Doctor of Chiropractic

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Chiropractic medicine

Daniel David Palmer (founder)

1895 · Davenport, US

D.C. MSc.Chiro, MTech.Chiro

World Federation of Chiropractic

Schools · Accreditation

Doctor of Chiropractic (D.C.) is a degree of chiropractic for chiropractors in North America. Chiropractors practice chiropractic medicine, a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.[1] Chiropractors emphasize manual and manipulative therapy for the treatment of joint dysfunctions. Chiropractic is generally classified as complementary/alternative medicine.[2]

In some countries it is a professional doctorate where training is entered after obtaining between 90 and 120 credit hours of university level work (see second entry degree) and in most cases after obtaining a bachelors degree. 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 degree following the completion of a bachelor degree leads to the MSc (Chiro).[1] In South Africa the Masters of Technology in Chiropractic (M.Tech Chiro) is granted following 6 years of university. 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.[1] 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.[3]

Upon meeting all clinical and didactic requirements of chiropractic school, a degree in chiropractic medicine is granted. However, in order to practice, chiropractors must be licensed. The regulatory boards are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.[4] Currently, chiropractors practice in over 100 countries in all regions of the world, however chiropractors are most prevalent in North America, Australia and parts of Europe.[1][5]

Scope of practice[edit]

Chiropractors emphasize manual and manipulative therapies as an alternative to medications and surgery for neuromusculoskeletal disorders.[6] Chiropractors are generally regarded as primary contact, portal of entry health care providers. Although chiropractors have many attributes of primary care providers, chiropractic has more attributes of a limited medical specialty like dentistry or podiatry.[7] Chiropractors are licensed to communicate a neuromusculoskeletal diagnosis and order X-rays and may use broad diagnostic methods including skeletal imaging, observational and tactile assessments as well as orthopedic and neurological evaluation.[1] A chiropractor may also refer a patient to an appropriate specialist, or co-manage with another health care provider.[7] Common patient management involves spinal manipulation (SM) and other manual therapies to the joints and soft tissues, rehabilitative exercises, health promotion, electrical modalities, complementary procedures, and lifestyle counseling.[8] When indicated, chiropractors may also refer a patient to an appropriate specialist, or co-manage with another health care provider.[7]

Due to the historical differences in philosophy and treatment approaches, there are range of 'broad' and 'narrow' scopes of practice for American chiropractors which tend to reflect 'straight' or 'mixer' underpinnings.[9] A focus on evidence-based research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.[10] However, the majority of chiropractors currently view themselves as "back/neck pain musculoskeletal specialists."[11] The vast majority who seek chiropractic care do so for relief from back and neck pain and other neuromusculoskeletal complaints;[12] most do so specifically for low back pain.[13] Although it is generally accepted that chiropractic care is appropriate for musculoskeletal complaints, there is considerable debate on their role in treating visceral disorders.[14] Certain jurisdictions allows the practice of animal chiropractic, whereby licensed chiropractors and veterinarians practice manual and manipulative therapies on animals for musculoskeletal disorders.[15] Increasing evidence-based practice and aligning with conventional medicine has been suggested to obtain more university affiliation and access to hospitals and long-term facilities; aligning with the complementary and alternative medicine movement could bring more patients looking for non-medical approaches.[16] In 2005, the World Health Organization developed chiropractic guidelines on basic training and safety to help standardize formal accreditation and licensure of chiropractors in countries where they remain unregulated.[1] Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent in North America, Australia and parts of Europe. The majority of mainstream health care and governmental organizations classify chiropractic as traditional or complementary alternative medicine.[2]

Training[edit]

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.[1] 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.[3] 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 Boards require candidates to complete a 12 month clinical internship to obtain licensure. Licensure is granted following successful completion of all state/provincial and national board exams so long as the chiropractor maintains malpractice insurance. Nonetheless, there are 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 boards are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.[17]

Regulation and accreditation[edit]

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.

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 across the world.[18] The minimum prerequisite for enrollment in a chiropractic college set forth by the CCEI is 90 semester hours, and the minimum cumulative GPA for a student entering is 3.0 on a 4.0 scale.[2] 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.[19] Chiropractic programs require at least 4,200 hours of combined classroom, laboratory, and clinical experience.

Australia[edit]

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.[20]

A graduate of RMIT will have attained a Bachelor of Applied Science (Chiropractic) and a Master of Clinical Chiropractic.[21] Similarly, a typical graduate of Macquarie University will have a Bachelor of Chiropractic Science followed by a Master of Chiropractic.[22] Murdoch University graduates possess the double-degree of Bachelor of Science (Chiropractic Science) / Bachelor of Chiropractic.[23] Students at University of Central Queensland graduate with a Bachelor of Science (Chiropractic) followed by a Master of Chiropractic Science.[24]

Canada[edit]

Canadian chiropractors received their Doctorate in Chiropractic (D.C.) following a minimum of 7 years of university. 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.[25] In 2010, the majority of students (87%) entering the CMCC program had completed a baccalaureate university degree, and approximately 3% have a graduate degree.[26]

South Africa[edit]

In SA (South Africa) there are two schools of chiropractic: the Durban Institute of Technology and the University of Johannesburg.[27] 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[edit]

In 1993 Princess Diana visited the Anglo-European College of Chiropractic and became its patron by calling for legislation to prevent unqualified individuals from practicing chiropractic in the UK.[28] 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.[29] 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.[30] 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.[31] The Anglo-European College of Chiropractic and the University of Glamorgan chiropractic graduates with the Masters degree (MChiro).

United States[edit]

American chiropractors received their Doctorate in Chiropractic (D.C.) following a minimum of 7 years of university. There are currently 18 schools of chiropractic in the United States. In the United States, schools of chiropractic follow either a 'mixer' or 'straight' paradigm; the two schools of thought lead to two national bodies, the International Chiropractors Association and the American Chiropractic Association. Mixers form the majority of American chiropractors;[6] however, straight practice chiropractors are believed to have a disproportionate influence since they are "purists".[32]

New Zealand[edit]

As of 2005, the New Zealand College of Chiropractic (NZCC). obtained accreditation by the CCEA (Council on Chiropractic Education Australasia) and subsequently the CCEI.

Chiropractic specialities[edit]

Chiropractic scientists (DC/PhD)[edit]

Chiropractors can conduct clinical and basic scientific research and publish in peer-reviewed journals during training and after graduation. Chiropractors can also pursue a Ph.D degree in various health care disciplines including epidemiology, biomechanics, neurophysiology and kinesiology,[33]

Fellowships and other credentials[edit]

Chiropractors, like other health care professionals, can pursue post-graduate education in various chiropractic specialties. Most are 2 year post-graduates degrees in chiropractic specialities such as clinical sciences, sports chiropractic, radiology, animal chiropractic and others.There are other chiropractic credentials that may or may not be recognized by the major health care organizations, medical or chiropractic communities.

Chiropractic career[edit]

Realistic median annual wage of chiropractors was $67,200 in May 2010.[34] According to Health Resources and Services Administration (HRSA), Chiropractic Student Loan Default Rates for October 1999, May 2010, and January 2012 are 54%, 53.8%, and 52.8% respectively.[35] Chiropractic school graduates default on their loans more often than law school graduates, engineers, medical doctors, and business school graduates.

References[edit]

  1. ^ a b c d e f g World Health Organization (2005). WHO guidelines on basic training and safety in chiropractic (PDF). Retrieved 2008-03-03. 
  2. ^ a b Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.). Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 111–34. ISBN 0-07-137534-1. 
  3. ^ a b http://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf
  4. ^ Facts & FAQs
  5. ^ "The current status of the chiropractic profession". World Federation of Chiropractic. Retrieved 16 February 2013. 
  6. ^ a b Keating JC Jr (2005). "Philosophy in chiropractic". In Haldeman S, Dagenais S, Budgell B et al. (eds.). Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 77–98. ISBN 0-07-137534-1. 
  7. ^ a b c Meeker WC, Haldeman S (2002). "Chiropractic: a profession at the crossroads of mainstream and alternative medicine" (PDF). Ann Intern Med 136 (3): 216–27. doi:10.7326/0003-4819-136-3-200202050-00010. PMID 11827498. 
  8. ^ Mootz RD, Shekelle PG (1997). "Content of practice". In Cherkin DC, Mootz RD (eds.). Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research. pp. 67–91. OCLC 39856366. Retrieved 2008-10-10.  AHCPR Pub No. 98-N002.
  9. ^ Parkman CA (2004). "Issues in credentialing CAM providers". Case Manager 15 (4): 24–7. doi:10.1016/j.casemgr.2004.05.004. PMID 15247891. 
  10. ^ Villanueva-Russell Y (2005). "Evidence-based medicine and its implications for the profession of chiropractic". Soc Sci Med 60 (3): 545–61. doi:10.1016/j.socscimed.2004.05.017. PMID 15550303. 
  11. ^ Villanueva-Russell, Y. (2011). "Caught in the crosshairs: Identity and cultural authority within chiropractic". Social Science & Medicine 72 (11): 1826–1837. doi:10.1016/j.socscimed.2011.03.038. PMID 21531061.  edit
  12. ^ Hurwitz EL, Chiang LM (2006). "A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03". BMC Health Serv Res 6 (49): 49. doi:10.1186/1472-6963-6-49. PMC 1458338. PMID 16600038. 
  13. ^ Lawrence DJ, Meeker WC (2007). "Chiropractic and CAM Utilization: A Descriptive Review". Chiropr Osteopat 15 (1): 2. doi:10.1186/1746-1340-15-2. PMC 1784103. PMID 17241465. 
  14. ^ Gleberzon BJ, Cooperstein R, Perle SM (2005). "Can chiropractic survive its chimerical nature?". J Can Chiropr Assoc 49 (2): 69–73. PMC 1840015. PMID 17549192. 
  15. ^ Ramey DW (2003). "Regulatory aspects of complementary and alternative veterinary medicine". J Am Vet Med Assoc 222 (12): 1679–82. doi:10.2460/javma.2003.222.1679. PMID 12830858. 
  16. ^ Cooperstein & Gleberzon. "Current and future utilization rates and trends". pp. 297–305. 
  17. ^ Facts & FAQs
  18. ^ "Basic training and safety in chiropractic". World Health Organization. Retrieved 16 February 2013. 
  19. ^ "Admissions Requirements - D.C". Palmer.edu. Retrieved 2012-09-16. 
  20. ^ [1][dead link]
  21. ^ RMIT Chiropractic
  22. ^ Macquarie University Department of Chiropractic
  23. ^ Murdoch University Chiropractic
  24. ^ CQU - Bachelor of Science (Chiropractic)
  25. ^ "Accreditation of Educational Programmes". Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards. Retrieved 2009-10-16. 
  26. ^ "An Overview of CMCC Admissions - Shortcuts: Admissions Brochure". Canadian Memorial Chiropractic College. Retrieved 2011-08-21. 
  27. ^ "CASA : Student Info". Retrieved 2009-10-19. 
  28. ^ Staff (June 18, 1993). "Chiropractic Report Calls for Registry of DCs in United Kingdom". Dynamic Chiropractic 11 (13). 
  29. ^ "Regulation of chiropractic". Retrieved 12/02/2009. 
  30. ^ GCC Criteria for Recognition of Degrees in Chiropractic
  31. ^ McTimoney College Prospectus
  32. ^ Kaptchuk TJ, Eisenberg DM (1998). "Chiropractic: origins, controversies, and contributions". Arch Intern Med 158 (20): 2215–24. doi:10.1001/archinte.158.20.2215. PMID 9818801. 
  33. ^ "Research chairs and professorships". Canadian Chiropractic Research Foundation. Retrieved 16 February 2013. 
  34. ^ Occupational Outlook Handbook, Bureau of Labor Statistics, March 29, 2012: http://www.bls.gov/ooh/healthcare/chiropractors.htm
  35. ^ Health Resources and Services Administration (HRSA), January 2012: http://www.chirobase.org/03Edu/

See also[edit]