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How does regulation and training in Osteopathy vary globally?

The legal status and the professional training process in osteopathy is different in every country in the world.

In the United States, the profession of osteopathy is an integral part of Western Medicine and one out of every four medical students is an Osteopathic Medicine student. In addition to the core study program of western medicine, students of osteopathic medicine learn Osteopathic Manipulative Medicine techniques. These techniques include the use of hands for the purpose of diagnosis, treatment and rehabilitation of musculoskeletal problems. The techniques combine use of focused pressure on tender muscles, movement of joints and massage and stretching of soft tissues. Upon graduation, students receive a degree of: DO = Doctor of Osteopathy. This degree is equivalent to: MD = Medical Doctor in conventional medicine. Osteopathic physicians in the US can prescribe drugs, perform surgeries and specialize in all areas of modern medicine. They are often characterized by an integrative treatment philosophy that focuses on the patient's needs and combines manual therapy as required in practice.

Outside the US, the profession of osteopathy has not merged with Western medicine and the training focuses on the diagnosis and treatment of musculoskeletal pain through the application of osteopathic treatment techniques. Amongst osteopathy practitioners around the world (excluding the US), the title DO refers to a Diploma in Osteopathy. Practitioners are referred to as Osteopaths and they are not certified as doctors. The length of training in most countries ranges from 4-5 years of study which include at least 1000 hours of clinical study in the clinic. Throughout the studies students acquire expertise in using their hands as a tool for the diagnosis and treatment of musculoskeletal problems. The therapeutic model in practice is based on acquiring a broad knowledge base in western medicine with a strong emphasis on studies in anatomy, pathology, physiology, nutrition and biomechanics.

In countries where the profession of osteopathy is regulated, the title "Osteopath" is protected by law. In order to work as an osteopath, one must first successfully complete academic studies at universities and then pass official licensing exams. In countries where academic studies are part of the training, the title DO is accompanied by a Bachelor of Science degree (BSc, BOst, BOstMed) or a Master's degree (MOst) depending on the program at the educational institution.

European countries where there is regulation include: England, Switzerland, Portugal, Norway, Malta, Luxembourg, France, Iceland, Liechtenstein, Finland, Denmark and Cyprus. Outside of Europe, there is regulation for osteopathy in Australia, New Zealand and some provinces in Canada. In these countries there is official recognition of osteopathy in the ministries of health and governments and providing a service without a license is a violation of the law.

In Israel and other countries where osteopathy has not yet entered the university framework, the training is done in private schools and colleges that teach the contents of western medicine together with osteopathic treatment techniques. These programs last between 4-5 years and upon completion students receive a Diploma in osteopathy (DO).

The Israeli Register of Osteopaths (IRO) unites most of the osteopaths in Israel and in recent years has taken on the regulation of practitioners in a voluntary manner until there is regulation of the profession in the Knesset. The IRO supervises the schools of osteopathy through an external supervisor who is a Doctor that is a member of the Israeli Society for Musculoskeletal Medicine. A school supervised and recognized by the IRO is a school that meets the requirements of the European Federation & Forum For Osteopathy (EFFO) in terms of study hours, study content and the standards accepted by the European associations. The final exams in osteopathy schools are conducted by external examiners of the IRO that undergo specialized training to meet the European standards. Each member of the IRO must prove his competence to be an Osteopath by completing a final exam at a supervised school or by confirmation of institutions (which are part of EFFO) that the specific osteopath graduated from a recognized school. The IRO is currently not a full member of the EFFO however its representatives are recognized as observers in the EFFO.

Practicing in the field of osteopathy in Israel does not require licensing and recognition by law. Despite this fact, there is a great demand in Israel for osteopathic practitioners among patients suffering from a variety of musculoskeletal problems. The evidence for this is that all of the Health Maintenance Organizations employ osteopaths in their complementary health clinics and a number of Pain Clinics also employ osteopaths as part of their staff.

Implementation of recommendations in this blog are the sole responsibility of the reader. Your physician should be consulted. Yaron Konigsberg will not be held legally or otherwise responsible for any damages caused or claimed to have been caused to any person following information provided in the blog. The articles should not be seen as recommendation to stop/avoid medical care recommended to you by your physician.


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