Chiropractic - Education

Editor-in-Chief: Dr. Stephen J. Press [mailto:drsjp@drpress.com]

Chiropractic Main Article

United States
Graduates of chiropractic schools receive the degree Doctor of Chiropractic (DC), are referred to as "doctor", and are eligible to seek licensure in all jurisdictions. The Council on Chiropractic Education (CCE) sets minimum guidelines for chiropractic colleges, but additional requirements may be needed for a license depending on the jurisdiction where a chiropractor chooses to practice. All 19 chiropractic institutions are accredited by the CCE. In 1991, the University of Bridgeport established its College of Chiropractic, becoming the first chiropractic school in the USA to be affiliated with a university.

Students often enter chiropractic school with a Bachelor's degree, but, in 2005, only one chiropractic college required this as an admission requirement. The minimum prerequisite for enrollment in a chiropractic college set forth by the CCE is 90 semester hours, and the minimum cumulative GPA for a student entering is 2.50. Commonly required classes include: psychology, biology, organic and inorganic chemistry, and physics. Other common medical classes are: anatomy or embryology, physiology, microbiology, diagnosis, neurology, x-ray, orthopedics, obstetrics/gynecology, histology, and pathology. Chiropractic programs require at least 4,200 hours of combined classroom, laboratory, and clinical experience. The last 2 years stress courses in manipulation and spinal adjustment and provide clinical experience in physical and laboratory diagnosis, orthopedics, neurology, geriatrics, physiotherapy, and nutrition.

To qualify for licensure, graduates must pass 4 examinations from the National Board of Chiropractic Examiners and complete State specific requirements; most State boards require at least 2 years of undergraduate education, and an increasing number require a 4-year bachelor’s degree. All licensing boards in the US require the completion of a 4-year program at an accredited college leading to the DC degree. Once licensed, most States require chiropractors to attend 12-50 hours of continuing education annually. Chiropractic colleges also offer postdoctoral training in neurology, orthopedics, sports injuries, nutrition, rehabilitation, industrial consulting, radiology, family practice, pediatrics, and applied chiropractic sciences. After such training, chiropractors may take exams leading to "diplomate" status in a given specialty including orthopedics, neurology and radiology.

Canada
There are currently 2 schools of chiropractic in Canada; Canadian Memorial Chiropractic College, in Toronto, Ontario and the Universite du Quebec a Trois Rivieres, in Trois Rivieres, Quebec. Both programs are fully accredited by the Council on Chiropractic Education of Canada. Canadian Chiropractic students undergo a course of study similar to that of other doctoral-level health care professionals, including medicine, optometry and dentistry and have similar entrance requirements. Students are required to complete a minimum of three years of university before they are eligible for admission to the CMCC Doctorate of Chiropractic Degree program. Approximately 90 per cent of students entering the CMCC program have completed a baccalaureate or graduate university degree. The CMCC program is a privately funded institution and requires four years of full-time study, including a 12-month clinical internship. Both the CMCC and the UQTR programs include courses in anatomy, neuroanatomy, neurodiagnosis, neuroscience, biochemistry, physiology, orthopaedics, diagnosis and symptomotalogy, laboratory diagnosis, embryology, principles of chiropractic, radiology, immunology, microbiology, pathology, clinical nutrition and other basic and clinical medical sciences. In terms of manual therapy skills, the psychomotor department of CMCC teaches the diversified technique for spinal manipulative therapy, and have formally introduced soft tissue techniques in 2006.

Canadian chiropractic schools teach an evidence-based medicine paradigm as opposed to the traditional vertebral subluxation model. The chiropractic schools state that the role of the doctor of chiropractic is primary care for neuromusculoskeletal conditions. The doctor of chiropractic assess, diagnose and treat biomechanical dysfunctions of the neuromusculoskeletal system. In addition to manual therapy which may include spinal manipulation and soft tissue mobilization, DC's may prescribe corrective exercises, make nutritional recommendations, emphasize healthy lifestyle practices and other natural, holistic means. Doctors of chiropractic can, depending on the province, order x-rays, MRI, CT-Scan, diagnostic ultrasound, bone scans and other imaging that would facilate a diagnosis and plan of management. Furthermore, there is increasing multi-discplinary collobaration between DC's and other health professionals for co-managing patient care.

Four Canadian public universities currently have government-funded Canada Research Chairs in Chiropractic, with plans to have at least one in each of Canada's 10 provinces in the near future. Pilot projects involving doctors of chiropractic in hospitals in the province of Ontario are underway. In August 2005, CMCC became the first private institution in Ontario to be granted the privilege of offering a professional health care degree under the Post-secondary Education Choice and Excellence Act. It sets the program within the hierarchy of education in Ontario as comparable to that of other primary contact health care professions, such as medicine, dentistry, and optometry. As of 2005, graduates of CMCC are formally recognized to have at least 7-8 years of university level education which will facilitate the acceptance of credits if they choose to further their education at the post graduate level. Additionally, CMCC offers chiropractic graduate studies in sport sciences, clinical sciences, and radiology following the 4 year Doctor of Chiropractic Degree. CMCC also offers a 1 year continuing education programme in acupuncture. In contrast, the doctorate of chiropractic degree in Quebec is within a publically funded university (UQTR) and is a five-year program following graduation from CÉGEP, a system of education that is unique to the province of Quebec.

Canadian Chiropractic Examining Board requires all candidates to complete a 12 month clinical intership to obtain licensure, as well as write a total of 3 exams in their 4th year of study. Candidates must successfully pass Components A and B (Written Cognitive Skills Examination) to be eligible for the Clinical Skills Examination. Canadian accrediting standards are higher than the United States, and admission requirements into the Doctorate of Chiropractic Degree programme are the strictest in North America.

Australia
In Australia, chiropractic is taught at three public universities: RMIT in Melbourne, Murdoch University in Perth and Macquarie University in Sydney. The RMIT and Maquarie programs graduate chiropractors with a masters while Mudoch University graduates attain a double bachelors degree, any of which is necessary for registration with state registration boards.

United Kingdom
There are three UK chiropractic colleges with chiropractic courses recognised by the General Chiropractic Council (GCC), the statutory governmental body responsible for the regulation of chiropractic in the UK. These are:
 * Anglo-European College of Chiropractic (AECC), accredited by Bournemouth University,
 * McTimoney College of Chiropractic (MCC), accredited by the University of Wales and,
 * Welsh Institute of Chiropractic (WIOC) a faculty of and accredited by University of Glamorgan.

The AECC graduates chiropractors with a undergraduate Masters degree (MChiro). The WIOC graduate chiropractors with a BSc (Hons) Chiropractic and so does the MCC graduate chiropractors with a BSc (Hons) Chiropractic. It is a legal requirement that all chiropractors in the UK register with the GCC to practice. A minimum of 30 hrs per annum Continuing Professional Development is required to retain registration.

South Africa
In SA there are two schools of chiropractic: 1.Durban Institute of Technology and, 2. University of Johannesburg Doornfontein campus. They are both 6 year full-time courses leading to a MTECH or Masters of technology in Chiropractic.

It's a legal requirement that chiropractors must be registered with the Allied Health Professions Council of SA (AHPCSA) the governmental statutory body in order to practice Chiropractic in SA. Being a member of the Chiropractic Association of SA (CASA) is voluntary. CASA is the only voluntary national association in the country and aims to promote the profession through publications in newspaper, interviews, internet and public enquires over the phone.

Currently continuing professional development (CPD) education is not compulsory in order to stay registered with the AHPCSA only keeping up to date with the council's annual registration fees are.

Federation of Chiropractic Licensing Boards

 * See main article: Federation of Chiropractic Licensing Boards

The FCLB is a conglomeration of all 50 US state licensing boards and the District of Columbia. It also includes several Canadian provinces and US territories. Its stated purpose is to protect the public and to serve the member boards by promoting excellence in chiropractic regulation.

Chiropractic schools

 * See main article: Chiropractic schools

A chiropractic school is an institution involved in the education of future chiropractic practitioners (chiropractors). The entry criteria, structure, teaching methodology and nature of chiropractic programs offered at chiropractic schools vary considerably around the world.

Council on Chiropractic Education

 * ''See main article: Council on Chiropractic Education

The Council on Chiropractic Education - USA (CCE-USA) is an agency for accreditation of programs and institutions offering the doctor of chiropractic degree. Its accreditations are recognized by the U.S. Department of Education. It seeks to insure the quality of chiropractic education in the United States by developing accreditation standards, encouraging educational improvement and providing public information.