Chiropractic Boards - Part 4 Exam Overview

More Chiropractic Student Resources
Reference Text for Part Four

Visit for the official overview brochure with current test dates and locations.

TEST PLAN Part Four Overview

(10 Case Scenarios)

You will be asked to identify radiographic features from the radiograph(s) and/or other diagnostic images presented. A test committee will have selected the cases according to the following criteria:

1. Cases that are commonly encountered in practice
2. Cases that present cautions or contraindications to chiropractic case management
3. Cases that require early detection to preserve life/health of the patient


Normal radiographic anatomy
Congenital anomalies, skeletal variants and dysplasias
Scoliosis and spondylolisthesis
Intervertebral disc disease and spinal stenosis
Traumatic skeletal disorders (spine and extremities)
Arthritic disorders (spine and extremities)
Tumors and tumor-like processes (spine and extremities)
Hematological and vascular conditions
Bone infections and miscellaneous conditions

(10 Techniques)

You will be given two case scenarios in each of the five adjusting areas listed below for a total of 10 techniques. From the information provided in the case scenario, you will demonstrate patient placement, doctor placement, hand placement, procedure and the line of drive.


Cervical adjusting
Thoracic adjusting
Lumbar adjusting
Pelvic/sacral adjusting
Extremity adjusting

(10 Simulated Patient Encounters and 10 Post-Encounter Probes)

There will be 10 patient stations which may be divided as follows:

6 - Orthopedic and neurologic examinations
3 - Case history taking
1 - Physical examination

You will address cases that:

1. are commonly encountered in practice
2. present cautions or contra-indications to chiropractic case management
3. require early referral to preserve the life/health of the patient
4. present significant diagnostic challenges

Each interaction between the case management examinee and the standardized patient is followed by a post-encounter probe (PEP) station. At the PEP station, you are presented with a binder that contains additional clinical information, such as additional physical findings and laboratory results. There may also be radiographs and/or other diagnostic images pertaining to the case in the station.

At the PEP stations, you will complete two multiple-choice questions based on your interactions with the standardized patients in the previous stations and on the additional clinical information presented. Each multiple-choice question will have 10 choices. You will be required to select three of the most correct answers for each question.


Chiropractic Board Review Books
NBCE Chiropractic National Board Review & Exam Reference Books.

Part Four Reference Books
Part Four - Chiropractic Board Exam Reference Text


Top of Page