Alabama Administrative Code Chapter 190-X-7 — Preceptor and Extern/Intern Program

190 Alabama State Board of Chiropractic Examiners

Ala. Admin. Code r. 190-X-7-.01 Preceptor Doctor

(1) Definition: This preceptor program is designed to provide experience and practice for unlicensed or student doctors under the direct on-premises supervision of a sponsor licensed to practice chiropractic in this state, the Preceptor, before or after graduation as further qualified by this section in cooperation with sponsoring licensed doctors and participating chiropractic colleges.

(2) All preceptor doctors must:

(a) Be approved by the Alabama State Board of Chiropractic Examiners for each participation.

(b) Have an active Alabama license.

(c) Be in active practice in Alabama for three (3) years or more.

(d) Provide evidence of malpractice insurance for themselves and provide the location and submit a schedule showing when the extern will working be under direct on premises supervision for the program.

(e) Contribute a fee as established in Rule 190-X-1-.18 (payable the first quarter with the preceptor application and thereafter quarterly in advance) to the Alabama State Board of Chiropractic Examiners to defray expense of administration of this program only when the Preceptor actually has an extern in the office. Recent graduate compensation is between the parties involved.

(f) Have no Class A or B violations of Board rules for two (2) years and have no present investigations for possible Board violations.

(g) Complete application which states that he or she has read and understands Code of Ala. 1975, §34-24-145, and Board rules and regulations pertaining to this program.

(3) Violations of this program by the Preceptor is considered Unprofessional Conduct.

(4) In cases where more than one licensed doctor is in the clinic, each one who will direct the unlicensed student must be approved as outlined above. A sponsor may not supervise more than one student or graduate at one time.

(5) The board shall notify the preceptor doctor when the applicant is approved for each tier.

(6) The Preceptor shall notify the board when the extern departs his or her oversight.

History

• Author: Board of Chiropractic Examiners
• Authority: Code of Ala. 1975, §34-24-145.
• Filed February 16, 1984. Amended: Filed January 29, 1990. Amended: Filed November 25, 1997; effective December 30, 1997. Amended: Filed June 13, 2008; effective July 18, 2008. Amended: Filed July 3, 2013; effective August 7, 2013. Amended: Filed February 22, 2016; effective April 7, 2016. Amended: Filed June 29, 2018; effective August 13, 2018. Amended: Published March 31, 2021; effective May 15, 2021. Amended: Published August 29, 2025; effective October 13, 2025.

Ala. Admin. Code r. 190-X-7-.02 Extern

(1) Extern. A student enrolled in their last year at a Board approved chiropractic college accredited by the Council of Chiropractic Education or a recent chiropractic graduate of such an accredited school who is approved by the board to practice under the direct on-premises supervision of a sponsor licensed to practice chiropractic in the state of Alabama and in the case of a student, under the supervision of the accredited school.

(2) Qualifications. In order to receive a permit as :an Extern the following applies

(a) Student

1. In addition to the requirements imposed in Code of Ala. 1975, §34-24-145, the following qualifications must be met:

(i) Currently enrolled in the final academic year at an approved chiropractic college which maintains a standard of training acceptable to the Board.

(ii) Documentation of successfully completing the written examination Parts I and II of the National Board of Chiropractic Examination.

(iii) Provide evidence of malpractice insurance coverage.

(b) Graduate

1. In addition to the requirements imposed in Code of Ala. 1975, §34-24-145, the following qualifications must be met:

(i) Graduated within six (6) months preceding the filing of an application from an approved chiropractic college maintaining a standard of training acceptable to the Board and not yet licensed in any other state.

(ii) Documentation of successfully passing Parts I and II of the National Board of Chiropractic Examination.

(iii) Successfully passing Part III and IV of the National Board of Chiropractic Examination within twelve (12) months following the date of graduation.

(iv) Provide evidence of malpractice insurance coverage.

(c) Any student or graduate must submit an application which shall include a provision that in executing the application the applicant agrees to comply with the provisions of the Alabama Chiropractic Practice Act and all the Rules adopted by the Board. In addition, a student, in order to be approved, must have submitted a current and complete application, including any fee in the amount set forth by Board rule. The fees must be in the form of a cashier's check, bank certified check, or money order only. These fees are non-refundable.

1. For purpose of this rule the following meanings shall apply.

(i) Tier I applicants are those whose results from any required background checks have not yet been received. Tier I applicants are not allowed to adjust, or make any diagnosis or treatment directly with the patient. Tier I extern can perform same services as a chiropractic assistant as long as under the direct supervision of the preceptor doctor and may observe the preceptor doctors treatment of patients.

(ii) Tier II applicants are those who have successfully complied with all requirements set out in this rule. Tier II applicants should be able to have full patient treatment privileges as long as under the direct supervision of the preceptor doctor. A student who graduates is no longer eligible to possess a permit to participate in the preceptorship program unless at the time of graduation the requirements of Part III and IV of the National Chiropractors Examination have not been satisfied. In that event, participation in the preceptor program may continue for no longer than twelve (12) months following the date of graduation.

(d) Anyone approved as an extern shall only deliver chiropractic services under the direct on-premises supervision of an approved preceptor. The chiropractic services delivered are those specified in the Alabama Chiropractic Practice Act or in any Rule adopted by the Board.

(e) Externs performing chiropractic procedures under the supervision and direction of a Preceptor shall not represent themselves to the public as licensed Chiropractors or use terms such as "Chiropractor", "Doctor of Chiropractic" or "D.C."

(3) Each applicant for this permit shall be of good moral character or have not engaged in any act or omission which is a ground for discipline set out and described in Code of Ala. 1975, §34-24-166(b). In addition, the applicant must be a citizen of the United States or if not such a citizen, a person who is legally present in the United States with appropriate documentation from the Federal Government.

History

• Author: Board of Chiropractic Examiners
• Authority: Code of Ala. 1975, §§34-24-145, 34-24-165.
• Filed February 16, 1984. Amended: Filed February 23, 1987; January 29, 1990; December 18, 1992. Amended: Filed March 22, 1994; effective April 26, 1994. Amended: Filed November 25, 1997; effective December 30, 1997. Amended: Filed June 12, 2000; effective July 17, 2000. Amended: Filed December 13, 2001; effective January 17, 2002. Amended: Filed June 13, 2008; effective July 18, 2008. Amended: Filed June 18, 2009; effective July 23, 2009. Amended: Filed June 21, 2010; effective July 26, 2010. Amended: Filed April 13, 2010; effective May 18, 2010. Amended: Filed June 1, 2011; effective July 6, 2011. Repealed and New Rule: Filed July 3, 2013; effective August 7, 2013. Amended: Filed June 29, 2018; effective August 13, 2018. Amended: Published December 31, 2020; effective February 14, 2021. Amended: Published January 31, 2023; effective March 17, 2023. Amended: Published June 28, 2024; effective August 12, 2024. Amended: Published June 30, 2025; effective August 14, 2025. Amended: Published August 29, 2025; effective October 13, 2025.

Ala. Admin. Code r. 190-X-7-.03 Establish Director Of Preceptor And Extern/Intern Program

(1) The director of this program shall be a licensed Alabama doctor in active practice and be appointed by a majority vote of the Board of Examiners. The director will serve a term of one year and may be re-appointed.

(2) Duties of the director of the Preceptor Extern Program should be, but are not necessarily limited to:

(a) Reviewing qualifications and approval or denial of acceptance of prospective preceptor doctors or extern.

(b) Confirming that applicants are notified of acceptance or denial of application within two (2) weeks of approval in writing to the address on the application.

(c) Monitoring the rules and regulations, recommend necessary changes to the Board of Examiners and in general administer the program within the established guidelines.

(d) Checking either by phone or on-site visit with each preceptor doctor at least quarterly and provide a short report at the Board meetings.

(e) Notifying the Board president or the Board liaison of known violations of the rules.

(3) The director of this program shall not have disciplinary or administrative powers other than those established by the Board of Examiners.

(4) Funds to pay the actual expenses incurred will be paid from the $25.00 monthly payments made by participating doctors.

(5) Director may receive no monetary compensation other than actual expenses incurred while discharging outlined duties.

History

• Author: Board of Chiropractic Examiners
• Authority: Code of Ala. 1975, §§34-24-145, 34-24-165.
• Filed February 16, 1984. Amended: Filed January 29, 1990; June 19, 1991. Amended: Filed June 12, 2000; effective July 17, 2000. Amended: Filed July 3, 2013; effective August 7, 2013.