Chiropractic Certification, Licensure and Education
Chiropractic care has been a regulated healthcare profession in the United States for more than 100 years. Before being granted a license to practice, doctors of chiropractic (DCs) must meet stringent educational and competency standards. Along with completing a pre-professional college education and graduating from an accredited chiropractic college, chiropractors who wish to attain a license to practice in the US must first pass rigorous national board exams to verify that they have the knowledge and skills necessary to effectively and safely treat patients. Individual state chiropractic boards, which approve and manage licensure, may have additional requirements to obtain a license.
National Testing
The national board exam system for the chiropractic profession is managed by the National Board of Chiropractic Examiners (NBCE). NBCE develops, administers, and scores standardized exams that assess chiropractic college graduates' knowledge, higher-level cognitive abilities, and problem-solving in various basic science and clinical science subjects. NBCE's exam is divided into four parts: Part I assesses academic proficiency in six areas of science, Part II assesses academic proficiency in six clinical science areas, Part III assesses the application of knowledge in nine areas of clinical competency, and in Part IV examinees are asked to perform assessments similar to those they might encounter in clinical practice. In New Mexico, physiotherapy is also required, and it is an examination that includes passive and active adjunctive procedures.
State Licensure
Each state has its specific requirements for chiropractic licenses, based in part on the scope of practice determined by the state for DCs within its borders. In addition to meeting established educational requirements and passing national board exams, licensure in a state might include testing to verify a doctor's knowledge of the state's scope of practice, a background check, providing personal references, and proof of malpractice insurance.
Like their medical colleagues, chiropractors must renew their licenses regularly. As a requirement for renewal, most states mandate that chiropractors take continuing education (CE) courses and earn a specific number of CE credits each year. In the state of New Mexico, that requirement is a minimum of 16 hours per year.
Education
DCs are educated in nationally accredited, four-year doctoral graduate school programs through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory, and clinical internship, with the average DC program equivalent in classroom hours to allopathic (MD) and osteopathic (DO) medical schools.
Chiropractors are designated as physician-level providers in the federal Medicare program and in other federal health delivery systems, including those administered by the US Department of Veterans Affairs, the US Department of Defense, the Federal Employees Health Benefits Program, Federal Workers' Compensation, and all state workers' compensation programs.
The typical applicant at a chiropractic college has already acquired nearly a pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology, and related lab work. The requirements become even more demanding once accepted into an accredited chiropractic college. Four to five academic years of professional study are the standard. Because of the hands-on nature of chiropractic and the intricate adjusting techniques, a significant portion of time is spent in clinical training.
In some areas, such as anatomy, physiology, rehabilitation, nutrition, and public health, they receive more intensive education than their MD counterparts. Like other primary health care doctors, chiropractic students spend a significant portion of their curriculum studying clinical subjects related to evaluating and caring for patients. As part of their professional training, they must complete a one-year clinical-based program dealing with actual patient care.
This extensive education prepares chiropractors to diagnose healthcare conditions, treat those within their scope of practice, and refer patients to other healthcare practitioners when appropriate. This course of study is approved by an accrediting agency, the Council on Chiropractic Education, which is recognized by the US Department of Education.
