Key Areas to Study for the Acupuncture Section of CALE

1. Key Acupuncture Points and Their Details
   • Focus on Major Categories:
     • Five Shu Points (Jing-Well, Ying-Spring, Shu-Stream, Jing-River, He-Sea): Understand their functions, energetic properties, and clinical applications.
     • Yuan Source Points: Know their role in regulating the corresponding Zang Fu organs (e.g., LU 9 Taiyuan for Lung issues).
     • Other Key Points: Xi-Cleft, Luo-Connecting, Back-Shu, Front-Mu, Eight Influential Points, and Confluent Points of the Eight Extraordinary Vessels.
   • Details to Master for Each Point:
     • Location: Be able to locate points anatomically.
     • Functions/Indications: What conditions does the point treat? 
     • Needling Depth and Techniques: How deep to needle, at what angle, and any special techniques (e.g., perpendicular vs. oblique insertion).
     • Cautions and Contraindications: Know when to avoid needling (e.g., ST 12 Quenpen: no deep needling at ST 12 Quepen due to proximity to the lungs and artery. Avoid needling during pregnancy).
   • Why It Matters: The CALE may ask you to select points for specific conditions or identify risks associated with needling certain points.
2. Acupuncture Techniques and Moxibustion
   • Study Source: Read Chapter 11: Acupuncture and Moxibustion Technique from the Chinese Acupuncture and Moxibustion (CAM) book 
   • Key Techniques to Understand:
     • Needling Methods: Tonification (reinforcing), sedation (reducing), and even techniques—know how to manipulate needles to achieve these effects.
     • Moxibustion: Direct vs. indirect methods, indications (e.g., cold conditions), and contraindications (e.g., avoid in heat syndromes).
     • Electroacupuncture: When to use it, settings, and precautions (e.g., avoid in patients with pacemakers).
     • Cupping and Gua Sha: Indications (e.g., stagnation, pain) and safety (e.g., avoid over broken skin).
   • Why It Matters: The exam may include practical scenarios, like choosing the right technique for a patient with Qi deficiency or knowing when moxibustion is contraindicated.
3. Point Selection and Prescription for Common Conditions
   • Learn Point Combinations: Study classical and clinical point prescriptions for common TCM patterns:
     • Example: For Liver Qi Stagnation (stress, irritability), use LV 3 Taichong + LI 4 Hegu to move Qi and calm the mind.
     • Example: For Spleen Qi Deficiency (fatigue, poor digestion), use ST 36 Zusanli + SP 3 Taibai to tonify the Spleen.
   • Understand Pattern Differentiation: Point selection should align with the patient’s TCM diagnosis (e.g., don’t use LI 11 Quchi in a cold pattern).
   • Why It Matters: The CALE often tests your ability to select points based on a patient’s symptoms and TCM diagnosis, reflecting real world clinical decision making.
4. Anatomical Knowledge for Safe Needling
   • Understand Anatomy: Know the underlying structures (e.g., nerves, blood vessels, organs) to avoid complications.
     
     • Example: Avoid deep insertion on ST 9 Renying as it may puncture common carotid artery. 
     • Example: Be cautious at GB 21 Jianjing (shoulder) in pregnant patients, as it can induce labor.
   • Study Resource: Use a book like Clinically Oriented Anatomy by Keith L. Moore to understand anatomical landmarks. You can also use our Acupuncture Deck. 
   • Why It Matters: The CALE tests your ability to needle safely, often with questions about contraindications or risks based on anatomy.
5. Integration with TCM Theory
   • Link Points to Theory: Acupuncture on the CALE isn’t just about memorizing points—it’s about applying them within a TCM framework.
     • Example: If a patient has Kidney Yin Deficiency (night sweats, dry mouth), select points like KI 3 Taixi to nourish Kidney Yin.
   • Connect to Foundations: Use your knowledge of Yin-Yang, Five Elements, and Zang Fu (from Key Tip No. 4) to justify point selection.
   • Why It Matters: The exam often integrates acupuncture with TCM diagnosis, so you’ll need to show how your point choices align with the patient’s pattern.

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Study Tips for the Acupuncture Section

• Use Visual Aids: Create or use charts of points (like our Acupuncture study cards) to memorize locations and functions.
• Practice Scenarios: For a given condition (e.g., “Patient with insomnia and anxiety”), select points and justify your choices based on TCM diagnosis.
• Cross-Reference with CNT: Always consider safety when studying points—know the risks and precautions for each.
• Mock Exams: Take practice tests to get familiar with question styles (e.g., multiple choice on point selection or safety protocols). 
  • We’ve kicked off practice questions on Boncho School! Our team is hard at work building more practice questions and tests, and once they’re ready, we’ll announce it through our email newsletter. Be sure to sign up at bonchofriends.com and stay tuned for updates! 📩

Key Areas to Study for the Chinese Herbal Medicine Section of CALE

Single Herbs: The Building Blocks of Formulas

• Focus on Major Categories:
  • Herbs that Release the Exterior: Warm, acrid herbs (e.g., Ma Huang for Wind Cold) and cool, acrid herbs (e.g., Bo He for Wind Heat).
  • Herbs that Clear Heat: Heat-clearing and toxin-resolving herbs (e.g., Huang Qin for damp-heat in the Large Intestine).
  • Herbs that Tonify: Qi tonics (e.g., Ren Shen for Qi deficiency), Blood tonics (e.g., Dang Gui for Blood deficiency), and Yin/Yang tonics (e.g., Rou Cong Rong for Kidney Yang deficiency).
  • Herbs that Drain Downward: Purgatives for excess conditions (e.g., Da Huang for constipation due to heat accumulation).
  • Other Key Categories: Herbs that transform dampness, move Qi, stop bleeding, and calm the spirit and more.
• Details to Master for Each Herb:
  • Functions/Indications: What does the herb treat? 
  • Properties: Temperature, taste, and channel entry 
  • Dosage: Typical dosage ranges (e.g., 3-9g for most herbs, but purgatives like Da Huang may be 3-15g depending on the method).
  • Contraindications and Cautions: When to avoid using the herb (e.g., Ma Huang is contraindicated in hypertension or with excessive sweating; avoid Dang Gui in cases of dampness or diarrhea).
  • Preparation Methods: How the herb is processed to modify its effects (e.g., Zhi Gan Cao is honey-fried to enhance its tonifying properties).
• Why It Matters: The CALE often tests your ability to select herbs for specific TCM patterns or identify when a herb is contraindicated based on a patient’s condition.

Herbal Formulas: Understanding Composition and Modification

• Learn Core Formulas: Study classical formulas for common TCM patterns:
  • Example: For Spleen Qi Deficiency (fatigue, loose stools), use Si Jun Zi Tang (Four Gentlemen Decoction) with Ren Shen, Bai Zhu, Fu Ling, and Gan Cao to tonify Spleen Qi.
  • Example: For Liver Qi Stagnation (irritability, PMS), use Xiao Yao San (Rambling Powder) with Chai Hu, Dang Gui, and Bai Shao to soothe the Liver and nourish Blood.
• Understand Formula Structure: Know the roles of each herb in a formula:
  • Chief (emperor) herb: Addresses the primary pattern (e.g., Chai Hu in Xiao Yao San).
  • Deputy: Assists the chief (e.g., Bai Shao in Xiao Yao San).
  • Assistant and Envoy: Support or harmonize (e.g., Gan Cao in many formulas to harmonize).
• Master Formula Modification: Learn how to adapt formulas using single herbs:
  • Example: If a patient with Spleen Qi Deficiency (Si Jun Zi Tang) also has dampness, add Cang Zhu to dry dampness.
  • Example: For Xiao Yao San with more heat signs, add Zhi Zi to clear Liver heat.
• Why It Matters: The CALE may ask you to modify a formula based on a patient’s symptoms or select the right formula for a given TCM diagnosis, reflecting real world clinical skills.

Herb-Drug Interactions and Safety

• Understand Interactions: Know how herbs interact with Western medications:
  • Example: Avoid using Dang Gui or other Blood-invigorating herbs (e.g., Chuan Xiong) in patients on anticoagulants like warfarin, as they may increase bleeding risk.
  • Example: Ma Huang (ephedra) can raise blood pressure—avoid in patients on antihypertensives or with heart conditions.
• Study Resource: Use a pharmacology text like Essentials of Medical Pharmacology by KD Tripathi to understand drug mechanisms, and cross-reference with a TCM herbology book for interactions. You can also use our Pathology and Pharmacology Deck.
• Why It Matters: The CALE tests your ability to practice safely, especially in California where acupuncturists often work alongside Western medical providers. You might get questions like, “What herb should you avoid in a patient on blood thinners?”

Integration with TCM Diagnosis

• Link Herbs to Patterns: Herbal prescriptions on the CALE must align with the patient’s TCM diagnosis:
  • Example: For Kidney Yin Deficiency (night sweats, tinnitus), use herbs like Shu Di Huang or Shan Zhu Yu to nourish Yin, not Yang tonics like Lu Rong.
  • Example: For Damp Heat in the Lower Jiao (UTI symptoms), use Huang Bai and Cang Zhu to clear heat and dry dampness.
• Connect to Foundations: Use your knowledge of Yin/Yang, Five Elements, and Zang Fu to justify herb selection.
• Why It Matters: The exam often integrates herbal medicine with TCM diagnosis, so you’ll need to show how your herb choices address the patient’s pattern.

Study Tips for the Chinese Herbal Medicine Section

• Use Herbology Deck: Use our herb study cards to memorize herb functions, properties, and contraindications. Use our formula study cards to memorize the TCM diagnosis, functions, contraindications, tongue & pulse, formula structure, and list of ingredients. 
• Practice Scenarios: For a given condition (e.g., “Patient with insomnia due to Heart Blood Deficiency”), select a formula (e.g., Suan Zao Ren Tang) and justify your choice based on TCM diagnosis.
• Group Study: Discuss formulas with friends to reinforce learning. Quiz each other on modifications!
• Mock Exams: Take practice tests to get familiar with question styles (e.g., multiple-choice on herb selection or contraindications).
  • We’ve kicked off practice questions on Boncho School! Our team is hard at work building more practice questions and tests, and once they’re ready, we’ll announce it through our email newsletter. Be sure to sign up at bonchofriends.com and stay tuned for updates! 📩

Key Areas to Study for the TCM Foundations Section of CALE 

Know the Core TCM Theories: 

• Focus on Major Concepts:
  • Yin and Yang: Understand the balance and interplay (e.g., Yang excess can lead to heat symptoms like irritability; Yin deficiency can cause dryness like night sweats).
  • Five Elements Theory: Know the relationships! Generating cycle (e.g., Wood generates Fire), controlling cycle (e.g., Water controls Fire), and their clinical implications (e.g., a Wood imbalance might affect the Liver, causing anger or eye issues).
  • Zang Fu Organs: Learn the functions and relationships of the Zang (Yin) and Fu (Yang) organs (e.g., the Spleen transforms and transports food essence; the Liver stores Blood and regulates Qi flow).
  • Qi, Blood, and Body Fluids: Understand their roles and how imbalances manifest (e.g., qi deficiency = fatigue; Blood stasis = sharp pain).
• Details to Master for Each Concept:
  • Characteristics: What defines each concept? (e.g., Yin is cooling, nourishing; Yang is warming, active.)
  • Interrelationships: How do they interact? (e.g., Spleen Qi deficiency can lead to dampness.)
  • Clinical Applications: How do they guide diagnosis and treatment? (e.g., Five Elements can explain why a Liver issue might cause Spleen disharmony—Wood over controls Earth.)
• Why It Matters: The CALE tests your ability to apply TCM theory to clinical scenarios, such as selecting points or herbs based on a patient’s Yin/Yang or Five Elements imbalance.

Eight Principles: Framework for Diagnosis

• Learn the Eight Principles: These are the foundation for pattern differentiation:
  • Interior/Exterior: Where is the disease located? (e.g., Exterior = wind-cold invasion; Interior = Spleen Qi deficiency.)
  • Cold/Heat: What is the nature of the condition? (e.g., Heat = red tongue, rapid pulse; Cold = pale tongue, slow pulse.)
  • Deficiency/Excess: Is the body weak or overactive? (e.g., Deficiency = fatigue; Excess = acute pain.)
  • Yin/Yang: The overarching balance (e.g., Yang excess = agitation; Yin deficiency = night sweats.)
• Understand Their Application: Use the Eight Principles to categorize symptoms and guide treatment (e.g., an Exterior Heat Excess pattern might need cooling herbs like Bo He).
• Why It Matters: The CALE often presents patient scenarios where you’ll need to identify patterns using the Eight Principles to choose the right treatment strategy.

Channels and Collaterals: The Pathways of Qi

• Study the Meridian System: Know the 12 primary channels, their pathways, and their associated Zang Fu organs:
  • Example: The Lung channel runs from the chest to the thumb (LU 1 to LU 11); it’s paired with the Large Intestine channel.
• Understand Extraordinary Vessels: Learn the functions of the Eight Extraordinary Vessels (e.g., Ren Mai nourishes Yin and governs conception; Du Mai governs Yang and the spine).
• Why It Matters: The CALE may ask you to trace a meridian pathway or select points on a specific channel for a given condition.

Integration with Acupuncture and Herbal Medicine

• Link Theory to Practice: TCM foundations underpin point selection and herbal prescriptions:
  • Example: For Kidney Yang Deficiency (cold limbs, low libido), use points like KD 7 Fuliu and herbs like Rou Cong Rong to warm and tonify Kidney Yang.
  • Example: A Five Elements imbalance like Wood (Liver) over controlling Earth (Spleen) might cause bloating. Treat with points like LV 3 Taichong and SP 3 Taibai.
• Connect to Diagnosis: Use foundational knowledge to interpret symptoms (e.g., a pale tongue and weak pulse indicate Spleen Qi deficiency).
• Why It Matters: The exam tests your ability to integrate TCM theory with clinical decision making, ensuring your treatments are rooted in foundational principles.

Study Tips for the TCM Foundations Section

• Use Foundations Deck: The Foundations Deck is perfect for mastering Yin-Yang, Five Elements, and Zang Fu. Review key concepts on the go!
• Use Mnemonics: Memorize the Five Elements cycles (e.g., Generating: “Wood Feeds Fire, Fire Creates Earth, Earth Bears Metal, Metal Collects Water, Water Nourishes Wood”).
• Practice Case Studies: Apply theory to scenarios (e.g., “Patient with irritability and red eyes. How does the Liver relate to Wood?”).
• Review Regularly: TCM theory is foundational. Revisit these concepts often to ensure they’re second nature by exam day.

Key Areas to Study for the TCM Diagnosis Section of CALE

Four Diagnostic Methods: The Pillars of Assessment

• Focus on the Four Methods: Master each method to gather comprehensive diagnostic information:
  • Observation (Looking): Examine the patient’s appearance, tongue, and Shen (spirit). (e.g., Red sclera = Lung Heat; swelling under the eyes = Kidney Deficiency.)
  • Listening and Smelling: Note the patient’s voice, breathing, or body odor (e.g., a weak voice = Qi deficiency; foul breath = Stomach heat).
  • Inquiry (Asking): Ask about symptoms, medical history, and lifestyle (e.g., “Do you feel cold often?” might indicate Yang deficiency).
  • Palpation (Touching): Feel the pulse and palpate areas like the abdomen (e.g., a wiry pulse = Liver Qi stagnation).
• Details to Master for Each Method:
  • Observation Signs: Know what to look for (e.g., a pale, swollen tongue = Spleen Qi deficiency; a red tongue tip = Heart fire).
  • Pulse Diagnosis: Understand the 28 pulse types (e.g., slippery = dampness; rapid = heat).
  • Key Questions: Learn the 10 classic questions (e.g., chills/fever, perspiration, appetite, sleep).

Pattern Differentiation: Identifying the Root Cause

• Master Pattern Identification: Differentiate patterns using the Eight Principles, Zang Fu, and Six Stages:
  • Eight Principles: Combine Interior/Exterior, Cold/Heat, Deficiency/Excess, Yin/Yang
  • Zang Fu Patterns: Identify organ imbalances (e.g., Liver Fire Blazing = headache, red eyes, anger).
  • Six Stages: Understand disease progression (e.g., Tai Yang stage = wind cold with headache, stiff neck).
• Why It Matters: The CALE tests your ability to diagnose patterns accurately, which directly informs your treatment plan (e.g., selecting points or herbs).

Tongue and Pulse Diagnosis: Key Diagnostic Tools

• Tongue Diagnosis: Know how to interpret tongue signs:
  • Color: Pale = deficiency, red = heat, purple = stasis.
  • Coating: Thick = excess/dampness, peeled = Yin deficiency.
  • Shape: Swollen = dampness, thin = deficiency.
  • Example: A red tongue with a yellow, greasy coating = damp heat.
• Pulse Diagnosis: Understand pulse qualities and positions:
  • Qualities: Rapid = heat, slow = cold, wiry = stagnation, weak = deficiency.
  • Positions: Each position corresponds to an organ (e.g., left cun = Heart, right cun = Lung).
  • Example: A slippery, rapid pulse at the right guan position = Spleen damp heat.

Red Flags and Referrals: When to Act

• Recognize Serious Signs: Identify symptoms requiring referral to a Western medical provider:
  • Example: Sudden severe chest pain (possible heart attack) = refer immediately.
  • Example: Unexplained weight loss and night sweats (possible cancer) = refer for evaluation.
• Study Resource: Cross-reference with biomedicine knowledge (e.g., Robbins and Kumar Basic Pathology or our Pathology and Pharmacology Deck) to understand Western red flags.
• Why It Matters: The CALE tests your ability to recognize when a condition is beyond your scope, per California law (§ 4955 on unprofessional conduct).

Study Tips for the TCM Diagnosis Section

• Practice Observation: Look at tongue images online or in books (e.g., Tongue Diagnosis in Chinese Medicine by Giovanni Maciocia) to identify patterns.
• Pulse Training: Practice pulse-taking with a mentor or classmates to distinguish qualities like wiry vs. slippery.
• Case Studies: Analyze patient scenarios (e.g., “Patient with fatigue, pale tongue, weak pulse—what’s the pattern?”) and propose a diagnosis.
• Use Diagnosis Deck: The Diagnosis Deck helps you memorize key signs (e.g., “Red sclera = Lung Heat”) and practice pattern differentiation.

Acuproacademy: Offers online courses, videos, podcasts, and illustrated guides like AcuExams Made Easy. Best for those who prefer comprehensive learning with theory and case studies.

Boncho Friends: Specializes in fun, visual learning with hand-drawn study cards, books, and games. Their Boncho Icons simplify complex TCM concepts, making it ideal for visual learners who want to memorize points and herbs in an engaging way. 

HB Kim (Acupuncture Media): Known for the Handbook of Oriental Medicine, video lectures. It’s highly detailed and great for students who want a comprehensive, systematic approach. Best for disciplined learners who can handle in depth material.

Linda Morse (Acupuncture Review Classes): Offers video courses, flashcards, and private tutoring, with a focus on CALE and NCCAOM prep. Her teaching is clear, concise, and exam-focused, often paired with test-taking strategies and live Q&A sessions. Ideal for students who need structured guidance and personalized support.

TCM Study: Provides video lectures, cheat sheets, practice tests, and point location videos, focusing on channel theory. It’s a good fit for students who need straightforward resources to review meridians and points. Best for focused, self-paced learners.

Everyone’s prep journey is unique, so find the tools that work for you! Our team at Boncho Friends has created simple, fun, and easy study cards to help you ace the CALE, NCCAOM, and Pan-Can exams.