Pacing, flagging, and when to change an answer.
A test-day routine for the NCE and NCMHCE that protects your score from your nerves.
By Dr. Andrew Wichterman · September 14, 2026 · 5 min read · Updated October 22, 2026
Content gets you most of the way. The last few points come from how you manage the hours in the room. These are the habits that hold up under pressure.
Know your pace before you walk in
Divide the total time by the number of items or case studies and write down where you should be at each quarter. Check the clock only at those points. Watching it constantly costs attention and raises anxiety without changing your speed.
The arithmetic
200 items in 225 minutes is 67.5 seconds per item. The break after item 100 stops the clock. Aim to finish the first 100 at or before 110 minutes, leaving a small cushion for the second half when fatigue slows you. Practice at 60 seconds per item so that 67 feels generous.
Checkpoints to watch
Item 50 at 55 minutes or less. Item 100 at 110 minutes or less. Item 150 at 165 minutes or less. If you are behind at a checkpoint, stop deliberating on the current item, choose the best remaining option, flag it, and move. Flagged items get the leftover time at the end. Never leave an item blank; there is no penalty for guessing.
Check the current handbook. Time limits and item counts for both exams are set by NBCC and listed in the current candidate handbook. Use those numbers to calculate your pace.
First pass, then flag
Answer every item on the first pass. If you are unsure, pick your best choice, flag it, and move on. Never leave an item blank; there is no penalty for a wrong answer, and a blank is a guaranteed miss if time runs out. Come back to flagged items after the first pass with whatever time remains.
On changing answers
Change an answer only when you can name the reason: you misread the stem, you found the deciding word, you remembered the fact. Do not change because the new choice "feels" better on a second look. Research on answer-changing is more favorable than the folk wisdom suggests, but only when the change is based on new information rather than doubt.
Read the last line of the stem first
On long scenario items, read the actual question before the scenario. Knowing whether you are being asked for the first step, the most ethical response, or the likely diagnosis changes what you look for in the text. This is especially useful on the NCMHCE, where the case material is long and only part of it matters for any single question.
Eliminate before you select
Cross off the choices that belong to a different stage, a different theorist, or a different question. Two remaining choices at fifty percent is a far better position than four at twenty-five, and elimination is often faster than searching for the right answer directly.
Breaks
If the exam allows a break, take it, even if you feel fine. Stand up, drink water, look at something far away. Attention degrades quietly. A short reset in the middle protects the second half.
The night before and the morning of
No new content. A light review of your most-missed cards if it calms you, nothing if it does not. Eat what you normally eat. Arrive early enough that check-in is boring. Your job that morning is to be rested and unremarkable.
None of this replaces preparation. All of it protects the preparation you did.