Test of Competence
Please note all interviews are held remotely via Microsoft Teams. We are currently setting interview dates for 2023 but anticipate that we will continue to run those monthly. Interview dates will be listed below once confirmed.
Chiropractors who have qualified abroad must first pass the Test of Competence (TOC) before being eligible to apply for registration. Only once registration has been granted can a chiropractor practise in the UK.
The Test of Competence is an interview in which candidates must demonstrate to a panel of chiropractors that they meet the standards set out in The Code , and can practise safely in the UK.
Test of Competence interviews are conducted remotely via Microsoft Teams.
Test interview 2022
|29 March (Wednesday)||1 February (Wednesday)|
|26 April (Wednesday)||1 March (Wednesday)|
Please note that you cannot secure a place on a test until your application is fully complete, including payment of the fee.
To protect patients and the public, the GCC has a duty to check that all chiropractors, including those from outside the UK, are properly qualified and are fit to practise. Applicants with foreign qualifications are required to take a Test of Competence (TOC) to satisfy the Registrar that they have reached the required standard of proficiency, and are able to practice in accordance with The Code. In addition, applicants must have a satisfactory command of the English Language.
The TOC requires applicants to complete an Evidence of Practice Questionnaire which provides an insight into how they practise, as well as highlighting the importance of The Code in defining the required standards of practice in the UK. Applicants then have a TOC Assessment Interview with a panel of three experienced chiropractors.
Around 75% of the people who take the TOC are successful. Candidates who have taken the test have told us that it is challenging. It takes a significant amount of time to collate the required documentation and prepare for the interview. Applicants are strongly encouraged to read the Support For Applicants section, which provides a wide range of supporting information, including insight into the process from individuals that have experienced it first-hand.
The dates on which interviews are held are advertised in advance, together with an application deadline. However, places are allocated on a “first come, first served” basis, so applicants are advised to apply as soon as possible to maximise the opportunity of securing their preferred TOC interview date.
The current format of the TOC was developed in 2014, following a comparison of the UK education standards in place at the time (found here), with the international standards of the Council on Chiropractic Education International (CCEI) and the four other accrediting organisations across the world (in Europe, the USA, Canada and Australasia). The outcomes of these comparisons can be found here. Although there was much similarity between the different sets of standards, the differences identified were incorporated in the new Test of Competence. A summary of these differences is provided in the Support For Applicants section.
We have developed our Myth Buster which looks at some of the most common misconceptions about the Test of Competence. It also gives a good overview of the overall process and what is required by those applying.
The TOC has an independent Test of Competence External Examiner appointed specifically for the TOC, and who has a key role in processes relating to quality assuring and enhancing the TOC. In addition to the TOC Annual Report prepared by the GCC, the External Examiner complies a separate Annual Report for the Education Committee (all TOC reports can be found here).
We recommend that you review the information below, which is provided to help you maximise your chances of success, before preparing for the TOC.
Previous candidates have commented that while the assessors on the panel are friendly and supportive, the TOC interview is challenging and that, to be successful, you will need to spend a significant amount of time preparing for the interview. We strongly recommend that you read the following blogs and interviews with past candidates, and an assessor, to get an idea of how best to prepare:
The Code outlines the standards that chiropractors must meet if they wish to practice in the UK. It is important that all those wishing to sit the TOC are familiar with, and fully understand, the Principles and Standards within The Code and are able to apply it to their practice.
We also publish a range of additional guidance and information to help chiropractors remain compliant with The Code. This can be found at the Registrants Resource Centre.
In order to pass the TOC, candidates are expected to have the same level of knowledge as a newly qualified UK chiropractor. Our Education Standards set out the criteria that chiropractic students in the UK must meet in order to qualify.
The Royal College of Chiropractors have developed an online module specifically aimed at those preparing for the TOC. The Royal College has also published a series of chiropractic standards that may provide further assistance for those preparing to work in the UK.
In addition to the evidence that you present in your Evidence of Practice Questionnaire and supporting documents, the TOC will focus on the differences between UK education standards and those of other regulatory authorities around the world. These differences have been identified as:
The involvement of patients and carers as partners in the care process (including consent)
The use of research evidence in influencing practice
Applying continuous quality improvement in practice, and the management of clinical risk
Understanding the implications on providing chiropractic care for patients on clinically relevant medications
Evaluating the effectiveness of chiropractic care and modifying care plans
The role of chiropractors in the UK healthcare system and relationships with other healthcare professionals
The nature of professional accountability and ethics, and the duty to protect and promote the interests of patients (including professional boundaries, raising concerns about others, and the various GCC requirements)
UK legislation, including: the Equality Act 2010, the Data Protection Act 2018 and UK GDPR, the Children Act 1989 and Children Act 2004, Mental Capacity Act 2005, Health and Safety at Work Act 1974, Ionising Radiation (Medical Exposure) Regulations 2017 and IR(ME)R 2018 (Amendment), and local safeguarding regulations
The use of wellness care and how this relates to evaluating care and reviewing care plans
There are four UK chiropractic professional associations that provide support and advice for their membership:
1. Transcript from the educational institution which awarded your chiropractic qualification.
The transcript must give details of how it meets the registration requirements and include:
Please refer to our rules on the qualification requirements for overseas applicants here. If you have not completed the relevant number of hours, you may still be able to apply depending on your circumstances. Cases will be reviewed on an individual basis.
2. The Evidence of Practice Questionnaire (EPQ)
The Evidence of Practice Questionnaire (download here) provides evidence of how you meet the standards in The Code, benchmarked at the level of the programme outcomes in the GCC Education Standards. The questionnaire forms a key part of your application and will be assessed by the Test of Competence Assessment Panel.
The Evidence of Practice Questionnaire includes the following sections:
All the answers given must be entirely your own work. Should there be any suspicion of collusion with others and/or copying the work of others, then you application to join the register may be refused. For further information, read our Plagiarism and Collusion Policy and Procedure.
As well as documenting your past or current practice, the responses that you give should also outline how you intend to ensure compliance with The Code in similar circumstances. Give enough detail to reassure the panel that you understand the reasons behind your practice and the rationale for any care you provided.
3. Anonymised patient records
You must provide an anonymised set of patient records to support your answers to Sections 2, 3 and 4 of the Evidence of Practice Questionnaire. These must include everything that is part of the patient record, including details of the initial consultation, all the subsequent treatment notes, any reports, images or letters, as well as any intake or administrative forms that the patient was provided with.
Patient records are a compulsory part of your supporting evidence. You will not be able to attend the TOC interview without providing them.
Requirements for Patient Records:
Patient records not prepared and collated as detailed above will be rejected.
Educationalists: If you are an educationalist not treating patients, we will accept the clinical cases of chiropractic students you have supervised rather than those you have assessed or cared for directly. In this case, you must make sure your role and the actions you took in relation to the patient are made clear.
Recent Graduates: If you are a recent graduate, we will accept patient notes taken as part of your supervised practical sessions within your course.
It is recommended and preferred that, wherever possible, you obtain real anonymised records for patients that you have cared for (if necessary, the General Chiropractic Council can provide information for overseas educational institutions and employers who may hold responsibility for the patient records that you wish to submit). If necessary, we will accept patient records taken while observing or shadowing chiropractic care. You may create patient records based on real cases only if you have exhausted all other options of obtaining real records; however, please ensure that you make explicit on your application that you have not provided real patient records, and also be aware that you will be subject to a longer, more intensive interview to ensure that you meet the standards.
You must provide an up-to-date copy of your CV/Resume that includes all your work history, especially related to chiropractic.
5. Passport Copy
Send a copy of the pages from your passport that contain your photo and personal details.
You are invited to fill in our Diversity Monitoring Form.
7. Pay the Test Fee of £2,000
It is a requirement of the TOC interview that the fee of £2,000 is paid before your place is confirmed. It is not possible to pay the fee after the interview or by instalments. Fees are reviewed annually and subject to change. You will be prompted to pay the fee at the end of your online application. Please note that the TOC fee must have been paid before you take the test.
English Language Skills
There are some circumstances, such as if the chiropractic programme you attended was not conducted in English, when we will ask you to provide evidence that you meet the English Language requirements (see our Guidance on English language skills for applicants).
After Receiving your Information
Once we have received your application and the test fee, we will check to ensure that you have provided all the information that is requested. We will then confirm an interview place or let you know if any information is missing. Any request for further information may result in a delay to your application, and you may miss the closing deadline.
Withdrawal and Refunds
Once you have had a TOC interview place confirmed, a withdrawal of your application up to 24 hours before the closing date will result in a 50% refund of your fee. No refund will be provided after the closing date, unless we agree that you have an exceptional mitigating circumstance.
The General Chiropractic Council stipulates that patient confidentiality must be protected by anonymising patient records. Applicants must therefore ensure that all personal data within the records are redacted or deleted before being submitted to us. All anonymised records are used for the sole purpose of the test of competence. The General Chiropractic Council does not use these records for any other purpose, nor are they shared with third parties.
After you have uploaded your completed application to our portal, including the Evidence of Practice Questionnaire, you will be required to attend a TOC Assessment Interview. We will send you information confirming the date and time of your interview after the closing date for applications has passed. The interview panel will be made up of three experienced chiropractors, and the interview will take place remotely using Microsoft Teams. A link will be provided for you to join at the appropriate time.
The role of the interview panel is to assess whether you have the knowledge, skills, understanding and attitudes to practice in accordance with The Code, benchmarked against the programme outcomes in the Education Standards. While we use a standardised criteria for the interviews, a significant number of the questions that you will be asked will be specific to the answers that you provided in your Evidence of Practice Questionnaire.
To help you prepare for the interview, it is strongly recommended that you review the additional information (including experiences of past applicants) that has been provided in the Support For Applicants section.
You should allow up to 2 hours for the interview. This will include sufficient time to deal with potential internet connectivity issues which may increase the length of interview. The interview itself will consist of three separate parts:
1. The Evidence of Practice Questionnaire
The panel will ask questions to explore the information that you have provided in your Evidence of Practice Questionnaire. You will need to be able to explain the rationale behind how you have practised in the past, and to reflect on what changes you might make if you were to practice in the UK. This section will comprise at least 50% of the interview.
2. An Ethical Dilemma
The panel will then provide you with a hypothetical situation to explore how you would approach an ethical dilemma. You will be given plenty of time to read and consider the scenario, before being asked some questions by the panel. This section is intended to investigate how you would handle a challenging situation, which may address areas such as: prioritising a patient’s wellbeing, handling your professional responsibilities, dealing with conflicts of interest, working within professional boundaries, consent and confidentiality, or fulfilling the duty of candour.
3. The Code and Practice in the UK
In the final section of the interview, the panel will ask a series of questions to assess your knowledge and understanding of The Code, and of the healthcare environment in the UK. The questions are heavily influenced by the result of analysis carried out to identify the main differences between the UK standards, and those of other regulatory authorities around the world (details of these areas are provided in the Support For Applicants section).
The interview will be held remotely, and we will send you a Microsoft Teams link in advance of the interview. We will need to carry out an identity check prior to the interview starting (please see below for the documents required), therefore please use the link to connect to Microsoft Teams 5 minutes before the interview is due to begin. You will initially enter a virtual lobby until the panel is ready.
IMPORTANT: There are a few things that you need to arrange before the interview starts:
If the name on your identification document is different from that on the confirmation you receive from us offering you an interview, you must provide original evidence that you are the person named in the letter. We will accept:
If you cannot provide the necessary document(s), you will not be allowed to sit the interview.
When will I know the result?
We are not able to give you a result on the day, as it is the role of the assessment panel to provide a recommendation to the Registrar. It may take up to 10 working days for the Registrar's decision.
What if I am absent or sick on the day of the interview?
If you are unable to attend the interview because of serious illness or another overwhelming problem, we will make a full refund of your fee. However, for us to refund your fee, you must tell us as soon as possible, and provide the following evidence:
What if something outside of my control has put me at a disadvantage?
You will need to apply for an exceptional mitigating circumstance. To do this you will need to read our Policy on Exceptional Mitigating Circumstances and complete the form included in the document.
What if I have a disability?
If you have a disability within the scope of the Equality Act 2010, we may be able to make reasonable adjustments to the interview. Read our Policy on Reasonable Adjustments for Disability to see what we can do if, for example, you have dyslexia, or a visual or motor impairment.
Will the panel be different if I have the resit the TOC?
If you fail the Test of Competence and subsequently apply to resit, there is a possibility that you may be assessed again by one of the same panel members. While we do our best to ensure you are assessed by different assessors this is not always possible.
We will inform you of the outcome of your Test of Competence (TOC) application by email within 10 working days of your interview. The outcome will be one of the following:
The GCC does not enter into correspondence on outcomes of the Test of Competence, but does provide feedback to candidates.
If the result of your TOC is 'Further Evidence Required', you will be given specific details of what you need to do. This further evidence must be provided within 6 months of the TOC interview. Despite this deadline, we have found that applicants who supply this evidence within 3 months of the interview have a much better chance of passing than those who take longer.
After passing the TOC, you will need to apply for registration. Before we grant you registration, you will need to make sure that your application for registration is complete. Our registrations team will normally get in touch with you once they have received notification of your pass.
We have a complaints procedure in place where a TOC candidate has concerns that processes, either for the TOC or the TOC administration, have not been fully followed. These are set out below:
Stage 1: If you have a complaint about the TOC, in the first instance, you should put your complaint in writing, addressed to the Registrations Officer (firstname.lastname@example.org).
Stage 2: Following Stage 1, and where you are unsatisfied that due process has been followed, or you wish to make a complaint about an administration matter, you may take a complaint to the Registrar. This must be made in writing and addressed to the Chief Executive and Registrar (email@example.com).
Stage 3: There is no formal right of appeal against the Registrar’s decision to accept a TOC assessment panel’s recommendation about the outcome of a TOC. If you wish to challenge such a decision, you would need to apply to the Court for permission to have the decision judicially reviewed.
If you are unsatisfied by the Registrar’s response to a complaint about the TOC process, you may wish to make a complaint to the Chair of the GCC Education Committee. Such a complaint represents the final stage of our internal complaints process about such matters. If you remain unsatisfied following the Chair of the Education Committee’s consideration of your complaint, you may wish to raise your concern with the body that oversees the work of the UK regulators of health and care professionals, the Professional Standards Authority.
This section puts the resources listed in the sections above in one place to assist candidates in preparing their application.
TOC Advice / Information
TOC Courses / Modules
GCC Policies / Guidance
UK Professional Associations
Other Professional Bodies