Reimagining integrative medicine fellowship core competencies with a health equity lens

Integrative medicine (IM) fellowships have grown significantly over the past decade. This review examines gaps in the original IM competencies and key revisions aligned with the Accreditation Council for Graduate Medical Education (ACGME) domains, informed by a multi-phase stakeholder engagement process. A task force from the Academic Consortium for Integrative Medicine and Health conducted a systematic review of existing IM competencies, ACGME core competencies, and relevant Diversity, Equity, and Inclusion (DEI) frameworks. A survey was sent to 23 IM fellowship programs, yielding a 96% response rate. Competencies were revised and refined through stakeholder input via conferences, focus groups, and surveys. Thematic analysis in December 2024 identified priorities for final revisions. Key updates include inclusive language and integration of underrepresented areas such as health equity, trauma-informed care, clinician well-being, interprofessional collaboration, and planetary health. Cultural humility and epistemic inclusivity are emphasized throughout, with health equity principles embedded across all domains. These updates mark a shift toward an inclusive, equity-centered model of whole-person care. Future efforts will focus on implementation, faculty development, and standardized assessment to support adoption in IM fellowship programs.