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NBCE Part 3 (Part III) · Clinical competency + imaging

NBCE Part 3: clinical competency and diagnostic imaging

Part III is the exam taken near graduation. It combines clinical case questions with Diagnostic Imaging Interpretation (DXI), the imaging section that moved over from Part IV in 2021.

What Part III covers

Part III tests whether you can work a case from start to finish. The NBCE's clinical competency areas are:

  • Case History
  • Physical Examination and Neuromusculoskeletal Examination
  • Diagnostic Imaging
  • Clinical Laboratory and Special Studies
  • Diagnosis or Clinical Impression
  • Chiropractic Techniques
  • Supportive Interventions
  • Case Management

On top of that is Diagnostic Imaging Interpretation (DXI), covering arthritic disorders, congenital anomalies, trauma, tumors, other osteoarticular conditions, and soft tissue.

Three kinds of questions

Item typeCountWhat it looks like
Traditional multiple choice (TMCQ)80One best answer
Extended multiple choice (EMCQ)20 (10 vignettes × 2)A longer case with two responses
Diagnostic Imaging Interpretation (DXI)30Read the image, name the finding

The case questions make up about 80% of the content and DXI about 20%. One rule catches people off guard: you can't go back to earlier items. Answer, commit, move on.

Format, timing, and scoring

  • Testing time: 4 hours, in an appointment of about 4½ hours.
  • Scoring: 125–800 scaled score; 375 passes.
  • Results: about four weeks after the exam window.
  • Fee: $710.

When to take it

You need to have finished the required coursework, passed Part I, and be within nine months of graduation, with registrar approval. Part III runs on the same 2026 computer-based calendar as Parts I and II.

How to practice for Part III

  1. Practice full vignettes under time. Long cases eat the clock. Get used to reading once, pulling out the key findings, and deciding.
  2. Give imaging its own practice. DXI is its own skill. You get better at it by looking at a lot of films and checking yourself.
  3. Train the no-going-back rule. Take mock exams without changing earlier answers, so test day feels normal.

ChiroEDU's Part 3 course has four full mock exams with multiple-choice vignettes, and radiology is included, created by a certified DACBR (board-certified chiropractic radiologist).

What comes next

The last step is Part IV, the hands-on practical exam. See all the exams on the NBCE board exam overview.

Sources: NBCE Part III · Part III Test Plan · Student FAQ · Fee Schedule. Checked September 2026; confirm dates and fees with the NBCE before you register.

FAQ

NBCE Part III questions

What is on NBCE Part 3?

Clinical competency areas: case history, physical and neuromusculoskeletal exam, diagnostic imaging, clinical lab and special studies, diagnosis, chiropractic technique, supportive interventions, and case management. Diagnostic Imaging Interpretation (DXI) is also part of the exam.

How many questions are on NBCE Part 3?

The NBCE describes it as 80 traditional multiple-choice items, 20 extended case-vignette responses, and 30 diagnostic imaging interpretation items.

Is radiology on Part 3?

Yes. Since 2021, Diagnostic Imaging Interpretation (DXI) is part of Part III and makes up about 20% of the content.

Can I go back and change answers on Part 3?

No. The NBCE notes you can't return to previous items on Part III, so pacing and commitment matter.

When can I take Part 3?

After completing the required coursework and passing Part I, within nine months of graduation, with registrar approval.

Next step

Practice the test before you take the test.

Register on the ChiroEDU testing platform, or email us with questions before choosing a course.