After some internal debate, I’ve decided to throw caution to the wind and share up front that tomorrow I will take my board exam to become a physician assistant (the PANCE).  The debate centers around the fear that passing is not guaranteed, and once I’ve shared with the internet (read: the world) that I’m taking it, there’s no hiding how I do.  But I plan to pass with flying colors, and I will hold my head high either way.  This article shares a little about what the exam is like.

About The Physician Assistant National Certifying Examination (PANCE)

The PANCE is a 6 hour, 300-question exam that assess a new PA school graduate’s fitness to join the field as a nationally certified physician assistant.  It is taken at a “secure” Pearson Vue testing center, on computer, and consists of five 60-minute blocks of 60 questions plus one hour for breaks throughout the day.

Topics I will be tested on are listed by system according to the following table:

Organ System % of Exam
Cardiovascular 16
Dermatologic 5
EENT(Eyes, Ears, Nose and Throat) 9
Endocrine 6
Gastrointestinal/Nutritional 10
Genitourinary 6
Hematologic 3
Infectious Diseases 3
Musculoskeletal 10
Neurologic System 6
Psychiatry/Behavioral 6
Pulmonary 12
Reproductive 8
Total: 100%

Each organ system will be tested according to the following “task areas. ”  Notice that the two big areas are – understandably – diagnosis and treatment:

Tasks % of Exam
History Taking & Performing Physical Examinations 16
Using Laboratory & Diagnostic Studies 14
Formulating Most Likely Diagnosis 18
Health Maintenance 10
Clinical Intervention 14
Pharmaceutical Therapeutics 18
Applying Basic Science Concepts 10
Total: 100%

All of the questions are multiple choice, just like the USMLE, and there are questions that require the examinee to interpret lab tests, photos of rashes, wounds, etc., imaging studies, and EKGs. The majority of the questions are in vignette format (“A 26 year old male comes into the ER complaining of…” Each section is timed, with one hour per 60 questions, and you can mark questions to come back to if you choose to jump around.

As you can see, the PANCE tests on a large content area.  If you want to look through the specific illnesses that are tested, you can do so on the NCCPA’s website (click this link and then scroll down).  It’s not all-inclusive by any means, but there’s plenty here.  The NCCPA also publishes practice tests for $35 made up of 120 questions each that have been previously used on the PANCE, but that have been retired.  This gives you a pretty good idea what the exam will look like.  A sample question from the NCCPA’s website can be found here, along with explanation of the right and wrong answer choices.  Yes, they do make money on this, but the real money is for the test itself – the registration fee is a breathtaking $475 – just another reason I hope to pass the first time!

How I’m Preparing For the PANCE

At this point in my learning, it’s about reviewing things I already know, getting comfortable with the question format, and filling in details that might have slipped through the cracks over the last two years.  Rather than studying from my primary resources (Current, Cecil Medicine, etc), it’s time to work from exam questions.  There are books of questions, some of which are good, and others not (KAPLAN’s were terrible for some reason) that you can use to get a feel for your weak areas.  I’m taking about 50 questions at a time, then going back and reading through the answer explanations – even for the questions that I got right – to assess for information I’ve either 1) never seen, or 2) forgotten.  I may make a few notes on a page for each organ system with the info that I need to learn, and then I move on to more questions.

So shortly after I post this article, I’m off to San Francisco to check into a hotel, review for one final day, and then take in a good night’s sleep before the fun starts at 8:00 AM tomorrow.

Wish me luck (please!)