Passing the NPTE: Tips for Success

Good luck to everyone taking the NPTE next week!

…Not funny? That’s fair. Not cool, Joe.

In all seriousness, we are just about 8 weeks out from the July test dates and if you haven’t started studying yet – I strongly recommend getting started soon.  It’s a tough exam and the more study time and practice you can get in, the better.

That said, I would like to share my thoughts on preparing for the NPTE, what I found to be helpful to focus on, and what ultimately led to me passing the exam.

Scorebuilders or O'Sullivan?

This question is always asked. It never fails. Which book is better? Is this all I need to pass the exam? Having owned both, I will give you an answer you’ve probably heard a lot in school – it depends. It depends on your learning style and your general level of comfort and proficiency in various topics. The truth is people have found success with either book. Here is what I found to be the difference between the two books.

  • Scorebuilders: An easier and more enjoyable read. Colorful, with a lot of diagrams, tables, and pictures. And a lot less daunting to go through. With that said, I felt that some sections were very brief at times and I was left wondering if I had really taken anything away from it at all. The practice exams themselves are considered to be on the easier side with questions usually asking for more basic and superficial information.
  • O’Sullivan/TherapyEd: This book contains a lot more detailed information with the downside being that it is quite devoid of many pictures or color in general. I've heard it likened as one long bullet point list. The practice exams are more difficult and really challenge you to think through your answers. Don’t be surprised if you’re scoring low on these.

**There are other review books out there as well as some review courses for the NPTE. I can't speak to their effectiveness however.*

Personally, I liked O’Sullivan a lot more. I felt that it was better to be exposed to as much information as possible with the hope that more will stick in the end. Again, this is just my opinion – by no means am I saying you’re doing anything wrong by choosing one over the other. It depends on what works for you.

"What is considered a passing percentage on a practice exam?"

There isn't really an answer to this question. Some have claimed scoring in the 60s as "good enough." Others advise scoring in the 70s (which I agree with). One guy on the StudentDoctor forum recommended scoring in the 90s on Scorebuilders (are you kidding me?).

Organize Yourself

Really Mr. Study Guru? This is your sagely advice? Well, it’s true… The NPTE has a lot of information on it and it can very easily feel like you’re in way over your head. What I did was buy those yellow file folders from Office Depot and labelled each one of them by test section (e.g. musculoskeletal, neuro, cardiopulm, integ, research, modalities, etc.). As I read through O’Sullivan, I wrote down defining characteristics of each topic and then threw those notes into their respective folder. Whenever I felt like I needed to brush up on a particular section, I would just refer to that folder. It really helped me a lot. So when I suddenly had no idea where venous insufficiency ulcers commonly occurred (hope you have an answer in your head), I had a quick and easy reference.

 [...medial malleolus.]

I also found mobile flashcard apps very useful - StudyBlue comes to mind. You can make flash cards that can be shared among your classmates, take it anywhere you go to maximize your productivity, review the content in a list-format, and even quiz yourself to test your knowledge. This is very convenient and less cumbersome than carrying a fat stack of cards around with you.

When In Doubt, Focus on the "Big 3"

The Musculoskeletal, Neuromuscular, and Cardiopulmonary systems make up the Big 3 of the NPTE – something like 70% of the exam. Sometimes you have to play the percentages here. Sadly, in my opinion, the topics that largely make us worthy of our doctorate titles (e.g. research and evidence-based practice) are only represented by 4-5 questions on the actual exam. I’m not saying don’t read up on the remaining 30% of the exam content (it’s very unlikely you will get ALL your Big 3 questions correct), but when you are studying and test day is around the corner – I would shy away from spending a disproportionate amount of time on a tiny detail within an underrepresented section.

>Here's a PDF courtesy of our friends at the FSBPT that outlines the exam with percentages and question ranges.

Review Your Practice Exams

It’s really great that you got a 63% on that O’Sullivan practice test… a three-point percentage increase from your last try. But why the improvement? What area did you improve in? Make sure to review ALL of the questions, not just the ones you got wrong. Why did you get something right? Did you have zero idea what the question was asking and you just got lucky? Were you down to 50/50 and you picked the right one? Is it a particular type of question (e.g. intervention-related) that you find yourself always getting wrong? Personally analyzing your performance on practice tests provides invaluable information that helps shape your studying from that point. Do it.

Buy and Take the PEAT

I can’t stress this point enough. The questions you encounter through Scorebuilders or O’Sullivan, while challenging at times, were not written by the committees that write the NPTE. The most accurate and representative of the type of questions you will encounter on the NPTE are found through the PEAT. For $99, you are provided with two practice exams developed by the FSBPT, one of which is an actual retired exam from a previous year. Why not take advantage of this?

Check this out:

At the PT level, the percentage of candidates who passed the PEAT retired form (with a score of 600 or higher) and later went on to pass the NPTE was 99.3%, meaning only 0.7% of those who passed the retired form later failed the NPTE. Although passing the PEAT is by no means a guarantee of future success on the NPTE, the finding that less than 1% of the PT candidates who were told they were on track to pass based on the PEAT retired form later failed is excellent – it demonstrates that candidates are not being misled by PEAT results.

Practice A Lot and in Test-Like Conditions

Take as many practice exams as you can handle (different for everyone). Or if you can’t handle a full exam, try to do a handful of practice questions. Repetition matters. More importantly here, practice in test-like conditions. No phones, no music, no snapchatting pics to your friends. Build up your endurance and attention span for the NPTE because mental fatigue is a real thing. During my early practice tests, I would always start floundering attention-wise at around question 70 or so. This resulted in some poor decision-making in an attempt to just get to the 15-minute break at the end of the section. Not a great strategy.


The most important tip of all is to just relax. Take breaks as you need them. Go for a run or watch a movie. Take one day a week to step away from your preparation. Whatever you need. It can feel overwhelming and sometimes frustrating - especially if you feel like you aren't seeing improvements on the practice tests. But don't worry. You deserve to be here. You've put in a lot of work to get to this point. You have the tools necessary for success. Fight the thoughts of Imposter Syndrome. And if you can't get it done on the first try, you'll come back even stronger on subsequent tries. This exam does not define your worth or skill-set as a physical therapist or a person.

Best of luck on the exam!