The chiropractic program at Technikon Natal in Durban, South Africa has been up and running now for 10 years. Some interesting aspects of this five-year, post-high school program include:
1. The program is incorporated into the government's tertiary educational system and therefore receives substantial (but never enough!) subsidy from the government.
2. The educational philosophy emphasizes the biomedical, reductionistic model of traditional medical assessment, specific (as one can be) diagnosis, followed by specific treatment for the quickest recovery. However, there's an increasing important role in the program for the aspects of patient education; lifestyle modification and rehabilitation; the "wellness" model, based on a holistic philosophy; and primary health care as it pertains to chiropractic.
3. The final year (fifth year) includes the traditional year of internship common to all chiropractic colleges (35 new patients and 350 follow-ups in our case). In the fifth year, or in the following year, students initiate and implement an individual research project. Most of these are in the form of controlled clinical trials, each with a minimum of a further 30 patients (15 per group). This obviously adds to the clinical experience of the student, albeit in a restricted field.
It is because of this research component, its magnitude and standard, that the students graduate with a master's degree. On the lighter side, some of our students still feel that they are not as well qualified as their North American peers who, after all, all get doctorates!
Interestingly, much of this research done between 1994 and 1996 was accepted by the World Federation of Chiropractic (WFC) for presentation at the Tokyo Education Conference last year. The research component at this level is only possible because of the small size of our intakes, viz. 40 first year students, which reduces to between 20 and 30 students by the fifth year.
4. Following the completion of the fifth-year requirements, the student now has to complete a further year of clinical experience to be registered (licenced) as a practitioner. This is a requirement of the registering authority, a statutory council, and is not a part of the chiropractic program. The rationale is that one year of clinical experience is insufficient to safely release the graduate on an unsuspecting public.
The sixth year also helps bridge the gap from the highly structured, highly supervised, greatly drawn out patient assessment and management experience of the fifth year (educationally necessary at that stage) to that more resembling "real life" practice. Furthermore, the sixth-year intern has to treat a minimum of an additional 25 new patients and 150 follow-ups. They also complete their research during this time, perform community service by treating historically underprivileged groups, and have rotations of one week's duration in the Kimberley Hospital, a government hospital where a chiropractic outpatient ward has been established. This latter venture has been so successful that the hospital has created a full-time post for a chiropractor.
Other experiences include a one-to-three month preceptorship in private practitioners' offices, which is planned so that they spend time with radiologists, neurologists, orthopods, physical therapists, biokineticists, rheumatologists, et al. Because we follow the British system of education, our sixth year interns would normally receive a salary, as do medical interns. However, as there is no money to pay the interns a salary, Technikon pays them a commission on what they earn. They receive 25% of the money they generate for the first 25 new patients and 150 follow-ups, then 50% of what they generate thereafter. Such method of compensation acts as a stimulus to build a practice, much as they will once they are registered.
5. We have had the good fortune of having had two American chiropractors on staff for the past 2-3 years. One is Dr. James Brantingham from California, who has a specialty on disorders of the foot and ankle and whose other main interest is in the history of chiropractic. He, his wife and two teenage boys have spent the past two-and-a-half years here.
The other is Dr. Brian Nook who, along with his wife Dr. Debbie Nook (she is a veterinarian) and their two young children have been here for the past two years. Unfortunately for us, they will be returning to the U.S. at the end of February. Dr. Brian's specialty is in the field of sports injuries. He has had a highly significant impact on both the profession and the program.
Because of Dr. Nook's return, and for other needs, we have posts for doctors with a specialty in the field of sports injuries and rehabilitation; a chiropractic radiologist (DACBR); and someone to lead our research effort. The latter person must have a DC and at least an MSc or its equivalent, and must also have a good track record in the field of research. Anyone interested in those posts can contact me by e-mail at gtill@umfolozi.ntech.ac.za, by telephone 011-31-204-2102, or fax 011-31-22-3632.
Dr. A. Glynn Till
Head, Department of Chiropractic
Technikon Natal
PO Box 953
Durban, Natal 4000
South Africa
Editor's note: Chiropractic education in South Africa has been the subject of a number of articles published in DC, including:
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