How are NABNE and NPLEX associated?

At the current time, all of the 23 states (plus Washington, DC and Puerto Rico) in the US and 4 of the provinces in Canada (with the exception of Ontario) that regulate the naturopathic medical profession recognize NABNE as the examining body and NPLEX as the examination(s) that will ensure that physicians who are licensed meet minimal competency standards. NABNE and NPLEX have been endorsed by the Council on Naturopathic Medical Education (CNME), the American Association of Naturopathic Physicians (AANP), the Canadian Association of Naturopathic Doctors (CAND), and the eight naturopathic medical programs recognized by the CNME.


  • Qualifies applicants to take the NPLEX
  • Administers the NPLEX
  • Sends NPLEX exam results to examinees and to regulatory authorities
  • Upon request, manually verifies responses on answer sheets


  • Surveys the profession to determine the competencies that an entry-level ND must master
  • Publishes the competencies on which examinees will be tested
  • Develops the NPLEX examinations
  • Establishes the passing score
  • Scores the NPLEX examinations

Both NABNE and NPLEX tax returns are available upon request.

What is the purpose of NABNE?

NABNE (the North American Board of Naturopathic Examiners) is an independent, nonprofit organization formed as a service to the naturopathic medical profession and the agencies that license/register naturopathic physicians. The purpose of NABNE is to determine the eligibility of applicants to take the NPLEX, to administer the NPLEX to examinees, and to send exam results and transcripts to regulatory authorities. The institutions that regulate naturopathic medicine grant authority to NABNE to be the examining body for the naturopathic medical profession through their agreement to use the results of the NPLEX examinations in their determination of a candidate’s eligibility for licensure (US) or registration (Canada, with the exception of Ontario).

How is NABNE structured?

NABNE’s structure is very similar to that of the National Board of Medical Examiners, although names for the various parts of the NABNE body differ. NABNE has a five-member Board of Directors. The NABNE Advisory Council is the body that advises NABNE on the state of the profession. NABNE invites every constituency to appoint a member to attend the annual Advisory Council meetings. The constituencies include all the states and provinces that have laws regulating the profession, represented by the Federation of Naturopathic Medical Regulatory Authorities (FNMRA), the Association of Accredited Naturopathic Medical Colleges (AANMC), the Council of Chief Academic and Clinical Officers (CCACO), the Council on Naturopathic Medical Education (CNME), the Canadian Association of Naturopathic Doctors (CAND), the American Association of Naturopathic Physicians (AANP), and the Naturopathic Medicine Student Association (NMSA).

How are members of the NABNE Board elected?

The Board has been selected based on expertise in some area of board examination or licensure and willingness to serve. The majority of Board Directors are appointed by NPLEX. For the other members, nominations are solicited from the Advisory Council. If no names are forthcoming, the Board looks to people who have met the qualifications for the type of director being sought. An applicant to the NABNE Board of Directors submits a resume of professional experience along with a list of two or three references. An ad-hoc committee of two or three NABNE Board members interviews the nominee and the references, by phone or in person. The committee then recommends to the Board whether the nominee should be approved or rejected. A majority of members voting to approve the nominee constitutes appointment of a new NABNE Director. Members who are approved reveal all professional commitments and recuse themselves from votes in which there may be a conflict of interest.

What is the purpose of NPLEX?

NPLEX (Naturopathic Physicians Licensing Examinations) is an independent, nonprofit organization whose purpose is to prepare valid and reliable Part I examinations that assess the readiness of students to enter the clinical phase of training, and Part II examinations that assess the entry-level competence of candidates who plan to become licensed/registered naturopathic physicians/doctors. NPLEX follows the testing standards outlined in the Standards for Educational and Psychological Testing (compiled by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education). These are the standards endorsed by the Council on Licensure, Enforcement, and Regulation (CLEAR – a North American organization, of which NABNE/NPLEX is a member). The NPLEX Council of Exam Chairs oversees the exam development process.

How are NPLEX Board and exam chairs selected?

The five-member NPLEX Board of Directors is responsible for the operations of the organization and is elected from the 16-member NPLEX Council of Exam Chairs (NCEC). The 16 members of the NCEC, in conjunction with the NPLEX Director of Exam Development and three Exam Development Specialists, are responsible for the exam development process. When an exam chair position is open, NPLEX first considers the people who have written items for an examination and who have served as volunteers on one of the committees (Local Exam Committee, Cut Score Committee). Applicants must meet the qualifications for the position (i.e., hold an appropriate degree in a biomedical science field, or notable knowledge in the content area of the specific examination). If no one is identified, NPLEX widens its search and takes suggestions from current NCEC members. The NPLEX Board has never had to look further than the current NPLEX volunteer base or recommendations from NCEC members. However, if in the future an exam chairmanship was open for which there were no nominations from these two resources, NPLEX would advertise the (volunteer) opening with the AANP and CNA.

The person who has been nominated for the position is asked to serve as chair for the next examination. If the nominee completes this task in a timely and competent manner, they will be interviewed by the NPLEX nominating committee. Two or three references are contacted. If the nominee meets the criteria, the next step is to attend an NCEC meeting and meet all the NCEC members. This will provide an opportunity for both the NCEC and nominee to determine if it is a good fit. The NCEC then votes whether or not to approve the person. NCEC members are evaluated every few years to ensure continuing performance as an exam chair.

NCEC members have been chosen based primarily on their expertise in the exam area and their willingness to volunteer the significant number of hours required. In its selection process, the Council does, however, also look at a number of other factors:


  • College affiliation, if the exam chair is not an ND
  • Naturopathic medical education program attended, if the exam chair is an ND
  • Licensing jurisdiction

What does an NPLEX examination look like?

See Examination Overview


Who writes the items (questions) on NPLEX examinations?

NPLEX has more than 100 item writers who have been trained in item writing techniques.

  • Biomedical science faculty and qualified naturopathic physicians write items for the NPLEX Part I – Biomedical Science Examination.
  • Licensed, practicing naturopathic physicians write items for the NPLEX Part II – Clinical Science Examinations.

Are items (questions) reviewed by anyone else before they go into the examinations?

Every item is reviewed by a minimum of nine naturopathic physicians to ensure that each item is appropriate and valid. All items are referenced from standard sources.

How does NPLEX ensure that the exams are fair and valid?

Since 1990, NPLEX has focused on developing procedures to ensure that national testing standards are followed. NPLEX follows AERA/APA/NCME standards for test development and administration. Extensive analyses of exam performance and passing results have led to refinement of systems. NPLEX has completed two criterion-related validity studies of the Part II – Clinical Science Examinations and has redone the original job analysis three times.


Who is eligible to take the NPLEX?

See Eligibility Requirements

Which naturopathic medical programs are approved?

See Approved Naturopathic Medical Programs

Why are students or graduates from only certain naturopathic medical programs eligible?

To eligible to take the NPLEX, an individual must have completed educational requirements at one of the naturopathic medical education programs currently accredited by the Council on Naturopathic Medical Education (CNME). The Council’s in-depth accreditation process promotes high-quality naturopathic medical education and training that leads to safe and effective practice of naturopathic medicine. The Council’s educational standards provide the basis for licensing/regulating naturopathic physicians/doctors in the US and Canada. The CNME is recognized by the US Department of Education to accredit doctoral programs in naturopathic medicine. To become an approved naturopathic medical education program (ANMP), the school must:

  • Provide two years of graduate-level biomedical science coursework as a foundation for clinical training
  • Meet standard requirements for appropriate curriculum and clinical experience
  • Give students a thorough knowledge of diagnostic techniques that can only be acquired through direct contact with actual patients
  • Require supervised clinical practice on patients seeking naturopathic medical care
  • Have been accredited or pre-accredited by the Council on Naturopathic Medical Education (CNME)

If I have completed a medical program outside of the US or Canada, am I eligible to take the NPLEX?

See Eligibility Requirements

Where can I get an Examinee Handbook?

See Examinee Handbooks

How much does it cost to take the NPLEX?

See Fees

How do I apply to take the NPLEX?

See Application Process

Can I be assured that the information I give to NABNE with my application is kept confidential?

See Confidentiality

Does NABNE require transcripts from my naturopathic medical college or undergraduate college?

NABNE does not require transcripts from your undergraduate college or from your naturopathic medical college. NABNE does require a letter verifying that you have completed all academic requirements appropriate to the examination(s) you are applying to take. NABNE will be working directly with the registrar from your ANMP to receive the letter required to determine your eligibility to take the NPLEX. When NABNE has received this letter and all materials required to complete your application, you will be approved to take the examination(s) and your online registration status will be updated accordingly.

When will I know if I have been approved to take the examination(s)?

See After You Submit Your Application

Can I postpone my examination(s) until the next administration?

See Cancellation

When can I print my Admission Ticket?

See After You Submit Your Application

How do I submit a change of address?

See Address Change Form

How do I report a name change?

See Name Change Form

How should I study for the examinations?

The first step in preparing to take the NPLEX is to review the official Blueprint and Study Guide for the Part I – Biomedical or Part II – Clinical Science Examinations. Although all exam questions are multiple-choice with one correct answer and three distractors, the way the questions are asked may take any of several forms.

 As part of your NPLEX application, you will receive a link to a free PDF of the NPLEX Blueprint and Study Guide pertaining to the examination(s) you are registering to take. The study guide is copyrighted, however, and may not be distributed. If you do not have Adobe Reader on your computer you may download it here.

If you are not applying to take the NPLEX but wish to obtain a study guide, you may submit your request and payment online to obtain a PDF of the study guide for either the Part I – Biomedical Science Examination or for the NPLEX Part II – Clinical Science Examinations.

Both the NPLEX Part I or Part II Blueprint and Study Guides are updated regularly. A study guide ordered before the current application period may not contain updated blueprint changes.

Study guides produced by individuals or organizations not affiliated with NPLEX can be useful in preparing to take the examination(s). NPLEX cannot warrant, however, that the information contained in these materials is representative of the content of the NPLEX examinations.

Are there any practice examinations I can take?

NPLEX does not publish complete practice examinations. The NPLEX Blueprint and Study Guide has a few examples of the types of items you may encounter on an examination. NPLEX recommends that you read through the sample items to get a complete picture of the item formats. Some non-NPLEX preparation courses do provide practice examinations; however, those examinations are not developed by NPLEX, and NPLEX cannot guarantee that they reflect the content of, or adequately prepare you to take, the examination(s).


When is the NPLEX administered?

See Exam Schedules

Where will the NPLEX be administered?

See Test Sites

What do I need to know about the exam administration?

See Examination Process

Will I have enough time to answer all of the questions?

The testing period is designed to give you enough time to answer all of the questions. It is rare for NPLEX to receive an answer sheet that has not been completed. At various intervals during the testing period, the proctor will announce the remaining time you have to complete the examination, so that you can pace yourself accordingly. While you should have no trouble completing the entire examination in the time allotted, some questions will require more time to answer than others, and spending too much time on one may cause you to feel pressured to speed through the rest.  When you encounter a question for which you do not know the answer with certainty, try to eliminate some of the response alternatives.  If, after eliminating one or two of the response alternatives, the correct answer is still not apparent, mark your best guess from among the remaining choices and return to the question later if time allows.  It is in your best interest to answer every question, even if it is a guess, because any question on the answer sheet you leave blank will be marked as incorrect.

What if I think there is problem with a question?

After each exam administration, NPLEX does a careful analysis to ensure the validity of every question. If there is a problem with a question, it will be reviewed before results are finalized. In the past, NABNE allowed examinees to comment on individual questions during the testing period, but research performed over the course of several exam administrations showed that questions that were potentially problematic had been identified by statistical item analysis. Therefore, the comments offered no new information. Exam results reflect any changes (e.g., giving credit for more than one correct answer) that are made in the post-test analysis process.


What happens after the exam administration?

See Scoring Process

What will the report of my exam results be like?

See Reporting of Exam Results

Can I have my answer sheet manually scored?

See Manual Scoring

Can I appeal to have my scores changed if I fail any examinations?

See Issues and Appeals

Can I find out how students/graduates from each of the approved naturopathic medical programs performed?

NPLEX does not release these statistics to the public. You will need to contact each individual Approved Naturopathic Medical Programs to request this information. 

Is there a limit on the number of times I can take an NPLEX exam?

There is not a limit to the number of times you can take an NPLEX examination. You may, however, be required to fulfill additional requirements in order to be eligible to take or retake the examination(s) if you:

  • Graduated from an ANMP more than five (5) years ago and have not passed both the NPLEX Part I and NPLEX Part II – Core Clinical Science Examination.
  • Have not passed the NPLEX Part II – Core Clinical Science Examination within ten (10) years of passing the NPLEX Part I – Basic Science Exam Series or Biomedical Science Examination.

If either of these circumstances apply to you, contact NABNE regarding additional eligibility requirements.


What is the difference between a report of exam results and a transcript?

  • A report of exam results contains the exam results from a single NPLEX exam administration (e.g., only the results from NPLEX examinations you took in the current NPLEX administration).
  • A transcript contains the exam results from every NPLEX examination you have ever taken.

How do I order Transcripts?

See Transcripts


Is NABNE a licensing board?

NABNE is not a licensing board. NABNE is an examining board. Passing the NPLEX does not guarantee that you will be eligible for licensure/registration in a jurisdiction.

Each regulatory authority has its own unique requirements for licensure/registration and may require that you take additional (non-NPLEX examinations). NABNE is not involved in the preparation, coordination, scheduling, or administration of these examinations.


If I pass the NPLEX, can I be licensed in every jurisdiction?

Jurisdictional requirements take precedence over NABNE policies regarding:

  • Waiver of the NPLEX Part I examination requirement (e.g., whether or not the regulatory authority will accept non-NPLEX Part I results, etc.)
  • Other (e.g., the number of times an examination may be retaken, etc.)

Check with the regulatory authority in the jurisdiction in which you plan to practice to determine their requirements.


Which states and provinces regulate the naturopathic profession?

See State and Provincial Requirements for Licensure/Registration


How do I find out which NPLEX Examinations are required by each regulatory authority?

See State and Provincial Requirements for Licensure/Registration

Is it illegal to practice as a naturopath in an unlicensed state if I have not graduated from a CNME-approved naturopathic program and have not passed the NPLEX?

Diagnosis of diseases/conditions by an unlicensed naturopath is illegal in most states. Although you may be able to prescribe botanical substances, if you cannot diagnose, the treatment may or may not be appropriate. Furthermore, if at some point an unlicensed state or province does pass a naturopathic licensing law, you may no longer be allowed to practice as a naturopath if you are not licensed.