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2026 Statistics

Key Facts: Eidgenössisches Examen Chiropraktik Exam

BAG / FOPH

Exam Authority

Federal Office of Public Health (MedBG)

60 Cases + 10 OSCE

Exam Format

BAG Examination Regulations 2026

4h + 150m

Examination Duration

Swiss Examination Commission

6 Years

University Education (BSc + MSc)

University of Zurich Faculty of Medicine

2 Years

Postgraduate Residency (SAC)

Swiss Academy of Chiropractic

100

Practice Questions

OpenExamPrep

The Eidgenössisches Examen Chiropraktik is the Swiss Federal Licensing Examination for chiropractors governed by the BAG under MedBG. It assesses 60 written clinical cases (4 hours) and 10 OSCE stations (13 min each) across spinal biomechanics, neuro-orthopedics, radiology, red flags, and Swiss healthcare law.

Sample Eidgenössisches Examen Chiropraktik Practice Questions

Try these sample questions to test your Eidgenössisches Examen Chiropraktik exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1In the healthy human lumbar spine, where is the Instantaneous Axis of Rotation (IAR) for sagittal flexion and extension physiologically located within the functional spinal unit (FSU)?

A.In the posterior third of the intervertebral disc / anterior to the spinal canal

B.Directly within the center of the superior articular facet joint

C.In the anterior third of the anterior longitudinal ligament

D.At the tip of the spinous process of the inferior vertebra

Explanation: In a healthy lumbar functional spinal unit (FSU), the instantaneous axis of rotation (IAR) for sagittal flexion and extension is situated within the posterior third of the intervertebral disc (or superior endplate of the subjacent vertebra). Disc degeneration and annular tear disruptions cause erratic migration of the IAR, leading to segmental instability and abnormal facet joint loading.

2According to spinal kinematic principles, which coupled motion pattern occurs in the mid-to-lower cervical spine (C2–C7) during lateral flexion?

A.Lateral flexion is coupled with contralateral axial rotation due to horizontal facet orientation

B.Lateral flexion is coupled with ipsilateral axial rotation due to the 45-degree oblique orientation of the facet joints

C.Lateral flexion is strictly uncoupled from axial rotation due to the uncinate processes

D.Lateral flexion is coupled with pure sagittal extension regardless of posture

Explanation: In the subaxial cervical spine (C2–C7), lateral flexion is biomechanically coupled with ipsilateral axial rotation (spinous processes rotate toward the convexity, vertebral bodies rotate toward the concavity). This coupling is dictated by the approximately 45-degree posterocaudal angulation of the subaxial zygapophysial (facet) joints and the guiding action of the uncinate processes (uncovertebral joints of Luschka).

3Real-time cine magnetic resonance imaging (MRI) and bioacoustic studies have confirmed that the audible 'cavitation' or 'pop' produced during a high-velocity, low-amplitude (HVLA) spinal manipulation is caused by which physical mechanism?

A.The sudden mechanical snapping of deep paraspinal tendons over bony transverse processes

B.The rapid elastic collapse of pre-existing intra-articular nitrogen microbubbles

C.Tribonucleation resulting from rapid distraction of articular surfaces, dropping intra-articular pressure below fluid vapor pressure and generating a clear gas cavity

D.Immediate mechanical contact and impact between opposing articular cartilage surfaces

Explanation: Pioneering cine-MRI investigations (Kawchuk et al., 2015) established that joint cavitation during HVLA manipulation is driven by tribonucleation. As opposing articular surfaces are rapidly separated beyond their elastic limit, severe negative hydrostatic pressure develops within the synovial fluid, causing dissolved gases (principally nitrogen and carbon dioxide) to nucleate into a low-density gas cavity, accompanied by the characteristic audible sound and a transient post-cavitation refractory period.

4How does the spatial orientation of the zygapophysial (facet) joints differ between the mid-lumbar levels (L1–L4) and the lumbosacral junction (L5–S1), and what is its primary functional consequence?

A.L1–L4 facets lie in the transverse plane to maximize axial rotation, whereas L5–S1 facets lie in the sagittal plane to resist lateral bending

B.L1–L4 facets lie in the frontal plane to prevent lateral bending, whereas L5–S1 facets lie in the transverse plane to allow pelvic rotation

C.L1–L4 facets are completely horizontal, whereas L5–S1 facets are inverted to lock the sacral base

D.L1–L4 facets are oriented predominantly in the sagittal plane to resist axial rotation, whereas L5–S1 facets are oriented more in the coronal (frontal) plane to resist anterior shear force

Explanation: Mid-lumbar facet joints (L1–L4) are oriented predominantly in the sagittal plane (with J-shaped or curved articular surfaces), which facilitates flexion-extension while strictly limiting axial rotation to approximately 1–2 degrees per segment. In contrast, the L5–S1 facet joints are oriented more coronally (frontal plane), a critical adaptation that resists the substantial anterior shear forces imposed by the downward and forward tilt of the sacral base.

5What primary intradiscal biomechanical change has been documented during Cox flexion-distraction motorized decompression therapy in the lumbar spine?

A.A sustained reduction in intradiscal pressure to negative (sub-atmospheric) levels (below 0 mmHg)

B.A progressive increase in nuclear hydrostatic pressure exceeding 250 mmHg

C.Complete osseous fusion of the posterior facet joints

D.Permanent lengthening of the anterior longitudinal ligament by more than 20 mm

Explanation: Intradiscal pressure transducer studies (Cox, Gudavalli et al.) demonstrated that distraction and flexion-distraction techniques significantly reduce intradiscal pressure, often creating negative (sub-atmospheric, -50 to -150 mmHg) pressure within the nucleus pulposus. This negative pressure gradient promotes centripetal retraction of herniated nuclear material and increases fluid diffusion into the avascular disc matrix.

6During quiet and deep inspiration, how do the kinematic motion patterns differ between the upper ribs (ribs 1–5) and the lower true ribs (ribs 6–10)?

A.Ribs 1–5 move exclusively via caliper motion, whereas ribs 6–10 move strictly via pump-handle motion

B.Ribs 1–5 exhibit predominantly 'pump-handle' motion increasing anterior-posterior thoracic diameter, whereas ribs 6–10 exhibit predominantly 'bucket-handle' motion increasing lateral thoracic diameter

C.Ribs 1–5 exhibit bucket-handle motion, whereas ribs 6–10 exhibit pump-handle motion

D.All ribs 1–10 exhibit identical pure translation along the vertical Y-axis

Explanation: Biomechanically, the upper ribs (ribs 1–5) have costovertebral and costotransverse axes lying close to the coronal plane, producing predominantly 'pump-handle' motion that elevates the sternum and expands the thoracic cage in the anterior-posterior dimension. The lower ribs (ribs 6–10) have axes oriented closer to the sagittal plane, producing predominantly 'bucket-handle' motion that elevates the lateral rib shafts and expands the transverse (lateral) diameter of the thorax.

7When delivering a high-velocity, low-amplitude (HVLA) adjustment to the upper cervical or mid-cervical spine, why is it critical from a vascular biomechanics standpoint to minimize end-range passive cervical extension combined with extreme contralateral rotation during pre-positioning?

A.Combined extension and rotation causes immediate mechanical compression of the internal carotid artery against the hyoid bone

B.It increases intradiscal pressure at C6-C7 sufficiently to cause spontaneous annular rupture

C.It produces maximum tensile strain and torsional shear on the contralateral V3 segment of the vertebral artery as it winds around the atlas lateral mass

D.It leads to irreversible osseous locking of the uncinate processes against the transverse foramina

Explanation: Cadaveric and duplex Doppler hemodynamic studies demonstrate that end-range cervical rotation combined with extension places maximum elongation, stretching, and shear strain on the contralateral vertebral artery, particularly at the loop of the atlantoaxial (V3) segment. Modern Swiss chiropractic technique guidelines emphasize neutral or minimal pre-rotation positioning with lateral translation and localized vector targeting to minimize hemodynamic compromise and intimal shear.

8In Manohar Panjabi's classic conceptual model of spinal stability, what constitutes the 'neutral zone' (NZ), and how does early degenerative disc disease alter it?

A.The NZ is the extreme physiological limit of range of motion, and it decreases during early degeneration

B.The NZ is the zone where only active muscle contraction stabilizes the spine, and it disappears in osteoarthritis

C.The NZ represents the osseous boundary of the spinal canal, which narrows during disc herniation

D.The NZ is the region of intervertebral motion around the neutral posture where movement occurs with minimal internal resistance, and it widens significantly with early disc degeneration

Explanation: Panjabi's spinal stability system comprises the passive osteoligamentous subsystem, the active muscular subsystem, and the neural control subsystem. The neutral zone (NZ) is the initial portion of physiological motion where osteoligamentous resistance is minimal; early disc degeneration and microtrauma increase the size of the neutral zone, producing clinical spinal instability that requires increased muscular compensation.

9Which of the following conditions represents an ABSOLUTE contraindication to high-velocity, low-amplitude (HVLA) thrust manipulation of the involved spinal segment?

A.Active vertebral osteomyelitis or spondylodiscitis with endplate destruction

B.Chronic mild myofascial trigger point pain in the paraspinal musculature

C.Asymptomatic facet joint arthrosis without neurological deficit

D.Postural thoracic hyperkyphosis in an otherwise healthy 25-year-old athlete

Explanation: Active infectious processes of the spine, such as spondylodiscitis, epidural abscess, or vertebral osteomyelitis, cause severe structural weakening of the bone and disc matrix; applying mechanical thrust forces carries a catastrophic risk of pathological collapse, spinal cord compression, and dissemination of infection. Mild myofascial pain, asymptomatic arthrosis, and postural kyphosis are non-contraindicated conditions commonly managed conservatively.

10During physiological sacroiliac joint 'nutation' (sacral flexion), which movement of the sacral base relative to the ilium occurs, and which ligamentous complex is primarily placed under tension?

A.The sacral base moves posterior-superior relative to the ilium, tensioning the long posterior sacroiliac ligament

B.The sacral base tilts anterior-inferior into the pelvic basin, placing the sacrotuberous, sacrospinous, and interosseous sacroiliac ligaments under tension

C.The sacral base translates purely lateral by 15 mm, relaxing all pelvic ligaments

D.The ilium rotates anteriorly while the sacral apex moves anteriorly, tensioning the inguinal ligament

Explanation: Nutation (sacral flexion) involves the anterior-inferior tilting and translation of the sacral base relative to the ilium, with posterior movement of the sacral apex. This movement is the close-packed, inherently stable position of the pelvis (form closure) and increases tension across the sacrotuberous, sacrospinous, and interosseous ligaments.

About the Eidgenössisches Examen Chiropraktik Exam

The Eidgenössisches Examen Chiropraktik (Examen fédéral de chiropratique) is the Swiss Federal licensing examination for chiropractors, conducted under the Swiss Federal Act on University Medical Professions (Medizinalberufegesetz / MedBG). In Switzerland, chiropractic medicine is recognized alongside human medicine, dentistry, pharmacy, and veterinary medicine as one of the five primary university medical professions. Passing this rigorous federal examination awards the Eidgenössisches Diplom als Chiropraktorin / Chiropraktor (Federal Diploma in Chiropractic Medicine), which entitles the graduate to practice as an assistant chiropractor and embark on the mandatory 2-year postgraduate residency program leading to the specialist title 'Fachchiropraktor / Spécialiste chiropraticien' for independent practice. The examination covers clinical neuro-orthopedics, spinal and extremity biomechanics, manual manipulative therapy, diagnostic radiology and MRI, red flags and differential diagnosis, and Swiss health law (KVG, UVG, prescribing competencies, and radiation safety). Note on format and language: While the official federal examination is administered in German and French using written cases (KAF/MC) and practical OSCE stations, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official BAG release—specifically designed to reinforce core clinical reasoning, biomechanical principles, imaging findings, and Swiss health law.

Assessment

Two-part federal qualifying examination: 1) Written Theoretical Examination (Einzelprüfung 1): 60 clinical cases testing knowledge and application through KAF and MC questions over 4 hours (240 minutes); 2) Practical Clinical Examination (Einzelprüfung 2): 10 structured OSCE stations of 13 minutes each assessing clinical examination, manual diagnosis, radiographic analysis, manipulative technique, communication, and emergency management.

Time Limit

240 minutes (4 hours) written theoretical exam plus 10 OSCE stations (13 minutes per station, approx. 150 minutes total practical time)

Passing Score

Criterion-referenced standard passing score established by the Federal Chiropractic Examination Commission for each part independently; both the written theoretical and practical OSCE parts must be passed.

Exam Fee

Official federal examination fee is governed by federal administrative regulations (EDI fee ordinance) without a published single private commercial fee; university tuition applies during the preceding Master's program. (Bundesamt für Gesundheit (BAG) / Federal Office of Public Health (FOPH) and the Swiss Federal Examination Commission for Chiropractic)

Eidgenössisches Examen Chiropraktik Exam Content Outline

25%

Neuromusculoskeletal Diagnosis & Clinical Orthopedics

Comprehensive physical and neurological examination of the spine and extremities, dermatomal/myotomal localization, cervical and lumbar radiculopathy, myelopathy, peripheral nerve entrapments, headache differentials, sacroiliac dysfunction, and clinical orthopedic tests.

20%

Spinal Biomechanics, Kinematics & Manipulative Techniques

Functional spinal unit biomechanics, instantaneous axis of rotation, coupled motions, facet joint kinematics, high-velocity low-amplitude (HVLA) thrust mechanics, cavitation physiology, lines of drive, mobilization, flexion-distraction, and core rehabilitation principles.

20%

Diagnostic Imaging, Radiology & Radiation Safety

Acquisition and radiographic interpretation of plain spine and extremity films, craniocervical and spinopelvic mensuration lines (ADI, George's line, Cobb angle, Meyerding classification), MRI grading of disc herniations (Pfirrmann, Modic changes), CT indications, musculoskeletal ultrasound, and Swiss radiation protection ordinance (StSV) standards.

20%

Red Flags, Differential Diagnosis & Clinical Emergencies

Identification and emergency triage of cauda equina syndrome, cervical artery dissection (CAD/VBI), spinal epidural abscess, spondylodiscitis, spinal malignancies and metastases, osteoporotic fractures, abdominal aortic aneurysm, and systemic inflammatory arthropathies (axial SpA, RA, crystal arthropathies).

15%

Swiss Health Law, MedBG Scope & Interprofessional Practice

Swiss Federal Act on University Medical Professions (MedBG), first-contact portal-of-entry competencies, statutory health insurance (KVG/LAMal) and accident insurance (UVG/LAA) billing, prescription rights (analgesics, NSAIDs, muscle relaxants), physiotherapy referrals, work incapacity certification, and interprofessional coordination.

How to Pass the Eidgenössisches Examen Chiropraktik Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score established by the Federal Chiropractic Examination Commission for each part independently; both the written theoretical and practical OSCE parts must be passed.
Assessment: Two-part federal qualifying examination: 1) Written Theoretical Examination (Einzelprüfung 1): 60 clinical cases testing knowledge and application through KAF and MC questions over 4 hours (240 minutes); 2) Practical Clinical Examination (Einzelprüfung 2): 10 structured OSCE stations of 13 minutes each assessing clinical examination, manual diagnosis, radiographic analysis, manipulative technique, communication, and emergency management.
Time limit: 240 minutes (4 hours) written theoretical exam plus 10 OSCE stations (13 minutes per station, approx. 150 minutes total practical time)
Exam fee: Official federal examination fee is governed by federal administrative regulations (EDI fee ordinance) without a published single private commercial fee; university tuition applies during the preceding Master's program.

Keys to Passing

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Eidgenössisches Examen Chiropraktik Study Tips from Top Performers

1Master Clinical Neuro-Orthopedic Algorithms: Be completely proficient in distinguishing nerve root radiculopathies (C5-T1, L4-S1) from peripheral entrapments (e.g., carpal tunnel, cubital tunnel, meralgia paresthetica, tarsal tunnel) and upper motor neuron myelopathies.

2Understand Biomechanical Coupling & Kinematics: Review spinal coupling mechanisms across the cervical, thoracic, and lumbar regions, Panjabi's neutral zone concept, and the biomechanical parameters of HVLA thrust manipulation (force vectors, cavitation physics, and line of drive).

3Memorize Swiss Radiological Mensuration Standards: Know the exact normal values and clinical thresholds for the atlanto-dens interval (ADI <3 mm), Chamberlain's/McGregor's lines, George's line, Meyerding spondylolisthesis grades, and Cobb angle measurements.

4Recognize Red Flags Immediately: Train rapid recognition of cauda equina syndrome, cervical artery dissection (5 D's and 3 N's, thunderclap headache, Horner syndrome), spondylodiscitis, epidural abscess, Pancoast tumor, and spinal metastases.

5Review Swiss Health Law & MedBG Prescribing Rights: Be clear on Swiss insurance frameworks (KVG mandatory benefits, UVG accident coverage), direct access regulations, prescription limitations (analgesics, NSAIDs, muscle relaxants), physiotherapy prescription rules, and radiation protection standards (StSV).

Frequently Asked Questions

What is the Eidgenössisches Examen Chiropraktik?

The Eidgenössisches Examen Chiropraktik is the Swiss Federal licensing examination required under the Medical Professions Act (MedBG) to obtain the Federal Chiropractic Diploma. It qualifies graduates to practice chiropractic medicine in Switzerland under supervision and enter the 2-year postgraduate specialty residency.

How is the official Swiss federal chiropractic examination structured?

The exam consists of two parts: 1) A written theoretical part featuring 60 clinical case vignettes with Short-Answer Questions (KAF) and Multiple-Choice items over 4 hours (240 minutes); 2) A practical clinical part comprising 10 structured OSCE stations of 13 minutes each evaluating clinical examination, manual therapy, radiology, and communication.

What are the language requirements for the Swiss federal examination?

The official federal examination is conducted in the official Swiss national languages, specifically German and French. Candidates can choose their examination language upon registration with the BAG.

What is the legal status and scope of practice of chiropractors in Switzerland?

Under the MedBG, chiropractors are recognized as independent primary care medical professionals (first-contact portal of entry). They have full diagnostic autonomy, direct patient access under basic health insurance (KVG/LAMal) without prior GP referral (in standard models), the authority to order and perform radiographs, order MRIs/CTs/lab tests, prescribe musculoskeletal medications (analgesics, NSAIDs, muscle relaxants), prescribe physiotherapy, and issue certificates of incapacity for work.

What is required to open an independent private chiropractic practice in Switzerland?

Following completion of the Master's degree and passing the Eidgenössisches Examen, graduates must complete a mandatory 2-year full-time postgraduate residency (Assistenzzeit) organized by the Swiss Academy of Chiropractic (SAC) and pass the final specialist examination to obtain the title 'Fachchiropraktor / Spécialiste chiropraticien'.

Why is this practice bank presented in English?

International scientific chiropractic research, spinal biomechanics literature, and clinical neuro-orthopedic evidence are primarily published in English. This OpenExamPrep bank provides an English-language MCQ study adaptation designed to help candidates rigorously test their clinical decision-making, diagnostic skills, and legal knowledge.