NBCE Part I Test: What You Have to Know (Updated August 2024)

The National Board of Chiropractic Examiners (NBCE) is the organizing body that administers the national licensing chiropractic exams in the United States. There are four parts (Part I, Part II, Part III and Part IV) and an additional Physiotherapy (PT) exam that is accepted and used to show chiropractic competency for licensure. This article gives you everything you need to know about the NBCE Part I exam.

• What is the NBCE Part I exam?
• What sections are on the NBCE Part I exam?
• How many questions are on the NBCE Part I exam?
• How long do I get to take the NBCE Part I exam?
• How can I sign up for the NBCE Part I exam?
• When can I take the NBCE Part I exam this year?
• What is a passing score for the NBCE Part I?
• How much does it cost to the NBCE Part I exam?

What is the NBCE Part I Exam?

The NBCE Part I is a computer-based test that tests those who are working towards chiropractic licensure on basic sciences. Part I dives into the foundational topics and Part II, Part III and Part IV exams test these same concepts but with a more clinical lens.

The six (6) basic science sections (the NBCE calls these “domains”) Part I tests are:

1. General Anatomy

2. Spinal Anatomy

3. Physiology

4. Chemistry

5. Pathology

6. Microbiology

Here’s a breakdown of the General Anatomy domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Topographical Anatomy (11%)
   • Planes of the body and anatomical terminology
   • Head and neck
   • Back and thorax
   • Abdomen, pelvis and perineum
   • Upper and lower limbs
   • Integument (including histology)
2. Osteology of the Appendicular Skeleton (13%)
   • Upper limb and shoulder girdle
   • Lower limb and pelvis
   • Development
   • Histology
3. Arthrology and Syndesmology of the Appendicular Skeleton (11%)
   • Classification of joints
   • Articulations of the appendicular skeleton
   • Biomechanics
4. Myology of the Appendicular Skeleton (12%)
   • Upper limb and shoulder (including innervation)
   • Lower limb and pelvic girdle (including innervation)
   • Development
   • Structure and histology
5. Cardiovascular and Lymphatic Systems (11%)
   • Heart
   • Arteries
   • Veins
   • Lymphatic vessels and lymphoid tissue (including spleen and thymus)
   • Development
   • Histology
6. Digestive System (11%)
   • Oral cavity and pharynx
   • Digestive viscera
   • Development
   • Histology
7. Respiratory System (11%)
   • Nose and sinuses
   • Larynx, trachea and bronchi
   • Lungs, pleura and mediastinum
   • Development
   • Histology
8. Urogenital System (10%)
   • Urinary organs
   • Male reproductive organs
   • Female reproductive organs
   • Development
   • Histology
9. Endocrine System (10%)
   • Endocrine glands and tissues
   • Development
   • Histology

Here’s a breakdown of the Spinal Anatomy domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Osteology of the Axial Skeleton (18%)
   • Skull
   • Vertebral column
   • Ribs and sternum
   • Development
2. Myology of the Axial Skeleton (17%)
   • Face and head
   • Back and neck
   • Thorax and abdomen
   • Pelvis and perineum
   • Development
3. Arthrology and Syndesmology of the Axial Skeleton (14%)
   • Classification of joints
   • Articulations of the axial skeleton
   • Biomechanics
4. Anatomy of the Central Nervous System and Related Structures (18%)
   • Cerebrum
   • Brainstem and cerebellum
   • Spinal cord and meninges
   • Vascular supply and relationships
   • Ventricles and cerebrospinal fluid
   • Development
   • Histology
5. Anatomy of the Peripheral and Autonomic Nervous Systems (19%)
   • Spinal nerves, plexuses, and branches
   • Cranial nerves
   • Visceral innervation
   • Cutaneous innervation
   • Development
   • Histology
6. Organs of Special Senses (14%)
   • Vision
   • Audition and equilibrium
   • OlfactionGustation
   • Development
   • Histology

Here’s a breakdown of the Physiology domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Neurophysiology (12%)
   • Membrane potentials, action potentials, and synaptic transmission
   • Motor function
   • Sensory function
   • Autonomic function
   • Higher cortical function
   • Special senses
2. Muscle Physiology (12%)
   • Cardiac muscle
   • Skeletal muscle
   • Smooth muscle
3. Cardiovascular Physiology (12%)
   • Cardiac pump
   • Electrophysiology of the heart
   • Hemodynamics
   • Regulation of circulation
   • Circulation in organs
   • Lymphatics
   • Hematology and immunity
4. Respiratory Physiology (11%)
   • Mechanics of breathing
   • Ventilation, lung volumes and capacities
   • Regulation of respiration
   • O2 and CO2 transport
   • Gas exchange
5. Body Fluids and Renal Physiology (11%)
   • Regulation of body fluids/micturition
   • Glomerular filtration
   • Tubular exchangeAcid-base balance
6. Gastrointestinal Physiology (10%)
   • Ingestion/motility
   • Digestion/secretion
   • Absorption
   • Regulation of GI function
7. Reproductive Physiology (10%)
8. Endocrine Physiology (12%)
   • Secretion of hormones
   • Action of hormones
   • Regulation
9. Exercise and Sports Physiology (10%)

Here’s a breakdown of the Chemistry domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Carbohydrates (13%)
   • Metabolism (Catabolic pathways vs. Anabolic pathways)
   • Chemistry (Structure, Properties, Function)
   • Nutritional Concepts (Food sources, Digestion)
2. Lipids (12%)
   1. Metabolism (Catabolic pathways vs. Anabolic pathways)
   • Chemistry (Structure, Properties, Function)
   • Nutritional Concepts (Food sources, Digestion)
3. Proteins, Amino Acids and Peptides (13%)
   • Metabolism (Catabolic pathways vs. Anabolic pathways)
   • Chemistry (Structure, Properties, Function)
   • Nutritional Concepts (Food sources, Digestion)
4. Enzymes (12%)
   • Classification and function
   • Kinetics and regulation
5. Hormones (13%)
   • Metabolic effects of specific hormones
     • Carbohydrate metabolism
     • Lipid metabolism
     • Protein metabolism
   • General properties (Chemistry, Mechanism of action)
6. Nucleotides and Nucleic Acids (12%)
7. Metabolism of purines and pyrimidines
   • Chemistry (Structure, Properties, Function)
   • DNA, RNA, and protein synthesis
8. Vitamins and Minerals (13%)
   • Chemistry (Structure, Properties, Function, Coenzyme precursors)
   • Nutritional concepts (Food sources, Absorption of metabolism, Storage)
9. Biochemical Energetics (12%)
   • Basic concepts
     • High-energy phosphate compounds
     • Oxidation-reduction reactions
   • Citric acid cycle
   • Oxidative phosphorylation and electron transport system

Here’s a breakdown of the Pathology domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Fundamentals of Pathology (15%)
   • Disease at the cellular level
   • Inflammation and repair
   • Neoplasia
   • Hemodynamic disorders
2. Genetic and Congenital Disorders (10%)
   • Chromosomal disorders
   • Inborn errors of metabolism
   • Congenital disorders
3. Disorders of the Immune System (14%)
   • Hypersensitivity reactions
   • Autoimmune diseases
   • Immunologic deficiencies
4. Environmental and Nutritional Diseases (13%)
5. Disorders of the Musculoskeletal System (16%)
   • Bone
   • Joint
   • Muscle
6. Disorders of the Nervous System (16%)
   • Central nervous system
   • Peripheral nervous system
7. Diseases of the Organ Systems (16%)
   • Cardiovascular
   • Gastrointestinal
   • Respiratory
   • Genitourinary
   • Endocrine
   • Blood and lymphatics

Here’s a breakdown of the Microbiology domain and what concepts chiropractic students should master before taking their NBCE Part I exam.

1. Immunology (18%)
   • Cells of the immune system
   • Antigens, antibodies and complement
   • Hypersensitivities and immunopathologies
   • Immunization/vaccination
   • Assessment of immune responses/serology
2. Bacteria (18%)
   • Structure and biochemical characteristics
   • Resistance, genetics, antigenicity, and pathogenicity
   • Communicable and infectious diseases
   • Reservoirs of infection and modes of transmission
3. Viruses and Prions (18%)
   • Structure and biochemical characteristics
   • Resistance, genetics, antigenicity, and pathogenicity
   • Communicable and infectious diseases
   • Reservoirs of infection and modes of transmission
4. Fungi (15%)
   • Structure and biochemical characteristics
   • Resistance, genetics, antigenicity, and pathogenicity
   • Communicable and infectious diseases
   • Reservoirs of infection and modes of transmission
5. Parasites (15%)
   • Structure and biochemical characteristics
   • Resistance, genetics, antigenicity, and pathogenicity
   • Communicable and infectious diseases
   • Reservoirs of infection and modes of transmission
6. Epidemiology and Disease Control (16%)
   • Health agencies and reporting/monitoring
   • Prevention, identification and control methods for communicable diseases
   • Population health assessments
   • Emerging diseases

How many questions are on the NBCE Part I exam?

Part I consists of 255 questions across the six sections (see above). The exam is divided into two sessions; each session consists of three domains.

• Session 1: General Anatomy, Spinal Anatomy, and Physiology
• Session 2: Chemistry, Pathology, and Microbiology

How long do I get to take the NBCE Part I exam?

You are allotted 3 hours and 26 minutes of total testing time for Part I. Testing appointments are 4 hours with:

• A pre-test tutorial on how to navigate the computer testing program
• Session 1
• One (1) optional 15-minute break after the first session
• Session 2
• End of exam survey

How can I sign up for the NBCE Part I exam?

If you’re wondering, “Am I eligible to take the NBCE Part I exam?” make sure to read this section.

You must be enrolled in, or graduated from, an eligible college to take Part I in your second year. You must first get online approval from your college before applying for the NBCE Part I exam. Approval from your chiropractic college is typically contingent on you passing certain courses before applying for a test. Chiropractic schools want to ensure the highest pass rates for their school so they only approve students who have satisfactory passed a minimum number of courses for the particular subjects that are tested for any given NBCE exam.

The courses must be completed by the application deadline. Individual chiropractic colleges may establish additional requirements.

If you have already graduated from a chiropractic school (it must be part of the NBCE’s approved or eligible college list) you may take Part I with online approval from the chiropractic college you attended.

While enrolled in a chiropractic college, you may take the examinations as many times as needed to pass. If you have graduated from a chiropractic college and are taking your NBCE Part I exam, you may take the examinations as many times as needed to pass too. Once you have passed Part I, you may not retake these exams without special requirement of a state licensing authority.

A doctor or a student of chiropractic who has successfully passed Part I is not allowed to retake any previously passed exam, except when required by a state licensing authority. Scores from retake examinations based on this criteria do not void the original passing scores.

When can I take the NBCE Part I exam this year?

The next exam dates for Part I in 2024 at Prometrix testing sites are as follows:

• September 14 - September 29
• October 12 - October 27

The next exam dates for Part I in 2024 at select chiropractic colleges are as follows:

• September 21 - September 22
• October 19 - October 20

For all Part I testing dates in September, your scores will be released October 14.

For all Part I testing dates in October, your scores will be released November 11.

Note, you must apply at least 16 days prior to the scheduled test date you’re applying for.

For the full 2024 exam and fee schedule for all NBCE exams, read this article: Updated 2024 NBCE Schedule and Fees For Chiropractic Board Exams.

What is a passing score for the NBCE Part I?

A passing score of at least 375 is required for the Part I. 

How much does it cost to the NBCE Part I exam?

It costs $710 to take Part I exam. This is the case for Part II and Part III as well.There are also a few scholarship opportunities, through the NBCE and NCMIC.

NBCE Scholarship for Chiropractic Board Exam

Amount per winner: $2,500 is awarded per each winner

How many chiropractic students can win?: Four (4) chiropractic students in 2024

Total amount in prizes: $10,000 in 2024

Submissions accepted: February 1, 2024 - October 1, 2024 (no later than 12 noon Pacific time)

How to submit your essay:   https://www.surveymonkey.com/r/NBCE2024EssayCompetition

Date when winners are announced: December 31, 2024

Rules:

• Submit an original essay on any topic of your choice, as long as the topic is relevant to chiropractic. Themes may include: history, philosophy, practice perspectives, jurisprudence/law, ethics, theory, sociology, politics, or social sciences.
• Your original essay must be submitted as a Word document.
• Essay must be no shorter than 1200 and no longer than 3500 words. Word count does not include title or references.
• The essay should include the following components:
  • Introduction - the introduction should provide a brief overview of the topic, a well-referenced and grounded rationale for the paper, and the purpose (or hypothesis) for the paper.
  • Discussion – the discussion should address the topic in a scholarly manner. Important points should be elaborated upon, and relate to the study's purpose. The discussion should cogently relate the current discussion and findings with other relevant publications.
  • Conclusion – The conclusion should provide insightful statements about the importance and relevance of the study without generalizing beyond the study's findings. The conclusion should not interject author opinions, make unsupported claims, or give statements that go beyond the limits of the study findings. This section should be brief, perhaps 1 paragraph, and provide clear answers and summarize how the purpose/hypothesis presented in the introduction was addressed.
  • References – References are expected and should be included throughout the paper. All statements made as fact should have supporting references. All references should be numbered according to their appearance in the text.
• Only one essay is allowed per student per competition and only one author per essay. Students who submitted in the past but did not win may compete again with a new essay.
• In addition to your essay you must confirm eligibility and identity:
  • You must sent a letter from your registrar confirming enrollment and that you are in good academic standing in your chiropractic program.
  • A portrait photo of yourself (JPEG, PNG, 300 dpi)

Judging criteria: includes relevance to the chiropractic profession, scholarly style, writing quality, originality and use of references.

Eligibility: Being in good academic standing and enrolled in a United States, CCE-accredited, chiropractic program at any time during 2024. You must also submit your essay by October 1, 2024.

All questions about the competition should be directed to Dr. Claire Johnson at [email protected].

To read more about this NBCE Essay Scholarship, read this.

NCMIC Bucks of Boards Awards

Amount per winner: $1,000 awarded per each winner

How many chiropractic students can win?: Twenty-five (25) chiropractic students every quarter in 2024

Total amount in prizes: $100,000 for the entire year of 2024

Entry Periods & Drawings”

July 1 - September 30 (Winner will be drawn: October 7, 2024)

October 1 - December 31 (Winner will be drawn: January 7, 2025)

Rules: Complete the application (simply put your first name, last name, email, date of birth, address, chiropractic school, anticipated graduation month and anticipated graduation year).

Eligibility:

• Current chiropractic student or have graduated within the last 6 months

To read more about this NCMIC Award, read this.

What is the best review course for the NBCE Part I exam?

As chiropractic students, you have many options when it comes to reviewing and preparing for your NBCE exams. The best review course for the NBCE Part I exam for you will depend on what type of student you are.

Which of the following do you agree with more?

• I need to be held accountable while reviewing and need to go to a live review.
• I prefer to review material all at once, in one or two sittings.
• I only need to go over the review material once.
• I don’t need to take any practice questions.
• I don’t care when my review course lands before my test.

If you agreed with the above statements, you will probably benefit from an in-person review. However, if you didn't feel like you resonated with this statements, read the below.

• I prefer for my review to work around my schedule, not the other way around.
• I thrive when I can review material multiple times.
• I would benefit from taking as many practice questions as I can.
• I value a review that has a pass guarantee.
• I want to be able to study anytime and anywhere.

However, if you agree with the above, you would benefit from an online review course. But not all online reviews are made equal.

Chiro AlignEd Learning review courses are:

• Comprehensive and Efficient: Our courses cover the most highly-tested concepts so there are no surprises on exam day. Information is simplified into digestible chunks so you can retain and recall it all easily.
• Convenient and Flexible: With our self-paced review, you can make the most of your time with access to all course materials anytime, anywhere. With 90 days of unlimited access you will have plenty of time to feel ready on exam day.
• Stress-Free: While we are confident you can pass on your first try, our Access Until You Pass Guarantee means you can study with peace of mind knowing we will renew your 90 day access until you pass.

If you want to learn more about our review courses, check them out here!

Whichever review course you choose to use, we hope you are able to pass your exam on your first try because the world needs more chiropractors like YOU.