To give this fantastic-but-often-misguided profession the fundamental overhaul that it so desperately needs, we’ve got to start where Doctors of Chiropractic are “born” – the schools. Chiropractic education shares many (of the better!) traits with those of conventional medical schools; however, a large chunk of the time spent in chiropractic school resonates somewhere between a for-profit trade school (the cheesy ones advertised on late-night TV commercials) and a spiritual (if not religious) cult.
But before the educational process can be effectively addressed, we’ve got to go one step further – the National Board of Chiropractic Examiners. Yep, that’s right – the lovely/dreaded board exam. For those who aren’t aware, chiropractic doctors, just like medical doctors, must sit for–and pass–multi-part standardized exams administered by their appropriate National Board. This test covers all aspects of foundational science, theory, and practice. Examinees must receive passing scores on all portions of the test to be eligible to sit for the state-administered jurisprudence exam to obtain proper licensure.
There are about 23 different chiropractic schools, and none of them have really appeared to master the marketing basics in terms of generating publicity. People typically enter the profession in one of two ways: 1) they visit a DC, who helps them with a physical problem, become interested in helping others the same way, and ask their doctor how to get into the field. The doctor will recommend one or more schools to investigate, and the process takes off from there. 2) Some become interested in the field whenever chiropractic ranks high on a “Hot Job” list or article, usually on Yahoo! News, CNN, Money, or some other media outlet. Maybe they’ve seen a DC before and maybe they never have, but either way, they like the income potential and the “only 3 years!” pitch that most of us have encountered.
Schools, despite their relative obscurity from the mainstream, remain in semi-tight competition for prospective students, and for those prospects who do their homework diligently, a school’s National Board (NBCE) exam “pass rate” becomes an important factor. The higher the NBCE pass rate, the better the school, or so the logic goes. Thus, schools do what they can to put their best NBCE foot forward…including forming their curricula and lesson plans (right down to factoids dispensed in individual lectures) around the known (and anticipated) NBCE exam question pool. Sometimes, this comes at the expense of true education, as seen in countless cases where students study their ever-lovin’ tails off for the board exams, memorizing questions and their correct answers, and yet retaining very little information a year or two after taking all the exams, obtaining their license, and doing little besides adjusting and self-promotion/marketing in daily practice.
When the pass rate is highlighted to intensely, becoming a deciding factor in a tight race between chiropractic schools, it’s tough to blame the school itself for teaching to the tests. After all, a school’s survival depends on it. What results, though, is often a fragmented education, where the meaningful assembly of meaningless minutia is left entirely up to the overworked, chronically-stressed student. It’s a very disorienting experience and graduates are often left drained, burned out, broken, and having to pick up the pieces of what’s left in order to make sense of their lives post-graduation – because, as they realize much to their horror, that’s where the “real work” begins.
What’s worse is, the board question pool contains information that is outdated and often just plain wrong. In intensive board-review classes that are given by private outfits just before each board exam, the phrase “THIS is what you do in real life….but THIS is what to know for Boards” is all-too-common. The discrepancy boils down to the fact that you’ve got elderly old-timers (and old-schoolers) who seem to perch themselves in a Chiropractic Ivory Tower and write theoretical questions to keep the board exam tough. Indeed, it gets tougher every year. But they’re drawing on information from yester-decade, which doesn’t always bode well for the profession because what results is yet another batch of chiro-ducklings muddling through miscellaneous information that in the end, doesn’t even turn out to resemble real life or help their future patients.
I promise I’ll tear the schools a well-deserved orifice next time, but this had to be said first. In short, it’s not entirely their fault.