NPLEX Examinations are case-based. This means that the examinations are comprised of clinical summaries followed by several questions pertaining to the patient’s case. On the Part I – Biomedical Science Examination, the clinical summary is very brief. On the Part II – Clinical Science Examinations, the clinical summary is more extensive. Items on the Part I – Biomedical Science Examination do not require clinical training, as all relate to the biomedical basis for the patient’s condition, not diagnosis or treatment. Items on the examinations are all in a multiple-choice, single-answer format (i.e., the “stem” asks a question and there are four response alternatives, only one of which is keyed as the correct answer).


The Part I – Biomedical Science Examination (BSE) is an integrated examination that consists of 200 items which cover the topics of anatomy, physiology, biochemistry & genetics, microbiology & immunology, and pathology. The examination is administered in two sections (morning and afternoon) of 2½ hours each.


The Part II – Core Clinical Science Examination (CCSE) is an integrated, case-based examination that consists of approximately 80 case clusters (400 items) which cover the topics of diagnosis (physical & clinical diagnosis, lab testing and diagnostic imaging, and interpretation and application of research studies), materia medica (botanical medicine and homeopathy), other treatment modalities (nutrition, physical medicine, and psychology), and medical interventions (emergency medicine and pharmacology). The examination is comprised of a series of clinical summaries followed by several questions pertaining to each patient’s case. For example, in a single case you might be asked to provide a differential diagnosis, to select appropriate lab tests, to prescribe therapies which safely address the patient’s condition, and to respond to acute care emergencies. This examination is administered in three sections over the course of 3 days (3½ hours each day).


There are four Part II – Clinical Elective Examinations that may be required for licensure/registration by some jurisdictions (See Jurisdictional Requirements for Licensure/Registration). The Elective Acupuncture and Elective Minor Surgery Examinations are case-based, i.e., 15-20 brief clinical summaries are presented and several questions are asked about each case. The Elective Pharmacology Examination is not case-based, but is comprised of 75 stand-alone items. The Parenteral Medicine Examination includes both case-based and stand-alone items. Examinees are allowed 90 minutes (1½ hours) to complete the 75 items that comprise each elective examination.