Fact-Checking the NBCE: What They Said in the Webinar—And What They Didn’t
Behind the Spin: How the NBCE’s Centralized Part IV Plan Collapses Under Scrutiny
Glossy Slides, Glaring Gaps
The speakers included Dr. Norman Ouzts, who opened and closed the session; Tamara Sterling, Vice President of Administration; Dr. Bruce Shotts, Vice President of Testing; Melissa Stockberger, Chief Financial Officer; Dr. Igor Himelfarb, Director of Psychometrics and Research; Dr. Andy Gow, Practical Testing Manager; and Dr. Karlos Boghosian, NBCE Board President. Each speaker played their part in delivering a seamless and highly rehearsed justification for the Part IV overhaul. What was presented as modernization was, in fact, a thinly veiled centralization of control and a cost shift onto students.
The core message was that the new eight-station format—featuring seven full encounter simulations and one hands-on technique station—more accurately reflects “real-world” chiropractic practice than the traditional task-based OSCE. NBCE officials claimed that only a purpose-built testing center in Greeley could deliver this model fairly, efficiently, and securely. They emphasized that upgrading and maintaining campus-based test sites would have cost $5 to $8 million, which would have led to a $1,000 exam fee increase. Instead, they framed centralization as a way to avoid raising fees and keep costs “flat” for students. Holding fees steady since 2021, they argued, was effectively a discount due to inflation.
They also claimed the centralized model would allow for more flexibility and faster licensure. With 48 weekends of testing per year and scheduling available as little as 17 days in advance, students could, they said, begin practicing up to three months sooner than under the current format. To support this rollout, they referenced two pilot exams—held in July 2024 and March 2025—with another scheduled for September 2025. Feedback, they said, had been “overwhelmingly positive.” As for the cost of travel, they estimated that most students would pay around $427 for airfare and one hotel night, and that NBCE would provide free shuttles and hotel discounts to ease the burden.
The Cracks Beneath the Surface
Beneath the polished presentation lay serious gaps in logic, fairness, and accountability.
Start with the finances. While NBCE claimed centralization reduced delivery costs by 6%, they failed to acknowledge that it pushed 100% of the travel burden onto students, many of whom previously tested at or near their campuses. NBCE’s $427 estimate assumes off-peak travel, only one night in a hotel, no baggage fees, no meals, and no local transportation. In reality, students—especially those from the West Coast, Puerto Rico, or international programs—can expect to spend $1,200 to $1,500 per attempt once meals, transportation, lodging, and missed income are factored in. This is not a cost savings—it’s a cost transfer from the testing organization to the examinees.
Even more troubling is the capacity issue. The new model can accommodate only eight examinees per track. At maximum throughput—two tracks per day, three days a week, for 48 weekends—that’s approximately 2,300 candidates per year. The current system tests more than twice that many. NBCE provided no data or plan explaining how this bottleneck would be resolved. Their own “faster licensure” claim begins to collapse under basic math.
Their insistence that travel is manageable also falters under scrutiny. The presentation made no mention of students with disabilities, caretaking responsibilities, financial hardship, or visa limitations. There is no NBCE-funded hardship program. Refunds, they said, may be offered case-by-case, but no guarantees were provided. In a profession that already faces significant diversity and access challenges, this new format is likely to make things worse, not better.
The “real-world simulation” rationale doesn’t hold up either. Fourteen-minute patient encounters followed by six-minute SOAP notes do not reflect the complexity of a busy clinical practice. There are no electronic health records, no overlapping appointments, no administrative disruptions—just staged roleplay under video surveillance. In fact, most chiropractic schools already provide more authentic, longitudinal assessments of clinical competence through their outpatient clinic requirements. Schools are doing the job already—without the Greeley price tag.
Finally, transparency was nowhere to be found. No live questions were permitted. No pilot data was shared. No psychometric analysis was disclosed. No explanation was given for how scoring reliability would be validated under the new video model. The NBCE simply asked the profession to take it on faith.
Factual Missteps and Misleading Claims
The webinar included several questionable or outright false statements. NBCE claimed that each Part IV exam weekend required roughly 1,250 staff members. That number is mathematically implausible and appears to be inflated to justify centralization. They also claimed that video recording removes examiner stress—while simultaneously admitting that pilots still used live examiners. No data was presented to prove that video scoring improves fairness or reduces variance.
The assertion that 40% of current students already travel to take Part IV was presented without citation and contradicts independent coalition surveys suggesting the number is closer to 25%. Meanwhile, the oft-repeated claim that the centralized model will allow students to begin practice “three months sooner” rests on a completely speculative premise: that the current model causes massive delays. NBCE offered no data showing this to be true.
No Legal Review, No Rulemaking, No Public Input
Perhaps most disturbing is the complete lack of legal or regulatory oversight. No state chiropractic board has conducted a formal rulemaking process, opened a public comment period, or evaluated whether the new centralized Part IV exam complies with existing state law. Many states still reference a multi-site, OSCE-style practical exam in their administrative rules or statutes. The NBCE is unilaterally redefining the nature of a national licensure exam that is embedded in multiple legal frameworks—without public process and without state-level alignment. This is not only unethical—it may be unlawful. Stakeholders, including students and educators, have had no official opportunity to object, and no assurance that their rights are being protected.
A Pattern of Control, Not Competence
This is not the first time the NBCE has moved forward without data, dialogue, or accountability. When a coalition of organizations requested outcomes data in 2023—including pass/fail trends, retake rates, and any evidence linking NBCE exams to clinical success or public safety—the NBCE delayed for months and ultimately provided no meaningful response.
Its 2025 Practice Analysis Survey has also come under fire. The survey, which NBCE now cites as the foundation for its strategic planning, was based on a convenience sample of just 3,876 responses—barely 5% of the profession. The sample skewed overwhelmingly older, White, full-time, and male. Gen Z chiropractors, women, minorities, part-time practitioners, and critics of the NBCE were largely excluded. State-by-state sample sizes were so small that error margins exceeded 50% in some cases. Yet NBCE continues to tout this document as representative of the profession’s views.
Meanwhile, the organization has amassed over $40 million in cash reserves. It now uses those funds to build real estate assets and testing infrastructure—while offloading new expenses onto students. This is not education reform. It’s empire building.
Conclusion: The Silence Speaks Louder Than the Slides
The NBCE’s June 2025 webinar was not a moment of transparency. It was a tightly managed rollout of a plan that consolidates power, increases student debt, restricts access, and abandons the very principle of stakeholder inclusion. Every important question—about fairness, legality, accessibility, and necessity—was either ignored or answered with spin.
If the NBCE wants to call this modernization, then the profession has every right to call it what it truly is: consolidation through coercion.
The centralized Part IV plan doesn’t solve problems—it creates new ones. And until it is subjected to public review, state board oversight, and data-based justification, it has no business being implemented.
What You Can Do
Demand that your state board open a formal review and public comment process on the new Part IV format. Urge chiropractic colleges to reject NBCE Part IV as a graduation requirement. Push lawmakers and regulators to audit NBCE’s data, finances, and legal compliance. Speak out against the monopolization of chiropractic licensure.
This is not just a test change. It’s a structural power grab—and the profession must not let it go unchallenged.
