Education of Acupuncture—Moxibustion and Tuina in Nanjing University of Chinese Medicine - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search… Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Med Acupunct . 2025 Apr 17;37(2):132–138. doi: 10.1089/acu.2024.0121 Search in PMC Search in PubMed View in NLM Catalog Add to search Education of Acupuncture—Moxibustion and Tuina in Nanjing University of Chinese Medicine Jinhong Yuan Jinhong Yuan , MD 1 School of Acupuncture-moxibustion and Tuina & School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, China. Find articles by Jinhong Yuan 1 , Yunchuan Wu Yunchuan Wu , MD 1 School of Acupuncture-moxibustion and Tuina & School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, China. Find articles by Yunchuan Wu 1, ✉ Author information Article notes Copyright and License information 1 School of Acupuncture-moxibustion and Tuina & School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, China. ✉ Address correspondence to: Wu Yunchuan, MD, Dean of the School of Acupuncture-Moxibustion and Tuina & School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210023, China [email protected] i ORCID ID ( https://orcid.org/0000-0002-9650-3707 ). Collection date 2025 Apr. Copyright 2025, Mary Ann Liebert, Inc., publishers PMC Copyright notice PMCID: PMC12038305 PMID: 40308732 Abstract Background: In contemporary China, acupuncture and moxibustion education is a part of higher education. A complete system of acupuncture education has been established. Methods: This article provides a detailed account of the curriculum system, teaching mode, practical requirements, the path to obtaining the qualification of a practicing physician, employment situation, and the challenges faced by acupuncture education in the Acupuncture and Moxibustion and Tuina major at Nanjing University of Chinese Medicine. Result: The Acupuncture and Moxibustion and Tuina major at Nanjing University of Chinese Medicine covers both university degree education (including international education) and non-degree education. The teaching mode includes both online and offline teaching. The majority of acupuncture and moxibustion practitioners have undergone rigorous and systematic university training, obtained a university diploma, and passed the examination for practicing Chinese medicine physicians to become licensed acupuncturists. Academic groups of acupuncture regularly hold various forms of continuing education and exchanges in acupuncture. Participation in continuing education is a necessary condition for practitioners to renew their licenses and also provides learning opportunities for non-degree education enthusiasts of acupuncture. Conclusions: Taking Nanjing University of Chinese Medicine as an example, the acupuncture education system in China ensures the educational quality and high-level development trend of the acupuncture profession and is also an important participant in the global exchange of acupuncture. Keywords: acupuncture-moxibustion, education, Nanjing University of Chinese Medicine (NJUCM), practicing TCM physician INTRODUCTION General Introduction of China University of Traditional Chinese Medicine in Mainland and Acupuncture and Moxibustion in Higher Education In the Chinese mainland, higher education related to acupuncture and moxibustion is highly regarded. Most of the 31 provinces or autonomous regions and municipalities directly under the central government in China have a special university of traditional Chinese medicine (TCM). As of June 2024, there are 26 universities of TCM in the Chinese mainland. In the five provinces or autonomous regions where there are no specialized universities of TCM, the medical universities in each of them also have schools of TCM. Among all the universities of TCM, acupuncture and moxibustion (including tuina) are established as specialized school. Acupuncture and Tuina Science has been a secondary discipline within the major of TCM since 1997. In September 2022, the Degree Committee of the State Council of China and the Ministry of Education elevated acupuncture science to a first-level discipline equivalent to TCM, becoming a major that can independently confer master’s degrees. 1 , 2 An In-Depth Review of Acupuncture Education at Nanjing University of Chinese Medicine The university education Nanjing University of Chinese Medicine (NJUCM), being the sole higher education institution specializing in Chinese medicine in Jiangsu Province, China, its major of acupuncture and tuina was founded in 1982 and is classified as a national first-class undergraduate major with a 5-year academic duration. In the past 5 years, the Acupuncture and Tuina School has enrolled approximately 100 students each year, and the number of undergraduate students studying at the school exceeds 500. In addition, there are nearly 90 postgraduate and doctoral students pursuing their studies. Undergraduate students who pass the National College Entrance Examination in China have the opportunity to select acupuncture and tuina as their main career orientation in the future, and this constitutes the main source of students. There are also a small number of students from other majors, such as TCM, public health management, and nursing, etc. who transfer to this major out of their interest in acupuncture and tuina ( Fig. 1 ). FIG. 1. Open in a new tab The main gate of Nanjing University of Chinese Medicine. In addition, the International Education College of NJUCM welcomes acupuncture and tuina enthusiasts from various countries across the globe for study. Students are classified into classes based on their proficiency in the Chinese language, and the decision is made regarding whether to provide translators in the classes. The acupuncture and tuina courses for the students majoring in acupuncture and tuina in the International Education College are also taught by senior acupuncture and tuina teachers. The teaching content and assessment requirements for international students being consistent with those for domestic students of this kind are referred to as homogenized education. Students who fulfill the credit requirements of all courses will be granted the graduation certificate and be conferred a bachelor’s degree in acupuncture and tuina. Nonuniversity education Apart from systematic higher education, individuals with a certain medical background or those having an interest in acupuncture and tuina also have the chance to acquire knowledge of acupuncture. For instance, practitioners such as nurses and those working in TCM health preservation centers also have means to study acupuncture. The Continuing Education College of NJUCM has established acupuncture and tuina courses, with part-time study as the main learning approach for diverse groups of people. The main learning mode is a combination of online learning and regular, centralized offline learning. Public online courses have offered considerable convenience for enthusiasts of acupuncture and tuina to study. Platforms such as China University MOOC ( www.icourse163.org ) and Rain Classroom ( www.yuketang.cn ) are widely used online learning platforms with a large number of users. The prerecorded videos of theoretical explanations and operational demonstrations delivered by experienced teachers are uploaded to the learning platforms. Besides following the study plan on the online platform, participants can also participate in online discussions, pose questions, submit after-class assignments, and take online exams after the course concludes. This modality provides an excellent opportunity for those unable to attend university classes to learn acupuncture. The advantages of acupuncture education may extend to all areas around the world with an internet connection. Certainly, this learning approach still requires continuous improvement to address more deficiencies of online learning; for instance, issues such as precise guidance and practical feedback for acupuncture operations. Those who complete the nonuniversity education in acupuncture and tuina may acquire a certificate of academic qualification but not a degree. University Education in Acupuncture—Moxibustion and Tuina The curriculum framework of the major of acupuncture—moxibustion and tuina The curriculum system of the acupuncture and tuina major comprises six components: the TCM course module, the western medicine course module, the acupuncture course module, the general course module, the medical humanities course module, and the TCM health preservation and health course module. The first three modules constitute the core courses of the acupuncture and tuina major. The TCM course modules encompass Basic Theories of TCM, Diagnostics of TCM, Chinese Materia Medica, Formulas of TCM, Internal Medicine of TCM, Surgery of TCM, Gynecology of TCM, Pediatrics of TCM, Traumatology of TCM, and the four classical courses—Huangdi Neijing, Shanghan Lun, Jingui Yaolue, and Wenbing Xue. A total of approximately 500 instructional hours. The module of Western medicine courses is composed of two major components: the basic medical course module and the clinical medical course module. The former encompasses courses such as Normal Human Anatomy, Histology and Embryology, Physiology, Pathology, Biochemistry and Molecular Biology, Microbiology and Immunology, Pharmacology, etc. The latter comprises courses such as Diagnostics, Medical Imaging, Internal Medicine, Neurology, General Surgery, Emergency Medicine, Infectious Diseases, Outline of General Practice, Preventive Medicine, etc. A total of approximately 700 instructional hours. The acupuncture and moxibustion course module encompasses Introduction to Acupuncture and Tuina Speciality, Science of Meridians and Acupoints, Science of Acupuncture and Moxibustion Manipulation, Acupuncture Therapeutics, Selected Readings of Acupuncture and Moxibustion Classics, Experimental Acupuncture and Moxibustion, Clinical Thinking and Comprehensive Skills of Acupuncture and Moxibustion, Practice of Tuina, Foundation of Tuina, Science of Manipulation of Tuina, Therapeutics of Tuina, Pediatric Tuina, and so forth. In addition, there are a multitude of elective courses on acupuncture and tuina, such as Characteristic Acupuncture Therapy and Its Clinical Application, Evidence-Based Acupuncture and Moxibustion, Combined Use of Acupuncture and Medication in Clinic, Sinew Acupuncture Therapy, Micro-Acupuncture Therapy, Folk Acupuncture Therapy, Fu’s Subcutaneous Needling Therapy, etc. Enabling students to select and master the latest clinical treatment approaches and research advancements in acupuncture and tuina. A total of over 800 instructional hours. The acupuncture and moxibustion course is not merely the principal course for students specializing in acupuncture and tuina but also a core one for students of other medical majors in universities of TCM. That is to say, although the student training programs for the major of TCM and that of acupuncture and tuina are distinct, and the courses taken are not completely identical, they are obliged to study the acupuncture course and obtain a qualified grade, which is one of the indispensable conditions for obtaining a university diploma in TCM. In contrast to the courses pursued by students specializing in acupuncture and tuina, the core contents of the acupuncture and moxibustion course, such as the Science of Meridians and Acupoints, the Science of Acupuncture and Moxibustion Manipulation, and Acupuncture and Moxibustion Therapeutics, remain the same for them. Nevertheless, there is significantly less in terms of the expanded contents of acupuncture and moxibustion. Course teaching: Teaching materials, teaching syllabus, and the teaching mode integrating traditional Chinese and Western medicine Teaching Materials: The teaching materials of NJUCM are meticulously selected from the planned textbooks specifically compiled for universities of TCM by China Press of TCM or People’s Medical Publishing House. The teaching materials undergo revision every 5 years. The acupoint system taught in the acupuncture and moxibustion teaching materials is the “Names and Locations of Acupoints” GB12346-2006, a national standard of China promulgated in 2006. 3 The teaching materials of other universities of TCM will be chosen from among those published by China Press of TCM, People’s Medical Publishing House, or other publishing houses ( Table 1 ). Table 1. The Main Course Textbooks and Their Publishers Textbooks The publishers Introduction to the Major of Acupuncture—moxibustion, Tuina and Manipulation Jiangsu Phoenix Science and Technology Press Meridians and Acupoints China Press of Traditional Chinese Medicine; Acupuncture and Moxibustion Manipulation China Press of Traditional Chinese Medicine; Acupuncture and Moxibustion Therapeutics People’s Medical Publishing House; China Experimental Acupuncture and Moxibustion China Press of Traditional Chinese Medicine; The Selected Classical Medical Texts on Acupuncture and Moxibustion China Press of Traditional Chinese Medicine; Clinical Thinking and Comprehensive Skills in Acupuncture and Moxibustion Self-prepared Teaching Materials Open in a new tab Teaching Syllabus: Every course is equipped with a teaching syllabus, which is categorized into a theoretical teaching syllabus and a practical training teaching syllabus. The teaching syllabus encompasses information such as major, academic duration, total class hours, and credits. There are explicit teaching objectives, analyses of students’ learning background, teaching content, and allocation of class hours. This involves the teaching content of each chapter, the allocation of class hours, and teaching approaches. Eventually, the teaching syllabus will precisely define the assessment methods. The assessment of NJUCM emphasizes process evaluation; that is, the usual grades, mid-term grades, and final grades constitute the final evaluation result of students based on a certain proportion. For example, in the assessment and evaluation of the acupuncture and moxibustion manipulation course, the usual grades account for 20%, consisting of classroom discussion speeches and practical training reports. The midterm grades make up 30%, composed of midterm theoretical assignments and practical skills examinations. The final exam takes up 50%, which is the score of the final examination paper. The assessment approach that focuses on process evaluation has enabled the pass rate of each course’s examination to exceed 90%. The teaching syllabus will be revised in accordance with the alterations in teaching materials, majors, and students’ learning situations. The teaching syllabus of our university is revised on average once a year. Integrated Teaching of Chinese and Western Medicine: the teaching at NJUCM adheres to the teaching concept of highlighting Chinese medicine, reinforcing Western medicine, and emphasizing capabilities. As previously mentioned, the curriculum system of the acupuncture—moxibustion and tuina major comprises modules such as Chinese medicine, Western medicine, and acupuncture. The course arrangement progresses gradually from the fundamentals to clinical practice. Chinese and Western medicine courses are provided concurrently, and courses in each module are interwoven. For instance, Normal Human Anatomy is a fundamental course of Western medicine, typically scheduled to be taught in the first semester. Simultaneously, the course on Basic Theories of Chinese Medicine is also arranged. In the second semester, there is the basic course of acupuncture, Meridian and Acupoint Science. At this point, there is already a certain understanding of meridians in basic theories of Chinese medicine, and the comprehension of the indications of acupoints in Meridian and Acupoint Science is also accomplished by integrating Chinese medicine meridians and Western medicine anatomy knowledge. When learning acupuncture treatment in the subsequent stage, for each disease type, it is necessary to master its etiologies and pathogenesis in both Western and Chinese medicine, and in some cases, differential diagnosis is required, followed by the treatment methods, prescriptions, and operations of acupuncture. The teaching of the integration of TCM and Western medicine can facilitate acupuncturists to conduct definite diagnoses and precise treatments more easily in clinical practice. Similar circumstances abound in the teaching of acupuncture and tuina. The Acupuncture Techniques and Practical Requirements Students specializing in acupuncture and tuina acquire acupuncture techniques primarily through the course of Acupuncture and Moxibustion Techniques. The main contents encompass techniques such as filiform needle acupuncture, moxibustion, cupping, electroacupuncture, dermal acupuncture, intradermal acupuncture, three-edged needle acupuncture, auricular acupuncture, scalp acupuncture, fire needling, and classical acupuncture techniques. These are all techniques belonging to traditional Chinese acupuncture and do not incorporate traditional therapies of other countries or ethnic groups. Naturally, apart from the course of Acupuncture and Moxibustion Techniques, the major of acupuncture and tuina also provides numerous other elective courses. For instance, special acupuncture therapies impart some emerging and effective acupuncture techniques, such as heat-sensitive moxibustion, sinew acupuncture, Fu’s subcutaneous needling, abdominal acupuncture, eye acupuncture, and acupoint catgut embedding. Generally, various courses related to acupuncture allocate 30%–90% of practical training class hours as required. General skills training and case discussions are more likely to stimulate students’ interest. As the course contents vary, the focuses and proportions of skills training and case discussions differ. For example, “Meridians and Acupoints” is a fundamental acupuncture and moxibustion course. When students are studying this course, they have relatively limited knowledge of acupuncture and moxibustion. Skills training accounts for 30% of the total class hours, mainly involving determining the locations of acupoints on the human body. Case discussions focus on the selection of acupoints based on certain symptoms of patients, aiming to better grasp the therapeutic ranges of the acupoints. In contrast, “Clinical Thinking and Comprehensive Skills in Acupuncture and Moxibustion” is a course for senior undergraduate students in their fourth year. Students have already mastered the majority of acupuncture and moxibustion knowledge and are preparing to become qualified clinical acupuncture and moxibustion practitioners. The practical training in this course constitutes 90%, with the main content being the diagnosis and treatment thinking and operational procedures of complete cases. All technical learning is conducted in accordance with the practical training syllabus. The modes of skill assessment and evaluation are diverse and determined in accordance with the characteristics of the skills required to be mastered: for instance, operating on training molds, operating on virtual simulation computer platforms, and students operating on each other. There are examinations of technical proficiency as well as evaluations of the entire process of example case diagnosis and treatment. In the study of acupuncture and moxibustion techniques, there are specific chapters explaining the safety issues of acupuncture and moxibustion, such as abnormal conditions like fainting during acupuncture, stuck needles, bent needles, broken needles, abnormal sensations during needling, hematoma, visceral puncture (including pneumothorax), central nerves puncture, peripheral nerves puncture, etc., including their manifestations, causes, treatments, and preventions. We will combine some reported clinical practical cases to learn the safety requirements of acupuncture and moxibustion. To alert students to the significance of safety in acupuncture, we integrate the reported clinical practical cases to study the safety requirements of acupuncture. For instance, present a case regarding pneumothorax caused by incorrect operation direction or depth, and analyze and discuss the operational errors in the case. The practice of acupuncture and tuina manipulation encompasses not merely practical training exercises within courses but also a one-semester apprenticeship in the sixth semester and a one-year hospital internship in the fifth academic year. The apprenticeship in the sixth semester is conducted in various departments, including the acupuncture department, tuina department, internal medicine department, gynecology department, surgery department, etc., in accordance with the apprenticeship plan for observation and learning. In the final year of the university, the internship will be carried out in diverse clinical and medical technical departments of the hospital. The internship duration for students majoring in acupuncture and tuina manipulation in the acupuncture department is approximately 10 weeks. In line with the requirements of the internship syllabus, they ought to master the acupuncture diagnosis and treatment approaches for common diseases such as stroke, vertigo, headache, low back pain, stiff neck, elbow strain, frozen shoulder, facial paralysis, stiff neck, insomnia, retention of urine, dysmenorrhea, herpes zoster, abdominal pain, sprain, etc. And be capable of conducting differential diagnosis and treatment for disorders such as stroke, cerebrovascular accident, lumbago and leg pain, and vertigo. Qualification of Licensed Traditional Chinese Physician Obtaining a graduation certificate in acupuncture and tuina along with a bachelor’s degree from the university does not imply that one can become a licensed acupuncturist. By presenting the evidence of having received a comprehensive education in TCM to register for the National Qualification Examination for Licensed TCM Practitioners (currently, there is no specific qualification for acupuncture and tuina practitioners in China), and after passing the examination successfully, one can acquire the qualification of a licensed TCM practitioner. Certainly, if you are involved in the work of acupuncture and tuina in a particular clinic or hospital, you also need to undertake professional registration for acupuncture and tuina. Professional registration requires regular renewal, and the condition for such renewal is that you must engage in continuing education studies. If individuals lacking a university education aspire to become practicing acupuncturists, they are required to complete and pass a series of courses successfully. These course programs are typically provided by the continuing education colleges of universities. Naturally, the programs are required to be filed and examined by the education authorities. The continuing education colleges issue graduation certificates to those who finish the studies but no degree certificates. With the graduation certificates, one can register for the qualification examination for TCM practitioners, and those who pass the examination can become practicing TCM practitioners. In addition, there exists another modality of apprenticeship for becoming an acupuncture and moxibustion practitioner. Students possessing a high school diploma follow a teacher who is above the deputy director level (a professional title in clinical practice, which is equivalent to the level of an associate professor in a university) or has over 15 years of clinical practice experience. They register and file with the medical administration department, meet a certain duration of apprenticeship each week, study for 3 or 5 years, and pass the examination to become an assistant practicing physician. After 3 years as an assistant practicing physician, one is eligible to take the examination to become a genuine practicing Chinese medicine physician. Employment With the advent of an aging society, the demand for disease prevention, treatment, and rehabilitation in society is escalating. The employment of acupuncture and tuina physicians has consistently maintained a favorable proportion. Over the past 3 years, the employment rate of students majoring in acupuncture and tuina at NJUCM has surpassed 93%. Among them, approximately 50% of the students pursue postgraduate studies, 43% are engaged in acupuncture and other medical or related work, and roughly 5% are preparing for the postgraduate entrance examination in the second year. Nearly half of the graduates majoring in acupuncture and tuina opt to continue their postgraduate studies. 4 The majority of them continue to pursue master’s or doctoral degrees in acupuncture and tuina, while a few shift their professional directions to pursue other specialties of TCM or even switch to the field of Western medicine. Due to the integrated model of Chinese and Western medicine education in the acupuncture and tuina major, these transitions are not arduous for them. The Challenges Confronted in Acupuncture and Moxibustion Education Broaden international exchanges As early as 1983, NJUCM was among the first three international acupuncture training centers established by the WHO. Over the past more than 40 years, we have cultivated foreign acupuncture physicians globally. In the past decade, the International Education College of NJUCM has offered diverse acupuncture and tuina programs of long and short academic systems for international students to select, as well as an online learning platform for all-English courses, such as acupuncture and tuina. After the epidemic, international exchanges in acupuncture have been impacted to a certain degree. To further deepen the international exchanges of Chinese cultures like acupuncture, the Chinese government provides ample scholarship opportunities for international students, and NJUCM will also be more actively involved in constructing international exchange programs for acupuncture. The alignment of remote practice with theoretical teaching Acupuncture and tuina is a discipline with highly demanding practical requirements. With the growing popularity of online teaching, aside from providing online courses, we have also established several virtual simulation experiment platforms to facilitate practical practice for remote learners. Nevertheless, the effect of online practice is still inferior to that of real practice. How to construct a more effective remote practical training program is the challenge we are confronted with. CONCLUSIONS In China, taking Nanjing University of Chinese Medicine as an instance, acupuncture education is one of the standardized and mature university education systems. The opportunity for acupuncture study is available through multiple channels. Only after a complete and systematic learning can one be qualified for the professional license examination. The license examination is separated from acupuncture education. Acupuncture education also confronts challenges such as deepening international communication and remote practical education. Currently, on a global scale, in aspects such as the depth and extensiveness of acupuncture education, the range of clinical application of acupuncture and the acceptance degree of patients, the research of acupuncture clinical treatment precisely, and the mechanism research of acupuncture effects, there is no doubt that the level of acupuncture in China is globally leading. Nevertheless, acupuncture practitioners still need to continuously enhance the above several aspects. Especially in the era when artificial intelligence arrives comprehensively, acupuncture education, acupuncture clinical practice, and acupuncture scientific research will all achieve intelligent integration and undergo significant transformative changes. The development objective of the acupuncture and tuina major of Nanjing University of Chinese Medicine in the recent 3 years is to facilitate interdisciplinary intersection, advance new medical science, forge a new domain of digital and intelligent acupuncture, and cultivate talents with innovative capabilities and in line with the demands of the new era. AUTHOR DISCLOSURE STATEMENT The authors declare that the report was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. FUNDING INFORMATION This report was supported by National Education and Research Projects of Higher Education of Traditional Chinese Medicine for the 14th Five-Year Plan in 2023 (Nos: YB-23-30). Research Project on Philosophy and Social Sciences in Colleges and Universities of Jiangsu Province, 2021SJA0342. REFERENCES 1. Liu BY. Promoting acupuncture-moxibustion to be world leading discipline. World Journal of Acupuncture - Moxibustion 2023;33(3):299. [ Google Scholar ] 2. Jing X. Acupuncture and moxibustion was officially classified as a first-level discipline in the “Discipline and Specialty Catalogue for Graduate Education (2022). China News of Traditional Chinese Medicine 2022. 9.21:1. [ Google Scholar ] 3. Tan YQ, Ma XT, Wang Q, et al. Investigation and research on the application of the national standard “names and locations of acupoints” (GB/T 12346-2006). Chinese Acupuncture & Moxibustion 2016;36(8):871–874. [ DOI ] [ PubMed ] [ Google Scholar ] 4. School of Acupuncture -Moxibustion and Tuina & School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine “Self-Evaluation Report on Audit and Evaluation of Undergraduate Education and Teaching 2023”. 2023; 40–41. 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