NBCE Part II 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 II exam.

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

What is the NBCE Part II Exam?

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

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

1. General Diagnosis

2. Neuromusculoskeletal Diagnosis

3. Diagnostic Imaging

4. Principles Of Chiropractic

5. Chiropractic Practice

6. Associated Clinical Sciences

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

1. Case History (12%)
2. Vital Signs (6%)
3. Head and Neck Examination/Findings (9%)
   • Eye
   • Ear
   • Nose and sinuses
   • Mouth and throat
   • Neck
4. Thorax Examination/Findings (including heart and lungs) (8%)
   • Inspection
   • Auscultation
   • Percussion
   • Palpation
5. Abdominal Examination/Findings (8%)
   • Inspection
   • Auscultation
   • Percussion
   • Palpation
6. Rectal and Male Urogenital Examination/Findings (6%)
7. Diagnosis or Clinical Impression (40%)
   • Eyes, ears, nose and throat
   • Respiratory diseases
   • Cardiovascular diseases
   • Blood and lymphatic diseases
   • Gastrointestinal diseases
   • Genitourinary diseases
   • Endocrine and metabolic disorders
   • Immunological disorders
   • Nutritional disorders
   • Infectious diseases
8. Laboratory Interpretation (11%)
9. Urinalysis
10. Hematology
11. Chemistry/serology
12. Special studies

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

1. Case History (18%)
2. Posture and Gait Assessment (10%)
3. Orthopedic Examination (21%)
   • Cervical spine
   • Thoracic spine
   • Lumbar spine and pelvis
   • Extremities
4. Neurologic Examination (21%)
   • Cranial nerve/CNS testing
   • Motor testing
   • Sensory testing
   • Reflex testing (Superficial reflexes, Deep tendon reflexes, Pathological reflexes)
5. Diagnosis or Clinical Impression (30%)
   • CNS disorders
   • Peripheral neurologic/neurovascular disorders
   • Muscular disorders
   • Bone and joint disorders

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

1. Imaging Technology (5%)
   • Physics and principles
   • Quality assurance
   • Radiographic imaging
   • Radiologic protection
2. Radiographic Positioning and Normal Anatomy (20%)
   • Spine and pelvis
   • Extremities
   • Thorax and abdomen
3. Imaging Diagnosis or Clinical Impression (50%)
   • Congenital anomalies and normal variants
   • Trauma
   • Arthritides
   • Tumors/tumor-like processes
   • Nutritional, metabolic and endocrine conditions
   • Hematologic conditions
   • Infectious conditions
   • Miscellaneous skeletal conditions
   • Thoracic and abdominal conditions
4. Methods of Interpretation (10%)
   • Biomechanical analysis/mensuration procedures
   • Imaging evaluation (including common misinterpretations)
5. Clinical Applications of Special Imaging (15%)
   • MRI
   • CT
   • Miscellaneous

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

1. The Chiropractic Paradigm (23%)
   • Core concepts
   • Research principles and methods
2. Concepts of Subluxation and Spinal Lesions (26%)
   • Dysafferentation (proprioceptive insult) / somatosomatic reflex models
   • Neural compression/traction models
   • Visceral reflex models
   • Vascular insufficiency models
   • Axonal aberration/trophic models
   • Neuroimmunomodulation models
   • Biomechanical models
   • Other
3. Basic Science Concepts in Chiropractic (25%)
   • Anatomical
   • Pathophysiological
   • Biomechanical
4. Applied Chiropractic Principles (26%)
   • Subluxation etiologies
   • General effects of adjustment and manipulation
   • Wellness

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

1. Spinal Analysis and Patient Evaluation (25%)
   • Case history and observation findings
   • Manual examination of the spine and extremities
   • Diagnostic procedures
2. Chiropractic Adjustive Technique (26%)
   • Cervical techniques
   • Thoracic techniques
   • Lumbar techniques
   • Pelvic techniques
   • Costal and extremity techniques
3. Patient Care (27%)
   • Case management
   • Contraindications for treatment
   • Home care, prevention and rehabilitation
4. Community Health and Wellness (12%)
   • Public health organizations
   • Healthy People initiatives
   • Screening activities for health promotion
   • Tobacco, alcohol and substance abuse
   • Exercise and healthy diet for obesity
   • Behavior theories and lifestyle change
   • Wellness counseling
5. Occupational and Environmental Health (10%)
   • Work-based health risks
   • Worker protection and ergonomics
   • Injury and violence
   • Impact of environment on human health
   • Pollution and wastes

Here’s a breakdown of the Associated Clinical Sciences domain and what concepts chiropractic students should master before taking their NBCE Part II exam.

1. Geriatrics (15%)
   • Anatomic and physiologic process of aging
   • Geriatric disorders and case management
2. Dermatology (11%)
   • Types of skin lesions
   • Microbial infections
   • Tumors
   • DermatitisScaling diseases
   • Vesicular and bullous diseases
   • Pigmentary disorders
   • Inflammatory reactions
   • Disorders of hair follicles and sebaceous glands
3. Sexually Transmitted Diseases (8%)
   • Gonorrhea
   • Syphilis
   • AIDS
   • Chlamydia
   • Herpes
   • Other
4. Toxicology (10%)
   • Pharmacology
   • Poisoning
   • Environmental and occupational toxicology
5. Emergency Procedures (13%)
   • Cardiopulmonary arrest
   • PoisoningThermal injuries
   • Shock
   • Head and spinal injuries
   • Choking
   • Fractures, dislocations, strains and sprains
   • Other
6. Psychology (11%)
   • Theories and general concepts
   • Mental and emotional disorders
   • Assessment methods and case management
7. Gynecology and Obstetrics (11%)
   • Gynecological examination
   • Breast examination and disorders
   • Gynecological disease and abnormalities
   • Pregnancy
   • Labor and delivery
   • Postpartum
   • Obstetric disorders
8. Pediatrics (14%)
   • Care of newborn
   • Growth and development
   • Congenital disorders
   • Childhood infectious diseases
   • Pathological conditions and childhood injuries
   • Emotional disorders and learning disabilities
   • Nutritional problems
9. Jurisprudence, Ethics and Basic Economics (7%)

How many questions are on the NBCE Part II exam?

Part II 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 Diagnosis, Neuromusculoskeletal Diagnosis, and Diagnostic Imaging
• Session 2: Principles of Chiropractic, Chiropractic Practice, and Associated Clinical Sciences

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

You are allotted 3 hours and 26 minutes of total testing time for Part II. 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 II exam?

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

You must be enrolled in, or graduated from, an eligible college to take Part II in your third year. You must first get online approval from your college before applying for the NBCE Part II 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 II 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 II exam, you may take the examinations as many times as needed to pass too. Once you have passed Part II, 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 II 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 II exam this year?

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

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

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

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

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

For all Part II 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 II?

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

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

It costs $710 to take Part II exam. This is the case for Part I 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 II 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 II 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.