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NPLEX Part I Exam Guide: Format, Scoring and Tips for Success
How the exam is built, how it is scored, what it weights most and how to prepare, all in one place for naturopathic medical students.
Updated October 2026 · Based on the official NPLEX Part I Blueprint and Study Guide (revised March 2026)
NPLEX Part I, officially the Part I – Biomedical Science Examination (BSE), is the first of the Naturopathic Physicians Licensing Examinations. It checks that you have the biomedical science foundation needed to begin the clinical phase of naturopathic medical training, so it is taken before clinical training starts.
The exam is competency-based: rather than rewarding pure memorization, it uses short clinical cases to test whether you can apply the sciences.
At a glance
The exam in numbers
One day, two sessions, every question multiple choice.
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Questions generally center on a patient case
Per the official study guide: a short case, then questions on the science behind it.
A brief patient summary, diagnosis included.
- 1Where is it, and what supplies it?Anatomy
- 2What normal process is involved?Physiology
- 3Which pathway or organism?Biochem · Micro
- 4Causes and complications?Pathology
An illustration only. Clusters vary, and each question has four choices with one best answer.
Scoring & passing
Two exam areas, five sciences
The 200 questions split into two general exam areas, with about 40 questions from each of five specific areas.
Structure / Function
~60%- Anatomy~40 questions
- Physiology~40 questions
- Biochemistry & Genetics~40 questions
Disease / Dysfunction
~40%- Microbiology & Immunology~40 questions
- Pathology~40 questions
You must pass both areas separately. A strong Structure/Function score cannot make up for a weak Disease/Dysfunction score, or the other way around. Fall short in either and you retake the whole exam.
No fixed pass mark, no curve. The cut score is set for each exam based on its difficulty, so it varies slightly between sittings. Scoring takes about seven weeks.
What it covers
NPLEX Part I blueprint: body-system weights
The blueprint lists competencies for each system with an approximate share of the exam. Some questions cross more than one system, and not every competency appears on every exam.
- CardiovascularLive on NDBlueprint12%
- GastrointestinalLive on NDBlueprint12%
- Musculoskeletal10%
- Neurological10%
- Reproductive10%
- Urinary10%
- EndocrineLive on NDBlueprint8%
- Immunological8%
- Pulmonary and Upper Respiratory Tract8%
- HematopoieticLive on NDBlueprint6%
- Integumentary6%
Weights are approximate and come from the published blueprint. They show where the exam puts its focus, not an exact breakdown of any single exam.
Exam-day strategy
How to approach the questions
These follow the official advice for NPLEX multiple-choice exams.
- Answer every questionA blank counts as wrong, so any answer beats none.
- Mark as you goAnswer each question when you read it. You can return and change answers, but don’t risk running out of time with blanks left.
- Eliminate, then chooseUnsure? Rule out what you can and make your best pick from the choices left.
- Don’t overthink itThere are no trick questions. Some will feel easy, and that’s fine: resist talking yourself out of a good answer.
How to prepare
Study it the way it’s tested
NDBlueprint is built around this exam, so your study time goes where the points are.
- Organized by the blueprintShort lessons with Study Guides, system by system, with every lesson and question tied to what the blueprint names.
- Practice real case clustersBoard Rounds and Grand Rounds give you one patient and four questions across the sciences, just like exam day.
- Learn from every answerEvery answer choice is explained, right or wrong, so each miss becomes a lesson.
- Make it stickDaily Review brings questions back right before you’d forget them and tightens up as your exam gets closer.
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Frequently Asked Questions
What is the NPLEX Part I blueprint?
It is the published outline of what NPLEX Part I tests: the competencies for each of the 11 body systems, split into Structure/Function and Disease/Dysfunction, with each system’s approximate share of the exam. This guide breaks it down, including the full table of body-system weights.
How many questions are on NPLEX Part I?
200 multiple-choice questions, each with four answer choices and one best answer. They are grouped into 50 case clusters of four questions.
How long is the NPLEX Part I exam?
It is given in two sessions of 100 questions on the same day, with 2.5 hours for each session.
What is the passing score for NPLEX Part I?
There is no fixed pass mark and no curve. The cut score is set for each exam based on its difficulty, so it varies slightly between sittings. You must pass Structure/Function and Disease/Dysfunction separately.
What happens if I pass one exam area but not the other?
You do not pass, and you retake the entire exam.
When should I take NPLEX Part I?
The official guidance is to sit it as soon as you are eligible, while the material is fresh.
Source: the official NPLEX Part I Blueprint and Study Guide (revised March 2026), which applies to the August 2026 administrations. NPLEX may revise it, so check the latest edition.