1. Based upon statistics compiled by the Department of Labor, Chiropractic was ranked the number ONE primary health care profession when all factors in the ranking process were rated as equal to each other.
2. Individuals who chose care for low back pain from Doctors of Chiropractic rated the health care they received much more highly than persons who sought care from family physicians. (BMJ No 7001 Abstracts on CHIROPRACTIC vs. HOSPITAL CARE)
3. The majority of Chiropractic patients were very satisfied with the amount of information provided to them about the cause of their pain.
4. The majority of Chiropractic patients were very satisfied with the amount of personal attention they received while under the care of Doctors of Chiropractic.
5. The majority of Doctors of Chiropractic feel very comfortable in the management of patients with low back pain because they specialize in problems of the spine.
6. Many published studies have shown a lower cost for workers who chose Chiropractic care over medical care.
7. The cost for Chiropractic care is usually paid by private insurance, by Medicare, by Medicaid or by Workman’s Compensation.
8. About half of the men and women ages 25 – 39 who have ever seen a Doctor of Chiropractic have done so in the last two years.
G.T.PRESS 1989. PRINTED IN U.S.A
Have you ever wondered just how much education your chiropractor has? The facts may very well surprise you. Today, highly specialized training is required to graduate and earn licensure, and chiropractic has gained recognition as a comprehensive, scientifically sound force among the healing arts. Only chiropractic concerns itself with the interrelationship of structure and physiological functioning.
A chiropractic program consists of 4 academic years of professional education averaging a total of 4,822 hours, and ranging from 4,400 hours to 5,220 hours in the 16 colleges.1 This includes an average of 1,975 hours in clinical sciences and 1,405 hours of clinical clerkship. The minimum hours for accreditation by the Council on Chiropractic Education is 4,200 hours.
Comparison with Medical Education and Training
A recent study comparing chiropractic and medical education collected data on all chiropractic and medical schools in North America and performed an in-depth analysis of three chiropractic and three medical schools (Coulter, submitted). Three States providing a broad geographic representation of the United States were chosen: California, Iowa, and Texas. These States account for almost half of the chiropractic colleges in the United States. A single chiropractic college and school of medicine were studied in each State.
The chiropractic schools included in this study had enrollments of 521, 773, and 1880, compared with a mean enrollment for all colleges of 878 (CCE Report, 1996). The three medical schools had enrollments of 691, 734, and 745, all moderately above the national average of 536 (JAMA, 1995).
There are a lot of myths about chiropractic care…I decided to look into each of these myths, and what I found is that chiropractic education, side-by-side, is more similar to medical education than it is dissimilar. – Jack Zigler, MD, orthopedic spine surgeon.
The Curriculum
Two questions are of paramount importance in comparing the curricula of the two professions; what subjects are taught and how much is taught? The two programs are relatively similar in total student contact hours: an average of 4,822 hours in chiropractic schools compared with 4,667 hours in medical schools (Coulter, et al, submitted).
Basic science comprises 25-30 percent of the total contact hours in both the chiropractic and medical programs (Table 1) and the two programs have roughly similar contact hours in biochemistry, microbiology, and pathology (Table 2). Chiropractors receive substantially more hours in anatomy education and physiology but many fewer in public health.
Comparisons of the Overall Curriculum Structure for Chiropractic and Medical Schools
Chiropractic Schools |
Medical Schools |
|||
Mean |
Percentage |
Mean |
Percentage |
|
Total Contact Hours |
4822 |
100% |
4667 |
100% |
|
||||
Basic science hours |
1416 |
29% |
1200 |
26% |
Clinical science hours |
3406 |
71% |
3467 |
74% |
|
||||
Chiropractic science hours |
1975 |
41% |
0 |
0 |
Clerkship hours |
1405 |
29% |
3467 |
74% |
Source: Center for Studies in Health Policy, Inc., Washington, DC. Personal communication of 1995 unpublished data from Meredith Gonyea, PhD.
Comparison of Hours of Basic Sciences Education in Medical and Chiropractic Schools
Subject |
Chiropractic Schools |
Medical Schools |
||
Hours | % of Total | Hours | % of Total | |
Anatomy |
570 |
40 |
368 |
31 |
Biochemistry |
150 |
11 |
120 |
10 |
Microbiology |
120 |
8 |
120 |
10 |
Public Health |
70 |
5 |
289 |
24 |
Physiology |
305 |
21 |
142 |
12 |
Pathology |
205 |
14 |
162 |
14 |
|
||||
Total Hours |
1,420 |
100 |
1,200 |
100 |
Source: Center for Studies in Health Policy, Inc., Washington, DC. Personal communication of 1995 unpublished data from Meredith Gonyea, PhD.
The contrast between the two programs is dramatic in the area of clinical clerkships, which averaged 3,467 hours in medicine versus 1,405 hours in chiropractic. In medicine this comprises, on average, 74 percent of the total contact hours, while in chiropractic it comprises only 29 percent (Table 1). Part of the difference can be explained by the way in which the programs are structured. In chiropractic 41 percent of the program (averaging 1,975 hours) is allocated to chiropractic clinical sciences, which consists of extensive laboratory and hands-on training in manual procedures and has no equivalent in medicine. Combining the chiropractic clinical sciences with the clinical clerkships, the percentage of a chiropractic program devoted to clinical education is 70 percent compared to medicine’s 74 percent. The major difference therefore is in didactic teaching and clinical experience.
Thus, on average, medical students receive twice the number of hours in clinical experience but receive over 1,000 fewer hours in lectures and laboratory education. If the medical residency is included, the total number of hours of clinical experience for medicine rises to 6,413 (Coulter, submitted).
_______________
1. Center for Studies in Health Policy, Inc., Washington, DC. Personal communication of 1995 unpublished data from Meredith Gonyea, PhD.
2. Source: Center for Studies in Health Policy, Inc., Washington, DC. Personal communication of 1995 unpublished data from Meredith Gonyea, PhD.
Average Total Contact Hours in Specific Clinical Subjects Taught in 16 Chiropractic Colleges (Includes lectures and laboratories).
Clinical subject |
Hours |
% of Total |
Adjustive technique/spinal analysis |
555 |
22% |
Physical/clinical/laboratory diagnosis |
410 |
17% |
Diagnostic imaging, radiology |
305 |
12% |
Principles of chiropractic |
245 |
10% |
Orthopedics |
135 |
6% |
Physiologic therapeutics |
120 |
5% |
Nutrition/dietetics |
90 |
4% |
Professional practice & ethics |
65 |
3% |
Biomechanics |
65 |
3% |
Gynecology/obstetrics |
55 |
2% |
Psychology |
55 |
2% |
Research methods |
50 |
2% |
Clinical pediatrics & geriatrics |
50 |
2% |
First aid & emergency |
45 |
2% |
Dermatology |
30 |
1% |
Otolaryngology |
25 |
1% |
Other |
160 |
7% |
Total hours of clinical training |
2460 |
100% |
Source: Center for Studies in Health Policy, Inc., Washington, DC. Personal communication of 1995 unpublished data from Meredith Gonyea, PhD.
Continuing Education
Participation in Continuing Education by chiropractors is commonplace as 47 of 50 States have mandatory continuing education requirements to maintain or renew a license to practice (FCLB, 1997).
Specialty Training
Chiropractic Physicians may also elect to take on some form of specialty, i.e. Neurology, Nutrition, Orthopedics, Radiology, Rehabilitation, Sports, Pediatrics, Whiplash, etc. Specialty training is available through U.S. chiropractic colleges for part-time postgraduate education programs or full-time residency programs. Postgraduate education programs are available in family practice, applied chiropractic sciences, clinical neurology, orthopedics, sports injuries, pediatrics, nutrition, rehabilitation, and industrial consulting. Rehabilitation has become a particularly popular program (Liebenson, 1996). Residency programs include radiology, orthopedics, family practice, and clinical sciences (Christensen, 1993). A typical residency program is 2-3 years in duration and includes ambulatory care and inpatient clinical rotations at chiropractic and medical facilities, along with didactic and research experiences. Other less rigorous postgraduate training programs may take 1-3 years to complete on a part-time basis. Both the residency and postgraduate programs lead to eligibility to sit for competency examinations offered by specialty boards recognized by the American Chiropractic Association, the International Chiropractors’ Association, and the American Board of Chiropractic Specialties. Specialty boards may confer “Diplomate” status in a given area of focus upon successful examination. Chiropractic orthopedics and sports chiropractic are the most prevalent specialty certifications.
Taken from Chiroweb. Chiropractic in the United States:Training, Practice, and Research. AHCPR Publication No. 98-N002.
December 1997, CHAPTER III, CHIROPRACTIC TRAINING. D. Coulter, PhD; Alan H. Adams, DC; Ruth Sandefur, DC, PhD.
Licensure
Chiropractors must meet stringent educational requirements, including approximately 600 hours of externship which qualifies them for licensure in all states. Chiropractic doctors and medical doctors must then pass the same basic science National Board Examinations. Additionally, each state administers its own rigid State Board Ethics Examination which Chiropractic Physicians must also pass.