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First of all, let me give you a few truisms:
- As of 2014, the NCCPA extended the recertification requirement to a 10-year interval.
- Traditionally, the PANRE has been a proctored exam (traditional PANRE). In 2023 the NCCPA adopted a new in-home recertification exam option called the PANRE-LA (Here's everything you need to know about the PANRE-LA)
- The traditional PANRE first-time pass rate overall was 97%
- Pass rate guaranteed by those costly Exam Review Courses: 97%
- No matter how hard you study for the traditional PANRE, the consensus is this: When you leave the exam room, you will feel like you have failed.
- Don’t worry if you have been working in a specialty for a while. A study from 2004 proves that this is not a factor (Check it out Here)
- Sitting in that sterile, pin-drop silent exam room with fluorescent overhead lighting for five hours is incredibly painful!
- When you leave the exam room, there is a 97% chance that you will have passed.
You can choose one of two recertification options:
- Take the PANRE-LA, which is a much more relaxed, open-book exam with 5 seconds to search for answers, testing quarterly over 2-3 years.
- Take the traditional proctored PANRE exam.
You have three options for PANRE preparation:
- Fire up the PANRE blueprint, study extremely hard, take review courses, purchase PANRE-specific review books, take a ton of PANRE review tests, and take time off of work and away from your family to prepare excessively.
- Choose not to study at all and wing it.
- Take the middle ground and eliminate the non-essential!
The PANRE Preparation Process
Whether you like it or not, the time will come when you have to recertify. And, of course, it's a big nuisance.
Unlike before, when you were preparing for the PANCE, you are no longer just a student with a bunch of responsibilities. You are a professional with a lot more responsibilities!
And regardless of the four attempts we are given to pass the traditional PANRE, the fear of failure still weighs heavily on the soul.
There is that nagging fear of how a low or failing score may reflect on our proficiency as a PA, not to mention the fear of shame or embarrassment that a failed attempt will evoke among our colleagues.
Either way, now is a great time to be a PA!
In 2023 you have some excellent options that will help you study and ace your exam with ease.
Points to Consider About the Physician Assistant Recertification Exam
Don’t wait until the last minute to register and pay for your exam.
Registration for the traditional PANRE is $350 (probably more by the time you read this), and space may be limited at your preferred testing location. So register early, set a date, and stick to it.
Certified PAs due for recertification in 2024, 2025, and 2026 were eligible for the 2023 initial launch of the PANRE-LA and must have applied between July – November 30'th, 2022. PAs due to recertify in 2027 can apply for PANRE-LA between July 5 – November 30, 2023.
Let me say that again: SET A DATE NOW, PAY, AND WRITE IT DOWN ON YOUR CALENDAR!
Here is a summary of what you need to know for the traditional PANRE: (Watch the NCCPA video)
- The traditional PANRE is a computer-based, multiple-choice exam administered at one of 300 Pearson VUE testing centers
- The four-hour traditional PANRE exam includes 240 multiple-choice questions administered in four blocks of 60 questions, with 60 minutes to complete each block. There is a total of 45 minutes allotted for breaks between blocks.
- If you do not receive a passing score, you can retake the exam after waiting 90 days.
- You may take PANRE up to two times in the 9th year and up to three times in the 10th year, with a maximum of four total attempts.
- The Score is based on the number of questions you get right, not on the number of questions you missed: ANSWER ALL THE QUESTIONS!
- Lab values will always be available at the click of a button, so don’t worry about that.
- You will receive your results usually in less than two weeks.
- Bad Case: you fail and have to wait 90 days to retake the exam.
- Worst Case: you did not set a date early enough, have to wait 90 days to retake the exam, and lose your certification in the process.
- PAs apply for the PANRE-LA in the 6th year of their cycle via their NCCPA portal.
- The exam is conducted over 12 quarters during years 7-9, but it can be completed in as few as 8 quarters.
- The final score is calculated based on the best results from 8 quarters.
- PAs have the option to work continuously or skip up to 4 quarters, given that at least one quarter is completed in both year 7 and year 8. More completed quarters provide additional opportunities to pass.
- Each quarter comprises of 25 questions, with a 5-minute limit per question.
- Use of printed or online references is allowed for assistance in answering the questions.
- Immediate feedback, including the correct response, explanation, and references, is provided for each answered question.
- Starting from the second quarter, 5 topics are repeated each quarter to reinforce existing knowledge. The better of the two responses is counted, and the other is removed from the score.
- Performance feedback is provided each quarter.
- If the exam is not passed by the end of the 12 quarters, there are three attempts to pass the PANRE in the 10th year before certification expiration.
- PAs must continue to fulfill their Continuing Medical Education (CME) requirements while participating in the PANRE-LA.
I will say it again so you don’t have to worry about this worst-case scenario: SET A DATE NOW, PAY, AND WRITE IT DOWN ON YOUR CALENDAR!
Take the Middle Ground, ELIMINATE THE NON-ESSENTIAL, and look for the ZEBRAS
Steve Jobs famously said:
You have to deeply understand a product to get rid of what is non-essential.
This quote reaches far beyond the realm of technology, holding profound relevance in the field of medicine as well.
You have to deeply understand the human body, the physiology, treatment, and diagnostic clues. This is what you learn in school and then later on as a practicing PA.
After ten years, you have eliminated a good proportion of the non-essential. Unfortunately, this is what the recertification exam is going to test you on.
So my first pearl of advice is this:
Eliminate the Essentials: Yes, you heard that right. What I mean by this is: Don’t waste your time studying things you already have a good working knowledge of. Look for the zebras!
Throughout the test, you are presented with the Zebras, and each one has a diagnostic clue. Know the diagnostic clues!
Five Steps to Pass Your PANRE or PANRE-LA
Step1: Familiarize yourself with the PANRE and PANRE-LA Blueprint
The first step in your journey to passing your PANRE or PANRE-LA is to become intimately familiar with the PANRE and PANRE-LA Blueprint. This blueprint is more than a mere guideline; it's a roadmap to success, outlining the specific knowledge areas you'll be tested on and their relative importance.
Click here to access an interactive PANRE-LA Blueprint
The PANRE and PANRE-LA Blueprint Breakdown:
In total, there are 378 topics included in the PANRE/PANRE-LA Blueprint. They are broken up into four assessment levels. I have included the approximate number of topics in each performance expectation level. I have combined H&P + Diagnosis, as all topics which require knowledge of H&P also require knowledge of the diagnosis.
- History and Physical + Diagnosis (139 topics):
- History and physical: Given a stated/differential condition, the PA knows the associated signs, symptoms, history, and physical examination components, complications, risk factors for and risks caused by the stated/differential condition.
- Diagnosis: Given the signs, symptoms, history, risk factors, physical examination findings, and/or appropriate study results/interpretations, the PA is able to determine the most likely diagnosis.
- Intervention (Basic) (194 topics): The PA is able to manage a disease/disorder with a basic/straightforward presentation, including referral to a specialist and complications of the management intervention.
- Intervention (Complex) (45 topics): The PA is able to manage a disease/disorder made complex by other factors and/or increasing in severity and complications of management or intervention.
Step 2: Develop a Systematic PANRE Study Plan
Armed with the NCCPA PANRE/PANRE-LA content blueprint, you have a clear picture of the specific topics that need to be covered. The next step is to construct a structured plan to review these areas and practice related questions concurrently. This way, you'll be actively engaging with the material, reinforcing your knowledge, and enhancing your understanding with each practice question.
To help streamline this process, consider following the Smarty PANCE 8-Week PANRE & PANRE-LA Blueprint Study Plan. This resource is designed to provide a systematic approach to your review, ensuring that you leave no topic uncovered and are fully prepared when the time comes to take the actual exam.
Step 3: Purchase an essential review books
There are some very good condensed review books out there. Here are a few tiles I use and recommend.
It's possible that the Lange Q&A Book would have been plenty. I like purchasing Swanson’s Family Medicine Review simply because I love the content, and it helps me in my actual medical practice.
I like the Comprehensive Review Book because it is indeed "comprehensive" and gives quick, bite-size summaries of the high-frequency info you need to know. However, PANCE Prep Pearls has quickly become a fan favorite!
Step 4: Sign Up For My Email Review Series
If you haven't already, you should sign up for my FREE PANCE and PANRE board review email series.
The best part of the email series is not that it has amazing questions (although it does). It's that you get a daily reminder that it is time to study. Not to mention, there is a midterm and final exam as part of the series, which is priceless.
Step 5: Take Review Tests... Lots of them!
The books mentioned above have review exams and review questions included, but you need to practice in a computer-simulated environment.
The NCCPA offers a viable solution. You can take a review exam for $35, and they offer two PANRE-specific exams with 120 questions each.
A Better PANRE Study Option
Practice exams like the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) are excellent predictors of PANCE and PANRE performance.
As a Smarty PANCE member, you will receive unlimited access to online exams, along with review tables, lectures, Quizlet flashcard sets, an audio PANRE review course, and a whole lot more.
Honestly, this is a great way to augment your studies.
Finish with my four-hour virtual PANRE (included with every membership), score in the 70th percentile, and you will know that you are ready!
If you follow the above steps and you have a dedicated PANRE study plan, you will do great!
If you absolutely must have more (although I don’t think you need it)
My professors at Rutgers (formerly UMDNJ) have put together a web-based version of the PANRE/PANCE review course: It is reasonably priced, and it is the best "all-inclusive" review course on the market. You can earn up to 27.25 hours of additional CME credit.
A great list of all the available PANCE/PANRE review courses can be found here on the AAPA website. They are offered by more organizations than I have room to list in a single blog post.
Some Other Useful Links
- SMARTY PANCE - Content Blueprint Board Review + ReelDX
- NCCPA on the PANRE
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Grant Roberts says
is all of the info posted here still relevant in June 2020? about to make some decisions based on what i’ve just read. wanna see if anyone would add or subtract anything before i proceed.