Chiropractic education

From Wikipedia, the free encyclopedia
  (Redirected from Chiropractor)
Jump to: navigation, search

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]

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.[2]

Profession[edit]

Main article: Chiropractic

Chiropractic education trains people in chiropractic, a form of alternative medicine[3] concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine, under the belief that such a disorder affects general health via the nervous system.[4] It is the largest alternative medical profession,[5] and UK chiropractors often aspire to become primary care providers, though they lack the medical and diagnostic skills necessary to fulfil this role.[6] The main chiropractic treatment technique involves manual therapy, especially manipulation of the spine, other joints, and soft tissues, but may also include exercises and health and lifestyle counseling.[7] The "specific focus of chiropractic practice" is chiropractic subluxation.[8] Traditional chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its innate intelligence.[9] Some chiropractors fear that if they do not separate themselves from the traditional vitalistic concept of innate intelligence, chiropractic will continue to be seen as fringe profession.[5]

The realistic median annual wage of chiropractors in the United States was $66,160 in May 2012.[10]

Training[edit]

Regardless of the model of education utilized, prospective chiropractors without 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 calculates out to 21 hours per week, using a standard 50 week year. This includes a minimum of 1000 hours of supervised clinical training.[2] Upon meeting all clinical and didactic requirements of chiropractic school, a degree in chiropractic 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 is regulated in North America by state/provincial statute, and also—to some extent—by the Business and Professions Code (e.g., in the state of California)--and the Case Law. Further, it has been argued that, at least in some states (in the USA), that this license subsumed the previous "drugless practitioner" license, and includes—within its scope of practice—that of the previous discipline.

In some countries, like the United States, chiropractors earn 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 bachelor's degree. The World Health Organization lists three potential educational paths involving full‐time chiropractic education around 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 Master's degree following the completion of a bachelor's degree leads to the MSc (Chiro).[2] In South Africa the Masters of Technology in Chiropractic (M.Tech Chiro) is granted following 6 years of university.[citation needed]

International degrees in chiropractic[edit]

Further information: List of chiropractic schools

Various degree designations for the chiropractic field exist in different countries. They generally follow the Bachelor's, Master's, Doctorate scheme. [11]

Degree Full Name Country in which it is awarded
B.App.Sc. (clin). & B.C.Sc. Bachelor of Applied Science (Clinical Science) & Bachelor of Chiropractic Science Japan
B.Sc. (chiro) & B.C. Bachelor of Science (Chiropractic) & Bachelor of Chiropractic Australia, Japan
B.App.Sc. (Compl) & M.Clin.Chiro. Bachelor of Applied Science (Complementary Medicine) & Master of Clinical Chiropractic Australia
B.Chiro. Bachelor of Chiropractic New Zealand
B.Chiro. & M.Chiro Bachelor of Chiropractic & Master of Chiropractic Australia
B.Sc. (Hons) Chiro Bachelor of Science (Hons) Chiropractic Malaysia[citation needed]
B.Tech. (chiro) and M.Tech. (chiro) Bachelor in Technology (Chiropractic) & Master in Technology (Chiropractic) South Africa
D.C. Doctor of Chiropractic Brazil, Canada, France, Japan, Mexico, South Korea, Spain, Sweden, United States
M.C. or M.Chiro. Master of Chiropractic or Master in Chiropractic Australia, Switzerland, UK
M.C.B. Master in Clinical Biomechanics Denmark[citation needed]
M.Tech. (chiro) Master in Technology, Chiropractic South Africa[citation needed]

Licensure and regulation[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 program.

Chiropractic is governed internationally by the Councils on Chiropractic Education International (CCEI). This body is recognized by the World Federation of Chiropractic and the World Health Organization as the accrediting agency for schools of chiropractic around the world.[1] 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.[1] 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.[12] 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 bachelor's degree followed by a master's degree while Murdoch University graduates attain a double bachelor's degree, any of which is necessary for registration with state registration boards.

A graduate of RMIT will have attained a Bachelor of Applied Science (Chiropractic) and a Master of Clinical Chiropractic.[13] Similarly, a typical graduate of Macquarie University will have a Bachelor of Chiropractic Science followed by a Master of Chiropractic.[14] Murdoch University graduates possess the double-degree of Bachelor of Science (Chiropractic Science) / Bachelor of Chiropractic.[15] Students at University of Central Queensland graduate with a Bachelor of Science (Chiropractic) followed by a Master of Chiropractic Science.[16]

Canada[edit]

There are currently two schools of chiropractic in Canada: Canadian Memorial Chiropractic College, in Toronto, Ontario and the Université du Québec à Trois-Rivières, in Trois-Rivieres, Quebec. Both programs are fully accredited by the Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards.[17] In 2010, the majority of students (87%) entering the CMCC program had completed a baccalaureate university degree, and approximately 3% have a graduate degree.[18] The CMCC program is a privately funded institution and requires four years of full-time study, including a 12-month clinical internship.[19] 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.[20]

Pilot projects involving doctors of chiropractic in hospital emergency rooms in the province of Ontario are underway.[21] 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.[22] 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.[23]

Germany[edit]

There are no accredited chiropractic schools in Germany. Chiropractors that are qualified abroad need a license as physician or healing practitioner "Heilpraktiker". In the past the authorities demanded a general examination to obtain the license as Heilpraktiker. In recent rulings German courts decided that the graduation of an accredited school of chiropractic and professional experience abroad has to be recognized to obtain the license as Heilpraktiker limited to the field of chiropractic.[24]

South Africa[edit]

In South Africa (SA) there are two schools offering chiropractic: the Durban Institute of Technology and the University of Johannesburg.[25] Both offer a 6-year full-time course leading to a Masters of Technology (M.Tech) in Chiropractic; the course comprises two years of basic sciences followed by four years specialising in chiropractic, and incorporates a research dissertation. In order to practice in SA chiropractors are required to complete an internship, and must be registered with the Allied Health Professions Council of SA (AHPCSA) the relevant governmental statutory body. Membership of the Chiropractic Association of SA (CASA) is voluntary; CASA is the profession's sole national association and aims to promote Chiropractic through publications in newspaper, interviews, internet and other public inquiries.

United Kingdom[edit]

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.[26] 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.[27] 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.[28]

The McTimoney College of Chiropractic offers an Undergraduate master's degree in human Chiropractic and two post-graduate Masters programmes in Animal Manipulation, plus a masters in Paediatric Chiropractic[29] The Anglo-European College of Chiropractic graduates chiropractors with an undergraduate master's 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.[30]

United States[edit]

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;[31] 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 2.8 on a 4.0 scale.[32] Common prerequisite classes include those of the biological, chemical, and 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.[33] In 1997, American chiropractic schools tended to have lower entry requirements than medical or dental schools.[34] In 2005, only one chiropractic college required a bachelor's degree as an admission requirement.[35]

Accreditation[edit]

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]

Chiropractic controversy and criticism[edit]

Throughout its history chiropractic has been the subject of internal and external controversy and criticism.[5][36] According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all diseases of the human race.[37] A 2003 profession-wide survey found "most chiropractors (whether 'straights' or 'mixers') still hold views of Innate and of the cause and cure of disease (not just back pain) consistent with those of the Palmers."[38] A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today."[37] Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license.[37] D.D. Palmer considered establishing chiropractic as a religion to resolve this problem.[39] For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as subluxation.[40] Chiropractic has been controversial, though to a lesser extent than in past years..[41]

Chiropractic researchers have documented that fraud, abuse and quackery are more prevalent in chiropractic than in other health care professions.[42] Unsubstantiated claims about the efficacy of chiropractic have continued to be made by individual chiropractors and chiropractic associations.[37] The core concept of traditional chiropractic, vertebral subluxation, is not based on sound science.[37] Collectively, systematic reviews have not demonstrated that spinal manipulation, the main treatment method employed by chiropractors, was effective for any medical condition, with the possible exception of treatment for back pain.[37] Although rare,[2] spinal manipulation, particularly of the upper spine, can also result in complications that can lead to permanent disability or death; these can occur in adults[43] and children.[44]

In 2008, Simon Singh was sued for libel by the British Chiropractic Association (BCA) for criticizing their activities in a column in The Guardian.[45] A preliminary hearing took place at the Royal Courts of Justice in front of judge David Eady. The judge held that merely using the phrase "happily promotes bogus treatments" meant that he was stating, as a matter of fact, that the British Chiropractic Association was being consciously dishonest in promoting chiropractic for treating the children's ailments in question.[46] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[47] The libel case ended with the BCA withdrawing its suit in 2010.[48][49]

Chiropractors historically were strongly opposed to vaccination based on their belief that all diseases were traceable to causes in the spine, and therefore could not be affected by vaccines.[50] Some chiropractors continue to be opposed to vaccination.[4] Early opposition to water fluoridation included chiropractors in the U.S. Some chiropractors opposed water fluoridation as being incompatible with chiropractic philosophy and an infringement of personal freedom. Recently, other chiropractors have actively promoted fluoridation, and several chiropractic organizations have endorsed scientific principles of public health.[51]

See also[edit]

References[edit]

  1. ^ a b c "Basic training and safety in chiropractic". World Health Organization. Retrieved 16 February 2013. 
  2. ^ a b c d World Health Organization (2005). "WHO guidelines on basic training and safety in chiropractic" (PDF). Retrieved 2008-03-03. 
  3. ^ 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. Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 111–34. ISBN 0-07-137534-1. 
  4. ^ a b Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558free to read. PMID 16000175. 
  5. ^ a b c Kaptchuk TJ, Eisenberg DM (November 1998). "Chiropractic: origins, controversies, and contributions". Arch. Intern. Med. 158 (20): 2215–24. doi:10.1001/archinte.158.20.2215. PMID 9818801. 
  6. ^ Jones-Harris, Amanda R (October 2010). "Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study". Chiropr Osteopat. 18 (28). doi:10.1186/1746-1340-18-28. PMC 3161390free to read. PMID 20979615. 
  7. ^ Mootz RD, Shekelle PG (1997). "Content of practice". In Cherkin DC, Mootz RD. 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.
  8. ^ NBCE (2014), About Chiropractic, National Board of Chiropractic Examiners, retrieved February 1, 2015 
  9. ^ Keating JC Jr (2005). "A brief history of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B, et al. Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 23–64. ISBN 0-07-137534-1. 
  10. ^ Occupational Outlook Handbook, Bureau of Labor Statistics, 8 January 2014: http://www.bls.gov/ooh/healthcare/chiropractors.htm
  11. ^ Shearer, Kevin. "Chiropractic Education". Quantum Integrated Health. Retrieved 15 July 2016. 
  12. ^ "Admissions Requirements - D.C". Palmer.edu. Retrieved 2012-09-16. 
  13. ^ "Bachelor of Health Science (Chiropractic)". rmit.edu.au. 
  14. ^ "Macquarie University Department of Chiropractic". chiro.mq.edu.au. 
  15. ^ "Murdoch University in Perth Australia". murdoch.edu.au. 
  16. ^ "CQU - Bachelor of Science (Chiropractic)". cqu.edu.au. 
  17. ^ "Accreditation of Educational Programmes". Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards. Retrieved 2009-10-16. 
  18. ^ "An Overview of CMCC Admissions - Shortcuts: Admissions Brochure". Canadian Memorial Chiropractic College. Retrieved 2011-08-21. 
  19. ^ "Undergraduate education". Canadian Memorial Chiropractic College. Retrieved 2011-08-21. 
  20. ^ "Becoming a Chiropractor". Ontario Chiropractic Association. Retrieved 2009-10-16. 
  21. ^ "Chiropractic Services". St. Michael's Health Centre. Retrieved 2011-11-08. 
  22. ^ "Canadian Chiropractic Examining Board". cceb.ca. 
  23. ^ "G037 - Wed 29 Nov 2000 / Mer 29 nov 2000". ontla.on.ca. Archived from the original on 11 May 2003. 
  24. ^ "October 17, 2014 «  ACLANZ". aclanz.de. 
  25. ^ "CASA : Student Info". Retrieved 2009-10-19. 
  26. ^ Staff (June 18, 1993). "Chiropractic Report Calls for Registry of DCs in United Kingdom". Dynamic Chiropractic. 11 (13). 
  27. ^ "Regulation of chiropractic". Retrieved 2009-02-12. 
  28. ^ "Home Redirect - Contact Us - Website - GCC". gcc-uk.org. 
  29. ^ "McTimoney College Prospectus". mctimoney-college.ac.uk. 
  30. ^ "Home Redirect - Contact Us - Website - GCC". gcc-uk.org. 
  31. ^ Council on Chiropractic Education (2007). "Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status" (PDF). 
  32. ^ Council on Chiropractic Education (2007). "Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status" (PDF). p. 22. 
  33. ^ "Admissions Requirements - D.C". Palmer.edu. Retrieved 2012-09-16. 
  34. ^ Cherkin; Mootz (1997). "Chiropractic in the United States: Training, Practice, and Research" (PDF). p. 19. Retrieved 18 February 2013. 
  35. ^ Wyatt, Lawrence H; Stephen M Perle; Donald R Murphy; Thomas E Hyde (2005-07-07). "The necessary future of chiropractic education: a North American perspective". Chiropractic & Osteopathy. 13 (10): 10. doi:10.1186/1746-1340-13-10. PMC 1181629free to read. PMID 16001976. 
  36. ^ Jaroff, Leon (27 February 2002). "Back Off, Chiropractors!". Time. Retrieved 7 June 2009. 
  37. ^ a b c d e f Ernst, E (May 2008). "Chiropractic: a critical evaluation". Journal of Pain and Symptom Management. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. ISSN 0885-3924. PMID 18280103. 
  38. ^ Gunther Brown, Candy (July 7, 2014). "Chiropractic: Is it Nature, Medicine or Religion?". The Huffington Post. 
  39. ^ Palmer, Daniel (May 4, 1911), D.D. Palmer's Religion of Chiropractic (PDF), The Chiropractic Resource Organization, retrieved February 22, 2015 
  40. ^ Keating JC Jr; Cleveland CS III; Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Retrieved 2008-06-16. A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine. Chiropractors' tendency to assert the meaningfulness of various theories and methods as a counterpoint to allopathic charges of quackery has created a defensiveness which can make critical examination of chiropractic concepts difficult (Keating and Mootz 1989). One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994). 
  41. ^ DeVocht JW (2006). "History and overview of theories and methods of chiropractic: a counterpoint". Clin Orthop Relat Res. 444: 243–9. doi:10.1097/01.blo.0000203460.89887.8d. PMID 16523145. 
  42. ^ Murphy, DR; Schneider, MJ; Seaman, DR; Perle, SM; Nelson, CF (Aug 2008). "How can chiropractic become a respected mainstream profession? The example of podiatry" (PDF). Chiropractic & osteopathy. 16: 10. doi:10.1186/1746-1340-16-10. PMC 2538524free to read. PMID 18759966. 
  43. ^ Ernst, E (Jul 2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100 (7): 330–8. doi:10.1258/jrsm.100.7.330. ISSN 0141-0768. PMC 1905885free to read. PMID 17606755. Lay summaryMed News Today (2 July 2007). 
  44. ^ Vohra, S; Johnston, BC; Cramer, K; Humphreys, K (Jan 2007). "Adverse events associated with pediatric spinal manipulation: a systematic review". Pediatrics. 119 (1): e275–83. doi:10.1542/peds.2006-1392. ISSN 0031-4005. PMID 17178922. 
  45. ^ Eden, R (16 August 2008). "Doctors take Simon Singh to court". The Daily Telegraph. London. Retrieved 16 August 2008. 
  46. ^ Boseley, Sarah (14 May 2009). "Science writer accused of libel may take fight to European court". London: The Guardian (UK). Retrieved 2009-05-19. 
  47. ^ "Unjust burdens of proof". Nature. 459 (7248): 751. June 2009. Bibcode:2009Natur.459Q.751.. doi:10.1038/459751a. PMID 19516290. 
  48. ^ Pallab Ghosh (2010-04-15). "Case dropped against Simon Singh". BBC News. 
  49. ^ Mark Henderson (2010-04-16). "Science writer Simon Singh wins bitter libel battle". London: Times Online. 
  50. ^ Busse, JW; Morgan, L; Campbell, JB (Jun 2005). "Chiropractic antivaccination arguments". Journal of manipulative and physiological therapeutics. 28 (5): 367–73. doi:10.1016/j.jmpt.2005.04.011. ISSN 0161-4754. PMID 15965414. 
  51. ^ Jones, RB; Mormann, DN; Durtsche, TB (Oct 1989). "Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success". American Journal of Public Health. 79 (10): 1405–8. doi:10.2105/AJPH.79.10.1405. ISSN 0090-0036. PMC 1350185free to read. PMID 2782512.