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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!
Source: NCCPA
Traditional PANRE
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.
PANRE-LA
- 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
Kelly says
Hi Stephen!
I think i’m going to sign up for your exam academy. Does your reviews/material count for any CME credits?
Thank you!
Kelly
Stephen Pasquini PA-C says
Hi Kelly,
I have not yet applied to offer official category 1 CME but many, many users have claimed this as category 2 credit. You can essentially claim up to 50 CME credits in this manner. Here is a short video I put together quickly to show you how you would go about doing this on through the NCCPA dashboard. https://youtu.be/bb0CsvVhIfo
Let me know if you have any questions whatsoever.
Stephen
Libby says
If we work in the Emergency Room (mainly adult), would you recommend Adult Medicine or Primary Care? I still can’t decide after reading some of these comments. I’m in my 6th year of the 6 year cycle and hoping to take PANRE in July.
Marcos V Pienasola says
Hi Libby, I have the exact same question, I signed up for the adult medicine which seemed to correlate a little better, but my ED PA friends did the primary care test and they did alright. I am still looking for some input. Good luck.
Jose Luis Ruiz says
Hi Stephen. I’m agonizing regarding retaking PANRE once again, even though never failed PANCE/PANRE before. I’m in my sixth year. I’ve been practicing in Urology for 20 years. I just followed your advice, purchase the books, and I’ll be enrolling in an on-line course (thinking Rutger’s). How much time do you think I need to prepare for, so I can determine the test’ date? Would like to study 30-60 min most days in the evening, and hopefully 4-6 hrs in the weekends. Thanks in advance
gregory bickel says
This is the absolute best way to prep for the PANRE. I have worked as PA-C since 1999. Family Practice is my area of expertise. This time I decided not to study and take the test and see how I would do. I barely missed passing the test. A little frustrating but not a big deal. Now it is time to study. I looked at a number of systems and decided to use Stephen’s. I did modify it by just taking test questions over a two month period and allowing the questions to teach me. I easily passed and improved my score by over 50 points. My take away is to continue the daily questions he sends out and then taking tests and researching areas I need to shore up. Thanks Stephen for a practical approach to PANRE.
Stephen Pasquini PA-C says
Thank you Gregory! And here’s to 10 years of certification 🙂
katelynn griffith says
Invaluable comments ! I loved the information ! Does anyone know where my business would be able to find a blank ATF 5310.12 document to complete ?
Melinda Balsmeier says
Do you know if any of the study materials you recommend for the PANRE can also count towards category 1 CME? I know an earlier editions of Swanson’s did. I am trying to kill two birds with one stone so to speak and would appreciate any recommendations you have. Thanks!
Sk says
Hey Stephen,
Deciding whether to sign up for the adult medicine or primary care panre. Is there really much of a difference?
Stephen Pasquini PA-C says
Hi SK,
The adult medicine will be geared more toward internal med and will have little (maybe no) pediatrics. Primary care will encompass the entire spectrum. I would lean towards the primary care PANRE unless you have been working in adult ICU, geriatrics or internal medicine.
Amy says
Hi Sephen,
This is my 6th year and I have only 3.5 months left and ready to start my study. I need your help or opinion which I have to use – Rutgers or Help Zebra? Thanks
Stephen Pasquini PA-C says
I just recently tested the Help Zebra online course and was very impressed, they have a large quiz bank and cram cards which are very useful. I have experience with the in-person Rutgers course which is wonderful, although I have not been able to explore their online option so I cannot compare them apples for apples. I have contacted them to test their online courseware but they haven’t gotten back to me. I would have to say though, if you were to choose an online review I don’t think you would be disappointed with the Help Zebra course. If you are going for an in-person option, the Rutgers course is top notch!
– Stephen
Anna says
Hi! I’ve been a PA for 19 years in a subspecialty and now need to recertify for the 3rd time. Would you recommend a home study course or attending a PANRE review course? BTW, I’ve failed 2 attempt already.
Stephen Pasquini PA-C says
Hi Anna, since this is your third attempt I would recommend an in-person review course. My cousin (an orthopedic PA) just completed the CME Resources in person review course and said it was wonderful. Despite being in subspecialty she was able to pass the first time. I also like the HelpZebra online review course and have heard good thing about the Rutgers online review as well.
– Stephen
Jen says
What do you think about the HippoEd online course to review for the PANRE?
Stephen Pasquini PA-C says
It’s OK, I had an opportunity to test it a couple years back for free (through HippoPA) and I liked it but it has a hefty price tag. Since then though their website has received various upgrades and they have some nice tracking features that some of the other online review doesn’t offer. I found HelpZebra to be a bit better (if you take the time to figure it out) and if you search for a coupon code you can get a month access for about $200 which is a lot better than HippooPA.
– Stephen
Taniya says
Hi,
I ama fresh graduate, i ave my exam in three weeks. I have been studying and followed first three steps but now i feel i should have bought rutgers course too, do you think i should do it since just three weeks are left?
Stephen Pasquini PA-C says
Hi Taniya,
The Rutgers course is always a great choice and the only negative you will incur is in your bank account. But if you are feeling uneasy, three weeks out is the perfect time to complete the course if you have the time and the resources. I doubt you would regret it.
– Stephen
Lesa Smith says
I have been a “stay at home mom” for many years now, and am ready to re-join the PA workforce. Since I let my recertification lapse years ago, I need to take the PANCE to re-certify. Which online review course would you recommend?? Thank you!
Stephen Pasquini PA-C says
Hi Lesa, I really like the Rutgers or Help Zebra online courses. They are compressive review courses designed by PAs and allow you to learn at your own pace.
– Stephen
Theresa Kelly says
I am a PA specializing in Psychiatry. Needless to say, I have forgotten most other specialties. Are the resources suggested good for someone like myself?
thank you!!
Stephen Pasquini PA-C says
I like the Rutgers or Help Zebra courses. They are both very good!
Chip says
Stephen,
Any sense of the real difference between Adult Med and Primary Care for the PANRE? Can’t seem to find this info, other than just “no peds”. Do they ramp up the intense, complicated nephro/pulm/cards questions? Or simply more of the same without Peds? Thanks!
Stephen Pasquini PA-C says
Hi Chip, I assume you are absolutely right, “more of the same without the peds.” For many this makes a lot of sense and it is certainly nice to have that option. You may find that there are more internal medicine type questions which can seem complex, that is unless, you are working in adult primary care medicine where you will face this on a daily basis. 🙂
– Stephen
Sandra says
Hi Stephen,
I’m just getting ready to start preparing for the PANRE. Any way I can talk to you via phone?
Stephen Pasquini PA-C says
Hi Sandra, what specific questions do you have?
– Stephen
Caitlen says
I have several of the review books you recommend but they were purchased 5 years ago when I was preparing for the PANCE. Os it necessary to buy newer versions? I’d like to avoid that if possible but I’d rather pass the PANRE 😉
Stephen says
Hi Caitlen,
I had the same debate myself! I would recommend the updated versions, given the cost of having to retake the PANRE it is actually quite a bargain 🙂
Stephen
Dustin says
How far out from the pandemic should I start studying and how many hrs a week?
Thanks
Dustin
Stephen says
Hi Dustin,
The best time to take your exam is in your fifth year (if you are still in the 6 year cycle) or if not then take it in your 9’th year. This will relieve a lot of stress. The earlier you start preparing the better, and for everyone this is different. I think 3 months is the minimum, preferably 5 months. That way you can take it at a leisurely pace, reviewing a topic a week out of the Lange Q&A as well as the Swanson Family Practice review which I love. I would do practice exams along the way to get in the right head space. If you are taking an in-person review course I would do this 2-3 weeks in advance if possible. Too soon and you will lose any benefit from an in-person review course. What is your plan?
– Stephen
Dustin says
Hi Stephen,
I planning on starting to study now for about 2 hrs, 3 x per week with the review books suggested. I will then take the 5 day live PANRE review in June 2015 (this is my 5th year). I was ten going to take the exam a few days after the live review course. Do you think a few days is too soon after the live review?
Dustin
Stephen says
No it is not too early at all, in fact, I think it is perfect! Sounds like a great plan, you will do very well on your exam!
Stephen
Everest says
What’s the difference between the primary care or adult medicine PANRE version?
Tracy says
The most recent edition of the Lange Q and A book is from 2010. Do you still recommend this?
Stephen says
Yes Tracy, absolutely. I have the Kindle version which is Copyright 2011 but I find the content to be evergreen and completely relevant!
– Stephen
Alex says
Great site, very helpful tips! Only one criticism. Your spelling of calendar is incorrect. Twice.
Stephen says
Wow, and those were not the only spelling errors. I just made the changes. Thanks so much for the heads up Alex!
– Stephen