BOC Exam Format
BOC Exam Format: Questions, Timing, Scoring, and Test Windows (2026)
The complete breakdown of the BOC athletic training exam, the Board of Certification, Inc. certification exam for athletic trainers: 175 questions in four hours, the five item types including focused testlets, the five domains and their exam weights, how scaled scoring and the 500 passing score work, eligibility, fees, the 2027 test windows, and retake rules. Sourced from the BOC certification requirements, the exam candidate handbook, and the Practice Analysis, 8th Edition.
Item Types
The Five Types of Questions on the BOC Exam
Every one of the 175 questions is one of five formats. Knowing the mechanics of each before exam day is worth points by itself.
One correct answer from four or more options. Multiple-choice questions are the most common item type on the BOC certification exam, and the one most review books prepare you for. Read the stem for the qualifier (first, most appropriate, best) before you read the options.
Choose all that apply, with partial credit for partially correct responses. The item tells you it is multi-select; the BOC specifically warns candidates to check whether a question is single or multi-select before answering. Guessing extra options costs you credit.
Order steps or match items to categories, with partial credit. Used heavily for emergency sequences (what you do first, second, third) and for matching findings to diagnoses or modalities to parameters.
Click a location on an image: a palpation landmark, a manual muscle testing position, an injury site, an electrode placement. Precision matters; practice with the BOC Self-Assessment Exams so you know how tightly the target is drawn.
A clinical scenario followed by several related items that build on each other: evaluate this athlete, then choose the next step, then decide on return to play. Testlets are where the exam tests clinical reasoning across the domains, and where pacing breaks down for unprepared candidates.
You can move forward and back through the exam and flag items for review. There is no penalty for wrong answers, so never leave an item blank. The BOC recommends deciding on a flagging strategy before exam day, for example reviewing flagged items every 20 questions or only at the end (BOC study tips). The BOC posts sample exam questions for each of the item types on its website, and the BOC Self-Assessment Exams (SAE) reproduce all five in test mode.
Content
The Five Domains and Their Exam Weights
The Practice Analysis, 8th Edition has been the exam blueprint since the March/April 2023 window. Domains II and IV together are 51 percent of the exam.
| Domain | Exam weight | Items (of 175) | What it covers |
|---|---|---|---|
| I. Risk Reduction, Wellness and Health Literacy | 20.0% | about 35 | Screening, evidence-based practice in risk reduction, environmental monitoring, protective equipment, patient education |
| II. Assessment, Evaluation and Diagnosis | 25.6% | about 45 | History, examination, special tests, differential diagnosis, plan of care, referral |
| III. Critical Incident Management | 20.8% | about 36 | Emergency action plans, triage, emergent care, scene assessment |
| IV. Therapeutic Intervention | 25.6% | about 45 | Rehabilitation planning, therapeutic exercise, modalities, manual therapy, return to activity, general medical conditions |
| V. Healthcare Administration and Professional Responsibility | 8.0% | about 14 | Quality improvement, policies, documentation, laws, regulations, and professional standards |
The five domains of athletic training practice in the Practice Analysis, 8th Edition replaced the five of the 7th edition in March 2023; the most visible change was Immediate and Emergency Care becoming Critical Incident Management, with Risk Reduction, Wellness and Health Literacy absorbing the old injury prevention domain. The free Content Outline for Practice Analysis lists every task statement under each domain; the full Practice Analysis adds the knowledge and skill statements, including the evidence-based practice expectations that run through every domain. Items on the exam are written from the BOC exam references list, so the content outline tells you what is tested and the references tell you where it comes from.
Scoring
How BOC Exam Scoring Works
The BOC uses criterion-referenced scoring: the passing standard is set by subject-matter experts to represent entry-level competence, not by a curve against other candidates in your window. The pass rate in your window has no effect on your scaled score. Your raw score, the number of scored items answered correctly, is converted to the 200 to 800 scale to adjust for small differences in difficulty between forms. Because the conversion is form-specific, there is no fixed number of correct answers that equals 500, which is why third-party practice exams can only estimate readiness.
Results are posted to your BOC profile two to four weeks after the last day of the exam window, with an email notification from the BOC. Candidates who pass see a pass result without a numeric score. Candidates who do not pass receive a score report with domain-level feedback, which is the single most useful document for planning a retake. Details are in the candidate handbook.
Eligibility and Registration
How to Register for the BOC Exam
You must graduate from, or be enrolled in the final semester or quarter of, a professional athletic training program accredited by CAATE. Since baccalaureate programs stopped enrolling after fall 2022, this is a master’s degree for nearly all candidates. Internationally certified athletic therapists (ARTI, BASRaT, CATA) have a separate pathway under the International Arrangement.
Your program director confirms your eligibility through the BOC system before you can register. Start the application early; the BOC advises allowing enough time for this step before the application deadline.
Create a BOC profile and submit the exam application with the non-refundable fee: $75 for NATA members, $100 for non-members. Application deadlines fall about four weeks before each window opens (dates).
Registration opens a few days before the application deadline and closes about a week after it. The exam fee is $375 in the United States and Canada, $495 elsewhere. ADA accommodation requests are due by the registration deadline.
Scheduling emails go out roughly a week after registration closes. Seats at Meazure Learning test centers fill in popular locations, so schedule the day the email arrives.
Test during the two-week window. If you tested before graduating, your final transcript showing the degree title is required before certification is issued. Results post two to four weeks after the window closes.
Fees
What the BOC Exam Costs
Current fees per the BOC certification page. A first attempt costs $450 to $475 for a domestic candidate; a retake costs the exam fee again.
Test Windows
2027 BOC Exam Dates and Deadlines
Five windows a year. Most spring graduates test in March/April or May/June; most December graduates test in January.
| Window | Apply by | Register | Exam dates | Results |
|---|---|---|---|---|
| January 2027 | December 7, 2026 | December 4 to 16, 2026 | January 2 to 16, 2027 | February 1 to 15, 2027 |
| March/April 2027 | February 22, 2027 | February 19 to March 3, 2027 | March 20 to April 3, 2027 | April 19 to May 3, 2027 |
| May/June 2027 | April 26, 2027 | April 23 to May 5, 2027 | May 22 to June 5, 2027 | June 21 to July 6, 2027 |
| July/August 2027 | June 28, 2027 | June 25 to July 7, 2027 | July 24 to August 7, 2027 | August 23 to September 7, 2027 |
| October 2027 | September 7, 2027 | September 3 to 15, 2027 | October 2 to 16, 2027 | November 1 to 15, 2027 |
Retakes
BOC Exam Retake Rules
The retake pass rate is the number to respect: 29.3% of retakers passed in 2024-25 versus 74.6% of first-time candidates, per the BOC exam report. A retake that repeats the first preparation gets the first result. Use the domain-level feedback on your score report to rebuild the plan around the domains that failed you; see our BOC exam pass rate analysis for the full retaker data.
Exam Day
What to Expect at the Test Center
Government-issued photo ID that matches your BOC profile name exactly, plus a second form. A name mismatch is the most common reason candidates are turned away at the test center.
Check-in includes identity verification and a personal item check. Personal items, including phones and watches, go in a locker. Arriving late can forfeit the seat and the exam fee.
About 82 seconds per item on average across 175 questions, less for simple multiple-choice and more for focused testlets. Run at least one full-length mock exam at the same length before you sit, and take the SAE in test mode so the clock and the navigation are familiar. Decide your flagging and review strategy before you sit down, and keep moving; the clock does not stop for breaks.
No negative scoring and partial credit on multi-select and drag-and-drop items. A blank item is the only guaranteed zero on the exam.
Get Started
Walk In Knowing the Format
FAQ
BOC Exam Format: Common Questions
175 items, including scored items and unscored experimental items that the BOC uses to test future questions. The BOC does not publish how many of the 175 are scored, and candidates cannot tell which items are experimental, so answer every item as if it counts. Source: BOC steps to become certified.
The BOC athletic training exam runs four hours in a single sitting at a Meazure Learning test center, with the ability to move forward and back through the exam. That works out to about 82 seconds per item, and focused testlets, which present a scenario followed by several related items, take longer than stand-alone questions.
Five item types: multiple-choice questions, multi-select (choose all that apply), drag-and-drop (ordering or matching), hot spot (click a location on an image, such as a manual muscle testing position or palpation landmark), and focused testlets (a clinical scenario followed by related items). Multi-select and drag-and-drop items can earn partial credit; there are no negative points for wrong answers. The BOC posts sample exam questions for each type, and the BOC Self-Assessment Exams (SAE) reproduce them in test mode.
Yes. The BOC athletic training exam, the BOC certification exam, and the ATC exam all refer to the same test: the Board of Certification, Inc. certification examination for athletic trainers. Passing it earns the ATC credential. There is one exam for the profession; the five domains of athletic training practice in the Practice Analysis, 8th Edition are its blueprint.
A scaled score of 500 on a 200 to 800 scale. Your raw score is the number of scored items answered correctly, all equally weighted, converted to the scale so that scores are comparable across exam forms. Candidates who pass do not receive a numeric score on their result letter; candidates who fail receive a score and domain-level feedback.
A non-refundable application fee of $75 for NATA members or $100 for non-members, plus a $375 exam fee for testing in the United States or Canada ($495 outside those countries). Total first-attempt cost: $450 to $475 domestically. Fees are listed on the BOC certification page.
The BOC offers five exam windows each year: January, March/April, May/June, July/August, and October. Each window has an application deadline about four weeks before testing opens, a registration period, a scheduling period, a two-week testing window, and a results date two to four weeks after the window closes. Candidates in the final semester of a CAATE-accredited program may apply before graduating.
The BOC Self-Assessment Exams (SAE) are the official practice tests, sold as $35 vouchers, with a test mode that mirrors the real item types and timing; the BOC recommends taking the SAE in test mode to learn the format. Third-party mock exams and question banks, including Practitionr, report raw percentages rather than scaled scores, so use them for pacing and gap-finding and the SAE as the calibrated check.
You can retake it in the next exam window; the BOC allows unlimited retakes within one year of the date your results were posted and recommends registering for the next window as soon as possible. Each attempt requires new registration and the exam fee. Some state regulatory boards set their own attempt limits. Per the BOC exam report, 29.3% of retakers passed in 2024-25, so treat a retake as a full preparation cycle, not a second try.