How to Become a Chiropractor: A Step-by-Step Guide

Chiropractors provide relief to patients suffering from musculoskeletal ailments like chronic back aches, joint pain, and sciatica. While other medical professionals might conduct surgery or prescribe pharmaceuticals to remedy physical conditions, chiropractors use non-invasive techniques, such as hands-on adjustments, to help reduce body pain and inflammation.

But, just as other health care professionals, chiropractors must undergo specific medical training and become licensed by the state.

In this guide, you'll learn more about what chiropractors do, what they earn, and the steps you need to take to become one, including what you can expect when attending chiropractic school to earn your Doctor of Chiropractic (DC) degree and taking the National Board of Chiropractic Examiners (NBCE) exams. You'll also learn about specializations you might consider pursuing and find suggested courses to help you start gaining relevant knowledge today.

What does a chiropractor do?

A chiropractor works with the neuromuscular skeletal system of the human body, adjusting the positioning and alignment of the spine and other joints to treat pain and promote overall wellness. Some of the most common duties and responsibilities that chiropractors perform regularly include:

• Understanding and assessing a patient’s medical history

• Assessing a patient’s posture and spinal alignment

• Aligning and manipulating the spine and other joints as needed

• Creating plans for pain management based on patient’s needs

• Treating pain and discomfort using other non-invasive methods that may include massage, heat/cold, targeted exercises, and more

• Providing nutritional advice and other health and lifestyle suggestions

• Interpreting X-rays and running other diagnostic tests 

5 steps to becoming a chiropractor

Chiropractors are highly-trained medical professionals who must possess an undergraduate degree, undergo four years of specialized training to earn a Doctor of Chiropractic (DC) degree, pass a number of national exams, and earn state licensure.

While each of these requirements might make a career as a chiropractor seem like a lofty goal, you can confidently work your way towards the profession by taking the right steps at the right time. Below, you'll find a detailed explanation of each of the five steps you'll likely need to take to start working in this impactful medical profession.

1. Prepare with undergraduate study.

The first step to becoming a chiropractor is to obtain your undergraduate degree or complete at least 90 hours of undergraduate coursework (worth roughly three years of study) to be eligible for chiropractic school. Each school will have its own entry requirements, though, so make sure to research the undergraduate coursework requirements before applying to any school. 

Your undergraduate degree should ideally be on a topic related to chiropractic care. Some examples of undergraduate degrees most commonly held by chiropractic school students include exercise science, human biology, and health sciences. 

Read more: Bachelor of Science (BS) Degree: What It Is and How to Earn One

2. Obtain your Doctor of Chiropractic (DC) degree.

Once you’ve satisfied the undergraduate degree requirements, you’re ready to apply for a Doctor of Chiropractic (DC) degree program.

These programs are offered at chiropractic schools, where you can typically expect to obtain your degree after four years of dedicated study. Expect to see a mix of classroom and clinical experiences. Some topics covered over your four years in chiropractic school include anatomy, microbiology, radiology, functional kinesiology, principles, and philosophy of chiropractic care. 

During your time in chiropractic school, you will also begin taking a series of exams offered by the National Board of Chiropractic Examiners (NBCE), which all chiropractors must pass to become licensed. These exams are broken down into four separate tests, taken at different times of your journey to becoming a chiropractor: 

• Part I of the exam is taken in your second year of chiropractic school. This exam is offered on campus in three separate sessions and covers six basic science area domains, including spinal anatomy and microbiology.

• Part II is taken in your third year of chiropractic school. Like part I, the exam is taken in three separate sessions, but unlike the first exam will cover more in-depth clinical science topics like diagnostic imaging and principles of chiropractic.

• Part III can be taken when you are at least nine months away from graduating from chiropractic school. This exam is taken in two separate sessions and consists of clinical-based content such as diagnostic imaging, chiropractic techniques, and case management.

• Part IV is typically taken after obtaining your degree but can be taken as early as six months before graduation. This final exam involves two sections: chiropractic technique and case management. This is the most hands-on portion of the exam as you move to different “stations” to complete varying tasks and assessments that an examiner evaluates. 

3. Get your license.

After passing all four parts of the NBCE exams and graduating from chiropractic school, you are ready to apply for a license to practice as a chiropractor in your state.

Every state has its own unique requirements for licensure. Many states will have additional requirements or documents for the application process, like passing a background test, providing proof of malpractice insurance, or listing personal references. Some states like Florida, Missouri, Oregon, and Oklahoma have their state exam administered by the NBCE.  

As in other medical professions, you’ll need to renew your license per state guidelines, which will likely include earning a certain amount of continuing education units (CEU). 

4. Consider a specialization.

In addition to providing the services that you studied in chiropractic school, you may also consider becoming qualified to provide specialized services like acupuncture or nutritional counseling to your patients.

Earning specific board certifications is an excellent way to tailor your offerings as a chiropractor to your current and future career goals. It can also widen your scope of care. Some popular specializations are pediatrics, sports, and acupuncture.

There are a few ways to earn specialized certifications and build your postgraduate education. Most specialty certifications require you to attend a postgraduate program approved by the certifying organizations and pass an exam. 

The American Board of Chiropractic Specialities (ABCS) offers several certifications, but you may also earn independent board certifications. A few popular ABCS specialty certification options include: 

• American Board of Forensic Professionals Diplomate (DABFP)

• American Chiropractic Neurology Board Diplomate (DACNB)

• American Board of Chiropractic Acupuncture Diplomate (DABCA)

• American Board of Chiropractic Internists Diplomate (DABCI)

• Chiropractic Board of Clinical Nutrition Diplomate (DCBCN)

• American Board of Chiropractic Pediatrics Diplomate (DABCP)

• American Chiropractic Rehabilitation Board Diplomate (DACRB)

• American Chiropractic Board of Occupational Health Diplomate (DACBOH)

Other specializations you can earn from independent chiropractic boards include: 

• Certification in animal chiropractic by the Animal Chiropractic Certification Commission (ACCC) of the American Veterinary Chiropractic Association (AVCA)

• National reflexology certification offered by the American Reflexology Certification Board 

5. Gain work experience.        

Once you’ve obtained your license to practice as a chiropractor in your state, it’s time to think about your ideal work environment and long-term career goals. Like other medical professionals, chiropractors can join an existing practice with other chiropractors or start their practice.

New graduates eager to pay off their student debt and gain some experience may join a practice as an associate. While some might enjoy working as an associate for the entirety of their careers, others might prefer building their own private practice and only gaining experience as an associate for a short time. Others, meanwhile, find that they prefer working as independent contractors.

Each path has its own unique benefits. Some common considerations you for each one include:

• Owning your own practice may require a lot of logistics, but you’ll likely have a great deal of freedom in the hours you set, the services you offer, and the overall environment where you work. Be sure you’re mindful of the work that goes into starting your own practice. You will be a business owner, so you’ll need a business plan, financing, and a building.

• Working as an associate is ideal for anyone who wants to get to work right out of school. Either temporarily or as a career, working with an already established clinic can help you to gain key critical experience and build a loyal client base. The downfalls to consider would be that you may not have as much freedom with the hours you work or the services you provide. Keep in mind that going this route means that you can work in various settings, from an integrated office where you work with doctors and other chiropractors to a multidisciplinary environment where you work with other alternative medicine practitioners.

• Independent contractors are “freelance chiropractors” who may work in various settings, from corporations to in-home visits. This option can be riskier than working for an established practice, but you do have the freedom to make your own hours and work where you want to work. Be mindful that you are responsible for paying your own malpractice insurance. You are your own employee and may not have the same benefits as you would working in a traditional chiropractic office. 

What skills do I need to become a chiropractor?

To become a chiropractor, you’ll need skills like good communication, dexterity, and problem-solving abilities. 

Chiropractors work with their hands and are on their feet most of the day. They must also work with many different types of patients with different needs. Figuring out how to help each person and communicate plans for pain management is critical. There should be a level of empathy and compassion when working with patients. Patience is another skill that serves a chiropractor well, especially when working with younger patients. 

Aside from these human skills, you will also need to be proficient in technical skills like using your hands to manipulate the spine and joints, taking vital signs, interpreting X-rays and other diagnostic tests, and diagnosing and treating physical ailments. 

How much do chiropractors make?

According to the US Bureau of Labor Statistics (BLS), Chiropractors in the US make a median salary of $75,000 annually as of May 2021 [1]. The lowest 10 percent of US chiropractors earned less than $37,400, while the top 10 percent of earners brought home just over $128,750 [2]. 

Factors that may impact how much you make as a chiropractor include the state where you work, any specialized certifications you have, and if you work for yourself or are employed with a practice or clinic. The size and type of practice are also factors in how much you can expect to earn as a chiropractor. 

Read more: Chiropractor Salary: Your 2022 Guide

Career progression

A chiropractor's career progression can follow many different paths depending on your interests and long-term career goals.  

A new graduate can go to work as an associate with a practice where they can shadow a chiropractor and learn the ropes of the business and hone their foundational skills and techniques. If you choose this route, you can take your time deciding on specialties you’d like to pursue and if you’d like to go out on your own or choose to be a career associate. 

New graduates may also choose a freelance approach and work as independent contractors. Going this route can offer a similar experience, but you may need to seek out a mentor to help you through the logistics of working for yourself. Building a base of clients may also be trickier if you’re newly out of school. 

For an experienced chiropractor, there are more options available. After having spent years honing your skills and building a client base, working as an associate, or an independent contractor, you may look to open your own practice. In choosing this route, you can decide what services you’d like to offer and if you’d like to bring on other chiropractors or alternative medicine practitioners like a massage therapist or reflexologist.

And, for chiropractors who have quite a few years of experience, you may also pursue another pathway in another discipline like education, research, or administration. 

Start working toward your career today

If you’re ready to become a chiropractor, get started by earning your undergraduate degree, applying for chiropractic school, and thinking about what specialties you might want to offer as a professional.

Even before attending chiropractic school, though, you can take courses to help you gain critical knowledge that will prepare you for your future training. For example, you might consider taking a course or specialization through Coursera, such as the University of Minnesota's Preventing Chronic Pain: A Human Systems Approach, which pairs evidence-based science with creative and experiential learning to help course takers better understand chronic pain conditions and how they can be prevented.

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• How to Become a Physical Therapist

• What Do Health Care Jobs Pay? Salaries, Job List, and More

• How to Become an Exercise Physiologist

• What Is Case Management? Definition, Process, and Models

Article sources 

1. US Bureau of Labor Statistics. “Occupational Outlook Handbook: Chiropractors,  https://www.bls.gov/ooh/healthcare/chiropractors.htm Accessed August 6, 2022.

2. US Bureau of Labor Statistics. “Occupational Outlook Handbook: Chiropractors, Pay,  https://www.bls.gov/ooh/healthcare/chiropractors.htm#tab-5” Accessed August 6, 2022.