Abstract
Chinese medicine education increasingly crosses national, institutional and regulatory boundaries, yet its evidence base remains fragmented across empirical studies, historical accounts, programme descriptions, policy analyses and technology-supported teaching reports. The central curriculum challenge is to preserve epistemic and cultural identity while demonstrating patient safety, educational quality and public accountability. We conducted a critical integrative review using targeted searches of PubMed, Google Scholar, journal websites, institutional repositories and backward citation tracking, updated through 16 July 2026. Empirical, policy, historical and conceptual sources were charted across regional context, curriculum architecture, clinical education, regulation and accreditation, research literacy, and digital pedagogy. The synthesis was interpretive rather than exhaustive and used iterative comparison to identify recurrent curriculum tensions and derive a theory-informed framework. Across China, Australia, the United Kingdom, Canada, the United States and selected additional settings, the literature indicates shared commitments to safe and competent practice but marked differences in learner backgrounds, clinical resources, regulation, research expectations and public legitimacy. Recurrent tensions concern heritage knowledge vs external accountability, contact-hour equivalence vs demonstrated competence, clinical exposure vs local scope-of-practice restrictions, and digital innovation vs pedagogical governance. Internationalization is better understood as curriculum negotiation than curriculum export. We propose six linked domains: epistemic and cultural foundations; biomedical and safety literacy; clinical competence and entrustment; research and evidence translation; intercultural and interprofessional competence; and responsible digital and AI-enabled pedagogy. The framework is a theory-informed design tool that requires empirical validation through curriculum audits, consensus studies, assessment validation and graduate outcome research.