Regulatory texts, published in September and December 2014, profoundly reform the legal framework for the training of osteopaths in France.
This evolution is the result of global actions led by French professional organizations working together under the label of Unité Pour l’Ostéopathie (SFDO, CNO, ROF, SNOS, SNESO, INFO, FEDEO).
Contentious actions : As requested by the SFDO, all previous accreditations delivered to osteopathic training institutions by the Health Ministry since 2007, giving them the right to deliver the title of professional osteopath, have been canceled by the law courts.
Control of training institutions : Following the first law court decisions, a parliament law was voted, allowing a control of training institutions by the health and social affairs authority IGAS. The published results were condemnatory for the government authorities and their management of osteopathic training regulation.
These two events put considerable pressure on the French government.
Publication of benchmarks for training in osteopathy : Concurrently, the SNESO and SFDO were working together on benchmarks for training in osteopathy under the direction of Professor Jacques Tardif, published in 2012. This document legitimized the seriousness and maturity of both professional and educational representatives working together for osteopathy in France.
Monitoring of European standards : The SFDO, SNESO and CNO funded the creation of a French mirror committee whose role was to monitor and contribute to European standards on the quality of osteopathic care. This stimulated debates and awareness within the French public authorities.
Continuous and powerful media actions : French professional organizations used all forms of media to communicate on the benefits of osteopathy and the great difficulties in osteopathic training regulation.
Political actions : Building on these actions and highlighting the health risks of inadequate osteopathic training, the professional bodies led an awareness strategy directed at politicians and political institutions.
The pressure of professional bodies, coupled with a growing demand for osteopathic care (in 2014, 48% of the French population declared to have consulted an osteopath at least once) led the Health Ministry to open an official debate in April 2013 to modify the legal framework of French osteopathic training. This project was accomplished after more than 20 meetings marked by strong technical and political challenges.
A new accreditation system for osteopathic training institutions :
A decree, published on the 12th September 2014 and its bylaw published on the 29th of September modified the accreditation rules of osteopathic training institutions.
From now on, 24 criteria are required for all training institutions, regardless of the student background (previous health professional qualification or not):
- Training institutions are higher education institutions and contribute to the public service for higher education. They are thus under the joint authority of the Health Ministry and the Higher Education Ministry.
- Their governance must be specifically organized; Scientific Council, Education/Academic Council, Disciplinary Council, and an Examination and Professional Skills Validation Commission.
- The facilities must be exclusively dedicated to the osteopathic training and respect the appropriate regulations. Their surface area must be at least 5 m2 per student.
- The institution must justify a financial capacity sufficient to guarantee at least one year of training.
- The director of the institution must be an osteopath, with a high level of management skills.
- The teachers must have appropriate qualifications. Osteopaths who teach must have at least 5 years of professional osteopathic experience.
- The number of teaching staff must be equivalent to one full-time teacher per 25 students. - In addition, it must include 5 full time education/academic coordinators.
- Clinical training must account for 150 complete and validated consultations per student. - Two thirds of these consultations must be made at the institution’s on-site clinic.
- The institution must undertake a graduate follow-up survey at 18 and 30 months after graduation.
- The student capacity of the institution is calculated based on its adequation with the quantitative criteria.
New benchmarks for osteopathic training in France :
A decree published on the 12th of December 2014, and its two bylaws of the same date, define the curriculum.
The training lasts 5 years and has the following characteristics:
As from September 2015, students will have to complete 4860 teaching hours in order to become an osteopath. These hours are divided as follows:
-760 hours of fundamental sciences
-632 hours of semiology of health alterations
-160 hours of human and social sciences, management and legislation
-160 hours of osteopathic concepts and principles
-1266 hours of practical training in osteopathy
-168 hours of academic work methods
-194 hours of skill development in osteopathy
-1500 hours of clinical practice, including 150 complete and validated consultations
-20 hours of thesis guidance
To obtain the title of osteopath, physiotherapists and midwives will have to complete 1900 hours of training. 2300 hours of training is required for nurses and chiropodists-podiatrists.
Medical physicians will have to complete a little less than 800 hours of training.
Clinical training will be highly supervised. An individual student clinical record book will ensure the monitoring and validation of consultations throughout the cursus.
The teaching units are specifically detailed in the 69-page bylaw.
A control of the institutions by IGAS is programmed for 2015.
In all, French benchmarks for training in osteopathy are the most complete and detailed benchmarks for training among health professions in France.
A new accreditation procedure for osteopathic training institutions :
All training institutions must request a new accreditation from the French Health Ministry for the academic year beginning September 2015, authorizing them to deliver the professional title of osteopath necessary to practice osteopathy in France. This request must respect all the conditions laid down in the decree and its bylaws.
The demand must be completed by February 28th 2015 and will be examined before July 2015 by a commission made up of government and professional representatives. The Health Ministry will announce its decisions based on the opinion of this commission.
French professional organizations commend the ambition of the French government. The expectations are that these new regulations will harmonize the quality of training and reduce the number of osteopathic training institutions in France.
Paris, January 30th 2015,
Philippe Sterlingot
