A Naturopathic Doctor (ND) has a total of 8 years of training. After receiving a 4 year bachelor degree they attend a 4-year graduate-level medical school and are educated in conventional medical sciences including anatomy, physiology, microbiology, immunology, clinical and physical diagnosis, laboratory diagnosis, cardiology, gastroenterology, gynecology and pediatric care. In addition to the standard medical curriculum, they are required to complete training in clinical nutrition, botanical medicine, homeopathy, physical medicine and counseling. Upon completion of medical school graduates must pass rigorous science and clinical board exams to be licensed by the state as a primary care doctor.