For one last time, I get to use writing a blog post as a welcome reprieve from board studying—this time, it’s for Part IV, the final board exam. This is the part of the boards I’ve been most anxious about since I first learned of its existence. Part IV is the practical portion, where you walk into a room, and any simulated clinical situation can take place. The breakdown of the exam includes three case histories, six rooms where we must perform specified orthopedic and applicable neurological physical exams, a physical exam room (where we’ll either examine the patient’s heart, lungs or abdomen—depending on their complaint), and five adjustment set-up rooms. All rooms (aside from the adjustment set-up rooms) have “post-encounter probes,” where we must answer questions related to diagnosis and applicable treatment/referral based on findings from the room.

At this point, this exam is mostly a review of things we’ve done time and time again throughout the Chiropractic Medicine curriculum. We’ve even had practicals simulating this type of exam in Physical Diagnosis and Advanced Diagnosis. However, this is the main event—the final board exam we all need to pass to become licensed after graduation. I’ve been consistently seeing real patients over the past 11 months, but there’s something much more nerve-wracking about a choreographed encounter with a simulated patient while a doctor sits in the room, grading your every move. For these reasons, field doctors have described Part IV of the board exam as the “easiest yet most nerve-wracking” section.

Ultimately, the Part IV board exam represents the culmination of years of study, practice, and perseverance. Each encounter is a reminder of the skills we’ve honed and the knowledge we’ve accumulated. While this final exam may be the most cumbersome, it truly represents a significant milestone toward a rewarding career in chiropractic medicine.

I’ve found that the best way to fight the nerves is with preparation, and with that preparation comes confidence. This last hurdle before graduation and licensure is here, giving my peers and me one final chance to prove we’re ready to bring our skills and compassion to the real world.

Learn more about career support for NUHS Doctor of Chiropractic students here.