Chiropractors are primary health care professionals. This means that while many patients are referred by their general medical practitioner or other health care provider, there is no requirement to be referred and potential patients may contact the chiropractic clinic or office directly to request an appointment.
Chiropractors undergo a minimum of four years of training prior to graduation. There are almost 50 educational institutions providing chiropractic education throughout the world. Twenty of these programmes are located in North America, ten programs are offered in Europe, seven in Latin America, six in Australasia, two in Africa and one in the Eastern Mediterranean.
In countries where chiropractic has primary legislation, standards of education and training for chiropractors are prescribed. There are a number of accreditation agencies that set out the framework for the content and standard of chiropractic training. An overarching body, the Councils on Chiropractic Training International (CCEI), bring many of these accreditation agencies together.
In some countries, notably the United States of America and Canada, applicants for chiropractic programmes are required to have completed a relevant undergraduate degree. In others, entry into chiropractic degree programmes is direct. The award granted at the conclusion of the programme varies throughout the world. In the USA and Canada, graduates are awarded a Doctor of Chiropractic degree. Other institutions, depending on the nature of the jurisdiction, may award a Masters or Bachelors degree.
In the early years of chiropractic training, students study subjects that are common to many health professions, including anatomy, physiology and biochemistry. Courses in neuroanatomy, neurophysiology, pathology and neurology also form part of all chiropractic programmes. As experts in manual therapy, there is an emphasis on biomechanics, biophysics and the acquisition of manual therapy skills such as spinal adjustment and other forms of joint and soft tissue manipulation.
Regardless of the award, upon graduation from accredited institutions, chiropractors have completed a rigorous course of training that enable them to be safe and competent to assess, diagnose, manage and treat patients.
In many countries, chiropractors are required to undertake continuing professional development. This helps to ensure that chiropractors stay up to date and inform themselves of the latest evidence. This lifelong learning is common to many health professions and helps to ensure that patients receive safe and effective care.