educational strategies.

SWOT analysis and discussion:
The idea of IM is strong because it is consumer/patient-driven demand. The threats of the conservative and commercialised environment are present but opportunities for integration of care have never been greater. IM-paradigm provides the frame and have the potential to mediate and mix the conventional and nonconventional medical therapies. Western medicine, is the practice of healthcare that most of the Europeans and particularly the Bulgarians are familiar with and they even call it “traditional medicine”. However, the physicians need to get basic IM-knowledge in order to empower their patients with new choices or to direct them for additional medical treatments apart from the conventional therapies that they usually prescribe. Hence, the only sustainable educational approach for the introduction of IM in the academic training in Bulgaria is the collaborative strategy which combines traditions and innovation. Increased international exchange of IM and educational expertise, more awareness and literacy among the key stakeholders about the public health benefits related to IM can contribute to the embedding of comprehensive IM-curriculum in higher education.

Conclusions:
Worldwide, IM is a progressive patient-centred movement and innovative research field. The growing need of IM-education is a derivative of the increasing public interest,of labour market and skill needs forecasting in healthcare. It is important that the future generation of doctors and health professionals are more aware and competent regarding IM and its role in preventing disease, improving health-related quality of life and treating acute and chronic conditions. The educational approaches could be broad: classical or innovative, targeting students, medical residents and all public health specialists who strive to be modern and competent professionals. The current article is an evidence-based analysis and a public health imperative to action for embedding IM as a distinct discipline into higher medical education curriculum.

Keywords:

Integrative medicine, higher education, public health, Bulgaria.