Acupuncture and Chinese medicine board exam preparation : the bad, the worse, and the ugly

I recently took and passed three NCCAOM board exams. I think I may have lost months and years of my life’s energy in doing so. It was one of the more annoying testing experiences of my life. This was the case due to a number of factors, and none of them have to do with my education or ability. I’d like to briefly review those factors, discuss the board review products I employed and make a few recommendations for those of you who are planning to take the NCCAOM board exams sometime soon.chinese_medicine_board_exams.jpg

Signing up, paperwork, scheduling and managing board exams

I swear that all testing authorities believe that actually signing up for the exams should be the first big test. NCCAOM is actually better than some testing authorities I’ve had to deal with, but the process was still needlessly complicated. I suggest that you download the board exam application as soon as possible and read through the instructions several times.



There are a few important things to note :

  1. Don’t forget the official transcript.
  2. Don’t skimp on the passport photo, just get it professionally done.
  3. Don’t forget to get the application notarized.
  4. Make sure you fill out the information so they can inform you when your application has been received.
  5. Make a full copy of the application right before you send it.
  6. Send it certified mail so you can track it and get confirmation that it was received.
  7. Call them if it takes more than a week or so for them to let you know it has been received. You really need to keep on top of things with any organization like this.

It is VERY IMPORTANT that you check what board exams are required for licensure before you apply. In many states, the herbal board exam is not necessary. Now, you may want to take it anyway (I think most folks should), but the reality of the situation is that you may not be prepared, or may not WANT to take that particular exam before you want to be licensed. In my situation, in Oregon, only the Foundations, Biomedicine and Acupuncture (w/ point location) exams are necessary. I will be taking the herbal board, but because it tests you on TCM herbalism (which I did not learn well) I want to give myself time to prepare. I want to practice before that time. However, not paying attention, I signed up and paid for the “Oriental Medicine” board exam application, which has the herbal board wrapped into it.

Unfortunately, the state licensing board in most places wants to receive “certified” status from the NCCAOM before they will process your application. If you have signed up for the Oriental Medicine application (and paid for it) they WILL NOT send “certified” status to the state licensing board until you have taken the herbal board. You have to pay $100 to “downgrade” the application and, later, completely reapply (and pay the FULL APPLICATION FEE, plus board exam fees) in order to take the herbal board. I have my own emotional reaction to this practice, but will not share it. Just know that this is the reality, and go from there.

The service that NCCAOM uses to actually schedule the individual board exams is actually great. They gave me no problems whatsoever, and you can change a board exam time up to 24 hours (business days only) in advance. I know a few people had problems with getting to the testing center to see that the place had been overbooked, but most people have no problems with this part of the process.

Studying for your exams

I used several board prep products. I’ll list them each below, in no particular order, with a brief review.

  1. Blue Poppy’s Test Prep series (Zhong Bai-song, author), including “Test Prep Workbook for the NCCAOM Bio-medicine Module” (Zhong Bai-song). This book is a series of multiple-choice tests, followed by answer keys. How many questions and how many tests vary given the topic. These books are well laid out, and an errata sheet was provided to fix mistakes in the initial version. That being said, there were still a number of strange errors, and there was much inconsistency in the book. In particular, I was annoyed that some answers to the multiple choice questions had no explanation – many of them needed it, particularly in the biomedicine book. I actually abandoned these books about 2/3rds of the way through because they tended to increase instead of decrease my anxiety.
  2. Test Prep book by Jim Cleaver of Muddy Bottom Press (not available online). I’m not sure if Jim makes books for all of the exams, but he made an excellent one for the Acupuncture exam. It is also a list of questions and answers, but divided into different sections based on the type of knowledge being tested (cun measurements, for instance, or pattern differentiation). I felt the most adequately prepared from this book, compared to all of the others in my list. You may be able to buy it through the NCNM bookstore. Just give them a call.
  3. The most expensive option, way out of reach for many students, is also probably the best. They offer a variety of testing products, including an option where you can make your own test using their question banks to help drill you on your weakest subjects. There are timed and untimed tests. Possibly the most important section of their website is where they have tests on particular subjects, for instance cun measurements or divergent channels. This helps you really work where you are weak, and I believe doing the divergent and luo channel tests may have saved me on the exam. It is quite expensive, though. I suggest you decide what exams you really need help with, and buy those ala carte. Make sure that you have the time available to devote to daily practice when you pay for it. I know a couple of students who paid for access but were unable to take advantage of it because of time pressures. That’s a costly mistake!
  4. Official NCCAOM Practice Tests. These have two advantages over First, they are relatively cheaper – you are in for a smaller outlay of cash. However, that doesn’t make them the best value – look at your options carefully. Second, they give you a (likely false) sense of security – these are tests from the test-writers themselves, right? How can that fail? So, if your anxiety level is high and you feel soothed by knowing that you’re being tested by the masters, try out a set of these. The format is essentially the same as TCMtests, except they don’t have as many options. No individualized tests, no single subject tests. You will get a taste for the way the exams actually flow – which is a good thing.
  5. The outlines and bibliographic lists provided by NCCAOM. By far, this was the most important “board prep” resource I used in studying. Pay. Very. Close. Attention. To. The. Content. Outline. If you don’t know something on there, like, say, divergent channels or… perhaps… the full list of “caution” or “contraindication” points – study it very closely. To my knowledge, no other board prep resource more adequately prepared me for the actual breadth and depth of the board exams. I’m serious. Read these. Know them. Love them.

I used many, many other resources in studying for the board exams. In general, you should use books you are already familiar with, but make sure to look at all the books in the bibliography section mentioned above. You should pay special attention to finding a TCM theory book you are comfortable with. I didn’t study much for the Foundations exam, as I feel I have that material pretty firmly down, but I know others were very thankful for their Maciocia as they studied.


My friends, you’re just going to have to memorize. I discussed a little of this in my prior post about studying using audio. However, I do have a few other suggestions about good study practices.

  1. Point category charts : Create a good set of your own point category charts, color coded if that works for you. Draw them several times a day until you could do so in your sleep. While I didn’t find a lot of specific category questions on the tests, knowing this information will go a long way towards making you feel generally comfortable and ready for the test.
  2. Drawing important parts of the body : I made a habit of frequently drawing the front and back of the body, along with all relevant points from all channels and any special information (like where organs are located, and at what depth). This helps engage your creative mind a bit, while also keeping you enmeshed in what this is supposed to be all about – real human bodies!
  3. When you’re sick of studying one topic, move to another – don’t just quit. I was studying for three exams at the same time, so when I would tire of rote memorization of point categories, I’d spend some time reading chapters of the Neijing or going through some old Western pathology notes. I might even change my location (from living room to backyard) or call a friend to do some back and forth quiz-and-recall. Speaking of quiz-and-recall, please do yourself a favor and read everything Cal Newport has ever written.  Yes, I know you’re not in undergrad anymore, but… seriously.

Here’s the deal, the adaptive testing mechanism that NCCAOM uses ensures that the test is going to be difficult, no matter how hard you study. While I know some people felt pretty confident when they pressed the final button, many people passed the ten seconds or so between ending the exam and getting their results in sheer terror of what they may see. I’m just thankful you get your results right away! The test is often incomprehensible, testing you on things you really aren’t sure anyone needs to know. You will throw your hands in the air wondering why, oh why, the testing gods have it out for you. But, one way or another, you’ll get through it. 🙂



About Eric Grey

Hi - I'm the founder of this site and the primary master of all functions here. When I'm not writing, you can find me reaching out to the Chinese Medicine community across the web and in my own backyard. I currently teach Chinese herbs at my alma mater, the National College of Natural Medicine. Additionally, I'm the founder of Watershed Wellness, a thriving local clinic in Southeast Portland in Oregon. No matter where I'm working, you'll find my focus on the Classical approach to Chinese medicine laced throughout everything I do.

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