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Part IV Test Plan


(20 Stations)

You will answer two multiple-choice questions related to the condiition. A test committee will have selected the conditions according to the following criteria:

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


  • 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
  • Chest and abdominal 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.