CCE: Poised to Dilute Chiropractic Education

James Musick, DC

Dr. Musick is currently Western Regional Director and on the Board of the International Chiropractors Association and serving on ICA’s CCE (watchdog) Committee. He has served on the CCE Board of Directors, as a CCE Commissioner on Accreditation and on multiple CCE site visitation teams. He is one of the founders and incorporators of Pacific States Chiropractic College (now Life West) and President of Northern California College of Chiropractic (now Palmer – West).

I had the opportunity to develop the curriculum for two different chiropractic colleges in the mid to late 1970s; first Pacific States Chiropractic College (PSCC, now Life – West) and secondly, Northern California College of Chiropractic (NCCC, now Palmer – West). 

To comply with California Law, CCE accreditation was required. CCE mandated that each college disclose whether-or-not the institution provided all necessary educational requirements for each respective state.  If an institution did not provide any necessary requirements in a given state, the college had to disclose that fact to prospective students through their college catalog. 

In order to qualify students for chiropractic licensure in all states, it was a simple task of evaluating minimal educational requirements for each state, then developing a curriculum, fulfilling the state with the highest number of hours, per subject. 

For example, in California the requirement is a minimum of 4,400 hours of chiropractic education for licensure in this state (16 CCR, Art. 4, Sec. 331.12.2).  More specifically, California requires 616 hours in anatomy.  If another state required 800 hours in anatomy, the minimum hours taught in anatomy would have to be 800 hours in order to qualify students for licensure in both states. 

Following this process, the total number of hours required of the institution, at that time, to satisfy minimal educational requirements for all states was around 4,800 hours. This would qualify a chiropractic graduate to practice in any state, regardless of the state’s slant toward a narrowed or broad scope practice. 

Both PSCC and NCCC elected not to teach minor surgery, an Oregon requirement.  In fact, chiropractors (and therefore our students) were prohibited by California law from puncturing or penetrating the skin.  So, to develop a curriculum to provide requirements for Oregon (in a different state), the college would have to include the estimate of 4,800 hours, plus those required by Oregon to do minor surgery. 

Assuming each college is meeting CCE and all respective state educational requirements, each graduate going into a state requiring a subluxation analysis or diagnosis, requiring exceptional adjusting skills, or mobilization or manipulation skills, should be well trained to do so, and should know the difference between a specific adjustment, mobilization and a manipulation. 

States requiring a strong emphasis and training in the examination and diagnosis of neuromusculoskeletal conditions, and the use of physical and manual methods, should be well educated and trained to meet the minimal requirements for that respective state.  To remind you, I graduated in 1972 from a straight college but chose to practice in California. 

Regardless, the chiropractic licentiate is well trained in approximately 4,800 hours to meet minimal licensure requirements for all states.  Therefore, a patient should have some idea of what to expect from a chiropractor when traveling from one chiropractor to another, or from one state to another. 

Chiropractic education is unique, has a long lasting tradition and has produced well trained effective scenically based, subluxation based, chiropractors.

Consider the CCE proposed standards, to remove traditional cornerstones from chiropractic education, i.e.:  the use of the word “subluxation”, and the phrase, “without the use of drugs and surgery”.  The motivation is to allow colleges to teach proprietary drugs, medicine, injectibles and/or surgery, while maintaining their accreditation through the CCE. 

Remember, there is already a 4,400 to 4,800 hour requirement to meet minimal state requirements for licensure.  Does this mean that additional hours are necessary to teach added courses, such as minor surgery for Oregon?  Yes it does, because you really can’t dilute minimal state requirements for licensure and be state and CCE compliant for all states.

Consider minimal educational requirements for medical physicians at the time of their graduation.  The question is, “How much addition time would a medical school graduate need, to study, learn and do what chiropractors know and do?" 

The United Nations (UN), World Health Organization (WHO) has already evaluated this question (www.wfc.org > About WFC > World Health Organization > English > Annex 3).  According to WHO, the average graduate from medical school would need an additional 2,205 hours to know and do what chiropractors are trained to do.  Assuming their education is 4,400 to 4,800 hours that would mean that the medical graduate (and medical physician with no additional training in physical medicine) would have to go to chiropractic college for two to three additional years to obtain the same education and skill level as a graduate chiropractor.

If it takes 2,205 additional hours for a medical physician to be educated and trained as a chiropractor, how many more hours would it take for a chiropractor to be legitimately educated and trained as a medical physician? 

Assuming both first professional degrees are 4,400 to 4,800 hours, and it takes an additional 2,205 hours for a medical physician to train as a chiropractor, the math is simple.  The chiropractor would, also, need 2,205 hours to train as a medical physician, assuming all other course requirements were equal. 

There is nothing wrong with being a medical physician, if you accept the use of drugs and surgery.  However, to meet minimal state requirements for licensure, a chiropractic college cannot honestly dilute their current 4,400 to 4,800 hours and substitute those hours with courses in proprietary drugs, injectibles, pharmaceuticals and surgery. Outside admitting to fraud, an institution cannot meet all state educational requirements, and would have to add hours to their current curriculum to teach these additional courses.  

If an institution wishes to train students as medical physicians, simply add 2,205 hours in addition to the D.C. program, get their medical curriculum accredited through an appropriate accreditation agency, and leave the chiropractic curriculum, intact. Otherwise, the outcome is a partially trained medic and a partially trained chiropractor. 

Chiropractic institutions should already have an educational tract to educate medical physicians in chiropractic care. If the chiropractor wishes an MD degree, count on two - three additional years, not 75 to 95 hours for a weekend credential from a chiropractic college accredited, or not, by the CCE.  It is substandard care and dilutes chiropractic education and our profession.