Chiropractic Education and Training Profile of Typical Chiropractor The typical practicing doctor is a married male, although the proportion of female doctors has increased over the past decade. The doctor is 39 years old, and has a 51.7% chance of living in a town or city with a population under 50,000. He or she has been in practice for about 10 years. Prior to attending chiropractic college, the doctor has attended a college or university for at least two years, majoring in premedicine, or the physical and biological sciences. Coursework is taken in inorganic and organic chemistry; physics; biology/zoology; and psychology. The doctor was 26.5 years old at graduation from chiropractic college. He or she is qualified to practice the profession under state law in all states, through examination before state basic science boards, and/or state chiropractic licensing boards. The doctor of chiropractic is actively involved in postgraduate education, either at the colleges themselves or through state and regional seminars. Many doctors take advanced training for certification in such areas as diagnostic roentgenology, chiropractic orthopedics, nutrition, neurology, diagnosis, thermology and sports injuries. The majority of doctors of chiropractic are in solo practice, although those involved in some form of group practice now comprise about one-quarter of the total. The typical doctor's office is located in a neighborhood business district, and employs three assistants. The typical doctor practices an average of five days a week, 50 weeks a year. Each week he or she attends to the needs of 130 patients. Surveys both within and outside the profession have shown that there is no statistically significant difference between chiropractic patients and those of any other healing art, relative to age, sex, ethnic affiliation or income status. The doctor of chiropractic's income, lifestyle, and community standing are equivalent to those enjoyed by other primary health-care providers. He/she is a member of his/her national, state, and district professional associations, and a contributing member of community and civic groups. Chiropractic Patients In 1964, there were about 4,250,000 chiropractic patients in the United States, or 2.2% of the entire population. By 1974, the number had increased to over 7,500,000 patients, or 3.6% of the population. This 77% increase in the number of patients occured while the general population grew by only 10.4%. New chiropractic patients totaled at least 10,700,000 in calendar 1984. Patient visits in the same year reached an unprecedented 163,000,000. New patients in 1990 exceeded 16,500,000. Patient visits exceeded more than 308,000,000. This year it is estimated that the number of patients treated is over 19,500,000. The types of patients chiropractors see in their practices represent a broad cross-section of society not any different than might be seen by any other health professional. Doctors of chiropractic treat more female than male patients for a variety of ailments. Problems classified as neuromusculoskeletal account for about 85% of all conditions treated. Other conditions in order of their frequency, are visceromotor, vascular-related, and metabolic/nutritional. Chiropractic Student Profile Most students are male, although the percentage of females continues to rise as with other professional occupations. Recent trends have indicated that the female student population in chiropractic colleges is surpassing 30% of the total student population. (10-12) The entering student has a minimum of 60 semester hours of college credit including a prescribed curriculum of biological and physical science courses. The qualifications of chiropractic college students continue to improve. According to a 1993 Survey, approximately 40% have bachelor's degrees or better. Recent reports from chiropractic colleges indicate that, on the average, students have completed three and one-half (3 1/2) years of undergraduate academic education prior to matriculation into Chiropractic College. This means successful completion of about 100 semester hours of undergraduate academic credit. It has also been reported that "this total [of matriculating credit hours] has risen with recently entering classes and is likely to increase to four (4) years of undergraduate education in the near future (13). Further, the mean entering grade point average (GPA) has been steadily increasing and is currently 3.1 on a four-point scale (13). Chiropractic Education Wide acceptance and an increasing population make the future of chiropractic bright. Further, an active program of research assures students who are planning a career in chiropractic that their profession will continue to grow and progress in its service capabilities. As research opens new doors for chiropractic procedures and service, new career opportunities are created. Not only are there more patients to serve, there are also more specialized ways in which to serve. The population growth, research, greater acceptance and understanding, greater need for health care, improved financial opportunity, better state and federal health programs, increased insurance recognition, and greater health consciousness all assure chiropractic a future of increased need and service. Literally hundreds of towns and cities throughout the United States and Canada are without any, or have less than an adequate number of, chiropractic physicians to offer patients this specialized health service. Few of even the largest cities have enough DC's in ratio to population and the profession's growing popularity. A doctor of chiropractic is a particular type of physician. As such, he or she is engaged in the treatment and prevention of diseases and in the promotion of public health and welfare. Such a physician is thoroughly trained in accepted methods of diagnosis. Also, the doctor of chiropractic has the advantage of understanding the significance of structural and functional maladjustment's which are always present in disease. Training equips the DC for this most important and difficult part of diagnosis and health care. Chiropractic is a broad field. With a background in the basic and clinical sciences, and knowledge of the advances made in the field of body mechanics, a doctor of chiropractic will find unlimited areas of service open as a general practitioner engaged in family practice, or as a specialist, teacher, or researcher. Pre-Chiropractic College All candidates must furnish proof of having acquired two years of 60 acceptable hours leading to a baccalaureate degree in the arts and sciences. The pre-professional education, which has been acquired, must have an average of 2.25 on a 4.0 scale, with no less than a "C" grade in courses with laboratory in biology, chemistry, and physics. No more than 20 semester hours of a candidate's pre-professional education (in courses other than the natural, biological and physical sciences) can have been acquired through CLEP exam or through challenging courses. Purpose The purpose of the curriculum is to give a student a thorough understanding of the structure and function of the human organism in health and disease. A well-balanced presentation gives the student an understanding of the essential features of the life processes: digestion, excretion, physical and mental growth, nutrition, metabolism, energy, nervous control, the significance of development defects, behavior, and other elements fundamental to the understanding of pathological conditions. An understanding of structure and function makes it possible for students to identify deviations from the normal and provides the essential facts required later for the diagnosis, prognosis, and treatment of disease. A minimum of four academic years of study at a chiropractic college, including practice in a teaching clinic, is required for the doctor of chiropractic degree. In the teaching clinics of the colleges, the advanced student obtains experience in diagnosis, treatment or referral that represents the culmination of the academic learning experience and the transition from student to chiropractic physician. Sample of Required Subject Study The following is sample of various areas of study: Human anatomy Neurology Embryology Special senses Human dissection and topographical anatomy; Biochemistry Physiology Pathology Laboratory procedures Roentgenology Diagnosis Clinical human behavior Obstetrics and gynecology Pediatrics and febrile disorders Geriatrics and cardiovascular disorders Toxicology Dermatology Otolaryngology Psychology Dietetics Orthopedics Physical therapy First aid and emergency procedures Spinal analyses Principles and practice of chiropractic: manipulation, mobilization, manual therapy, adjustive techniques and clinic. Such courses are taught in sufficient depth to fulfill the concept of the chiropractic physician as set forth within the Educational Standards of the Council on Chiropractic Education. The above standards of the CCE have been adopted by the Federation of Chiropractic Licensing Boards (FCLB). The FCLB has recommended to the various state licensing boards that a rule of law be adopted, either by statute or by administrative regulation, wherein it will be provided as follows: "All applicants for licensure who matriculate in a chiropractic college after October 1, 1975, must present evidence of having graduated from a chiropractic college having status with the Commission on Accreditation of the Council on Chiropractic Education, or its successor, or from a chiropractic college which meets equivalent standards thereof." Chiropractic Assistants A certified chiropractic assistant may be defined in general as "an individual who has received education in chiropractic philosophy, terminology, various diagnostic procedures, anatomy and physiology, clinical laboratory, ethics and jurisprudence radiological technology, adjunctive therapy, and basic office procedures. Such individuals are professional aides to the doctor of chiropractic, under whose direct guidance and supervision they perform various technical duties, have basic office responsibilities, and assist in the preparation, control and care of patients." Presently there are no national licensing provisions for chiropractic assistants, although some states are now considering some manner of licensure. Several chiropractic and liberal arts colleges have given recognition to and effected an educational curriculum for their special training. These programs were initiated to meet the needs and responsibilities of the chiropractic physician as a primary health-care provider. Plans are now being developed within chiropractic postgraduate education to encourage greater use of chiropractic assistants to increase professional productivity. State and national chiropractic organizations, in conjunction with the chiropractic colleges, are developing plans to pass legislation that would establish a nationwide accredited chiropractic assistants program.