Chiropractic is a very unique profession. As such, there are a good amount of questions concerning the perception of chiropractic education. Unfortunately some of the reasons for these questions is the lack of a common and unified voice from my profession in educating the public. One of these lulls in public education and of the most common questions I get is the education required to become a chiropractor. According to a recent Gallup poll, there is a reason I get that common question as a majority of Americans are unaware of the education of a chiropractor. Of the 5442 people polled 67% underestimated the education of a chiropractor (49% answered 4-6 years, 18% answered 2 years or less) and another 19% stated that they did not know. Only 15% of those polled correctly identified the 7 or more years required to become a chiropractor. These answers represent a wide amount of individuals who have seen a chiropractor within the last 12 months, within 5 years, more than five years ago, or those who have never seen a chiropractor. Interestingly enough, although individuals who have recently been to the chiropractor had a higher likelihood of correctly guessing the education requirements, a significantly large amount did not. This means that there are individuals currently receiving care that are asking this exact question. So in an effort to help educate and inform past, current, and prospective patients of chiropractic, here is both a summary of the educational requirements of chiropractors vs other common health professionals as well as a few takeaways from these statistics.
Comparison in Education
In order to earn a Doctorate of Chiropractic, a chiropractor must first achieve a bachelors degree and apply for chiropractic school. Much like the prerequisites for medical school, chiropractic school requires a large amount of education in basic and biological sciences and require a proficient passage of these courses with at least a 3.0 on a 4.0 scale. Although many chiropractic schools have a different breakdown in the academic calendar (some use semesters, others, trimesters, and even others quarters) all chiropractic programs are essentially a 5 year degree condensed into just over 3 years. This means that per academic term, chiropractic students will have between 26 – 35 credit hours per term. In my school we used trimesters and the average number of hours was 30+ per trimester. That accounts for class schedules that start as early as 7am and go until 4 or 5pm (sometimes even later). Chiropractic education is also year round schooling and there is no break from start to finish in the curriculum. Medical and Osteopathic schooling is 4 years of schooling which is typically back loaded in terms of hours. Initially, med students get summer breaks and only operate at about 24-28 hours a semester. This cranks up after their second year into pretty much year round training. As you may notice below, the educational hours that chiropractors go through is very similar to the educational hours of an M.D. and D.O. during medical school. There are, however some very important differences between medical school and chiropractic school, as well as the extended training required after schooling is completed. These are the things that I wish to explore, and explain the reasons for these differences in training.
So what constitutes the difference in hours between doctors of Medicine, Osteopathy, Chiropractic, or even Physical Therapy. First and foremost, it should be said that Doctors of Osteopathy and Doctors of Medicine are, for the sake of simplicity, one in the same when it comes to their schooling. There will be minor differences in curriculum but it will be essentially the same education. This is what accounts for the small difference in hours which only really accounts to a handful of classes. Medical/Osteopathic school is essentially a foundational education in medicine. Classes are heavily weighted in cover chemistry, microbiology, physiology, pharmacology and toxicology, immunology, and pharmacology.
Chiropractic education contains all focus subjects listed above, however its roots are more embedded in musculoskeletal diagnosis, neurology, physiologic and rehabilitative therapy, anatomy (most specifically spinal and musculoskeletal anatomy), and hands on assessment and treatment techniques specific to the skills of a chiropractor.
Physical therapy will lend itself to a similar schooling as chiropractic, but has traditionally been less in depth and less rigorous. A DPT program encompasses 3 years or less of education. This involves a heavy dosage of physical rehabilitation, physiological therapy, musculoskeletal diagnosis, and some anatomy. Some schools spread their hours out over the entire year, whereas others still are able to enjoy a summer break. Overall, the class loads of Physical Therapy are much lower per term than Chiropractic or Medical school, which accounts for the difference in overall hours shown.
The reason for these differences in focus? The differences in profession of course! Medical, osteopathic, and chiropractic education are all focused on having a broad knowledge portal of entry level knowledge of many different conditions across all systems of the body. They branch off from here due to their scope of practice, treatment strategies, and management duties. In the medical and osteopathic professions most treatment surrounds drugs and surgery and less around physical treatment and rehabilitation. Therefore, these schools are going to be much more heavily weighted towards chemistry, biology, pharmacology in toxicology, and immunology, and less on physical rehabilitation and physiological therapeutics and musculoskeletal anatomy. Furthermore, because medical and osteopathic doctors directly handle more systemic and disease conditions than chiropractic or physical therapy, they will focus less on specifics of musculoskeletal diagnosis and anatomy.
Chiropractic education requires well-rounded knowledge of each body system and pathology in order to properly refer to the correct medical specialist. The vast majority of services that chiropractic provides will be physical in nature and less invasive. They’re also, by professional nature, more specialized to musculoskeletal conditions and many also take their own x-rays. This is why chiropractic school must be so heavily weighted in subjects such as anatomy (specifically spinal and musculoskeletal anatomy), physiology, radiology, rehabilitation, and physical treatment of the musculoskeletal system.
It is important to note that these comparisons are made on the basis of schooling only. On one hand we can look at this and see that for musculoskeletal conditions chiropractors are the most educated profession. On the other hand it is very important to understand that one’s education is only a small indicator of the clinical skills and abilities of a practitioner. The letters behind a given health practitioners name are merely an indicator on their educational background. It is very important to understand that just like in any other profession there are good and bad practitioners in each profession, and even though all these professionals are doctors there is still a spectrum of skill in each profession. There are some physical therapists that are better skilled and produce better results than chiropractors and vice versa. The reason for this is not because of the base level of education, but rather the application of that education and the focus on improvement of that education following graduation. There is also a case to be made about the level of specialization that occurs across these professions as well. Medical and osteopathic doctors complete many more years of education following graduation of medical school than chiropractic doctors or doctors of physical therapy. In part two of this series we will explain why these two points should be taken into account by the patient when seeking healthcare for various conditions. The goal here is not to put down or prop up one profession over the other, but to understand each profession (specifically chiropractic education) and when you should seek one professional over the other.