Future of Chiropractic Curriculum

Have you ever wondered where the chiropractic curriculum developed from? It is quite an amazing story of intrigue, bootstrapping, and warfare. I won’t fill you with too many of the details today (as I am working on a two-hour online course on the history of the CCE…),1 but I would like to share a bit of my vision of what is possible with you.

The first real attempt at an integrated curriculum was pioneered at Palmer College of Chiropractic in the 1920s. The chiropractic greenbooks integrated the philosophy of innate intelligence and the central importance of the vertebral subluxation in human health and dis-ease throughout every course from chemistry to symptomatology, physiology to anatomy. I recently summarized the quotes about innate intelligence from many of these texts written by B.J .Palmer’s staff. The quotes show extraordinary evidence that the philosophy of chiropractic was on its way to becoming the first systems science of human health, rooted in a deep philosophy that explained human physiology as part of an intricate pattern of intelligence expressing through matter itself. 2

Alas, this approach was short lived due to historical circumstance, economics, philosophical and political disputes, and eventually political agendas, which would soon take over the accreditation process in all American chiropractic colleges. B.J. Palmer was voted out of his leadership role of the Universal Chiropractors’ Association (UCA) in 1926. He then started the Chiropractic Health Bureau, which became the International Chiropractors Association (ICA). According to one of chiropractic’s most revered historians, the break within the “straight” chiropractic movement in the 1920s, “had an impact that was significant enough to change the whole course of the chiropractic education and politics for the rest of the century.”3 The remainder of Palmer’s UCA joined with the newly formed ACA (1922), to become the NCA in 1935, which became the modern-day ACA in 1963. The direction of chiropractic education took a decidedly “medical” turn because of these events.

Chiropractic suffered the fate of most of the pioneering approaches to biology in the first half of the twentieth century. Chiropractic’s systems orientation was often overshadowed by a more molecular/medical approach. The brilliant ideas of emergence, holism, organismic biology, and systems theory, which all emerged around the same time as the Palmer greenbooks, were to take a backseat to the developments in molecular biology inspired by Watson and Crick’s discovery of DNA in 1952. The mechanistic approach to biological systems would gain dominance for the rest of the century.4

Chiropractic curriculum reform was undertaken by John Nugent starting in the 1930s, a Palmer graduate from the 1920s. As the NCA Director of Education, Nugent took on the task of reforming the chiropractic schools by modeling Flexner’s approach to reorganizing America’s medical schools. Not only did Nugent encourage many schools to close and merge, go from profit to nonprofit, from no pre-reqs to pre-reqs, from 18 month programs to 36 month programs, but he also led the charge on a standardized curriculum (based on the molecular/medical school curricula) and wrote the first manuals of accreditation.  In 1943, the first handbook of the NCA’s accrediting agency, Nugent wrote, “The chiropractor is a physician -a particular kind of physician, and as such is engaged in the treatment and prevention of disease…” Chiropractors from the philosophical side of the profession were outraged at being referred to as physicians. The new standardized curriculum was modeled after the medical schools. The only significant change was that drug and surgery courses were replaced by chiropractic courses. Nugent was hated by both sides of the profession. In fact, B.J. Palmer referred to Nugent as the anti-Christ. Nugent was also viewed as one of the great reformers of chiropractic education. The CCE of today can be attributed to Nugent’s efforts. 5

Calls for curriculum reform are louder than ever in chiropractic (especially with the recent controversy over the CCE’s lack of accountability to the profession, which resulted in CCE’s being required to comply with 43 violations within a year). Calls for curriculum reform span the profession, from the extreme medical fringe of the profession suggesting we fire all philosophy faculty,6 to a more balanced look at innovative approaches to pedagogy and contemporary content,7 to more visionary approaches.8,9,10  It is time we totally revamp our medical chiropractic education.

What if we start fresh and envision a chiropractic curriculum for the twenty-first century, one that keeps the important elements of the old system of education and develops something totally new? What could that look like?

Well, for starters, all students should have a clear and honest exploration of the history and philosophy of this amazing profession. These courses should be standardized and free from politics and disrespect. All future chiropractors should understand the story that is theirs, the good, the bad, the ugly, as well as the leading edge and at least some of what was left behind.

We should also study chiropractic within the context of the paradigms that it helped to bring forth such as systems theory, holism, complexity theory, autopoiesis, non-linear thermodynamics…all of the important biological models of the 20th century. Students should not just study the linear molecular level of biology but also the 40,000 foot view. How do the systems fit together? What are the latest ideas in theoretical biology? Are those ideas consistent with the philosophy of the body as an intelligent and self-organizing system? If so, why aren’t they being taught? (As an offshoot to these additions, we should include the latest research and theory on subtle energy systems and energy medicine!)11

Of course, central to such a curriculum would be the latest science of vertebral subluxation, the leading models of spinal and neural integrity, chiropractic adjusting, instrumentation, alongside the best techniques of the past, ones that have been honed and refined for decades and mastered by the great artists of this profession.

Most importantly we need an integral model that can tie things together; chiropractic philosophy and science, practice and theory, while also developing systems where people feel nurtured and can grow within a community. The chiropractic campus could become a place where humans develop themselves while studying this great profession and feeling included in a worldwide community. Any future curriculum should model the latest ideas of Integral Education.12

Imagine if students could have all of their courses integrated each quarter, with practical hours that were relevant? Imagine if chiropractic school prepared future chiropractors with the practical and business skills needed for their future? Imagine if social networking were integrated into the curriculum not only for each class or each school, but between all chiropractic students worldwide? (I am sure there are many practicing chiropractors that would love to act as mentors through such a system.) Imagine if chiropractic education was a model for doctoral level training that centered on assisting human beings to be their best, serve at the highest, and live a flourishing life?

There is so much more to be added and subtracted to an ideal curriculum. The future of chiropractic education is bright. We are the profession. We get to set the standard if we can share a vision and move forward together.

*(previously published in LifeWest student newspaper – March 2012)

  1. Online Chiropractic Philosophy and History CE Course
  2. Third Wave of Chiropractic Philosophy
  3. Senzon S. 2003. What is Life? JVSR.
  4. Gibbons, R. 1980. The Rise of the Chiropractic Educational Establishment. In: Who’s who in Chiropractic. P. 346
  5. Gibbons R. 1985. Chiropractic’s Abraham Flexner: the lonely journey of John J. Nugent, 1935-1963. Chiropractic History 5:44-51. *Reprinted by permission of the Association for the History of Chiropractic
  6. Murphy, D, Schneider M, Seaman D, Perle S, Nelson C. How can Chiropractic become a respected mainstream profession? Chiropractic and Osteopathy 2008, 16.10.
  7. Johnson C., Green B. 2010. 100 Years after the Flexner Report: Reflections on its influence on chiropractic education. J Chiro Ed. 24(2).
  8. Kent, C. 2010. A new direction for CCE? Dynamic Chiropractic 28(24).
  9. http://mcqi.org/vitalistic-curriculum/introduction
  10. Senzon, S. 2007. What I Wish I Learned in Chiropractic College. Today’s Chiropractic Lifestyles.
  11. Senzon, S. 2008. Chiropractic and Energy Medicine: A Shared History. J Chiro Hum 15.
  12. http://nextstepintegral.org/resources/integral-education-resources

6 thoughts on “Future of Chiropractic Curriculum

  1. Lots of good stuff here Simon, I love the idea of aligning the curriculum with the philosophy with holism, non-linear dynamics, subtle energy, and so on.

    I was lucky enough to attend Parker College of Chiropractic and so there was a philosophical bend to most classes, even classes like physiology and biochemistry.

    I think it would be wonderful if the chiropractic technique classes were taught by an instructor authorized to teach that particular technique. Of the ten techniques we were taught at Parker, only one instructor met that criteria.

    One thing that I would love the legal ability to do as a practitioner is to write MRI reports. I see no reason why MRI interpretation could not be included in the chiropractic curriculum to make this so.

    Hans Conser
    Chiropractor in Bozeman MT

  2. I certainly envision all chiropractic science courses taught within the context of vitalism. The science of epigenetics is the logical offshoot of the role of vitalism in the preservation of health.

  3. Peter Kevorkian

    you are a master Simon. Thank you for this article and all you do for TIC. I am at the board at Sherman and it is indeed a conundrum to satisfy CCE and reform the curriculum to resemble chiropractic. I do not believe the current structure allows us to graduate chiropractors – they are clearly medipractors who can manipulate!! I plan on a reformation of the curriculum at Sherman – one that the CCE cannot refute and one that has real TIC in it. I would love to bounce some ideas off of you in the next few weeks. Hugs,
    Peter

  4. Thank you Simon for mentioning a visionary curriculum and referencing it with MCQI.ORG.

    You are doing an amazing job. Please resend me the info to sign up for your philosophy course. I will take it this summer as I will have more time.

    LOVE;

    ARNO

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