The PANCE and PANRE is the certification exam for physician assistants.

PANRE - Physician Assistant National Recertifying exam - this exam occurs every 6 years but will soon increase to every 10 years.
PANCE - Physician Assistant National Certifying Exam - this is the initial exam for certification after graduation.

The Exam is broken down into 300 questions.

The Blueprint is linked here at the NCCPA website

The break down is as follows:

System Percent # of Pance questions # of PANRE questions
Cardiovascular 16% 48 42
Dermatologic 5% 15 12
EENT(Eyes, Ears, Nose and Throat) 9% 27 21
Endocrine 6% 18 14
Gastrointestinal/Nutritional 10% 30 24
Genitourinary 6% 18 14
Hematologic 3% 10 7
Infectious Diseases 3% 10 7
Musculoskeletal 10% 30 24
Neurologic System 6% 18 14
Psychiatry/Behavioral 6% 18 14
Pulmonary 12% 36 28
Reproductive 8% 24 19
Total 100% 300 240


Study thoroughly

  1. Become well versed in all topics that the exam is likely to cover (refer to the NCCPA’s Content Blueprint).
  2. Answer as many practice questions as you can. (Study books & CDs are excellent for this.)
  3. Become familiar with all parts of a test question.
  4. Take a review course (you’re here) or organize a study group with others planning to take the exam.
  5. Ask an instructor or colleague for help if you encounter material that's unfamiliar or difficult to grasp.


Plan carefully


  1. Schedule your exam at a test site near your residence, if possible. This way, you can familiarize yourself with parking facilities and travel time before the test date. If you must travel far and stay overnight, make hotel arrangements well before the test date to make sure you have a convenient place to stay.
  2. Schedule your examination for the time of day when your performance peaks. Some people work best in the early morning; others, in the late afternoon or early evening.
  3. Get a good night's sleep the night before the test. Staying up late for last-minute cramming probably will hurt rather than help your performance.
  4. Eat a nutritious breakfast on the day of the test. Don't alter your caffeine intake on test day. (if you drink coffee, that's fine...if you do not drink coffee or other stimulants...don't start!).
  5. Try to avoid last-minute anxiety that can sap your energy or disturb your concentration. Although mild anxiety is normal and can heighten your awareness, too much anxiety can impair your performance.
  6. Keep your admission ticket and identification where you can easily retrieve them when you arrive at the test site. You must present your "Authorization to Test'' from the NCCPA, along with two forms of identification with your signature, including one photo ID. Without them, you won't be permitted to take the test.


Master test-taking strategies


  1. Read each case study carefully. It contains information you'll need to answer the question correctly. There is rarely extraneous information to trick you.
  2. Pay special attention to such words as best, most, first, and not when reading the questions. These words, which may be italicized, capitalized, or otherwise highlighted in some way, usually provide clues to the correct response.
  3. Try to predict the correct answer as you read each question. If your predicted answer is among the four options, it is probably the correct response.
  4. Read each question and all options carefully before making your selection. If two options seem equally correct, reread them; they must differ in some way. Also reread the question; you may notice something you missed before that will aid your selection. If you're still not sure, make an educated guess and “flag” the question for later review.


  1. Remain calm if a question focuses on an unfamiliar topic. Try to recall patients with problems similar to those in the question. Determine the medical principles involved in your patient’s care and how they apply to the test question. This may help you eliminate some options and increase your chances of choosing the right answer.
  2. Don’t panic! Systematically eliminate the distracters you know are wrong, then make an educated guess and move on.
  3. “Flag” questions you can't answer in a reasonable amount of time (more than 2 minutes). Don't forget to go back to those and at least guess later. You must average 1 minute per question to finish each block in time.
  4. Take the necessary time for each question without spending too much time on any one item. Pace yourself according to the time allotted. Pay no attention to other candidates or the time they need to complete their tests.
  5. Finally, take advantage of breaks during the test to give your mind and body a needed rest. If you tend to get hungry, bring a small snack with you to eat during the breaks. Do some stretching exercises during breaks to help you relax.


Specific Comments about the Computerized PANCE/PANRE:


  1. Call the testing center early and be sure about the date you choose, it is difficult to change later.
  2. Staring at a computer screen is hard on the eyes. Be sure your eyes have been check, you have your "proper" glasses, and/or your contacts in before you go.
  3. It is not possible to mark key words in the questions. You really have to read and reread the question to make sure you don't miss key words like EXCEPT.
  4. Start preparing for the PANCE on your first rotation. While on mandatory clinical rotations, study each like you are preparing for the exam. Make your own study guide notes for each rotation. These will make your studying time for the exam more of a review of information you already know.
  5. Arrive at least 30 minutes early (day before?) and be sure you know where the testing center is and where to park.
  6. Bring a photo ID (driver’s license or passport) and scheduling permit. Bring your test center receipt also to be sure.
  7. You will be issued a locker for valuables, including your digital watch. (The computer has a visible timer).
  8. Personal belongings are NOT allowed in the testing room.
  9. The only writing permitted while in the testing room is on the center’s non-removable, erasable laminated note boards.
  10. You are allotted six (6) hours for the 300-question exam.
  11. Once you begin a block of test questions, no clock-stopping breaks are permitted.
  12. There is a total of 45 minutes allotted for breaks during the examination to be taken between blocks. While taking a "scheduled" break, you are permitted to access personal items that have been stored in your locker during the exam. While on an "unscheduled" break, you are not allowed to access any personal items other than medication or food required at a specific time and with the approval of the test administration. Items not permitted include, but are not limited to, cell phones, PDAs, computers, and blackberries. In addition, you may not access exam notes, books or study guides.
  13. To pass PANCE/PANRE, you must correctly answer ~55% of the questions, depending on which version of the test you take.


Hancock Educational Learning Programs offers an online review course and a live course with online access click the links to learn more.

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