Abstract:

Background:
We live in a civil society where every citizen has the right to equal access and free choice to healthcare and education. The research interest in integrative medicine (IM) and its place in education reflects the growing need for holistic and individualized care. IM emerged as an ideological movement to integrate complementary and alternative medicine (CAM) into modern healthcare. The definition of IM is constantly evolving, but it will always be patient/person-centered, empathic, and judiciously applying all known scientifically proven therapies (conventional and CAM) to prevent or manage the disease. Medical professions are regulated and the introduction of any new subject related to IM should pass a long and evidence-based path.
The aim is to propose a standard educational matrix for attaining key and professional competencies in the field of IM developed as a part of a professorship dissertation at the Medical University of Varna.

The study employs a mixed-methods approach that consists of a literature review regarding the world experience of programs (content and regulations) on CAM and IM; a regional needs assessment survey among students and professionals (2021); and a Delphi study (March-May 2022) among higher education and health experts in Bulgaria. The development of a universal national matrix for achieving IM and CAM competencies was the final project phase.

Results:
IM considers the individual holistically, in his/her physical, psychological, spiritual, social, and environmental context, so the presented universal educational matrix has the same characteristics and scope. The proposed educational model can be extended to an independent discipline or built as a certified course within the continuing postgraduate training. The universality of the model allows for integration into various preclinical and clinical disciplines involved in regulated professions trainings. Existing successful models of practice-oriented courses and disciplines related to one of the CAM modalities could also use the proposed framework in the context of their specific educational goals.

The recommended program content that is related to IM should be guided by the following four thematic areas or features:
1) "Principles and characteristics" - history, culture, philosophy, ethics, legal aspects;
2) "Building elements" - conventional medicine, CAM, scientific epidemiological methods, health promotion;
3) "Educational levels" - undergraduate and postgraduate, specialization, lifelong learning;
4) "Specialties" - physicians, pharmacists, etc. In the courses and programs intended for a specific professional field, in addition to the general introductory part is important to prepare a specific practical part. A pilot program has been developed in the curriculum at the Medical College of Varna.

Conclusion:
The proposed educational matrix for achieving competencies related to IM reflects the latest developments in healthcare and higher education. The matrix was created as IM is a new medical and social category, and it emphasizes the importance of interprofessional education, preparing future health professionals to work collaboratively with shared values. Additionally, the study underscores the necessity of double competencies in healthcare, encompassing both conventional and non-conventional therapies. The presented matrix offers a comprehensive training framework, facilitating the provision of individualised and holistic care.

Keywords:

Integrative medicine, healthcare, medical education, postgraduate training, health promotion, competencies, Bulgaria.