Issue 10 - July2004

NBCE: Success in a common cause

Although the chiropractic profession had been unable to unify philosophical differences, in 1963, it overcame differences and came together for one cause — establishing a national testing agency, the National Board of Chiropractic Examiners. The unity of purpose overcame years of barriers.

Basic science tests a barrier
Basic science statutes, first introduced in Connecticut and Wisconsin in 1925, had blocked the licensure of doctors of chiropractic in half of the United States and a few Canadian provinces.

The basic science barrier was introduced in those states where the allopathic community had failed to prevent passage of legislation for alternative healers. These laws required that all would-be licensees (allopaths, chiropractors, naturopaths and osteopaths) must pass an examination in subjects considered fundamental for all clinicians (such as anatomy, pathology, bacteriology, biochemistry and sometimes public health and diagnosis) before sitting for tests given by their respective licensing boards.

Basic science exams were often devised and administered by medical school faculty, and although the test administrators were supposedly blinded to the professional identity of candidates, this was often not the case. Injustice was rampant.

The effect of basic science legislation was devastating for the profession. In Nebraska, for example, the board of chiropractic examiners (BCEs) was unable to grant new licenses from 1929 to 1950, because no DC had successfully hurdled the basic science barrier.

In the 1940s and 1950s Joseph Janse, DC, ND, president of the National College of Chiropractic, was a regular participant in the annual meeting of the American Association of Basic Science Boards.

Janse suggested to the Council of State Chiropractic Examining Boards of the United States and Canada (COSCEB, now known as the Federation of Chiropractic Licensing Boards) that scores from the tests administered by the National Board of Medical Examiners were accepted by several basic science boards (BSBs) in lieu of their own tests and that additional substitutions seemed imminent in other states.

Janse advised that a well-planned National Board of Chiropractic Examiners (NBCE) might reasonably expect to supersede BSBs in those jurisdictions that required the redundant basic science testing.

A final attempt
COSCEB, comprised of delegates from the various BCEs and with an agenda to look out for the good of patients rather than doctors, considered Janse’s recommendation in 1962, aware that this was the fourth attempt to create and sustain an NBCE.

The first attempt had been initiated by B.J. Palmer and the Universal Chiropractors Association in the early 1920s.

A second attempt to form an NBCE was made in the mid-1930s by the National Chiropractic Association.

And COSCEB itself had attempted to establish an NBCE in the mid-1940s.

The Council determined that its testing agency would equal or exceed the rigor of any BSB, but would be administered with fairness to all concerned.

COSCEB made its decision to establish the NBCE at its annual meeting in 1962; the new agency was incorporated in 1963. Leading this initiative were several COSCEB officers: Drs. Devere Biser of Texas, Robert Runnells of Colorado, Gordon L. Homan of Wyoming and Edward M. Saunders of Florida.

Feuds put aside
Faculty from the traditionally feuding chiropractic schools came together for test item development and worked in surprising harmony to prepare questions and answers. A psychometrician from the University of Missouri was hired to perform test construction, and the NBCE went to great lengths to insure the security and integrity of test administration and scoring.

With financial assistance in the form of loans from the newly formed ACA, the first NBCE examinations were administered in 1965, and the earliest “diplomate” certificates were issued shortly thereafter.

Henry G. Higley, DC, MS, clinical scientist and research administrator for both the ACA and the Los Angeles College of Chiropractic, was commissioned to study the relationships among performance in college examinations, BCE test results and scores on the NBCE examinations.

Several BCEs were initially wary about accepting NBCE test results in lieu of their own examinations. They viewed the new testing agency as a challenge to their state’s sovereign authority. However, these apprehensions were gradually overcome as BSBs accepted the logic of the NBCE. The triumph of the NBCE was further in evidence during 1967-1979, as the various basic science statutes were finally repealed.

In its 40+ years of operation, the NBCE has become a fundamental component of the profession’s infrastructure. Although problems and controversies have arisen along the way, these have not interfered with the agency’s operations. The NBCE must be acknowledged as an example of a successful outcome when chiropractors work together for a common purpose.