Program and department chairs in consultation with faculty members determine the requirements and standards for the AC for each course. Students are also evaluated on a quarterly basis by clinical faculty during their last two years. The results of this exam are used by all states that license individuals to practice naturopathic medicine. As of December 1999, naturopathic physicians are licensed as primary health care providers in Alaska, Arizona, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont and Washington. In the District of Columbia, naturopathic physicians must register in order to practice.
Legal provisions allow the practice of naturopathic medicine in most other states.
Naturopathic physicians are also recognized in Alberta, British Columbia, Manitoba, Ontario and Saskatchewan. The three professionally accredited naturopathic medicine universities that currently exist in the U.S. are Bastyr University, National College of Naturopathic Medicine and Southwest College. Canadian College of Naturopathic Medicine is, as of December 1999, a candidate for accreditation. University of Bridgeport, an academically accredited university, also offers a naturopathic medicine degree. Approved unanimously by King County Council, it opened in October 1996.