Ruixia Wang

Abstract: According to laws and regulations of Japan, the profession of acupuncturist is a nationally recognized qualification. To become an acupuncturist, individuals are required to complete a three-year education at an acupuncture school. After graduation, you must pass the National Qualification Examination for Acupuncture Practitioners, and then one can obtain a license to practice acupuncture.

Historically the development of Japanese acupuncture to the present, just like the use of herbal medicines deriving from Chinese traditional medicine (Kampo), acupuncture has experienced periods of flourishing and decline which correspond with the historical changes in Japan, and has even been, at times, in danger of being eliminated.

The author is engaged in acupuncture education in Japan, and this article will be an introduction to the acupuncture system and current state of acupuncture education in Japan.

1. Historical changes in the acupuncturist system in Japan

The current law in Japan regarding acupuncturists and their practice of medicine is the “Laws Relating to Massage, Acupuncturists, and Moxibustion Practitioners.”In other words, according to Japanese law, the title acupuncturist is not one qualification, but two qualifications: acupuncturist and moxibustionist.

Typically, after passing the national qualification examination for acupuncturists, two licenses for acupuncture and moxibustion will be issued in the name of the Japanese Minister of Health and Welfare (equivalent to the Minister of Health in China). Every year when students who graduate from Japanese acupuncture schools take the national qualification examination, if they only pass the acupuncture examination, they will only get an acupuncture license and can only perform acupuncture treatment, and ff they only pass the moxibustion examination, they will only get a moxibustion license and are able to perform moxibustion treatment. If they pass both, they have both an acupuncture and moxibustion license and can perform acupuncture and moxibustion treatment.

Before the current acupuncturist system was formed, the Japanese acupuncture community, like other traditional medicines, had experienced political and policy changes in various eras. The history of Japanese acupuncture and moxibustion from a developmental and regulatory context, can be roughly divided into four periods: the early stage、the Meiji Restoration period to the early Showa period、the middle Showa period and the late Showa period to the present.

The initial stage of the transmission of Chinese medicine to Japan occurred in the 5th to 6th centuries. During the early Meiji period (around 1870), both practitioners of traditional Chinese medicine and acupuncturists had equal status and were considered mainstream medical professionals. Acupuncturists even had titles such as “Needle Doctor,” “Acupuncturist,” and “Apprentice Acupuncturist.” Tanba Yasuyori, the author of the well-known Kampo medicine classic “Yishinbo”, which is now designated as a national treasure of Japan, holds the title of doctor of acupuncture during the Heian period (784-1185).

The period from the Meiji Restoration to the early Showa era marked the comprehensive decline of traditional Japanese medicine. During this time, the Japanese government, under the policies of “enrich the country, strengthen the military” and industrial revitalization, established a modern healthcare system in 1874 that imitated Western medical systems. This system mandated that only those who had studied Western medicine could receive a medical license, and acupuncture as a medical practice had to be conducted under the supervision of Western medical doctors. However, because acupuncture was very popular among the people this edict was resisted by the acupuncture community, and this system was not implemented.

In view of this actual situation, the relevant departments issued the “Acupuncture and Moxibustion Business regulation Law” in the 18th year of Meiji (1885), allowing the business practice of acupuncture treatment, that is, the acupuncture business licensing system. Then, in 1911, during the 44th year of the Meiji era, the “Acupuncture and Moxibustion Business Regulations” were issued, which allowed not only the traditional master-apprentice method of learning acupuncture and moxibustion, but also formal education at schools to train acupuncture practitioners. This meant that practitioners could be trained in two ways: through apprenticeships under experienced masters or through formal education at schools.

After the end of World War II in Showa 20 (1945), Japan once again ushered in a major reform of the medical system. Acupuncture treatment was branded as “unscientific”, and some advised the government to completely ban medical practices other than Western medicine. However, after strong opposition campaigns from celebrities, scholars and groups in both Western and Kampo medicinal communities, and after passing the defense of the Medical System Review Committee of the Ministry of Health and Welfare, the Massage, Acupuncture, Moxibustion, and Judo Rehabilitation Business Act was established in 1947 (“Judo rehabilitation” refers to those who are trained in martial arts and traditional bone setting for injuries). This act was revised in Showa 26 (1951), and the business law was changed to regulate the massage, acupunctuet, moxibustion, and judo osteopathypractitioners. After this reform, the regulation of acupuncture and moxibustion transitioned from a business license system to individual medical licenses.

The mid-Showa period can be considered a phase of improvement in the acupuncture and moxibustion healthcare system in Japan. In 1970, during the 45th year of the Showa era, the Judo Manipulator Act was separated from the existing law and established as the Judo Manipulator Act. The relevant lawsconcerning acupuncturists and moxibustion therapists were officially categorized under the “Massage Therapist, Acupuncturist, Moxibustion Therapist Act.”

However, at this time, the legal authority to grant licenses to acupuncturists and moxibustion therapists was held by the governors of the prefectures in Japan (equivalent to mayors or provincial governors in China). The licensing examinations for acupuncturists and moxibustion therapists were conducted at the prefectural level, with no nationwide standardized examination.

In 1988, during the 53rd year of the Showa era, another legal amendment was implemented. The authority to issue licenses was transferred from the prefectural governors to the Minister of Health and Welfare (equivalent to the Minister of Health in China). This change meant that acupuncture, and moxibustion therapist licenses became national qualifications, and the licensing examinations were standardized nationwide.

2.Japan’s current acupuncture education system

Acupuncture schools in Japan are also called “acupuncture training facilities.” In addition to training acupuncturists and moxibustion practitioners, some schools also offer massage, acupressure and other majors. There are currently about 90 three-year acupuncture schools and 11 four-year acupuncture universities. A master’s degree program in acupuncture was established in 1991, and a doctoral degree program in acupuncture was established in 1994.

Since the main institutions responsible for acupuncture and moxibustion education in Japan are the three-year specialized schools, this article provides an overview of the education system in these specialized schools.

Acupuncture and moxibustion specialized schools admit students who have completed at least a high school education or its equivalent. The student body in these schools is typically diverse and may include recent high school graduates, individuals with general work experience, as well as those who have worked in medical-related fields such as nursing, pharmacy, physical therapy, and even homemakers. The age of the students ranges from 20 years old to around 70 years old.

During the three-year period of enrollment in these specialized schools, students are required to complete the curriculum prescribed by the school. The curriculum typically consists of 86 credits, which are divided into the following categories:

Basic Courses: 14 credits

Basic Professional Courses: 27 credits

Specialized Courses: 45 credits.

Upon successfully completing these required credits and passing the graduation examination, students become eligible to participate in the national examination for acupuncturists and moxibustion therapists. It’s important to note that Japan does not recognize Chinese medicine qualifications obtained outside of Japan. Even if someone has graduated from a Chinese medicine university in their home country, they must, like Japanese students, study in these specialized schools for three years, complete the prescribed courses and credits, pass the graduation examination, and then become eligible to take the national examination for acupuncturists and moxibustion therapists.

It’s worth mentioning that the curriculum in specialized Japanese acupuncture and moxibustion schools has been consistently based on Western medical courses since the Meiji Restoration. These schools offer a broader range of subjects in Western medicine, spanning from basic medical sciences to various clinical disciplines, compared to traditional medicine. This can be clearly observed from the content of the Japanese national examination for acupuncturists and moxibustion therapists, as it emphasizes a strong foundation in Western medical knowledge.

Here is a table outlining the subjects covered in the Japanese national examination for acupuncturists and moxibustion therapists, which includes topics from both traditional Eastern medicine and Western medicine。

From the table, it’s evident that the number of subjects related to Western medicine is greater than those in the Eastern medicine category. Additionally, the subjects listed in the Eastern medicine category, namely Acupuncture Theory and Moxibustion Theory, essentially encompass content related to Western medical physiology and pathology. In other words, the content related to Eastern medicine on the Japanese national examination for acupuncturists and moxibustion therapists is limited to Oriental Medicine Overview (equivalent to the fundamental theories of traditional Chinese medicine taught in Chinese medicine schools), Oriental Clinical Medicine (which includes concise versions of clinical specialties like internal medicine, external medicine, gynecology, etc, as taught in Chinese medicine schools), and Meridians and Acupoints.

Another distinctive aspect of Japan’s acupuncture and moxibustion education system is the presence of specialized schools for the blind that teach acupuncture and moxibustion.

Japanese acupuncture education facilities for the blind were first established in the Edo period. Sugiyama Kazuichi, a famous blind acupuncturist at that time, won the favor of Edo shogunate Tokugawa Tsunayoshi because of his superb medical skills. Relying on this relationship, he established the “Sugiyama Acupuncture Guidance Training Center”, the first acupuncture education institution for blind people. The emergence of this educational facility laid the foundation for blind people to learn and engage in acupuncture work at that time and in the future. It was also the origin of the long-term active participation of blind people in the Japanese acupuncture community.

During the Meiji era, the Blind Medical Association was established, and in 1902, the “Blind Acupuncture and Massage Training School” was officially opened, eventually evolving into specialized schools for blind individuals in the field of acupuncture, moxibustion, and massage.Currently, Japan has two forms of schools for blind individuals in the field of acupuncture and moxibustion. One type is under the jurisdiction of the Japanese Ministry of Education, Culture, Sports, Science, and Technology (equivalent to the Ministry of Education in China). These schools typically admit students with junior high school qualifications and have a 5-year curriculum. The other type falls under the jurisdiction of the Ministry of Health, Labour, and Welfare and accepts students with high school qualifications, offering a 3-year curriculum. Like students in other acupuncture and moxibustion schools, blind individuals studying at these schools, upon completing the prescribed courses and credits and passing the graduation examination, are eligible to participate in the national qualification examination. The difference is that the examination rooms for people with normal eyes and those with visual impairments are separate during the examination.

The establishment of specialized acupuncture and moxibustion education facilities for blind individuals has made a significant contribution to their employment, livelihood, and active participation in societal activities.

This has been a brief introduction to acupuncture medical regulation in Japan and the current Japanese acupuncture education system.

Reference List:

1. Kitagoshikoji, H. (2021). Changes in the Acupuncture and Moxibustion Healthcare System, Education, and Research during the Meiji Era. Journal of the Japan Acupuncture and Moxibustion Society, 62(1), 29-37.

2. Shinohara, S. (n.d.). Characteristics of Acupuncture and Moxibustion in Japan: Post-War History, Education, and System. Meiji International Medical University, Traditional Acupuncture and Moxibustion Research Office.

3. Terada, K., & Wada, T. (2018). Visual Impairment and Acupuncture & Massage. Proceedings of the Human Rights Research Laboratory at Tenri University, 21, 19-27.

4. Wakayama, I. (2022). Comprehensive Traditional Chinese Medicine. Seifusha, 275-276.

About the Author:

Wang Ruixia, a graduate of the Traditional Chinese Medicine Department at Shandong University of Traditional Chinese Medicine, holds a master’s degree from Beijing University of Chinese Medicine and a doctoral degree from the Medical Faculty of a Japanese university. She serves as a lecturer at Japan Medical Judo Orthopedics and Acupuncture school.