By Barsha Bhattacharya
Two significant exams, the Physician Assistant National Certifying Exam (PANCE) and the Physician Assistant National Recertifying Exam (PANRE), must be passed to become and stay a certified Physician Assistant (PA).
Although they are used for different reasons, both help ensure that a PA keeps their credentials at an optimal level. Also, an alternative to recertifying with the PANRE is the PANRE-LA.
Understanding the differences between these PANCE exams, their structures, and how to prepare for them is essential for every PA.
This article will explore these key differences and provide guidance on how to choose the right exam pathway for your career.
PANCE Exam vs. PANRE Exam
The PANCE and PANRE tests are for various phases of a PA’s career.
- PANCE: It is the first certifying examination, which is mandatory for newly graduated Pas graduating from accredited PA programs. Successful completion of this examination makes the candidate eligible for obtaining the first certification and licensure to practice as a PA.
- PANRE: It is the initial ten-year recertification exam to keep PA certification current. It tests a PA’s ongoing proficiency in clinical judgment and medicine.
- PANRE-LA: It is a substitute for the conventional PANRE through which Pas can recertify in the long-term using an open-book longitudinal examination instead of all at once.
Having knowledge about when to attempt each test and how to prepare for them is essential in being able to be able to successfully navigate a successful PA career.
| Aspect | PANCE | PANRE |
| Purpose | Initial certification for PA graduates | Recertification for practicing PAs |
| Timing | Taken after graduating from an accredited PA program | Required every 10 years to maintain certification |
| Exam Structure | 300 multiple-choice questions over 6 hours (5 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) | 240 multiple-choice questions over 5 hours (4 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) |
| Content Areas | Covers various medical systems with specific weightings | Similar content with slight variations in emphasis |
| Complexity | Focuses on entry-level medical knowledge | May include more complex scenarios to assess ongoing competency |
| Eligibility | Up to 6 attempts within 6 years post-graduation | Can be taken during the ninth or 10th year of the certification |
| Scoring | Scaled score from 200 to 800; passing typically at 350 | Same scoring system as PANCE |
| Certification Validity | Grants initial certification as a PA-C | Ensures continued certification and competency |
When to Take the PANCE vs PANRE
It is important to know the basics of both PANCE vs PANRE, so check them out.
- PANCE: Can be attempted after graduation from an accredited PA program. The applicant needs to apply for the examination, and there is a 180-day window in which to take the test. PANCE can be attempted six times in six years following graduation.
- PANRE: Must be taken on the tenth year of certification. Pas may try taking the PANRE twice on the ninth year and three times during the tenth year of the cycle of certification.
- PANRE-LA: Longitudinal assessment starts on the ninth year of certification and goes on for three years, on which Pas may choose to respond to questions every quarter as opposed to all-at-once testing.
About the PANCE: The Initial Certification Exam
PANCE is an extensive computer-based test to assess a PA candidate’s ability to reason clinically and medical knowledge in applying it for patient care.
- Format: 300 multiple-choice questions spread over five blocks of 60 questions.
- Duration: Five hours, including 45 minutes of break time.
- Content Areas: Major medical topics such as cardiovascular, pulmonary, gastrointestinal, musculoskeletal, and psychiatric disorders.
- Passing Criteria: Scaled scoring system defines pass/fail status.
About the PANRE: The Recertification Exam
The PANRE is used to keep active Pas up-to-date and proficient in medical practice. It is administered and utilized differently from the PANCE.
- Format: 240 multiple-choice items, distributed across four blocks of 60 questions.
- Duration: Four hours, breaks at the candidate’s discretion.
- Content Areas: Less about overall medical knowledge, but Pas can restrict some portion of the test to practice area.
- Passing Criteria: Scaled score model with passing level established by the NCCPA.
About the PANRE-LA: The Recertification Alternative
The PANRE-LA (Physician Assistant National Recertifying Longitudinal Assessment) provides a contrast to the PANRE of the past. It is a less formal and less anxiety-inducing approach to the high-stakes single test.
- Format: Quarterly three-year test.
- Number of Questions: 25 questions per quarter, or 100 questions a year.
- Open-Book Feature: Enables reference materials to be used to answer questions.
- Passing Criteria: Pas must pass at an acceptable level within three years.
The Difference Between PANRE vs. PANRE-LA
| Aspect | PANRE | PANRE-LA |
| Purpose | A recertification exam for practicing PAs | An alternative recertification option focused on ongoing learning |
| Timing | Taken during the ninth or 10th years of your certification cycle | Begins in the seventh year and can be completed by the eighth or ninth year |
| Exam Structure | 240 multiple-choice questions over 5 hours (4 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) | 25 questions per quarter over 8-12 quarters (spanning 2-3 years) |
| Content Areas | Covers multiple medical specialities based on the NCCPA blueprint | Follows the exact NCCPA content blueprint as the traditional PANRE |
| Complexity | Focuses on clinical reasoning and include more complex scenarios | Adapts question difficulty based on your performance over time |
| Eligibility | Available to certified PAs in their ninth or 10th year | Open to certified PAs starting in the sixth year of their cycle |
| Scoring | Scored on a scale of 200-800, with 379 required to pass | Scored on a scale of 1000-1500, with 1150 required to pass |
| Certification Validity | Certification is valid for 10 years upon passing | Certification is valid for 10 years upon passing |
| Format | Proctored, closed-book exam at a testing center | Open-book exam that can be completed at home |
| Flexibility | A 1-day, single-attempt exam | Spreads out over multiple quarters |
| CME Credits | No CME credits are allotted for PANRE prep | Earns 2 category 1 CME credits for completing each quarter |
| Retake Options | Allows up to 3 attempts in the 10th year | Can continue through all 12 quarters, with the option to switch to the traditional PANRE if necessary |
| Reference Materials | No external materials are allowed during the exam | Permits the use of reference materials during the assessment |
| Questions Time Limit | Each question must be answered in 60 seconds | Provides up to 5 minutes per question |
How to Choose Between PANRE and PANRE-LA
Individual choice and career requirements determine whether to choose PANRE or PANRE-LA.
- Use PANRE if: You like to get recertification done all at once, are already settled and relaxed with high-pressure tests, or don’t have much time to devote to long tests.
- Use PANRE-LA if: You like more time and a lower degree of tension, want to be able to refer to materials, or want an easy workload to get it done over time.
How to Prepare for PANCE, PANRE, and PANRE-LA
Preparation varies according to the exam. Here’s how to prepare for each of them effectively:
PANCE Study Tips:
1. Study the NCCPA Content Blueprint – Familiarize yourself with the topics.
2. Practice Question Banks – Make PANCE format questions every day.
3. Practice Full-Length Tests – Simulate test conditions for accumulated stamina.
4. Study in Study Groups – Study with groups to recall better.
5. Work on Weak Spots – Identify weakness and plug it.
PANRE Study Tips:
1. Study Clinical Guidelines – Stay current with changing medical practices.
2. Practice Time Management – Do practice questions in a timely fashion.
3. Tailor Your Study Plan – Practice material you implement in practice daily.
4. Practice NCCPA Exams – Get used to the format.
5. Use CME Resources – Continuing medical education (CME) credits typically review similar content.
PANRE-LA Study Tips:
1. Smart Use of Open-Book Strategy – Have resources ready for instant use.
2. Regularity – Question every three months to remain updated.
3. Systematic Reading of Each Question – Know the logic behind the rightness or incorrectness of an answer.
4. Watching Performance Patterns – Know areas of weak areas and work on them.
5. Usage of Official NCCPA Study Materials – Make maximum use of assistance provided.
Final Suggestions!
Knowing the difference between the PANCE, PANRE, and PANRE-LA enables you to make an informed best decision in terms of your certification requirement and prepare for the exam accordingly.
- Plan Ahead: Taking the PANCE, PANRE, or PANRE-LA, have a systematic plan of study beforehand.
- Use More Than One Study Aid: Mix textbooks, question banks, and internet tutorials.
- Simulate Testing Conditions: Practice under timed conditions to help on test day.
- Stay Current: Medical standards change, and ongoing learning is necessary.
- Work-Life Balance: Burnout is avoidable by including breaks and relaxation.
Good luck with exam prep and on certification Physician Assistant!
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