Author Identifier (ORCID)
Abstract
Objective: To compare competency standards and regulatory expectations for osteopathic practice across jurisdictions where the profession is formally regulated or recognised as a healthcare profession. Methods: A documentary analysis was undertaken across regulated and formally recognised jurisdictions. National competency frameworks, regulatory standards and professional guidance documents were identified through regulatory and professional body websites and direct contact with relevant organisations. Nineteen national competency, regulatory or professional framework documents from 17 jurisdictions were included. The World Health Organization Benchmarks for Training in Osteopathy and EN16686 Osteopathic Healthcare Provision were included as international comparison points. Data were extracted using a structured template informed by international health profession competency frameworks. Template analysis identified shared competency domains and areas of regulatory, educational and practice variation. Results: Core competencies expected of practising osteopaths showed strong international convergence. Common domains included patient-centred assessment, clinical reasoning and decision-making, safe and effective treatment, ethical and professional conduct, communication, evidence-informed practice, referral and collaboration. Variation was greatest in education pathways, qualification levels, continuing professional development requirements, scope-of-practice restrictions, health-system integration, and the operationalisation of digital health, quality improvement and outcome measurement. Conclusion: Competency and regulatory standards for osteopathic practice show strong international alignment despite variation in regulatory structures, education, scope of practice and health-system integration. These findings support updating international benchmark guidance, including the World Health Organization Benchmarks for Training in Osteopathy, to reflect contemporary healthcare expectations while allowing national adaptation. Updated guidance may support comparability, public protection and regulatory alignment without imposing uniformity.
Keywords
comparative analysis, competency standards, international benchmarking, osteopathy, professional regulation, workforce mobility
Document Type
Journal Article
Date of Publication
9-1-2026
Article Number
100856
ISSN
17460689
Volume
61
Publication Title
International Journal of Osteopathic Medicine
Publisher
Elsevier
School
School of Medical and Health Sciences
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Muddle, L., McLeod, G. A., Treffel, L., Thomson, O. P., Ferreira, A. P. A., & Vaughan, B. (2026). International competency and regulatory standards in osteopathic practice: A comparative documentary analysis of regulated and formally recognised jurisdictions. International Journal of Osteopathic Medicine, 61, Article 100856. https://doi.org/10.1016/j.ijosm.2026.100856