Acupuncture and Related Therapies 4 (2016) 1–5 Contents lists available at ScienceDirect Acupuncture and Related Therapies journal homepage: www.elsevier.com/locate/arthe Adverse events during acupuncture training at the 3rd Edition of the Post-Graduation on Medical Acupuncture at Health Sciences School of the University of Minho Gustavo Pereira a,b,c , Alexandra Mesquita d , António Paulo Martins-da-Encarnac ¸ ão e,f,g,* a Anesthesiology Resident at Hospital de Braga, Competence in Medical Acupuncture, Portugal b Instructor of the University of Minho School of Health Sciences Post-Graduation Course on Medical Acupunctur, Portugal c Instructor of the NOVA Medical School (Lisbon) Post-Graduation Course on Medical Acupuncture, Portugal d Family Medicine Resident at USF Amares Saúde, Amares, Portugal e Physical Medicine and Rehabilitation Specialist, Competence in Medical Acupuncture, Portugal f Organizing Commission of the University of Minho School of Health Sciences Post-Graduation Course on Medical Acupuncture, Portugal g Organizing Commission of the NOVA Medical School (Lisbon) Post-Graduation Course on Medical Acupuncture, Portugal a r t i c l e i n f o Article history: Received 16 July 2016 Accepted 8 August 2016 Available online 9 August 2016 Keywords: Acupuncture Needling Adverse effects a b s t r a c t Acupuncture is a therapeutic technique in which fine solid metal needles are inserted into the body and manipulated, in order to elicit local, segmental and extra-segmental effects, thus modulating the activity of the Peripheral and Central Nervous System (including the activity of the Autonomic Nervous System). Training on Acupuncture for medical doctors usually involves peer practice of needling throughout the duration of the training program. It is expected that the occurrence of adverse events during training reflects the most common adverse events reported during acupuncture practice. We recorded all of the adverse events reported by the trainees of the 3rd Edition of the medical acupuncture training program of the Health Sciences School of the University of Minho (HSS-UM) and classified them according to the Common Terminology Criteria for Adverse Events (CTCAE, version 4.0, June 2010). The most common events reported, as we expected, were pain and bruising. We conclude acupuncture training is safe, as mostly minor effects occurred during the training program, bruising and pain being the most common. We also concluded that the CTCAE is a valuable tool for classification of acupuncture related adverse events. © 2016 Elsevier GmbH. All rights reserved. 1. Introduction Acupuncture is a therapeutic technique in which fine solid metal needles are inserted into the body, usually onto the muscle tis- sue, and stimulated manually or electrically, in order to elicit local, segmental and extra-segmental effects, with the objective of mod- ulating the activity of the Peripheral, Central and the Autonomic Nervous System [1]. Acupuncture is a very safe therapeutic technique, especially when its practitioners have training in anatomy and adequate needling technique [2]. Post-graduation training in acupuncture for Medical Doctors at public medical schools in Portugal has started in 2003, and since more than 300 Medical Doctors have been trained. * Corresponding author. E-mail address: antoniopauloencarnacao@yahoo.co.uk (A.P. Martins-da-Encarnac ¸ ão). Surface anatomy and safe needling techniques take a large part of the training programs of Medical Acupuncture. Especially, when training in Western Style Acupuncture (WSA), the training in sur- face anatomy, muscle palpation and testing and deep needling techniques skills are the major components of the training program [3]. Our group has been involved in the training of medical doctors in Acupuncture since 2005, having participated in the development of two WSA oriented post-graduation training programs, at the NOVA Medical School, in Lisbon, and at the HSS-UM, in Braga [3]. During the course, students will practice needling in their peers, under instructor supervision. Needling techniques taught during the Course Program include electro-acupuncture, auriculotherapy, trigger point Dry Needling, needling into para-spinal and abdom- inal muscles for segmental stimulation, distal needling, both into muscle tissue and also near neuro-vascular bundles. In order to keep needling practice as safe as possible, trainees are required to study the insertion locations anatomy before needling practice. Anatomy and safety concerns are reviewed and the correct needling http://dx.doi.org/10.1016/j.arthe.2016.08.001 2211-7660/© 2016 Elsevier GmbH. All rights reserved.