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National Academy of OsteopathyNational Academy of Osteopathy - Full Time & Part Time Clinically Based Practive Oriented Scientific Manual Osteopathic EducationApplication Form and Calendar

Frequently Asked Questions

What is Osteopathy?

Osteopathy (founded in 1874 by Dr. Andrew Taylor Still in USA) is an established internationally recognized manual medicine system of analysis and treatment, which lays its main emphasis on the structural and functional integrity of the musculoskeletal system.

Manual osteopaths use a variety of hands-on physical treatments. These include soft tissue techniques, osteo- articular joint mobilization, cranial osteopathy (osteopathy in the cranial field), visceral manipulation, strain/ counterstrain technique, lymphatic drainage, spinal manipulation, muscle energy techniques, myofascial release technique, trigger point therapy, etc. These techniques are normally employed together with exercise, dietary, and occupational advice in an attempt to help patients recover from pain, disease and injury.

European style Osteopaths do not prescribe medications or perform surgery, while American style osteopaths perform surgery and prescribe medications as well as using osteopathic techniques in managing a patient’s condition.

National Academy of Osteopathy (NAO) teaches European style osteopathy; also known as pure osteopathy; manual osteopathy, traditional osteopathy or osteopathic manual practice.

What is the Minimum Academic Admission Requirement?

Any student with a grade 12 high school diploma or its equivalent may apply for admission to the osteopathic manual practice program offered by National Academy of Osteopathy. The diploma in osteopathic manual practice program is one year full time or two years part time in length for high school graduates or any other student without prior health education. The program length for students with prior health education is 6 months full time or 12 months part time.

How Long is the DO(MP) Program?

The Diploma in Osteopathic Manual Practice (DOMP) offered by the National Academy of Osteopathy(NAO)may be taken as a full time or part time program. For high school graduates and other students who do not have any previous health education the DOMP program is one year full time or two years part time. For students who have previous health education (such as massage therapists, medical doctors, physiotherapists, kinesiologists, acupuncturists, athletic therapists, etc) the program is six months full time or 12 months part time. This is the first and only condensed six months full time accredited manual osteopathy program in Canada for health professionals.

How Much is the Tuition for DOMP Program?

The DOMP program may be taken as a campus based program or online on-demand. The tuition for students without previous health education is $10,813 (Canadian) for the complete campus based manual osteopathy program at our York University Heights campus in Toronto (Ontario, Canada).

It makes no difference if you take it part time or full time. The tuition is the same for international students taking this program in the Toronto campus.

The tuition for the online on-demand program for students without previous health education is $9,270.80 (plus 13% tax).
For students with previous health education the campus based DOMP program tuition is $7,070.80 (plus 13%). For these students; the online distance education program is $5,528.60 plus tax.

Is There a Tuition Discount For Health Practitioners?


Students who have previous health education background complete the DOMP program in half the time it takes other students.

Tuition for the campus based students who have previous experience as a chiropractor, physiotherapist, medical doctor, physician and/or surgeon, massage therapist, aromatherapist, occupational therapist, ergonomist, athletic therapist, podiatrist, chiropodist, acupuncturist, pharmacist, optometrist, dentist, pedorthist, orthotist, homeopath, optician, personal support worker, social worker, dental hygienist, psychologist, kinesiologist, personal trainer, dietician, nutritionist, and naturopath is set at $7,070.80 plus 13% tax.

TTuition for study at home online on-demand program for these students is set at $5,528.60 plus 13% tax.

When Does the DOMP Program Start?


The full time & part time DOMP programs of NAO start twice a year; in the first week of September and March of each year.

Is Financial Help Available?

A number of Student loans and scholarships are available. Canadian and international NAO students are entitled to a student loan of up to $2,500 (Canadian) depending on their programs. Contact NAO registrar for more information. Student loans are for a 5 year term; at an interest rate of 8% per year. Aboriginal students in Canada may be eligible for scholarships from their government including the Métis Nation of Ontario.

What Diploma Offered Upon Graduation?

Upon gradations students receive the following designation: Diploma in Osteopathic Manual Practice. The academic designation you may use in front of your name is DOMP.

What Employment Opportunities Exist For Osteopaths?

Upon graduation; osteopathic manual practitioners have the option of opening their own osteopathy clinics; or to rent rooms in established medical, health or rehab clinics and benefit from cross referrals; or to work as employees in other osteopathic, medical, chiropractic, physiotherapy, massage or rehab clinics.

Most osteopaths work in private clinics, often as sole proprietor, associate or employee. However, the increase in multidisciplinary health care facilities and physical rehabilitation clinics in Canada has opened new opportunities for osteopathic manual practitioners to collaborate with other health care professionals (such as family physicians, chiropractors, registered massage therapists, naturopaths, athletic therapists, kinesiologists, podiatrists, chiropodists, occupational therapists, ergonomists, and physiotherapists) and benefit patients with interprofessional care. A small numbers of osteopaths also work in hospitals, nursing homes, health spas, sports teams, insurance companies claims services department, fitness clubs, osteopathic colleges, motor vehicle accident (MVA) assessment centres and other institutions.

Most new graduates start their professional work as employees. Later they establish their own private clinics.

What is Average Salary of Manual Osteopaths?

The average salary for a new manual osteopathy graduate who works as an employee in a health or rehab clinic is generally between $30 to $40 per hour in Europe, Australia, Caribbean and North America and $10 to $20 in Asia, Latin America and Africa. An 'average' European style manual osteopath can earn up to $90,000 or more per year in Europe, Australia, Caribbean & North America. There is virtually no unemployment in this field.

Manual osteopaths in private practice generally charge between $90 to $140 per hour of treatment in Europe, North America, Australia & Caribbean and $20 to $60 per hour in Asia, Latin America & Africa.

Manual osteopathy treatment provided by National Academy of Osteopathy graduates are covered by more than 95% of insurers in Canada.

For patients injured in a motor vehicle related accident in Ontario (Canada) all auto insurers cover osteopathic treatments performed by NAO graduates at the rate of $53.66 per hour as per fee guideline set by Financial Services Commission of Ontario.


Is NAO registered with MTCU as per Private Career Colleges Act, 2005?

Private Career Colleges Act, 2005 regulates most private colleges in Ontario. There are a few educational health programs however; under NOC sections 3123 and 3232 such as osteopathy, podiatry, and chiropody that are exempted from being registered under this act. These exempted health educational programs must be registered under different government agencies. NAO is registered and licensed by Ontario Ministry of Government Services to operate in the Province of Ontario (license # 200607893) and it is also registered federally by Industry Canada (reg # 757053-8).

What is Osteopathy Unemployment Rate?

There is virtually no unemployment in this health care profession. Almost all osteopathic manual practitioner find employment.

How Many Osteopaths Practice in North America?

There are approximately 1500 osteopathic manual practitioners (OMP) in Canada, 500 OMPs in the USA and 67,000 osteopathic physicians in the USA. Nearly half of them are women.

What Countries Offer Osteopathy Education?

There are currently eight osteopathic colleges in Canada that offer a World Health Organization (WHO) compliant osteopathic education approved by the Council on Manual Osteopathy Education and accepted by the College of Osteopathic Manual Practitioners of Ontario, all teaching European style osteopathy (no surgery, no medications, only hands-on work), and 28 colleges in the USA, teaching American style osteopathy (which includes surgery and prescribing medications).
National Academy of Osteopathy (NAO) is the only college offering a condensed four months full time osteopathy program for health practitioners. Students without prior health education complete the DOMP program in 8 months.

There are also osteopathic colleges & universities in Argentina, Australia, Norway, Denmark, Portugal, Switzerland, The Netherlands, Sweden, Belgium, Germany, Russia, England, Spain, Israel, Italy, New Zealand, and France.

NAO teaches manual osteopathy in 65 cities across 35 countries including Canada (Toronto, Vancouver, Ottawa, London), USA (Atlanta, Boston, Palm Beach, New York, Broward, Phoenix, Victorville), China (Shenyang, Hong Kong), Iran (Tehran North, Tehran West, Kerman, Shiraz, Isfahan), Taiwan (Taipei), Mexico (Mexico City), Botswana (Gaborone), Dominican Republic (Santo Domingo), Brazil (Sao Paulo), Spain (Madrid), Italy (Rome), France (Paris), Greece (Athens), Turkey (Istanbul), Japan (Tokyo), South Korea (Seoul), Germany (Frankfort), Netherlands (Amsterdam), Portugal (Lisbon), South Africa (Cape Town, Soweto), , Nigeria (Lagos, Abuja), Swaziland (Mbabane), United States Virgin Islands (Charlotte Amalie), Jamaica (Kingston), Barbados (Bridgetown), Bahamas (Nassau), Ghana (Accra, Kumasi), Trinidad & Tobago (Port of Spain), Turk & Cacaos (Grand Turk), and Venezuela (Caracas, Maracaibo. This list is expanding.

Is Tuition Tax Deductable?

Yes. NAO Tuition is a tax-deductable expense if you own a business. Students receive a receipt for tuition paid. The cost of books and supplies are also tax deductable. Those students who do not own a business are recommended to register a business so they could use these expenses for tax reduction. In any case students must register a business if they plan to practice as manual osteopaths. We will teach you the best way to register your business to reduce your taxes while protecting your assets.

Is 12 months Enough to Learn Manual Osteopathy?


The total hours of study at National Academy of Osteopathy surpasses the teaching hours of most other manual osteopathic colleges. Most colleges offer 3 year part time programs at one weekend a month. As such NAO students spend more time learning techniques compared to many other osteopathic colleges.

The minimum required teaching hours set by the International Osteopathic association for a diploma program in manual osteopathy is 2000 hours and the NAO program exceeds the guidelines established by IOA. There are colleges in Europe offering osteopathy in a 3 to 4 year full time osteopathy program. These colleges teach comprehensive diagnosis courses.

Rendering a diagnosis is a controlled act in many countries; such as Canada & USA. In these countries only medical doctors, chiropractors and physiotherapists are permitted to render a medical diagnosis. As such National Academy of Osteopathy does not teach medical diagnosis. NAO students learn only osteopathic diagnosis.

This is what one of the full time students of NAO said about the program: "Dear Dr. Pourgol; In July 2010 when you told me about osteopathy I was interested in it but the thing that was always in my mind was:

"Is it possible for me with no background in Health to start this program?"

You told me that you are creating a program that anyone with no background in Health can study and learn manual osteopathy and be successful in it. Still In February 2011 when I started osteopathy I was not sure about it but I did it because I trusted you.

Now after a month that I am in the osteopathy Program I am Sure that with your method of teaching the manual practice of osteopathy and the passion you have for teaching and also the curriculum you gather for other subjects in this program (anatomy, pathology,...) IT IS possible to become a successful manual osteopath ONLY in so few months.

I just want to thank you for creating this opportunity."

What is the Online On-Demand Manual Osteopathy program offered at NAO?

For national and international students (including those in Toronto) who are unable to attend the campus based program; we offer an online on-demand manual osteopathy program through a combination of online teaching video sessions through the internet, complete lectures on hard disk drive (mailed to student at the start of program), and optional on-site classroom osteopathy technique labs. National & International graduates of online distance education manual osteopathy program receive a Diploma in Osteopathic Manual Practice (DOMP) upon graduation.

National Academy of Osteopathy - School - Class - Interactive Manual Osteopathy

What is the Difference Between a Manual Osteopath and a Chiropractor?

Chiropractors and manual osteopaths are both health professionals who treat patients with a focus on the musculoskeletal system, including the spine, joints, muscles, tendons, and ligaments.

Historically there is a political answer relating to the founder of osteopathy, Dr Andrew Taylor Still, falling out with his student, Dr. D.D. Palmer, who then went on to be the founder of chiropractic.

The principle working difference is that osteopaths tend to use more rhythmical and gentler techniques while chiropractors use more often stronger, high velocity, low amplitude manipulative techniques. Chiropractors may also employ modalities such as ultrasound and various electrotherapies for pain relief while osteopaths generally rely on hands-on manual techniques to relieve pain.

Essentially, both offer valuable and useful services, and each can be included in a holistic healthcare regimen. There are now many multidisciplinary clinics offering osteopathy, chiropractic, physiotherapy and registered massage therapy services. This seems to be the new growing trend in Canada, USA and Europe, specially for patients injured in motor vehicle accidents.

Since chiropractors are able to render a diagnosis their education is more detailed and it takes 4 years of full time studies plus 3 years of university education 9total of 7 years) leading to a doctor of chiropractic (DC) degree.

Financially the salary range and annual income levels of doctors of chiropractic ($30 to $50 per hour) and manual osteopaths ($30 to $40 per hour) are similar (approximately $90,000 per year) as insurers and patient pay same amounts for both treatments (except for motor vehicle accident cases; where FSCO guidelines in Ontario enforces insurers to pay $104 per hour of treatment performed by chiropractors compared to $53.66 paid to manual osteopaths for each hour of MVA treatment).

Are NAO graduates eligible to write board exams?

Yes. All national and international NAO graduates are eligible to apply and register for examinations administered by Canadian Manual Osteopathy Examining Board, International Osteopathy Examining Board, & College of Osteopathic Manual Practitioners of Ontario.

Following successful passing of the board exams you may apply for membership to the International Osteopathic Association and / or College of Osteopathic Manual Practitioners of Ontario to receive a license number that enables you to open your own clinic and work as a manual osteopath in Ontario and all other Canadian provinces as well as all other countries worldwide. With a license number from IOA and / or COMPO you may bill more than 95% of insurers that cover osteopathic treatments.

Is NAO accepted by International Osteopathic Association (IOA)?

Yes. NAO is accepted as being a fully accredited manual osteopathy educational centre by International Osteopathic Association ( NAO graduates are permitted to apply for IOA membership and to receive certificates of registrations.

Where is NAO campus?

Both the full time and part time class based manual osteopathy programs of National Academy of Osteopathy (NAO) are offered at the campus in Toronto (York University Heights 121 Limestone Crescent Toronto, Ontario Canada M3J 2R1).

The practical technique classroom part of interactive manual osteopathy program offered internationally by NAO is held at the board rooms of selected hotels in each city. For the list of hotels please see the "Contact US" section.

Is NAO approved by Medical Financial?

Medical Financial; located in Toronto, Canada, is a Canadian financial company that provides health related private loans. National Academy of Osteopathy is the only osteopathy college in Canada approved by Medical Financial as an accredited health education facility. Depending on the programs, NAO students are eligible to receive guaranteed student loans of up to $2,500 (Canadian). The loan is for a five year term at annual interest rate of 8%. The monthly payment for a loan of $2,500 is $50.66. This guaranteed student loan is available for all NAO students (Canadian and international). The student loan is not available for the online DOMP program for health practitioners.

Does NAO Offer Accelerated Program for Health Professionals?

For health professionals who wish to enter the rewarding health care profession of manual osteopathy; National Academy of Osteopathy (NAO) offers the Accelerated Manual Osteopathy Program for Health Practitioners...Click here for more information

Is Manual Osteopathy Treatments Covered by Insurers?

In certain countries (such as Canada, Australia & most European countries) manual osteopathic treatments are covered by most insurance providers.

In Canada more than 90% of insurers cover osteopathic treatments. And of these 95% cover osteopathic treatments offered by National Academy of Osteopathy graduates who have joined the Ontario Osteopathic & Alternative Medicine Association, College of Osteopathic Manual Practitioners of Ontario, Ontario Association of Osteopathy & Natural Medicine or other associations.

Is the DOMP Diploma Offered by NAO Accepted by Insurers?

Out of many insurers that cover osteopathic treatments; More than 95% accept the DOMP diploma offered by National Academy of Osteopathy (NAO has the copyright to the DOMP title). However even though insurers accept the DOMP title issued by NAO, to receive reimbursement by insurers, an NAO graduate must apply for membership to an association that accepts NAO graduates; such as the Ontario Osteopathic & Alternative Medicine Association, Ontario Association of Osteopathy & Natural Medicine, or College of Osteopathic Manual Practitioners of Ontario and that issue a license number that may be used to bill insurers for manual osteopathic treatments rendered.

Can International Students Write Canadian Board Exams?

Yes. They should, if they plan to immigrate and work in Canada.

Is NAO the Only Osteopathy College Offering DOMP?

No. Diploma in Osteopathic Manual Practice - DOMP is offered by a number of osteopathic schools in Canada. DOMP is a Canadian designation and title copyrighted by Dr Shahin Pourgol, president of NAO.

Is DOMP a Recognized Title?

Yes. After DO (Doctor of Osteopathy); DOMP: Diploma in Osteopathic Manual Practice is the most recognized title. It is accepted by most insurers and government agencies as being a valid diploma. DOMP is a title used only by the Canadian colleges of manual osteopathy. It is copyrighted by NAO president; Dr Shahin Pourgol, MBA, DC, DOMP, DO.

Is There a Waiting List for NAO Campus Based Program?

Yes. Due to limited space the campus based program is in high demand and there is a waiting list to get into the campus based program.

Is NAO Program Shorter Than Other Osteopathy Colleges?


No. While it may seem that NAO program (12 months full time or 24 months part time) is shorter than other colleges; in reality the total hours is more than most osteopathic colleges in Canada and internationally who offer a diploma program in manual osteopathy. Even though most osteopathic colleges have programs ranging from 3 years to 5 years; they are offered mostly on part time basis, one weekend a month, six months per year, or 13 weekends (modules) in 3 years. Their total teaching hours are generally less than NAO’s. In the case of an Ontario college that teaches manual osteopathy in 3 years, the total teaching days are 36 days as it offers 13 modules in 3 years, each module covering two days of lectures.

In England and Australia the osteopathy program is offered 4 years full time. But they are advanced programs. They teach medical diagnosis. NAO does not teach medical diagnosis as it is a controlled act in Canada and only medical doctors, physiotherapists and chiropractors are permitted to render a diagnosis. Instead our students learn osteopathic diagnosis.

What Osteopathic Techniques Are Taught at NAO?

National Academy of Osteopathy teaches more techniques than any other osteopathy college in Canada. We teach only scientific techniques for all joints including lumbar, thoracic, cervical, temporomandibular joint, shoulder, scapula, elbow, wrist, hand, sacrum, hip, knee, ankle and foot.

Some of the techniques include osteo-articular joint mobilization, palpation & osteopathic assessment, muscle energy techniques & proprioceptive neuromuscular facilitation, soft tissue therapy, myofascial release technique, trigger point therapy, therapeutic exercise, cranial osteopathy (osteopathy in the cranial field), visceral manipulation, strain / counterstrain technique, etc.

What Makes NAO the Best Osteopathy College in the World?

The short answer is: Our professors including Dr Shahin Pourgol. World famous osteopath & distinguished author.

What Makes NAO Different From Other Osteopathic Colleges?

1) National Academy of Osteopathy teaches more scientific osteopathy techniques than any other manual osteopathic college.

2) NAO is the only osteopathic college focused on graduating successful manual osteopaths. NAO graduates receive full education on marketing, business management, financial planning, tax strategies, asset protection, wealth creation, public relations, advertising, estate planning, etc.

3) NAO teaches students how to create a niche market and be known as an expert in that market. We teach students about geriatrics osteopathy, osteopathic MVA rehab, slip & falls management, multidisciplinary accident care, sports osteopathy, paediatric osteopathy, independent disability evaluation, TMJ pain management, orthopaedic supports, orthotic footwear, compression support hose, functional abilities evaluation, ergonomic assessment, job site analysis, decompression traction therapy, auxiliary osteopathy, work hardening, & work conditioning, amongst other topics. NAO is the only osteopathic school teaching these topics.

4) Professor Pourgol’s lecture series on "Setting Up a Million Dollar Practice" and "Improving Your Brain & Achieving Your Goals by Manipulating Reticular Activating System & Psychocybernetics Mechanism" are available only to NAO students.

5) We prepare our students academically for the board exams and offer free tutorials.

6) NAO is the only manual osteopathic college in Canada accepted by Medical Financial as an accredited health education facility.

7) NAO offers World Health Organization (WHO) compliant osteopathic education.

8) NAO is the largest provider of osteopathic education in the world. It teaches in 70 cities across 45 countries and is the main reason manual osteopathy has expanded greatly internationally in the past few years.

9) NAO is the only osteopathic college in Canada that has been accepted as an affiliate member of Ontario Hospital Association.

10) NAO is accepted by the WorkBC program of the Canadian government. Eligible unemployed people in British Columbia, Canada may receive full scholarship from the Canadian government to study manual osteopathy at NAO.

11) NAO graduates may join the charity based not-for-profit organization, Osteopathy Health Clinics (, free of charge. OHC is founded by NAO president Dr Shahin Pourgol in 2014.

12) World Osteopathy Day (June 22nd) was founded by NAO president, Dr Shahin Pourgol. Every year NAO hands our many scholarships to celebrate this day.

13) NAO graduates receive advanced credits to continue their education at the National University of Medical Sciences (

14) NAO graduates receive guaranteed scholarships from National University of Medical Sciences ( Our can apply for any of the Doctor of Osteopathy (DO) or the Bachelor of Science in Osteopathy program of NUMSS and pay only 1,100 EURO in tuition, a saving of up to 5,400 EURO.

What is the Difference Between the DO and DOMP programs?
What is World Osteopathy Day?

As a result of tireless work of Dr Shahin Pourgol for suggesting a World Osteopathy Day and collaboration between National Academy of Osteopathy, International Osteopathic Association, Canadian Manual Osteopathy Examining Board, and a number of other organizations, manual osteopaths, and osteopathy students, we are pleased to announce that June 22nd has been chosen and named “World Osteopathy Day”.

For over 130 years osteopathy has done so much to help human beings have a better quality of life and it deserve a day of its own as recognition of its contribution to human society worldwide.

At 10AM on June 22, 1874 in Baldwin, Kansas (USA), the 46 years old Dr Andrew Taylor Still founded osteopathy. Dr Shahin Pourgol recommended this day in oppose to Dr Still’s date of birth (August 06, 1828) as the World Osteopathy Day and his suggestion was accepted by the majority.

Dr Pourgol is bringing a private member bill to the Canadian parliament to request the government of Canada officially recognize June 22ndas the World Osteopathy Day.

International Osteopathic Association has committed to do the same with parliaments of a number of other countries in Europe, Latin America, Asia and Africa.

Is osteopathy treatments covered by insurers for MVA patients?

In certain countries (such as Canada, Australia & most European countries) osteopathic treatments provided to patients who suffered injuries in a motor vehicle accident are covered by all insurance providers including State Farm, Allstate, Aviva, Belair, Certas, RBC, Royal, TD, Dominion, Cooperators, Chubb, Pilot, & Perth. For example in the province of Ontario in Canada all insurers as per Financial Services Commission of Ontario (FSCO) must cover osteopathic treatments at a rate of $57.67 per hour for non-catastrophic injuries and at a rate of $88.28 for catastrophic injuries.

Can manual osteopathy be learned online?

Yes. There is no difference between online and campus based education. In some ways the online education is even superior to the campus based because students have the ability to pause the lectures and watch any techniques over and over again. National Academy of Osteopathy has been teaching manual osteopathy in 32 countries and countless successful manual osteopaths are practicing around the world who studied manual osteopathy through an online course. The professions of osteopathy, chiropractic, massage therapy, physiotherapy and even medicine and dentistry have offered at one time or another correspondence courses. With the technology NAO uses students feel they are sitting in a classroom watching the lectures. They have also the ability to email NAO at any time and ask any academic questions they may have.
With the advancement in communication technology online education is improving rapidly. Time has shown that many of health related programs can indeed be taught online. Here are some examples:

  • Since 2003; many universities in the USA have been offering transitional Doctor of Physical Therapy (tDPT) through 100% online education. The tDPT is available only to physiotherapists as a post professional degree. However the older generation of physiotherapists did not study diagnostic imaging, medical diagnosis or manual therapy. And the tDPT program teaches these subjects. So it is possible to learn diagnosis, radiology and manual therapy through online programs.
  • Since 2010; National Academy of Osteopathy has been offering online osteopathic education. NAO teaches in 65 cities and as such has graduates many manual osteopaths. These osteopaths are working now in Europe, Asia, Africa and America treating many patients. Since 2010, there has not been even one reported complaint against any of the NAO graduates. This is a clear indication of the safety and efficacy of online osteopathic education.
  • Since a decade ago; the University of Western Ontario has been offering a Diploma in Pedorthics program. The program has 6 courses which are online. These courses includes assessments and pedorthic examinations. The university has graduated many students and they are currently working as certified pedorthists in Canada. This shows that pedorthic education can be learned online.
  • A United Kingdom university is offering a 100% online specialty program in orthopedic surgery to medical doctors since the past few years.
  • Many universities in the USA are offering online master’s degrees in nursing since the past decade.
  • A college in Alberta, Canada is offering a diploma program in massage through online education.
  • Many colleges and universities in USA and elsewhere offer naturopathy diplomas and degrees through online format.
  • A school in USA has just started teaching needle-less acupuncture online.
  • Traditional Chinese Medicine is offered online through many schools.
  • Clinical nutrition is offered by hundreds of universities and colleges worldwide.
  • Kinesiology & human kinetics is offered through online education by a number of schools.
  • Degrees in clinical psychology is offered by many universities.

How does osteopathic treatment help patients with low back pain?

There are a few known mechanism affecting individuals who receive osteopathic treatment for low back pain.

First mechanism: Osteopathic spinal manipulation increases joint mobility by producing a barrage of impulses in muscle spindle afferents and smaller-diameter afferents ultimately silencing facilitated ? (gamma) motoneurons as proposed by Korr. This theory is supported by several recent studies by the Pickar lab and by findings that low back pain patients have altered proprioceptive input from muscle spindles. Recent work has also shown that that spinal manipulation modifies the discharge of Group I and II afferents. This has been accomplished by recording single-unit activity in muscle spindle and Golgi tendon organ afferents in an animal model during manipulation.

A second mechanism is that osteopathic spinal manipulation, by mechanically opening the intravertebral foramina (IVF), decreases pressure on the dorsal roots. Substantial evidence shows that the dorsal nerve roots and dorsal root ganglia are susceptible to the effects of mechanical compression. Compressive loads as low as 10 mg applied to dorsal roots increase the discharge of Group I, II, III and IV afferents. This compression can also alter non–impulse-based mechanisms (eg, axoplasmic transport) and cause edema and hemorrhage in the dorsal root. Spinal manipulation mechanically decreases the pressure in the IVF by gapping the facet joints and opening the IVF. For instance, the synovial space of the lumbar facet joints increases by about 0.7 mm in individuals receiving manipulation. This doesn’t seem like much, but as with any therapy there is usually a course of care involved. Even in moderate stenosis patients treated by osteopaths typically see significant pain reduction following a period of 1-2 weeks of treatment.

A third mechanism is based on findings that persistent alterations in normal sensory input resulting from an injury can increases the excitability of neuronal circuits in the spinal cord. Osteopathic spinal manipulation works by applying non-noxious mechanical inputs to these circuits. This involves mechanisms similar to the pain-gate theory proposed by Melzack and Wall wherein activation of A-a and A-ß fibers can reduce chronic pain and increase pain threshold levels. This is supported by studies where spinal manipulation of the lumbar region decreases central pain processing as measured via pin-prick tests. Additional studies have shown a reduction in central pain sensitivity after spinal manipulation using graded pressure and noxious cutaneous electrical stimulation.

A fourth mechanism involves ß-endorphin mechanisms. Studies have shown increases in beta-endorphin levels after spinal manipulation but not after control interventions.

Fifth mechanism: Substantial evidence also shows that spinal manipulation activates paraspinal muscle reflexes and alters motoneuron excitability. These effects are still being studied and appear to differ depending on whether performed on patients in pain or pain-free subjects.

A sixth mechanism involves inhibition of somatosomatic reflexes by alterations in muscle spindle input produced by osteopathic spinal manipulation. It is thought that spinal manipulation may normalize spindle biomechanics and improve muscle spindle discharge.

Lastly, in humans, osteopathic manual treatment can decrease heart rate and blood pressure while increasing vagal afferent activity as measured by heart-rate variability. Manual therapies in rats have been shown to produce an inhibitory effect on the cardiovascular excitatory response and reduce both blood pressure and heart rate. Manual therapies such as osteopathic soft tissue therapy have been shown to impact behavioral manifestations associated with chronic activation of the HPA axis such as anxiety and depression, while decreasing plasma, urinary, and salivary cortisol and urinary corticotropin releasing factor-like immunoreactivity (CRF-LI). Manual stimulation in rats has been shown to significantly increase glucocorticoid receptor gene expression which enhanced negative feedback inhibition of HPA activity and reduced post-stress secretion of ACTH and glucocorticoid.

Osteopathic Education: 4 Months or 4 Years?

We are often asked a question in regards to the length of osteopathic education, as it differs widely, from 4 months to 9 years. This confuses many individuals, so here we try to explain the differences between the different types of education offered by European style osteopathic colleges.

In this article we will discuss only the osteopathic education of the European style osteopathy (also known as manual osteopathy or osteopathic manual practice). The American style osteopathy is similar to medical education in that it takes 3 years of university, followed by 4 years of osteopathic medical college and 2 years of residency, making it a total of 9 years. The American style osteopaths (also known as osteopathic physicians) can perform surgery and prescribe medications. This is available only in the USA.

Manual osteopathy is taught in diploma or degree formats.

The osteopathic colleges that offer diploma programs either issue a DOMP (Diploma in Osteopathic Manual Practice, a DO (Diploma in Osteopathy, not be confused with the Doctor of Osteopathy), a DMO (Diploma in Manual Osteopathy) and so on, ranging from 4 months full time to 5 years part time.

The osteopathic universities offering degree programs either issue a DO (Doctor of Osteopathy), BSc (Bachelor of Science in Osteopathy), MSc (Master of Science in Osteopathy), and so on, ranging from 3 to 6 years full time.

The diploma programs are generally offered in USA & Canada. In the diploma programs of osteopathy, medical diagnosis is not taught. Spinal and joint manipulations are also not taught as these two are controlled acts in Canada and USA. Manual osteopaths in Canada and USA are not permitted to render a medical diagnosis nor may they do manipulation. They can use hundreds of other osteopathic techniques though such as mobilization, muscle energy techniques, soft tissue therapy, etc.

As a result the diploma program in manual osteopathy is a lot shorter in time than the degree programs. The diploma programs generally include 800 to 2000 hours of lectures.

The World Health Organization (WHO) report on osteopathic education recommends a total number of 1000 hours of osteopathic education for students with previous health education, and 4200 hours of education for students without previous health education. National Academy of Osteopathy offers a diploma in osteopathic manual practice that fits in this category. It takes 4 months of condensed education for students with prior health education to complete the DOMP program of NAO.

NAO graduates with a DOMP degree can work in all countries of the world as osteopaths. However in USA, Canada, Australia, New Zealand, & United Kingdom they must work as osteopathic manual practitioners, as the term osteopath is either reserved for osteopathic physicians (in USA & Canada) or is used by those with a degree program in osteopathy (in Australia, New Zealand & UK).

NAO also offers a post graduate 4 years (4200 hours) fellowship program for manual osteopaths in Osteopathic Rehabilitation Sciences for those interested in postgraduate studies.

The degree programs offered in osteopathic education range from 3 to 6 years full time. Most require 2 to 3 years of prior university education, and some are available only to health professionals.

In the degree programs students learn full medical diagnosis, with a lot of emphasis on practical training and they learn more diverse techniques. National University of Medical Sciences ( for example offers two degree programs in osteopathy, a full time 3 years bachelor of science in osteopathy & a 4 years full time doctor of osteopathy. Students with prior health education can finish the degree programs faster, as per WHO guidelines.

For example, physiotherapists can finish the BSc in 6 months or the DO in 1 year. This depends to the university offering the degrees. Some do not offer any advanced credits, as the case is in Italy, where they accept physiotherapists only to the osteopathy program and then they must study 6 more years.

World Health Organization (WHO) recommends that osteopathic schools give advance credits to students who are health practitioners and recommends 1000 hours of study for them.

It is important to note that manual osteopaths with either a diploma or a degree program can work in all countries, without exception. All they need is to pass the board exams of the International Osteopathy Examining Board and then become a member of the International Osteopathic Association. They will receive a license number which allows them to obtain malpractice insurance, and then either work in a clinic or to open their own clinics.

It is understandable that a number of osteopaths with degrees, such as the ones in Italy, who have studied 9 years to become an osteopath (after paying up to $90,000 in tuition) feel bitter and resentful towards the new osteopaths with a diploma who in 4 months (after paying just $5026 for tuition) are able to work as osteopaths in Italy and elsewhere.

Thousands of manual osteopaths with a DOMP diploma have been practicing more than 30 years in Canada & USA and are offering excellent osteopathic care. Knowledge of medical diagnosis is not necessary to practice manual osteopathy. Massage therapists for decades have been providing great services to patients without ever being able to medically diagnose a patient. The practice of manual osteopathy is actually quite safe when medical diagnosis is removed as the manual osteopath can just focus on treatment.

In summary, the diploma in osteopathic manual practice is for those students who want to graduate quickly, pay less tuition, and have a more relaxing osteopathic practice. The degree programs in osteopathy is for those students who wish to become doctors, who wish to have advanced knowledge of the body and deep mastery of the osteopathic techniques. For this they have to pay more tuition & spend more time studying.

Both the diploma and degree programs are great ways to serve patients. They are just two sides of the same coin, each with different type of benefit for the osteopathic practitioner. National Academy of Osteopathy & National University of Medical Sciences offer diploma and degree programs that can be taken online or in-campus. With our diplomas or degree we guarantee that you can practice in any country of the world.

To see the difference between scope of practice of diploma and degree programs in osteopathy please click on the link below:

Click here


What Organizations Have Accredited NAO?

We are a fully accredited osteopathic school and our students have access to membership in many organizations in their fields. Some of the organizations that approve NAO include:

  1. International Osteopathic Association (IOA)
  2. College of Osteopathic Manual Practitioners of Ontario (COMPO)
  3. Canadian Manual Osteopathy Examining Board (CMOEB)
  4. Ontario Osteopathic ^ Alternative Medicine Association
  5. Ontario Association of Osteopathy & Natural Medicine
  6. Alberta College of Osteopathic Rehabilitation Sciences (ACORS)
  7. International Osteopathy Examining Board (IOEB)
  8. Ontario College of Osteopathic Rehabilitation Sciences (OCORS)
  9. Council on Manual Osteopathy Education (CMOE)
  10. British Columbia College of Osteopathic Rehabilitation Sciences (BCCORS)

I am a licensed health practitioner. Can I use my osteopathic education towards my Continuing Education (CE) requirements of my regulatory board?

Yes. Most regulatory boards for chiropractors, physiotherapists, massage therapists, naturopaths, acupuncturists, occupational therapists, kinesiologists, athletic therapists & trainers, homeopaths, & medical doctors accept the time you spent studying in our programs towards your CE requirement. Most regulatory boards require 20 to 40 hours of CE in a year or two, and our programs cover this requirement as all our programs are over 40 hours.

Could osteopaths bill insurers for two types of treatments?

Yes but it depends on the type of patient’s coverage, EHP or MVA.

In most cases you cannot bill extended health plan (EHP) insurers for osteopathy and another type of treatment (chiropractic, physiotherapy, massage therapy, naturopathy, athletic therapy, acupuncture, etc) on the same day. Most EHP insurers accept only one type of treatment from one health practitioner. Your clinic can bill for osteopathy and massage therapy for example on the same day if the treatments are performed by two health practitioners. But if the health practitioner is a massage therapist/osteopath then in one day massage therapy must be billed and another day osteopathy.

This does not apply to motor vehicle accident (MVA) patients. For MVA patients health practitioners can charge the insurers for more than one type of therapy. For example on the same visit an insurer can be billed for osteopathic treatment, physiotherapy, and rehabilitation.

After graduating from your osteopathy program, can I practice in Canada, USA, Australia, UK & New Zealand?

Yes, you can practice and open a clinic in all Canadian provinces, all US states, and everywhere else in Australia, United Kingdom and New Zealand. However the osteopathy profession is regulated in these countries and our graduates must work as osteopathic manual practitioners. They may not use the term osteopaths in these countries. For example in the USA & Canada, the term osteopath is reserved for osteopathic physicians who do surgery and prescribe medications.

In all other countries, including Italy, Spain, France, Ireland, Germany, Netherlands, South Korea, Brazil, Iran, China, Taiwan, Japan, Israel, Saudi Arabia, United Arab Emirates, Pakistan, Singapore, Mexico, Venezuela, Greece, Vietnam, Netherlands, Turkey, Austria, Sweden, Denmark, Norway, Switzerland, & Denmark , our graduates can use the term osteopath and practice as osteopaths.

Who Holds the Copyright to DOMP?

Dr Shahin Pourgol (, president of the National Academy of Osteopathy, National University of Medical Sciences (, & the Canadian College of Pedorthics ( has copyrighted the designation DOMP (Diploma in Osteopathic Manual Practice) with the Canadian Intellectual Property Office of the Industry Canada on October 09, 2013. DOMP is a Canadian title awarded to those manual osteopaths who have graduated from a Canadian osteopathic school. This designation is accepted by Canadian extended health plan insurers.

What is Osteopathy TV?

Osteopathy TV, founded by our president Dr Shahin Pourgol as an instrument to increase the name recognition of osteopathy amongst the public while also increasing their health related knowledge. This is the first ever TV channel dedicated to osteopathic health care. The TV station is being developed and soon will start producing programs on a weekly basis. It is financially supported by NAO and NUMSS.

Is there a database of osteopathic related research papers?

There are many. Our president, Dr Shahin Pourgol has set up a Facebook page called “Osteopathy Related Research & Science” at which compiles links to many useful manual osteopathic related research papers.

Do you offer any seminars?

Yes, we offer a number of manual osteopathic related seminars at very low fees. Please contact the admissions office for more info. You can also visit our seminar Facebook page for more info at Our seminars are offered on a wide variety of topics including sports osteopathy, kinesiological taping, decompression traction therapy, leg length discrepancy, osteopathic wellness protocol, etc.

What is Osteopathy Health Clinics?

OHC ( or ( is a not for profit charity based organization founded by our president, Dr Shahin Pourgol. Membership to OHC is free to all manual osteopaths. For every patients referred by OHC, the manual osteopath member pays 10% of the treatment fee received to a charity.

Who teaches the visceral manipulation & cranial osteopathy techniques?

We have two professors who cover these lectures; professors Jorge Aranda and Amir Ghafari.

What is the Treatment Satisfaction Rate of Manual Osteopathy?

With a treatment satisfaction rate of 95%, manual osteopathy is the number one choice of patients in Canada for low back pain relief (data from 2012).2012 Treatment Satisfaction Rate

What is the Patient Confidence Rate for Manual Osteopaths?

Of all the alternative health care practitioners in Canada, patients have the highest confidence in manual osteopaths (data from 2006).Manual osteopaths enjoy the highest confidence rate between Canadian patients

How Do Manual Osteopaths Save Lives?

Fracture of the femur bone due to a slip & fall is the main cause of accident related death in seniors. This is mainly due to osteoporosis making the bones weak, and subsequently when the person fells down the bone breaks easily. The fractured bone in some cases cuts through the femoral artery. A number of patients die due to bleeding even before reaching the hospital. The osteopathic muscle energy techniques (MET) are known to improve function & balance by improving range of motion of the joints and the muscle tone. A better function & balance decreases the chance of a fall, and subsequent bone fracture and possible death. Seniors should receive weekly manual osteopathic care to remain more active and to continue enjoying a better quality of life. Manual osteopaths help prevent injuries. And by decreasing chances of a slip & fall they ultimately save lives.

How much Canadians spent yearly on manual osteopathic care?

Canadians on average spend about $220 per year on manual osteopathic care (data from 2006).Amount Spent on Manual osteopathy in 2006

What is the financial status of manual osteopaths in Canada?

Statistic Canada reported that 10% of Canadians have annual income of over $80,000. Manual osteopaths in Canada, with an average income of $90,000 per year are part of the wealthiest 10% of Canadians (data from 2013).

What is the job satisfaction rate for manual osteopaths?

According to the most recent Gallup survey of the American workplace in 2013; only 30% of workers were satisfied with their employment. Manual osteopaths in Canada, with a job satisfaction rate of 95% have one of the highest job satisfaction rates of all occupations as there is zero unemployment in this health profession and the starting salary is $30 per hour. Manual osteopathy has been included in the top 25 best occupations in demand in Canada by the Canadian Imperial Bank of Commerce.

What are the similarities & differences between manual osteopathy, massage therapy, physiotherapy & chiropractic?

Dr Pourgol has prepared an article on major similarities and differences of these four health professions that offer manual therapy. To read the article please click on the link below which takes you directly to Dr Pourgol’s personal blog site.
Click here

What are the top 10 job vacancies in 2013?

Top 10 Job Vacancies in Canada in 2013 (Half of these jobs are in health care sector, report Published in the Toronto Star Newspaper)

  • Primary health care providers (physicians, dentists, chiropractors, manual osteopaths, veterinarians, athletic therapists and other treating health professionals.)
  • Managers in engineering, architecture & information systems.
  • Managers in health care, education & social services.
  • Managers in construction and transportation
  • Accountants & other business service professionals.
  • Scientists & engineers.
  • Nurses & nursing supervisors.
  • Medical technologists.
  • Social workers, psychologists, counsellors, probation officers.
  • Supervisors in mining, oil & gas manufacturing & processing.

Is there a Facebook group on manual osteopathy?

There are many such groups. However one of the largest ones is “We Love Osteopathy” which is founded by our president Dr Shahin Pourgol. It is open to everyone. Feel free to join the group. The group address is:

Is there a business related site for manual osteopathy?

Yes, Dr Pourgol has set up the “Osteopathy Business Tips” Facebook page that offers valuable business tips to practicing manual osteopaths. It is open to everyone. You can visit it by clicking on the link below:

Is there a free book on manual osteopathy?

Dr Pourgol has completed a book called “An Introduction to the Profession of Manual Osteopathy” which is currently being edited and hopefully be published soon. The book will be available free of charge to everyone and would be mailed to all libraries, schools, colleges & universities. It is written to increase the public awareness to the beautiful wonderful profession of manual osteopathy.

Is there a film documentary on manual osteopathy?

Dr Pourgol in cooperation with Osteopathy TV and the financial backing of National Academy of Osteopathy & the National University of Medical Sciences is in the process of producing a full length film documentary on manual osteopathy called “The Last Resort”. The documentary discusses why manual osteopathy is in such a high demand in Canada and why patients sometimes wait months to see a manual osteopath. The documentary will be provided free of charge to Netflix, the Documentary Channel, PBS and other networks, with the hope that it increases the public awareness to the wonderful beautiful profession of manual osteopathy.

Does the Government Refund Part of Tuition?

Yes, but that depends on your annual income level. The Canadian government and a number of other governments in Western Europe and elsewhere refund a portion of the tuition you paid as tax deduction.
For example in Canada, there is a tax rate of up to 50% for annual income. If you enrol in the DOMP program of NAO to generate income and increase your annual income level, and if you have registered a personal business or incorporated a company, then you can apply the full cost of tuition, books, travel expenses, etc as tax deduction. That means if you are in the 50% tax bracket then 50% of your expenses are refunded by the Canadian Revenue Agency to you as tax deduction. If your tax bracket is 20% then 20% of the expenses you spent on upgrading yourself is refunded, and so on. Please check with the tax authorities of the country you work to get more information as each country has its own rules and regulations.

What Associations NAO Graduates Can Join?

NAO graduates can join many organizations including;

Ontario Osteopathic & Alternative Medicine Association (accepted by Canadian insurers), Alliance Canadienne de Médecine Alternative , Collège des Ostéopathes Canadiens , Asociation des ostéopathes Regroupement des Intervenants et Thérapeutes en Médecine Alternative (Quebec) , College of Osteopathic Manual Practitioners of Ontario, Society of Osteopaths of Canada , International Osteopathic Association, Ontario Association of Osteopathy & Natural Medicine, Ontario Association of Osteopathic Practitioners, Ontario College of Osteopathic Rehabilitation Sciences, Alberta College of Osteopathic Rehabilitation Sciences, & British Columbia College of Osteopathic Rehabilitation Sciences.
NAO graduates are eligible to write the board exams of the Canadian Manual Osteopathy Examining Board & the International Osteopathy Examining Board. NAO graduates are eligible to bill Auto Insurers for treatments rendered to patients injured in a motor vehicle accident as per FSCO (Financial Service Commission of Ontario) & other provincial MVA guidelines.
NAO is accredited by the Council on Manual Osteopathy Education and offers World Health Organization (WHO) compliant manual osteopathic education. All Canadian insurers insurers cover treatments provided by NAO graduates if they are members of two or more of the above organizations and all osteopathy malpractice insurance providers accept NAO graduates for errors & omission & liability insurance.

How can I get $4000 under the Youth Employment Program?

$4000 in guaranteed scholarships is available to you under the Youth Employment Program to study manual osteopathy at the National Academy of Osteopathy. All Canadians between the ages of 18 to 22 are eligible to enter this program. $4000 is offered as a scholarship, not a loan, meaning students will not have to pay it back.

You are eligible for the Youth Employment Program is you are an unemployed Canadian high school graduate.
Email us for more info at .

Can I study the DOMP program in Chinese?

Our Diploma in Osteopathic Manual Practice (DOMP) program is now offered in Chinese language. We teach online across China, Taiwan, Hong Kong, and across the world. Those interested to study in campus can study manual osteopathy at our York University Heights campus in Toronto, Canada. Email us at to receive more info.

Why chiropractors study manual osteopathy?

We have many chiropractors and chiropractic students as students. This is because manual osteopathy is very popular with patients. In Canada there is a waiting list of over a year (in London, Ontario), 6 months (in Halifax) and so on. In 2012 Canadians chose manual osteopathy as their #1 choice for low back pain relief as compared to chiropractic, massage therapy, physiotherapy, acupuncture, and pain medication.

By becoming a manual osteopaths chiropractors assure that they will have a full practice. Here is a testimonial from a chiropractor graduate of NAO click here.

Why so many massage therapists study manual osteopathy at NAO?

Manual osteopathy is a great addition to a massage therapy practice. Patients that do not respond to massage get better quickly through manual osteopathic treatments, specially patients with chronic musculoskeletal pain. That is one reason why manual osteopathy is so popular with massage therapists.
The other reason is that we graduate successful manual osteopaths. We train our students in all aspects of clinic management, including wealth creation, marketing, asset protection, tax planning & accounting. Click on the link below to read a testimonial from NAO graduate & registered massage therapist (RMT), Angele Boyle who doubled her income in less than a year following graduation: click here

What Insurers Reimburse Manual Osteopathic Treatments by NAO Graduates?

That depends on which associations NAO graduates join. For example the following insurers provide reimbursement to NAO graduate for manual osteopathic treatments provided if they are OOAMA (Ontario Osteopathic & Alternative Medicine Association) members: -Desjardins, Chamber of Commerce, Claimsecure, Sunlife, Medavie BlueCross. Manulife, EmpireLife, Greenshield, Benefit Trust, Maximum Benefit, Health Source Plus, NexgenR, Sobien, Wawanesa Life, UFCW, union benefits, all auto insurers, and others.

Is NAO approved by WorkBC?

The WorkBC program of the Canadian Government in British Columbia may now cover your full tuition to study manual osteopathy at the York University Heights campus of National Academy of Osteopathy in Toronto if you are found eligible. Contact the WorkBC Employment Center nearest you for more information.

What does NAO student card look like?

Click on the link below to see a sample of student card issued to students. Your National Academy of Osteopathy student card entitles you to discount on thousands of items in North America, Europe and elsewhere. Please make sure you keep your student card with you at all times as a proof of being an NAO student. Click Here

Who are the first osteopathy family of NAO?

Physiotherapist & university professor Dr Hossein Khorami, his daughter Saba, a kinesiologist & optometrist wife Dr Maryam Gharahgozloo graduated together as manual osteopaths from NAO in July 2014. While we had a number of couples and siblings studying together at NAO, this is the first time all members of a family enrolled together at NAO. Click on the link below to see their photos: Click Here

What is the most popular treatment for low back pain?

A survey done in 2012 indicates that manual osteopathy is the most popular treatment for low back pain by Canadian patients as compared to chiropractic, physiotherapy, acupuncture, pain medication and massage therapy.

How Many Students are Studying Manual Osteopathy?

There are over 14,700 students of European style osteopathy (also known as manual osteopathy) enrolled in degree or diploma programs around the world.

There are 21,741 students of American style osteopathy (also known as osteopathic medicine) enrolled in the DO (Doctor of Osteopathy) programs in American osteopathic universities and schools.

USA is the only country offering education in osteopathic medicine. All other countries where students enrolled offer European style osteopathic education (no surgery, no medication).

How many manual osteopaths practice around the world?

The total number of European style osteopaths (as opposed to American style osteopathic physicians who practice surgery and prescribe medications) is 43,000. The total number of American style osteopathic physicians is 87,000.

Who Refers Patients to Manual Osteopaths?

A 2013 survey indicates that manual osteopaths receive the most number of patients through word of mouth referrals of their own patients. The second most common source of patient referral is from family physicians. Here are the most common sources of patients referrals to European style manual osteopaths. The amount is in percentage.

Friend of patient 29.7%
Medical Doctor (M.D.) 23.6%
Doctor of Osteopathic Medicine (D.O.) 3.9%
Chiropractor 1.8%
Chinese medicine 2.3%
Physiotherapist 15%
Counselor/psychologist 3.5%
Podiatrist 4.1%
Dietician 1%
Personal trainer 3.5%
Massage therapist 6.6%

Where Do Osteopaths Work?

A 2013 survey of European style manual osteopaths finds that the majority of manual osteopaths prefer to own their own private osteopathy clinic. Of interest is that over 3% of manual osteopaths work in hospital and 6.5% of them have positions in universities.

Private clinic 43%
With 1 partner 14.1%
More than 2 partners 18.2%
Hospital 3%
Outpatient clinic 2.9%
Medical institution 3.9%
University 6.5%

How Long Does it Takes for an Osteopathic Treatment?

30 to 45 minutes is the most common treatment length for manual osteopathic treatments. A 2013 survey indicates 40.5% of patients manual osteopaths see in Canada, USA & Europe receive this length of treatment.
The 2nd most common is 45 to 60 minutes, which 31.8% of patients receive.

Do Family Physicians Refer to Osteopaths?

The 2nd most common referral sources of manual osteopaths (also known as European style osteopaths) in Canada, USA & Europe are medical doctors. 18.5% patients manual osteopaths see are referred by MDs, a 2013 survey finds.

Do Physiotherapists Refer to Manual Osteopaths?

A 2013 survey finds that over 10.6% of the patients that manual osteopaths treat in the USA, Canada and Europe are referred to them by physiotherapists. Physical therapists make up the third most common referral sources of manual osteopaths. By manual osteopath we mean European style osteopaths as opposed to American style osteopathic physicians who perform surgery and prescribe medications. Manual osteopaths limit treatments to hands-on manual therapy.

How Many Manual Osteopaths Practice in Each Country?

Here are approximate number of European style osteopaths (also known as manual osteopaths) in a selected number of countries.

Argentina 125 Australia 1,725 Austria 600 Azerbaijan 2 Bahamas 1
Bahrain 3 Belgium 1,539 Belize 1 Bosnia & Herzegovina 2 Brazil 250
Brunei 1 Bulgaria 5 Cameroon 2 Canada 1,750 Cayman Islands 1
Chile 45 China (including Hong Kong & Macau) 150 Costa Rica 15 Croatia 2 Czech Republic 5
Colombia 15 Croatia 16 Cyprus 11 Denmark 50 Dominican Republic 2
Egypt 35 El Salvador 2 Estonia 5 Finland 300 France 17,460
Germany 7,000 Greece 40 Hungary 5 Iceland 2 India 360
Indonesia 10 Iran 120 Ireland 120 Israel 50 Italy 6,000
Jamaica 1 Japan 275 Jordan 20 Latvia 20 Lebanon 10
Lithuania 10 Luxembourg 40 Malaysia 25 Malta 1 Martinique 5
Mexico 175 Morocco 35 Namibia 1 Netherlands 639 New Zealand 400
Nigeria 10 Norway 250 Oman 1 Palestine 5 Panam 20
Philippines 30 Poland 30 Portugal 400 Qatar 2 Romania 35
Russia 1,300 Saudi Arabia 50 Serbia 5 Singapore 30 Slovakia 2
Slovenia 2 Spain 800 South Africa 49 South Korea 200 St Lucia 1
St Martin 10 Sweden 200 Switzerland 850 Taiwan 30 Tanzania 4
Thailand 45 Trinidad & Tobago 1 Turkey 25 UAE 30 UK 4,211
Ukraine 80 USA 2,000 Venezuela 10 Vietnam 20

I am a student at another college of osteopathy. Can I transfer to NAO?

Yes, you can. While most schools of osteopathy offer excellent education, many of their students do transfer to National Academy of Osteopathy for a variety of reasons.

Most colleges offer osteopathic education that is 3 to 5 years part time one weekend a month for 6 months per year, while NAO offers a compact 6 months to 1 year full time program. This is popular by students as they can finish their program sooner and start working and helping patients.

Tuition is another reason they transfer to NAO. In Italy students pay up to 100,000 EURO and in Canada up to $45,000 for osteopathic education. Our DOMP program starts from $5528, which is one of the most affordable accredited manual osteopathic education.

But by far the most common reason for transfer of osteopathic students of other schools to NAO is our business lectures. If a student wants to graduate as a manual osteopath, all schools offer great education. However if the student wants to graduate as a successful manual osteopath then NAO is the best choice. Our “setting up a million dollar practice” lecture series are legendary. By the time NAO students graduate they have the knowledge necessary to own, operate and manage a successful manual osteopathic clinic. They are well versed in the art of marketing, public relations, advertising, wealth creation, tax planning, asset protection, accounting and financial management.

Does Canadian Government Recognize Manual Osteopathy?

We are glad to announce that the title "Osteopathic Manual Practitioner" has now been officially entered into the National Occupational Classification of Canada; under the NOC Code # 3232 (Practitioners of Natural Healing).

This is great news for the profession of manual osteopathy as it gives a unique identity to the job title of our graduates, and it is a great step towards regulating the profession of manual osteopathy in Ontario and elsewhere in Canada.

Previously there was only the title “osteopath or Doctor of Osteopathy” was classified in Canada to represent anyone who practices any forms of osteopathy. Now there are officially two distinct forms of osteopathy in Canada, one the osteopathic medicine, which its practitioners call themselves osteopaths in Canada and the other European style manual osteopathy which its practitioners are called manual osteopaths or osteopathic manual practitioners.

Did Canada Post Publish a World Osteopathy Day Mailing Stamp?

On Nov 11, 2014, Canada Post published World Osteopathy Day stamps, designed by Dr Shahin Pourgol, president of the National Academy of Osteopathy & the National University of Medical Sciences, the largest providers of manual osteopathic education worldwide. Osteopathy, since it was founded over 137 years ago by Dr Still in the USA, had never had a day of its own until 2012 when Dr Pourgol founded June 22nd as the World Osteopathy Day.

What is the National Occupation Classification Code for Manual Osteopaths?

The NOC (National Occupation Code) for “Osteopathic Manual Practitioners” in Canada is 3232 and it falls under “Practitioners of Natural Health”.

Did HCAI add Osteopathy?

IN Ontario, all practitioners who treat MVA patients use HCAI. Health Claims for Auto Insurance (HCAI) is an electronic system for transmitting auto insurance Ontario Claim Forms (OCFs) between health care businesses and insurers in Ontario. Previously there was no category for osteopaths, and osteopathic manual practitioners in Ontario had to use “other” to list themselves on the forms and auto insurance standard invoice (AISI). Now we have our own category “osteopathy” which manual osteopaths can use when submitting OCF 18 (treatment plans) and OCF 21 (Auto Insurance Standard Invoice).
First Canadian government recognized manual osteopathy by adding it to National Occupational Classification under NOC code 3232 and now the Ontario provincial government permitted osteopathy to be added as an independent category under HCAI.
The profession is getting more recognition. And these all helps us in getting the profession regulated in Ontario. Our president, Dr Shahin Pourgol has donated $200,000 to the “Osteopaths Unite” campaign and in such short term we have seen the profession advance quite rapidly.

Is NAO certified by the Minister of Employment & Social Development of Canada?

Yes, National Academy of Osteopathy has been certified by honorable Jason Kenney, the Canadian Minister of Employment & Social Development on December 07, 2014. This certification remains active for 5 years until December 07, 2019.

Are there tax credits available to NAO students?

Canadian National Academy of Osteopathy students are permitted now to claim for tax credits for the NAO tuition, textbooks & educational expenses (up to $5580) they paid to study manual osteopathy as per Income Tax Act of Canada. Full time NAO students can claim $4800 in tuition tax credit, and $780 for textbooks credit (total $5580) for the 12 months Diploma in Osteopathic Manual Practice program. Students in the six months DOMP program can claim $2400 for tuition tax credit and $390 for textbooks credit (total $2790).
Part time NAO student can claim $2880 for tuition tax credit and $480 for textbooks tax credit (total of $3360) for the 2 years program. Students in the 12 months part time program can claim $1440 for tuition tax credit and $240 for textbooks tax credit (total of $1680).
This applies to any NAO students who registered in 2014 and for the next 5 years.

How much tuition tax credit is offered by the Canadian government?

The Canadian government offers up to $4800 in tuition tax credit to residents of Canada to study manual osteopathy at National Academy of Osteopathy.

How much the Canadian government offers for textbooks tax credit?

The Canadian government offers up to $780 in textbooks tax credit to residents of Canada to study manual osteopathy at National Academy of Osteopathy.

Are NAO Graduates Eligible to Apply for Futurpreneur Canada Loans?

Our graduates of the diploma in osteopathic manual practice (DOMP) program, 18 to 34 years old who are Canadian citizens or permanent residents are eligible to apply for business development loans of up to $15,000 (at prime posted by CIBC plus 3% interest rate) under the Futurpreneur Canada program of the Canadian government.
You must have already been graduated as a manual osteopath and have already opened your own private osteopathy clinic. Your clinic must be less than one year old and you have to agree to work with a mentor for up to 2 years and prepare a business plan.

Are NAO Graduate Eligible to Apply for Smart Start Seed Fund Grants?

Ontario NAO graduates who are between 18 and 29 years old are eligible to apply for up to $60,000 in non-payable grant, and those who are 30 years old and over are eligible to apply for up to $30,000 under the Smart Start Seed Fund from the Ontario Centres of Excellence (OCE).
The money must go to start up costs of your osteopathy clinic and is non-payable (this is a grant, not a loan).
Each grant comes with its own criteria and rules, but they all require that a start-up osteopathy clinic be endorsed and that the cash investment be matched by a third, non-government source (such as the manual osteopath).
Your clinic must be located in Ontario, and be incorporated. You must be the director or majority shareholder of your osteopathic clinic. The clinic must be less than 3 years old and you must be a Canadian citizen or a permanent resident.

Is Discount Available to NAO Graduates for Foot Orthotics?

Professor Majid Javadifar, an orthotist & Prosthetist and a manual osteopath, is a graduate of National Academy of Osteopathy (Canada) who just now completed his DO (Doctor of Osteopathy) degree from National University of Medical Sciences (Spain).

Dr Javadifar teaches custom made foot orthotics & orthopedic shoes casting, making, modification & dispensing at NUMSS to the manual osteopathy, physiotherapy and pedorthics students. He also owns one of the best orthotics manufacturing labs in Canada, while also having a multidisciplinary clinic in North York, Ontario. Shahla & Sara, two NAO graduated manual osteopaths work with Dr Javadifar in his clinic.

We congratulate Professor Javadifar on becoming a doctor of osteopathy and wish him continued success.

Any of our graduates who needs an orthotics lab, please contact him directly. NAO and NUMSS graduates receive discounts.

What College is Best for Osteopathic Techniques?

NAO teaches more osteopathic techniques than any other osteopathic college in the world.
Did you know that we are the only osteopathic college that has Canadian, American, European & Asian technique instructors?

Is the DOMP Program Regularly Update?

Yes. We consistently upgrade all our diploma program. Every term we add a number of osteopathy techniques as well as business lectures to the DOMP program.

Does NAO has a Poem of its Own?

This poetry is by NAO student, Dr Chris Vincent, MBBS, titled " Students of National Academy of Osteopathy".

A poem

We are the chosen.
Ordinary people
from different places
training for extraordinary work,
under the benevolent gaze
of Dr. Shahin Pourgol,
>We are diamonds in the rough,
cut and polished
with words of wisdom
spoken by our teachers,
and the techniques taught
online and in-class.
We are coached
to be valiant fighters
and skilled archers
who are battle ready
to attack the army of pain.
We are students
of National Academy of Osteopathy,
learning the great art
of manual osteopathy,
eager to serve
the people of Canada
and all the countries
around the world.
We are the past, present
and future students
with flames
of healing power
in our hands.

Written by – Dr. Chris Vincent, MBBS

Is There Any Discount Available to OHA Seminars?

Yes. We are the only Canadian osteopathy college that has been accepted as an affiliate member of Ontario Hospital Association (OHA). As such NAO students with their student ID card are eligible to register for a number of continuing education seminars offered by OHA.
Please visit their website for a list of their seminars. If interested please contact them directly.

Are NAO Graduates Eligible to Apply for BDC Loans?

Yes. Our Canadian DOMP (diploma in osteopathic manual practice) graduates are eligible to apply for up to 50,000 in loan money from Business Development Bank of Canada (BDC) if they are residents of the province their osteopathy clinic is located.
The graduates must be the clinic owner, and be a Canadian citizen or permanent resident. The osteopathy clinic must have been in operation for two years or longer. Clinics less than two years old are not eligible to apply. The loan must be repaid within 4 years and the current interest rate is 5.7%. The application process is completely online, eliminating any need for personal visits and meetings.

Why is online education better?

A recent research on hands on skill learning indicates that in the long term online students learn better techniques than those enrolled in a campus based program.
The research done recently in USA compared two sets of students learning a manual skill, one set in a class and another from an online video.
The results indicated that in the same day, after watching the skill being taught online vs live in the classroom, those classroom students learned the skill better. However after one week, the online students performed the skill clearly better than the campus students.
The conclusion the researchers made is that the campus based students learn from an instructor and then rely on memory to perform the skill task every day. While the online students get to watch the instructor everyday and this makes their skill set closer to what the instructor teaches.
So in the short term (the same day) campus based education is better. However in the long term online students perform better techniques.

Why Osteopathic Osteoarticular Techniques are so effective?

Osteopathic spinal osteoarticular techniques are proven through scientific research to cause neurophysiological effects resulting in hypoalgesia (local and/or distal), sympathoexcitation, reduction in spinal stiffness, heterogeneous in location and timing, and improved muscle function.

These techniques also produce increased nociceptive flexion reflex threshold, improved posture, decreased concentration of substance P, and improved sway index.

The evidence for effectiveness of osteopathic osteoarticular techniques suggests involvement of an endogenous pain inhibition system mediated by the central nervous system.

Who are the instructors teaching visceral & cranial osteopathy?

We teach visceral techniques of osteopathy (visceral manipulation) & cranial osteopathy (osteopathy in the cranial field) both online, as well as on-campus. Dr Oleg Bagren, MD, DOMP & Mr Jorje Andas, MSc (O) teach visceral techniques and Pamela Crosson Fournier, RMT, DOMP & Dr Daniel Nuzun, DO teach cranial osteopathy.

What are the lost techniques of manual osteopathy?

Dr H. R. Spitler was a medical doctor, chiropractor, osteopath and optometrist in Ohio, USA who invented a model of osteopathy techniques about a hundred years ago that dealt with soft tissue as well as osseous manual therapy. As his techniques focused mainly on orthopedic conditions of musculoskeletal system, he fell out of favour with the osteopathy leadership of the time and his techniques were not taught in most osteopathic schools.
We, the National Academy of Osteopathy along with NUMSS (Spain) and NUMSS (USA) are the only osteopathy schools teaching the manual mechanotherapy techniques of Dr. Spitler.
Manual mechanotherapy is now mainly practiced in Ohio by a group of practitioners calling themselves mechanotherpists. The techniques are considered the lost techniques of osteopathy.
Dr. Daniel Nuzum, NMD, DO (from Ohio, USA) has done six lectures on this technique which is now available for our students to watch at our video server.

What are the Forgotten Osteopathic Techniques?

Dr. Andrew Taylor Still, MD, DO (founder of osteopathy) developed many methods of treatments. In one such method (commonly known as the Still Techniques) the patient is initially moved away from the dysfunctional barrier, then a well-directed focusing force is applied, during which the dysfunctional joint is carried through a path of least resistance into the barrier. The Still technique loosens the ligaments and tendons binding a joint by first moving away from the barrier into relaxation, and then reverses direction to allow the joint to slide back into place while the supporting ligaments and tendons are relaxed. The Still techniques never gained popularity with early osteopaths because easier and quicker osteopathic manual therapy techniques were available to osteopaths. Still techniques, the ground breaking methods of relaxing the soft tissue and then settling the joint were somewhat forgotten until Dr. Richard VanBuskirk, DO published “The Still Technique Manual” in 2000. Now these techniques have regained the popularity they deserve as a number of schools including National Academy of Osteopathy (Canada), National University of Medical Sciences (Spain) and National University of Medical Sciences (USA) have added them to the curriculum of their manual osteopathy diploma and degree programs. Dr Daniel Nuzum, NMD, DO teaches Still Techniques which is uploaded to our video servers for our registered students to watch.

What makes us different?

Our education differs from other schools because we teach our students everything we know about managing their business. Our students learn a lot about how to run, market and manage their clinics effectively. Our lectures include varied topics such as tax planning, asset protection, marketing, public relations, accounting, investing and financial planning. We strongly believe a successful graduate is a happy graduate and that society as a whole improves with success of our graduates. A successful graduate spends more, and helps charities more often. This would result in the economy being stimulated once a person has better purchase power. It is a common knowledge that money improves quality of life. However there was not much research available to back this up. In the past few years a number of research projects have shown this to be true. The most recent research published by the Toronto Star, and done by PhD graduate student, Annie Xiaoyu Gong and her team at McGill University indicates that “Higher income increases people’s life satisfaction in general”. The word “money” is a taboo in healthcare. We do not agree. We believe you can be a great health professional while also being financially successful. We graduate successful health professionals and that is what helped us become the number one provider of manual osteopathic education in the world, teaching in 68 countries. You can study manual osteopathy in many schools. However to learn about how to manage and grow your practice with proven effective tips, then we are your only choice.

Where can I find the NAO alumni survey?

For the first time ever we have done a survey of National Academy of Osteopathy alumni for the year 2015. We will repeat this every year from now on.
We wish to thank all the NAO graduates who took the time to complete this survey. We know you are busy and we are grateful for your time.
Here is a brief highlights of the survey completed by both online as well as campus based Canadian graduates of the DOMP (diploma in osteopathic manual practice) program:
Please Visit :

What is the annual gross income of NAO graduates in Canada?

11.1% of Canadian NAO graduates in 2015 had annual gross income of over $150,000. 11.1% had annual gross income of $100,000 to $149,999. 33.3% had annual gross income of $90,000 to $99,999. 22.2% had annual gross income of $80,000 to $89,000 (source from NAO alumni survey 2015).

National Academy of Osteopathy annual alumni survey 2015  chart 3

How much is the annual income increase of NAO alumni?

100% of National Academy of Osteopathy graduates in Canada with prior health education (such as massage therapists, chiropractors and physiotherapists) increased their annual gross income after becoming a manual osteopath. 33.3% of them increased their annual income by 31 to 40% in 2015.

NAO survey  2015  income increase

What are the income sources of NAO alumni?

44.4% of the annual gross income earned by National Academy of Osteopathy graduates in Canada (in 2015) came from private health insurance payments (most extended health plan insurers cover osteopathy services provided by our graduates).
33.3% of our alumni income in 2015 came from patients paying cash and 22.2% came from auto insurance payments for those injured in an MVA (all auto insurers pay for osteopathic care provided by NAO graduates to accident patients).

NAO survey  2015 income sources

What are the differences between a 5 years vs a 1 year osteopathy diploma program?

This is a review posted by registered massage therapist & manual osteopath, Andrew Subieta, RMT, DOMP who is an alumnus of National Academy of Osteopathy in Toronto. He has also studied at the first osteopathy school in Ontario, the Canadian College of Osteopathy which offers a 5 years osteopathy program.
Please click here for more information

Do you teach osteopathy in all Canadian provinces?

Yes, we do. We have graduates in all Canadian provinces.
Did you know osteopathy was introduced to the province of Newfoundland & Labrador (Canada) by National Academy of Osteopathy in 2013 followed by National University of Medical Sciences ( in 2016?
We are the main reason osteopathy has expanded so much around the world in the past few years.

Do Canadian extended health plan insurers pay for osteopathic care?

Yes, currently they all do.

Are NAO graduates permitted to bill Canadian private health insurers?

To bill an extended health plan (EHP) insurer in Canada NAO alumni must first join one or more osteopathic association in Canada, such as Society of Osteopaths of Canada (based in Quebec but available for NAO graduates in all Canadian provinces), Regroupement des Intervenants et Thérapeutes en Médecine Alternative (available in Quebec only), National Manual Osteopathic Society (based in Alberta but available to our graduates in all Canadian provinces), & Ontario Osteopathic & Alternative Medicine Association (the 2nd oldest osteopathic association in Canada) among others. The full list is found at the first page of NAO website. Membership in these associations would provide billing numbers for NAO graduates which permit them to bill extended health insurers in all Canadian provinces including Alberta, British Columbia, Quebec and Ontario.

What is NOPA?

NOPA, the National Osteopathic Practitioners Alumni ( is an association that our graduates can join free of charge. Membership is available only to the alumni of National Academy of Osteopathy, National University of Medical Sciences (USA) & National University of Medical Sciences (Spain).

Does BCAOMP accept NAO graduates ?

Yes. The British Association of Osteopathic Manual Practitioners (BCAOMP) accepts as members the graduates of Diploma in Osteopathic Manual Practice (D.O.M.P.) program of National Academy of Osteopathy.

What professions originated from osteopathy ?

Chiropractic and naprapathy are two health professions originated from osteopathy. Most manual therapy techniques used by physiotherapists are also osteopathic in origin. Osteopathy is the grandfather of most manual therapy primary health care systems.

Can NAO graduates join NLOA ?

Yes, our graduates are eligible to join the Newfoundland & Labrador Osteopathic Association. Visit for more information.

Is osteopathic care available in Bermuda ?

Yes! We made history (again!) by introducing osteopathy to Bermuda. Anyone wishing to receive manual osteopathic care in an exotic beautiful island setting in Bermuda should contact Thomas Andrew at the Reefs, a five star luxury resort in Southampton, Bermuda ( Thomas is the only practicing osteopath in Bermuda. He is one of the students of National Academy of Osteopathy (Diploma in Osteopathic Manual Practice – D.O.M.P.) & National University of Medical Sciences (Doctor of osteopathy - DO).

Can NAO graduates join MOA ?

Yes, National Academy of Osteopathy graduates can join the Manitoba Osteopathic Association for membership.

Can RESP's be used to pay for osteopathic education ?

Yes it can. Canadians can use registered education savings plan (RESP) to pay in full for the cost of tuition of the diploma in osteopathic manual practice program of National Academy of Osteopathy.

The Canadian government offers thousands of dollars to help families defray the cost of tuition for their children by allowing them to open a registered education savings plan for each child. And here's the best part: for every dollar you put into the plan, the government kicks in a little extra for you. Depending on your income, the government portion can rise to as much as 40 cents for every dollar you put in yourself.

Is osteopathy regulated in Ontario or Canada ?

The word "osteopathy" is not regulated in Ontario or any of the other provinces in Canada. The word "osteopath" is regulated in Ontario. That is why National Academy of Osteopathy (Canada) graduates are permitted to use the word "osteopathy" in their clinic names or call what they do "osteopathy". The term "osteopath" is regulated in Ontario, British Columbia and some other provinces but not all.

In the province of Quebec and some other provinces our graduates can call themselves "osteopath". In provinces where the term "osteopath" is regulated our graduates call themselves manual osteopaths or osteopathic manual practitioners.

Online vs On-campus Education: Which one is better?

The answer may surprise you!

Here is a research article by the US Department of Education that indicates online students perform better than on-campus students. "The meta-analysis found that on average, students in online learning conditions performed modestly better than those receiving face-to-face instruction."

Who is Dr Bruno Bordoni?

Dr Bruno Bordoni, DPT, DO is an Italian physiotherapist and osteopath who is also a member of our board of directors. Dr Bordoni is a world re-known researcher and has published numerous peer reviewed research articles. Here is a recent research paper about effectiveness of osteopathy in cardiology. Dr Bordoni the only osteopath of this research. We are so proud of him!

Can students shadow practitioners?

Our students who wish to shadow one of our alumni in their private health clinics should contact the alumni directly. We do not arrange this between alumni and students. Sometimes alumni ask us to post a request about their willingness to allow students to observe their practice. This is usually posted in our private alumni FB group. We also email the post to all our students. Here is a recent shadowing opportunity we emailed students today: "National Academy of Osteopathy graduate, Frederic Koomsatira, BSc, CSCS, DOMP (osteopath & a Brazilian Jiu Jitsu champion and coach) has been kind enough to allow our students to shadow him and work on a volunteer basis in his clinic in Montreal (Quebec, Canada). Our interested students who wish to do some volunteer work should contact Frederic directly at or 1-514-581-3400. The clinic website is: We are grateful to Frederic for helping our students."

What is the highest fee charged by an NAO graduate for osteopathic care?

$400 per 90 minutes of osteopathic care is the highest fee that we know of. NAO graduate, manual osteopath & registered massage therapist Thomas Andrew charges $300 US (about $400 Canadian) per 90 minutes of Osteopathic care provided to cash patients. Thomas is a Canadian who practices in the island of Bermuda. Previously the record of highest fee charged was by an NAO graduate practicing in London (Ontario) who charged $270 (Canadian) per hour.


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National Academy of Osteopathy, founded in 2010 is the largest provider of manual osteopathic education in the world, teaching in 68 countries. NAO admissions office, York University Heights campus & teaching clinic are located in Toronto (Canada). NAO is an accredited, registered & licensed Canadian school of osteopathy and the copyright holder of the Canadian title “DOMP – Diploma in Osteopathic Manual Practice”. Please send an email to to receive the information package.