Evidence-Based Complementary and Alternative Medicine 3 Table 1: Questions endorsed at the highest levels by all 3 years of students. Table 3: Likelihood of suggesting CAM to a patient (% of respondents). The spiritual beliefs and practices of patients play no important role in healing, and practices of patients play no important role in healing. (reverse scored) A strong relationship between patient and physician can equally important as other therapeutic interventions. Physicians who model a balanced lifestyle (i.e. Attending to their own health, social, family and spiritual needs, as well as interests beyond medicine) generate improved patient satisfaction. Physicians who strive to understand themselves generate improved patient satisfaction. Teaching medicine based on a healing model, which integrates the biochemical, psychological, social, and spiritual compo- nents of disease, will lead to better patient care. Table 2: Reported likelihood of suggesting CAM to at friend (% of respondents). First year (n = 93) Second year (n = 80) Third year (n = 88) Modality Meditation/Yoga/ Relaxation/Imagery Massage Spirituality Herbals Chiropractic Traditional oriental medicine T’ai Chi Homeopathy Biofeedback Hypnosis Ayurveda Osteopathy Therapeutic touch Curanderismo First year (n = 93) Second year (n = 80) Third year (n = 88) 67.4 69.5 48.4 38.9 34.7 41.1 43.2 13.7 11.6 17.9 10.5 18.9 10.5 4.2 76.8 72 58.5 26.8 39 50 35.4 11 15.9 19.5 7.3 19.5 11 3.7 61.4 56.8 38.6 29.5 14.8 30.7 34.1 13.6 33 15.9 5.7 17 9.1 2.3 CAM modality Meditation/Yoga/ Relaxation/Imagery Massage Spirituality Herbals Chiropractic Traditional oriental medicine T’ai Chi Homeopathy Biofeedback Hypnosis Ayurveda Osteopathy Therapeutic touch Curanderismo 68.4 73.7 57.9 55.8 33.7 43.2 40 16.8 5.3 16.8 8.4 16.8 11.6 11.6 69.5 73.2 59.8 31.7 32.9 42.7 34.1 13.4 17.1 22 7.3 17.1 7.3 4.9 51.7 57.5 43.7 28.7 16.1 35.6 29.9 12.6 17.2 5.7 6.9 10.3 5.7 2.3 Familiarity with CAM modalities did not diﬀer signiﬁ- cantly by year in medical school. Of the modalities, the least familiar was curanderismo, a Mexican form of folk healing, with 85% of the students reporting they had never heard of this. Willingness to recommend CAM to friends or patients is reported in Tables 1 and 2. Although there was some relationship between what students have used and what they will suggest, this was not always linearly correlated. For example, almost half of the students reported they would suggest Traditional Oriental Medicine (TOM) to patients, while only about 20% reported use of TOM. On the other hand, more students had used herbs or supplements than would recommend herbs or supplements to a patient. Female students in the ﬁrst 2 years were more likely to recommend CAM to a friend than their male classmates (P = .02 for ﬁrst years and P = .01 for second years). However, there were no diﬀerences seen between male and female responses for third year students. Overall beliefs and opinions about complementary and alternative medicine were not signiﬁcantly diﬀerent between the ﬁrst and second year classes, with a mean score of approximately 3.7 out of ﬁve for the 23 questions. However, third year students were more negative on the CAM attitude scale than either ﬁrst or second year students [F(2,258) = 7.283, P < .01]. The highest rated attitude items overall are seen in Table 3. They appear to reﬂect a belief in the physician- patient relationship and the importance of self-care for physicians. The lowest rated items (reverse scored) indicated that medical students have embraced the basic tenets of evidence-based medicine (“Treatments not tested by ran- domized control trials should be discouraged” and “Physi- cians should avoid recommending botanical medicines based on observations of long-term use in other cultures and systems of healing, because such evidence is not based on large randomized controlled trials.”). 3. Discussion The students at UCLA appear to be familiar with the most commonly used forms of CAM and would be relatively comfortable recommending those with which they are familiar. However, despite the predominance of Hispanic patients in this medical community and the cross-cultural emphasis of this southern California school, very few of the students were familiar with or comfortable with the Mexican folk healers, the curanderismo.