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.
Term
National Board of Chiropractic Examiners
Category
Regulation

The National Board of Chiropractic Examiners (NBCE) is a key organization in the chiropractic profession. It was created to develop and deliver standardized exams that measure whether chiropractic students and graduates have the knowledge and skills needed to practice safely and effectively. Unlike chiropractic schools or state licensing boards, the NBCE operates independently to ensure fairness and consistency across all test takers, regardless of where they studied or plan to work.
Chiropractic licensure in the United States typically requires passing NBCE exams. The exams cover a broad range of subjects, including anatomy, physiology, diagnosis, chiropractic techniques. And clinical case management. By setting these national standards, the NBCE helps protect patients by ensuring that licensed chiropractors meet a baseline level of competency before treating the public.
The NBCE exam process begins with test development. A team of chiropractic educators, clinicians. And psychometricians designs questions that reflect current chiropractic practice and education standards. These questions are reviewed, tested. And updated regularly to ensure they remain relevant and fair. The exams are administered in secure testing centers across the country, often in multiple parts taken at different stages of a chiropractor’s education.
The most common NBCE exams include Part I, which covers basic sciences like anatomy and physiology; Part II, which focuses on clinical sciences such as diagnosis and chiropractic principles; Part III, which tests clinical competency; and Part IV, which evaluates hands-on skills like spinal adjustment techniques. Some states also require additional exams, such as physiotherapy or acupuncture, depending on local licensing requirements. Once a candidate passes the required exams, their scores are sent directly to the state licensing board, which then decides whether to grant a license.

The NBCE plays a critical role in maintaining public trust in chiropractic care. By setting a national standard for competency, it helps ensure that all licensed chiropractors, regardless of where they trained, have demonstrated a minimum level of knowledge and skill. This consistency is especially important because chiropractic laws and requirements vary from state to state. Without the NBCE, each state would need to create its own exams, which could lead to inconsistencies and make it harder for chiropractors to move or practice across state lines.
For patients, the NBCE’s work means that when they visit a licensed chiropractor, they can feel confident that the provider has met rigorous national standards. For chiropractors, passing NBCE exams is often the final step before starting their careers, making it a crucial milestone in their professional journey.
NBCE exams matter most during key moments in a chiropractor’s education and career. For students, these exams are typically taken during or after chiropractic school, often as a requirement for graduation. For graduates, passing NBCE exams is usually necessary before applying for a state license to practice. Some states also require chiropractors to retake certain NBCE exams if they let their license lapse or move to a new state with different requirements.
The NBCE also matters when patients are choosing a chiropractor. While the NBCE itself doesn't endorse individual providers, patients can check if their chiropractor is licensed, which means they have passed NBCE exams. In Riverdale, GA. And across the country, licensed chiropractors rely on their NBCE exam results as proof of their qualifications to offer safe, effective care.
The NBCE exams are not just a hurdle to licensure—they reflect the evolving standards of chiropractic care. Regular updates to exam content ensure that chiropractors stay current with best practices and patient safety guidelines.
A chiropractic student graduates from a four-year program and plans to practice in Georgia. Before applying for a license, they must pass Parts I-IV of the NBCE exams. Once their scores are sent to the Georgia Board of Chiropractic Examiners, the board reviews their application and grants a license, allowing them to start treating patients in Riverdale, GA.
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