How to survive chiropractic school

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Like it or not, chiropractic school is nearly identical to medical school, the principal differences being in the treatment methods used.  Nobody cares if you “just want to adjust”, you still have to learn to be a doctor, and with that title comes a high expectation that you have an insane amount of knowledge.  And the curriculum is packed to give you just that.  (Nevermind that you have to sort it all out for yourself, because it goes in really jumbled and meaningless.)

I’ve compiled some key points that I’ve learned over the trimesters.  I’m eternally grateful for those generous souls who met my standard question, “any advice for someone who’s green?” with honest answers–pearls that at times literally turned out to be my saving graces.

And thus, in the same spirit, I pass them on to anyone willing to read them…

1. You’re going to feel like you’re at a Gallagher show, except that instead of flying pieces of fruit and its juice, you’re being bombarded with informational tidbits.  During all this, keep in mind that no matter how wide open your mind is to guzzle every trivial snippet thrown at you, you’re simply not going to retain, digest, or understand everything.  You just won’t.  You can’t possibly write down everything and memorize it.  Well, I guess you could if you were primarily an auditory learner (meaning that you learn best by hearing the information–more on learning styles later), or if you had a photographic memory, but for most people, it’s just not a realistic expectation.  Understand that you’re going to miss a lot of information, even if you manage to stay awake every minute of every day, with your pen poised to the paper and ready to go.  That’s just the nature.  I’m glad someone told me this, because I was one of the four-point-oh nerds who did write down and memorize everything.

2. On the other hand, keep in mind that you do need to study, and not just to pass your classes.  You’re not in undergrad anymore, and these are not just the standard general education classes that everyone has to take.  These are classes that relate directly to the rest of your life.  Yes, even the seemingly-meaningless basic science classes.  You may not enjoy Biochemistry and you may wonder what the hell polar amino acids have to do with knocking down a “subluxation” but the fact is that every class you take, including biochemistry, relates to the function of the human body–function that you are altering with your adjustments, whether you realize it or not.  So do yourself and your future patients a huge favor: give a shit and get your nose in a book or ten.

3. Studying made easy(er): get to know yourself and your learning style.  Different people learn more efficiently in different ways.  Auditory learners learn best by hearing the information, or maybe listening to themselves repeat it back or read it out loud.  Read-write learners learn by, well, reading the information from a book or writing it down.  Visual learners like pictures and diagrams because the information seems to “click”, often easily, when they see the big picture put together.  If visual learners must take notes in class, they often benefit from decorating them with diagrams, flow charts, pictures, or at least color coding.  Kinesthetic people learn by doing, by feeling, and by going through the motions.  They’re the “hands-on” people for whom information sticks when they can gain experience in the trenches.

My advice is to identify your learning style, and fast.  The sooner you do, the more efficient–and less nerve-wracking–your studying will become.  You’ll learn faster, retain more, understand more, remember more, and bonus points: you’ll spend less time doing it.  Sometimes it’s hard to figure out exactly how you learn best, because most people don’t fit in to just one type, but instead are a combination of several types.  For others, like me, it gets even trickier, because although I’m primarily a visual and kinesthetic learner, I can also learn by other styles, although very inconsistently.  Sometimes I’ll hear something in class and remember it very well and other times I won’t; same goes for reading and/or writing.

I will say this: the way the information dispensing is set up, it’s much friendlier to read-write and auditory types, especially on the academic side (the lecture classes).  The lab components are a bit more hands-on, but there’s till a ton of reading, writing, and hearing, and lots of trivial info to be responsible for, come test time.  Only when you get into your game in the clinics at the tail end of the program do the kinesthetic learners start to feel comfortable.

4. To enhance your studying, you may be able to score yourself some copies of old tests.  This is primarily true for the basic science classes in Tri’s 1-3, and some of Tri 4. Once you get into the applied or clinical sciences or technique classes, old tests are more scarce.  Some profs used to let students keep their exams to study from them but no longer do.  Old tests are primarily good for identifying weak spots in your knowledge.  Do use them as a guide; the questions serve as examples of the depth of knowledge expected of you and the kinds of questions you’re likely to see on the test.  Do NOT rely on them as your chief secret weapon, however.  Why?  Lots of reasons.  The answers could be wrong – we identified numerous mis-keys that would’ve actually lost us points had we given the answer from the old test.  Profs are well aware of the fact that old exams are circulating wholesale and they also know what the questions are.  If they don’t like your class, they may mess with you by taking an old question verbatim and changing a single word that changes the correct answer to the question.  When all you’ve done is cram some old tests at the last minute and you take your exam, you come across a question that reads (almost) exactly like one you recognize from your cram-session and without finishing reading the question you go to select your (wrong) answer, which of course is still there among the multiple choices.  You don’t realize the question is actually not the same one you remember.  Another reason not to rely on old tests alone is, the prof could change up the test questions all together and select a whole new batch of questions.  Or perhaps, updated information from a new research study changes the answer to an old question.  No matter what, it’s not fair to yourself or most importantly, your patients if you simply cram and dump information.

5. Make time for yourself.  This means, don’t study too much.  If you do, you’ll lose your sanity.  Make time to relax, to meditate.

6. Keep in touch with your family and friends.  Let them all know what you’re going through.  Make sure they understand exactly what it is you’re doing and how rigorous it is.  Some people honestly think that our program is a 6-month trade school where we just learn to find high spots and knock them down.  They don’t realize that we also learn anatomy, physiology, neurology, biochemistry, endocrinology, pharmacology, diagnosis, case management, physiotherapy (a bastardization of basic physical therapy and its concepts), biomechanics, nutrition, geriatrics, pediatrics, obstetrics and gynecology, orthopedics, radiology, embryology, cytology, and histology, just to name some.

Just as important, let them tell you what they’re going through.  Because while we’re submerged in school, dog-paddling around in this chiro-bubble, real life is happening in the real world.  Real people you know and love are aging another three years without you even realizing it.  They’re going through changes, too.  Your spouse is getting his/her first gray hairs or changing their jobs or growing distant from you, or closer to you as they start looking up to you even more.  Your wife is carrying, delivering, and nursing your child. Or your child is getting out of diapers or starting school or entering puberty or graduating high school or entering college or dating a significant other or getting married.  Life happens.  Don’t lose touch with it.  Don’t let three years go by without going out to dinner with your friends.  Don’t let a year go by without taking a night and shooting the breeze with your spouse or becoming intimate.  They need to know you’re still you and that you’re still there for them.

7. Take care of yourself.  This means first and foremost, abandoning unhealthy habits.  You’re a doctor now, like it or not, and you serve as an example for your patients.  They only end up behaving as well as you do, and you can’t expect them to do anymore.  Don’t just talk the talk; walk the walk, too.  Kick the Friday night case of beer.  You don’t need it.  You won’t have time to work it all off and it’ll just accumulate. Not only that, but you can’t afford it.  You’re not on a doctor’s salary yet, so don’t start expecting to live the doctor life.  Do the same with cigarettes, weed, anything else you’re into.  Ditch the junk food, too.  It’s expensive and full of empty calories that pack on pounds but offer very little else.  The feel-good rush you get from eating it?  That’s all addictive neurotoxins designed specifically to manipulate pleasure centers of your nervous system such that you derive pleasure from eating that “food” and can’t say no to the prospect of eating more.

Instead, replace these things with fruits, vegetables, whole grains, and organic meats.  Have a coke or some junk food every once in a while–you gotta have some fun occasionally–but don’t make a habit out of it.  These foods give you quick highs and rushes, but you’ll crash quickly.  It’s not worth it.

8. Manage your money.  When you get your student loan dispersal check, you may feel like you’ve won the lottery, but the truth is, that has to last you the next 4 months.  Once you start figuring food, gas, rent/mortgage, utilities, payments, miscellaneous spending, etc, you start to realize it’s not so much after all.  One of the coolest pieces of advice we ever got is this: when you get that check, the first thing you do is to write out your next 4 rent checks, car payments, credit card payments, etc, and mail them in, with notes in the memo fields like “January mortgage” or “March Visa payment”.  That way, the recipient companies know what you’re doing and can apply the money properly.  You also have the piece of mind of knowing that when money runs thin at the end of the trimester, you don’t have to worry about making your rent.  This way, you’ll never get foreclosed on or evicted, your car will never get reposessed, and your credit rating won’t plunge nor will your interest rates get jacked up due to a late or missed payment.

All other spending?  Curb it as best you can.  School comes first, so make sure you’ve bough all the supplies and clinic clothes you’ll need.  Put off splurging for a black tie dinner until after you’ve graduated and have the salary to back up your desired lifestyle.  You’re still a college student, and it’s best to live as thin as you can.

A final word on purchases: please please please do not make large purchases right off the bat in school.  Yes, that Microlight laser or $18,000 Biofeedback machine looks pretty dang cool and the sales rep (often a student putting themselves through school via the commissions they make on products they sell borderline MLM-style) promises the moon and stars to you in future additional revenue streams of income once you open your practice, and some will swear you can use their toy now, before you’re even out of school.  Coaching consultants will instill fear in you as a lowly student that the world is so tough and hostile out there toward chiropractors that you’ll go bankrupt without a practice coach.  Bullshit.  These practice management companies are all about scare tactics, guilt trips, and do-or-die mantras.  It’s how they want to rope you in as students, and it’s how they’ll instruct you to rope in your patients.  Top secret: it may work for some, but only a very small percentage.  Most doctors are too smart to fall for that, and so are most patients.  The spouted dogma rings too hollow for most people.  Save your money.  If you really see something you like, wait a year and see if you still want it.  Often, you’ll change your mind and end up glad you didn’t spend the money.

9. Establish a routine/schedule.  First, get a calendar.  Some are just day calendars, others have slots for times of the day for writing in specific appointments.  Programs like Microsoft Outlook (somebody please tell me there are others) give you multiple views–monthly, weekly, and daily broken down into half-hour increments.  Enter everything in on the same calendar to make sure you don’t commit yourself to two things at once.  Go through your school calendars first.  There are more of them than you think.  First, there’s the master schedule of school events, and some of these like assemblies or certain seminars could be required (as was the case for us).  In the second half of your career, there are National Board exams (everyone has these).  And everyone has finals, midterms, and tests in between.  Don’t forget about your lab practical exams; these might not be included on the master schedule, as they often take place during individual lab times.

After that, put in your work schedule, if you have a job.  Don’t forget work study, if you participate.  As you enter clinic, put your patient’s appointments in, too.  This way, you don’t go scheduling a whole lot of patients the night before a big exam.  You also know which tests you have coming up.  And, you don’t double-book yourself (schedule two patients at once), or miss an important deadline.

Then, make sure to schedule yourself workout times, relaxing times, specific dates and times for getting together with friends or having a family night at home.  Yes, write it into your schedule – or you’ll never do it.

Also, establish a daily routine.  Get your preparation for tomorrow done first thing, as soon as you walk in the door.  I pick out tomorrow’s clothes and either fix my homemade lunch or gather lunch money for eating out, and I put it right next to my phone, keys, glasses, and wallet, which all sit together on a main counter next to my clinic bag and laptop case.  Finish with that before turning on the TV and settling in for the night or it’ll hang over your head and you may forget to do it all together.  Come tomorrow, you might be scrambling.  If I miss my alarm, I’m much happier if everything’s right there ready to go as I’m running out the door.

10. Organize your surroundings.  Keep everything school-related in one spot, hopefully in a convenient, high-traffic area.  This way, you won’t forget anything should you have to rush out the door on autopilot after oversleeping.  Buy enough folders and notebooks that you don’t end up stuffing everything into one notebook or folder; this way, nothing gets jumbled.  I learned this the hard way; everything got cluster-messed and I misplaced several important assignments, creating a lot of extra work for myself by having to re-write them, only to find them later, in my folder behind a bunch of notes from another class.  Yes, I looked through the folder before–several times–I just didn’t see them until much later when I was cleaning everything out once those classes were done.

Also, make a space that is yours for studying and studying alone. Remove all sources of entertainment or distraction from that space.  Make sure it’s far away from a messy area or a cat’s sleeping place, because you’ll be surprised at how little it will take to distract you from studying.  A cat sleeping in a cute position can easily occupy you for 20 minutes as you subconsciously try to find excuses not to study.

11. Buy books that your profs recommend, as long as they don’t have a self-serving vested interest in recommending them.  We found that a prof we especially liked recommended a lot of neat books that explored different subjects more deeply.  Many of these were out-of-print and rare gem-like finds, yet available at Half Price Books or Amazon for a dollar or less.  We picked up a lot of great information.  The prof was one we respected deeply, who had already read all of these books.  It’s nice to have an impartial book reviewer you respect, and to be privvy to his info before going out and buying books, especially on a limited budget.

12. Go to seminars.  Since money is limited, do pick and choose carefully.  Ask around; there are plenty of reliable sources – professors, students in upper tri’s, classmates in your own tri, chiropractic doctors practicing in the field, and extracurricular clubs that meet during lunch.  Seminars are geared field doctors rather than students, and thus will teach you how to clinically apply the information in the real world.  You may feel a bit lost, because they may throw around terms or concepts you haven’t encoutered yet, but do your best.  Don’t worry too much, though, unless you’re Tri 1 or 2; they often avoid getting too technical, because a lot of field doctors don’t remember some of the basic science nitty-gritty themselves.  The exception to this is neurology programs.  Those are tougher, because neurology is such a brainy subject anyway, and requires a lot of advanced knowledge.  Adjusting or nutrition seminars, on the other hand, you can feel pretty much comfortable right away.

Seminars rock, and it’s important to go to them especially while you’re in school because in school, it’s easy to forget the big picture and what motivated you to do this, and they keep you in touch with why you’re doing what you’re doing.  They teach you why it is you should care about what you’re learning, because while school is teaching you facts and concepts, the seminars teach you what those concepts will look like when they walk into your office.

Also, school doesn’t do a great job of teaching you how to treat–or “help with”–much of anything, whereas seminars highlight all the possibilities and often give you a framework from which to manifest them.

13. Practice, practice, practice.  Palpate.  Adjust, as soon as it’s safe to do so (once you’ve had a class or a couple of weekend intensives and have some formal training to go on).  Get with other field docs and observe them in their offices (be professional and transparent; dress well, stay in the background, ask lots of questions later).  Ask them if you can adjust them and have them critique you.  Make friends with upper tri students, but don’t take everything they say as gospel; they may have some good ideas, but remember that they know just enough to be dangerous and not enough to realize it.  Make friends with staff docs; they’ve often been in the field.  (Some, however, don’t have enough field experience.  Many came to our school after only 6 years in practice.  Look for someone who’s been out for at least 10.  Also, seek out those who did NOT go to Parker.  Overall an OK school, but their focus is on business/practice management and passing National Boards, and not adjusting or diagnostics [you know, doctor stuff].  Some of their student body reflects that.  If they did graduate from Parker, make sure they’ve at least sought some kind of significant post-doctoral training outside of Parker, whether it’s neurology or applied kinesiology or clinical nutrition certification.)  But anyway, get together with a group of friends you trust, make a pact that you’ll never rat each other out, and go to town.  Feel.  Push.  Thrust.

14. Don’t believe all the stories you hear at school.  As you progress through the program, you’ll hear people telling stories about how they got this or that segment to “go”, or about some practice opportunity they have or a mentor guru that took them under his/her wing, and you might start to feel like something’s wrong, like you missed the boat.  Don’t worry.  Everyone finds their own niche, their own specialty, their own group to hang out with, their own mentors to learn from.  I reunited with one of mine at the end of Tri 7 (out of 9) and we met another who took us under his wing at the transition from Tri 8 into Tri 9.  Opportunities will come knocking. That’s not to say that you’ll fall into fortune without having to lift a finger–you will have to lay groundwork for making these opportunities happen–but just when you feel like the world is passing you by, you will have your moment.

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