Chiropractic 2025:

Chiropractic 2025: Divergent Futures
Florida is now in its fifth year and remains the only endowed chiropractic research program at a College of Medicine
within the U.S. 33 The more philosophical-leaning Life University has also expanded its research on vitalism and has
developed its Octagon series of conferences to promote this research and the integration of chiropractic and health
care reform.
Clinical Training and Partnerships
One of the direct measures mentioned by the CCE to assess whether a student has reached the “meta-competencies,”
which are the basis of CCE evaluations, 34 involves “relevant internships/clinical experiences with evaluation.” No
minimum number of hours is specified. Chiropractic colleges are free to define, explicitly or not, how many clinical
training hours they deem necessary and how to integrate them into the curriculum, as long as students eventually
acquire the meta-competencies.
A common theme among interviewees is the need for more clinical training opportunities for DC students,
and particularly opportunities that allow them to rotate through hospitals and care settings with other health
professionals. While MDs receive clinical training in a variety of settings to translate learning into real-world
experiences, clinical training opportunities for chiropractors have been limited so far. Chiropractic programs
were already offering training at associated clinics. Also, DC graduates have the option of joining a practicing
chiropractor’s practice as an associate before moving on to their own practice. However, there is an overall trend
toward providing chiropractic students with more field practice and clinical training before licensure.
Although DC residencies do not formally exist in the VHA or DoD medical facilities, a rising number of DC
students are also training in these settings. Since the introduction of chiropractic services to the VHA in 2004, for
example, chiropractic students may undergo clinical training within VHA medical facilities that have affiliations
with chiropractic institutions. 35 As of April 2009, 17 VHA facilities had established academic affiliations with
11 chiropractic colleges and several other affiliations were in development. 36 In 2013, there are 46 chiropractic
clinics in the VHA, staffed by 49 chiropractors: 41 of these are employees, 4 are contractors, and 4 are without
compensation appointments in conjunction with an academic affiliate. Palmer College has affiliations with 11, and
will send approximately 30 students to clinical rotations this year.
Although the VHA is not the largest provider of chiropractic training, it may be the largest provider of integrated
training opportunities for chiropractic students to practice with other health care professionals. As one interviewee
forecasted, the number of affiliations that chiropractic colleges have with VHA hospitals may increase exponentially
by 2025.
Disruptive Innovations
Given flat or declining enrollments in most colleges and increasing tuition fees, interviewees felt that chiropractic
education needs reform. DC colleges are interested in improving the quality of education, including reducing
duplication by improving coordination in coursework and curriculum with undergraduate programs. Students trying
to obtain multiple degrees have to manage both the costs of the programs and the time required to acquire new skills.
Interviewees noted that DC colleges need to consider a more multifaceted system beyond the traditional classroom.
To address these challenges, many higher educational institutions have begun in recent years to offer programs of
study either entirely online or through a “blended-learning environment,” i.e., a combination of online and offline
learning that allow teachers to coach and tutor students on more of an individual basis. For example, 40% of course
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