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The PANCE Exam at a Glance

The PANCE exam is a computer-based, timed test comprised of 300 multiple-choice questions assessing medical and surgical knowledge required to become a certified physician assistant. The PANCE exam is administered in 5 blocks of 60 questions each, with 60 minutes provided for the completion of each block. Exam questions fall into two categories: organ systems and diseases, disorders and medical assessments that relate to those systems; and knowledge and skills needed to confront those diseases, disorders and assessments. The PANCE exam is administered by computer year round at more than 200 Pearson VUE testing centers throughout the U.S.

For a breakdown of the PANCE content blueprint check out the NCCPA web site at

PANCE Registration Basics

Before scheduling an appointment to take the PANCE, you must submit a registration application to the NCCPA, and pay the PANCE examination fee of $475. After obtaining a scheduling permit from the NCCPA, you can then register to take the PANCE at any Pearson VUE Testing Center. The scheduling permit spells out the specific start and end dates of your selected three-month window of eligibility. Visit to schedule your exam date and get directions to testing centers in your area.

Before choosing your three-month window of eligibility to take the PANCE, you should be aware of several factors that need to be taken into account:

  • The NCCPA does not accept PANCE applications until 90 days prior to your expected program completion date.
  • The NCCPA requires a 7-day waiting period after graduation from PA school in order to verify your program completion. If this verification of completion is not received from your school, your exam window is withdrawn by the NCCPA.
  • You should allow time after graduating date for the verification process (above) and several additional weeks to assure that you have sufficient room within your window end date to secure a test appointment at the location you select.
  • You can only take the PANCE once in a 90-day window, or three times a year.

Learn more about the PANCE Exam.

Understanding Your Score

Your PANCE score is a scaled score, which means that it does not report the number of items answered correctly, or a percentage answered correctly. Rather, the scaled scoring system involves the number correct as well as the relative difficulty of those items. There are different versions of the exam, which vary slightly in difficulty. A slightly lower percent correct is required for examinees receiving a more difficult version of the test, while a slightly higher percent correct is required for examinees receiving a slightly less difficult version of the test.

PA graduates from 2003 on have up to six attempts in six years to pass the exam, and may take the exam once in any 90 day period or 3 times in a given year.

Once examinees have registered for the PANCE, and have received their three-month eligibility window, they can request a letter from the NCCPA verifying their eligibility status to be sent to their state board in order to obtain a temporary license. The Credentialing Info Release form, from the examinees personal record, may be sent by fax, email, or regular mail., Check the NCCPA web site at for specific addressing information for the applicable sending method.


Physician Assistants who currently hold NCCPA certification must pass a recertification exam before the expiration of their certificates, which occurs at the end of the sixth year of the certification maintenance cycle. The exam may be taken as early as year five. PANRE is administered at Pearson VUE Testing Centers. PANRE is a computer based examination composed of 240 multiple choice questions administered in four blocks of 60 questions with 60 minutes to complete each block. PANRE examinees must complete the exam within 4 hours. You have choices to make when taking the PANRE. While 60% of the generalist exam will cover the same content as always, the remaining 40% can be directed towards more generalist questions in one of these three areas:

  • Adult medicine
  • Surgery
  • Primary care

This option gives PAs the opportunity to focus more of the exam on their general area of practice—or continue with "business as usual" by choosing the "primary care" option. The PANRE will still be a generalist exam, you will just have the option of having more generalist questions in one of the areas listed above. No matter which option you choose, the content blueprint remains the same because it is still a generalist exam.

You may only take the PANRE once in any 90-day period and you may only take PANRE twice in your fifth year and twice in your sixth year. You have up to 180 days from the beginning of your exam timeframe to take the exam. If you apply late in your sixth year, your time frame will be shorter than 180 days.

Taking the Exam



Take a comprehensive test

If you have access, use the PANCE/PANRE Qbank to take a comprehensive test to measure where your recall is right now. Take the test under timed mode so it will provide a more reliable estimate of your current readiness and knowledge level across all subjects.


Determine how much time to invest in each area

Once you know your current recall (% correct) for each subject, use this data to decide how much time to invest in each area. For example, if Cardiology is 20% lower than Pulmonary, you should spend at least 20% more time reviewing Cardiology than you put into reviewing Pulmonary.


Stay focused on what is most important for you to know

Use the PANCE Notes to do this more efficiently, rather than going back to course notes or text books.


Do some practice questions

After you study a section of material, do some practice questions (at least 25 items) covering what you just reviewed. This will help you locate gaps where you still need to clarify your understanding and give you practice in applying your knowledge to questions.


Take a 90-item test

If you have access, use the PANCE/PANRE Qbank to create and take a 90-item test containing items from all of the subjects that you have reviewed up to that point as you complete each new subject. For example, if you have finished Musculoskeletal and Endocrine, take a timed test assessing those 2 subjects.


At the beginning of the final week, take at least three 90-item tests covering all subjects

The hours spent self-testing will increase your mental stamina and help you feel comfortable with the pacing needed on test day. Keep track of your percent correct as you take practice tests so that you can see your progress.


During the final week, review your summaries and take practice tests

Plan time during the final week to do nothing but review your own summaries and do practice tests with 5-10 minute breaks in between. This is the final "get it all fresh in mind and intensive test-taking" phase. Performance of 70% or better is a good level to aim for.


As you review, try to analyze what kinds of errors you are making on practice questions

Look not just at topics that might be weak, but look at other aspects of questions that give you trouble, such as items that present symptoms and ask for a diagnosis, items that ask which lab test confirms a diagnosis or what physical defects would give a certain pattern of findings, items that ask how common or rare a problem is, etc. Spotting patterns among the errors you make usually gives you a pretty good idea of what to fix in either your review or test-taking approaches.


Be realistic about the number of hours per day you plan to study

Efficient study for 6-7 hours will probably accomplish far more than forcing yourself to study for many more hours per day. Think of this final study phase as an opportunity to understand and integrate what you know so you will have a foundation to think with when you look at the PANCE questions.


Mix up what you are doing during each study day to break the monotony

For example, you might want to review your notes for 2 hours, and then spend an hour doing practice questions. Take a lunch break, and then spend some time reading questions explanations and searching for patterns in your errors or working with flash cards or using a cover up card to practice recalling from charts or tables. Locate and clarify problematic topics you discovered in practice testing to wind up the study day.


Consider finding another student who is willing meet you to do questions aloud

Alternate roles so that one person talks through the item while the other gives feedback. Both benefit and you may notice some habits that are costing you points and pick up new strategies from each other.

A Week Before the Exam


Focus on what you know

Taper off your reviewing and focus instead on making what you already know more retrievable.


Review your summaries

Review your own summaries and concentrated notes to refresh the key concepts and crucial aspects in your mind.


Review practice questions

Work through practice questions in order to pinpoint what you still find it difficult to recall so that you can then clarify the information using your notes or the item explanations.


Adjust your internal clock

If you tend to be a night owl, gradually adjust your biological clock so that you will be able to sleep the night before and wake up on test day ready to perform mentally. Avoid taking naps during the day this week to train yourself to be alert during the hours you will be taking the exam.


Allow at least 6-8 hours to sleep each night

Your brain continues to integrate and consolidate information while you sleep, so this rest mode is essential for good recall.


Allow at least some time every day this final week for recreation and relaxation

Last week cramming will only raise your anxiety level and leave you feeling less in control, so don't succumb to the temptation to get through it all just one last time. What you will be most likely use in dealing with the questions is already stored in your head anyway, so be gentle with yourself.


Do a dry run to the test center

You may want to check out a map or drive to the test center so you will know exactly how it's situated and how long it will take you to get there on test day.


Familiarize yourself with the Pearson VUE testing software

If you aren't already familiar with the testing software and administration details, review these at the Pearson VUE web site ( this week. Make sure that you understand what you should bring along that morning, where the key information and function buttons are on the testing screen and how to navigate among the screens, and how break time is handled.

The Day Before the Exam


Take the day off from studying

Research has shown that anything you study right before an exam is more likely to hurt than help your performance. Why? Because the last-studied information is still floating around in your short term memory and actually interferes with recall of information that you studied days, weeks or even months before.


Plan something fun to do as a reward for all the effort you have put into getting ready

Call friends to make plans for after the exam is over. Take in a good movie or shop at a favorite store. In short, do something appealing that you put off during the previous weeks of preparing and treat yourself to something special.


Watch your intake of caffeine

Nothing drives up your anxiety level faster than not being able to fall asleep the night before an exam, so avoid beverages like coffee, tea, or colas unless they are decaffeinated.


Try to relax

Try to relax with physically tiring activities like swimming, jogging, or biking so that you will feel tired enough to sleep. A warm shower or bath close to bedtime will also help relax you. Unless you know exactly how it will affect you the next day, avoid taking any sleeping medications because they may leave you feeling groggy.


Prepare the night before

Lay out everything you will need the night before so you won't have to stress out locating your lucky shirt or the test permit tomorrow morning. If you plan to drive to the test center, make sure you have enough gasoline.

Managing Test Day

Taking the PANCE is NOT the make-or-break day of your life, nor is it a test of your intelligence. It's just one more step on your path to becoming a licensed physician assistant. So keep it in perspective. If you have prepared carefully and practiced with questions, you can approach this exam in a methodical way, dealing with each question as it comes, making your choice, and then moving on.

No matter how well you have prepared, however, you should expect to miss some questions. Unlike school exams, standardized licensure exams are designed so that everyone will miss at least some items. It is important to record an answer to every question because there is no guessing penalty, so you will score higher by never leaving an item blank.

Test Day Tips


Plan to arrive early

Plan to arrive at the Pearson VUE testing center at least 30 minutes ahead of time. If you are unfamiliar with its location, look at a map or scout out the location before your test date so that you won't have to worry about getting lost or find a place to park.


Use your break time wisely

Using the restroom, grabbing a quick snack, or simply stretching your legs will help you stay comfortable and better able to focus during each 60-minute testing period.


Don't change answers

Don't change answers unless you realize that you have misread something that directly affects the meaning of the question or a choice. Initial choices tend to be correct ones, and everyone feels tempted to change when dealing with items assessing weaker topics. Most answer changes move from one wrong answer to another wrong answer, so stick with your first decision and don't obsess.


Monitor your time

Monitor your time so you won't have to rush through final questions in a block. Time use is displayed on the testing screen, so check the time remaining at questions 15, 30, and 45. These 1/4-, 1/2-, and 3/4-point checkpoints will allow you to adjust your speed if necessarily, without allowing you to lose thinking time by too frequent glances at the clock.


Focus on what you know

With each question, focus on what you DO know rather than mentally berating yourself when you encounter unfamiliar terms or other elements in questions. Ask yourself what more general principle or concept the question is assessing, and then reason from that more general knowledge to eliminate choices and to select an answer more likely to be correct. Giving up too soon and marking your favorite letter should be a final resort option used only when you are truly clueless about what's being asked.


Remember that the correct answer will be the only choice that fits ALL the information given in the question

If a choice fits most, but not all, the clues, then it is incorrect and should be ruled out.