<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.43.16.04" title_num="10" subtitle_num="43" chapter_num="16" heading="Minimum Education and Training Required.">
  <paragraph num="A.">
    <text>A chiropractor with physical therapy privileges shall be in good standing before registering to perform dry needling.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The Board shall accept a dry needling course completed before May 18, 2020, if:</text>
    <paragraph num="(1)">
      <text>The same course, in substantially similar form, is sponsored by a continuing education provider approved by the Board; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The chiropractor seeking to perform dry needling provides the Board with a certificate of completion of 3 hours of a recertification course in dry needling.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>In order to perform dry needling, a chiropractor with physical therapy privileges shall complete a minimum of 80 hours of total instruction in the following content areas, including:</text>
    <paragraph num="(1)">
      <text>60 hours of:</text>
      <paragraph num="(a)">
        <text>Academic coursework obtained through completion of a college program accredited by the Council of Chiropractic Education, as part of the Doctor of Chiropractic program, including the following minimum requirements:</text>
        <paragraph num="(i)">
          <text>Foundations;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Basic sciences;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Clinical sciences; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Professional practice; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Coursework required to sit for Part I, Part II, Part III, Physiotherapy, and Part IV of the examination administered by the National Board of Chiropractic Examiners; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Board-approved coursework consisting of 20 hours to be done in a hands-on classroom setting, including but not limited to the following learning topics:</text>
      <paragraph num="(a)">
        <text>Philosophy and historical perspective of dry needling;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Indications, contra-indications, and qualifications for treatment;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Protocols, doctor and patient safety, usage of dry needling, and dry needling as a diagnostic tool;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Case management and jurisprudence; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Direct, hands-on implementation and testing for competency in dry needling of:</text>
        <paragraph num="(i)">
          <text>Cervical, thoracic, lumbar, and pelvic regions;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Anterior and posterior thoracic and ribs;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The upper and lower extremity;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>The face and head;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Technique; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Needle size and gauge appropriateness.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>