NBCE Test Development Committees

The NBCE Test Development Committees bring together subject matter experts to select the questions, or items, used on all of its exams. Participants include chiropractic college faculty nominated by Deans with final selection by NBCE,  and practitioners from state boards serve on these annual Test Development Committees.

Standard Setting Committees are usually held every three years. Participants determine and approve the cut scores (passing) for exams. Members include chiropractic college faculty, practioners and state board members.

To ensure the fairness of all of its exams, the NBCE seeks committee members from every chiropractic college in the U.S. and from each state licensing board on a rotating basis.

Review Item Writing Guidelines here. (PDF version)

Part I Reference Texts

Part II Reference Texts

Part III Reference Texts

Physiotherpary (PHT) Reference Texts


The video below contains additional information about the NBCE exam selection process.

NBCE Exam Development from NBCE on Vimeo.


History of NBCE Exam Development

The first NBCE tests consisted of what we still call the Part I and Part II exams. Part I tests students in general and spinal anatomy, physiology, chemistry, pathology and microbiology. Part II assesses knowledge of general diagnosis, neuromusculoskeletal diagnosis, diagnostic imaging, principles of chiropractic, chiropractic practice and associated clinical sciences.

The Part III exam was added in 1987. It tests the applicant’s understanding of case history, physical examination, neuromusculoskeletal examination, diagnostic imaging, clinical laboratory and special studies, diagnosis or clinical impression, chiropractic techniques, supportive interventions and case management.

Then in 1995, the Part IV practical exam rounded out today’s four-part process. It tests hands-on skills. When a patient walks into the exam room, how does the chiropractor-to-be take the patient’s history and conduct the physical exam? Depending on symptoms, which tests should be ordered? Can the examinee properly read CT scans and other imaging? Can he or she demonstrate proper adjustment techniques? Administrating this exam involves developing case scenarios, training groups of patient actors and ensuring reproducible scoring methods.

Candidates typically take NBCE exams before graduating from chiropractic college. Exam scores are made available to licensing authorities within and outside the United States. In the U.S., all 50 states either accept or require passing scores on NBCE exams Parts I, II, III, and IV for licensure.



and public safety through excellence in testing