A total of 1,343 DCs and students completed Dynamic Chiropractic's online survey regarding the fees charged by the National Board of Chiropractic Examiners (NBCE) and its resultant excess profits:
1. In 2021, the NBCE had excess income of $5,178,512. This is more than what all students paid for Parts I and II combined. Should the nonprofit NBCE rebate the money paid by chiropractic students for Parts I and II exams ($710 per exam, per student) in 2021?
No – 14%
2. Also in 2021, the NBCE donated over $1 million to other chiropractic organizations. Should the NBCE cease using student exam fees to make donations to / purchase sponsorships from other chiropractic organizations and apply that money to reduce the exam fees?
Yes – 90%
No – 10%
3. Based on 2021 financial figures, the nonprofit NBCE could reduce the total cost of the Parts I – IV exams from $3,715 to $2,200 by applying the donation / sponsorship money to reducing those fees and reducing its excess income. Should the NBCE reduce its Parts I – IV total exam fees by at least $1,500 per student and keep its exam fees at a level where its excess income from operations and investments is no more than 5% of its examination fee revenue?
Yes – 94%
No – 6%
Nearly 500 respondents included comments, many of which focused on how the NBCE exam costs have added to the financial and emotional struggles chiropractic students (and former students) face. As one student stated:
“These excessive fees [add to] the anxiety and stress over taking these exams. Chiropractic school is already extremely expensive and inflation is rising rapidly. There are students struggling to pay rent and provide food for themselves and their families because we cannot get a lucrative job while being in school and living off loans is simply not enough. These fees NEED to be reduced."
Other survey respondents were less diplomatic:
“They are literally robbing us because they can. What are we supposed to do? Not get our licenses? It is disgusting and should be illegal."
“NBCE is a monopoly and they operate like one. They do not care about chiropractic nor students' success."
Many suggested the number of exams should be reduced:
“No other professional students have to pay so much to prove their knowledge. We've already passed the coursework. Give us ONE reasonably priced examination."
“Part 4 is the only test that means anything to a chiropractor. The 1st 3 are straight money grabs. The 4th one is the only one worth money to me."
Many respondents were also frustrated by the NBCE donating student loan money:
“Respectfully, if I want to donate to a chiropractic organization I will do it myself, with my own money, and to an organization that I choose to support."
“The NBCE is not in business to be a donation center for other non-profits, regardless of whether or not they are supporting chiropractic organizations. Most students are living on low budgets, much of it borrowed money. They should not be charged more than is necessary to administer the tests. If the NBCE finds itself with a surplus, that's a clear signal that it is charging too much and it needs to lower its testing fees, not give the money away."
A few comments tended to be more positive. For example:
“The NBCE helps to keep students who are not ready from becoming licensed. I am a part IV examiner and so many last-quarter students are incompetent. The exams are straightforward, they are just not prepared by their colleges. Yes, the same colleges that have a vested interest in making money just like the NBCE."
Still others questioned the contractual monopoly between the NBCE and FCLB:
“The NBCE makes the exams so expensive because students HAVE to take them, so they can essentially set the price at whatever they want. It is ridiculous to have to pay over $3,000 for exams, when the majority ... are online."
“The excess money has corrupted the FCLB to the point where states are dropping out of its membership. There needs to be an independent audit of the NBCE and a disassociation of the FCLB from the NBCE. Finally, the leadership of both of these organizations should be replaced by a bylaw change that limits their participation to only 6-years (2 terms) to keep corruption and nepotism from their ranks."
“There should be an attorney general investigation into the NBCE donating 5% of fees to the FCLB. This is a clear conflict of interest."
A few respondents suggested the NBCE was overspending and could save even more; for example, by “eliminating the excessive honoraria paid to directors, reducing travel for directors, and substantially cutting the lavish spending on their board retreats and board meetings held at luxury hotels."
A few respondents sought influence from outside the NBCE ; one called on “a panel of college presidents and state boards" to address the situation and another for “the ICA and ACA to stop being afraid of NBCE and think about the future landscape we are creating for newly graduated chiropractors."
Editor's Note: More comments and access to all comments accompany our feature article in the September issue.
Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email
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