In the past chiropractic had numerous levels and types of confusing postgraduate credentials, fellowships, diplomates and certifications, some of which have titles elevated past their level of effort and accomplishment.  Having watched the education and maturation of medical diplomates who work long hard hours, sometimes seven days a week, for three to six years, I am mindful that most of our diplomates require only 300-400 hours of weekend seminars.  [The exceptions being the DACBR and other full-time college-based residencies.]  Now 300 hours of training over several years is an accomplishment that is very hard to do while maintaining a practice and balanced life, but it is not the 8,000-16,000 hours that may be put in by medical residents.

Certainly this problem is not the fault of chiropractors who sacrifice much to travel and study to improve themselves at diplomate courses.  The problem is finances.  Who will fund true full-time chiropractic residencies?

Hospital-based medical internships and residencies are subsidized by government.  Agencies such as Medicare grant money to institutions that train medical doctors and provide internships and residency opportunities.   These agencies provide financial grants to hospitals to fund graduate medical education (GME).  These agencies do this because it is believed to be in the best interest of the country to have a ready supply of medical physicians.  The result is a comprehensive medical GME, at no or low cost to the physician.  In fact, these MDs are typically paid modest salaries during their specialty training. 

Can you imagine the quality of GCE (graduate chiropractic education) we would have if the government placed the same value on creating a ready supply of chiropractors, as it does on medical doctors?  Our current system of weekend seminars would be replaced with true residencies.   Visualize a subsidized three-year residency in Chiropractic Science, or for those who specialize in neuromusculoskeletal conditions the Diplomate of Chiropractic Physiatry.   Of course our current diplomates could be expanded into full-time residencies.

State, federal and foundational financial support would be compelled to fund full-time chiropractic residencies. But what would it take to stimulate these entities to fund GCE?  Governmental funding agencies would need to be convinced that our nation needs a ready supply of residency-trained chiropractors. This vision could only become reality if chiropractic is able to establish cultural authority.

Cultural authority occurs when a profession has established a defined, substantiated and ethical niche in society.  Dentists have the cultural authority to provide dental care.   Dentists stand alone without rival in this healthcare niche.  Ophthalmologists and optometrists warily share the niche of eye care.   Podiatrists and orthopedic surgeons continue to vie for ownership of surgical foot care.  But where does chiropractic fit in?  What is our niche in healthcare?  Wellness?  Conservative musculoskeletal care?  General practice?  Subluxation care?  

Thus far we have failed to create an occupational niche or create substantial research in any of these niches to the level needed to claim ownership.  We need to focus on one niche and pursue it until we are the owner of that aspect of healthcare.  When you have a tooth ache you think dentist.  We need to be identified with one aspect of healthcare so that when you think of it chiropractic is the first thing that comes to mind.