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Practicing Physician Assistant Resources

Tools and Resources Practicing PAs

As physician assistants, we have the best career in the world. But even though you have made it through the PA school years, there is still work to be done to maintain certification, manage debt, attain CME, prepare a professional resume and cover letter, enter an optional PA residency program and continue your growth beyond the clinical and didactic years of your training.

As a new graduate, the transition from PA student to working PA-C can be stressful and confusing. There are several things you need to accomplish or obtain before you can practice the full scope of your abilities, and this process varies by state and can change over time.

I have created this ever-evolving guide as a go-to resource to help you along the way.

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As a newbie PA, you will have to 

  1. Become nationally certified (by the NCCPA via the PANCE)
  2. Obtain a state license in the state you wish to practice
  3. Obtain an NPI number
  4. Obtain a federal DEA number

As an established PA, you will have to

  1. Maintain national certification (Take the PANRE)
  2. Complete 100 hours of CME credits every two years
  3. Pay your state dues
  4. Renew your DEA license

Most hospitals also have their own privileging process with a variety of requirements in addition to the steps mentioned above. Remember that some of these requirements are step-wise and must be completed in a particular order with processing and wait times in between. Try to start this process as early as possible as not to delay your employment.

National Provider Number (NPI)

Apply for your National Provider Identifier (NPI) number

  • What is it? The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard unique identifier for health care providers. The National Plan and Provider Enumeration System (NPPES) collects identifying information on health care providers and assigns each a unique National Provider Identifier (NPI)
  • You must obtain this number before applying for the Federal DEA number
  • The application is free and takes under 24 hrs to receive

Get Your NPI Number

Federal DEA Number

You need the following for your DEA Number:

  1. DEA Form 224: New Application for Retail Pharmacy, Hospital/Clinic, Practitioner, Teaching Institution, or Mid-Level Practitioner.
  2. Fee: $731 every 3 years (and always rising)
  3. This must be done AFTER you receive the ability to prescribe in your state.

Apply or Renew DEA

 

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Interactive map of physician assistant state licensing boards

Physician Assistant State Licensing: Everything you Need to Know

Posted: May 30, 2017

As a freshly minted new graduate PA there are four steps you have to complete to move successfully from program to practice: Become nationally certified (by the NCCPA via the PANCE) Obtain a state license in the state you wish to practice Obtain an NPI number Obtain a federal DEA number As a practicing PA, you must […]

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Become nationally certified (PANCE) or maintain certification (PANRE)

You can sign up for the Physician Assistant National Certification Exam (PANCE) no earlier than 90 days before your anticipated program completion date. The earliest you may test is 7 days after your program completion” The exam currently costs $475.

To develop test-taking skills, you must actively practice what you will be doing on the test - answering multiple-choice questions.

  • The NCCPA offers practice exams for $35
  • Interactive practice exams are part of the PANCE and PANRE Exam Academy and SmartyPANCE

Be sure to check the exam blueprints section of the NCCPA website to see a breakdown of the exam content. Download my free interactive Content Blueprint Checklist.

  • Download the PANCE and PANRE interactive content blueprint, which links each required disorder to the corresponding SMARTYPANCE lesson

If you do not pass, you can retake the exam no sooner than 90 days later, and no more than 3 times per year

Free PANRE Practice Exam

Questions 60-90

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Enter your name and email address below to have your results as well as the test questions, your answers and the correct answers delivered to your inbox.
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Your answers are highlighted below.
Question 1
A patient presents complaining of severe pain and "burning" in an extremity.  You note that the extremity is pale and cool to the touch. You cannot appreciate a palpable pulsation. Which of the following diagnostic modalities will identify the source of this patient's problem in approximately 95% of cases?
A
chest x-ray
B
echocardiogram
C
angiogram
D
abdominal flat plate
E
aortic ultrasound
Question 1 Explanation: 
An angiogram is the "gold standard" for occlusion of an arterial vessel. Arterial embolism/thrombosis is covered as part of the PANCE Cardiology Blueprint.
Question 2
A 31-year-old pharmacist complaining of rectal pain. He describes the pain as "a severe tightness that awakens him from sleep." His bowel activity is normal. He denies rectal bleeding and seepage. He adds that sleep interruption is problematic because, with the number of hours he works, every minute of sleep is important. What is the most likely diagnosis?
A
anal abseess
Hint:
Abscess would be constant
B
perianal fistula
Hint:
fistula would drain
C
proctalgia fugax
D
ulcerative colitis
Hint:
UC would cause bloody mucousy diarrhea
E
internal hemorrhoids.
Hint:
hemorrhoids would cause no pain, but bleeding.
Question 2 Explanation: 
proctalgia (rectal pain) fugax (comes and goes) is the best description. An abscess would be constant, fistula would drain, UC would cause bloody mucousy diarrhea, hemorrhoids would cause no pain, but bleeding. Disorders of the Anus and Rectum are covered as part of the PANCE GI and Nutrition Blueprint.
Question 3
A 38-year-old chronic smoker presents with shortness of breath and wheezing. He has had several similar episodes in the past. He states that each previous episode began after developing a "cold that moved into his chest." Usually, after treatment with albuterol (VENTOLIN) and several days, the wheezing stops. He adds that he has a chronic cough, productive of mucous, most mornings during the past several years. Which of the following best describes this patient's condition?
A
chronic emphysema
B
chronic bronchitis
C
chronic bronchitis with hypersensitive airways (asthmatic bronchitis)
D
cor pulmonale
E
bronchiectasis
Question 3 Explanation: 
This is the best descriptor. Chronic bronchitis is covered as part of the PANCE Pulmonary Blueprint.
Question 4
A patient is being treated for Tuberculosis. She is experiencing central scotomata, a loss of green-red color perception and decreased visual acuity. Which agent is most likely responsible?
A
rifampin
B
isoniazid
C
streptomycin
D
ethambutol
E
para-aminosalicylic acid
Question 4 Explanation: 
Ethambutol is the TB drug that causes eye symptoms. It's helpul to remember "E" for Ethambutol causes "E"ye symptoms. Tuberculosis is covered as part of the PANCE Infectious Disease Blueprint.
Question 5
Secondary to a traumatic event, a child complains of pain in the index finger. An x-ray of the digit demonstrates a fracture line through the metaphysis of the proximal aspect of the middle phalanx, ending at the epiphyseal plate. What type of fracture does this child have?
A
Salter Harris Type I
Hint:
Salter I = slight increase in Space between epiphyseal plate and metaphysis
B
Salter Harris Type II
C
Salter Harris Type III
Hint:
Salter III = fx Lower (in the epiphyseal plate)
D
Salter Harris Type IV
Hint:
Salter IV = fit Through (both the metaphysis and epiphysis)
E
Salter Harris Type V
Hint:
Salter V = Really bad (comminuted fx compressing the epiphysis) This spells SALTR and may help you remember.
Question 5 Explanation: 
  • Salter I = slight increase in Space between epiphyseal plate and metaphysis
  • Salter II = fx Above the plate (in the metaphysis)
  • Salter III = fx Lower (in the epiphyseal plate)
  • Salter IV = fit Through (both the metaphysis and epiphysis)
  • Salter V = Really bad (comminuted fx compressing the epiphysis) This spells SALTR and may help you remember.
Types of fractures and Salter-Harris classification are covered as part of the PANCE Musculoskeletal Blueprint
Question 6
A 24-year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved by sitting up and leaning forward. He denies trauma, a cough, and shortness of breath. Which of the following tests would be most compatible with your suspected diagnosis?
A
a hiatal hernia visualized on chest x-ray
B
a normal erythrocyte sedimentation rate
C
calcified "popcorn" lesions in the lung fields bilaterally
D
diffuse ST segment elevation on his electrocardiograph
E
a widened A-a gradient on his arterial blood gas
Question 6 Explanation: 
This is pericarditis (by clinical presentation) which causes diffuse ST-segment elevation on ECG (there can be notching of the R wave as well). Acute pericarditis is covered as part of the PANCE Cardiology Blueprint.
Question 7
A 2-month-old febrile male is brought to your facility to be evaluated for loss of appetite, irritability, and an acute petechial rash. Rectal temperature is 102.8F. Which of the following diagnostic studies is the most important in this child's evaluation?
A
white blood cell count and differential
B
urinalysis
C
CSF analysis
D
serum glucose
E
chest X-ray (CXR)
Question 7 Explanation: 
Any infant (neonate) with fever and rash should have a lumbar puncture (LP). While I would certainly do a CBC, even if it was normal, I would want the LP.
Question 8
Your 27-year-old sister is visiting and requests you to provide refills of dexamethasone and homatropine ophthalmic drops for her. What condition is most likely being treated?
A
conjunctivitis
B
glaucoma
C
iritis
D
Herpes keratitis
E
blepharitis
Question 8 Explanation: 
Iritis is treated with steroid drops (dexamethasone) and miotic drops *homatropine, like atropine (to constrict and fix the pupil to help the pain and open the angle until the iritis is resolved). Iritis and disorders of the Eye (PEARLS) are covered as part of the PANCE EENT Blueprint.
Question 9
A 58-year-old male presents complaining of weakness of his grip. Your examination reveals that the problem is bilateral. During the next few office visits, you note the development of hyperactivity of his DTRs, extensor plantar reflexes and dysarthria. The patient's sensory system remains normal and he denies any urinary symptomatology. Which of the following is the most likely diagnosis?
A
multiple sclerosis
Hint:
MS may have dysarthria, but reflexes are normal, sensation is impaired and bladder function is frequently affected
B
Alzheimer's disease
Hint:
Alzheimer's has normal neuro exam with cognitive disability.
C
Huntington's chorea
Hint:
Huntington's causes a movement disorder with writhing choreiform movements of the body
D
amyotrophic lateral sclerosis
E
myasthenia gravis
Hint:
Myasthenia causes fatigue of the ocular muscles typically worsening at the end of the day.
Question 9 Explanation: 
ALS (Lou Gehrig's disease) is a progressive bilateral muscle disease which causes fasciculations (lower motor neuron), and hyperreflexia, plantar reflexes (upper motor neuron) and dysarthria. Sensation is normal as is bladder function.
  • MS may have dysarthria, but reflexes are normal, sensation is impaired and bladder function is frequently affected.
  • Alzheimer's has normal neuro exam with cognitive disability.
  • Huntington's causes a movement disorder with writhing choreiform movements of the body.
  • Myasthenia causes fatigue of the ocular muscles typically worsening at the end of the day.
Question 10
Which of the following is NOT a characteristic feature of multiple myeloma?
A
elevated serum calcium
B
osteoporosis
C
"punched out" osseous lesions
D
plasma cell infiltration of bone marrow
E
hypogammaglobulinemia
Question 10 Explanation: 
Multiple myeloma is a HYPERgammaglobulinemia - all of the other findings occur in multiple myeloma. Multiple myeloma is covered as part of the PANCE Hematology Blueprint.
Question 11
Which of the following is NOT a risk factor for the development of osteoporosis?
A
Low testosterone levels in men
B
Low levels of physical activity
C
Inadequate dietary protein
D
Cigarette smoking
E
Chronic corticosteroid use
Question 11 Explanation: 
Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the others are risk factors. Osteoporosis is covered as part of the PANCE Musculoskeletal Blueprint.
Question 12
A 12-year-old male presents complaining of no appetite for 24 hours and pain near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis?
A
mesenteric ischemia
B
diverticulitis
C
mesenteric adenitis
D
cholecystitis
E
proctitis
Question 12 Explanation: 
Mesenteric adenitis (lymphadenopathy of the mesentery - usually from a virus) can mimic appendicitis and usually occurs in kids. There is usually no way to diagnose it pre-operatively, except perhaps with a CT of the abdomen (usually done nowadays before going to the OR). Review Diseases of the Small Intestine and Colon (PEARLS) from the PANCE GI and Nutrition Blueprint
Question 13
A patient that must be on a beta-blocking agent has reactive airway disease and commonly experiences central nervous system side effects from medications. Which of the following beta-blockers would most likely be tolerated by this patient?
A
atenolol
B
metoprolol
C
nadolol
D
propranolol
E
pindolol
Question 13 Explanation: 
This is a picky question for the Boards. Of these Beta-blockers (which are usually AVOIDED) in reactive airway disease - metoprolol is the most "cardioselective", so theoretically could be used.... although, on an exam, I would avoid beta-blockers in general. Asthma is covered as part of the PANCE Pulmonary Blueprint
Question 14
A polarized light microscopic study of joint fluid demonstrates negative birefringent crystals. What is the diagnosis?
A
rheumatoid arthritis
B
septic arthritis
C
pseudogout gout
Hint:
Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence - To remember this think "P"seudogout has "P"rism shaped crystals and "P"ositive birefringence.
D
aseptic arthritis
E
gout
Question 14 Explanation: 
Uric acid (gout) is "Needle-shaped crystals with Negative birefringence). Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence - To remember this think "P"seudogout has "P"rism shaped crystals and "P"ositive birefringence. Gout/pseudogout are covered as part of the PANCE Musculoskeletal Blueprint
Question 15
Which of the following agents is most appropriate in the treatment of a pregnant patient infected with Chlamydia?
A
tetracycline
Hint:
Tetracyclines (A & E) should be avoided.
B
penicillin
Hint:
PCN does not work for Chlamydia.
C
norfloxacin
Hint:
Quinolones (norfloxacin) are contraindicated.
D
erythromycin
E
doxycycline
Hint:
Doxycycline is contraindicated in the second and third trimesters of pregnancy.
Question 15 Explanation: 
Azithromycin 1 g orally in a single dose is both safe and effective - it is now considered first-line treatment by the CDC for use in pregnancy. Of the choices above, erythromycin is best and is considered an alternative regimen. PCN does not work for Chlamydia. Tetracyclines (A & E) should be avoided. Quinolones (norfloxacin) are contraindicated. Note: Erythromycin estolate is contraindicated during pregnancy because of drug-related hepatotoxicity. So you would use either Erythromycin base or Erythromycin ethylsuccinate. Chlamydia is covered as part of the PANCE Infectious Disease Blueprint.
Question 16
Typically, it produces a local burning, followed in 3 to 4 hours by a white area of vasoconstriction. Subsequently, a bleb forms at the bite site, darkens, and is followed over hours to days by tissue necrosis. Which of the following inflicts this envenomation?
A
brown recluse spider
B
black widow spider
C
scorpion
D
Dermacentor andersoni tick
E
the centipede
Question 16 Explanation: 
This is a brown recluse spider bite. Spider bites are covered as part of the PANCE Dermatology Blueprint
Question 17
A patient with acute renal failure provides a urine specimen that demonstrates normal osmolality and sodium content. The urine contains no casts, but RBCs are present. Which of the following is the most likely etiology of this patient's acute renal failure?
A
prerenal cause
Hint:
In pre-renal ARF, the sodium content of the urine would be decreased (because the patient is volume depleted, so the kidneys try to retain Na - less is in the urine)
B
intrarenal — glomerulonephritis
C
intrarenal — acute tubular necrosis
Hint:
In intrarenal disease, the urine would contain casts.
D
intrarenal — interstitial nephritis
E
postrenal cause
Question 17 Explanation: 
In pre-renal ARF, the sodium content of the urine would be decreased (because the patient is volume depleted, so the kidneys try to retain Na - less is in the urine). In intrarenal disease, the urine would contain casts. So, this is postrenal disease (usually a big prostate or stones) which would cause normal urine with rbc's. Acute renal failure is covered as part of the PANCE Genitourinary Blueprint.
Question 18
All of the following, when administered to the physically dependent opiate abuser, can precipitate withdrawal symptoms EXCEPT:
A
naloxone
B
pentazocine
C
nalbuphine
D
methadone
E
buprenorphine
Question 18 Explanation: 
That is why we use methadone when weaning folks from opiates (like heroin). Substance Use Disorders are covered as part of the PANCE Psychiatry Blueprint.
Question 19
During a sports 'screening physical' examination, a 15-year-old male is noted to have a murmur. You perform bedside maneuvers in an attempt to delineate which type of murmur you are auscultating. Which of the following would be the finding associated with the highest risk of sudden death for this patient?
A
the intensity of the murmur increases during a valsalva maneuver
B
the intensity of the murmur decreases during standing
C
the murmur does not change while the patient squat
D
the intensity of the murmur decreases during exercise
E
elevation of the legs while the patient is supine increases the intensity of the murmur
Question 19 Explanation: 
Hypertrophic cardiomyopathy (most common cause of sudden cardiac death in this age individual) would have a systolic ejection murmur which would INCREASE with Valsalva (decreased preload causing a smaller LV volume and an increase in the obstruction) The murmur would DECREASE with squat or elevating the legs (increase preload, make the LV volume larger and decrease the obstruction). Hypertrophic Cardiomyopathy is covered as part of the PANCE Cardiology Blueprint.
Question 20
A 44-year-old male presents with a fever, a cough productive of brownish sputum, rigors and lethargy for seven days. A chest x-ray reveals a right middle lobe infiltrate and a right-sided pleural effusion. A thoracentesis is performed. Which of the following results from the pleural fluid analysis would be most characteristic of acute pneumonia?
A
pleural fluid: serum LDH ratio >0.6
B
pleural fluid specific gravity < 1.006
C
pleural fluid without protein
D
pleural fluid without LDH
E
pleural fluid:serum protein ratio <0.5
Question 20 Explanation: 
The question suggests bacterial pneumonia. The pleural fluid should have high LDH (pleural > serum), a high specific gravity (lots of "stuff' in the fluid), a large amount of protein (WBC's, bacteria, and "stuff"). Bacterial pneumonia is covered as part of the PANCE Pulmonary Blueprint.
Question 21
A patient presents with severe diarrhea described as watery and bloody. He states he ate some chicken at a farm and wasn't sure if it was cooked well enough. His stool demonstrates many WBC's and S-shaped gram-neg rods. Which of the following antimicrobial agent of choice should be used to treat this patient?
A
metronidazole
B
erythromycin
C
ampicillin
D
ciprofloxacin
E
doxycycline
Question 21 Explanation: 
Campylobacter = erythromycin. Infectious and Noninfectious Diarrhea is covered as part of the PANCE GI and Nutrition Blueprint.
Question 22
An 82-year-old man presents with acute, atraumatic left flank pain which is constant. He denies fever. Since its onset, the pain has moved from the flank to the central abdomen and also radiates into the left inguinal area. Of the following, which diagnosis do you suspect?
A
acute bacterial prostatitis
B
spigelian hernia
C
calyceal obstruction
D
acute biliary colic
E
dissecting aortic aneurysm
Question 22 Explanation: 
This is CONSTANT pain, so not colicky (like colic, C & D). It is in the abdomen, and not perineal (like BPH), and I have no idea what a Spigelian hernia is.... but in this older gentleman, the most important thing to r/o is AAA which is dissecting. Aortic aneurysm/dissection is covered as part of the PANCE Cardiology Blueprint.
Question 23
A 32-year-old female presents with an acute narrow-complex tachycardia noted on her twelve lead EKG. Her blood pressure is 110/72. Her heart rate is 156. She denies chest pain and dyspnea. What do you order next for this patient?
A
bretylium 500 mg intravenously
B
verapamil 5 mg intravenously
C
adenosine 6 mg intravenously
D
digoxin 0.5 mg intravenously
E
lidocaine 100 mg intravenously
Question 23 Explanation: 
The treatment for SVT (regular narrow complex tachycardia in a young healthy patient) could be valsalva or carotid massage, and then adenosine 6 mgm. IV bolus. Supraventricular tachycardia is covered as part of the PANCE Cardiology Blueprint.
Question 24
A 56-year-old male presents complaining of night sweats, weight loss, a cough and shortness of breath. A urinalysis demonstrates hematuria. The patient had a positive PPD skin test six months ago but was never treated. You order a chest x-ray and expect to find pathology in which area of the lung?
A
the anterior aspect of the lung bases
B
the lingual of the left lung
C
the right middle lobe
D
the posterior aspect of the lung bases
E
the apices of the lungs
Question 24 Explanation: 
TB reactivated typically appears in the apices of the lung fields. Tuberculosis is covered as part of the PANCE Pulmonary Blueprint.
Question 25
A mother brings her nine-year-old son to your office, along with the snake that bit him 20 minutes earlier. Which of the following, if identified during your examination of the snake, is most suggestive that the snake is poisonous?
A
elliptical pupils
B
a rounded head
C
a double row of caudal plates
D
the length of the snake
E
the presence of a black band next to a red band
Question 25 Explanation: 
There are two families of poisonous snakes: Viperidae is pit vipers, rattlesnakes, water moccasins, copperheads. They are distinguished by elliptical pupils vs. round in non-venomous snakes. Elapidae contains cobras, mambas, taipan and coral snakes. There are differentiated by their color bands, "red on yellow kills a fellow", "red on black, venom lack". Most poisonous snakes in the US - coral snakes. Mambas are the most poisonous in the world; cobras are hooded at the neck and are next most poisonous but neither of these is found in the U.S. Animal and insect bites are covered as part of the PANCE Infectious Disease Blueprint.
Question 26
Which of the following vaccines can prevent cancer?
A
rubella vaccine
B
rubeola vaccine
C
hepatitis B vaccine
D
influenza vaccine
E
tetanus vaccine
Question 26 Explanation: 
Think of Hep B and Hep C as carcinogens. We don't have a Hep C vaccine yet, but we DO have a Hep B vaccine. Since chronic Hep B and Hep C infection cause liver cancer, a vaccine can "prevent" it. Acute and chronic hepatitis are covered as part of the PANCE Genitourinary Blueprint.
Question 27
A 51-year-old male who has smoked for 32 years, presents complaining of a persistent cough. His chest x-ray is unremarkable. The cough began shortly after he started a new medication. Which medication do you suspect as the cause?
A
verapamil
B
digoxin
C
captopril
D
acetaminophen
E
lovastatin
Question 27 Explanation: 
ACEI's cause chronic cough. Captopril is the prototypical ACEI. Ace inhibitors and other cardiac medications are covered as part of the PANCE Cardiology Blueprint
Question 28
Which of the following is associated with a reduced risk of ovarian cancer?
A
delivering the first child at an age greater than 40 years old
B
a positive family history of ovarian cancer
C
present age greater than 50 years old
D
being nulliparous
E
oral contraceptive use
Question 28 Explanation: 
OCP's protect (reduce risk by 40% for a decade after one year of use). Ovarian Neoplasms are covered as part of the PANCE Reproductive System Blueprint.
Question 29
A patient is given a new product for an acute migraine headache. Shortly after the injection, the patient complains of significant chest tightness. Which of the following medications do you suspect this patient received?
A
promethazine
B
metoclopramide
C
sumitriptan
D
trimethobenzamide
E
ketorolac
Question 29 Explanation: 
Sumatriptan (Imitrex) and all triptans can cause chest tightness as it is a potent vasoconstrictor. You must use it with caution in a patient with risk factors for coronary disease and in uncontrolled hypertension. Migraine headaches are covered as part of the PANCE Neurology Blueprint.
Question 30
Which of the following does NOT increase the likelihood of infection in a cancer patient?
A
thrombocytopenia
B
malnutrition
C
the presence of catheters or shunts for therapeutic intervention
D
neutropenia
E
splenectomy
Question 30 Explanation: 
Decreased platelets could predispose the patient to bleeding, the others would increase his risk for infection. Thrombocytopenia is covered as part of the PANCE Hematology Blueprint.
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Smarty PANCE Board Review

14 NCCPA™ Content Blueprint Courses

  1. Cardiology 13% - 51 disorders
  2. Pulmonary 10% - 31 disorders
  3. GI and Nutrition 9% -38 disorders
  4. Musculoskeletal 8% - 36 disorders
  5. ENT 7% - 61 disorders
  6. Reproductive 7% - 46 disorders
  7. Neurology 7% - 34 disorders
  8. Endocrinology 7% - 17 disorders
  9. Infectious Disease 6% - 41 disorders
  10. Psychiatry/Behavioral Science 6% -18 disorders
  11. Genitourinary 5% - 25 disorders
  12. Renal 5% -  14 disorders
  13. Dermatology 5% - 55 disorders
  14. Hematology 5% - 15 disorders

Total: 14 organ systems and 482 diseases/disorders

Topic Specific Practice Exams

  1. Cardiology Exam - 147 Questions
  2. Pulmonology Exam - 143 Questions
  3. GI and Nutrition Exam - 149 Questions
  4. Musculoskeletal Exam -126 Questions
  5. ENT Exam -111 Questions
  6. Reproductive Exam - 107 Questions
  7. Genitourinary Exam - 72 Questions
  8. Neurology Exam - 84 Questions
  9. Endocrinology Exam - 76 Questions
  10. Psychiatry Exam - 78 Questions
  11. Dermatology Exam - 66 Questions
  12. Hematology Exam - 39 Questions
  13. Infectious Disease Exam (coming soon)

Comprehensive Practice Exams

  1. 225 question exam 1
  2. 225 question exam 2
  3. 225 question exam 3
  4. 225 question exam 4
  5. 225 question exam 5
  6. Virtual PANCE
  7. Virtual PANRE
  8. 60 question Academy exam 1
  9. 60 question Academy exam 2
  10. 60 question Academy exam 3
  11. 60 question Academy exam 4
  12. The Daily PANCE and PANRE Exam 1
  13. The Daily PANCE and PANRE Exam 2
  14. The Daily PANCE and PANRE Exam 3
  15. The Daily PANCE and PANRE Exam 4
  16. The Daily PANCE and PANRE Final Exam

Easy Listening

Why not accomplish more during your long commutes? These two podcasts can make the hours seem like minutes and ease the pain of studying for your PANRE.

The Audio PANCE and PANRE Physician Assistant Board Review Podcast

The Audio PANCE and PANRE Physician Assistant Boards Podcast

Subscribe on iTunes  Google Play

Physician Assistant Exam Review Podcast by Brian Wallace

Subscribe on iTunes

Looking for the even-numbered episodes? These can be downloaded on the Academy Members Homepage

Posts to read:

FREE PANCE AND PANRE PRACTICE EXAM

FREE PANCE and PANRE Practice Exam

Posted: June 21, 2012

  Want 100’s of more questions just like these? Join Smarty PANCE Complete the next 90 questions to get your score – Gain full access to all my interactive board review exams including the audio PANCE and PANRE and the brand new Virtual PANCE and PANRE.

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PANCE and PANRE Content Blueprint Checklist

The PANCE and PANRE Content Blueprint Checklist

Posted: November 15, 2016

Your Blueprint to Success Starts Here! If you are at all like me the hardest part of studying for your PANCE or PANRE is figuring out where to begin. There is an ever-growing list of review books, podcasts, online programs, in-person review courses, and anecdotal recommendations to choose from. It’s overwhelming! So, the key to success […]

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The DO’S and DON’TS of the PANCE and PANRE Examination

Posted: March 22, 2015

What do you think? While taking your PANCE or PANRE should you change your answer if you have a good reason to do so? The DO’S and DON’TS of the PANCE and PANRE Examination The following DO’S and DON’TS are excerpted from the wonderful Lange Q&A Physician Assistant Examination Board Review Book and summarize important points you should always […]

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Four Best PANCE and PANRE REview Books 300x

The 4 Best PANCE and PANRE Study Guides and Review Books

Posted: September 2, 2018

What are the best PANCE and PANRE board review books? Here are my picks for the top PANCE and PANRE review books of 2023. These books helped me score in the top 5% on the PANCE and PANRE exams. You can browse my complete list of reading recommendations or sign up for my reading list newsletter […]

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State Board of Registration

You can visit your state chapter’s website for a link to your state’s Board of Registration. You will likely need official transcripts from all schools attended. You should download this form well in advance and start collecting transcripts and all other information that you can to speed up the process.

Based on five regions (for state chapters) and five federal service areas – provide their members locally-based CME, networking opportunities, social gatherings, timely information, advocacy, and job resources. Below are links to all 56 of AAPA’s constituent organization chapters.

  • Alabama Society of Physician Assistants
  • Alaska Academy of Physician Assistants
  • Arizona State Association of Physician Assistants
  • Arkansas Academy of Physician Assistants
  • California Academy of Physician Assistants
  • Colorado Academy of Physician Assistants
  • Connecticut Academy of Physician Assistants
  • Delaware Academy of Physician Assistants
  • District of Columbia Academy of Physician Assistants
  • Florida Academy of Physician Assistants
  • Georgia Association of Physician Assistants
  • Hawaii Academy of Physician Assistants
  • Idaho Academy of Physician Assistants
  • Illinois Academy of Physician Assistants
  • Indiana Academy of Physician Assistants
  • Iowa Physician Assistant Society
  • Kansas Academy of Physician Assistants
  • Kentucky Academy of Physician Assistants
  • Louisiana Academy of Physician Assistants
  • Maine Association of Physician Assistants
  • Maryland Academy of Physician Assistants
  • Massachusetts Association of Physician Assistants
  • Michigan Academy of Physician Assistants
  • Minnesota Academy of Physician Assistants
  • Mississippi Academy of Physician Assistants
  • Missouri Academy of Physician Assistants
  • Montana Academy of Physician Assistants
  • Naval Association of Physician Assistants *
  • Nebraska Academy of Physician Assistants
  • Nevada Academy of Physician Assistants
  • New Hampshire Society of Physician Assistants
  • New Jersey State Society of Physician Assistants
  • New Mexico Academy of Physician Assistants
  • New York State Society of Physician Assistants
  • North Carolina Academy of Physician Assistants
  • North Dakota Academy of Physician Assistants
  • Ohio Association of Physician Assistants
  • Oklahoma Academy of Physician Assistants
  • Oregon Society of Physician Assistants
  • Pennsylvania Society of Physician Assistants
  • Physician Assistant Academy of Vermont
  • Public Health Service Academy of Physician Assistants *
  • Rhode Island Academy of Physician Assistants
  • Society of Air Force Physician Assistants *
  • Society of Army Physician Assistants *
  • South Carolina Academy of Physician Assistants
  • South Dakota Academy of Physician Assistants
  • Tennessee Academy of Physician Assistants
  • Texas Academy of Physician Assistants
  • Utah Academy of Physician Assistants
  • Veterans Affairs Physician Assistant Association *
  • Virginia Academy of Physician Assistants
  • Washington Academy of Physician Assistants
  • West Virginia Association of Physician Assistants
  • Wisconsin Academy of Physician Assistants
  • Wyoming Association of Physician Assistants
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Job Search Spots

Finding the right drop is not so daunting. As a physician assistant, job prospects abound, and if you set your feelers loose, you will likely find many jobs in various specialties.  Here are some of the tools I use:

  • Indeed.com: I am a big fan of Indeed and found my current job using the mobile app. You can set alerts and get updates delivered directly to your inbox once a week.
  • AAPA Joblink: Sponsored job search through the American Academy of Physician Assistants
  • Check your state chapters; most of them have job postings
  • Linked In: If you haven't already done so, you should update your LinkedIn profile: I get recruiter emails all the time, and employers still use this to find and screen candidates.
  • PAJOBsite.com
  • Monster.com
  • CareerBuilder.com
  • Craigslist: This used to be a great tool for finding PA jobs in your area and still can have some listings not found in other popular outlets. It is worth searching and setting alerts.
  • Check individual hospital/practice websites in your area (some organizations only post on their own career site)

Posts to read:

The 10 Best Websites for Physician Assistant Job Search The PA Life

The 10 Best Websites for Physician Assistant Job Search in 2022

Posted: October 10, 2017

If you’re a physician assistant/associate looking for a new job, you’re in luck! There are plenty of great places to look for your next PA position. But where is the best place to start? To help you out, we’ve outlined some of the best places to search for jobs as a PA in 2022. Here is […]

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Paying for PA School

An excellent, comprehensive informational tool on loan repayment. Geared toward medical students, but much of the information applies to PA students as well. This site offers information on loan repayment apps and links to great repayment options.

  • Association of American Medical College’s Loan Repayment Options
  • Public Service Loan Forgiveness
  • Student Academy of AAPA Financial Aid Resources

Service-Connected Scholarships/Repayments:

  1. Loan Repayment Programs: U.S. Airforce; U.S. Army; U.S. Navy
  2. NHSC Loan Repayment Program
  3. Indian Health Service Program
  4. U.S. Public Health Service Corps

Loan Repayment Programs:

  1. The National Health Service Corps Program (NHSC) is a competitive federal program. Students dedicated to practicing primary care in communities of greatest need can compete for educational scholarships. I was an NHSC Scholar, and you can read more about that here. They also offer a generous loan repayment program in exchange for two years of service in a designated healthcare shortage area (see the next section below).
  2. Federal and state-funded programs

Posts to read:

How to Bankroll PA School Without Going Broke

Scholarships, Grants and Loan Repayment Programs for Physician Assistants

Posted: September 1, 2015

PA School is Expensive It goes without saying, PA school is expensive. PA school is also demanding, which means you will have limited time (if any) to work while attending school. With the average undergraduate education debt prior to PA school at $36,300 and the average anticipated debt load from PA school at $75,000-$124,000, it […]

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PA Postgraduate Residency and Fellowship Programs

  • Residency programs allow the physician assistant to gain both clinical and didactic knowledge that would take years of on-the-job training to attain.  It provides a faster-paced, formalized training program of supervised practice, allowing physician assistants to be utilized much faster than new graduates.
  • The PA can develop the judgment and technical abilities in a specialized practice area, thus increasing their confidence in their chosen specialties.
  • Many employers give preference to residency-trained physician assistants.
  • Residency programs can be a great way to transition to a specialty practice for a mid-career PA looking for a new challenge.
  • It is also recognized that most employers are willing to pay more for a physician assistant who completed a residency program.

Use the search box to search by specialty or location. Click the header column to sort based on that criteria. Click on the web link to visit the postgraduate residency program website.

wdt_ID Program Specialty Location Months Size web
1 University of Missouri Acute Care Columbia, MO 15 2
2 Carolinas Healthcare System Center Acute Care Charlotte, NC 12 28
3 Advanced Practitioner Acute Care residency at Mission Health Acute Care Asheville NC 12 4
4 Mercer-Piedmont Heart Cardiology Atlanta, GA 12 2
5 St. Joseph Mercy Hospital Cardiothoracic Ypsilanti, MI 12 1
6 Dartmouth-Hitchcock Medical Center Cardiothoracic Lebanon, NH 12 2
7 Methodist DeBakey Heart and Vascular Center Cardiothoracic Houston, TX 12 3
8 Carolinas Healthcare System Center Critical Care & Trauma Charlotte, NC 12 28
9 Intermountain Medical Center Critical Care & Trauma Murray, UT 12 1
10 Einstein/Montefiore Division of Critical Care Medicine Critical Care & Trauma Bronx, NY 12 ?
11 Emory Critical Care Critical Care & Trauma Atlanta, GA 12 2
12 Johns Hopkins Hospital Critical Care & Trauma Baltimore, MD 12 6
13 St. Joseph Mercy Hospital Critical Care & Trauma Ypsilanti, MI 12 1
14 St. Luke's Hospital Critical Care & Trauma Bethlehem, PA 12 4
15 Mayo Clinic Arizona Critical Care & Trauma Phoenix, AZ 12 1
16 WakeMed Health and Hospitals Critical Care & Trauma Raleigh, NC 12 3
17 Winthrop University Hospital Critical Care & Trauma Mineola, NY 12 1
18 Medical College of Wisconsin Dermatology Milwaukee, WI 12 ?
19 Albany Medical Center Emergency Medicine Albany, NY 12 5
20 Albert Einstein Medical Center Emergency Medicine Philadelphia, PA 18 3
21 Arrowhead Regional Medical Center Emergency Medicine Colton, CA 14 15
22 Baylor College of Medicine Emergency Medicine Houston, TX 12 6
23 Brown Alpert Medical School Emergency Medicine Providence, RI 12 ?
24 Carilion Clinic Emergency Medicine Roanoke, VA 12 3
26 St. Luke's Hospital Emergency Medicine Bethlehem, PA 12 4
27 Jane R. Perlman / NorthShore University Health System Emergency Medicine Evanston, IL 12 2
28 Johns Hopkins - Bayview Hospital Emergency Medicine Baltimore, MD 18 1
29 Lakeland Regional Health Emergency Medicine Lakeland, FL 12 4
30 Marquette University - Aurora Health Emergency Medicine Milwaukee, WI 12 ?
31 New York University (NYU) Emergency Medicine New York, N.Y. 10 2
32 University of Missouri Emergency Medicine Columbia, MO 13 2
33 New York Presbyterian-Weill Cornell Medical Center Emergency Medicine New York, NY 12 4
34 Regions Hospital Emergency Medicine St. Paul, MN 18 2
35 Staten Island University Hospital Emergency Medicine Staten Island, NY 24 4
36 Team Health EMAPC Fellowship Emergency Medicine Oklahoma City, OK 12 3
37 University of Iowa Emergency Medicine Iowa City, IA 18 ?
38 University of New Mexico School of Medicine Emergency Medicine Albuquerque, NM 18 2
39 UCSF Fresno Emergency Medicine Fresno, CA 18 2
40 The US Army/ Air Force-Baylor Emergency Medicine Physician Assistant (EMPA) Residency Must be Active Duty Army or Air Force, with a minimum of 4 years (Army) or 2 years (Air Force) active commissioned service as a Physician Assistant. Emergency Medicine JBSA Fort Sam Houston, TX 18 ?
41 Yale New Haven Hospital Emergency Medicine New Haven, CT 18 2
42 University of Kentucky Emergency Medicine Lexington, KY 12 4
43 Carolinas Healthcare System Family Medicine Charlotte, NC 12 28
44 Carilion Clinic Urgent Care and Rural Health Family Medicine Daleville, VA 12 2
45 Michael E. DeBakey VA Medical Center - Houston, Texas - Physician Assistant Post-Graduate Residency in Geriatric Medicine Geriatrics Houston, TX 12 ?
46 Mayo Clinic Arizona Hematology & Oncology Phoenix, AZ 12 1
47 MD Anderson Cancer Center - The University of Texas Hematology & Oncology Houston, TX 12 2
48 Carolinas Healthcare System Hospitalist Charlotte, NC 12 28
49 Mayo Clinic Arizona Hospitalist Phoenix, AZ 12 1
50 Regions Hospital Hospitalist St. Paul, MN 12 1
51 Carolinas Healthcare System Internal Medicine Charlotte, NC 12 28
52 Children's Hospital of Philadelphia Neonatology Philadelphia, PA 12 2
53 University of Kentucky Neonatology Lexington, KY 12 3
54 Arrowhead Regional Medical Center OB-GYN Colton, CA 12 6
55 Montefiore Medical Center OB-GYN Bronx, NY 12 2
56 Arrowhead Orthopedics Orthopedics Redlands, CA 12 6
57 Carilion Clinic Orthopedics Roanoke, VA 12 2
58 Illinois Bone and Joint Institute Orthopedics Park Ridge, IL 12 7
59 DMC Orthopaedics and Sports Medicine Orthopedics Warren, MI 12 2
60 UCSF Fresno Orthopedics Fresno, CA 13 2
61 Riverside University Health System Orthopedics Moreno Valley, CA 12 ?
62 Navy PA Graduate Training: Orthopedics - Career military physician assistants Orthopedics Portsmouth, VA 12 4
63 Mayo Clinic Arizona Otolaryngology Phoenix, AZ 12 2
64 Carolinas Healthcare System Pediatrics Charlotte, NC 12 28
65 Shasta Community Health Center Primary Care Redding, CA 12 3
66 North Florida-South Georgia Veterans Health System – University of Florida Physician Assistant Residency in Primary Care Primary Care Gainesville, FL 12 ?
67 The Emory Physician Assistant Program and The Veterans Atlanta Medical Center (VAMC) Primary Care Atlanta, GA 12 ?
68 Nationwide Children's Hospital Child and Adolescent Psychiatry PA Program Psychiatry Columbus, OH 12 2
69 University of Iowa Psychiatry Iowa City, IA 12 2
70 The Cherokee Mental Health Institute (CMHI) Psychiatry Cherokee, IA 12 ?
71 Bassett Healthcare Surgery Cooperstown, NY 12 2
72 Duke University Medical Center Surgery Durham, NC 12 ?
73 Hartford Healthcare Surgery Hartford, CT 12 4
74 Johns Hopkins Hospital Surgery Baltimore, MD 12 11
75 Montefiore Medical Center - Albert Einstein College of Medicine Surgery Bronx, NY 14 5
76 Norwalk Hospital/Yale Surgery Norwalk, CT 12 12
77 Texas Children's Hospital Pediatric Surgery Surgery Houston, TX 12 6
78 University of Florida Surgery Gainesville, FL 12 4
79 University of Pittsburgh Medical Center Surgery Pittsburgh, PA 12 2
80 Carolinas Healthcare System Urgent Care Charlotte, NC 12 28
81 Carilion Clinic Urgent Care and Rural Health Urgent Care Daleville, VA 12 ?
82 Carolinas Healthcare System Urology Charlotte, NC 12 28
83 UT Southwestern Medical Center Urology Dallas, TX 12 1
84 Hepatology Physician Assistant Fellowship Hepatology Alexandria, VA 12 ?
85 Hispanic Serving Health Professions Schools (HSHPS) Graduate Fellowship Training Program Other Multiple Locations 12 ?
86 Public Health PA Fellowship, GA Epidemic Intelligence Service (EIS) Public Health Atlanta, GA 12 ?
87 Physician Assistant Abdominal Organ Transplant Fellowship (Arizona) Organ Transplant Arizona 12 ?
88 The Ohio State University Oncology Columbus, OH 27 ?
89 Regions Hospital Psychiatry Advanced Practice Clinician Fellowship Psychiatry Minneapolis, MN 12 2
90 Postgraduate PA fellowship in behavioral health at Pacific University Psychiatry Hillsboro, OR 12 1
91 University of Iowa Department of Family Medicine Family Medicine Iowa City, IA 12 ?
Program Specialty Location Months Size web

Posts to read:

Physician Assistant Postgraduate Residency and Fellowship Programs

Physician Assistant Postgraduate Residency and Fellowship Programs: The Ultimate Guide

Posted: January 22, 2017

Postgraduate PA School Residency and Fellowship Programs As a new or even experienced PA, it is normal to feel uncomfortable with the thought of jumping into a medical specialty. Often, we have had little more than 30 days of training in a particular field, and we join a team of specialists who may expect us […]

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Contract and Negotiations 

  • The AAPA Salary Report: $200 (yes, that is ridiculously overpriced)
  • AAPA interviewing and contracts basics
  • AAPA Career Companion
  • AAPA Career Central
  • Student SPARK Session Powerpoint at AAPA Conference
    • Contract Negotiations

Posts to read:

Physician Assistant Resume – Curriculum Vitae and Cover Letter Downloads

Posted: June 10, 2012

These are Fully Customizable Microsoft Office, Word Templates – No Formatting Required! *Need help crafting your physician assistant resume, CV, or cover letter? Resume Editing Cover Letter editing New Graduate Physician Assistant Resume Template This is a resume geared specifically for new graduate Physician Assistants. It is a clean, professional, and simple design (it also happens […]

Physician Assistant Resume Sample

Use VisualCV to Create a Stunning Physician Assistant Resume

Posted: April 26, 2017

I have a confession to make. For many years I have had a copy of my physician assistant resume posted here on the website, available for download as a guide to help you structure and organize your own physician assistant CV. It has helped 100’s (if not 1000’s) of practicing and new graduate PAs like […]

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Continuing Medical Education

There are lots of options for CME, but here are some of my timeless favorites. They are not only good for CME, but they are good for your mind as well.

  1. UpToDate: If you have an UpToDate subscription, it automatically tracks CME each time you log in and read and article
  2. American Family Physician: you can get anywhere from 4-6 CME credits, with each journal averaging about 50 per year. The articles are spectacular.
  3. Primed: Yes, this is heavily pharma-sponsored, but the lectures are great, and the conferences are a real bargain.
  4. Prescribers Letter: Although the CME credits are not groundbreaking, subscribing to this letter will make you a better practitioner, and it's good for about 15 Credits per year.
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Apple and Android Applications

Here are a few of my favorites. You can see my full list of preferred apps by clicking here.

Tarascon Pharmacopoeia: There are lots of Pharmacopeia apps out there, but Tarascon continues to be my favorite. If you are a fan of the pocketbook (and let’s be honest, who’s not), you will love the app. Loaded with some amazing tools (especially the pediatric dosing charts), blazing-fast load times, and zero advertisements, the Tarascon Pharmacopoeia is well worth the one-time annual investment. I would find it hard to practice without it.
EMRA Antibiotic Guide: The easy-to-use EMRA Antibiotic Guide helps you navigate the multitude of choices in antibiotics quickly and efficiently so you can offer your patients the best care based on the latest guidelines.
Shots Immunizations: If you work in family practice medicine, pediatrics, or you are an urgent care PA trying to figure out whether or not your patient needs a tetanus booster, this app will save the day. It is simple, updated annually, free, and incredibly useful. Download this app, and you will be set for life (at least from an immunization standpoint). Shots Best Apps for PA School
Essential Anatomy 5: I find this to be a handy tool in the clinic that my patients (and my kids) absolutely love. It has a beautiful and intuitive interface that my 5-year-old can use. It allows you to isolate individual systems, muscles, organs, etc., etc. The muscle functions add-on, which allows you to visualize a muscle's action, is spectacular and easily worth the extra seven bucks. I have learned more about anatomy from this app than a year's worth of undergraduate anatomy or the anatomy class I had in PA school, for that matter. Without a doubt, this is the most beautiful, well-designed, and “essential” anatomy app on the market. Essential Anatomy 5 Physician Assistants
LabGear – Medical Lab Values & Tests Reference: Although this is becoming a bit less useful in the era of electronic medical records having a good lab reference is a must. If you are going to use one, Lab Gear is by far the best. LabGear sports a clean, well-designed, and simple to navigate user interface that makes finding lab values painless and extremely fast. The best part is that Lab Gear provides a differential diagnosis based on high and low abnormal values, the ability to add notes and favorite along with direct links to Wikipedia articles covering each topic. Once again, I have tried many lab apps, and this is by far the best.
UpToDate: If you are lucky enough to have a free subscription to UpToDate, consider yourself blessed. This is hands down the best application in the world with extremely detailed summaries on the most "up-to-date" diagnosis and treatment protocols.
Pedi QuikCalc: As the name implies, this app allows you to quickly calculate medication doses based on weight and age. It also has several other useful tools such as pediatric BP goals, growth charts, vaccine recommendations, and pretty much everything else you can imagine. It's a must-have app!

Posts to read:

The Best Medical Apps for Physician Assistant and PA Students

The Best Apps for Physician Assistant Students and PA Professionals

Posted: August 28, 2015

The Augmented PA If you haven’t noticed the medical app business is booming and for good reason.  As physician assistant students, PAs, or practicing medical professionals we need to synthesize a tremendous amount of data and be able to recall it in a pinch. We are short on time, overloaded with information and expected to […]

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Patient Handouts and Resources

  • Epocrates Patient Literature Library: Did you know Epocrates Online offers an amazing collection of English and Spanish Patient Resources? Check it out. It's amazing!
  • Patients Like Me:  An amazing idea: Bring patients together and let them document their symptoms and what helped. This is set to revolutionize the way we do healthcare!
  • RxAssist: A wonderful resource for free and discounted medications for patients. Search by medicine to find discounted pharmacies. This tool is priceless!
  • Needy Meds: information on patient assistance programs. All our information is free and updated regularly.

Help patients deal with bills:

  • 5 Questions to Ask During Your Hospital Stay
  • 6 Questions to Ask Before Every Doctor's Appointment
  • How to Choose a Doctor
  • How to Deal With Bills
  • Templates for Protest Letters
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Books to Read

Read these books, and you will be a better physician assistant. For even more recommendations check out my constantly updated big list of the very best books for PAs.

Check Prices on Amazon

Being Mortal Medicine and What Matters in the End

Check Prices on Amazon

Mountains Beyond Mountains

Check Prices on Amazon

When Breath Becomes Air

Check Prices on Amazon

Posts to read: 

The Big List of The Very Best Books for PAs

The Big List of The Very Best Books for PAs

Posted: February 23, 2014

The Best Books for Pre-PAs, Practicing PAs, and For Your PA School Clinical and Didactic Years “The more that you read, the more things you will know. The more that you learn, the more places you’ll go.” – Dr. Seuss, I Can Read with My Eyes Shut One of the best habits you can develop […]

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