Obtaining a chiropractic license in Mississippi is the mandatory legal process by which an individual is granted the authority to practice chiropractic medicine within the state 1. This regulatory framework is administered by the Mississippi State Board of Chiropractic Examiners (MSBCE), an entity established to ensure that all practitioners meet specific educational, examination, and character standards, thereby protecting public health and safety 1. The licensure process reflects the profession's evolution from its foundational principles, as articulated by developers like D. D. Palmer 2, to a standardized and regulated healthcare discipline. The Federation of Chiropractic Licensing Boards (FCLB) supports state boards like Mississippi's in their mission to maintain high standards of practice and public protection across jurisdictions 3.
The scope of chiropractic practice in Mississippi is defined by the competencies required for licensure, which are assessed through a rigorous series of national and state-level examinations. A candidate must successfully pass all four parts of the examinations administered by the National Board of Chiropractic Examiners (NBCE) 1. These examinations systematically evaluate a candidate's knowledge base. Part I covers six basic science subjects, including Spinal Anatomy, Physiology, and Pathology 4 5. Part II assesses proficiency in six clinical science areas, such as General Diagnosis, Neuromusculoskeletal Diagnosis, and Diagnostic Imaging 6 7. Part III evaluates skills in case history, physical examination, and diagnostic studies through clinical case scenarios 8. The final practical examination, Part IV, tests a candidate's abilities in diagnostic imaging interpretation, chiropractic technique, and case management across a series of standardized encounters 9. The development of standardized techniques has a long history within the profession, as documented in texts on the topic.
Furthermore, the scope of practice in Mississippi explicitly includes the use of adjunctive therapies, as evidenced by the state's requirement that all applicants must pass the NBCE's specific Physiotherapy examination 10. This requirement indicates that licensed chiropractors in the state are authorized to use therapeutic modalities beyond manual spinal adjustments. The licensure process is not a one-time event; it represents an ongoing commitment to professional standards. To maintain an active license, chiropractors in Mississippi are required by state law to complete twelve hours of continuing education each year. The Mississippi Code of 1972 Annotated specifies that at least three of these annual hours must be dedicated to the subject of risk management, ensuring that practitioners remain current with best practices in patient safety and professional conduct 11. This system of initial credentialing and subsequent professional development is central to the state's regulation of the chiropractic profession.
Governing authority: The Mississippi State Board of Chiropractic Examiners
The sole regulatory body for the chiropractic profession in Mississippi is the Mississippi State Board of Chiropractic Examiners (MSBCE). This state agency is vested with the exclusive authority to grant, renew, suspend, or revoke licenses for the practice of chiropractic within the state's borders. The legal foundation for the MSBCE's existence and its powers is established by the state legislature in the Mississippi Code of 1972 Annotated 11. This statutory authority empowers the board to create and enforce the rules and regulations necessary to govern the profession, ensuring that all practitioners meet defined standards of conduct and competence. The board's fundamental and official mandate is the protection of the public's health, safety, and welfare 1. It achieves this by verifying that every individual who holds a chiropractic license in Mississippi is qualified and adheres to the state’s legal and ethical requirements for practice.
The MSBCE’s responsibilities are extensive and cover the entire lifecycle of a chiropractor’s professional career. Its primary functions include evaluating the qualifications of applicants for licensure, issuing original licenses to those who meet the state’s criteria, and managing the annual renewal process for all active practitioners. A specific manifestation of this authority is the board's power to set examination prerequisites for licensure. For instance, the MSBCE requires applicants to have successfully passed the Physiotherapy examination, which is administered nationally by the National Board of Chiropractic Examiners 10. Beyond initial credentialing, the board is tasked with investigating complaints and allegations of misconduct made against its licensees. It has the authority to conduct hearings, impose disciplinary actions ranging from reprimands to license revocation, and enforce compliance with all practice standards.
The establishment of the MSBCE reflects a broader historical pattern in American healthcare regulation. Throughout the 20th century, the chiropractic profession actively sought state-level legislative recognition to standardize education, define scope of practice, and achieve legitimacy alongside allopathic medicine. The creation of state licensing boards was a central component of this movement, a process documented in histories of the profession's development, such as David D. Palmer's account of chiropractic's evolution from its origins 2. The board itself is composed of six licensed, practicing chiropractors from Mississippi's congressional districts and one consumer member from the state at large, all appointed by the Governor of Mississippi 1. This structure ensures that oversight is conducted by individuals with direct knowledge of the profession, balanced by a public perspective. Through its comprehensive regulatory functions, the MSBCE acts as the gatekeeper and ongoing overseer for the practice of chiropractic in Mississippi.
The foundational educational requirement: CCE-accredited Doctor of Chiropractic degree
The primary and non-negotiable academic prerequisite for chiropractic licensure in Mississippi is the attainment of a Doctor of Chiropractic (DC) degree 1. The Mississippi State Board of Chiropractic Examiners (MSBCE) mandates that this degree must be conferred by a chiropractic college holding accredited status with the Council on Chiropractic Education (CCE). The CCE is recognized by the United States Department of Education as the official national accrediting agency for DC programs. This accreditation is significant because it ensures that educational institutions adhere to rigorous, nationally accepted standards for curriculum content, faculty qualifications, research, student outcomes, and clinical training facilities. The establishment of such uniform educational standards was a defining objective in the professionalization of chiropractic during the 20th century, a process detailed in regional histories of the profession such as Walter R.12 Rhodes's The official history of chiropractic in Texas 13, which chronicles the push for legitimacy and standardized training.
A CCE-accredited DC program is a post-baccalaureate course of study, typically requiring at least 90 semester hours of undergraduate coursework for admission, with a strong emphasis on the sciences. The DC curriculum itself is an intensive, four-academic-year program that is broadly divided into basic sciences and clinical sciences. The initial phase of study is concentrated on foundational biomedical sciences, which form the basis for clinical diagnosis and treatment. These subjects are systematically tested in Part I of the examinations administered by the National Board of Chiropractic Examiners (NBCE) 4. The core subjects include General Anatomy, Spinal Anatomy, Physiology, Chemistry, Pathology, and Microbiology 5. This foundational knowledge is analogous to the basic science education required in other doctoral-level health care professions.
As students advance, the curriculum transitions to clinical sciences and specialized chiropractic subjects. This phase focuses on the application of scientific principles to patient care, diagnosis, and therapeutic techniques. The coursework aligns with the subject areas evaluated in the NBCE Part II examination 6, encompassing General Diagnosis, Neuromusculoskeletal Diagnosis, Diagnostic Imaging, Principles of Chiropractic, Chiropractic Practice, and Associated Clinical Sciences 7. The final stage of the DC program is a supervised clinical internship, where students gain direct, hands-on experience in patient management. In a college-operated clinic or an approved off-campus facility, interns perform patient examinations, formulate diagnoses, and provide chiropractic care under the direct supervision of licensed faculty clinicians. This practical training is designed to build competency in the skills that are ultimately assessed in licensure examinations, such as the case management encounters required for the NBCE's Part IV practical exam 9. Successful completion of this entire accredited educational sequence is the mandatory first step before an applicant is eligible to pursue the national board examinations and apply for a license to practice in Mississippi 3.
National Board Examinations Part I: Foundational sciences
Following the completion of the required didactic and clinical education at an accredited chiropractic college, the first major testing milestone for a prospective licensee in Mississippi is Part I of the national board examinations 3. Administered by the National Board of Chiropractic Examiners (NBCE), an organization established in 1963, Part I is a comprehensive assessment designed to evaluate a candidate's understanding of foundational, non-clinical sciences 5. This examination serves as a critical gatekeeper, ensuring that individuals possess the requisite scientific knowledge before progressing to examinations focused on clinical application. The historical development of chiropractic education, moving from apprenticeships to standardized, science-based curricula, underscores the importance of this foundational testing, a shift from the early days of the profession as described by pioneers like D.D. Palmer.
The NBCE Part I examination is divided into six distinct subject areas: General Anatomy, Spinal Anatomy, Physiology, Chemistry, Pathology, and Microbiology 5. The content distribution and specific topics within these domains are outlined in the official NBCE Part I Test Plan 4. General Anatomy questions assess knowledge of embryology, histology, and the gross anatomy of the entire human body. The Spinal Anatomy section receives particular emphasis, reflecting the chiropractic profession's central focus on the vertebral column and its relationship to the nervous system, a principle tracing back to the earliest chiropractic theories 2. This section covers the detailed structure of the vertebrae, pelvis, discs, ligaments, and associated musculature.
The remaining four sections ensure a broad scientific base. The Physiology domain tests the candidate's knowledge of the function of human systems, from the cellular level to the complex interplay of organ systems. Chemistry focuses on the biochemical processes vital to life, including metabolism, molecular genetics, and nutrition. The Pathology section requires an understanding of disease processes, including their causes, mechanisms, and manifestations. Finally, the Microbiology domain covers bacteriology, virology, immunology, and public health principles related to infectious diseases 4. Successful passage of Part I is a prerequisite for taking the subsequent NBCE examinations and is a mandatory step in the licensure pathway for all 50 states, as coordinated through the Federation of Chiropractic Licensing Boards 3. It confirms that the candidate has mastered the basic science curriculum essential for the diagnostic and clinical challenges evaluated in later examinations, such as Part II 7 and Part III 8.
National Board Examinations Part II: Clinical sciences
The National Board of Chiropractic Examiners (NBCE) Part II examination represents the candidate's formal transition from foundational scientific principles to clinical science application 6. Administered to students typically during their third year of a Doctor of Chiropractic program, this exam assesses proficiency in six major clinical science domains 7. Passage is a mandatory prerequisite for licensure in Mississippi, as determined by the Mississippi State Board of Chiropractic Examiners 1. The examination is structured to evaluate a candidate’s ability to integrate patient information, form a diagnosis, and understand the principles behind chiropractic care before proceeding to the practical application sections of the board examinations 9.
The six subject areas tested in Part II are General Diagnosis, Neuromusculoskeletal Diagnosis, Diagnostic Imaging, Principles of Chiropractic, Chiropractic Practice, and Associated Clinical Sciences 7. The General Diagnosis section covers the evaluation of all body systems, requiring knowledge of case history taking, physical examination procedures, and laboratory data interpretation to formulate differential diagnoses. The Neuromusculoskeletal Diagnosis section concentrates specifically on the spine, pelvis, and extremities, testing the candidate's ability to diagnose conditions through orthopedic and neurological tests, biomechanical analysis, and functional assessment.
The Diagnostic Imaging component evaluates the interpretation of radiographs, with an emphasis on skeletal pathology, anomalies, and trauma. While X-ray is the primary focus, the test plan also includes concepts related to other advanced imaging modalities 6. The Principles of Chiropractic section assesses the candidate’s understanding of the profession's historical and philosophical foundations, including vertebral subluxation theories and the biological mechanisms of chiropractic adjustments. This domain connects modern practice to the foundational concepts articulated by early figures like D.D. Palmer and chronicled in historical texts 2.
The final two sections broaden the clinical scope. Chiropractic Practice covers case management strategies, contraindications to care, and the application of various chiropractic techniques, such as those detailed in specific technique manuals. It ensures the candidate can develop a coherent and safe treatment plan. Lastly, Associated Clinical Sciences is a comprehensive category that includes topics in nutrition, public health, geriatrics, pediatrics, and dermatology, confirming the candidate's ability to recognize conditions that may require co-management or referral to other healthcare providers 7. Successful completion of Part II demonstrates to regulatory bodies, including those coordinated by the Federation of Chiropractic Licensing Boards 3, that a candidate possesses the necessary clinical judgment to advance toward licensure.
National Board Examinations Part III and IV: Clinical competency and practical skills
Following the foundational science assessments of Parts I and II, candidates for chiropractic licensure in Mississippi must successfully complete the final two examinations administered by the National Board of Chiropractic Examiners (NBCE): Part III and Part IV. These exams shift the focus from theoretical knowledge to clinical application and practical skill, serving as a final gateway before state licensure. Both are required by the Mississippi State Board of Chiropractic Examiners 1.
The NBCE Part III is a comprehensive, written examination that assesses a candidate's ability to apply knowledge in a clinical context. The exam consists of 110 multiple-choice questions presented through various case vignettes 8. Its structure is divided into nine clinical domains, each weighted to reflect its importance in general chiropractic practice. The largest domains are Case History, Physical Examination, and Neuromusculoskeletal Examination, which test the foundational data-gathering skills of a clinician 8. Other significant sections include Diagnostic Imaging, which evaluates the interpretation of radiographs and other imaging modalities, and Diagnosis or Clinical Impression, which assesses the ability to synthesize findings into a coherent diagnosis 8. The remaining sections cover Clinical Laboratory and Special Studies, Chiropractic Techniques, Supportive Interventions (such as nutritional advice or ergonomic recommendations), and Case Management. This case-based approach requires the examinee to demonstrate sound clinical judgment, a critical attribute for any healthcare provider.
Part IV is the practical culmination of a chiropractic student's training, assessing hands-on skills in a standardized testing environment. This exam moves beyond written questions to evaluate performance in real-time clinical scenarios. The NBCE structures the Part IV exam around a series of stations, which include seven Case Management Encounters and one dedicated Technique Station 9. In the Case Management stations, candidates interact with standardized patients, who are actors trained to portray specific clinical presentations. The candidate is evaluated on their ability to take a relevant history, perform a focused physical examination, interpret diagnostic imaging studies presented to them, and articulate a diagnosis and management plan. Communication skills and professionalism are also assessed during these encounters. The Technique Station requires the candidate to demonstrate psychomotor proficiency in performing specific chiropractic adjustments. This direct assessment of manipulative skill reflects the practical application of principles developed since the profession's inception by figures like D. D. Palmer and refined in manuals such as Textbook of chiropractic technique.
Successful completion of all four NBCE parts is a mandatory requirement for licensure in the state of Mississippi 1. The Federation of Chiropractic Licensing Boards acts as a clearinghouse, providing verified score reports to state regulatory bodies upon the candidate's request 3. It is also a requirement in Mississippi that applicants pass the separate Physiotherapy examination, which is an additional test administered by the NBCE, to qualify for a full chiropractic license 10.
State-specific testing: The Physiotherapy exam and Mississippi jurisprudence
In addition to the foundational four-part examinations administered by the National Board of Chiropractic Examiners (NBCE), applicants seeking licensure in Mississippi must successfully complete two further tests. These examinations are designed to ensure competency in specific therapeutic modalities authorized in the state and to verify a thorough understanding of Mississippi's unique legal and regulatory landscape for chiropractic practice. The state mandates that all candidates pass both the NBCE's Physiotherapy (PT) examination and a state-specific jurisprudence examination administered by the Mississippi State Board of Chiropractic Examiners 1.
The first of these additional requirements is the Physiotherapy examination, an elective test offered by the NBCE 10. While not part of the core sequence of Parts I through IV, passing this examination is a prerequisite for a full, unrestricted license in Mississippi 10. The PT exam assesses a candidate's knowledge of passive adjunctive therapies used for patient care. Its content covers the principles, application, and contraindications of various physiotherapeutic modalities, which may include thermotherapy, cryotherapy, electrotherapy, light therapy, and mechanotherapy. By mandating this exam, the Mississippi board ensures that its licensees possess a verified level of proficiency in the adjunctive procedures that fall within the state's defined scope of chiropractic practice.
The second required test is the Mississippi Jurisprudence Examination. This state-level assessment is administered directly by the Mississippi State Board of Chiropractic Examiners and focuses exclusively on the laws, rules, and ethical standards that govern the profession within the state's borders 1. The examination is designed to confirm that an applicant is prepared to practice safely and legally in Mississippi. Content is derived from official state sources, including the Mississippi Code of 1972 Annotated and the administrative regulations of the board. Topics typically include the legal scope of practice, advertising rules, standards for patient records, disciplinary actions and procedures, and requirements for professional conduct. For example, candidates are expected to know the specific regulations for maintaining their license, such as the annual continuing education mandate of twelve hours, which must include at least three hours in the subject of risk management 11. The development of such state-specific legal examinations is a common feature in the history of chiropractic regulation, as different jurisdictions have codified distinct scopes of practice and ethical standards, a process chronicled in regional histories of the profession 13. Successful completion of the jurisprudence examination demonstrates to the board that a candidate is not only clinically competent but also ready to adhere to the professional and legal obligations of a Mississippi chiropractor.
The application process: From submission to licensure
Upon successfully passing all required examinations, a candidate for chiropractic licensure in Mississippi must complete a formal application with the Mississippi State Board of Chiropractic Examiners (MSBCE) 1. The process is an administrative procedure that requires the assembly and submission of a specific portfolio of documents. The first step for an applicant is to obtain the official application packet directly from the MSBCE, which outlines all requisite materials and contains the necessary forms 1. The completed application form itself requires detailed personal, educational, and professional history.
A core component of the application is the verification of educational and examination credentials. Applicants must arrange for their CCE-accredited chiropractic college to send an official, sealed transcript directly to the MSBCE. Similarly, official score reports from the National Board of Chiropractic Examiners (NBCE) must be sent directly from the NBCE to the board 1. These scores must demonstrate passing results on Parts I, II, and III of the national board examinations. Part I of the NBCE exam assesses foundational knowledge in six basic science subjects, including Spinal Anatomy, Physiology, and Pathology 5. Part II evaluates competency in six clinical science domains, such as Neuromusculoskeletal Diagnosis, Diagnostic Imaging, and Principles of Chiropractic 7. Mississippi also requires proof of passing the NBCE's practical Part IV examination, which tests clinical skills through a series of case management encounters and a technique station 9.
In addition to the core NBCE parts, the MSBCE has a specific requirement tracked by the Federation of Chiropractic Licensing Boards (FCLB) 3. Applicants must provide evidence of passing the separate Physiotherapy examination administered by the NBCE 10. This requirement underscores the state's specific scope of practice rules. The formalization of licensing requirements, including the use of standardized national examinations, represents a significant evolution from the profession's early days, a transition documented in historical accounts of chiropractic's struggle for legitimacy and structure 2.
The application packet must also include a state and national criminal background check. The applicant is required to submit fingerprints as instructed by the MSBCE to facilitate this process 1. All required fees, including a non-refundable application fee and the initial licensure fee, must be paid by cashier's check or money order made payable to the Mississippi State Board of Chiropractic Examiners. Once the board receives the complete application with all supporting documentation and fees, it is reviewed by board staff. If the application is deemed complete and the candidate meets all statutory and regulatory requirements, the board will formally grant the license to practice chiropractic in the state of Mississippi 1.
License maintenance and national context
Obtaining a chiropractic license in Mississippi marks the beginning of a practitioner's professional obligations, not their conclusion. The Mississippi State Board of Chiropractic Examiners (MSBCE) oversees a mandatory annual license renewal process to ensure that all active chiropractors maintain the standards required for public safety and professional competency 1. Each year, licensees must submit a renewal application, pay the stipulated renewal fee, and provide documented proof of compliance with continuing education requirements. Failure to complete this process by the annual deadline results in the expiration of the license to practice.
A central component of license maintenance in Mississippi is the completion of continuing education (CE). The Mississippi Code of 1972 Annotated specifies that chiropractors must complete twelve hours of board-approved CE annually 11. Within this twelve-hour total, the state mandates that a minimum of three hours must be dedicated specifically to the subject of risk management 11. These CE programs, which must be approved by the MSBCE, are designed to keep practitioners current on advancements in clinical practice, diagnostic procedures, and regulatory compliance. This ongoing education builds upon the foundational knowledge assessed during initial licensure examinations, such as the clinical science subjects of Part II of the National Board of Chiropractic Examiners (NBCE) exams, which include General Diagnosis and Chiropractic Practice 7.
Viewed within the national landscape, Mississippi's requirements for license maintenance are consistent with standards upheld across the United States. The Federation of Chiropractic Licensing Boards (FCLB), which serves as a clearinghouse for regulatory information and promotes uniformity among state boards, reports that all jurisdictions requiring active licensure also mandate some form of continuing education for renewal 3. While the total number of required hours varies by state, typically ranging from 12 to 24 hours per year, Mississippi's 12-hour mandate falls squarely within this common standard 3. Furthermore, the practice of requiring specific CE topics is a widespread regulatory mechanism. While Mississippi focuses a portion of its CE on risk management 11, other states may mandate hours in subjects such as ethics, documentation, or state-specific jurisprudence. This system of state-level control over professional development, while adhering to a national model of ongoing education, reflects the profession's historical evolution toward established standards and public accountability, a journey chronicled in works like David D. Palmer's Three generations: a history of chiropractic 2. The FCLB facilitates this by providing resources and a forum for boards like the MSBCE to collaborate on best practices for protecting the public 3.
Sources
-
Mississippi Code of 1972, § 73-6-31 - https://billstatus.ls.state.ms.us/documents/2021/html/HB/0001-0099/HB0073IN.htm
-
Three generations: a history of chiropractic by David D. Palmer (1967) - https://openlibrary.org/works/OL6449150W
-
Federation of Chiropractic Licensing Boards, About Page - https://www.fclb.org/about
-
NBCE Part I Test Plan - https://mynbce.org/part-i-test-plan/
-
National Board of Chiropractic Examiners - https://mynbce.org/part-i/
-
NBCE Part II Test Plan - https://mynbce.org/part-ii-test-plan/
-
National Board of Chiropractic Examiners - https://mynbce.org/part-ii/
-
NBCE Part III Test Plan - https://mynbce.org/part-iii-test-plan/
-
National Board of Chiropractic Examiners - https://mynbce.org/part-iv/
-
Federation of Chiropractic Licensing Boards - https://www.fclb.org/PublicInfo/StateDetails.aspx?st=MS
-
Mississippi Code of 1972 Annotated, § 73-6-17 - https://billstatus.ls.state.ms.us/documents/2006/html/HB/0500-0599/HB0544IN.htm
-
Walter I. Wardwell, Chiropractic (1992) - https://openlibrary.org/works/OL4280776W
-
The official history of chiropractic in Texas by Walter R. Rhodes (1978) - https://openlibrary.org/works/OL6827451W