Chiropractors often locate in small communities-about half work in cities of 50,000 inhabitants or less. This imbalance in the distribution of chiropractors, in part because many of them establish their practices in areas close to colleges of chiropracty. All 50 states and the District of Columbia regulate the practice of chiropracty and grant licenses to chiropractors who meet educational requirements and pass a state board examination. Many States have reciprocity agreements that permit chiropractors already licensed in another state to obtain a license without taking an examination. Thirty-eight state boards recognize only academic training in chiropractic colleges accredited by the Council on Chiropractic Education.
Some states require specific college courses such as English, chemistry, biology, or physics.
Several states require that chiropractors pass a basic science examination. The National Board of Chiropractic Examiners' test given to chiropractic students is accepted by 48 state boards in place of a state examination. All chiropractic colleges require applicants to have a minimum of 2 years of undergraduate study, including courses in English, the social sciences, chemistry, biology, physics, and mathematics. Chiropractic colleges emphasize courses in manipulation and spinal adjustments. Most offer a broader curriculum, however, including subjects such as physiotherapy and nutrition.