Taking the PANCE

October 6, 2014

Article by Global Pre-Meds
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Pre-physician assistant clinical exposure in Tanzania If you attended physician assistant school and made it through the required coursework and clinical rotations, that’s a big accomplishment. But before you get a job as a physician assistant, you have another step to complete.

The Physician Assistant National Certifying Exam, which is referred to as the PANCE, is required in order to become licensed as a physician assistant.

In order to be eligible to take the PANCE, you must be a graduate of a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant. Applicants who earned their physician assistant degree in a country outside of the United States must still attend a school that is accredited by the commission.

An application and exam fee may be submitted 90 days before you expect to complete your program. Although you can submit an application and get the process started, the earliest you can take the exam is a week after you complete school.

After you apply to take the PANCE and your application is accepted, you will be given a 180-day timeframe in which you have to take the test. If you do not pass the exam, you can attempt it again, but need to wait 90 days before your next attempt. Although it seems unlikely to take six years to pass the test, that’s the maximum number of years given.

According to the National Commission on Certifying Physician Assistants, the pass rate for first-time test takers in 2013 was 94 percent. If you prepare appropriately, the odds are good you will pass the first time around.

Test content

The PANCE is a computer-based test that consists of 300 multiple-choice questions. The exam is broken down into six blocks, and each has a one-hour time limit to complete. Each section has 60 questions.

Questions on the test involve various organ systems and possible diseases and illnesses related to the system. Systems such as the endocrine, pulmonary, cardiovascular and reproductive are included. Some questions deal with choosing pharmaceutical therapy or formulating a diagnosis. Other questions are centered on taking a patient history or using diagnostic studies appropriately.

You can complete questions within the same block in any order. You can also go back to questions within a block to review. Once you move on to another block of questions, you cannot return to the previous block.

PANCE prep

Review material from lectures periodically. After every organ system, consider reviewing important information, such as the various diseases that can affect the organ. Reviewing the material as you go can make it easier when it comes time for the test.

Use study guides specifically for taking the PANCE. There are several different publishers of PANCE study guides. Although studying your notes and information from textbooks is helpful, study guides will help you become familiar with the type of questions asked.

Give yourself enough time. Most physician assistant programs take about two years to complete. You will likely want to take the PANCE as soon as you are eligible. While you don’t need to start studying for the exam on the first day of PA school, don’t wait until a week before the exam. If you have been staying current on the material, giving yourself a month or two to focus on the test is probably a reasonable amount of time.

Consider applying to be a teaching assistant (TA) in an anatomy or similar science class. Some PA programs may hire second year PA students to work as teaching assistants in a first-year science class. Teaching the material is a great way to reinforce the information.

When you are unsure of a concept, make flashcards, which provide a quick reference for you to refer to at a later time. Flashcards are a great tool to make studying easier and more organized.

Take practice exams. The National Commission on Certifying Physician Assistants has practice exams that can be purchased on their website. The exams provide you with an example of how questions are worded and the type of content included. Practice exams are also helpful to get an idea of your strengths and weaknesses.

Taking the PANRE

After you take and pass the PANCE, it may seem like you are home free as far as certifying exams—but not so fast. As part of the recertification process for physician assistants, you are required to take the Physician Assistant National Recertifying Exam (PANRE).

In 2014, the credentialing cycle for a physician assistant went from six to ten years. Every two years, physician assistants must complete 100 hours of continuing education. During the ninth or tenth year of your credential you must take the PANRE to recertify.

The PANRE is set up similarly to the PANCE. The good news is that the test is a little shorter than the PANCE. There are 240 multiple-choice questions that make up the PANRE. Each section is broken into 60-minute blocks.

When you take your recredentialing exam, you can pick a focus to be tested on. The three areas of focus are adult medicine, surgery and primary care. Although a certain percentage of general question are still asked, about 40 percent of the exam will focus on an area selected by the test taker. This allows physician assistants to focus on questions relating to the area of medicine in which they work.

Exam tips

Skip questions you cannot answer in a few minutes. If you are stuck on a question, move on temporarily. Get through the material you do know, then return to the questions you had trouble with. Keep in mind that you cannot go back to a previous block.

Read case studies carefully. Missing one or two words can make a difference in getting a question right or wrong.

Pay close attention to words, such as best or always, as they often provide helpful hints as to the correct answer.

Decrease pretest anxiety as much as possible. Too much anxiety can decrease your energy level and leave you thinking unclearly. Get a good night’s rest before the exam, eat a healthy breakfast, and give yourself credit for knowing your stuff.


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Gap Medics provides year-round hospital work experience for people aged 16 and over. Our shadowing placements offer a unique insight into the work of doctors, nurses, midwives, and dentists – helping students to focus their career aspirations before embarking upon medical training.