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Common international standards of education have been achieved through a network of accrediting agencies that began with the US Council on Chiropractic Education (CCE), recognized by the US Office of Education since 1974. These agencies are now represented by the Councils on Chiropractic Education International (CCEI).

Entrance requirements vary according to country, but in North America are a minimum of three years university credits in qualifying subjects. The chiropractic college professional program has a minimum of 4 full-time academic years, and results in a masters degree or equivalent in many countries. It is followed by postgraduate clinical training and/or licensing exams in many countries. Postgraduate specialties include chiropractic sciences, orthopedics, pediatrics, neurology, radiology, rehabilitation and sports chiropractic.

In former times most chiropractors graduated from North American colleges. There are now colleges in Australia, Brazil, Canada, Denmark, France, Japan, Korea, Mexico, New Zealand, South Africa, Spain and the UK as well as the United States. Depending upon the country chiropractic education is either within the university system (most countries) or in private colleges. Colleges are being developed in many other countries (e.g. Argentina, Chile, China, Italy, Switzerland and Thailand).

Research

There is substantial evidence supporting the safety and effectiveness of chiropractic treatment for patients with the conditions most frequently seen in chiropractic practice and highly prevalent in the population, namely:

In recent years, numerous independent researchers and various government agencies have conducted studies which focus on the efficacy, appropriateness and cost-effectiveness of chiropractic treatment. Several of these important studies are listed below.
 

U.S. Government Agency Report

A 1994 study published by the U.S. Agency for Health Care Policy and Research (AHCPR) and the U.S. Department of Health and Human Services endorses spinal manipulation for acute low back pain in adults in its Clinical Practice Guideline # 14. An independent multidisciplinary panel of private-sector clinicians and other experts convened and developed specific statements on appropriate health care of acute low back problems in adults. One statement cited, relief of discomfort (low back pain) can be accomplished most safely with spinal manipulation, and/or nonprescription medication.
 

The Manga Report

A major study to assess the most appropriate use of available health care resources was reported in 1993. This was an outcomes study funded by the Ontario Ministry of Health and conducted in hopes of sharing information about ways to reduce the incidence of work-related injuries and to address cost-effective ways to rehabilitate disabled and injured workers. The study was conducted by three health economists led by University of Ottawa Professor Pran Manga, Ph.D. The report of the study is commonly called the Manga Report. The Manga Report overwhelmingly supported the efficacy, safety, scientific validity, and cost-effectiveness of chiropractic for low-back pain. Additionally, it found that higher patient satisfaction levels were associated with chiropractic care than with medical treatment alternatives. "Evidence from Canada and other countries suggests potential savings of hundreds of millions annually," the Manga Report states. "The literature clearly and consistently shows that the major savings from chiropractic management come from fewer and lower costs of auxiliary services, fewer hospitalizations, and a highly significant reduction in chronic problems, as well as in levels and duration of disability."
 

Rand Study on Low Back Pain

A four-phase study conducted in the early 1990s by RAND, one of America's most prestigious centers for research in public policy, science and technology, explored many indications of low-back pain. In the RAND studies, an expert panel of researchers, including medical doctors and doctors of chiropractic, found that:
 
  • chiropractors deliver a substantial amount of health care to the U.S. population.
  • spinal manipulation is of benefit to some patients with acute low-back pain.
  • The RAND reports marked the first time that representatives of the medical community went on record stating that spinal manipulation is an appropriate treatment for certain low-back pain conditions.
 

The New Zealand Commission Report

A particularly significant study of chiropractic was conducted between 1978-1980 by the New Zealand Commission of Inquiry. In its 377-page report to the House of Representatives, the Commission called its study "probably the most comprehensive and detailed independent examination of chiropractic ever undertaken in any country." The Commission entered the inquiry with "the general impression ... shared by many in the community: that chiropractic was an unscientific cult, not to be compared with orthodox medical or paramedical services." By the end of the inquiry, the commission reported itself "irresistibly and with complete unanimity drawn to the conclusion that modern chiropractic is a soundly-based and valuable branch of health care in a specialized area..." Conclusions of the Commission's report, based on investigations in New Zealand, the U.S., Canada, the United Kingdom, and Australia, stated:
 
  • Spinal manual therapy in the hands of a registered chiropractor is safe.
  • Spinal manual therapy can be effective in relieving musculoskeletal symptoms such as back pain, and other symptoms known to respond to such therapy, such as migraine.
  • Chiropractors are the only health practitioners who are necessarily equipped by their education and training to carry out spinal manual therapy.
  • In the public interest and in the interests of patients, there must be no impediment to full professional cooperation between chiropractors and medical practitioners.
There are numerous research papers and ongoing projetcs accessible on line.