CBI Is Not a Job Shadow. It’s a Doctor-Making Program

Why Preceptorships Must Prioritize Training Future Chiropractors - Not Just Clinic Efficiency

For many chiropractic students, the final phase of clinical education is called the Clinical Based Internship (CBI). Some schools refer to it as the Community Based Internship. Regardless of the name, the goal is the same: to transition students from classroom learners to confident, capable doctors. This phase is supposed to be where everything comes together: technique, communication, clinical reasoning, and patient flow.

But too often, that promise falls flat.

Instead of being treated like interns preparing to become doctors, many students are treated like chiropractic assistants. They scribe, observe, and manage front desk tasks while receiving little-to-no mentorship in examination, diagnosis, care planning, or patient communication. And that’s not just disappointing. It’s a failure of the model.

Mentorship Must Be the Mission

CBI placements are supposed to simulate real-world clinical practice, but with structure, supervision, and active teaching. Students should be learning how to think and act like chiropractors, not just watching from the sidelines or doing clerical work to lighten the doctor’s load.

Preceptorships were designed to build clinical independence. That means students should be:

• Taking health histories

• Performing physical exams

• Formulating care plans

• Delivering adjustments under supervision

• Practicing patient communication

• Receiving real feedback for growth

When that doesn’t happen, students don’t just miss out on practice hours. They lose the chance to develop the skills and confidence they need to succeed post-graduation.

The Expectation Gap

Part of the problem is a lack of clarity. Some preceptors don’t know what the CBI program is meant to provide. Others are unclear about what students are allowed to do under supervision. Some schools don’t provide enough guidance on expectations for both parties. As a result, students get thrown into environments with no roadmap, no teaching structure, and no progressive responsibility.

CBI programs need to do a better job of:

• Setting expectations for student involvement from day one

• Clearly outlining intern competencies and boundaries

• Defining a path from observation to hands-on care

• Ensuring the clinic is a learning environment, not just a working one

Students Have a Role, Too

It’s not just on the preceptors or the schools. Interns need to show up ready to learn. That means being proactive, staying engaged, asking questions, and communicating when something feels off. This is not the time to coast. It is the time to absorb everything and push for growth.

You should not expect to run the show on day one, but you should expect to be coached toward that level of readiness by the time you graduate.

The Stakes Are Too High to Get This Wrong

CBI is not a formality. It’s the bridge between student and doctor. If that bridge is weak, the entire profession feels it. We graduate students who know how to pass a board exam, but not how to build a care plan, communicate confidently, or handle a patient visit from start to finish.

Interns are not assistants. They are doctors-in-training. They should be mentored, challenged, and supported as such.

Final Thoughts: When CBI works the way it should, everybody wins. Students get the mentorship they deserve. Preceptors build a lasting legacy. And the profession gains a new generation of chiropractors who are competent, confident, and prepared.

-JG