State examinations may supplement the National Board tests, depending on state requirements. To maintain licensure, almost all states require completion of a specified number of hours of continuing education each year. All chiropractic colleges require applicants to have at least two years of undergraduate study, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelors' degree, which may eventually become the minimum entry requirement. Several chiropractic colleges offer pre-chiropractic study, as well as a bachelor's degree program.
Chiropractic colleges emphasize courses in skeletal manipulation and spinal adjustments.
All, however, offer a broader curriculum consisting of basic and clinical sciences in addition to the chiropractic courses. During the first two years, most chiropractic colleges emphasize classroom and laboratory work in basic science subjects such as anatomy, physiology, public health, microbiology, pathology, and biochemistry. The last two years stress physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition, in addition to adjustment techniques and clinical experience. Chiropractic requires keen observation to detect physical abnormalities and considerable hand dexterity but not unusual strength or endurance. Chiropractors should be able to work independently and handle responsibility.