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West Virginia Chiropractor — Requirements & Free Practice

US-WV · 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

Licensing authority: West Virginia Board of Chiropractic · Application information

Licensure by endorsement
Board discretion
Issuance is at the Board’s discretion.
Oral scope
Endorsement oral examination covers jurisprudence and clinical competency.
Other state exam
Passed a chiropractic licensing examination given in English in the other jurisdiction that the Board finds equivalent.
Prior license
Current valid chiropractic license in another United States jurisdiction with no past or current discipline.
Initial licensure for foreign chiropractic graduates
Foreign degree
Foreign chiropractic degree or Board approved equivalent and eligibility for unrestricted licensure in country of training.
Immigration
Satisfy applicable United States immigration requirements.
Language
Demonstrated command of English and notarized translations of foreign language documents.
Spec trigger
SPEC applies only after a second unsuccessful oral attempt.
Initial licensure by examination
Board discretion
Board may require another examination, test or procedure under §30-16-6(b)(6).
Education
Accredited chiropractic degree and required prior college study under §30-16-6(b).
Oral score
The oral examination requires an average grade of 70 percent.
Spec trigger
SPEC is required before another oral attempt only after a second unsuccessful oral attempt under §30-16-7(b).
Licensure from reciprocal jurisdiction
West Virginia Board Oral Examination Covering Jurisprudence
Interview
Board application page additionally requires an interview with Board members.
Prior license
License to practice chiropractic in a United States jurisdiction with equivalent requirements and reciprocal privileges for West Virginia chiropractors.
Written waiver
Board may license without a written examination at its discretion.
Licensure after lapse exceeding two years
Other requirements
Must newly satisfy all other §30-16-6 licensure requirements after lapse.
Prior status
Former certificate holder whose license lapsed more than two years.
Reinstatement after failure to renew within two years
No examination is required for this applicant pathway.
Continuing education
Complete required continuing education for every suspended year.
Fees
Pay missed renewal and reinstatement fees.

Official no-examination sources

Effective from 2026-09-22.

Annual license renewal
No examination is required for this applicant pathway.
Continuing education
At least 18 hours annually; Board may mandate up to six hours in special subjects.
Renewal deadline
Renew annually on or before July 1 with form and fee.

Official no-examination sources

Effective from 2026-09-22.

Universal licensure for qualified out of state licensees
West Virginia Board Oral Examination Covering Jurisprudence
Prior exams
Previously passed examinations required by the other licensing state; those scores are prior evidence.
Prior license
Current same discipline and practice level license in another state, with good standing and other §30-1-27(b) conditions.
Residency
Applicant establishes West Virginia residence or is the spouse of an active duty service member transferred to a West Virginia installation.
State law exam discretion
§30-1-27(d) permits the Board to require its examination specific to West Virginia law; the Board page does not say whether it exercises this option for this pathway.

Conditional or Restricted Chiropractic License

Licensing authority: West Virginia Board of Chiropractic · Application information

Conditional or restricted license
Limits
Board determines the conditions, practice restrictions and limited time period case by case.

Temporary Chiropractic License

Licensing authority: West Virginia Board of Chiropractic · Application information

Temporary license for visiting physicians and professors
Board discretion
Board decides whether applicant is demonstrably qualified for a full unrestricted license.
Event purpose
Treatment of individuals involved with special events as a visiting chiropractic physician or visiting professor.
Jurisprudence timing
Board offers temporary licensure with intent to sit for the jurisprudence examination later; application packet is due six weeks before it.
Prior license
Current valid out of state chiropractic license without past or current disciplinary action.

Special Volunteer Chiropractor License

Licensing authority: West Virginia Board of Chiropractic · Application information

Special volunteer license for otherwise eligible applicants
Eligibility
Retired or retiring chiropractor otherwise eligible for licensure under Article 16.
Practice limit
Uncompensated care for needy or indigent persons in qualifying clinics only.
Special volunteer license for already licensed retired chiropractors
No examination is required for this applicant pathway.
Eligibility
Retired or retiring chiropractor already licensed to practice; practice limited to uncompensated care for needy or indigent persons in qualifying clinics.
Renewal
Continuing education and renewal as specified in §30-16-7a.

Official no-examination sources

Effective from 2026-09-22.

NBCE 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

NBCE Part III Exam

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

NBCE Part IV Exam

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

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

West Virginia Board Oral Examination Covering Jurisprudence

Practice scope

Inferred from the examination name; the authority has not published an examination outline.

  • West Virginia Chiropractic Practice Act
  • Universal Professional and Occupational Licensing Act of 2025
  • Regulation of Chiropractic Practice
  • Procedures of the West Virginia Board of Chiropractic Examiners
  • Contested Case Hearing Procedure
  • Formation and Approval of Professional Limited Liability Companies
  • Disciplinary and Complaint Procedures for Chiropractors
  • Prior Criminal Convictions in Initial Licensure Determinations
  • Chiropractic Telehealth Practice
Examination sources