Part 4’s is very different than the other 3 national boards exams.
This test consists of 3 major sections:
- Diagnostic Imaging
- Chiropractic Technique
- Case Management
Before You Apply
Know well before hand the requirements to apply for Part 4.
- You are eligible to apply for Part 4 if you have passed all subjects of Part 1.
- You must also be within 6 months of graduation or a graduate of an eligible chiropractic college.
Part 4 is a 2 day, 2 part test. It takes the entire weekend. And here’s the biggest catch of Part 4: They choose where you take the test. This means that when you apply, you pick your top 4 locations (different chiropractic colleges in the US) where you’d want to take the test.
This is the first part of this boards exam. This part is quick, you only take one test and it lasts 40 minutes. But depending on the random selection in the order of the groups, you could be sequestered for up to 5 hours until everyone has finished the exam.
You will be viewing X-rays, diagnostic images, and other clinical data then asked to identify radiographic features from the X-rays and/or other diagnostic images presented and choose 2 of 10 of the best answers. This part is hard. Really hard. To prepare for this, I highly recommend taking Irene Gold’s Part 4 reviews – the radiology review is an intense 4 days of hundreds of X-rays and other diagnostic imaging to make sure you’ve seen it all before entering this exam.
You will have to perform 2 adjusting set ups in each of the 5 techniques stations for a total of 10 set ups. From the information provided in the case scenario, you will demonstrate patient placement, doctor placement, hand placement, procedure and the line of drive. HINT: you are only required to verbalize the line of drive, but you can get more points by verbalizing how you find that contact point, tissue pull, etc.
You will have 2 set ups per technique: cervical adjusting, thoracic adjusting, lumbar adjusting, pelvic/sacral adjusting, and extremity adjusting.
These sections are your ‘gimme’ points as long as you read very carefully. It is very different than how our practical technique exams are at Life West, in a good way. Life West prepares us very well for this section on Part 4’s.
There will be 10 simulated patient encounters and 10 post-encounter probes. The patients are hired actors, but after my experience, not the best actors. There will be 10 patient stations which may be divided into orthopedic and neurologic examinations, case history taking, physical examination.
Each interaction between the case management examinee and the standardized patient is followed by a post-encounter probe station. At this 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 these post stations, you will complete 2 multiple-choice questions based on your interactions with the 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 3 of the most correct answers for each question.
How to Prep
Thankfully, at Life West Chiropractic College, we are wildly prepared to take Part 4’s. Each school is different, especially in their clinical procedures, and at Life West our Clinic Exit Exam is aimed at simulating exactly what Part 4 is like. Plus, for the past year or so, you have been doing these orthopedic exams and and chiropractic techniques everyday. You are continually studying and practicing for Part 4’s essentially your whole clinical experience.
Additionally, an amazing tool to utilize in order to prep for boards is Irene Gold’s Part 4 reviews. Again, the radiology review is invaluable and prepares you so well to take the Diagnostic Imaging section o Part 4.
Yay!! You’re DONE with all of your Chiropractic National Boards exams!! Time to celebrate!! Then take 2 more tests….
You’re next step is graduating (finally!), deciding where you want to practice, and looking into what are the state requirements for that location. In the state of California, and for most states, the next step is taking the Jurisprudence exam – this is the state’s specific laws and ethics. Next, if you wish to take X-rays in your future practice, is to take the X-ray exam – then you’re DONE!!
A huge congrats and celebration is in order because you are now a licensed Doctor of Chiropractic!!