The National Advisory Committee on Institutional Quality and Integrity (NACIQI) voted to reject the renewal bid for the Council on Naturopathic Medical Education (CNME), citing concerns about student outcomes and the accreditor’s integrity as a reliable authority. NACIQI’s vote was 12-0, while several committee members were absent, and the case now moves to the U.S. Department of Education for a final determination. NACIQI members challenged CNME’s rationale for weaker outcomes, including references to student demographics—such as CNME’s member institutions primarily enrolling working adults with an average age of 33. Critics also raised concerns about faculty expertise at member institutions, inadequate oversight, and heavy student debt and limited career prospects. CNME supporters argued CNME-accredited programs are rigorous and comparable to conventional medical training and that debt issues are systemic across health care. Still, the rejection is described as rare and could affect recognition, even though CNME has not yet lost recognition.