In many European countries osteopathy is a fulltime course lasting four to five years. In Europe osteopathy is nearest to its original form as in the United States osteopaths are physicians. Their training is longer and manual skills make up only a relatively small portion of their education. However, osteopaths skilled in manual therapy exist also in The U.S. In Canada osteopaths mostly follow a similar formation as in the European lineage.
In Finland one can study osteopathy as part of either public or private education system. To work as an osteopath one has to register at Valvira, an agency charged with the supervision of social and healthcare sectors. At my university (Metropolia University of Applied Sciences) the formation took four years and consisted of extensive studies of anatomy and physiology as well as osteopathic examination and treatment. Two and a half years we worked at the practice clinic Positia alongside physiotherapists and podiatrists. In addition we studied medical knowledge, differential diagnosis, interaction and patient educational skills as well as research and development competence in osteopathy.
In Spain osteopathy is not yet regulated, which means anyone can call themselves osteopaths. Osteopaths working in Spain who have an education up to the European standards have either studied abroad or are physiotherapists who have taken a two-year-long additional course in osteopathy.