Chiropractic Education, Schools, and Career Overview

Chiropractors are members of an alternative medicine community who focus on correcting disorders of the skeleton and musculature. Although chiropractors are most often associated with the work they perform directly on the spine and surrounding tissue to help relieve neck, shoulder, and back pain, the work they perform does not necessarily stop there. The body is comprised of many complex systems, but they all interconnect in some way to the spinal column and central nervous system. Because of this interrelation, chiropractic work can be far reaching in its ability to address a multitude of other issues.

Specializations in Chiropractic Bodywork

Options are available in chiropractic medicine for specializing in working with a specific clientele. The additional certification necessary to practice a specialized form of chiropractic medicine is called a diplomate. Examples of specialized chiropractic diplomates include:

• Pediatrics
• Geriatrics
• Sports
• Wellness
• Animal adjusting

Doctor of Chiropractic, Alta Mahan, explains how additional diplomates can broaden the scope of practice available to a practitioner, while at the same time allowing them to refine their practice so as to work with a specific type of client, "Earning additional diplomates doesn't mean we don't work on other cases as well. In our office we have quite a big auto accident clientele, and the doctor I work with tends to work more with geriatrics."

Programs for specialized forms of chiropractic bodywork are available through the same chiropractic schools that provide the Doctor of Chiropractic (DC) credential.

How to Become a Chiropractor

Most students spend a total of between eight and nine years in college to prepare for a chiropractic career. The U.S. Bureau of Labor Statistics (BLS.gov) indicates that chiropractors must earn a Doctor of Chiropractic degree from a program accredited by the Council on Chiropractic Education (CCE).

Degree Programs

The Doctor of Chiropractic (DC) is a doctoral-level degree program that requires the successful completion of between four and five years of chiropractic college after earning a four-year Bachelor of Science (BS) degree.

Prerequisites

Chiropractic programs often have high standards for admission. In addition to completing a Bachelor of Science (BS) degree, applicants may also be required to complete specific course requirements in the social sciences and humanities. Coursework in subjects such as finance, business law and nutrition may also be required by some programs. A grade point average of 2.75 or better is often required for admission to an accredited DC program, although exact GPA requirements vary from program to program.

Doctoral Degree Coursework

Students in Doctor of Chiropractic programs can expect comprehensive training in the various assessment and diagnostic techniques specific to chiropractic medicine, such as:

• Postural assessment
• Human developmental diagnosis
• Diagnosis and management of extremities
• Correlative image assessment
• Advanced imaging techniques

Classes that train students in the various techniques used in performing chiropractic bodywork are spaced throughout the four or five years of schooling. These classes are introduced at appropriate stages in the academic process after related biological study and assessment techniques are mastered. Technique classes common to all chiropractic education programs include:

• Psychomotor skills
• Intro to palpation
• Spinal assessment
• Extremities technique
• Soft tissue techniques
• Flexion Distraction Technique

First-year students of chiropractic medicine can expect to learn about:

• Cell and tissue biology
• Neuroscience
• Biochemistry
• Philosophy and history of the practice of chiropractic medicine
• Spinal radiology
• Nutrition and metabolism

Second- and third-year students would begin to explore:

• Clinical microbiology
• Environmental health
• Emergency procedures
• Bone and joint imaging
• Visceral pathology
• Musculoskeletal physiopathology
• Chiropractic theory
• Principles of physiopathology

Fourth- and fifth-year students typically focus on:

• Passive and active care
• Patient communication
• Clinical psychology
• Concepts in pharmacology
• Ethics and law

To prepare students for a career in chiropractic medicine, many schools also include classes in business practices that aim to prepare students for how to:

• Acquire an independent practice from a doctor entering retirement
• Join a partnership
• Establish an independent practice from the ground up

Hands-On Training: The Clinical Component

A chiropractic school usually requires at least two trimesters of clinical training. This means students work in the live setting of a school-based clinic for first-hand exposure. The first trimester of clinic is called Student Clinic during which time students are only allowed to work on fellow classmates. This portion is completed once a certain number of adjustments are performed under the observation of a clinic instructor. During the time of the Student Clinic, students also take their radiologic imaging classes, which require them to actually take X-ray images and diagnose the ailments that these images reveal.

The next portion of clinical training involves at least two trimesters of performing outpatient adjustments: treating actual paying patients within the school's clinic. Students perform the full chiropractic exam and treatment under the observation of a clinic instructor. This includes X-raying, diagnosing, and treating patients' subluxations with the various techniques of chiropractic adjustment. During this part of the clinical training component of chiropractic college, students are responsible for retaining clients, and either administering the appropriate treatment or making referrals to other medical professionals as needed.

Internships

After students have completed the clinical requirements of the chiropractic program, they may elect to go out into the field and work with a practicing chiropractic physician in what is referred to as a preceptorship. During a preceptorship students would typically be restricted from performing adjustments and their participation would be limited to performing exams, and observing the treatment administered by the resident chiropractor. In a very few states, students are allowed to perform adjustments during their preceptorship.

Check with your chosen institution for specific details on their program's course offerings and internship requirements.

Licensure

All chiropractors who wish to practice in the U.S. must earn a Doctor of Chiropractic (D.C.) degree from an accredited institution.

And in order to practice in all 50 states and the District of Columbia, chiropractors must also be licensed. Licensure requirements vary from state to state and can be obtained from your state's Board of Chiropractic.

Skills and Qualities

Aside from meeting the educational requirements and earning a state license, chiropractors must have a certain set of skills and abilities in order to offer care that meets the standards of the profession. The Occupational Information Network (ONET) indicates active listening and critical thinking are among the most important skills for an aspiring chiropractor, with social perceptiveness and complex problem solving not far behind.

Deductive and inductive reasoning abilities are also vital for success as a chiropractor, as well as the capacity to communicate effectively and clearly through both speech and writing. Accomplished chiropractors should also have an aptitude for switching their perspective from the details of a situation to the big picture, and a sense of empathy that can be invaluable when caring for people in pain.

Career Outlook and Salary Information

Working Environment

Although it has been most common for chiropractors to work independently, it is increasingly common to find massage therapists, physical therapists, herbalists, and acupuncturists working under the same roof as chiropractors. Chiropractic offices that work collaboratively with other practitioners of alternative medicine and bodywork are known as a multi-practice offices.

Veteran chiropractor, Alta Mahan, offers an explanation of the vital partnerships that are becoming more common in chiropractic medicine: "We do a lot of referrals to other healthcare professionals such as MDs, Naturopaths, physical therapists, and acupuncturists. For most patients we tend to be their primary care provider and so we have to be able to recognize when something is out of our scope of practice and refer them to the appropriate source of care. There are even chiropractors that are working in hospitals alongside MDs to take care of patients there."

According to the Bureau of Labor Statistics (BLS.gov), the following facilities might employ chiropractors:

• Physicians' offices
• Alternative medical offices
• Hospitals
• Outpatient care facilities
• Dentists' offices

Sources:

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• Chiropractors, Bureau of Labor Statistics, Occupational Employment Statistics, May 2013, http://www.bls.gov/oes/current/oes291011.htm
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