By the time you reach NBCE Part II, it feels like everything is starting to “count.”

This is the point where boards stop feeling like random tests and start feeling like they’re measuring your readiness for real patients.

Part II doesn’t just test what you know — it tests how well you can apply clinical sciences across systems.

In this guide, we’ll cover:

• The exact format of NBCE Part II

• How the exam is structured and timed

• Passing score and fees

• Big-picture study strategy that actually moves your score

• FAQ straight from what students ask all the time

What Is NBCE Part II?

According to the NBCE, Part II is a computer-based test covering clinical sciences, with 255 questions across six domains. 

The exam is administered in two sessions during one appointment:

• Session 1:

• General Diagnosis

• Neuromusculoskeletal Diagnosis

• Diagnostic Imaging  

• Session 2:

• Principles of Chiropractic

• Chiropractic Practice

• Associated Clinical Sciences  

You get:

• 3 hours 26 minutes of total testing time

• A 4-hour testing appointment, including:

• Tutorial

• End-of-exam survey

• Optional 15-minute break after the first session  

So: One appointment, two sessions, six domains, 255 questions.

The Six Part II Domains (Clinical Science Areas)

NBCE lists the six Part II domains as: 

1. General Diagnosis

2. Neuromusculoskeletal Diagnosis

3. Diagnostic Imaging

4. Principles of Chiropractic

5. Chiropractic Practice

6. Associated Clinical Sciences

Each domain has its own test plan with topics, subtopics, and weightings; NBCE publishes a detailed Part II Test Plan and a reference text list on their site for deeper breakdown. 

Who Can Take Part II?

Per NBCE: 

• You can typically take Part II in your third year if you’re enrolled in an eligible chiropractic college.

• Your registrar must approve your application.

• There are additional eligibility rules if you’ve already graduated or are retaking Part II.

So realistically, most students take Part II while:

• Deep in clinic

• Juggling school + boards at the same time

Which is why strategy matters more than ever.

Fees, Testing Sites, and Passing Score

From the NBCE site: Part II full exam fee is $710.

Testing is:

• Computer-based, at chiropractic colleges and Prometric test centers

• You choose a test site when you apply

Security is strict: you can only bring one form of ID into the secure area (they even specify they’ll store one car key). 

Passing score: A scaled score of 375 or higher is required to pass Part II.  

What Makes Part II Challenging?

Part II can feel tough even for strong students because it combines:

1. Integration across systems

Questions expect you to connect:

• History + exam findings

• Imaging + diagnosis

• Red flags + management decisions

2. Clinical decision-making

It’s not “What is this condition?”

It’s “What is the most appropriate next step?”

3. Endurance in a long appointment

Two sessions, six domains, 255 questions under time pressure.

If you feel tired just reading that—that’s normal.

High-Yield Focus Areas for Part II

The NBCE test plan and student experience both point to these as consistently high-yield areas:

• Red flags & urgent conditions

• Abdominal emergencies

• Serious neuro compromise

• Infection / malignancy indicators

• Neurologic & orthopedic exams

• How exam findings change management

• Diagnostic imaging “don’t-miss” findings

• Fractures

• Infections

• Tumors

• Contraindications to adjusting

• Systems patterns

• Endocrine, cardiovascular, pulmonary, GI presentations that require referral or co-management

• Chiropractic practice & principles

• Safety, contraindications, scope, and reasonable technique choices

Low-yield (for score movement):

• Obscure conditions

• Hyper-detailed memorization that doesn’t change management

Boards care more about what you do with the information than whether you know every obscure fact.

A High-Yield Study Strategy for Part II

Step 1: Base your plan on the NBCE Test Plan

Use the official Part II Test Plan as your starting framework, then plug CAL resources into that structure.

Step 2: Train “NBCE thinking,” not just recall

Every time you practice a question, ask:

• “What is the safest answer?”

• “Which option changes care the most?”

• “Am I missing a red flag?”

Step 3: Use mixed-domain practice

At least once a week, do question sets that mix domains, since that’s how clinical thinking works and how fatigue actually feels.

Step 4: Build an endurance rhythm

In the final 3–4 weeks:

• Simulate Session 1-length blocks

• Then Session 2-length

• Practice break timing and nutrition the way you plan to do on test day

Your brain will perform better when the format feels familiar, not new.

What Successful Students Do Differently

Students who do well on Part II usually:

• Start from the NBCE test plan instead of random notes

• Focus on clinical consequence (What happens if I miss this?)

• Practice NBCE-style questions every week

• Don’t try to memorize everything — they prioritize

• Respect rest days to avoid cognitive burnout

It’s not about who studies the longest.

It’s about who studies in alignment with how the exam is built.

Frequently Asked Questions (FAQ)

How many questions are on NBCE Part II?

Part II has 255 questions across six domains, delivered in two sessions during one computer-based testing appointment.  

How long is the Part II exam?

You’re allotted 3 hours and 26 minutes of total testing time, and the testing appointment is 4 hours, which includes:

• Tutorial

• Optional 15-minute break after Session 1

• End-of-exam survey  

What is a passing score for Part II?

You need a scaled score of 375 or higher to pass the Part II exam.  

How much does Part II cost?

NBCE lists the fee as: 

• $710 for Part II

Can I retake individual domains?

No. Effective January 1, 2026, the NBCE will no longer allow candidates to retake individual domains within Parts I or II. After this date, candidates who wish to retake an exam will be required to retake the full Part.

When am I eligible to take Part II?

Generally, you may take Part II in your third year if you’re enrolled in an eligible chiropractic college, and your registrar must approve your application. 

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