To take the case I know best, Australia, there has been a rise, in the requirements of the Australian Homeopathic Association, (the only national association) for accrediting courses. Whereas previously the Association required courses to contain a minimum of 340 hours of education in homeopathy and there were no requirements for supervised clinical experience, the number of homeopathy hours was raised a few years ago to 550 and a requirement for 100 hours of supervised clinical experience was added. Of course increasing the gross number of hours of instruction in itself does not guarantee higher standards, but it is an indication that higher standards are being set in place.

Around the same time a number of smaller associations banded together to form a new accrediting body, the Australian Council of Homeopathy, which developed an exhaustive set of standards. These standards specify in great detail every aspect of the skills and underpinning knowledge required in courses accredited by the Council. The clinical skills and homeopathic knowledge necessary to investigate a wide range of specified conditions are required and spelled out in the standards.

Thus, in Australia we have developed two different models of homeopathic education. One standard gives greater emphasis to the student's mastery of "classical" homeopathy — knowledge of the materia medica from a holistic point of view, of case-taking and case analysis, — but is deficient in the area of clinical skills and not specific in terms of knowledge of bio-sciences (although these are required). The other standard is highly rigorous in its requirements for clinical skills and knowledge of the bio-sciences, but gives less explicit emphasis to homeopathic knowledge. The two standards exemplify the two divergent paths down which homeopathic education has hitherto traveled. On the one hand is a "lay" model of homeopathic education wherein the distinctively homeopathic content is given priority. On the other hand is a medical or quasi-medical model, wherein greater priority is given to knowledge of underpinning medical knowledge and diagnostic skills.

Fortunately it may be possible, in Australia at least, to arrive at a synthesis of these two models. All the associations are currently working together (this in itself is a great achievement) on the development of a "National Competency Based Standard." Under our national training system, these standards can be developed for any profession or trade, and given government approval if the required process is followed and there is sufficient consensus within the trade or profession to adopt the standard. We are working to finish the standard by the end of the year, and it is shaping up as a mechanism for overcoming the divisions between the various groups.

In the US, the Council of Homeopathic Certification makes available a single examination in homeopathic competency which has the potential to become a national standard. In the UK, the Society of Homoeopaths has rigorous requirements for listing on its register, and RSHom (Registered by the Society of Homeopaths) has become a designation which inspires considerable confidence in the competence of the practitioner.

Also, the International Council of Classical Homeopathy has been working towards common international standards and has developed a set of educational guidelines towards that end. A handful of colleges have been accredited on the basis that they have substantially met the requirements of these standards. It would be a great achievement if we could build on this foundation and bring about inter-recognition of qualifications from different countries, all at a high standard.

A second trend emerging in the development of homeopathic education is that homeopathy is starting to break out from the private colleges into the university sector. A number of US universities teach a little homeopathy now within their medical schools (see Chronicle of Higher Education 1996). Bastyr University has a strong homeopathic stream within its naturopathy courses. In Australia, several homeopathic subjects have been included within the new Bachelor of Naturopathy at Southern Cross University, a regional university in New South Wales. The University of Westminster in London is offering a BSc (Hons) in Health Sciences (Homoeopathy), in conjunction with the London College of Classical Homoeopathy. And of course homeopathy is quite well entrenched in the university system in India, as we have already seen.

The emergence of homeopathic education within the mainstream university system will bring to a head the necessity to choose between the medical and "lay" models, or, preferably, to develop our own model. Let us look at the advantages and disadvantages of the two existing models.

To some it is obvious that the medical model is all that is needed. The medical degree contains medical knowledge at its highest level, is built on the findings of leading-edge medical research, and gives the most rigorous clinical training to graduates. Therefore we ought to model homeopathic education on medical education, or teach homeopathy only to medical graduates.

There are problems with these arguments. To begin, they are not really based on first principles. There is no first principle that says the degree of MBBS or MD is the optimal training for a homeopath. Such courses are collations of knowledge that have been put together to serve as appropriate training for the use of allopathic treatments, based on an allopathic understanding of health and disease. The homeopathic understanding of health and disease, and homeopathic therapeutics, are radically different. Therefore, we would expect that the underpinning knowledge required to train someone in homeopathic methodology and therapeutics would be different in nature and in content.

We should aim to design an optimal course in homeopathy, not to take an existing model designed for a different purpose. In order to do this we should ask what skills and knowledge are required to train someone to be a first-class homeopath? To do it justice, the idea of the competency-based standard is precisely that. The way it has been implemented in Australia is often bureaucratic and heavy-handed in many respects, but the underlying concept is not a bad one. Homeopathy, like medicine, is an applied discipline. Training in homeopathy should be directly designed to lead to good practice. Therefore it makes sense to start by asking what good practice is, then to derive the curriculum from that. This differs greatly from the traditional academic approach, which has been to teach the breadth of academic knowledge in the field and then add on some practical techniques.