Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

Special Contribution

Licensing and Education Systems of Acupuncturists andMoxibustionists in JapanTANIGUCHI Kazuhisa
President of Japan College Association of Oriental Medicine
Chairman of Meiji University of Integrative Medicine
Abstract
I. Development of licensing and education systems for acupuncturists
The business licensing and education system of Japanese acupuncturists (and moxibustionists) began in 1911.
After 1911, licensed schools were established, but for a time both the licensed schools and apprentice system existed simultaneously. The law of license for practicing acupuncture began in 1947. In 1947, following World War II,
the law was revised and has persisted until the present day.
II. Two recent important turning points in the field of education of acupuncture and moxibustion
A recent turning point in the education system included the addition of a four-year university program in 1983. In
1994, a graduate school program was also added, awarding doctorates in acupuncture.Vocational schools for acupuncture for people with no visual impairment increased from 24 to 76 schools by 2006.
III. Activity of the Japan College Association of Oriental Medicine
As of 2006, 41 of the 76 vocational schools for acupuncture for people with no visual impairments became members of the Japan College Association of Oriental Medicine. The activity of the association is manifold, and includes holding seminars for instructors, performance of the academic congress, publication of textbooks and bulletins.
IV. Proposal of refinements to the licensing and education system in the field of Japanese acupuncture andmoxibustion
For acupuncturists, a discussion of the refinements to the licensing and education system is necessary to gaineven more trust from society. It is essential that this discussion include the academic congress and occupationalgroup, according to results of a research survey conducted by the Japan College Association of Oriental Medicine.
Key words: words:licence, education, acupuncturist, moxibustionist

Ⅰ．Introduction
Recently, complementary and alternative medicine(CAM) including acupuncture and moxibustion has been
noticed in the world. Although there is the article introduced Japanese situation about CAM1), the article that
introduced in detail licensing and education system

about Japanese acupuncturist and moxibustionist is few.
Therefore, we reported regarding development fromthe foundation to the present as to licensing and education systems of Acupuncturists and Moxibustionists inJapan. Simultaneously, we propose the refinements tolicensing and education system in the field of Japanese
acupuncture and moxibustion.

Corresponding author Taniguchi Kazuhisa
Meiji University of Integrative Medicine, Hiyoshi-cho, Nantan-shi, Kyoto 629-0392, Japane-mail:wakut@meiji-u.ac.jp

20
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

Furthermore, this paper is the report as standpoint of
the Japan College Association of Oriental Medicine
organized by vocational schools for training acupuncturists, moxibustionists and anma-massage-shiatsu therapists in all Japan.
Ⅱ．Development of licensing and education systems
for acupuncturists and moxibustionists
The licensing and education system of Japanese acupuncturists and moxibustionists began approximately 95
years ago.
The regulations of business for acupuncturists andmoxibustionists were enforced in 1911 and training inschool by the appointment of the local director for the
first time was began (Table 1).
Namely, licensed school system was introduced while
maintaining partly education by an apprentice system,and two licensing and education systems of acupuncturists and moxibustionists in Japan were started (One wasan apprentice system that was able to acquire businesslicense of acupuncture and moxibustion, if they passed
examinations after four years training. The other was
licensed school system that was able to start business ofacupuncture and moxibustion without examinations, if
students graduated the school.).

Afterwards, the regulations of business for acupuncturists and moxibustionists were changed to the businesslaw of anma, acupuncture, moxibustion and judotherapy
in 1947, and an apprentice system disappeared and licensed school system only continued.
The term of study to become acupuncturist andmoxibustionist was four years in a junior high-school
graduate and two years in a high-school graduate. If thestudents passed the examinations that a governor executed after graduating from licensed school, it was changed
to the system that they could start business of acupuncture and moxibustion.
A name of law was changed from the business law ofanma, acupuncture, moxibustion and judotherapy to thelaw of anma therapist, acupuncturist, moxibustionist andjudotherapist in 1951 and the term of study was extended from two years after a high-school graduate to two
and a half years after a high-school graduate.
Moreover, a name of anma therapist was changed to aname of anma-massage-shiatsu therapist by including
business of massage and finger pressure (shiatsu) that
had been recognized as business of anma therapist. Because anma-massage-shiatsu therapist, acupuncturist andmoxibustionist are qualification that is based on thesame law, there are licensed schools that educate to become acupuncturist, moxibustionist and anma-massage-

21
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

shiatsu therapist.
Afterwards, the law for acupuncturists andmoxibustionists was revised any number of times. In
1988, authority of licensing changed from the governor
to the Minister of Health and Welfare (the Minister of
Health, Labor and Welfare at the present) and the termof study became over three years after a high-school
graduate (Table 2).
At the same time, although the contents of the curriculum in each licensed school of the whole country was atime system and was almost unified into the same contents until that, the curriculum become an outlined system and was changed from a time system to a credit unit
system. As a result, each licensed school could haveindividuality of the curriculum.
Ⅲ．Two recent important turning points in the fieldof education of acupuncture and moxibustion
The first of recent two important turning points in thefield of education of acupuncture and moxibustion is the
beginning of a university education.
The only source of formal acupuncture andmoxibustion education was at vocational schools until

the beginning of a university education. For that reason,
it is considered that a university education necessarilyneeds to increase the quality of education, and three-year
junior college program (the term of study is over three
years after a high-school graduate) was started for the
first time in Kyoto, Japan (Meiji University of Integrative Medicine at the present) in 1978 (Table 2). Afterwards, a four-year acupuncture and moxibustion university program was started (the junior college was raised tothe university at the present).
However, each graduate of vocational school, juniorcollege and university as licensing system of Japan takessame examination of each prefecture, and the licensethat each graduate can acquire is same among vocational
school, junior college and university.
Furthermore, master course program (acupuncture andmoxibustion) in graduate school of the same university
was added in 1991. Following, doctor course program(Ph.D.) in acupuncture and moxibustion was establishedin 1994, and Ph.D. in acupuncture and moxibustion for
the first time in Japan was born in 1997. As a result of
these changes, research in the field developed dramatically.
The second important turning point in the field of ed-

22
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

ucation of acupuncture and moxibustion is the sudden
increase of licensed school. New licensed school for
acupuncturists and moxibustionists was not approved
after 1977. But new licensed schools were approved
after government of Japan lost by a judgment at Fukuoka
in 1998 and increased in the whole country.
Ⅳ．Education system of acupuncture and moxibustion at the present (as of April, 2006)
From the standpoint of the Japan College Associationof Oriental Medicine, author summarized the present
educational system for training acupuncturists andmoxibustionists in a sighted person below.
The requirements for admission are graduating fromhigh school as a general rule (Fig. 1). Private vocational
schools for sighted persons (approval by the Minister of
Health, Labor and Welfare) are 76 schools in the wholecountry as of April, 2006, and the fixed number of admission is 5, 893.
The number of private university (approval by the
Minister of Education, Culture, Sports, Science andTechnology) is 4 as of 2006, and the fixed number ofadmission is 349. There are schools for persons with
impaired vision as licensed school except such vocational schools and universities for sighted persons.
When students receive the education in these licensed
schools and fill the standards decided by government,
students take the qualifications of candidacy for national

examination. If the candidates pass the examination, theMinister of Health, Labor and Welfare give the licenseof acupuncturist and moxibustionist to them. Althoughacupuncturist and moxibustionist are originally different
license, almost students acquire both license, accordingly it is generally called acupuncturist and moxibustionist
shin-kyu-shi in Japanese. When students acquire thelicense, they can start business independently in every
region. Further, acupuncturist and moxibustionist canserve in hospital and clinic.
Ⅴ． Standards for the establishment of vocational
school in acupuncture and moxibustion (approval by
the Minister of Health, Labor and Welfare)
Table 3 shows an outline of standards for theestablishment of vocational school of acupuncturists andmoxibustionists in Japan. Vocational school has toestablish the subjects of classes over 86 units for three
years in the contents of the curriculum (Table 4).
When students learn in vocational school that filled
such the terms, the students take the qualifications ofcandidacy for national examination. The number ofuniversity approved by the Minister of Education,
Culture, Sports, Science and Technology is very few incomparison to vocational school, because standards forthe establishment of university in acupuncture andmoxibustion is very severe about the number of faculty
and facilities.

23
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

VI. National examination of acupuncturists andmoxibustionists
The national examination of Japanese acupuncturists
and moxibustionists is conducted in spring once a year,
and the examination is only Japanese language. The
examination is a computer-scored test, and the numberof the question is 80 in the morning and 80 in theafternoon for a day (Table 5).
Although acupuncturist and moxibustionist are
different license, the overlap of the subjects when
students take both examinations at the same time isexempted. Fig.2 shows the national examination passrate of acupuncturist and moxibustionist in sighted
persons for five years from 2001 to 2005.
VII. The number of licensed school of acupuncturist
and moxibustionist and the change of the fixed
number of admission
The fixed number of admission in licensed school ofacupuncturists and moxibustionists was 1, 558 until new
licensed schools were approved after government ofJapan lost by a judgment at Fukuoka (in 1998) after

24
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

25
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

1977. Afterwards, the fixed number of admission
increased to 2,188 in 2000 and 5,893 in April, 2006
according as the increase of new licensed school. The
number increased to 3.8 times as many as the number in1999 (Fig.3).
Although the number of licensed school was 24
schools (there were 2 schools for a specialized anmamassage-shiatsu therapists except above 24 schools)
until 1999, the number of licensed school also increased
to 76 schools (except university) by 2006 (Fig.4). 41
schools of 76 schools (approximately 54 %) are themember of the Japan College Association of Oriental
Medicine.
VIII. Activity of the Japan College Association ofOriental Medicine
The Japan College Association of Oriental Medicine
started as an association including licensed school ofjudotherapists in 1956, and the name of association
changed and the association became corporation in 1985.
Activity of the Japan College Association of Oriental
Medicine is to hold a congress for presentation ofresearch performed by students of the member schools
once a year, publish the journal of the congress andtextbooks, hold seminars (a theme such as objective
structured clinical examination is annually established)
for instructors of the member school, and issue bulletinsfor exchanging each information.

IX. Proposal of refinements to the licensing andeducation system in the field of Japanese
acupuncture and moxibustion
Author proposes refinements to the field of Japanese
acupuncture and moxibustion in the future from the threefields such as license (national examination), educational
institution (the Japan College Association of Oriental
Medicine), and academic society (and occupationalgroup).
1. Proposal of refinements (license and national
examination)
Although acupuncturist and moxibustionist are
different license at the present, there is a proposal to be
one license as shin-kyu-shi in Japanese by integrating
acupuncturist with moxibustionist. Namely, it is
proposal to separate the law of anma-massage-shiatsu
therapist, acupuncturist and moxibustionist into the lawof acupuncturist and moxibustionist and the law ofanma-massage-shiatsu therapist. Author considers that is
immediately separated, because anma-massage-shiatsu
and acupuncture or moxibustion are different treatment
method.
There is a proposal that revive skill test again
regarding the national examination. However, author
considers that more enough discussion including theother objective examination is important than revive
simply skill test. Finally, because acupuncturists andmoxibustionists have responsibility to national medical

26
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

care, author would like to propose renewal system of
medical license at California in USA, in addition to the
proposal of the independent law of acupuncturist andmoxibustionist.
2. Proposal of refinements (educational institution)
There was no new entry for a long time in the Japan
College Association of Oriental Medicine, and applicant
increased in proportion to recognition rising, and accordingly management of licensed school was steady very
well. However, the number of licensed school suddenly
increased after 2000.

Although licensed school is slightly increase in 2005,
we have to make a plan for long -term by estimatingwhen management of licensed school is steady period
again (Fig.5). It is thought that need to review education
for acupuncturists and moxibustionists from each viewpoint of manager, instructor, faculty, student and society
in each licensed school.
Author considers that it is the time to consider how
guarantee quality of students that is worried about decrease of academic ability of students by sudden increaseof vocational school. Furthermore, although there arepartly new licensed schools that aim to train therapists

27
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

very hard, the other side, there are also partly new licensed schools that only target the national examination
pass rate. Accordingly, the Japan College Association ofOriental Medicine has to make a plan to increase qualityof member school and continuously has to train acupuncturists and moxibustionists that have good skill andknowledge. Furthermore, author considers the Japan
College Association of Oriental Medicine builds up a
closer connection with the member schools and has totrain the therapists that answer the needs of the times,
because there is the change of constitution of disease
with sudden change of society.
To be guaranteed as learning from admission to graduation in peace by discriminating between the member
schools of the Japan College Association of Oriental
Medicine and non-member school needs. For that purpose, each member schools make effort with conducting
self-study and self-inspection, and conduct estimation of

28
Taniguchi Kazuhisa, Japanese Acupuncture and Moxibustion, 2008; Vol.4(1): 19-28

each member school by third party as the Japan College
Association of Oriental Medicine, and author considers
that it is important to form as the organization can makecertification of the Japan College Association of Oriental
Medicine.
3. Proposal of refinements (cooperation academic
society and occupational group 1)
The Japan College Association of Oriental Medicine
conducted twice questionnaire surveys in 1997 and 2002
for 17,069 persons of the member school graduates ofsuccessful applicants from the first national examinationin acupuncturist and moxibustionist to the ninth examination. Answerers were 5,691 persons and the collection
rate was 33.3 % (Table 6).
Fig.6 shows the course of the graduates, the experience in business, and the ratio of men to women in the
results of the questionnaire surveys. Graduates that startbusiness independently in answerers was 25.4% fromthe first national examination to the fourth examination,
and was 27.4% from the fifth examination to ninth examination (Table 7).
Next, the rate of admission to occupational group in
graduates that start business independently was 23.3% inJapan Acupuncture and Moxibustion Association andwas 24.0% in All Japan Acupuncture, Moxibustion and
Massage Association from the first examination to thefourth, and was 21.6% in Japan Acupuncture andMoxibustion Association and was 28.5% in All Japan
Acupuncture, Moxibustion and Massage Associationfrom the fifth to the ninth.
The number of graduates that start business independently from the fifth examination to the ninth increased by 186 persons than graduates from the first to
fourth. However new members only increased by 111
persons between Japan Acupuncture and Moxibustion
Association and All Japan Acupuncture, Moxibustion
and Massage Association, and licensed therapists of
82.4% in average from the first to the ninth were not themembers of the occupational group (Fig.7).
The rate of admission to the Japan Society of Acupuncture and Moxibustion was 5.1% (133 persons) fromthe first examination to the fourth and was 6.8% (210persons) from the fifth to the ninth. Although answerers
from the fifth examination to the ninth in comparison
with answerers from the first examination to the fourthincreased by 489 persons, the new members only increased by 77 persons.

Accordingly, the number of new member to the academic society and occupational group is very few. It isclear that we have to be anxious about this situation
when we consider about the field of Japanese acupuncture and moxinustion in the future, that increase of thenumber of new licensed therapists for a year by the increase of new licensed school suddenly is realized.
Therefore, author considers that more need to cooperate
among the educational institution of acupuncture andmoxibustion, academic society, and occupational group
and need the step for the next period.
4. Proposal of refinements (cooperation academic
society and occupational group 2)
The Society for the study and propulsion of medical
treatment of acupuncture and moxibustion was started in2006 as cooperation of the Japan College Association ofOriental Medicine, the Japan Society of Acupunctureand Moxibustion and each occupational group. The purpose is the establishment of scientific evidence in acupuncture and moxibustion, preparing of guidelines inacupuncture and moxibustion treatment, and activity of
spread and education in medical treatment of acupuncture and moxibustion. The activities were started by thefoundation of four groups.
Furthermore, the Safety Commission of Acupunctureand Moxibustion also was held, and the activity of conference and enlightenment on safety in medical treatment of acupuncture and moxibustion in Japan and preparing of guidelines on safety in medical treatment ofacupuncture and moxibustion was started (published in
January, 2007). Author considers that more cooperation
among the Japan College Association of Oriental Medicine, the Japan Society of Acupuncture and Moxibustion,
Japan Acupuncture and Moxibustion Association and
All Japan Acupuncture, Moxibustion and Massage Association necessarily need for development of Japanese
acupuncture and moxibustion.
Further, the questionnaire surveys in this paper were
performed by funding from the Japan College Association of Oriental Medicine.
References
1) Suzuki N. Complementary and alternative medicine:a Japanese perspective. eCAM 2004; 1: 113-8.