Chiropractic education

Founded in 1945, the Canadian Memorial Chiropractic College, in Toronto, Ontario, Canada.

Chiropractic education trains future chiropractors. The entry criteria, structure, teaching methodology and nature of chiropractic programs offered at chiropractic schools vary considerably around the world.^[1] To help standardize chiropractic education, in 2005 the World Health Organization published guidelines for basic training in chiropractic.^[2] In general, the World Health Organization lists three potential educational paths involving full‐time chiropractic education across the globe. This includes: 1 – 4 years of pre-requisite training in basic sciences at university level followed by a 4 year full‐time Doctorate program; DC. A 5 year integrated bachelor degree; BSc (Chiro). A 2 - 3 year Masters program following the completion of a bachelor degree; MSc (Chiro).^[3]

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.^[3] Health professionals with advanced clinical degrees, such as medical doctors, 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.^[2] Upon meeting all clinical and didactic requirements of chiropractic school, a degree in chiropractic is granted.

The fourth year of education persistently showed the highest stress levels. Every student, irrespective of year, experienced different ranges of stress when studying.^[4] The chiropractic leaders and colleges have had internal struggles. Rather than cooperation, there has been infighting between different factions. A number of actions were posturing due to the confidential nature of the chiropractic colleges in an attempt to enroll students.^[5]

Chiropractic career

In the United States, mean annual wage of chiropractors was $79,550 in May 2012.^[6] An estimated 52,600 chiropractic jobs exist, with a faster than average job growth outlook through 2020.^[7]

According to Health Resources and Services Administration (HRSA), 52% of health professionals in the United States in default on Health Education Assistance Loans (a program running from 1978 to 1998^[8]) in 2013 are chiropractors,^[9] representing approximately 0.89% of total chiropractors.^[7] In Canada, only 1% of chiropractic graduates defaulted on their student loans.^[10]

Components

Basic sciences

Recognized programmes either require essential basic science components as prerequisites, or include necessary units of chemistry, physics and biology within the first‐year curriculum.

Pre-clinical sciences

The preclinical science components within chiropractic programmes generally include: anatomy, physiology, biochemistry, pathology, microbiology, pharmacology and toxicology, psychology, dietetics and nutrition, and public health.

Clinical sciences

Clinical science components would include or cover: history‐taking skills, general physical examination, laboratory diagnosis, differential diagnosis, radiology, neurology, rheumatology, eyes, ears, nose and throat, orthopaedics, basic paediatrics, basic geriatrics, basic gynaecology and obstetrics, and basic dermatology.^[3]

International degrees in Chiropractic

Licensure and regulation

Regulations for chiropractic practice vary considerably from country to country. In some countries, such as. the United States of America, Canada and some European countries, chiropractic has been legally recognized and formal university degrees have been established. In these countries, the profession is regulated and the prescribed educational qualifications are generally consistent, satisfying the requirements of the respective accrediting agencies. However, many countries have not yet developed chiropractic education or established laws to regulate the qualified practice of chiropractic. In addition, in some countries, other qualified health professionals and lay practitioners may use techniques of spinal manipulation and claim to provide chiropractic services, although they may not have received chiropractic training in an accredited programme.

United States

Graduates of chiropractic schools receive the degree Doctor of Chiropractic (DC), and are eligible to seek licensure in all jurisdictions. The Council on Chiropractic Education (CCE) sets minimum guidelines for chiropractic colleges;^[11] all 18 chiropractic institutions are accredited by the CCE. 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 2.5 on a 4.0 scale.^[12] Common prerequisite classes include those of the biological, chemical, & physical sciences, including: human anatomy and physiology, embryology, genetics, microbiology, immunology, cellular biology, exercise physiology, kinesiology, general chemistry, organic chemistry, analytical chemistry, biochemistry, toxicology/pharmacology, nutrition, nuclear medicine, physics, biomechanics, and statistics.^[13] In 1997, American chiropractic schools tended to have lower entry requirements than medical or dental schools.^[14] In 2005, only one chiropractic college required a bachelors degree as an admission requirement.^[15]

Australia

In Australia, a minimum of five-years worth of chiropractic education is needed before one may register as a practicing chiropractor. Chiropractic is taught at four public universities: RMIT in Melbourne, Murdoch University in Perth, Macquarie University in Sydney and new in 2012 Central Queensland University in Mackay. The RMIT, UCQ 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.^[16]

A graduate of RMIT will have attained a Bachelor of Applied Science (Chiropractic) and a Master of Clinical Chiropractic.^[17] Similarly, a typical graduate of Macquarie University will have a Bachelor of Chiropractic Science followed by a Master of Chiropractic.^[18] Murdoch University graduates possess the double-degree of Bachelor of Science (Chiropractic Science) / Bachelor of Chiropractic.^[19] Students at University of Central Queensland graduate with a Bachelor of Science (Chiropractic) followed by a Master of Chiropractic Science.^[20]

Canada

There are currently two 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 Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards.^[21] In 2010, the majority of students (87%) entering the CMCC program had completed a baccalaureate university degree, and approximately 3% have a graduate degree.^[22] The CMCC program is a privately funded institution and requires four years of full-time study, including a 12-month clinical internship.^[23] The UQTR and CMCC programs both include courses in anatomy, biochemistry, embryology, immunology, microbiology, neurology, clinical nutrition, pathology, physiology, principles of chiropractic, radiology, and other basic and clinical medical sciences.^[24]

Pilot projects involving doctors of chiropractic in hospital emergency rooms in the province of Ontario are underway.^[25] Canadian Chiropractic Examining Board requires all candidates to complete a 12 month clinical internship to obtain licensure, as well as write a total of three exams in their fourth year of study. Candidates must successfully pass Components A and B (Written Cognitive Skills Examination) to be eligible for the Clinical Skills Examination.^[26] Canadian accrediting standards are higher than the United States, and admission requirements into the Doctorate of Chiropractic Degree program are the strictest in North America.^[27]

South Africa

In SA (South Africa) there are two schools of chiropractic: the Durban Institute of Technology and the University of Johannesburg.^[28] 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.

United Kingdom

In 1993, HRH Princess Diana visited the Anglo-European College of Chiropractic and became its patron. She also appeared at a news conference that launched a report calling for legislation to prevent unqualified individuals from practicing Chiropractic in the UK.^[29] In 1994, Parliament passed legislation regulating the practice of Chiropractic, like other health care professions, and creating the General Chiropractic Council as the regulatory board. Since that time, it is illegal to call oneself a Chiropractor in the UK without being registered with the General Chiropractic Council.^[30] 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.^[31]

The McTimoney College of Chiropractic offers an Undergraduate Master Degree in human Chiropractic and two post-graduate Masters programmes in Animal Manipulation, plus a masters in Paediatric Chiropractic.^[32] The Anglo-European College of Chiropractic graduates chiropractors with an undergraduate Masters degree (MChiro). The WIOC has also recently changed from a Bsc to an Mchiro programme.^{[citation needed]}

It is a legal requirement that all chiropractors in the UK register with the GCC to practice. A minimum of 30 hours per annum Continuing Professional Development is required to retain registration.^[33]

New Zealand

The College was formed in 1994 by the New Zealand Chiropractors’ Association (NZCA) to address the demand created by a shortage of chiropractors in New Zealand. Its first location was in Auckland city and its founding President was Dr Jim Stinear. By the end of 1999 New Zealand Qualifications Authority (NZQA) approval of the BSc (Chiropractic) /BSc qualification had been gained and College ownership was transferred to the NZCA Chiropractic Education Trust, a not-for-profit organisation. In 2002 the College was renamed the New Zealand College of Chiropractic. In 2005 the College obtained its first accreditation by the CCEA (Council on Chiropractic Education Australasia). The College was re-accredited in 2007 and in the same year moved to its new campus in Mount Wellington.

Fellowships and scholarly designations

Chiropractors, like other health care professionals, can pursue post-graduate education in various chiropractic specialties such as animal chiropractic, sports chiropractic as well as clinical sciences, radiology and others. There are some other chiropractic credentials, however, that are not recognized by the major health care organizations, medical or chiropractic communities. The following is a comprehensive list of the various designations that chiropractors can attain with further continuing and post-graduate education programmes.

Accreditation

Chiropractic is governed internationally by the Councils on Chiropractic Education International (CCEI). This body is officially recognized by the World Federation of Chiropractic and the World Health Organization as the accrediting agency for schools of chiropractic around the world.

In 2005, in efforts to improve consistency and equivalency in chiropractic training, the WHO published basic training and safety guidelines to provide international minimum requirements for chiropractic education and to serve as a reference for national authorities in establishing an examination and licensing system for the qualified practice of chiropractic.^[1]

See also

• Medical school

References