By Lindsay Kluge

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May 10, 2021

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Richmond Natural Medicine is one of the few clinics on the east coast where graduates with a naturopathic medicine degree can complete their residency to gain additional mentorship and guidance during their first year of clinical practice. This is a unique opportunity to develop their clinical practice skills seeing their own clients, while also rotating with the other doctors within the practice to increase their expose so various health conditions and outcomes.

RNM currently has two naturopathic residents in our practice: Dr. Naomi Gerep and Dr. Shruti Paskar. Each share their personal experience of what it’s like behind the scene of the RNM residency.

Watch: Meet Dr. Gerep and Dr. Paskar

What is involved in a naturopathic residency? What sort of skills and training are involved?

Dr. Paskar: Naturopathic residency programs, similar to conventional residencies, can differ significantly based on the program and focus of the residency site. Many of the residency programs are based in primary care, in states where we are recognized as primary care physicans, and require skills and training of a general medicine or family medicine doctor. Naturopathic clinical residency sites are located in hospitals, universities, or often private clinics and some are also able to provide opportunity for additional training in IV medicine or minor surgery.

One of the ways the RNM residency site is unique is that we are in an unlicensed state and even though we have all passed our board exams and hold licenses to practice medicine (in another state), we cannot perform physical exams, order labs, or prescribe pharmaceuticals in Virginia as we would be able to in other states that do recognize us as physicians. 

However while this creates some barriers to care, it can also encourage more collaboration with other providers and use of natural therapies which is what we’re here to do. I continue to use clinical reasoning skills from a naturopathic and primary care perspective, just in a different capacity here.

Dr. Gerep: We see our own patients but also have time scheduled every day for us to do rotations with each of the other providers in office so that we can exponentially increase our exposure to different conditions and the therapeutic approaches used by each provider. The residency also involves a mentorship with Dr. Hollon, in which she is available to guide us when we encounter difficult cases.

Tell us about a day in the life of the RNM residency.

Dr. Paskar:  A typical day starts 30 minutes before the clinic opens — prepping for patients and maybe charting. Naomi and I will then either see our own patients or rotate with other doctors in the clinic for the entire day. We also help out with administrative tasks when we are needed.

Read More: Naturopathic Appointments: A Comprehensive Guide to What is Included and What to Expect

What’s your favorite part of a typical day? 

Dr. Gerep: My favorite parts of the day are spending time getting to know new patients, and getting to hear about the progress that an established patient has made since their last visit. I also love making customized herbal formulas and leafing through my homeopathic repertory to find the perfect remedy for a patient.

Why did you choose the residency at RNM?

Dr. Gerep: I chose the residency at RNM for many reasons. First of all, I am originally from Tennessee, so helping improve access to Naturopathic Medicine in the Southeast region of the country has been a dream of mine. Secondly, despite having been exposed to many conditions and patients while in school, I felt that I would benefit greatly from having additional mentorship and guidance during my first year out in practice. Finally, this residency has allowed me to learn a lot about what running a Naturopathic practice in a pre-licensed state looks like.

Dr. Paskar: I applied for the RNM residency because it was in an unlicensed state where I knew I would be challenged out of necessity to develop care plans based completely in natural medicine as opposed to also being able to use pharmaceuticals as we did in school.

How does the ND residency experience better prepare you for clinical practice? 

Dr. Paskar: An ND residency is special because mentorship under a medically-trained naturopathic physician offers an opportunity to understand and develop a unique perspective and skillset in medicine compared to what most people have access to in the United States. 

This is extremely important because no matter what state a person is in, natural medicine can always be a useful tool in improving their health, if you are knowledgeable and skilled in its use. The options in natural medicine are seemingly infinite and I find it empowering for myself and my patients to be able to share that with them. Residencies exist so new doctors with limited experience can continue to explore and train in their profession under the safety and guidance of a skilled practitioner aka apprenticeship, which is how medicine was traditionally taught. We have medical schools now which are critical in understanding the foundations, but sometimes lack true apprenticeship which to me is integral in becoming a truly developed physician. With this residency site also being a small business, we have also been able to observe operations and decision-making from an entrepreneurial perspective which will also serve us in our own practices one day.

Dr. Gerep: Entering an established practice has allowed me to start seeing patients immediately, and at a volume that would have likely been impossible if I were in practice on my own. Not having to worry about marketing, scheduling, paperwork, etc. has been great because I can focus on delivering care and cultivating myself as a practitioner. I am also able to gather information about the business side of things, which I’m sure will help make the process smoother once I endeavor to start my own business in the future.

Share with us your experience with collaborating with the other practitioners at RNM.

Dr. Gerep: If there is a clinical situation I haven’t encountered yet or otherwise do not feel totally comfortable with, I always feel extremely supported by the other practitioners, by their wisdom and experiences.  Sometimes I will ask every provider about a case, and they will each have a different and unique perspective, which allows me to integrate and synthesize all of their experiences to inform my overall understanding of a condition or clinical situation. I love that this allows me to shape the development of my own philosophies of medicine from a more balanced perspective than relying merely on textbooks and what I see with my own eyes.

To schedule an appointment with Dr. Gerep or Dr. Paskar, click here, or call our office for more information.