How to Become a Chiropractor

By: Dr. April McDowell, MFT

Last Updated: Dec 17, 2018

Chiropractors are health care professionals who treat illnesses and injuries and promote overall health using hands-on adjustments of the spine and joints. Unlike medical doctors, they do not prescribe drugs or perform surgeries. Instead, they focus on increasing the body’s natural healing power. Chiropractors are experts in caring for the neuromusculoskeletal system, which includes the nerves, spinal cord, bones, ligaments, and tendons.

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People often turn to them for treatment of back and neck pain, headaches, arthritis, and injury rehabilitation. Chiropractic care is also believed to promote overall health and wellness. For this reason, a growing number of people are choosing a chiropractor as their primary care provider.

Most chiropractors are generalists, but some specialize in a practice area like pediatrics, orthopedics, nutrition, or sports rehabilitation.

Chiropractic is based on a wellness model of human health and functioning. Chiropractors believe that structural maladjustments of the joints and spine impair the nervous system, causing pain and dysfunction throughout the body. Relieving these maladjustments enhances the body’s natural healing abilities. Chiropractors also acknowledge the roles that infection, injury, and occupational and lifestyle factors play in human health.

Many chiropractors are drawn to the field because of its emphasis on natural, patient-centered care. They take pride in healing their patients without the use of invasive treatments. They also like being part of a well-established health care field with a high degree of acceptance and prestige.

Workplace Details

About 37 percent of chiropractors were self-employed in 2012, either as solo practitioners or joint owners in a group practice. Most of the rest work for chiropractic practices, physician practices, hospitals, holistic health centers, and chiropractic schools.

Self-employed chiropractors enjoy considerable freedom to set their own hours. About a third of chiropractors work part-time. However, it’s common for these professionals to work some evening and weekend hours for the convenience of patients.

Hover over any state to explore local income and job growth data.

According to the US Bureau of Labor Statistics, chiropractors earn a mean annual wage of $81,210. The lowest-earning 10 percent earned a median salary of $32,380, and the highest-earning 10 percent earned a median of $141,030.

Salary tends to grow with experience and years in practice. Chiropractors can build their clientele by being personable, achieving great results for patients, and taking time to educate themselves about the business side of the profession.

There are many resources available to chiropractors who are looking to start a new practice or manage an existing practice. The ACA maintains an online practice resource center for its members.

Job prospects for chiropractors should be very good over the next ten years. The US Bureau of Labor Statistics expects employment to grow by 17 percent between 2014 and 2024.

In large part, growth will be driven by increased public demand for alternative and complimentary therapies. People of all ages are seeking nonmedical treatments to their health problems. In addition, medical doctors have begun to recognize the value of chiropractic care. As a result, chiropractors are increasingly joining team practices within physician groups and hospitals.

Demand for all health care services is expected to increase over the next decade as the population ages. Members of the Baby Boomer generation are staying active longer and are more engaged in their own health care than previous generations. In many cases, they are choosing chiropractic treatment for arthritis, back pain, and other bone and joint conditions associated with aging.

Finally, federal health care reform and expanded insurance coverage has given more people access to all health care services, including chiropractic care.

The International Chiropractors Association maintains a job board, as do several of the chiropractic specialties.

High school students interested in a chiropractic career should take as many high-level science classes as possible. Coursework in anatomy, physiology, biology, chemistry, physics and psychology can help to lay a strong foundation for this career path. This is also a great time to learn more about chiropractic philosophy and practice through job shadowing, volunteering, and reading.

Some chiropractic schools admit strong students who have completed two to four years of undergraduate work, but most prefer candidates with bachelor’s degrees. No specific major is required, but students should have a strong background in the natural sciences. A good rule of thumb is to take the same prerequisites required for medical school:

• One year of biology
• Two years of chemistry (through organic chemistry)
• One year of English
• One year of physics

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Chiropractors must earn a Doctor of Chiropractic (D.C.) degree, which will require usually 4-5 years of study after undergraduate study. Chiropractic schools are accredited by the The Council on Chiropractic Education. Students receive extensive classroom and lab instruction in anatomy, physiology, rehabilitation, nutrition, and public health. They also complete at least one full year of clinical experience, during which they care for patients under supervision.

In order to become board-certified in some chiropractic specialties (radiology or sports rehabilitation), candidates must complete a three-year residency, or supervised clinical training program.

There are several other levels of post-graduate study available to chiropractors:

• Certificate programs in veterinary, extremity, rehabilitation, sport, and spinal trauma care
• Three-year post-graduate programs leading to board certification in pediatrics, acupuncture, orthopedics, neurology, radiology, diagnosis and internal disorders, sports medicine, family practice, and clinical nutrition
• A master’s degree in a related field such as nutrition, rehabilitation, or public health

Chiropractors must be licensed in all 50 states and the District of Columbia. This process is usually administered by the state health department or a specific board of chiropractic examiners.

All states require the following for licensure:

• Completion of an accredited Doctor of Chiropractic program
• A passing score on parts I through IV of the National Board of Chiropractic Examiners (NBCE) exam

Some states also require:

• A bachelor’s degree
• Passage of a state licensure exam
• Additional requirements

Chiropractic specialists are generally board-certified, which requires additional study and the passage of a specialty-specific exam.

Experienced chiropractors can expand their opportunities by:

• Starting a private practice
• Pursuing certification or board-certification in a specialty
• Learning new techniques
• Becoming a faculty member at a chiropractic training program, which involves teaching, research, and administrative duties
• Advancing the profession through involvement in professional organizations

For students interested in becoming leaders within the profession, the Student American Chiropractic Association (SACA) provides a Leadership Apprentice & Mentor Program. This prepares new professionals to serve as state delegates and to head committees and specialty councils within the American Chiropractic Association.

All states require chiropractors to hold a DC from an accredited program in order to practice.

Most chiropractors start their educational journeys by completing at least 90 hours of undergraduate coursework. (Note that a few states require a bachelor’s degree for chiropractic licensure.) They then spend 3–4 years in chiropractic school earning a DC. Those who wish to specialize or enter academia often go on to complete 1–5 years of additional postgraduate study.

As undergraduates, future chiropractors can major in any subject, but must complete the prerequisites for chiropractic school. These typically include 24 hours in the life and physical sciences with a GPA of 3.0 or higher. At least half of these science classes should have a lab.

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Undergrads can apply to chiropractic school at any time, so long as they can demonstrate they’ll have completed their prerequisites before entering the DC program. Some colleges have accelerated 3+3 programs that help students make an early transition to chiropractic school.

DC degree programs are found at private colleges of chiropractic and health professions schools. The Council on Chiropractic Education accredits programs that meet its quality and curriculum standards. In May 2017, 15 schools offered DC programs in 17 locations around the United States.

Chiropractic training blends classroom and hands-on instruction. DC students study:

In addition to their classwork, DC students complete at least a year of hands-on clinical education. This might take place at the school’s chiropractic clinic, at an integrated health practice, or even with a government agency like the VA.

After earning a DC, chiropractors have many opportunities for postgraduate education:

• Certificate courses (1 year) – learn a new skill or modality
• Residency (3 years) – become eligible for board certification in a specialty like pediatrics or sports medicine
• Fellowship (1–2 years) – train in a subspecialty, usually with the intention of becoming an academic or researcher

Many chiropractic schools also offer combined DC-MS programs in majors like nutrition or acupuncture.

The National Board of Chiropractic Examiners administers primary board certification testing for chiropractors. Most states require board certification as a condition of licensure.

The American Board of Chiropractic Specialties (ABCS) offers two basic levels of credentialing:

• Certificate programs require 100–150 hours of post-graduate coursework and an exam. They may serve as a prerequisite or accelerated pathway to a diplomate.
• Diplomates are board certified in a medical specialty. This credential requires at least 300 hours (about 3 years) of post-graduate training, usually in the course of a residency.