Part III
Status Update:
The Part III exam has been updated to include the Diagnostic Imaging Interpretation (DXI) domain, which was previously included in the Part IV exam. If you have already passed the Part IV exam with the Diagnostic Imaging (DIM) domain, you will be taking the Part III without DXI. Helpful hint: All Part IV exams prior to January 2022 include the DIM domain.
If you have not previously passed a Part IV exam, you will be taking the Part III with DXI. Please make sure you are referencing the correct test plan below. If you are still unsure which version of Part III you will be eligible to take, please contact us. More details about this change to the Part III and Part IV exams are available here: https://www.nbce.org/pad/
Part III without Diagnostic Imaging Interpretation
Part III is a computer-based test, delivered on chiropractic college campuses.
Part III consists of two sessions, with a total of 110 standard multiple-choice questions and 10 case vignettes, broken down as follows:
- Each section has 55 standard multiple-choice questions, plus five case vignettes.
- Each of the five case vignettes contains three extended multiple-choice questions.
- Each extended multiple-choice question requires three answers.
Each session is allotted two hours of testing time, with an optional 15-minute break between sessions. Testing appointments are 4 hours and 30 minutes.
Part III with Diagnostic Imaging Interpretation
The NBCE Part III examination with DXI is composed of three types of test items;
– Traditional multiple-choice (TMCQ), 80 questions
– Extended multiple-choice cases (EMCQ), 20 cases
– Diagnostic imaging interpretation (DXI), 30 imaging sets
TMCQ items consist of one question followed by four potential answers, one of which is correct. EMCQ items provide case information of a patient, followed by a question with five answer choices, two of which are correct.
Each item of the DXI portion of the exam consists of images followed by one question with four possible answers, one of which is correct. The DXI portion of the exam tests the examinee’s ability to interpret diagnostic images, and comprises approximately 20% of the exam content.
The content mapping for the Part III test plan is divided into two sections; the first portion of the test plan covers the TMCQ and EMCQ items. The second portion of the test plan covers content only included in the DXI portion of the exam. (Content categories outlined in the blue box).
Administration of the test is divided into two sessions, and the three types of items are equally divided between the first half and second half of the exam.
Part III without Diagnostic Imaging Interpretation
Tests 9 Clinical Areas:
- Case History
- Physical Examination
- Neuromusculoskeletal Examination
- Diagnostic Imaging
- Clinical Laboratory and Special Studies
- Diagnosis or Clinical Impression
- Chiropractic Techniques
- Supportive Interventions
- Case Management
Part III with Diagnostic Imaging Interpretation (DXI)
Traditional multiple-choice (TMCQ) and Extended multiple-choice cases (EMCQ) cover nine clinical content categories (80%):
- Case History
- Physical Examination
- Neuromusculoskeletal Examination
- Diagnostic Imaging
- Clinical Laboratory and Special Studies
- Diagnosis or Clinical Impression
- Chiropractic Techniques
- Supportive Interventions
- Case Management
The Diagnostic Imaging Interpretation (DXI) section is comprised of six categories (20%):
- Arthritic Disorders
- Congenital Anomalies and Skeletal Variants
- Trauma
- Tumors and Tumor-like processes
- Miscellaneous Osteoarticular
- Soft Tissue
Who Can Take Part III?
- Your coursework must be at an eligible chiropractic college.
- You must have completed NBCE Part I.
- You must be within nine months of graduation before the administration of Part III.
- Your registrar must approve your application.
See additional eligibility requirements if you have graduated, or are retaking Part III.
Topics, Sample Items, and Reference Texts
The NBCE develops every exam based on a test plan. The detailed Part III Plan includes topics, subtopics, and weightings (the percentage of the test devoted to each topic).
The NBCE uses reference texts from the chiropractic colleges for the Part III Exam. See a comprehensive list by clicking on one of the links below.
The NBCE offers Sample Items for the Part III Examination with Diagnostic Imaging Interpretation. Click here for an example of a Traditional Multiple-Choice (TMCQ), Extended Multiple-Choice Case (EMCQ), and Diagnostic Imaging Interpretation (DXI) question.
Part III without Diagnostic Imaging Interpretation Links:
Part III without DXI Reference Text List
Part III without DXI Test Plan
Part III Links with Diagnostic Imaging Interpretation Links (DXI):
Part III with DXI Reference Text List
Part III with DXI Sample Items
Test Sites And Test Site Rules
The NBCE offers Part III at chiropractic colleges and Prometric testing centers across the country. Each test site utilizes computer-based testing. You can select a test site when you apply. See the list of accredited Test Sites.
The NBCE is committed to exam security. The only item you are allowed to bring into the secure testing area is one form of ID. The NBCE will provide a place to store your car key (one key allowed). Please review the additional Test Site Rules before you arrive to take your test.
Exam Administration Dates
| Administration Dates | Application Deadline | Exams Offered |
| Mar. 18 OR Mar. 19, 2023 | Feb. 16, 2023 – 5PM (MT) | Part III and Physiotherapy |
| July 15 OR July 16, 2023 | June 15, 2023 – 5PM (MT) | Part III and Physiotherapy |
| Oct. 21 OR Oct. 22, 2023 | Sept. 21, 2023 – 5PM (MT) | Part III and Physiotherapy |
What Is A Passing Score For Part III?
The NBCE recommends a passing score of 375 for the Part III Examination. Most states require or accept the Part III Examination in lieu of a state-level written clinical competency examination. For current information on state regulations pertaining to Part III scores, you must contact the licensing board of the state(s) in which you plan to practice.
Fees
| Part III | $710 |
Withdraw / Reschedule
Prior to the published application deadlines, examinees may withdraw from or reschedule their Parts I, II, III, Physiotherapy computer-based exams using the Prometric scheduling tool. After published deadlines, you may not make any changes to your appointment and the NBCE will issue no refunds. I understand that I will not be refunded any of my exam fees if I change or cancel my testing appointment within 29 days of the first day of my scheduled testing weekend, or fail to appear for my exam.