Chiropractic education

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Chiropractic education trains future chiropractic practitioners (chiropractors). The entry criteria, structure, teaching methodology and nature of chiropractic programs offered at chiropractic schools vary considerably around the world.

Chiropractic medicine is currently formally regulated in approximately 60 countries although chiropractors are also practicing in several other countries where there is no formal legal recognition of the profession at this time^{[citation needed]}. To help standardize and ensure quality of chiropractic education and patient safety, in 2005 the World Health Organization published the official guidelines for basic training and safety in chiropractic ^[1] Most commonly, chiropractors obtain a first professional, second entry, degree in Chiropractic medicine. Typically a 3 year university undergraduate education is required to apply for the chiropractic degree.^[2][3] In general, the World Health Organization lists three major educational paths involving full‐time chiropractic education across the globe:

• A four‐year full‐time programme within specifically designated colleges or universities, with suitable pre-requisite training in basic sciences at university level;
• A five‐year bachelor integrated chiropractic degree programme offered within a public or private university
• A two or three‐year pre‐professional Masters programme following the satisfactory completion of a specifically designed bachelor degree programme in chiropractic or a suitably adapted health science degree.

Regardless of the model of education utilized, prospective chiropractors without relevant prior health care education or experience, must spend no less than 4200 student/teacher contact hours (or the equivalent) in four years of full‐time education. This includes a minimum of 1000 hours of supervised clinical training. ^[4] Health professionals with advanced clinical degrees, such as medical doctors, can can meet the educational and clinical requirements to practice as a chiropractor in 2200 hours, which is most commonly done in countries where the profession is in its infancy. ^[5] Upon meeting all clinical and didactic requirements of chiropractic school, a degree in chiropractic medicine is granted. However, in order to legally practice, chiropractors, like all self regulated health care professionals, must be licensed.

All Chiropractic Examining Board requires all candidates to complete a 12 month clinical intership to obtain licensure. Licensure is granted following successful completion of all state/provincial and national board exams so long as the DC maintains malpractice insurance. Nonetheless, there still some variations in educational standards internationally depending on admission and graduation requirements. Chiropractic medicine is regulated in North America by state/provincial statute. The regulatory colleges are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.^[6]

Contents 1 Chiropractic education, licensure, and regulation 1.1 United States 1.2 Canada 1.3 Australia 1.4 United Kingdom 1.5 South Africa 2 Federation of Chiropractic Licensing Boards 3 Chiropractic schools 4 Council on Chiropractic Education 5 See also 6 References

[edit] Chiropractic education, licensure, and regulation

[edit] 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.[2]

Students often enter chiropractic school with a Bachelor's degree, but, in 2005, only one chiropractic college required this as an admission requirement. [3] 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.

[edit] 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. ^[7]

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. ^[8] 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. ^[9] Additionally, CMCC offers chiropractic graduate studies in sport sciences, clinical sciences, and radiology following the 4 year Doctor of Chiropractic Degree ^[10]. CMCC also offers a 1 year continuing education programme in acupuncture. In contrast, the doctorate of chiropractic degree in Quebec is within a publicly 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.

In addition to the academic program, chiropractic education requires hands-on clinical experience under faculity supervision. This experience includes clinical assessment, diagnosis, treatment, and referral protocols. The multi-disciplinary faculty at both CMCC and UQTR have diverse backgrounds including MD's and PhD's that offer students a wide range of expertise in the medical and clinical sciences. 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. Additionally, 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.

Canadian Chiropractic Examining Board requires all candidates to complete a 12 month clinical internship 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. ^[11] 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. ^[12]

[edit] Australia

In Australia, a minimum of five-years worth of chiropractic education is needed before one may register as a practising chiropractor. Chiropractic is taught at three public universities: RMIT in Melbourne, Murdoch University in Perth and Macquarie University in Sydney. The RMIT and Macquarie programs graduate chiropractors with a bachelors degree followed by a masters degree while Murdoch University graduates attain a double bachelors degree, any of which is necessary for registration with state registration boards.[4]

A graduate of RMIT will have attained a Bachelor of Applied Science (Complementary Medicine and/or Chiropractic) and a Master of Clinical Chiropractic. Similarly, a typical graduate of Macquarie University will have a Bachelor of Chiropractic Science followed by a Master of Chiropractic. Murdoch University graduates possess the double-degree of Bachelor of Science (Chiropractic Science) / Bachelor of Chiropractic.

The Council on Chiropractic Education Australasia undertakes accreditations of Australasian chiropractic courses [5]

[edit] United Kingdom

There are three UK chiropractic colleges with chiropractic courses recognised[6] by the General Chiropractic Council (GCC), the statutory governmental body responsible for the regulation of chiropractic in the UK.

The AECC graduates chiropractors with an undergraduate Masters degree (MChiro). The WIOC has also recently changed from a Bsc to an Mchiro programme.

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 [7].

[edit] 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 an 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.

[edit] Federation of Chiropractic Licensing Boards

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.^[13]

[edit] Chiropractic schools

See also: List of 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. Chiropractic schools, curriculums, paradigms and scope of practice differ accordingly to the dominant belief structures within chiropractic. These clinical and philosophical approaches primarily include straight principle/subluxation-based chiropractic, mixer chiropractic and reform chiropractic.

[edit] Council on Chiropractic Education

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.

[edit] See also

• Medical school
• Veterinary school

[edit] References