What is it like to be a Chiropractor, and what are the requirements to become one?
As a Chiropractor who has been working in Singapore for the past 4 years, I often hear a few repeating things from my patients ranging from, “That was damn shiok (the Adjustment)” to “How do you know exactly where that sore spot is?” and “How do I become a Chiropractor, this feels awesome!”.
What the patient sees is a smooth and structured exam process, detailed history, and a specific Chiropractic Adjustment, but most don’t understand what it takes to get to this professional skill level.
There is an estimated 40 Chiropractic colleges worldwide, with 20 of them in the U.S.A. There are no Chiropractic schools in Singapore, so I would advise finding a school that is accredited by the Council of Chiropractic Education (CCE-I) which regulates Chiropractic training programmes. I will be sharing my perspective as a U.S.A. graduated Doctor of Chiropractic, since each country has different requirements and regulations.
Chiropractic Degree Requirements - The Nuts and Bolts
For most schools, they require at least 3 years of an undergraduate degree (90 semester hours) with at least 24 hours in lecture and lab-work for the physical sciences prior to applying. In my class at Palmer College of Chiropractic - Florida Campus, most had completed their B.S. or B.A. before entering Chiropractic, as I did with my Bachelor of Science in Biology from University of Central Florida.
The application process is fairly easy, since there is no Medical College Admission Test (M.C.A.T.) and scrutiny is placed on your previous undergraduate classes, GPA (3.0 minimum on average), references (make sure to shadow a few Chiropractors and get letters of recommendation) and face-to-face interview with the admission representative.
How Long is Chiropractic Education?
After your separate 90 semester hours in undergraduate work, a Chiropractic degree in the United States of America (U.S.A.) will involve an average of 4,200 theory and practical teaching hours and 1,000 hours of supervised clinical training. The unique part of having a Chiropractic education in the U.S. versus in Europe, Australia, or New Zealand, is that the time you spend in school is “shorter” at about 3.25 years as compared to 4-5 years elsewhere. The major difference is there are a lot more hours squished into our years, and the intensity of the multiple classes can be much more demanding.
Check out a sample curriculum at Palmer Chiropractic here.
What Is It Like in a Chiropractic Program?
Thankfully for my experience, everything was a great balance of serious professionalism, specialised and tough classes, led by good natured and kind professors, and helpful classmates. As the first year can be overwhelming with the heavy hours of Anatomy and Physiology, it’s nicely balanced with a few hours a week of “hands on” study of palpation and Chiropractic Adjustment set ups (“No thrust!”) to build up your psycho-motor skills.
At Palmer Florida, we had access to a cadaver lab on campus which was not only utilised as a teaching lab, but also as a testing lab where colored pins would be placed into certain anatomical structures for you to identify and answer any physiological questions regarding the area. Not all schools have access to this, but this was an excellent way for me personally to cement in the textbook knowledge to the physical body. Often we would spend extra hours after school in the “Lab” to review for tests and reinforce anatomical markers.
Every school and class is different, but your classmates will become your extended family. You will be seeing them 7:30 am to 4:30 pm every day, studying with them, working with them, working on them, and everyone shares their ups and downs. While you will have more time to yourself in the later years of education (after 9th quarter), most of those hours will be spent studying for Part 3 and Part 4 board certification.
You will take extremely difficult classes (with a higher failure rate) like Neurology of Spine and Peripheral Nervous System 1 and 2, Advanced Neurology, Pathology, and Radiology Diagnosis 1 and 2. You will also take easier classes like Health Psychology, X-Ray Physics, Normal Aging and Development. Although the amount of in-school hours are heavy, they also do not reflect the vast amount of time studying outside of school. For this reason, taking up a part time job is usually not advised the first two years.
So When Do You Start Adjusting?
Most schools start adjusting after their second year of education, but Palmer uniquely starts at 5th quarter. In regards to adjusting, your first year is all about building up your psycho-motor skills, palpation technique, adjusting set ups, diagnostics, and building proper body control and ergonomics.
Your very first adjustment is done on your willing and eager classmate (after all, the whole class has been setting up and saying “thrust” for the past year). Some students find adjusting skills very difficult to “get” or to “master”. Patience, repetition, and practice under specialised instruction is always key. As noted in other articles on Align Chiropractic, the Chiropractic Adjustment is incredible safe when there has been a proper examination, history, and is performed by a qualified Chiropractor.
It can take a long time to become a consistent, good adjuster with great post-adjusting checks (indicators showing positive nervous system adaptation to the adjustment, not just a decrease in pain). Every school has amazing and dedicated teachers and adjusting clubs on campus to help you progress and master the very difficult and varied techniques. At Palmer, we learn Diversified technique, Sacro-Occipital Technique, Gonstead, Thompson Drop Technique, Upper Cervical Toggle Technique, and many more. In addition, you will learn soft tissue (muscle and fascia) techniques, passive modalities (Ultrasound, E-Stim, Cold Laser) and Physiotherapy.
Accreditation and Licensing of Chiropractic Degree
During all of your hard work of school training, you will also have to manage studying and passing “Boards” which are 5 board certifications that are necessary to become licensed in the U.S.A.
During your second year (roughly 6th quarter) you have learned enough of the basic sciences, Anatomy and Physiology, Chemistry, Microbiology, and Pathology to sit for Part 1. They are delivered by National Board of Chiropractic Examiners (N.B.C.E.), are notoriously extremely difficult, can take 5 hours to complete each part, and cost about $685 each test.
Along the way, you’ll also have to pass Part 2, Part 3, Physiotherapy, and Part 4.
Part 3 has an interesting difficulty level added to it, with 4 hours of testing for 110 questions and 10 case vignettes involving case history, neuro-muscular examination, diagnostic imaging, clinical laboratory and special studies. Part 4 is beast of a test involving 20 stations where you will have 2 minutes each station to view diagnostic images and answer 2 related questions, a Chiropractic Technique section where you will be critiqued on your Adjustment set up, and a last section of 20 stations where you will be asked to perform a full case history, physical examination, or orthopaedic testing or neurological testing, within 5 minutes. Whew.
Once you have completed all of your Chiropractic education and passed all 5 parts of the board certifications, you are now a registered Doctor of Chiropractic (D.C.). If you want to practice inside of the U.S. you need to additionally take a licensing test for each individual state and take continuing education hours depending on state requirements.
What Is The State of Chiropractic In Singapore?
Currently, there are less than 150 Chiropractors in Singapore. Even though there are over 70,000 Chiropractors in the U.S. alone, Chiropractic is still very new to Southeast Asia. We are seeing that more and more people are looking for an alternative solution to their health problems, and seeking a way to help them “live healthier and better.“
As of now, Chiropractic is recognised and regulated in nearly every first world country except Singapore. Technically a foot reflexologist could open up a clinic and say they are a Chiropractor. When seeing a Chiropractic in Singapore always make sure to check if they have an education from an accredited school. We are hopeful that one day soon Singapore moves forward to regulate the profession, as this will benefit everyone. As a local Singaporean, you should only need to have your Chiropractic degree, but it would be advisable to attain all board certifications for any future licensing requirements in Singapore.
As an expat, to apply for an Employment Pass (E.P.) you will have to send all transcripts and degrees, and licensing in at least 1 state or country.
In My Opinion
I graduated from Palmer Chiropractic-Florida Campus following the traditional path (3.25 years, or 13 quarters after my B.S. Biology degree), although some classmates chose to take a slower approach extending their education time by taking less hours each quarter. I am happy to recommend Palmer Florida as it’s a well known for having one of the best blends of great medical training and still being very philosophically bound to Chiropractic.
Education everywhere is not cheap anymore, and typical costs of school for a full program are $120,000 USD. That does not include the cost of relocation, housing, food, textbooks, and transportation costs. Many Chiropractors end up with a debt of at least $150,000 USD. Given that the average Chiropractic salary in the U.S. is $68,640 USD, I advise not going into Chiropractic “for the money”. If you are truly looking to help people in a way that will substantially improve their lives, and not rely on the medical answer of drugs and surgery, then Chiropractic is the best profession to choose. I love being a Chiropractor. It is incredibly rewarding to help people and see amazing changes happen once their body becomes aligned.
We can see all of the poor posture, poor physical habits, aches and pains all around us, yet this dysfunction is becoming a part of our daily culture! Health and healing comes from the body, via a complex web of adaptation and homeostasis.
By specifically checking and adjusting the spine, Chiropractors are doing much more than eliminating pain. Chiropractic is designed to assess and correct Nervous System dysfunction at the root cause. Neurological health, and slowing down the slow wear and tear of the body (degeneration) is becoming a more popular and recognised health focus, and with the raising Chiropractic awareness I truly do see a happy and healthy future for the profession and our patients.
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