Program Pengelolaan Peralatan Medis

Passing the NCCPA PANCE
The PANCE is the most feared exam for physician assistant students. After all, in order to
become certified, this is a necessary obstacle.
It's funny, even those who are calm, cool, and collected throughout PA school start to feel the
pressures of this exam.
Why do we have so much anxiety about the PANCE?
I mean, it's not like the material is new or different. In fact, you have been studying for this
moment the second you started the program. And, if you've gotten this far, then you’ve not only
studied for 2-3 years, but you've also passed and graduated.
Yet, for some reason everyone still tends to stress 10x more about the boards.
In this guide, we are going to show you exactly what you need to know to pass the boards and
get into practice!
So, let’s get started…
1. The PANCE Blueprint

A breakdown of the categories and tasks
The Physician Assistant National Certifying Exam (PANCE) measures two categories:
• Knowledge of the diseases/disorders

• Skills related to tasks PAs perform (e.g. formulating likely diagnoses, clinical interventions,
etc).
All topics tested are found on the NCCPA’s 2019 PANCE blueprint.
What has changed in the 2019 NCCPA blueprint?
As of 2019, there are changes in the content of the blueprint - creation of new sections and
increases or decreases in other sections.
Below you will find a table that lists the changes
Medgeeks Page 1 of 37
NCCPA PANCE—Prior Blueprint vs 2019 Blueprint by Organ Systems
Organ System Prior Blueprint 2019 Blueprint Total Changes
percentage percentage
Cardiology 16% 13% Decrease 3%
Dermatology 5% 5% None
Endocrine 6% 7% Increase 1%
Eyes, Ears, Nose, and 9% 7% Decrease 2%
Throat
Gastrointestinal/Nutrition 10% 9% Decrease 1%
Genitourinary 6% 5% Decrease 1%
Hematology 3% 5% Increase 2%
Infectious disease 3% 6% Increase 3%
Musculoskeletal 10% 8% Decrease 2%
Neurology 6% 7% Increase 1%
Psychiatry/behavioral 6% 6% None
science
Pulmonary 12% 10% Decrease 2%
Renal 0% 5% New section
Reproductive 8% 7% Decrease 1%
NCCPA Task Categories

Task Categories Prior Blueprint 2019 Blueprint Total Changes
percentage percentage
History Taking and 16% 17% Increase 1%
Performing Physical
Examination
Using Diagnostic and 14% 12% Decrease 2%
Laboratory Studies
Formulating Most 18% 18% None
Likely Diagnosis
Managing Patients
Health Maintenance, 10% 10% None
Patient Education,
and Preventive
Measures
Clinical Intervention 14% 14% None
Pharmaceutical 18% 14% Decrease 4%
Therapeutics
Applying Basic 10% 10% None
Scientific Concepts
Professional Practice 2% 5% Increase 3%
Besides this table, I wouldn’t spend too much time overanalyzing the details of what else has
changed. Yes, some sections were moved to other organ systems, new titles were given to other
sections, etc.
But, don’t worry about this too much.
Just focus on what really matters: Passing the PANCE!
What you should and shouldn’t study
Studying should be guided by the NCCPA PANCE blueprint, which quite literally lists all the
topics—categorized by organ systems— that could be on the exam.
Do you get the inkling that this blueprint is perhaps the most important study guide ever? Yep!
Make sure you have enough time to cover each and every topic. Some systems are more heavily
weighted than others (see table above). As such, it is recommended to spend more time on these
specific organ systems!
Now, let’s focus our attention on a few scenarios…
Something, most struggle with, is deciding whether to order a CT vs MRI vs ultrasound - when
all are considered acceptable.
What if they put all three choices on your exam, which will you choose?!
What's important here is understanding they won't ask you to choose - so long as they are all
considered to be equal in the context of the question.
This means you will only be presented with one option.
If they give you more than one option, they must give you a scenario, with some sort of
contraindication.
Let's take the CT scan and pregnancy.
Your exam will give you everything you need to know to make the diagnosis and to properly
treat the patient. Another way to think of this is:
• On your exam, you will get all the information up front.
• In real life, you will get the information you ask for.
This means they have to tell you something pertinent to make the diagnosis.
The only way to do this is to give you associations, classic presentations, triads, etc.
Learn these, because it would be unfair to test you on unusual presentations and/or on
uncommon scenarios.
Syphilis is another great example of this. On exams, syphilis always presents with a painless
genital ulcer. But, guess what? In clinical practice, the ulcer can be painful.
Again, here lies the difference between exams and real life; you will never see syphilis present
this way on your exam… because it would be unfair.
Lastly, what do we do about guidelines which aren't clear or with those treatment options that
don't have a definitive role?
Easy! Don’t worry about them.
I know, easier said, than done.
Most students obsess over controversy and comb through the literature to try and come up with a
definitive answer - when there isn’t one. Certain things, like the management of pulmonary
nodules, are largely based on experience, the patient, and comfort of the clinician.
But, within this controversial subject, there are things that are clear e.g., nodules over 2 cm are
high risk for malignancy so you want to remove these. These are the facts you should focus your
attention on.
You will not, however, be asked questions on controversial topics.
In order for a question to be asked, there needs to be evidence and concrete answers behind it.
You will not get questions which have answers that are subjective and/or unclear.
We know you've struggled with these concepts, because we've been helping students and
clinicians pass their exams and practice better medicine, since 2013.
How deep do you need to go with the details?
You should study the material enough so that you understand the medicine.
Basically, we do not suggest mindless memorization of diseases and conditions. You’ve been
through didactic, end of rotation exams, and finals to know that memorization of facts doesn’t
really get you anywhere—besides maybe impressing a preceptor.
Keyword: maybe.
You will remember a lot more of the material, and will be able to access information to answer a
difficult question, if you truly understand the disease and/or underlying pathophysiology i.e.
knowing the details.
The key to success is the ability to make connections to previous knowledge, cases, and patterns.
Our suggestion is to learn the material with whatever method works best for you - read, re-write
notes, listen to lectures - and then test yourself on the ability to recall that information via
questions.
With that said, how deep is too deep, regarding details?
Many students who are studying for the boards tend to focus on things that don't matter.
The minutiae of each disease is not high yield and there's a high likelihood it won't be tested. The
problem? As a student, everything seems important!
We get countless of emails from students who are unsure how far they need to dig.
For example, how much do you really need to know about atrial fibrillation?
• Are we expected to know how to rate control? Yes.
• You need to know that beta blockers and the nondihydropyridines (verapamil and diltiazem)
are first line.
• You should probably know that digoxin is occasionally used as an adjunctive medication.
But, you most likely don't need to know the mechanism of action for digoxin, in regards to rate
control.
Now, we are not saying these things aren't important. What we are saying is if you want the best
possible chance of passing, then you need to focus your attention on understanding the bread and
butter of each disease process.
Think of the other details as the icing on the cake.
Once you understand the basics of what you are expected to know, then you can dive deeper.
That is the time to turn your attention to the minutia.
Studying essentially serves two purposes:

• to pass your exams
• to help patients
You need to ensure you pass first. Because without passing, you will never get the opportunity to
help your patients. It's not a matter of ignoring the latter; its simply a matter of prioritizing.
People tend to question this.
And, to be honest, it's understandable. Passing the boards is a big deal. It doesn't matter how
prepared we are - we somehow manage to trick ourselves into thinking we don't know enough.
High yield information, triads, classic presentations, etc.
Charcot’s triad, Virchow’s triad, Christmas tree pattern, Koplick spots.
Ahh yes, we all remember these from our lectures and textbooks.
Classic presentations are extremely important to know—that includes epidemiology (e.g. age,
gender) as well as characteristic signs and symptoms.
Triads or common descriptors help organize the material nicely to ease learning.
Like we said before, the exam has to tell you something pertinent to make the diagnosis.
The only way to do this is to give you associations, classic presentations, and triads.
Learn these, because it would be unfair to test you on unusual presentations and/or on
uncommon scenarios.
But, be wary of studying via rote memorization and word associations! Memorizing word
associations for diseases in clinical practice is not realistic and it isn’t realistic for exams either.
You have been warned!
Studying for the exam vs what your preceptors do and why you should be careful
Most PA schools are structured with didactic, followed by rotations. Once ready to take the
PANCE, students have been training under different physicians & PAs for 1-1.5 years.
It is important to remember that a lot of clinicians do not practice medicine exactly as textbooks
suggest or per evidence-based medicine. Keep this in mind when prepping for the PANCE.
When studying, focus on learning items such as:

• What is the most likely diagnosis
• Treatment of choice
• Test of choice
• Best initial test
• What is the next best step
• Most accurate test
• etc…
When taking studying for the PANCE, be sure you’re answering exactly what that question is
asking.
For Example, if the question is asking you to select the most appropriate initial test, it is most
likely asking you to decide which is the most noninvasive, inexpensive, and sensitive test that
will help give you the diagnosis.
The other answer choices may be correct and can also give you said diagnosis, but perhaps are
more invasive or less sensitive.
Focus on the question—most appropriate initial test. Your goal is to select the most correct
answer!
Trust us, we hate that phrase just as much as you do—“most correct.”
Exams are black and white - this means there isn't much left open to interpretation.
Another way of putting this is - there is always only one best answer.
Often times, when students see two seemingly correct answers, an oversight was made. If you’re
dealing with treatment options, there was probably a contraindication somewhere in the vignette.
If it's a diagnosis question, there was a specific association or risk factor thrown in the patients
history, which was missed.
Exams follow a predictable pattern and there are only a certain number of questions which will
be asked (refer to the questions listed above).
The point is, exams follow a predictable pattern.
A Few Recommendations
• You will be given a list of normal lab values for you to access during the exam. Do not spend
time memorizing these values.
• Always learn the generic medication and not the brand name. The NCCPA isn’t advertising a
certain brand. Also, there will be multiple brands for every generic - how will you know which
they might use? Generics will always be used. Know them.
• There technically isn’t any pharmacology or medication section listed on the NCCPA PANCE
blueprint, but ensure you review pharmacology with each organ system!
2. How to Study for the PANCE

Let’s review study practices and techniques to prepare for the PANCE. We will also share
personal experiences and thoughts on popular reviews.
Studying for the boards is enough to make our stomachs turn, or for the seasoned PA, to have
flash-backs of flash cards, mnemonics, and videos of pathophysiology.
But, keep in mind, the goal of a PA program is to produce competent, intelligent and
compassionate clinicians. A goal, which is helpful in accomplishing this, is passing the PANCE,
or the Physician Assistant National Certifying Exam.
So, from the moment you are chosen to attend a program, it’s guaranteed that an admission
committee has looked at your GRE scores, work ethic, overall impression and has decided you
are a good candidate to help them increase and/or keep their PANCE pass rate high.
So take a deep breathe, you got this.
As you enter your didactic year of graduate medical education, the foundation of medicine is
laid. You learn about disease processes, pathophysiology, treatment, and the clinical management
of diseases. You also learn the History and Physical.
In the hectic nature of this schedule, you forget that the foundation is being laid for your PANCE
passing score.
In your second year, you learn how to apply the knowledge you gained during the first year, with
living, breathing patients. Attendings give you pearls and the end of rotation exams confirm
understanding and competency of key concepts and your ability to translate them to patient care.
So, with all of this education, tests, quizzes, and clinical presentations, how do we prepare for
“the big one”?
Before reviewing different techniques, it’s important to point out one caveat. If you are in PA
school, close to graduation, or within a few months of the PANCE, trust your instincts.
Whatever you have done thus far has worked and it has worked well. The end of your education
is not the time to make drastic changes to your study regimen.
For those with a little more time prior to taking the PANCE, play to your strengths. Look over
and think about the techniques we discuss, but remember that everyone is different and that each
person learns differently.
Now, on to some evidence based techniques….
Spaced Repetition
One popular study technique used in graduate medical education is that of spaced repetition,
which is a learning technique that incorporates increasing intervals of time between subsequent
review of previously learned material.
This is a technique in which the study method is a service such as e-mail, quick written
summaries of information, and/or quick lecture review of a pertinent topic.
This method has been tested by educators as an experiment to teach urology to medical students.
Results were promising, showing that spacing time between information and repeating key
points was very helpful in the students’ ability to retain and recall information when they were
later tested(American Journal of Surgery).
Our thoughts on spaced repetition are positive, because it translates well to clinical practice and
is proven in the academic setting.
In our opinion, this mimics clinical practice because the same concepts are used. For example,
lets say a patient presents with a certain set of symptoms that are worrisome for pulmonary
embolism i.e. cough, hemoptysis, shortness of breath. But, for some reason, the CT wasn’t
ordered and the diagnosis was missed.
Well, rest assured you will be tested on this very thing down the road. It may be soon, or it may
be in a few months, but regardless, another patient will sit in the exam room with similar
symptoms. This time, the clinician will strongly consider pulmonary embolus as a diagnosis,
based on the previous encounter.
As you can see, there was an interval of time between the previously learned material (prior PE
patient) and the current case; this is why spaced repetition most mimics real life situations.
Oh yes, the learning does not stop when you pass the PANCE. In fact, it’s really just the
beginning.
Memory Associations
Another particularly helpful method of study includes memory associations, which is the ability
to learn and remember the association between two unrelated items. The more associations you
can form to something you're trying to learn, the more likely you are to remember it in the future.
Memory associations are really student preference, but there are a great deal of mnemonics out
there for studying.
This is something that is routinely broadcast throughout the academic and clinical setting.
Students generally respond fairly well to this type of learning, as it is easy to remember and easy
to recall.
We are particularly fond of this type of studying, because the sky is really the limit.
As I worked through PA school, our study group had students with a broad range of
backgrounds. Everyone worked and learned differently, which was an opportunity to try new
techniques, and see what worked for me.
Mnemonics have always been helpful to bring success on examinations. Even during the
PANCE, I found myself reciting memory associations that allowed me to score points.
In addition, I would recommend students take memory associations one step further to patients.
For example, in school I could never remember the 2nd or 3rd line treatment for acute otitis
media. But, my very first otitis media in practice, was with a patient who had a penicillin allergy.
After seeing this patient, I never forgot alternative treatment plans for otitis media, as I would
always recall this patient in every subsequent patient’s with a penicillin allergy.
Test Enhanced Learning
Test enhanced learning, aka the testing effect or retrieval practice, is a technique in which long
term memory is increased when some of the learning is devoted to retrieving the information
through testing and proper feedback (feedback is what makes this most important).
With this particular method, the goal is to use repetitive testing, to enhance retention of
knowledge. This is perhaps the most discussed technique in relation to physician assistant
education.
Evidence shows that repeated testing increases the relative grasp and command of the material
by students. By testing immediately post lecture, the knowledge is still fresh in the student’s
mind, and is then affirmed by the testing process.
Test enhanced learning, in our opinion, is the most successful technique as it is what physician
assistant programs model their success on.
By the time one sits to take the PANCE, we have been tested on hundreds of diseases, over and
over, in many different ways.
For example, in our program, after a weekly lecture, our assignment was to read an article on a
specific topic, such as esophageal reflux. We then took an individual quiz, and performed a TBL
(team based learning) exercise, where we would work in a group to answer the questions. Our
program director would then go through all of the answers, explaining what was right and what
was wrong.
Moving through the education required to become a physician assistant, we can take the
esophageal reflux topic a little further. After being quizzed and lectured upon GERD, we likely
took an end of topic examination, where we encountered GERD questions.
As we moved forward in our education, we saw patients with GERD in the clinic, and discussed
the diagnosis and treatment with a senior physician assistant or attending. This type of repetition
is a combination of both spaced repetition and test enhanced learning, as we are intermittently
being tested on the topic, both formally and informally, and in slightly different ways.
As you will see, there are a variety of different techniques, all designed to improve your success
moving forward.
Understanding the PACKRAT
There is one resource that is free and offered by your program: The PACKRAT.
The PACKRAT is a 225 question self assessment test that is offered by the PAEA. Physician
assistant programs typically offer this test twice during a student’s time at a program:
• Once at the end of didactic year
• At the end of thee rotational year
This way you can compare your progress. The goal is to evaluate strength, deficits, and help
programs identify areas of study that need to be improved. For the individual, it is a way to
assess progress.
Questions are peer reviewed, but have varying difficulty.
The PACKRAT allows students to see a raw score, individual performance by content and topic,
and then are compared to the national average.
The PACKRAT has long been marketed as a predictor of whether a student will pass the PANCE.
It is important to keep in mind that the test difficulty varies based on the questions.
Think of the PACKRAT as a breath of fresh air. An average to above average score is a way to let
students know that everything they are doing, in terms of studying, is working.
If anything, it is a way to practice getting used to taking the “exam” on the computer.
We have discussed a great deal of information today, much of which leaves you, the student with
a lot of food for thought. What are the best techniques for you? For me, there were a few
different techniques that worked well.
The journey from starting PA school to the PANCE is long. During didactic year, I focused on
doing well and passing my exams. As much as I could, I tried not only to memorize facts and
figures and most commons, but to continually ask why?
I have found in my education that it’s one thing to learn a concept, but to learn why and to apply
the concepts to clinical medicine helps retain and solidify the material. At the end of didactic
year, taking the PACKRAT helped to affirm that I was well on my way to a successful rotational
year.
During my clinical year, I tried to remember every patient I saw that day, as I studied in the
library. Applying concepts to real patients helped confirm my knowledge.
In addition, I used the processes of spaced repetition and test enhanced learning to test my
knowledge every few weeks by taking a set of 50 to 100 questions related to whatever topics I
had encountered on my rotation. Over all, I studied thousands of questions to prepare myself for
the biggest exam in a physician assistant students’ life.
I would estimate I saw between 7,000 and 10,000 questions during the last 6 months of my
studying. The important distinction is that I did not stop with a correct answer, I read through all
of the explanations as to why questions were right and why they were wrong.
During the year, I encountered other students, residents, and attendings whom provided me with
memory associations for difficult disease processes or most commons. This paid big dividends as
I moved forward towards prepping for the PANCE.
10 Tips To Help You Study the NCCPA Blueprint
•Trust your program, they know how to help you pass the PANCE.
•Study hard in didactic year, but always ask WHY?
•Use the packrat to affirm your didactic year knowledge.
•Be studious and engaged on your rotations.
•Pick up pearls, mnemonics, and ask others during rotations how they study.
•Pick a combination of whatever study techniques works well for you and learn to perfect it.
•Expose yourself to as many review questions as you can.
•Analyze not only why an answer was correct, but why the other answers were wrong.
•Use the resources available to you for review.
•Relax. In a few short months, you’ll be a certified physician assistant: PA-C
3. Resources To Use
Let’s next dive into resources to use to help you study for the NCCPA PANCE! There are a
myriad of different options that students can use. The most important thing to remember is that
each and every one of us is different, and one person may not learn the same way as another.
One individual may learn best when sitting quietly and reading. The next may succeed in
studying with a group of peers bouncing review questions off of one another, and a third person
may learn best by listening to podcasts or in a live review program.
The key is knowing which serves you best as a student getting ready to take the PANCE, getting
through the arduous hours of studying, and then crushing the examination on test day!
Review Books for the PANCE

A very common method students will use to study during their time in physician assistant school,
as well as when it comes time to study for the PANCE, is by using review books. Even when I
was in physician assistant school you would regularly see copies of what was known as “The
Green Book” (A Comprehensive Review for the Certification and Recertification Examinations
for Physician Assistants) floating around the program’s hallways.
This did not change when it came time to study for the PANCE either.
Great PANCE review textbooks include:

• A Comprehensive Review for the Certification and Recertification Examination for Physician
Assistants
• Swanson’s Family Medicine Review
• PANCE Prep Pearls
• PANCE Strategies, Practice, and Review” by Kaplan, author is Judy Schwenker
• First Aid for the USMLE Step 2
• Case Files
Along with question books such as:

• Lange Q&A for Physician Assistant Examination
• PANCE/PANRE
! ! !
All these books are excellent resources to use if you are looking for a concise source that follows
the PANCE blueprint of topics that you must master to be successful on the examination.
Additionally, the question and answer books allow you to test your knowledge on these topics.
Let’s dive in a bit deeper into these resources…
Comprehensive Review for the Certification and Recertification Examinations for

Physician Assistants
I particularly like this book because it has 303 pre-book questions that are on various medical
topics. It gives concise, key point oriented answers which I found very helpful. The book is then
a review of all of the diseases on the PANCE, organized by body system.
The only qualm I have with this resource is that sometimes the information is a little bare boned,
for example: saying that “penicillins are effective versus pneumonia” when the boards might ask
a specific drug. Also, I found some areas where I felt some PANCE pearls and commonly tested
facts were omitted.
Cost is reasonable, between $20 and $40
PANCE Strategies, Practice, and Review [Kaplan]
I found this book to be well organized and succinct.
As a PA student nearing my inevitable dance with the PANCE, I found it very helpful as it has an
initial section titled “Overview of the PANCE” which took away some nervousness regarding the
set up, logistics, and even a section with tips on how to take a computer based test.
I found that the questions were thoughtful, straightforward, and asked a lot of what I felt to be
relevant pearls. The questions are broken into “blocks” which made working through them a bit
easier.
The answer explanations also provided good explanations as to why answers were correct, but
also gave good pearls about other conditions. My one concern is that occasionally I encountered
a question that was not relevant or was too focused on pathophysiology.
Cost is reasonable. Used are available for less than $20.
First Aid for the USMLE Step 2
Although this is more focused for medical students, I found this to be very helpful for a variety
of reasons. I found this book to be very well organized into topics, had good, concise and clear
information.
It is also in color, which helped me look at images and EKGs; this helped me understand things
much better.
The only downside for me is that there aren’t any questions or ways to gain feedback on the
knowledge presented.
Cost is between $40 and $50.
Case Files: Multiple Books by McGraw Hill
I found these to be particular helpful because they were rotation specific.
The set up is a case that is described with a history, physical, and sometimes lab work.
The book does an excellent job of keying in on pearls and points commonly tested on the
PANCE, and additionally has questions that affirm thought processes and tests to order.
Commonly, during my rotations I read this book ing my free time, during lunch, and used it to
reaffirm pearls from cases I had encountered in the clinic.
The Pros of Using Review Books

• Theoretically, these books should have all the information needed, covering all of the topics, in
one concise resource for everything that might be tested on the PANCE.
• Many of these books will often give the high yield information needed to know for the
examination
• They will be a one-time fee
• Overall one of the cheaper routes for students
The Cons of Using Review Books

• By the time a review book gets published, the information and content are typically outdated.
Medicine is rapidly evolving, and just by the nature of the beast, there is a high likelihood that
there will be newer and more accurate information.
• There are usually a lack of images for radiologic findings, CT imaging, rashes in the
dermatology section, blood smear results for hematology, or pathognomic findings for specific
diseases.
• Can’t ask for help. When studying from a review book, if you have a question, you have no
source to ask this question to. Contrast that with online or live review courses, where the
lecturer can be contacted through the website or in person at the event.
Online Resources for the PANCE

Just like with the review books, there are countless options of online sources to aid in preparation
for the PANCE and PANRE.
Often these sources will have similar content regarding the review of topics and what you need
to know on these topics for the PANCE. However, these websites often time will have
associated videos, audio, or lectures as well as the text to read to prepare yourself on each topic.
Some online sources for PANCE and PANRE review include:

• Medgeeks Board Review Course
• Rosh Review
• Med-Challenger PANRE
• Hippo PANCE/PANRE Board Review.
Additionally, some of the online sources for prepping will include a mock examination or
question and answer banks. There are also stand-alone websites or programs such as PANCE
Master and the Medgeeks Question Bank that provide high yield content in question form -
similar in format that you might expect on your upcoming examination.
The Pros to Using Online Reviews

• The content will often be continually updated on these sources and websites. So as medicine
changes, so should the material you are studying.
• As mentioned earlier in the article, each and every person might learn differently, and the
online platforms aim to cater to this by not only providing text versions of the review content,
but additionally videos for the visual learner, and audio recordings for those who may be on
the go frequently or for those commuting long distances.
• Additionally, for those online sources that provide question and answer banks, as well as mock
tests, this will often give you detailed information as to where a student strengths and
weaknesses are. This information will allow you to make informed decisions on which systems
you may need to spend more time on.
• Lastly, when I was in physician assistant school, I used content from Medgeeks, PANCE
Master, and Rosh - the customer service was top notch. If I had a question in regards to
something listed in the content or perhaps if I did not understand part of a topic, I could send a
simple email, and I would always get a helpful response back from all three of these
companies.
The Cons to Using Online Reviews

• When compared to the review books, these typically tend to be more expensive. Alternatively,
on the other end of the spectrum, these companies may require recurrent charges (monthly
fees) for their content.
• The reviews require access to the internet, which may be another cost for a student to consider.
Studying with Podcasts

We are all busy! It is the life in which we live in this day and age.
The recent data from U.S. Department of Transportation noted that American’s spend right under
one hour each day driving or riding in a vehicle (0.96 hours to be exact).
Podcasts give healthcare providers, as well as students studying for the PANCE, the opportunity
to put this time to good use. There are some wonderful resources regarding podcasts for those
who are practicing clinicians and/or those preparing to take the PANCE.
Some of these include:

• Medgeeks Podcast
• The Physician Assistant Exam Review Podcast
• The Audio PANCE and PANRE Board Review Podcast
Pros of Using Podcasts to Study
• The ability to listen on the go and use this time to study for the PANCE.
• These options will often be free content that can be heard on one’s smartphone.
The Cons of Using Podcasts to Study

• Audio may not be the best way to learn for everyone (it is not the best option for me!).
• Some students may want or need to take notes while listening, and if you are driving, walking
the dog, or doing bicep curls at the gym while listening to a podcast, it can be challenging to
do so.
Live Review Courses

If you as a student or clinician are looking for a structured event with lectures on the material
tested on the PANCE, then a live review course is the way to go.
These courses will bring in lecturers who are experts in the topics being discussed with many
years of experience.
These courses provide well-organized lectures, printed slides/material, and/or digital files. They
may also provide practice examinations and CME.
Some courses include:

• CME Resources
• Rutgers Physician Assistant Program PANCE/PANRE Review
• CME 4 Life
The Pros of Attending a Live Event

• The high yield information will be lectured directly to you.
• With having a live lecturer, you will have the ability to ask questions directly to the speakers.
The Cons of Attending a Live Event

• These events are very pricey.
• The majority of those in my physician assistant program attended a live PANCE review course.
I thought that it was a good review; however, I felt like it was largely a review of things I
already knew, coming right out of physician assistant school. I think it would be more
beneficial for a practicing clinician, especially if one is practicing in a specialty.
• These events are normally in large cities. So, you need to account for travel time and lodging
as well.
NCCPA Practice Exams
In addition to the above resources, I also took advantage of an offer that is available through the
NCCPA.
This entity also publishes two PANCE practice tests, which are 120 questions in length, and are
“mock” exams. These cost $50 each.
I purchased one of these during my second year of PA school and found the test itself to be
helpful with well written questions, but was displeased to find that I did not get copies of the
individual answers or explanations.
Instead, one is given a summary based on the categories. For example, one will get feedback on
how one performed on urology as a whole, but not on the individual questions.
As a student who is learning material, I was not at a stage where I was interested in individual
categories, therefore I would recommend against buying these tests.
Here is a link to help you make your own decision.

https://www.nccpa.net/practiceexams
Conclusion on Resources
Overall, the path to studying and preparing for the PANCE can be one of many roads traveled.
There are a plethora of different options as discussed above. No one single way is the best for
every individual student. You need to know what learning style best suits you. Additionally,
there is nothing wrong with combining multiple options to create your learning and studying
regimen!
4. Creating a Study Schedule
How soon after graduation should you take the PANCE and when should you start
studying?
The earliest date you'll be able to test is seven days after your program completion.
But, I wouldn’t necessarily look at it this way. Instead, plan your test date so that you have at
least 7-8 weeks to cover all of the PANCE blueprint material. Everyone will be different in his/
her approach to the material (some more intense than others), but 7-8 weeks was the sweet spot
for me as well as the majority of my classmates.
It gives you ample time to plan so you’re not cramming but you’re also not spending so much
time test prepping & potentially forgetting material.
What Should a Full Day of Studying Look Like?
I suggest 7-8 hours of studying a day for 6 days/week. My study days were 8 hours/day, but a lot
of days were more like 10 hours/day. Anything more than 10 hours/day and I would personally
hit a roadblock & my mind would stray.
I would always give myself Sundays off.
The NCCPA PANCE 8 Week Study Plan
Week PANCE Content Categories
1 Dermatology: 5%, Infectious disease: 6%, Hematology: 5%
2 Pulmonary: 10%, ENT: 7%
3 Genitourinary: 5%, Reproductive: 7%
4 Cardiovascular: 13%
5 Gastrointestinal System/Nutrition: 9%, Renal: 5%
6 Endocrine 7%, Musculoskeletal 8%
7 Neurology 7%, Psychiatry/Behavioral Science 6%
8 Review/Reinforce/Question Bank
9 PANCE Exam
Ways to Approach the PANCE Blueprint Study Schedule:
First off, yes…this is a lot of material in a short amount of time. But, the material isn’t
necessarily new—you’ve been reading about & managing a lot of these diseases/conditions
while on rotations. Now you must focus on organizing and remembering it well enough for the
PANCE & for your future patients. Do not forget the latter!
Use the Medgeeks Board Review Course—it was created specifically for the PANCE. Be an
active learner and incorporate your own ways to best learn the material.
Repetition is important!
Each day, start by simply doing a short review of the topics from day before
Using the Question Bank:

• You must test your knowledge of the material with questions. Tip: get into the habit of
reading the LAST sentence (the actual question) of the clinical vignette FIRST. This way you
know exactly what you’ll be answering. Then read the (often long) clinical vignette.
Remember, the vignette must have all the relevant information included for you to correctly
answer the question. If they spend time telling you about a sign or symptom (or lack thereof),
you bet it is important!
• Do at the very least 20-30 questions everyday. Write down notes on questions you answered
incorrectly. At the end of the week, create a practice exam, and attempt to simulate the
testing environment. Time yourself, remove all distractions. This weekly practice test is
written in & incorporated in the schedule below so that you won’t forget.
Rest Days: The schedule gives you one day off to rest, recover, and start anew the following
week. You will have a tough pace of the material all throughout the week. Some days or weeks
will feel impossible, but keep going. It is recommended to take short breaks during the long
study hours as well. Resting is just as important as getting through the material!
Get enough sleep: We really don’t have to explain this one, do we?
Week 8: You’ll notice that the last week before the PANCE is light compared to the rest of the
weeks. This is done for a reason—so that you’re not burned out once it is time to the take the
PANCE. Use this time appropriately—do practice exams, review what you need to review (you
know your weaknesses), but also take some time to relax. Do not study 1-2 days before the exam
date. We know you’re more than prepared!
A Deep Dive into the 8 week NCCPA PANCE Study Schedule
Week 1: Dermatology: 5%, Infectious disease: 6%, Hematology: 5%

Monday Tuesday Wednesday Thursday Friday Saturday Sund
ay
Today’s focus: Today’s focus: Today’s Today’s focus: Today’s Today’s focus:
Dermatology Dermatology focus: Infectious focus: Hematology/
Dermatology diseases Infectious Practice test
& Infectious diseases &
diseases Hematology
▪ Acneiform ▪ Derm ▪ Other ▪ Parasitic ▪ Viral ▪ Hemoglobino

eruptions Neoplasms dermatol diseases diseases pathies
▪ Desquamatio ▪ Papulosqua ogic ▪ Prenatal ▪ Immunologic
n mous disorders transmissi disorders
Heme:
▪ Diseases/ disorders ▪ Infectiou on of Heme
s disorders ▪ Autoim ▪
disorders of ▪ Pigment mune neoplasms,
the hair and disorders diseases ▪ Sepsis/ premalignanci
disorder
nails (Derm) systemic es, &
▪ Skin s
▪ Envenomati integrity inflammat malignancies
ory ▪ Coagula
ons and ▪ Vascular Infectious tion
response Catch up
arthropod abnormaliti Disease: disorder
bite syndrome
es ▪ Bacterial s
reactions diseases ▪ Spirocheta ▪ Practice test:
▪ Vesiculobu ▪ Cytopen
▪ Exanthems l diseases 60 questions
llous ▪ Fungal ias block exam
▪ Keratotic disease diseases ▪ Cytoses (Timed 60
disorders ▪ Mycobac minutes)
terial
diseases
Week 2: Pulmonary: 10%, ENT: 7%

ay
Pulmonary Pulmonary focus: Eyes focus: Ear/ Oropharyngeal /
Pulmonary Nose Practice Test
▪ Chronic ▪ Pleural ▪ Sleep ▪ Conjuncti ▪ External ▪ Oropharyngea
obstructive diseases apnea/ val ear l disorders
pulmonary ▪ Pulmonary Obesity disorders ▪ Inner
diseases circulation hypovent ▪ Corneal ear
▪ Infectious ▪ Restrictive ilation ▪ Lacrimal ▪ Middle
disorders pulmonary syndrom disorders ear
▪ Respiratory diseases e ▪ Lid ▪ Hearing
Neoplasms ▪ Other disorders impairm
pulmona ▪ Neuro- ent Catch up
ry ophthalmo ▪ Other
disorders logic abnorm ▪ Practice test:
disorders alities Two 60
▪ Orbital of the question
disorders ear block exam
▪ Retinal ▪ Foreign (60 min. each
disorders Bodies block)
▪ Traumatic ▪ Neoplas
disorders ms
▪ Vascular ▪ Nose/
disorders sinus
▪ Vision disorder
abnormalit s
ies
Week 3: Genitourinary: 5%, Reproductive: 7%
Monday Tuesday Wednesda Thursday Friday Saturday Sun

y day
Genitourinary Genitourinary focus: Reproductive focus: Reproductive/
Reproductiv Reproducti Practice Exam
e ve
▪ Bladder ▪ Genitourinary ▪ Breast ▪ Contrace ▪ Menop ▪ Complicated

disorders Neoplasms disorder ptive ause Pregnancy
▪ Congenital ▪ Nephrolithiasis/ s methods ▪ Menstr
and urolithiasis ▪ Cervical ▪ Human ual
acquired ▪ Penile disorders disorder sexuality Disord
abnormaliti ▪ Prostate s ▪ Infertility ers
es disorders ▪ Ovarian ▪ Sexually ▪ Neopla Catch up
▪ Human ▪ Testicular disorder transmitte sms of
sexuality disorders s d Breast
▪ Practice test:
▪ Genitourina ▪ Urethral ▪ Uterine infections & Three 60
ry disorders disorder /Pelvic Reprod question
Infectious s inflamma uctive block exam
disorders ▪ Vaginal/ tory Tracts (60 min.
Vulvar disease each block)
Disorde ▪ Trauma
rs
Week 4: Cardiovascular: 13%
ay
Cardiology Cardiology focus: Cardiology focus: Cardiology /
Cardiology Cardiology Practice Exam
▪ Cardiomyop ▪ Congenital ▪ Hyperten ▪ Lipid ▪ Valvular ▪ Vascular

athy heart sion disorders disorder disease
▪ Conduction  disease ▪ Hypoten ▪ Traumatic, s
▪ Coronary sion infectious, ▪ Heart
artery and failure Catch up
disease inflammat
ory heart ▪ Practice test:
conditions Four 60
question
block exam
(60 min. each
block)
Week 5: Gastrointestinal System/Nutrition: 9%, Renal: 5%

ay
GI GI focus: GI GI focus: Renal Renal
▪ Biliary ▪ Esophageal ▪ Hepatic ▪ Small ▪ Acute ▪ Congenital

disorders disorders disorders intestine disorder Renal
▪ Colorectal ▪ Food ▪ Metaboli disorders s disorders
disorders allergies c ▪ Hernias ▪ Acute ▪ Fluid and
and food disorders ▪ Infectious kidney electrolyte
sensitivitie ▪ GI diarrhea  injury disorders
s Neoplas Ingestion (acute ▪ Renal
▪ Gastric ms of toxic renal Neoplasms
disorders ▪ Pancreati substances failure)
▪ Nutritional c or foreign ▪ Chronic
and disorders bodies kidney
vitamin disease Catch up
disorders ▪ End-
stage ▪ Practice test:
renal Five 60
disease question
block exam
(60 min. each
block)
Week 6: Endocrine 7%, Musculoskeletal 8%
ay
Endocrine Endocrine focus: MSK focus: MSK
Endocrine/ MSK
MSK
▪ Adrenal ▪ Endocrine ▪ Thyroid ▪ MSK ▪ Rheuma ▪ Upper

disorders Neoplasms disorders Infectious tologic extremity
▪ Diabetes ▪ Parathyroi diseases disorder disorders
mellitus d disorders MSK ▪ Lower s ▪ Spinal
▪ Hypogonadi ▪ Pituitary ▪ Chest/rib extremity disorders
sm disorders disorders disorders
▪ Compart ▪ MSK
ment Neoplasm
syndrom s Catch up
e
▪ Degener ▪ Practice test:
ative Five 60
diseases question
block exam
(60 min. each
block)
Week 7: Neurology 7%, Psychiatry/Behavioral Science: 6%

ay
Neurology Neurology focus: Neurology/ focus: Psychiatry
Neurology Psychiatry Psychiatry
▪ Closed head ▪ Neurology ▪ Neurom ▪ Vascular ▪ Depress ▪ Neurodevelop

injuries infectious uscular disorders ive mental
▪ Cranial disorders disorders disorder disorders
nerve palsies ▪ Movement ▪ Peripher Psychiatry s ▪ Personality
▪ Encephalopa disorders al nerve ▪ Abuse and ▪ Disrupti disorders
thic ▪ Neurology disorders neglect ve, ▪ Schizophrenia
disorders Neoplasms ▪ Seizure ▪ Anxiety impulse spectrum and
▪ Headaches ▪ Neurocogn disorders disorders -control, other
itive ▪ Bipolar and psychotic
disorders and conduct disorders
related disorder ▪ Sleep-wake
disorders s disorders
▪ Dissoci ▪ Somatic
ative symptom and
disorder related
s disorders
▪ Feeding ▪ Substance-
and related and
eating addictive
disorder disorders
s ▪ Trauma- and
▪ Human stressor-
sexualit related
y disorders
▪ Obsessi
ve-
compuls
ive and
related
disorder
s
Week 8: Review/Reinforce/Question Bank
ay
Today’s focus: Today’s focus: Today’s Today’s focus: Today’s Today’s focus: REST
Review/ Review/ focus: Review/ focus:
Questions Questions Review/ Questions Review/
Questions Questions
▪ Review/ ▪ Review/ ▪ Review/ ▪ Review/ ▪ Review/ ▪ Review/

Question Question Question Question Question Question
bank bank bank bank bank bank
▪ Practice test: ▪ Practice ▪ Practice ▪ Practice ▪ Practice ▪ Practice test:
Five 60 test: Five test: Five test: Five test: Five Five 60
question 60 60 60 60 question
block exam question question question question block exam
(60 min. block block block block (60 min.
each block) exam (60 exam (60 exam (60 exam each block)
min. each min. min. each (60 min.
block) each block) each
block) block)
What to do the Day and Night Before the PANCE?
Day before the PANCE: DO NOT STUDY the day before the exam. When prepping for the
PANCE, I kept hearing this. At first my thoughts were, “That’s so silly! I want to spend as much
time on the material & prep as much as possible.” But, as the weeks went by, I began to realize
that studying the day before the exam wouldn’t be much help. I’m happy I took the day off to
decompress. I did not read or do anything related to studying the day before—yay Netflix,
shopping, and carb-loading! Be sure to hydrate yourself well throughout the day.
Night before: Get enough sleep & be well rested for the next day. Set your alarm, tomorrow is
the big day!
Day of the exam: You’ve been prepping for this exam for the entirety of PA school. Wake up
feeling confident and know that you got this! Make sure you eat a large enough breakfast to keep
you full and thinking clearly. This isn’t a time to try any new foods—keep it simple!
How to Reduce Test Anxiety

As someone who has dealt with plenty of test anxiety, I’m here to say it is absolutely normal &
you are certainly not alone in feeling this way.
You will be nervous on the day of the exam and even during the weeks leading up to it. But, the
trick is not to let it affect you to the point that it hinders your preparation or clouds your
knowledge/judgment.
Test anxiety can stem from fear of failure, being in an uncomfortable environment, and feeling
unprepared.
You can lessen these feelings through these steps:

• Think positive thoughts: Get rid of negative thoughts & failure early in the process! Yes, the
PANCE is difficult, but it is not impossible. Know that you absolutely can and will pass the
PANCE. You have to be able to visualize yourself passing. For me, each day would start off
with an inspirational quote or short mindfulness activity (~3 min). This really kept me
grounded throughout stressful days. Each Sunday, I’d spend 10-15 min writing down a list
titled, “This week’s focus.” At the end of each week, I’d list “Good things that happened/
Things I accomplished.”
• Recreate the testing environment: Attempt to recreate the exam & environment as much as
possible. I knew going in that the PANCE would be taken in a cubicle, with no access to
phones, music, snacks, etc. When I studied, I would set a timer for 60-minute intervals and
take a short 5-10 min break afterward.
- Doing well on the exam means having the stamina to last through a 5 hour, 300 question
exam! First 1-2 weeks, I practiced with one 60-question block and allotted 60 min to
complete it (the same amount of time given on PANCE). Then worked up to two 60 min
block, then three 60 min blocks. By week 6, 7,8, I was doing five 60 min practice block
exams in one sitting, mimicking the same time constraints as the exam.
- Like the exam, this meant NO access to phone, music/headphones, snacks, coffee/
water during those 60 minute blocks. I also programed the question bank so that it would
not show the correct/incorrect answer right away. Once the exam came around, I didn’t
feel quite as nervous because I had prepped my mind for the exact environment!
• Stick to your study plan & reward yourself along the way: A lot of test anxiety comes from
feelings of being unprepared. Once you have your study plan, stick to it and continue the
routine. It is normal to fall a bit behind here and there—no one is perfect. But, you’ll be less
stressed if you keep on task & finish all the topics as scheduled. I would even schedule in catch
up periods throughout the week in order to prevent any large deviations from the study plan.
Remember to also reward yourself with small breaks throughout the day and week. Break time
and your mental health are just as important as studying!
How is the PANCE Structured?

The PANCE is 5 hours, 300 multiple choice questions. It is divided into 5 sections, each 60
questions with 60 min to complete each block. Once each section of the exam is complete, you
cannot go back to that section.
Before moving onto the next block, you’ll be prompted on screen if you’d like to take a break.
You have a total of 45 min allotted for breaks between blocks. Just know that if you want to take
a break & leave the exam room (i.e. go to bathroom, eat something), you have to go through all
the security checks again to get back into the testing center.
In my testing center, that meant showing ID, going through the fingerprint machine, body scan,
emptying pockets. Just take this into consideration!
What Should You Expect the Day of the PANCE?
Prepare to be at the testing center at least 30 min before the exam.
Days before the exam, you may even want to do a practice run on how to get to the testing
center. Nothing will bring on more anxiety than logistical errors the day of the PANCE—getting
lost, being unable to find the testing center, parking, etc. Plan accordingly!
You will check in and go through the testing center security checks. There will be multiple
people taking different exams, so don’t worry if you overhear material you’ve never even heard
before!
What to Bring & What Not to Bring:

▪ ID, 2 forms. Be sure to check the NCCPA website for further requirements & acceptable
forms of ID
▪ Water/coffee, snacks—these are all left in the lockers assigned to you in the testing center.
▪ Sweater—testing centers are notorious for being cold
▪ Don’t even bother bringing your notes/books. Most testing centers have a policy that
doesn’t allow you to be looking over notes or book inside.
What if You Need to Reschedule the Exam?
If you wish to reschedule your test date, you must contact Pearson at least 24 BUSINESS
HOURS prior to your exam appointment. Since you need at least 24 business hours, our school
suggested we schedule the PANCE on a Tuesday, Wednesday, or Thursday, should anything
happen and we do need to reschedule. Just something to take into consideration when selecting a
date to take the exam!
If you try to reschedule an exam less than 24 BUSINESS HOURS prior to your scheduled
appointment you will lose your entire fee and will have to reapply and pay for the exam.
How Do They Score the PANCE?
Correct answers are awarded 1 point, while incorrect answers are awarded 0 points. Total points
are added up to produce a raw score, which is then calculated into a proficiency measure.
The proficiency measure is then converted to a scaled score. The scaled score is then compared
amongst different examinees
From NCCPA: ……Finally, the proficiency measure is converted to a scaled score so that results
can be compared over time and among different groups of examinees. The scale is based on the
performance of a reference group (some particular group of examinees who took the exam in the
past) whose scores were scaled so that the average proficiency measure was assigned a scaled
score of 500 and the standard deviation was established at 100. The minimum reported score is
200, and the maximum reported score is 800.
5. After the Exam

So, you have taken the PANCE.
A massive weight has lifted off of your shoulders and off your mind.
But, does it really?
I still remember taking my PANCE and going on vacation immediately, but in all honesty, I was
not fully relaxed until I got my final result.
We will be discussing the current national first-time pass rate of test takers, the overall pass rate
of test takers, when you will get your test scores, and what happens if you do not pass your
examination.
What is the National First Time PANCE Pass Rate?
The number of first-time exam takers for the PANCE, that pass has been continually increasing
each and every year.
In 2014 the number of first-time test takers was 7,435.
This rose to 7,784 in 2015.
In 2016 it bumped up to 8,082.
Then 2017 the number of first-time test takers that passed was 8,732.
Finally in 2018 the number of first-time exam takers to pass surged to 9,220.
As you can see the raw number of first-time passes has continually been increasing, so has the
percentage of first-time takers that are passing the PANCE.
The percentage of first-time PANCE takers that passed in 2014 was 95 percent, then in 2015 and
2016 it increased to 96 percent, then 97 percent in 2017, and finally 98 percent in 2018.
!
http://prodcmsstoragesa.blob.core.windows.net/uploads/files/PANCEPassRates.pdf
What is the Overall Pass Rate?

Next let’s look at the overall pass percentage rate. Just like the number of first-time takers of the
PANCE as well as the percent of first-time takers of the PANCE, the overall pass rate percentage
has been increasing steadily as well.
In 2014 the overall pass rate was 89 percent. This rose to 91 percent in 2015, 93 percent in 2016,
furthermore to 95 percent in 2017, and most recently 97 percent in 2018.
How Long Does it Take To Get Your Results?

The following two weeks after your exam, may be the longest two weeks of your life.
That’s right! The average time to hear your results, after finishing the examination, is
approximately two weeks.
During this time, it is important to relax as best as you can. As I mentioned above, I chose to go
on vacation during this time frame. Overall you want to do something other than studying, and
attempt to get your mind off the PANCE for a brief time.
Once the fateful day arrives, you will be notified via email that your scores have been posted
which will lead you to the NCCPA’s website to log in and view your test results. Not only will
this page tell you if you have passed or not, but they will allow you to see how well you did on
each portion of the PANCE.
What Happens if You Fail the PANCE?

We previously discussed that the number/percentage of first-time takers for the PANCE, that are
passing, have increased over the last several years; however, that number is not 100 percent.
It may be taboo to talk about this, but it is the elephant in the room.
So, what happens if you are one of those who do not pass the PANCE?
Unfortunately, some first-time takers or repeat takers of the PANCE do not pass the examination.
It happens.
There is a plethora of emotions that one may feel after getting this horrid result…
Fear, confusion, disappointment, sadness, and shame.
You get on social media and see classmates and others posting pictures about passing their
examination. You feel as if you are the only one in this situation and you might even feel like a
failure.
Take a deep breath, and remember, you are not the only one in this position. There have been
many more before you who have been in your shoes.
When something bad happens to us, such as failing the PANCE, we tend to not share this news
publicly. This might give other students who haven’t passed a sense of loneliness.
Simply because you do not pass the PANCE, does not make you a failure. This only becomes a
failure, if you allow it to become a failure.
In other words, this is only a setback, an obstacle, or hindrance that you have to overcome.
Remember a setback is only a setup for a comeback.
In the grand scheme of things, if one was to not pass the boards, it pushes them back three
months. That is a drop in the bucket, when looking at the rest of your life practicing medicine.
Three or six months of a delay is nothing when comparing it to thirty, forty, or fifty years as a
practicing clinician.
Another big psychologic hurdle that some may have to overcome is the fear of inadequacy.
Remember that standardized testing does not predict how good or how bad of a clinician one will
be. Standardized exams do not correlate to clinical practice.
Many students will not be good standardized test takers, but will become phenomenal clinicians.
Real life medicine is entirely different than sitting behind a computer and taking an exam.
A patient is not going to give you a story or question stem, and then subsequently ask you, “what
is the most likely diagnosis that I have?” or “what is the first best test to complete to confirm my
diagnosis?”.
There is a lot more that goes into practicing medicine, than there is when taking a standardized
examination. At the end of the day, what matters is that your patient knows you are going to do
everything in your power to make them better.
Your patient’s do not care how much you know, until they know how much you care.
It can be difficult to figure out where to start when something as tragic as not passing the boards
occurs. Remember, it is always darkest before the dawn. Things will tend to get better when
you are at your lowest point.
Additionally, there are no shortcuts in life, and there will be no shortcuts on your journey to
passing the PANCE.
It is going to take hard work, and long hours, but it will pay off.
One of the most important things you can do is go back and look at the results, and see which
sections you struggled with most. This will be helpful in guiding your studies for the next go
around.
For example, if you were in the 99th percentile in dermatology, then it would not be wise to spend
weeks reviewing this subject - move on and study your weak areas.
When Can you Retake the PANCE?

There is a 90-day waiting period between the time an individual can retake the PANCE. If you
need longer to prepare, that is up to the individual, but the bare minimum must be 90 days.
A question that may creep into your mind might be, “well I did not pass the PANCE the first
time, what happens if I do not pass it again?”
The maximum number of times a person can take the PANCE is three times per year. All of
which have to be separated by a minimum of 90 days.
Those who graduated from an ARC-PA approved physician assistant program on or after January
3, 2003 may take the PANCE for up to six years after completing and graduating from physician
assistant school. During this six-year timeframe, the examination may only be taken a maximum
of six times.
If a student takes the examination six times, or if the six-year time period has elapsed, then the
student loses eligibility to sit for PANCE thereafter.
At this point, the only way to be eligible to take the PANCE again, is to go graduate from a
physician assistant program all over again.
6. Know Your Why in Medicine

"Allow your passion to become your purpose and one day it will become your profession."
-Gabrielle Bernstein
Medicine will have you second guessing your abilities, it will push your limits, and test your
will.
I mean, what other profession "pimps" a student? Where else is it acceptable to ask a student
questions until they “fail”; to push them as close to the edge as possible?
Why do we do this to ourselves? Why do we put up with the sleepless nights, the missed
birthdays, and the stress?
The answer is because it's so much bigger than you and I.
You are sacrificing your life now, so that you can save the lives of others later.
We started Medgeeks in 2013.
And to think, this all started with a podcast...
The truth is, it took so much work to get to this point, more than most realize. It was really hard.
So, why do it?
Because we visualized what could be and the impact it could make in very much the same way
you are visualizing your future right now.
We often get discouraged if we don't see results right away. But, so long as you are putting in
100% effort - day in and day out - you will succeed.
It may take you a little longer than others, but you'll get there.
The question then becomes, how do we continuously put in 100% effort?
The answer is passion.
Passion will fuel you when things look bleak, it will help you put in the extra hour when all you
want to do is sleep, and it will motivate you to admit one more patient, even after your shift has
ended.
It's all about passion my friends.
Steve jobs said, "People say you have to have a lot of passion for what you're doing and it's
totally true. The reason is because it's so hard that if you don't, any rational person would give
up. It's really hard and you have to do it over a sustained period of time. So, if you don't really
love it, if you're not having fun doing it, then you're going to give up. And that's what happens to
most people.
If you really look at the ones that ended up, you know, being 'successful' in the eyes of society
and the ones that didn't, oftentimes, it's the ones who were successful who loved what they did -
so they could persevere, when it got really tough. And the ones that didn't love it quit, because
they're sane.
Who would want to put up with this stuff if you don't love it?”
These are words to live by.
So, when it gets tough, remember why you started.
Remember your passion, and remember all those who you'll end up helping along the way.
Wishing you the best and thank you for allowing us to help take your medical knowledge to the
next level!

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Passing the NCCPA PANCE

Why do we have so much anxiety about the PANCE?

So, let’s get started…

1. The PANCE Blueprint

• Knowledge of the diseases/disorders

What has changed in the 2019 NCCPA blueprint?

Below you will find a table that lists the changes

NCCPA Task Categories

But, don’t worry about this too much.

Just focus on what really matters: Passing the PANCE!

What you should and shouldn’t study

Now, let’s focus our attention on a few scenarios…

Let's take the CT scan and pregnancy.

Easy! Don’t worry about them.

I know, easier said, than done.

How deep do you need to go with the details?

With that said, how deep is too deep, regarding details?

Think of the other details as the icing on the cake.

That is the time to turn your attention to the minutia.

Studying essentially serves two purposes:

People tend to question this.

High yield information, triads, classic presentations, etc.

Charcot’s triad, Virchow’s triad, Christmas tree pattern, Koplick spots.

You have been warned!

When studying, focus on learning items such as:

The point is, exams follow a predictable pattern.

2. How to Study for the PANCE

Now, on to some evidence based techniques….

Test Enhanced Learning

Questions are peer reviewed, but have varying difficulty.

10 Tips To Help You Study the NCCPA Blueprint

Review Books for the PANCE

Great PANCE review textbooks include:

Along with question books such as:

Let’s dive in a bit deeper into these resources…

Comprehensive Review for the Certification and Recertification Examinations for

Cost is reasonable, between $20 and $40

PANCE Strategies, Practice, and Review [Kaplan]

I found this book to be well organized and succinct.

Cost is reasonable. Used are available for less than $20.

First Aid for the USMLE Step 2

Cost is between $40 and $50.

Case Files: Multiple Books by McGraw Hill

I found these to be particular helpful because they were rotation specific.

The Pros of Using Review Books

The Cons of Using Review Books

Online Resources for the PANCE

Some online sources for PANCE and PANRE review include:

The Pros to Using Online Reviews

The Cons to Using Online Reviews

Studying with Podcasts

Some of these include:

The Cons of Using Podcasts to Study

Live Review Courses

Some courses include:

The Pros of Attending a Live Event

The Cons of Attending a Live Event

Here is a link to help you make your own decision.

4. Creating a Study Schedule

What Should a Full Day of Studying Look Like?

I would always give myself Sundays off.

The NCCPA PANCE 8 Week Study Plan

Week PANCE Content Categories

1 Dermatology: 5%, Infectious disease: 6%, Hematology: 5%