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Texas Chiropractor — Requirements & Free Practice

US-TX · License preparation

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

License to Practice Chiropractic

Texas regular chiropractor license.

Licensing authority: Texas Board of Chiropractic Examiners · Application information

Reissuance after cancellation or suspension
No examination is required for this applicant pathway.
Board discretion
The Board may reissue the license on application under §201.511(a).
Prior status
Previous chiropractic license canceled or suspended under Tex. Occ. Code §201.511(a).
Revocation wait
If the license was canceled or revoked, wait at least one year and apply in the Board-required manner and form under §201.511(b).

Official no-examination sources

Effective from 2026-09-22.

Late renewal after one to three years on Board good cause waiver
No examination is required for this applicant pathway.
Expiry window
License expired for at least one year and no more than three years under 22 TAC §72.14(i).
Fees
Pay all applicable late fees under §72.14(i).
Good cause
Show good cause satisfactory to the Board and obtain its waiver of new-license requirements under §72.14(i).

Official no-examination sources

Effective from 2026-09-22.

New license after a lapse of one year or longer

All of the following:

Board waiver
For a lapse of one to three years, the Board may waive new-license requirements on satisfactory good cause and payment of late fees under §72.14(i).
Expiry window
License expired one year or longer under 22 TAC §72.14(h).
Initial conditions
Complete the ordinary initial-license education, application and fingerprint conditions under Tex. Occ. Code §§201.302–201.313.
Conversion from temporary faculty to permanent unrestricted license

All of the following:

Faculty status
Hold a temporary faculty license under Tex. Occ. Code §201.308(c).
Initial conditions
Meet all ordinary permanent-license conditions, including education and application requirements, under §201.308(j).
Renewal of inactive license
No examination is required for this applicant pathway.
Education exception
Continuing education is not required while inactive under §72.16(c).
Inactive status
Hold an inactive Texas chiropractic license under 22 TAC §72.16.
Renewal
Renew the license and request inactive status anew in each renewal period under §72.16(b).

Official no-examination sources

Effective from 2026-09-22.

Reactivation after six or more years inactive

All of the following:

Inactive period
License inactive six years or more under 22 TAC §72.16(g).
Maximum inactive period
An inactive license may not be maintained for more than twenty years under §72.16(i).
Waiver
The Board may exempt an applicant from the §72.16(g) examination requirement if the applicant held an active unrestricted good-standing license in another state or foreign jurisdiction under §72.16(h).
Reactivation after less than six years inactive
No examination is required for this applicant pathway.
Application
Apply for active status, verify the continuing education hours that would have been required for renewal, and pay the fee under §72.16(e).
Inactive period
License inactive less than six years under 22 TAC §72.16(e).

Official no-examination sources

Effective from 2026-09-22.

Placement on inactive status
No examination is required for this applicant pathway.
Application
Apply for inactive status before the expiration date and meet 22 TAC §72.16(a) or (d) as applicable.
Current status
Hold a current Texas chiropractic license and not practice while inactive under §201.311(b).

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by examination

All of the following:

Application
Submit the sworn Board application and fee under §201.302(b).
Chiropractic program
Graduate from or be in the final semester of a qualifying doctor of chiropractic program under §201.302(a)(3).
Education board notice
Texas Board of Chiropractic Examiners Licensing Requirements says: "If you entered Chiropractic College prior to September 1, 2005, 60 hours are required."
Education records
Submit the transcript and chiropractic diploma required by the Board licensing page.
Exam order
Under 22 TAC §72.7(e), complete all required National Board parts before taking the Texas jurisprudence examination.
Fingerprints
Submit fingerprints for the criminal history record check under §201.313.
Jurisprudence eligibility
The Board licensing page requires criminal background clearance before jurisprudence examination eligibility.
Minimum age
At least 18 years of age under Tex. Occ. Code §201.302(a)(1).
Prior coursework
Complete 90 semester hours of qualifying college courses under Tex. Occ. Code §§201.302(a)(2) and 201.303(a).
Renewal of license expired less than one year
No examination is required for this applicant pathway.
Expiry window
License expired less than one year under 22 TAC §72.14(g).
Renewal
Meet renewal requirements and pay the late fee under 22 TAC §72.14(g).

Official no-examination sources

Effective from 2026-09-22.

Military applicant with a current out of state license
No examination is required for this applicant pathway.
Agency discretion
The executive director may waive prerequisites after reviewing credentials under §55.004(b).
Military status
Be a military service member, military veteran, or military spouse under Tex. Occ. Code §55.004(a).
Qualification
Hold a current similar-scope good-standing license from another state under §55.004(a)(1).

Official no-examination sources

Effective from 2026-09-22.

Military applicant previously licensed in Texas
No examination is required for this applicant pathway.
Agency discretion
The executive director may waive prerequisites after reviewing credentials under §55.004(b).
Military status
Be a military service member, military veteran, or military spouse under Tex. Occ. Code §55.004(a).
Prior license
Have held the Texas chiropractic license within the five years before the application under §55.004(a)(2).

Official no-examination sources

Effective from 2026-09-22.

Licensure for applicants licensed in another jurisdiction

All of the following:

Board page notice
Texas Board of Chiropractic Examiners Licensing Requirements says an eligible out-of-state applicant "may substitute any missing part(s) of the national boards by taking and passing the Special Purpose Exam for Chiropractors (SPEC)"; 22 TAC §72.20(a)(3) states NBCE Parts I-IV plus Physiotherapy or SPEC as alternatives.
Current license
Hold a good-standing chiropractic license in another jurisdiction with requirements substantially similar to Texas Occupations Code Chapter 201 under §201.309(2) and 22 TAC §72.20(a)(1)-(2).
Discipline
Have no discipline or pending investigation in any jurisdiction under §201.309(3) and 22 TAC §72.20(b).
Education
Graduate from a Council on Chiropractic Education accredited and Board-approved doctor of chiropractic program under §201.309(4).
Experience
Practice chiropractic or teach in an accredited chiropractic program for the three immediately preceding years under §201.309(7) and 22 TAC §72.20(a)(4).
Other board recognized exam
Texas Occupations Code §201.309(5) also refers to a national or other examination recognized by the Board; 22 TAC §72.20(a)(3) identifies the NBCE Parts I-IV plus Physiotherapy or SPEC choices.
Biennial license renewal
No examination is required for this applicant pathway.
Application
Submit the renewal form and fee under 22 TAC §72.14(c).
Continuing education
Meet the Board continuing education requirements in 22 TAC Chapter 73.
Renewal date
Renew every two years on or before the first day of the birth month under 22 TAC §72.14(a).

Official no-examination sources

Effective from 2026-09-22.

Provisional License

Provisional license pending a qualifying military applicant's license application or out-of-state license recognition.

Licensing authority: Texas Board of Chiropractic Examiners

Provisional license during review of a military out of state application
No examination is required for this applicant pathway.
Duration
The provisional license expires when the application is approved or denied, or on the 180th day after issuance, whichever occurs first, under §55.004(b-1).
Military application
Submit a qualifying application under Tex. Occ. Code §55.004(a)(1) based on a current similar-scope good-standing out-of-state license.

Official no-examination sources

Effective from 2026-09-22.

Provisional license during review of a military former Texas license application
No examination is required for this applicant pathway.
Duration
The provisional license expires when the application is approved or denied, or on the 180th day after issuance, whichever occurs first, under §55.004(b-1).
Military application
Submit a qualifying application under Tex. Occ. Code §55.004(a)(2) based on a Texas license held within five years.

Official no-examination sources

Effective from 2026-09-22.

Provisional license pending recognition of a military applicant out of state license
No examination is required for this applicant pathway.
Duration
The provisional license ends when the agency issues or denies confirmation, or on the 180th day after issuance, whichever occurs first, under the S.B. 1818 text of §55.0041(b-1).
Military status
Be a military service member or military spouse under Tex. Occ. Code §55.0041(a).
Out of state license
Hold a similar-scope good-standing out-of-state license under §55.0041(a).
Recognition application
Submit the notice and information required by §55.0041(b) to seek recognition; the official compilation prints two 2025 texts labelled subsection (b-1).

Official no-examination sources

Effective from 2026-09-22.

Temporary Faculty License

Faculty chiropractic practice at the sponsoring school.

Licensing authority: Texas Board of Chiropractic Examiners · Application information

Temporary faculty licensure for active duty part time faculty
Texas Jurisprudence Examination
Active duty
Be on active duty in the United States armed forces under Tex. Occ. Code §201.308(d)(1).
Board page national exams
Texas Board of Chiropractic Examiners Licensing Requirements says: "Have taken and passed Parts I, II, III, IV and Physiotherapy of the National Board of Chiropractic Examiners (NBCE)." Section 201.308(c)(3) specifies the Texas jurisprudence exam for the temporary faculty license.
Critical need
The practice under the temporary license must fulfill critical needs of Texas citizens under §201.308(d)(2).
Faculty position
Hold an assistant professor or higher faculty position and work at least part-time at an institution named in §201.308(c)(5).
Other faculty conditions
Meet the other §201.308(c) qualifications and school-endorsed application requirements.
Initial temporary faculty licensure
Texas Jurisprudence Examination
Application
The sponsoring school applies and its dean or president endorses the application under §201.308(i) and 22 TAC §72.11(a)-(c).
Board page national exams
Texas Board of Chiropractic Examiners Licensing Requirements says: "Have taken and passed Parts I, II, III, IV and Physiotherapy of the National Board of Chiropractic Examiners (NBCE)." Section 201.308(c)(3) specifies the Texas jurisprudence exam for the temporary faculty license.
Existing license
Hold an unrestricted chiropractic license free of discipline or probation in another state or Canadian province under §201.308(c)(1)-(2).
Experience
Have practiced chiropractic or taught in an accredited chiropractic program for at least the preceding three years under §201.308(c)(4).
Faculty position
Hold a full-time salaried assistant professor or higher faculty position at the named chiropractic school under §201.308(c)(5).
Oath and affidavits
The chiropractor signs the oath and the chiropractor and school file the affidavits required by §201.308(e)-(f).
Practice limit
Practice is limited to the school or affiliate and the faculty assignment under §201.308(h).
Temporary faculty license renewal
No examination is required for this applicant pathway.
Continued practice
Under §72.11(e), a renewal applicant may continue practice under an expired temporary faculty license while the Board evaluates the application.
Renewal application
Apply to renew the temporary faculty license under 22 TAC §72.11(d).

Official no-examination sources

Effective from 2026-09-22.

Temporary License

Limited temporary chiropractic services by a licensee from another United States jurisdiction.

Licensing authority: Texas Board of Chiropractic Examiners · Application information

Temporary license for limited services
No examination is required for this applicant pathway.
Existing license
Hold an active, unrestricted chiropractic license with no pending disciplinary action in another United States jurisdiction under 22 TAC §72.15(b).
Notice
Apply at least 14 days before work begins and submit the license, signed good-standing statement, service description and host entity under §72.15(c)-(d).
Practice limit
Provide services for no more than 30 days in a calendar year, not to the general public, and comply with Texas practice rules under §72.15(a),(e)-(f).
Residency
This route excludes Texas residents and applicants for a regular Board license under §72.15(h).

Official no-examination sources

Effective from 2026-09-22.

Texas Jurisprudence Examination

Examination outline
  • Texas Occupations Code Chapter 201: Chiropractors
  • 22 Texas Administrative Code Chapter 72: Board Fees, License Applications, And Renewals
  • 22 Texas Administrative Code Chapter 73: Continuing Education
  • 22 Texas Administrative Code Chapter 74: Substance Abuse Testing And Monitoring
  • 22 Texas Administrative Code Chapter 75: Business Practices
  • 22 Texas Administrative Code Chapter 76: Patient Records And Documentation
  • 22 Texas Administrative Code Chapter 77: Advertising And Public Communications
  • 22 Texas Administrative Code Chapter 78: Scope Of Practice And Delegation
  • 22 Texas Administrative Code Chapter 79: Unprofessional Conduct
  • 22 Texas Administrative Code Chapter 80: Complaints
  • 22 Texas Administrative Code Chapter 81: Enforcement Actions And Hearings
  • 22 Texas Administrative Code Chapter 82: Internal Board Procedures
Examination sources

Part I

Provider
Prometric
Format
Computer-based examination; items are presented grouped by domain with one timer for all six domains, an optional break halfway through, and forward-only navigation. The NBCE grades across all six domains and reports one Part I score; individual domains are not scored.
Exam questions
255 items
Passing score
375
Examination outline
  • General Anatomy (20%)
    • Topographical Anatomy - 11% of the General Anatomy domain
    • Topographical Anatomy: Planes of the body and anatomical terminology
    • Topographical Anatomy: Head and neck
    • Topographical Anatomy: Back and thorax
    • Topographical Anatomy: Abdomen, pelvis and perineum
    • Topographical Anatomy: Upper and lower limbs
    • Topographical Anatomy: Integument (including histology)
    • Osteology of the Appendicular Skeleton - 13% of the General Anatomy domain
    • Osteology of the Appendicular Skeleton: Upper limb and shoulder girdle
    • Osteology of the Appendicular Skeleton: Lower limb and pelvis
    • Osteology of the Appendicular Skeleton: Development
    • Osteology of the Appendicular Skeleton: Histology
    • Arthrology and Syndesmology of the Appendicular Skeleton - 11% of the General Anatomy domain
    • Arthrology and Syndesmology of the Appendicular Skeleton: Classification of joints
    • Arthrology and Syndesmology of the Appendicular Skeleton: Articulations of the appendicular skeleton
    • Arthrology and Syndesmology of the Appendicular Skeleton: Biomechanics
    • Myology of the Appendicular Skeleton - 12% of the General Anatomy domain
    • Myology of the Appendicular Skeleton: Upper limb and shoulder (including innervation)
    • Myology of the Appendicular Skeleton: Lower limb and pelvic girdle (including innervation)
    • Myology of the Appendicular Skeleton: Development
    • Myology of the Appendicular Skeleton: Structure and histology
    • Cardiovascular and Lymphatic Systems - 11% of the General Anatomy domain
    • Cardiovascular and Lymphatic Systems: Heart
    • Cardiovascular and Lymphatic Systems: Arteries
    • Cardiovascular and Lymphatic Systems: Veins
    • Cardiovascular and Lymphatic Systems: Lymphatic vessels and lymphoid tissue (including spleen and thymus)
    • Cardiovascular and Lymphatic Systems: Development
    • Cardiovascular and Lymphatic Systems: Histology
    • Digestive System - 11% of the General Anatomy domain
    • Digestive System: Oral cavity and pharynx
    • Digestive System: Digestive viscera
    • Digestive System: Development
    • Digestive System: Histology
    • Respiratory System - 11% of the General Anatomy domain
    • Respiratory System: Nose and sinuses
    • Respiratory System: Larynx, trachea and bronchi
    • Respiratory System: Lungs, pleura and mediastinum
    • Respiratory System: Development
    • Respiratory System: Histology
    • Urogenital System - 10% of the General Anatomy domain
    • Urogenital System: Urinary organs
    • Urogenital System: Male reproductive organs
    • Urogenital System: Female reproductive organs
    • Urogenital System: Development
    • Urogenital System: Histology
    • Endocrine System - 10% of the General Anatomy domain
    • Endocrine System: Endocrine glands and tissues
    • Endocrine System: Development
    • Endocrine System: Histology
  • Spinal Anatomy (22%)
    • Osteology of the Axial Skeleton - 18% of the Spinal Anatomy domain
    • Osteology of the Axial Skeleton: Skull
    • Osteology of the Axial Skeleton: Vertebral column
    • Osteology of the Axial Skeleton: Ribs and sternum
    • Osteology of the Axial Skeleton: Development
    • Myology of the Axial Skeleton - 17% of the Spinal Anatomy domain
    • Myology of the Axial Skeleton: Face and head
    • Myology of the Axial Skeleton: Back and neck
    • Myology of the Axial Skeleton: Thorax and abdomen
    • Myology of the Axial Skeleton: Pelvis and perineum
    • Myology of the Axial Skeleton: Development
    • Arthrology and Syndesmology of the Axial Skeleton - 14% of the Spinal Anatomy domain
    • Arthrology and Syndesmology of the Axial Skeleton: Classification of joints
    • Arthrology and Syndesmology of the Axial Skeleton: Articulations of the axial skeleton
    • Arthrology and Syndesmology of the Axial Skeleton: Biomechanics
    • Anatomy of the Central Nervous System and Related Structures - 18% of the Spinal Anatomy domain
    • Anatomy of the Central Nervous System and Related Structures: Cerebrum
    • Anatomy of the Central Nervous System and Related Structures: Brainstem and cerebellum
    • Anatomy of the Central Nervous System and Related Structures: Spinal cord and meninges
    • Anatomy of the Central Nervous System and Related Structures: Vascular supply and relationships
    • Anatomy of the Central Nervous System and Related Structures: Ventricles and cerebrospinal fluid
    • Anatomy of the Central Nervous System and Related Structures: Development
    • Anatomy of the Central Nervous System and Related Structures: Histology
    • Anatomy of the Peripheral and Autonomic Nervous System - 19% of the Spinal Anatomy domain
    • Anatomy of the Peripheral and Autonomic Nervous System: Spinal nerves, plexuses, and branches
    • Anatomy of the Peripheral and Autonomic Nervous System: Cranial nerves
    • Anatomy of the Peripheral and Autonomic Nervous System: Visceral innervation
    • Anatomy of the Peripheral and Autonomic Nervous System: Cutaneous innervation
    • Anatomy of the Peripheral and Autonomic Nervous System: Development
    • Anatomy of the Peripheral and Autonomic Nervous System: Histology
    • Organs of Special Senses - 14% of the Spinal Anatomy domain
    • Organs of Special Senses: Vision
    • Organs of Special Senses: Audition and equilibrium
    • Organs of Special Senses: Olfaction
    • Organs of Special Senses: Gustation
    • Organs of Special Senses: Development
    • Organs of Special Senses: Histology
  • Physiology (18%)
    • Neurophysiology - 12% of the Physiology domain
    • Neurophysiology: Membrane potentials, action potentials, and synaptic transmission
    • Neurophysiology: Motor function
    • Neurophysiology: Sensory function
    • Neurophysiology: Autonomic function
    • Neurophysiology: Higher cortical function
    • Neurophysiology: Special senses
    • Muscle Physiology - 12% of the Physiology domain
    • Muscle Physiology: Cardiac muscle
    • Muscle Physiology: Skeletal muscle
    • Muscle Physiology: Smooth muscle
    • Cardiovascular Physiology - 12% of the Physiology domain
    • Cardiovascular Physiology: Cardiac pump
    • Cardiovascular Physiology: Electrophysiology of the heart
    • Cardiovascular Physiology: Hemodynamics
    • Cardiovascular Physiology: Regulation of circulation
    • Cardiovascular Physiology: Circulation in organs
    • Cardiovascular Physiology: Lymphatics
    • Cardiovascular Physiology: Hematology and immunity
    • Respiratory Physiology - 11% of the Physiology domain
    • Respiratory Physiology: Mechanics of breathing
    • Respiratory Physiology: Ventilation, lung volumes and capacities
    • Respiratory Physiology: Regulation of respiration
    • Respiratory Physiology: O2 and CO2 transport
    • Respiratory Physiology: Gas exchange
    • Body Fluids and Renal Physiology - 11% of the Physiology domain
    • Body Fluids and Renal Physiology: Regulation of body fluids/micturition
    • Body Fluids and Renal Physiology: Glomerular filtration
    • Body Fluids and Renal Physiology: Tubular exchange
    • Body Fluids and Renal Physiology: Acid-base balance
    • Gastrointestinal Physiology - 10% of the Physiology domain
    • Gastrointestinal Physiology: Ingestion/motility
    • Gastrointestinal Physiology: Digestion/secretion
    • Gastrointestinal Physiology: Absorption
    • Gastrointestinal Physiology: Regulation of GI function
    • Reproductive Physiology - 10% of the Physiology domain
    • Endocrine Physiology - 12% of the Physiology domain
    • Endocrine Physiology: Secretion of hormones
    • Endocrine Physiology: Action of hormones
    • Endocrine Physiology: Regulation
    • Exercise and Sports Physiology - 10% of the Physiology domain
  • Chemistry (13%)
    • Carbohydrates - 13% of the Chemistry domain
    • Carbohydrates: Metabolism
    • Carbohydrates: Metabolism: Catabolic pathways
    • Carbohydrates: Metabolism: Anabolic pathways
    • Carbohydrates: Chemistry
    • Carbohydrates: Chemistry: Structure
    • Carbohydrates: Chemistry: Properties
    • Carbohydrates: Chemistry: Function
    • Carbohydrates: Nutritional concepts
    • Carbohydrates: Nutritional concepts: Food sources
    • Carbohydrates: Nutritional concepts: Digestion
    • Lipids - 12% of the Chemistry domain
    • Lipids: Metabolism
    • Lipids: Metabolism: Catabolic pathways
    • Lipids: Metabolism: Anabolic pathways
    • Lipids: Chemistry
    • Lipids: Chemistry: Structure
    • Lipids: Chemistry: Properties
    • Lipids: Chemistry: Function
    • Lipids: Chemistry: Transport
    • Lipids: Nutritional concepts
    • Lipids: Nutritional concepts: Food sources
    • Lipids: Nutritional concepts: Digestion
    • Proteins, Amino Acids and Peptides - 13% of the Chemistry domain
    • Proteins, Amino Acids and Peptides: Amino acid metabolism
    • Proteins, Amino Acids and Peptides: Amino acid metabolism: Catabolic pathways
    • Proteins, Amino Acids and Peptides: Amino acid metabolism: Anabolic pathways
    • Proteins, Amino Acids and Peptides: Chemistry
    • Proteins, Amino Acids and Peptides: Chemistry: Structure
    • Proteins, Amino Acids and Peptides: Chemistry: Properties
    • Proteins, Amino Acids and Peptides: Chemistry: Function
    • Proteins, Amino Acids and Peptides: Nutritional concepts
    • Proteins, Amino Acids and Peptides: Nutritional concepts: Food sources
    • Proteins, Amino Acids and Peptides: Nutritional concepts: Digestion
    • Enzymes - 12% of the Chemistry domain
    • Enzymes: Classification and function
    • Enzymes: Kinetics and regulation
    • Hormones - 13% of the Chemistry domain
    • Hormones: Metabolic effects of specific hormones
    • Hormones: Metabolic effects of specific hormones: Carbohydrate metabolism
    • Hormones: Metabolic effects of specific hormones: Lipid metabolism
    • Hormones: Metabolic effects of specific hormones: Protein metabolism
    • Hormones: General properties
    • Hormones: General properties: Chemistry
    • Hormones: General properties: Mechanism of action
    • Nucleotides and Nucleic Acids - 12% of the Chemistry domain
    • Nucleotides and Nucleic Acids: Metabolism of purines and pyrimidines
    • Nucleotides and Nucleic Acids: Chemistry
    • Nucleotides and Nucleic Acids: Chemistry: Structure
    • Nucleotides and Nucleic Acids: Chemistry: Properties
    • Nucleotides and Nucleic Acids: Chemistry: Function
    • Nucleotides and Nucleic Acids: DNA, RNA and protein synthesis
    • Vitamins and Minerals - 13% of the Chemistry domain
    • Vitamins and Minerals: Chemistry
    • Vitamins and Minerals: Chemistry: Structure
    • Vitamins and Minerals: Chemistry: Properties
    • Vitamins and Minerals: Chemistry: Function
    • Vitamins and Minerals: Chemistry: Coenzyme precursors
    • Vitamins and Minerals: Nutritional concepts
    • Vitamins and Minerals: Nutritional concepts: Food sources
    • Vitamins and Minerals: Nutritional concepts: Absorption and metabolism
    • Vitamins and Minerals: Nutritional concepts: Storage
    • Biochemical Energetics - 12% of the Chemistry domain
    • Biochemical Energetics: Basic Concepts
    • Biochemical Energetics: Basic Concepts: High-energy phosphate compounds
    • Biochemical Energetics: Basic Concepts: Oxidation-reduction reactions
    • Biochemical Energetics: Citric acid cycle
    • Biochemical Energetics: Oxidative phosphorylation and electron transport system
  • Pathology (16%)
    • Fundamentals of Pathology - 15% of the Pathology domain
    • Fundamentals of Pathology: Disease at the cellular level
    • Fundamentals of Pathology: Inflammation and repair
    • Fundamentals of Pathology: Neoplasia
    • Fundamentals of Pathology: Hemodynamic disorders
    • Genetic and Congenital Disorders - 10% of the Pathology domain
    • Genetic and Congenital Disorders: Chromosomal disorders
    • Genetic and Congenital Disorders: Inborn errors of metabolism
    • Genetic and Congenital Disorders: Congenital disorders
    • Disorders of the Immune System - 14% of the Pathology domain
    • Disorders of the Immune System: Hypersensitivity reactions
    • Disorders of the Immune System: Autoimmune diseases
    • Disorders of the Immune System: Immunologic deficiencies
    • Environmental and Nutritional Diseases - 13% of the Pathology domain
    • Disorders of the Musculoskeletal System - 16% of the Pathology domain
    • Disorders of the Musculoskeletal System: Bone
    • Disorders of the Musculoskeletal System: Joint
    • Disorders of the Musculoskeletal System: Muscle
    • Disorders of the Nervous System - 16% of the Pathology domain
    • Disorders of the Nervous System: Central nervous system
    • Disorders of the Nervous System: Peripheral nervous system
    • Diseases of the Organ Systems - 16% of the Pathology domain
    • Diseases of the Organ Systems: Cardiovascular
    • Diseases of the Organ Systems: Gastrointestinal
    • Diseases of the Organ Systems: Respiratory
    • Diseases of the Organ Systems: Genitourinary
    • Diseases of the Organ Systems: Endocrine
    • Diseases of the Organ Systems: Blood and lymphatics
  • Microbiology (11%)
    • Immunology - 18% of the Microbiology domain
    • Immunology: Cells of the immune system
    • Immunology: Antigens, antibodies and complement
    • Immunology: Hypersensitivities and immunopathologies
    • Immunology: Immunization/vaccination
    • Immunology: Assessment of immune responses/serology
    • Bacteria - 18% of the Microbiology domain
    • Bacteria: Structure and biochemical characteristics
    • Bacteria: Resistance, genetics, antigenicity, and pathogenicity
    • Bacteria: Communicable and infectious diseases
    • Bacteria: Reservoirs of infection and modes of transmission
    • Viruses and Prions - 18% of the Microbiology domain
    • Viruses and Prions: Structure and biochemical characteristics
    • Viruses and Prions: Resistance, genetics, antigenicity, and pathogenicity
    • Viruses and Prions: Communicable and infectious diseases
    • Viruses and Prions: Reservoirs of infection and modes of transmission
    • Fungi - 15% of the Microbiology domain
    • Fungi: Structure and biochemical characteristics
    • Fungi: Resistance, genetics, antigenicity, and pathogenicity
    • Fungi: Communicable and infectious diseases
    • Fungi: Reservoirs of infection and modes of transmission
    • Parasites - 15% of the Microbiology domain
    • Parasites: Structure and biochemical characteristics
    • Parasites: Resistance, genetics, antigenicity, and pathogenicity
    • Parasites: Communicable and infectious diseases
    • Parasites: Reservoirs of infection and modes of transmission
    • Epidemiology and Disease Control - 16% of the Microbiology domain
    • Epidemiology and Disease Control: Health agencies and reporting/monitoring
    • Epidemiology and Disease Control: Prevention, identification and control methods for communicable diseases
    • Epidemiology and Disease Control: Population health assessments
    • Epidemiology and Disease Control: Emerging diseases
Examination sources

NBCE Part II

Provider
Prometric
Format
Computer-based examination; items are presented grouped by domain with one timer for all six domains, an optional break halfway through, and forward-only navigation. The NBCE grades across all six domains and reports one Part II score; individual domains are not scored.
Exam questions
255 items
Passing score
375
Examination outline
  • General Diagnosis (19%)
    • Case History - 12% of the General Diagnosis domain
    • Vital Signs - 6% of the General Diagnosis domain
    • Head and Neck Examination/Findings - 9% of the General Diagnosis domain
    • Head and Neck Examination/Findings: Eye
    • Head and Neck Examination/Findings: Ear
    • Head and Neck Examination/Findings: Nose and sinuses
    • Head and Neck Examination/Findings: Mouth and throat
    • Head and Neck Examination/Findings: Neck
    • Thorax Examination/Findings (including heart and lungs) - 8% of the General Diagnosis domain
    • Thorax Examination/Findings (including heart and lungs): Inspection
    • Thorax Examination/Findings (including heart and lungs): Auscultation
    • Thorax Examination/Findings (including heart and lungs): Percussion
    • Thorax Examination/Findings (including heart and lungs): Palpation
    • Abdominal Examination/Findings - 8% of the General Diagnosis domain
    • Abdominal Examination/Findings: Inspection
    • Abdominal Examination/Findings: Auscultation
    • Abdominal Examination/Findings: Percussion
    • Abdominal Examination/Findings: Palpation
    • Rectal and Male Urogenital Examination/Findings - 6% of the General Diagnosis domain
    • Diagnosis or Clinical Impression - 40% of the General Diagnosis domain
    • Diagnosis or Clinical Impression: Eyes, ears, nose and throat
    • Diagnosis or Clinical Impression: Respiratory diseases
    • Diagnosis or Clinical Impression: Cardiovascular diseases
    • Diagnosis or Clinical Impression: Blood and lymphatic diseases
    • Diagnosis or Clinical Impression: Gastrointestinal diseases
    • Diagnosis or Clinical Impression: Genitourinary diseases
    • Diagnosis or Clinical Impression: Endocrine and metabolic disorders
    • Diagnosis or Clinical Impression: Immunological disorders
    • Diagnosis or Clinical Impression: Nutritional disorders
    • Diagnosis or Clinical Impression: Infectious diseases
    • Laboratory Interpretation - 11% of the General Diagnosis domain
    • Laboratory Interpretation: Urinalysis
    • Laboratory Interpretation: Hematology
    • Laboratory Interpretation: Chemistry/serology
    • Laboratory Interpretation: Special studies
  • Neuromusculoskeletal Diagnosis (20%)
    • Case History - 18% of the Neuromusculoskeletal Diagnosis domain
    • Posture and Gait Assessment - 10% of the Neuromusculoskeletal Diagnosis domain
    • Orthopedic Examination - 21% of the Neuromusculoskeletal Diagnosis domain
    • Orthopedic Examination: Cervical spine
    • Orthopedic Examination: Thoracic spine
    • Orthopedic Examination: Lumbar spine and pelvis
    • Orthopedic Examination: Extremities
    • Neurologic Examination - 21% of the Neuromusculoskeletal Diagnosis domain
    • Neurologic Examination: Cranial nerve/CNS testing
    • Neurologic Examination: Motor testing
    • Neurologic Examination: Sensory testing
    • Neurologic Examination: Reflex testing
    • Neurologic Examination: Reflex testing: Superficial reflexes
    • Neurologic Examination: Reflex testing: Deep tendon reflexes
    • Neurologic Examination: Reflex testing: Pathological reflexes
    • Diagnosis or Clinical Impression - 30% of the Neuromusculoskeletal Diagnosis domain
    • Diagnosis or Clinical Impression: CNS disorders
    • Diagnosis or Clinical Impression: Peripheral neurologic/neurovascular disorders
    • Diagnosis or Clinical Impression: Muscular disorders
    • Diagnosis or Clinical Impression: Bone and joint disorders
  • Diagnostic Imaging (17%)
    • Imaging Technology - 5% of the Diagnostic Imaging domain
    • Imaging Technology: Physics and principles
    • Imaging Technology: Quality assurance
    • Imaging Technology: Radiographic imaging
    • Imaging Technology: Radiologic protection
    • Radiographic Positioning and Normal Anatomy - 20% of the Diagnostic Imaging domain
    • Radiographic Positioning and Normal Anatomy: Spine and pelvis
    • Radiographic Positioning and Normal Anatomy: Extremities
    • Radiographic Positioning and Normal Anatomy: Thorax and abdomen
    • Imaging Diagnosis or Clinical Impression - 50% of the Diagnostic Imaging domain
    • Imaging Diagnosis or Clinical Impression: Congenital anomalies and normal variants
    • Imaging Diagnosis or Clinical Impression: Trauma
    • Imaging Diagnosis or Clinical Impression: Arthritides
    • Imaging Diagnosis or Clinical Impression: Tumors/tumor-like processes
    • Imaging Diagnosis or Clinical Impression: Nutritional, metabolic and endocrine conditions
    • Imaging Diagnosis or Clinical Impression: Hematologic conditions
    • Imaging Diagnosis or Clinical Impression: Infectious conditions
    • Imaging Diagnosis or Clinical Impression: Miscellaneous skeletal conditions
    • Imaging Diagnosis or Clinical Impression: Thoracic and abdominal conditions
    • Methods of Interpretation - 10% of the Diagnostic Imaging domain
    • Methods of Interpretation: Biomechanical analysis/mensuration procedures
    • Methods of Interpretation: Imaging evaluation (including common misinterpretations)
    • Clinical Applications of Special Imaging - 15% of the Diagnostic Imaging domain
    • Clinical Applications of Special Imaging: MRI
    • Clinical Applications of Special Imaging: CT
    • Clinical Applications of Special Imaging: Miscellaneous
  • Principles of Chiropractic (14%)
    • The Chiropractic Paradigm - 23% of the Principles of Chiropractic domain
    • The Chiropractic Paradigm: Core concepts
    • The Chiropractic Paradigm: Research principles and methods
    • Concepts of Subluxation and Spinal Lesions - 26% of the Principles of Chiropractic domain
    • Concepts of Subluxation and Spinal Lesions: Dysafferentation (proprioceptive insult)/somatosomatic reflex models
    • Concepts of Subluxation and Spinal Lesions: Neural compression/traction models
    • Concepts of Subluxation and Spinal Lesions: Visceral reflex models
    • Concepts of Subluxation and Spinal Lesions: Vascular insufficiency models
    • Concepts of Subluxation and Spinal Lesions: Axonal aberration/trophic models
    • Concepts of Subluxation and Spinal Lesions: Neuroimmunomodulation models
    • Concepts of Subluxation and Spinal Lesions: Biomechanical models
    • Concepts of Subluxation and Spinal Lesions: Other
    • Basic Science Concepts in Chiropractic - 25% of the Principles of Chiropractic domain
    • Basic Science Concepts in Chiropractic: Anatomical
    • Basic Science Concepts in Chiropractic: Pathophysiological
    • Basic Science Concepts in Chiropractic: Biomechanical
    • Applied Chiropractic Principles - 26% of the Principles of Chiropractic domain
    • Applied Chiropractic Principles: Subluxation etiologies
    • Applied Chiropractic Principles: General effects of adjustment and manipulation
    • Applied Chiropractic Principles: Wellness
  • Chiropractic Practice (17%)
    • Spinal Analysis and Patient Evaluation - 25% of the Chiropractic Practice domain
    • Spinal Analysis and Patient Evaluation: Case history and observation findings
    • Spinal Analysis and Patient Evaluation: Manual examination of the spine and extremities
    • Spinal Analysis and Patient Evaluation: Diagnostic procedures
    • Chiropractic Adjustive Technique - 26% of the Chiropractic Practice domain
    • Chiropractic Adjustive Technique: Cervical techniques
    • Chiropractic Adjustive Technique: Thoracic techniques
    • Chiropractic Adjustive Technique: Lumbar techniques
    • Chiropractic Adjustive Technique: Pelvic techniques
    • Chiropractic Adjustive Technique: Costal and extremity techniques
    • Patient Care - 27% of the Chiropractic Practice domain
    • Patient Care: Case management
    • Patient Care: Contraindications for treatment
    • Patient Care: Home care, prevention and rehabilitation
    • Community Health and Wellness - 12% of the Chiropractic Practice domain
    • Community Health and Wellness: Public health organizations
    • Community Health and Wellness: Healthy People initiatives
    • Community Health and Wellness: Screening activities for health promotion
    • Community Health and Wellness: Tobacco, alcohol, and substance abuse
    • Community Health and Wellness: Exercise and healthy diet for obesity
    • Community Health and Wellness: Behavior theories and lifestyle change
    • Community Health and Wellness: Wellness counseling
    • Occupational and Environmental Health - 10% of the Chiropractic Practice domain
    • Occupational and Environmental Health: Work-based health risks
    • Occupational and Environmental Health: Worker protection and ergonomics
    • Occupational and Environmental Health: Injury and violence
    • Occupational and Environmental Health: Impact of environment on human health
    • Occupational and Environmental Health: Pollution and wastes
  • Associated Clinical Sciences (13%)
    • Geriatrics - 15% of the Associated Clinical Sciences domain
    • Geriatrics: Anatomic and physiologic process of aging
    • Geriatrics: Geriatric disorders and case management
    • Dermatology - 11% of the Associated Clinical Sciences domain
    • Dermatology: Types of skin lesions
    • Dermatology: Microbial infections
    • Dermatology: Tumors
    • Dermatology: Dermatitis
    • Dermatology: Scaling diseases
    • Dermatology: Vesicular and bullous diseases
    • Dermatology: Pigmentary disorders
    • Dermatology: Inflammatory reactions
    • Dermatology: Disorders of hair follicles and sebaceous glands
    • Sexually Transmitted Diseases - 8% of the Associated Clinical Sciences domain
    • Sexually Transmitted Diseases: Gonorrhea
    • Sexually Transmitted Diseases: Syphilis
    • Sexually Transmitted Diseases: AIDS
    • Sexually Transmitted Diseases: Chlamydia
    • Sexually Transmitted Diseases: Herpes
    • Sexually Transmitted Diseases: Other
    • Toxicology - 10% of the Associated Clinical Sciences domain
    • Toxicology: Pharmacology
    • Toxicology: Poisoning
    • Toxicology: Environmental and occupational toxicology
    • Emergency Procedures - 13% of the Associated Clinical Sciences domain
    • Emergency Procedures: Cardiopulmonary arrest
    • Emergency Procedures: Poisoning
    • Emergency Procedures: Thermal injuries
    • Emergency Procedures: Shock
    • Emergency Procedures: Head and spinal injuries
    • Emergency Procedures: Choking
    • Emergency Procedures: Fractures, dislocations, strains and sprains
    • Emergency Procedures: Other
    • Psychology - 11% of the Associated Clinical Sciences domain
    • Psychology: Theories and general concepts
    • Psychology: Mental and emotional disorders
    • Psychology: Assessment methods and case management
    • Gynecology and Obstetrics - 11% of the Associated Clinical Sciences domain
    • Gynecology and Obstetrics: Gynecological examination
    • Gynecology and Obstetrics: Breast examination and disorders
    • Gynecology and Obstetrics: Gynecological disease and abnormalities
    • Gynecology and Obstetrics: Pregnancy
    • Gynecology and Obstetrics: Labor and delivery
    • Gynecology and Obstetrics: Postpartum
    • Gynecology and Obstetrics: Obstetric disorders
    • Pediatrics - 14% of the Associated Clinical Sciences domain
    • Pediatrics: Care of newborn
    • Pediatrics: Growth and development
    • Pediatrics: Congenital disorders
    • Pediatrics: Childhood infectious diseases
    • Pediatrics: Pathological conditions and childhood injuries
    • Pediatrics: Emotional disorders and learning disabilities
    • Pediatrics: Nutritional problems
    • Jurisprudence, Ethics and Basic Economics - 7% of the Associated Clinical Sciences domain
Examination sources

Part III

Provider
National Board of Chiropractic Examiners; computer-based testing at chiropractic colleges and Prometric testing centers
Format
Computer-based examination with three item types that equally contribute to the total exam score: traditional multiple-choice (TMCQ, 1 response), extended multiple-choice cases (EMCQ, case presentation followed by a question requiring 2 responses) and diagnostic imaging interpretation (DXI, imaging set followed by a question requiring 1 response). Applications coded V2PT3 take this version with DXI; applications coded PT3 take the version without DXI, whose published test plan covers the same nine clinical categories without the DXI portion (category weightings on that plan: Case History 11%, Physical Examination 9%, Neuromusculoskeletal Examination 11%, Diagnostic Imaging 11%, Clinical Laboratory and Special Studies 7%, Diagnosis or Clinical Impression 14%, Chiropractic Techniques 14%, Supportive Interventions 8%, Case Management 15%). The NBCE states that almost every examinee takes the version with DXI.
Exam questions
80 traditional multiple-choice questions, 20 extended multiple-choice case presentations and 30 diagnostic imaging interpretation sets
Time limit
4 hours testing time; 4 hours 31 minutes appointment including tutorial, end-of-exam survey and optional 15-minute break
Passing score
375
Exam fee
$710
Examination outline
  • Traditional multiple-choice (TMCQ) and extended multiple-choice cases (EMCQ): nine categories of clinical competency (80%)
    • Case History - 11% of the TMCQ/EMCQ content
    • Case History: Chief complaint
    • Case History: Present illness
    • Case History: Past history
    • Case History: Family history
    • Case History: Personal and social history
    • Case History: Review of systems
    • Physical Examination - 8% of the TMCQ/EMCQ content
    • Physical Examination: General survey
    • Physical Examination: Head and neck examination
    • Physical Examination: Thorax and lung examination
    • Physical Examination: Cardiovascular examination
    • Physical Examination: Breast and axilla examination
    • Physical Examination: Abdominal examination
    • Physical Examination: Urogenital examination
    • Physical Examination: Rectal examination
    • Neuromusculoskeletal Examination - 12% of the TMCQ/EMCQ content
    • Neuromusculoskeletal Examination: Posture and gait analysis
    • Neuromusculoskeletal Examination: Standard spinal and extremity orthopedic procedures
    • Neuromusculoskeletal Examination: Standard neurological testing procedures
    • Neuromusculoskeletal Examination: Peripheral vascular examination procedures
    • Diagnostic Imaging - 11% of the TMCQ/EMCQ content
    • Diagnostic Imaging: Indications and contraindications for diagnostic imaging procedures
    • Diagnostic Imaging: Patient protection and positioning
    • Diagnostic Imaging: Normal anatomy
    • Diagnostic Imaging: Description and interpretation of images
    • Clinical Laboratory and Special Studies - 7% of the TMCQ/EMCQ content
    • Clinical Laboratory and Special Studies: Urinalysis
    • Clinical Laboratory and Special Studies: Hematology
    • Clinical Laboratory and Special Studies: Serology
    • Clinical Laboratory and Special Studies: Blood chemistries
    • Clinical Laboratory and Special Studies: Stool analysis
    • Clinical Laboratory and Special Studies: Joint fluid analysis
    • Clinical Laboratory and Special Studies: Electrophysiologic recordings (EEG, ECG, EMG, and NCV)
    • Diagnosis or Clinical Impression - 16% of the TMCQ/EMCQ content
    • Diagnosis or Clinical Impression: Patient history
    • Diagnosis or Clinical Impression: Physical and neuromusculoskeletal examinations
    • Diagnosis or Clinical Impression: Diagnostic imaging
    • Diagnosis or Clinical Impression: Clinical laboratory and special studies
    • Chiropractic Techniques - 11% of the TMCQ/EMCQ content
    • Chiropractic Techniques: Indications and contraindications for chiropractic care
    • Chiropractic Techniques: Spinal adjustive techniques
    • Chiropractic Techniques: Extremity adjustive techniques
    • Chiropractic Techniques: Skeletal biomechanics
    • Supportive Interventions - 9% of the TMCQ/EMCQ content
    • Supportive Interventions: Physiotherapy modalities
    • Supportive Interventions: Nutrition and diet
    • Supportive Interventions: Corrective exercises and rehabilitation
    • Supportive Interventions: Protective body mechanics and ergonomics
    • Supportive Interventions: Patient education and self-care
    • Supportive Interventions: Wellness and lifestyle counseling
    • Case Management - 15% of the TMCQ/EMCQ content
    • Case Management: Formulation of a treatment plan and prognosis
    • Case Management: Appropriate procedures for case follow-up and review
    • Case Management: Patient referral and/or co-management
    • Case Management: Clinical documentation and informed consent
  • Diagnostic Imaging Interpretation (DXI): six categories (20%)
    • DXI - Arthritic Disorders - 30% of the DXI content
    • DXI - Arthritic Disorders: Degenerative
    • DXI - Arthritic Disorders: Inflammatory
    • DXI - Arthritic Disorders: Metabolic/Crystalline
    • DXI - Congenital Anomalies and Skeletal Variants - 15% of the DXI content
    • DXI - Congenital Anomalies and Skeletal Variants: Spinal
    • DXI - Congenital Anomalies and Skeletal Variants: Extraspinal
    • DXI - Congenital Anomalies and Skeletal Variants: Scoliosis
    • DXI - Trauma - 10% of the DXI content
    • DXI - Trauma: Skeletal
    • DXI - Trauma: Soft tissue
    • DXI - Tumors and Tumor-like Processes - 20% of the DXI content
    • DXI - Tumors and Tumor-like Processes: Benign
    • DXI - Tumors and Tumor-like Processes: Primary malignant
    • DXI - Tumors and Tumor-like Processes: Metastatic
    • DXI - Tumors and Tumor-like Processes: Tumor-like
    • DXI - Miscellaneous Osteoarticular - 15% of the DXI content
    • DXI - Miscellaneous Osteoarticular: Hematological/Vascular
    • DXI - Miscellaneous Osteoarticular: Infections
    • DXI - Miscellaneous Osteoarticular: Nutritional/Metabolic
    • DXI - Miscellaneous Osteoarticular: Endocrine
    • DXI - Soft Tissue - 10% of the DXI content
    • DXI - Soft Tissue: Chest
    • DXI - Soft Tissue: Abdomen
    • DXI - Soft Tissue: Miscellaneous
Examination sources

Part IV

This assessment does not have a question bank.

Provider
NBCE Assessment Center, Greeley, Colorado
Format
Eight stations with simulated patients: seven case management encounters followed by a written SOAP note, graded on Patient Evaluations, Patient Examination, Clinical Decision Making & Case Management, Interpersonal & Communication Skills and Documentation, with content areas Musculoskeletal System, Neurological Conditions, Cardiovascular/Pulmonary Conditions, Gastrointestinal Conditions, Endocrine Conditions, Renal/Urological Conditions and Malignant Conditions; and one technique station with ten chiropractic adjustments (doctor position, patient position, line of drive) covering cervical, thoracic, lumbar, pelvic/sacral and extremity adjusting. Encounters are video-recorded for scoring. Offered Friday through Sunday, 48 weeks a year; after May 17, 2026 only at the NBCE Assessment Center.
Examination sources

Physiotherapy

Provider
National Board of Chiropractic Examiners; computer-based testing at chiropractic colleges and Prometric testing centers
Format
Elective, computer-based multiple-choice examination; may be taken individually or in conjunction with other NBCE examinations; candidates must have completed 120 hours of instruction in physiotherapy
Exam questions
90 standard multiple-choice questions
Time limit
75 minutes testing time; 90-minute testing appointment
Passing score
NBCE-recommended passing score of 375; individual states may require a higher passing score
Exam fee
$450
Examination outline
  • Thermotherapy (10%)
    • Thermotherapy: Hot moist packs
    • Thermotherapy: Ultrasound
    • Thermotherapy: Cryotherapy
  • Electrotherapy (10%)
    • Electrotherapy: Interferential current
    • Electrotherapy: High voltage therapy
    • Electrotherapy: Electrical muscle stimulation
    • Electrotherapy: TENS
    • Electrotherapy: Microcurrent
  • Mechanotherapy (10%)
    • Mechanotherapy: Cervical/lumbar traction
    • Mechanotherapy: Massage, vibration and trigger point therapy
    • Mechanotherapy: Bracing/orthotics
    • Mechanotherapy: Taping
  • Phototherapy (7%)
    • Phototherapy: Low Level Laser
    • Phototherapy: Ultraviolet
  • Functional Assessment (11%)
    • Functional Assessment: Gait
    • Functional Assessment: Movement patterns
    • Functional Assessment: Muscle imbalances
  • Exercise Physiology (8%)
    • Exercise Physiology: Neurobiology of training and conditioning
    • Exercise Physiology: Biochemistry of training and conditioning
  • Endurance Training (8%)
    • Endurance Training: Aerobic capacity and adaption
    • Endurance Training: Cardiovascular rehabilitation
  • Muscle Rehabilitation (11%)
    • Muscle Rehabilitation: Stretching
    • Muscle Rehabilitation: Strengthening
  • Neuromuscular Rehabilitation (11%)
    • Neuromuscular Rehabilitation: Balance and alignment
    • Neuromuscular Rehabilitation: Coordinated movement patterns
    • Neuromuscular Rehabilitation: Core/spine stabilization
  • Disorder-specific Rehabilitation (14%)
    • Disorder-specific Rehabilitation: Spine and pelvis
    • Disorder-specific Rehabilitation: Upper extremities
    • Disorder-specific Rehabilitation: Lower extremities
Examination sources

Special Purposes Examination for Chiropractic

Provider
National Board of Chiropractic Examiners; administered at Prometric Testing Centers throughout North America
Format
Post-licensure multiple-choice examination in two parts, 100 traditional multiple-choice questions (TMCQ) and 40 extended multiple-choice cases (EMCQ), addressing the general clinical knowledge and understanding required for chiropractic practice; offered six times per year; both sessions must be completed to receive a score. Candidates must hold or have held a chiropractic license and need authorization from a state board or international licensing agency.
Exam questions
100 traditional multiple-choice questions and 40 extended multiple-choice cases
Time limit
Approximately three hours, in two equal sessions of 90 minutes each
Passing score
NBCE-recommended passing score of 375; use of SPEC scores is at the discretion of individual state licensing boards
Exam fee
$1,500 exam fee/retake fee
Examination outline
  • Case History (11%)
    • Case History: Chief complaint
    • Case History: Present illness
    • Case History: Past history
    • Case History: Family history
    • Case History: Personal and social history
    • Case History: Review of systems
  • Physical Examination (8%)
    • Physical Examination: General survey
    • Physical Examination: Head and neck examination
    • Physical Examination: Thorax and lung examination
    • Physical Examination: Cardiovascular examination
    • Physical Examination: Breast and axilla examination
    • Physical Examination: Abdominal examination
    • Physical Examination: Urogenital examination
    • Physical Examination: Rectal examination
  • Neuromusculoskeletal Examination (12%)
    • Neuromusculoskeletal Examination: Posture and gait analysis
    • Neuromusculoskeletal Examination: Standard spinal and extremity orthopedic procedures
    • Neuromusculoskeletal Examination: Standard neurological testing procedures
    • Neuromusculoskeletal Examination: Peripheral vascular examination procedures
  • Diagnostic Imaging (12%)
    • Diagnostic Imaging: Indications and contraindications for diagnostic imaging procedures
    • Diagnostic Imaging: Patient protection and positioning
    • Diagnostic Imaging: Normal anatomy
    • Diagnostic Imaging: Description and interpretation of images
  • Clinical Laboratory and Special Studies (6%)
    • Clinical Laboratory and Special Studies: Urinalysis
    • Clinical Laboratory and Special Studies: Hematology
    • Clinical Laboratory and Special Studies: Serology
    • Clinical Laboratory and Special Studies: Blood chemistries
    • Clinical Laboratory and Special Studies: Stool analysis
    • Clinical Laboratory and Special Studies: Joint fluid analysis
    • Clinical Laboratory and Special Studies: Electrophysiologic recordings (EEG, ECG, EMG, and NCV)
  • Diagnosis or Clinical Impression (17%)
    • Diagnosis or Clinical Impression: Patient history
    • Diagnosis or Clinical Impression: Physical and neuromusculoskeletal examinations
    • Diagnosis or Clinical Impression: Diagnostic imaging
    • Diagnosis or Clinical Impression: Clinical laboratory and special studies
  • Chiropractic Techniques (9%)
    • Chiropractic Techniques: Indications and contraindications for chiropractic care
    • Chiropractic Techniques: Spinal adjustive techniques
    • Chiropractic Techniques: Extremity adjustive techniques
    • Chiropractic Techniques: Skeletal biomechanics
  • Supportive Interventions (10%)
    • Supportive Interventions: Physiotherapy modalities
    • Supportive Interventions: Nutrition and diet
    • Supportive Interventions: Corrective exercises and rehabilitation
    • Supportive Interventions: Protective body mechanics and ergonomics
    • Supportive Interventions: Patient education and self-care
    • Supportive Interventions: Wellness and lifestyle counseling
  • Case Management (15%)
    • Case Management: Formulation of a treatment plan and prognosis
    • Case Management: Appropriate procedures for case follow-up and review
    • Case Management: Patient referral and/or co-management
    • Case Management: Clinical documentation and informed consent
Examination sources