How My Acupuncture School Died

an acupocalypse guest post/warning by Maddie Foley, L.Ac.

Art by A. Cohen

About six months ago I wrote a post speculating that the acupuncture profession might die of snobbery. I didn’t expect to follow it up with a case study, but here we are. OCOM was the Oregon College of Oriental Medicine, one of the oldest acupuncture colleges in the US. It’s where I went to acupuncture school; it closed its doors forever last year. Maybe that takes awhile to sink in, because lately a lot of people have been asking, “What happened to OCOM?” And so one of WCA’s Board members, Maddie Foley, decided to answer that question for the record — because she was there.¹

Maddie at the Capitol: photo credit Winona Vaitekunas

If the definition of insanity is doing the same thing over and over and expecting different results, then OCOM’s dying days, and those of the rest of the acupuncture profession, fully deserve that designation.

Hi, I’m Maddie Foley, a Eugene-area acupuncturist, and from 2020-2022 I was OCOM’s Student Representative to the Board of Trustees. I occupied this position during OCOM’s final years in the midst of the pandemic, and watched a continuous denial of its obvious decline. Since the former #1 acupuncture school in the U.S. is now closed, I’m no longer bound by confidentiality — and so what I’m about to say here is probably going to hurt a lot of feelings. Fortunately, if you know me at all, I have somewhat of a reputation for hurting acupuncturists’ feelings, but not one of dishonesty, so let’s get right into it.

As a prospective student, I had considered both NUNM and even POCA Tech before committing to OCOM. NUNM was much more expensive, and the school as a whole seemed to have more of an emphasis on Naturopathic medicine. I had read up a bit about Community Acupuncture and POCA Tech and it really aligned with my values, and made way more sense financially.

However, the acupuncturist mentors I had at the time (who both went to OCOM) told me essentially that you “get what you pay for” and told me community acupuncture was basically a cheap knockoff of “real” acupuncture and that my practice would be incomplete without learning herbal medicine. So I took their advice and went to the “real” school. Four years later I left the program totally jaded, depressed and burned out, woefully unprepared to start a successful clinical practice, and wondering why the hell I hadn’t just spent those years of my life becoming a dentist.²

During my time at OCOM, mostly everyone was unhappy, which is a trend that began before the pandemic did. There was poor communication and blatant gaslighting coming from administration, many teachers were inexperienced and struggling with little support, and the curriculum itself was brand new, bloated, and full of problems.

For years, rumors had circulated that OCOM was going to close (but this time they were true, as we would all come to find out). The school had just spent a lot of time and money developing the Doctor of Acupuncture and Chinese Medicine (DACM) program, an entry-level doctorate that was put forth as the “new standard of the profession,” magically creating hospital jobs and the hard-earned respect that was sure to cure the profession of its woes.

Yes, it was more difficult than your standard 4 year Master’s degree, and oh yes, it was more expensive. But this program was the hope and promise of OCOM, the school that blazed the trail in opening one of the first acupuncture post-post-grad doctoral programs. And now it was going to re-invent the wheel by opening another unnecessary doctoral program, and elevate the standards of the profession along with it. ³

At the helm of our sinking ship was a brand new president, who started the same year I did and quit before I graduated. She was well-meaning but had no idea what she got herself into, and was a new grad herself still waking up to the enormity of the problems she had inherited, and simultaneously navigating the many and varied problems of the pandemic. Because people were so unhappy, and because I don’t know how to keep my hands to myself, I got involved in student leadership to try and use those hands for a bridge between students, staff, and administration. I got involved with the Board in the second year of my sentence, late 2020, a time absolutely no one remembers fondly.

For context, the school was being ripped apart by all the normal pandemic stuff we all went though culturally, plus we were in Portland with the national eye of Sauron fixed firmly upon us, PLUS our school was located in the Old Town neighborhood which was riddled with shuttered businesses, unsafe streets literally overflowing with the effects of all of our other epidemics: untreated mental health, unhoused neighbors, fentanyl. In the midst of that was a small, struggling school that was arguably the epicenter of the rot which encapsulates acupuncture professional culture.

In Board meetings these various crises were treated like a temporary, passing concern and we should just Keep Calm and Carry On (and spend more money on security) while we wait for students to inevitably flood the gates and get us back on our feet. This was the same strategy we had been employing for the previous decade of decline, long before the pandemic and the existing problems of Old Town were exacerbated. Everyone loves to blame the pandemic for the closure, but the truth is, we’d set course for disaster long before; we just arrived at our destination sooner than we thought.

Among those longstanding factors of decline was that of the building, our beautiful restored historic castle on a hill. For the sake of transparency, I was not around for much of the history of the building, but the story I pieced together goes a little like this: circa 2009, OCOM announced plans to move from its old campus on SE Cherry Blossom Drive (which it owned and successfully operated out of for decades). At the time, enrollment at OCOM was outgrowing the old campus, and the City of Portland was attempting to revitalize Old Town (again). Old Town contained the original China Town, and the neighborhood maintained a good amount of its historical features and Chinese aesthetics, although most of the Chinese and wider Asian immigrant community mainly occupied SE Portland by this time.

The story I was told is that Old Town’s revitalization efforts included financial incentives for businesses to move into the neighborhood, and that’s how OCOM got roped into its 15 million dollar construction project and moved into a historical building, right on the river on Portland’s infamous Northwest Couch street. The new campus opened in September of 2012, and lots of people were unhappy about this move, but it was pushed hard by the President and Board at the time as being a great opportunity and necessary for growth.

In the years between opening the new campus and closure, a lot of long-term core staff moved on to greener pastures and overall enrollment slowly but steadily declined as the national student debt crisis worsened. This contributed to a huge culture shift at the school that spiraled down to what I walked into when I enrolled in 2019. Staff and students didn’t feel heard, turnover was high and quality of teaching suffered, and there was a frustrating lack of transparency between administration and the rest of the school. I had been told that we needed 60+ people coming in yearly to sustain the financial burden of the move; this never consistently materialized. If I recall correctly, my cohort in the shiny new program started with about 45 people and ended with 30 or so.

In the midst of all of this, I attended board meetings, and always had a few minutes to give a student update. Most of my updates went something along these lines: “People are really unhappy, communication is poor and students are concerned about their loan burdens and having a hard time adjusting to the new program. We heavily financially depend on those incoming class numbers, and our enrollment has been trending down for awhile. What is the plan for us to financially sustain ourselves if enrollment continues to decline?” Clearly, not what they wanted to hear, and the response was usually a moment of silence, and then someone would invariably say something along the lines of “You’re so great! We appreciate your leadership so much! Thanks for being here! We’re so lucky to have you!” And then we would move onto the next agenda item which never had anything to do with any of the pressing concerns that I raised.

Over time I realized that’s because there was no answer to the “what’s the plan” question because there was no plan, therefore there was no answer. Actually, we were doing the plan: open the new program and hope it became our saving grace, in spite of all of the trends in the last 15+ years of the profession stating otherwise.

Art by A. Cohen

There was a plan to refinance the building, and we were waiting for rates to go down just a little more so we could save thousands per year — of course this was when rates were at a historic low. We did not manage to refinance before they skyrocketed to 7%, so that fell through. Prior to the commercial real estate crash the board was unwilling to entertain the idea of selling the building despite the obvious need. They seemed to change their tune on that in the last 6 months of operations, well beyond too late. Personally, I think it’s possible, if not likely, the school would still be open if they stayed at the SE Portland campus. Oh well, so much for that.

Nope, we were just going to keep marching along, raising tuition as needed (which happened during my time there despite a promise to lock-in the rate you started with). We were all just going to hope that the pandemic would be short and sweet, and the decade-long problem of declining enrollment would reverse, and Portland would magically clean up Old Town and it would be the hot up-and-coming neighborhood it was always supposed to be. We would look for some nonexistent grants and host an expensive failed fundraising gala in the meantime to give us a little boost. OCOM did receive some emergency pandemic loans, but the temporary cash infusion wasn’t reinvested into dramatically changing course, so naturally it didn’t stop the bleeding.

We were all on a sinking ship, we knew we were on a sinking ship (but denied it, despite the water level rising). Every once in a while someone would toss a bucket of water off the side, and we would all give ourselves a big pat on the back for still being the #1 sinking ship in the U.S.

Meanwhile, the Department of Education openly discussed pending debt-to-income requirements for schools, acupuncturists got really vocal about being misled about their career prospects and shackled by debt, the pandemic did its chaotic, divisive thing, stray bullets cracked windows at OCOM, and commercial real estate collapsed. And so the gradual decline that the school had passively accepted for years turned into a more rapid one, and OCOM exited quietly into the night, taking its reputation with it.

As is the story of most every other acupuncture school closure, we were willing to do everything except change.

I envisioned a lean, mean OCOM that had a mostly module-based program and heavily emphasized hands-on clinical skills. I would have loved to see the clinic be mostly student-run, giving us the opportunity to both practice clinically and learn practical, necessary skills like answering phones, taking payments, and other administrative work that’s like half of what actual practice management is like. What I got instead was 20-30 hours of mostly didactic classes a week in which the professor read us a slideshow, and then I spent my precious free time memorizing that slideshow and then I took a quiz on it. In my final year I had three five-hour clinical shifts weekly that were mostly devoid of patients, and largely consisted of students practicing the revered “10 Questions” with a small side of actual acupuncture treatment.⁴

It was a long, hard four years, and sadly, I hated almost every minute of it. And I was a good student! At least I was prepared for the boards, which fucking sucked, were super expensive, and tested me more on malaria and dysentery than chronic pain.

As the #1 school in the US, OCOM could have wielded its influence and advocated for necessary change in the profession and pushed us in a better direction. We should have and could have taken an honest look at ourselves and pushed for something that made more sense and catered to the needs of the majority of patients. But instead we fed on the status quo so much that it literally poisoned us and ultimately became our downfall.

The pandemic pushed us along, and all the while, we did the same thing over and over again, playing the blame game, as we assumed our position beneath the depths in the graveyard of sunken ships.

1. Due to recent events, this post is timely with regard to the hazards of doing the same thing and expecting different results. According to Inside Higher Ed:

Since the passage last week of President Trump’s domestic agenda, the Department of Education now has less than a year to carry out what policy analysts are calling the most significant overhaul to federal student aid in more than a decade…What colleges can do while they wait… is start “triaging” by collecting and analyzing data on how these policy changes will impact potential revenues. For graduate programs, that means assessing whether the cost of tuition exceeds borrowing thresholds. If it does, colleges may need to lower tuition, prepare for fewer students to enroll or cut the program altogether.

See also, Graduate Programs Face a Federal Reckoning. Now’s the time for acupuncture schools to buckle up and plan ahead.

I’m not optimistic.

2. Unlike most of my classmates in that position, I had a beacon of hope in the form of community acupuncture.

I started really waking up to the shitshow in the middle of my second year at OCOM, which, in hindsight, was totally early enough to jump off the sinking ship and grab a lifeboat, but I’m stubborn so that’s not what happened. In one of my empty clinic shifts, a professor showed us a short documentary about community acupuncture called “The Calmest Revolution Ever Staged.” After that, something broke in my brain. I was miserable and starting to have doubts about the career path I was walking. The first year of acupuncture school is always hard, but four quarters of 20 credits of straight memorization with 9 classes to juggle was having its toll on my sanity in the second year; four years of doing that was beginning to feel like an impossibly long time.

Hilariously, I had been prescribed Gan Mai Da Zao Tang at the OCOM clinic, which is a formula indicated for uncontrolled crying (I saw a lot of that formula being prescribed there), but since the root cause wasn’t being eliminated I just kept on crying, and I kept thinking there just has to be another way. I read Lisa’s books and I cried a lot more, but for a different reason, because I was so validated in what I had been feeling.

3. Because you know, the problem with the acupuncture profession isn’t the lack of jobs and high debt, it’s the lack of standards.

4. So I did what any normal person starts doing when they’re in a mental health crisis and their free time is very limited: I started volunteering at Working Class Acupuncture. I’ll never forget my first treatment there: it was from a POCA Tech student and she saw from my paperwork that I was also in acupuncture school. She very kindly asked me how it was going at OCOM, as I was coming in for stress and anxiety. I smiled back at her, and before I could say anything I just burst into tears. She gave me a lovely treatment and I felt much better after, and I started volunteering Sunday afternoons at WCA Cully for the next two years until I graduated and moved to Eugene.

Working at WCA Cully totally changed my life. I started to really see how lovely it would be if everyone had access to a place like that, and I became basically obsessed with community acupuncture, constantly reading the POCA forums and brainstorming my own future clinic. I started more or less begging my classmates at OCOM to at least look into it (hardly anyone did), which definitely was annoying to people and raised my teachers’ eyebrows, but no one ever talked about community acupuncture at OCOM, in the city where this whole thing started, and it was weird. I eventually met Lisa and Skip and probably did more embarrassing crying and freaked them out because I was SUCH a fan, and they very kindly invited me to audit classes at POCA Tech, because by this time it was very apparent that OCOM wasn’t really preparing me for clinical practice the way I hoped. So I started moonlighting as a community acupuncture student and it literally felt like living a double life, and it also probably saved my life. I went to at least one module quarterly for the next couple of years trying to fill in the gaps of my education, as POCA Tech covered subjects like trauma informed care, distal acupuncture, leadership skills, nonprofits 101 and much more that OCOM didn’t teach, but that I felt were essential to being a prepared and competent practitioner.