chiropractic identity through conformity to requirements that might be more suited to other health-care disciplines, cultural rel-evance (in some areas), and others. Two prominent Canadian members of the international chiropractic community who support and/or are working for the standardization of chiropractic education – Dr. Andre-Marie Gonthier, mentioned above, and Dr. Daniel Saint-Germain, president of the Federation of Chiropractic Licensing Boards (FCLB) – join Canadian Chiropractor in a discussion that addresses these reservations while considering the reasons for and advantages of standardizing curricula. DR.DANIEL SAINT-GERMAIN Dr. Saint-Germain prefaces his comments as follows: “My responses to these questions will be from the regulatory perspective. As president of the Federation of Chiropractic Licensing Boards, I have the unique op-portunity to consider education from the viewpoint of promoting what is best for the public.” Canadian Chiropractor: What exactly does standardizing chiropractic education entail? Which components need to be standardized and where might colleges retain some flexibility within their curricula? Standardizing education stems from es-tablishing minimum acceptable standards through the accreditation process. Accredi-tation, like regulation, must draw the line below which an educational standard is un-acceptable, while simultaneously encourag-ing programs to stretch for excellence. It is my belief that the standardization of educa-tion starts with the establishment of similar, measurable standards, below which pro-grams should not be accredited. These stan-dards should focus on developing doctors of chiropractic who can diagnose broadly, treat competently, refer specifically, and function ethically. Standardizing of chiropractic education has also come about via testing. Both the Canadian Chiropractic Examining Board and the National Board of Chiropractic Ex-aminers base their independent tests on a careful combination of what is taught in the accredited programs and practised in the field, all in accordance with the legal scopes of practice in the various jurisdictions. Reg-ulation’s reliance on examination has gone far to standardize education. I believe the accredited chiropractic 10 • CANADIAN CHIROPRACTOR | JULY/AUGUST 2010 educational programs worldwide are much more similar than they are different. There will always be room for flexibility in the methods of educational delivery and the philosophical emphasis, provided there is a uniform commitment to the best interests of the patient. CC: Why is the standardization of chiro-practic education necessary in North America? Globally? There are two primary reasons standard-ization is necessary in North America and throughout the rest of the world. Most importantly, the public should have a clear idea of what chiropractors can do to help them achieve maximum levels of health and flexibility. As the scopes of practice blend more to reflect what is taught at accredited colleges and assessed by in-dependent examinations, chiropractic will have a clearer identity and patients won’t be confused. The second reason is that practitioner mobility depends on standardization. Chi-ropractors no longer simply get just one li-cence and practice in the same location for a lifetime. We move to be near aging parents or warmer climates, or to take advantage of new business opportunities. We travel with athletic events both as volunteers and paid staff. Standardization in education, testing and regulation breaks down unnecessary bu-reaucratic barriers while assuring the public that its doctors are appropriately qualified. Legislation such as Canada’s Agreement on Internal Trade and Australia’s national health professional licensure are moving us in the right direction. I am a strong advocate of national, and indeed international, stan-dards with local (state or provincial) control. CC: In standardizing the curricula of chiro-practic training programs, which components must be retained across the colleges to ensure the identity of chiropractic and its status as a distinct and unique practice are not compromised? From the first day we become involved with the profession as patients and students, we begin to build our understanding of this unique profession. We should never forget our history, our roots, our philosophy. We cannot change our past nor deny it, even the sad parts, where we have failed to work as a team to unite the profession. The key components that must be re-tained centre on diagnosis, treatment skills, referral and ethics. By putting the patient ahead of the dollar, we keep our vision focused, and decisions are clear. The basic science of chiropractic will re-main the same. Its unique emphasis is on the patient as a whole, integrated person – not just a collection of independent symp-toms. The value of our core tool, spinal ma-nipulation, has been validated by research and outcomes to the point where other pro-fessions want to use it. As a regulator, my concern is that many of them do not have the depth of training and understanding of spinal manipulation to safely use it without endangering the public. I believe there are three key strategies that can help us retain our chiropractic identity: • We must review our postgraduate cre-dentials. Rather than small groups of specialty certifications, postgraduate education should embrace the rigours of university-level credentials. Aca-demic masters and doctoral degrees must become the norm, and we need to support our chiropractic colleges in adding these advanced degrees. • Research will improve and refine the basic science underlying chiropractic, and the effectiveness of various tech-niques and therapies. Each practising doctor of chiropractic should either be involved in a research project or con-tributing financially to research. Re-search creates our future. • Teamwork is essential. Competition within teams and among teams refines each endeavour but, in the end, the joy and the accomplishment of working together creates limitless energy and blurs boundaries. DR.ANDRE-MARIE GONTHIER CC: What are the reasons for standardizing chiropractic education? In my discussions with federal and pro-vincial government officials, I have received the comment that one of the biggest ad-vantages, or strengths, of our profession is its standardization in terms of education, and, in particular, the presence of the CCEI and its affiliated national Councils of Chi-ropractic Education organizations. But, in my opinion, this is not enough. We have to do more at the college or program level, all around the world. For instance, we must set uniform en-trance level requirements, in order to admit the best students. We must work harder not to limit the number of applicants, but to Continued on Page 40 www.canadianchiropractor.ca
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