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The complete guide

NPLEX Part I: A Breakdown of the Biomedical Science Exam

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.

200multiple-choice questions
50case clusters of four questions
2 × 2.5htwo 100-question sessions, same day
~7 wksfor scoring after the exam

Question format

Questions generally center on a patient case

Per the official study guide: a short case, then questions on the science behind it.

The case

A brief patient summary, diagnosis included.

  1. 1Where is it, and what supplies it?Anatomy
  2. 2What normal process is involved?Physiology
  3. 3Which pathway or organism?Biochem · Micro
  4. 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 round. 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

The 11 body systems and their 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%
  • Gastrointestinal12%
  • Musculoskeletal10%
  • Neurological10%
  • Reproductive10%
  • Urinary10%
  • EndocrineLive on NDBlueprint8%
  • Immunological8%
  • Pulmonary and Upper Respiratory Tract8%
  • Hematopoietic6%
  • 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.
  • Practise 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

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.

Which body systems carry the most weight?

Cardiovascular and Gastrointestinal (about 12% each), then Musculoskeletal, Neurological, Reproductive and Urinary (about 10% each). The full breakdown is in the table on this page.

How long do NPLEX Part I results take?

Scoring takes about seven weeks after the 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.

Is NDBlueprint affiliated with NPLEX or NABNE?

No. NDBlueprint is an independent study platform built around the published NPLEX Part I blueprint.

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.