FREQUENTLY ASKED QUESTIONS

NBCE Part IV Examination

What is the Part IV Examination?

Part IV is a practical examination developed by the NBCE, the results of which state licensing authorities may use for licensure purposes. The Part IV test plan consists of three major areas including Diagnostic Imaging, Chiropractic Technique, and Case Management. Like all NBCE examinations, Part IV adheres to accepted testing and measurement industry guidelines. To learn more about the Part IV Examination, read the NBCE Examinee Information brochure.

Why was Part IV produced by the NBCE?

Part IV resulted from a request by the Federation of Chiropractic Licensing Boards (FCLB) to develop a national standardized practical examination for chiropractic licensure.

How do I apply for Part IV?

Applicants may apply for Part IV online through the NBCE website at www.nbce.org. Applications are also available at college registrars' offices. Complete and submit the application, along with required fees and any documentation, to the NBCE by the published postmark deadline.

How do potential examinees know if the state in which they plan to practice accepts or requires Part IV?

For the most current information on state regulations pertaining to Part IV, potential examinees should contact the licensing board of the state in which they intend to practice. Links to licensing agencies are available from this website.

Who is eligible to take Part IV?

1. Students enrolled in chiropractic colleges whose students are eligible to take the NBCE examinations may apply for the Part IV Examination if they have passed all of the NBCE Part I Examination by the Part IV application deadline and are within six months of graduation at the time of the Part IV Examination administration. Student applicants must obtain signatures of approval from their authorized college representative. The NBCE will not issue official transcripts to students until they have successfully completed Parts I, II, III and IV.
2. Chiropractic college graduates taking Part IV for the first time must have completed all of the NBCE Part I Examination. Graduates may establish their eligibility by submitting a copy of their doctor of chiropractic degree or by obtaining approval signatures from their authorized college representatives.
3. A doctor of chiropractic who has passed all of the NBCE Part I Examination is eligible to take the Part IV Examination. A doctor of chiropractic who has not passed Part I, and who holds a valid license to practice chiropractic issued on or before December 31, 1997, is eligible to take Part IV upon submission of a properly completed application, and a letter bearing the state seal from an authorized representative of a state board that has licensed the applicant. The letter must verify that the applicant is licensed by that agency, that the applicant’s license is not currently under suspension, and that there is no known disciplinary action in effect or pending. The letter should also reference that it is being completed as a Part IV requirement. Examinees should enclose the letter with their applications.

What portion of the Part IV examination is based on radiographs and other special imaging?

The Diagnostic Imaging portion of the examination uses plain-film radiolgraphs and special imaging, such as MRI and CT scans. There are also 10 stations in the Case Management section that include x-rays. Overall, approximately one-third of the Part IV examination relies on imaging.

Where does the NBCE obtain the radiographs and special imaging for the examination?

The NBCE obtains most of its radiographs and special imaging from chiropractic college clinics or private chiropractic radiology clinics. Once a year, the National Board convenes Part IV test committee meetings whose members include state board examiners and chiropractic consultants. Item writers also bring radiographs that are used in developing new questions.

How is the Part IV examination scored?

During the Diagnostic Imaging portion of the Part IV examination, examinees use scannable answer sheets to record answers relevant to the data provided. During the Chiropractic Technique portion of the examination, examinees must demonstrate particular adjustment set-ups consistent with written instructions. During the Case Management portion, trained "patients" simulate conditions commonly encountered in chiropractic practice. Examinees must demonstrate procedures in accordance with particular symptoms or specific conditions described. Trained examiners (licensed chiropractors) assess the practical portions of the examination.

Why does it take seven weeks to receive my scores in the mail?

Before scores are released, the NBCE carefully analyzes the statistical performance of every question and reviews examinees' written concerns about test questions. Test questions are carefully reconsidered by a review panel and final scores are determined. To be sure all exams are scored accurately, the NBCE conducts thorough manual checking of answer sheets with additional reviews of answer sheets of those who scored below passing. Only after all of these reviews are complete are score letters mailed to examinees. An unofficial score report is available online approximately six weeks are the examination. Scores are mailed to state boards approximately eight weeks are the examination.

If I pass the Part IV Examination, am I automatically licensed?

No! The NBCE is not a licensing authority. Examination applicants are responsible for contacting licensing authorities of states in which they are interested in practicing. Some state licensing authorities may have additional requirements for licensure, and examinees are advised to contact any state(s) of interest for specific requirements.

Why does the Part IV Examination cost more than other NBCE examinations?

Part IV is a labor intensive examination. It takes approximately 1,200 support personnel to administer the examination, a ratio of about two support personnel to every three examinees. Throughout the year the NBCE must coordinate the activities of key personnel, train auxiliary staff, and manage the roles and responsibilities of those involved at each test site in order to have a successful administration of the Part IV Examination.

What does a score of 375 mean?

An NBCE score of 375 means that an individual has passed the overall examination at 75%.

What are the benefits of Part IV?

Today, passage of Part IV enables an individual to become eligible for licensure in a majority of states without taking another practical examination. The number of states that accept or require results of the Part IV examination continues to increase. Examinees may take Part IV on many chiropractic college campuses within six months prior to graduation. An additional benefit is that a doctor of chiropractic does not have to maintain multiple state licenses. The Part IV examination meets requirements of nationally standardized examinations.

How do I request a transcript, and how much does it cost?

To request a transcript, complete the transcript request form in the NBCE Examinee Information brochure for Part IV or download the form from this website. Mail it along with any applicable fees to NBCE. The first transcript is free; each additional transcript is $25 per state. Allow at least two weeks processing time for transcript requests.