Chiropractors are entrusted with the care of some of the body’s core systems: the nervous, muscular and skeletal systems. So it stands to reason that becoming a chiropractor takes a lot of preparation.
The process for getting your chiropractic license varies depending on where you want to practice. Each state has its own licensing requirements—which enables you to practice only within that jurisdiction—and some are stricter than others.
Before pursuing a career in chiropractic, you’ll need to become familiar with the laws and regulations specific to your state. In general, however, most chiropractors follow a similar path. Below are the basic steps every chiropractor must complete to obtain a license.
STEP 1: Earn a doctor of chiropractic degree.
The first step in getting your license is to earn a doctor of chiropractic degree from an accredited chiropractic college. This allows you to legally perform spinal adjustments in the United States.
Depending on your state, you may need to get a bachelor’s degree, as well. While most students earn a bachelor’s degree before enrolling in a doctor of chiropractic program, not everyone has to.
Although some states require a bachelor’s degree before you can obtain a license, most chiropractic schools typically require about three years of undergraduate education for admission. At Palmer College, we require:
• At least 90 undergraduate credit hours
• GPA of 3.0 or greater on a 4.0 scale*
• 24 semester hours in life and physical sciences, half with corresponding labs
• Official transcript and favorable background check review
• Well-rounded general education program in the humanities and social sciences
• (life science, humanities, behavioral sciences, etc.)
• Port Orange, Fla. campus only: priority seating given to those who’ve earned a bachelor’s degree
*Applicants who have fewer than 24 semester credits and/or a cumulative G.P.A. less than 3.0 may qualify through the alternative admissions track plan (AATP), which involves a more extensive review of personal enrollment factors.
STEP 2: Pass the NBCE exam.
The biggest hurdle most chiropractors face is passing the primary licensing exam, administered by the National Board of Chiropractic Examiners (NBCE). It’s a four-section exam, and the vast majority of states require chiropractors to pass it to obtain a license.
The four parts of the exam include:
• Part I—This section covers basic science subjects, including general anatomy, spinal anatomy, physiology, chemistry, pathology and microbiology. All but one of the states (Michigan) require chiropractors to pass this part of the exam, which students can take after their first year of chiropractic education.
• Part II—This section covers six clinical subjects, including general diagnosis, neuromusculoskeletal diagnosis, diagnostic imaging, principles of chiropractic, chiropractic practice, and associated clinical sciences. All but two of the states require chiropractors to pass this part of the exam, which students can take during their senior year of chiropractic college.
• Part III—This section covers case history, physical examination, neuromusculoskeletal examination, diagnostic imaging examination, clinical laboratory and special studies, diagnosis or clinical impression, chiropractic techniques, supportive techniques and case management. All but five of the states require chiropractors to pass this part of the exam, which students can take once they’ve passed Part I and are within eight months of graduation.
• Part IV—This section involves a practical exam covering x-ray interpretation and diagnosis, chiropractic technique, and case management skills. At least 21 states require chiropractors to pass this part of the exam, which students can take once they’ve passed Parts I and II and are within six months of graduation.
Palmer serves as a testing site for all of the NBCE exams. More than 80 percent of students who take the exam at our campuses receive a passing score.
STEP 3: Know and meet your state requirements.
Every state regulates chiropractors a bit differently. Although a doctor of chiropractic can legally perform spinal manipulations anywhere in the United States, each jurisdiction decides for itself what other modalities chiropractors are allowed to use.
For example, Oregon chiropractors can perform proctology and obstetrical procedures. They can also incorporate physiotherapy, venipuncture and nutritional supplements into their practice. By contrast, chiropractors have far fewer options in Michigan, where they’re restricted to detecting and adjusting spinal subluxations.
To ensure aspiring chiropractors understand these limitations, all but five states require students to pass a state-level exam in addition to the NBCE test. This exam often covers the state’s laws regarding scope of practice limitations; however, it can vary drastically from state to state.
“Some of these examinations consist of a personal interview, some consist of questions about the State statutes governing the practice of chiropractic, and others give written or practical examinations in various subjects, such as radiology, adjusting techniques, clinical science subjects, or other areas of particular interest to that state,” says chiropractic researcher Ruth Sandefur.
Additional state licensing requirements may include:
• Undergoing a criminal background check.
• Submitting a list of personal references.
• Obtaining the required malpractice insurance.
• Paying a licensing fee.
Once you obtain your chiropractic license, you’ll need to regularly renew it. This usually involves some form of continuing education as well as a renewal fee. Getting to know your state’s renewal requirements will help you stay on top of the process as you set about establishing your chiropractic career.