Changes to NBCE Chiropractic Board Testing in 2024: What it Means for Chiropractic Students and Chiropractors

The National Board of Chiropractic Examiners (NBCE) has put forth a series of proposed changes that they say will enhance its licensing exams.

What the NBCE has proposed

• Doing away with “domains” for Parts I and II. This would mean test takers would receive a single score for each of these exams, and not 6 separate scores for each domain.
• Increasing available exam administration dates for all NBCE board exams. This might mean utilizing nationwide testing sites like Prometric to accommodate the increase in volume.
• Changing the NBCE Part IV exam’s format to better simulate real-world patient encounters. Under the proposed changes each station would include a complete patient interaction, incorporating the patient process from taking a case history to what chiropractic technique/adjustment would be used. This would reduce the number of total stations but increase the length of each station.
• The NBCE is considering a shift to centralized testing locations (proposed location is Greeley, Colorado). Pilot testing for technology and exam changes is planned for 2024.
• Moving the NBCE Part IV exam grading to be completely paperless and possibly include video recording of a test taker’s attempt at each station.

There are many moving parts and things to think about with all of these proposed changes coming down the chiropractic board pipeline. Here is some food for thought.

Single scores for Parts I, II, III and the Physiotherapy*

• Possible advantages: Stronger “sections” can elevate the single score, theoretically making it easier to pass with a single score. For example, if you are very strong at physiology but weak with general anatomy, getting more physiology questions correct may raise your single score even though you didn’t do well on the general anatomy questions.
• Possible drawbacks: Weak areas for test takers may be masked by stronger areas and cause an overinflation of the overall single score which could mean less well rounded doctors. There is also the question of how the NBCE weights each question depending on its supposed importance to being a successful doctor of chiropractic. The NBCE says it has received input from chiropractic college teachers of which areas of study are more important and will take this into account for weighting scores.

• The NBCE hopes to implement these changes by the second quarter of 2024.

Increasing exam administration dates

• Possible advantages: If a test taker fails an exam, this decrease the time before their next opportunity to retake the exam.
• Possible disadvantages: Depending on the contract with the testing site NBCE goes with, this could potentially raise exam fees.

Changing the Part IV exam station format

• Possible advantages: Simulates a more realistic patient encounter for the test taker.
• Possible disadvantages: May invoke higher testing anxiety and thus lower success rate

Centralized Testing for Part IV exams

• Possible advantages: A designated location, instead of reserving the library of a chiropractic college, allows the NBCE to offer the Part IV exam possibly up to three days a week, 48 weeks a year, beginning as early as mid-2025.
• Possible disadvantages: Gets rid of the “home field advantage” you benefit from if you were to take Part IV at your own school and in the clinic you are most familiar with. The time and financial resources required to travel to the centralized location than to more nearby chiropractic colleges may be a burden on the test taker.

Paperless scoring/video recording of Part IV exams

• Possible advantages: This could benefit the test taker by having video evidence to appeal/review performances at a station.
• Possible disadvantages: Technical difficulties and technological glitches are always a possibility when switching from old school “pen and paper” to digital scoring. Higher cost to administer with increased technology could increase the cost to the student. This could also alter the processing time for scores which change how long it takes one to get licensed.

The NBCE is trying to to triple the number of testing opportunities annually by making exams available for more than two weeks a month, excluding May, November and December. This is great for anyone who has to retake an exam or for those who missed applying for an exam in an administration window.

The NBCE has provided an area on their website where stakeholders (chiropractic students, doctors of chiropractic, chiropractic college leadership, the general public, etc.) can provide their input. You can offer your feedback here.

Stay informed with all the changes by checking the NBCE’s official Projects page.