National Board of Chiropractic Examiners is an independent, nonprofit organization that develops and administers standardized exams to assess the knowledge and skills of chiropractic students and graduates. These exams help ensure chiropractors meet national competency standards before obtaining licensure to practice in the United States.
Category
Licensing examination organization
Used for
Chiropractic licensure and competency assessment
Common confusion
Often mistaken for a state licensing board or chiropractic school
Also called
NBCE
Often discussed with
Work Injury Treatment, Personal Injury Chiropractic Care

The National Board of Chiropractic Examiners (NBCE) is an independent organization responsible for creating and administering standardized exams that evaluate the competency of chiropractic students and graduates. These exams are designed to ensure that chiropractors possess the necessary knowledge and skills to provide safe and effective care to patients. The NBCE operates separately from chiropractic schools and state licensing boards, providing an objective measure of a candidate's readiness to practice.
Related glossary terms: Chiropractic License, Chiropractic School, Doctor of Chiropractic.
The NBCE was established in 1963 to address the need for consistent standards across the chiropractic profession. Before its creation, each state had its own licensing exams, which led to variations in requirements and difficulty. The NBCE exams help create a uniform benchmark, making it easier for chiropractors to obtain licensure in multiple states. Today, most states in the U.S. Require passage of NBCE exams as part of the licensure process.
The NBCE develops and administers several exams that cover different aspects of chiropractic education and practice. The most well-known are the Parts I, II, III. And IV exams, which assess knowledge in basic sciences, clinical sciences, patient care. And hands-on chiropractic techniques. Each exam is carefully designed by subject-matter experts, including chiropractors, educators. And scientists, to ensure relevance and accuracy.
Many projects start with Parts I and II focus on written exams that test foundational knowledge in areas like anatomy, physiology, diagnosis. And chiropractic principles. Part III includes a written exam on clinical case management. While Part IV is a practical exam that evaluates hands-on skills, such as spinal adjustment techniques and diagnostic procedures. The NBCE also offers specialty exams, like the Physiotherapy exam, for chiropractors seeking additional credentials.
Exams are typically taken during or after chiropractic school, depending on state requirements. The NBCE provides study guides and practice exams to help candidates prepare. Scores are reported directly to state licensing boards, which use them alongside other criteria, such as education and background checks, to determine licensure eligibility.

The NBCE plays a critical role in maintaining public safety and professional standards within the chiropractic field. By setting a national benchmark for competency, the NBCE helps ensure that licensed chiropractors are qualified to provide safe and effective care. That means especially important because chiropractic care involves hands-on techniques that, if performed incorrectly, could pose risks to patients. The standardized exams also promote consistency in the quality of care across different states and regions.
For chiropractors, passing NBCE exams is often a prerequisite for licensure, which is necessary to practice legally. Without these exams, chiropractors would face varying state requirements, making it difficult to move or practice in multiple states. The NBCE exams also provide a sense of credibility and professionalism, as they demonstrate a chiropractor's commitment to meeting national standards.
The NBCE exams are most important during key stages of a chiropractor's education and career. For students, these exams are typically taken during the final years of chiropractic school, as passing them is required to graduate and apply for licensure. Chiropractic graduates must also pass NBCE exams before they can begin practicing, making these tests a critical step in launching their careers.
The NBCE exams also matter when chiropractors seek licensure in additional states. Many states require proof of passing NBCE exams as part of the licensure application process, even for chiropractors already licensed in another state. And some chiropractors may need to retake certain exams if they let their licenses lapse or if state requirements change. Understanding the NBCE exam process is also important for patients who want to verify that their chiropractor has met national competency standards.
In Nashville, TN, as in other cities, the NBCE exams ensure that chiropractors practicing in the area have demonstrated their knowledge and skills through a rigorous, standardized process. This helps patients feel confident that their chiropractor has met the same high standards as those practicing in other states.
State licensing boards issue and regulate chiropractic licenses. While the NBCE develops and administers the exams used by these boards to assess competency.
Chiropractic school accreditation ensures educational programs meet quality standards. While the NBCE exams assess individual students' knowledge and skills.
The NBCE exams are not just a formality; they represent a critical quality control measure for the chiropractic profession. Passing these exams demonstrates that a chiropractor has mastered the core competencies needed to provide safe and effective care, which is especially important in a field where hands-on techniques are central to treatment.
A chiropractic student in Tennessee completes their final year of school and registers to take the NBCE Part III and Part IV exams. After passing both exams, they submit their scores to the Tennessee Board of Chiropractic Examiners, along with their educational transcripts and background check, to apply for their chiropractic license. Once licensed, they can begin practicing in Nashville.
Chiropractic License is an official government-issued credential that permits a Doctor of Chiropractic to legally diagnose and treat neuromusculoskeletal conditions using spinal adjustments and related therapies. Licenses ensure practitioners meet education, examination. And ethical standards set by state chiropractic boards before practicing on patients.
Chiropractic School is an educational institution where students train to become doctors of chiropractic (DC). These programs teach anatomy, spinal health, manual adjustments. And natural healing methods. Chiropractic School typically requires 3-4 years of graduate-level study after completing prerequisite college courses. Graduates must pass national board exams to earn a license to practice.
Doctor of Chiropractic is a licensed healthcare professional who specializes in diagnosing and treating musculoskeletal disorders, particularly those related to the spine. Doctors of Chiropractic use hands-on spinal manipulation and other alternative treatments to align the body's musculoskeletal structure, enabling the body to heal itself without surgery or medication.
Spinal Manipulation is a hands-on therapy technique where a trained healthcare provider applies controlled force to a specific joint in the spine. This force helps improve spinal motion, reduce pain. And restore function by addressing stiffness or misalignment. It's commonly used by chiropractors, osteopaths. And physical therapists to treat back, neck. And joint issues.
Chiropractic Care is a health care profession focused on diagnosing and treating musculoskeletal disorders, particularly those related to the spine. Chiropractic Care uses hands-on spinal manipulation and other alternative treatments to align the body's musculoskeletal structure, enabling the body to heal itself without surgery or medication.
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