Friday, November 25, 2016

5 Tips on Taking the PANCE

5 Tips on Taking the PANCE
Updated: 11/25/2016
After studying for the PANCE for about the past month and a half, I will finally be releasing a review of (most) resources for you all - my loyal readers. First off, a huge thank-you to all of you for your interest in the PA profession; whether you’re just starting your journey or close to finishing, I hope that my blog has influenced your life for the better. Thank you all for sticking with my blog even through the past month or so when I’ve been absent from almost all forms of social media.

Second, I’d like to start out by saying that I took my PANCE on a Tuesday and received my results the following Wednesday. Guess what? I passed! I’m now officially a certified physician assistant and am so grateful to have made it this far. My next journey begins as a PA at Children’s Health in Dallas working in Neurology.

Now, let’s get back to why you’re here - the PANCE. This test - while the ultimate determinant of your career - should not be feared. It can be both challenging and deterring, but not impossible. While there are many forums online promoting or demoting the many products, question banks, and review courses, I’m here to give you my own opinion on most of the popular ones out today. Though this review is not intended to be all inclusive, I hope to give you all a starting place no matter your budget or timeline.  

Please review the NCCPA Content Blueprint Areas listed by Organ System here. Also, note that the site does mention that “Other content dimensions cross-sect these categories. For example, up to 20 percent of the questions on any exam may also be related to surgery or infectious disease, and up to two percent may also cover legal or ethical issues.” One area that I don’t believe PA programs emphasize heavily is legal issues surrounding healthcare. We do cover a lot of ethical scenarios in PA school - I think most programs do - as it's probably an ARC-PA requirement, but legal issues are not. The Healthcare Handbook is a nationally known text summarizing the basics surrounding healthcare in the U.S. and is a great review that I highly recommend prior to starting PA school.

In my experience with the PANCE, I felt the rotation exams prepared me for the PANCE best by covering topics like surgery, emergency medicine, and pediatrics in great detail. Old PACKRAT questions were great for review as well as they give you a sneak peak into the vignette style questions you may encounter on rotation exams, PACKRAT, and PANCE. You can go here to learn more about the PACKRAT. In addition, PACKRAT files may be found online but the best place to check is Quizlet!

As stated previously, there are many options available to help you review for the exam. During my clinical rotations and month and a half study session, I utilized many of these resources myself to help gauge what I felt was most helpful. While I will not endorse one product over another, I will offer suggestions as to what I think would have been an appropriate study plan. Here are 5 tips on taking the PANCE. Stay tuned for my full review of PANCE resources, coming soon.

5 Tips on Taking the PANCE

  1. Start with old PACKRAT Questions - try to get through as many as you can. I felt that the content of these questions and the vignettes were very similar to questions I encountered on the PANCE. Similarly, I felt that these were also helpful for rotation exams and the PACKRAT.
  2. Purchase a Review Guide - there are many of these available with the most well-known being the Babcock O’Connell book (our class called this “the AAPA/PAEA green book”), but there are others coming to the frontline that are great resources for both the classroom and the clinic. Find something that fits your needs: if you don’t like looking things up in Harrison’s or CURRENT buy something that is more detailed, if you have 3 days to prepare for the PANCE and you want something cut/dry to the bones buy an outline, and also look at length and reviews that include a question bank. See below for detailed information.
  3. Find a quality Question Bank. In my opinion, you should shoot for anywhere between 2,000-3,000 questions in preparation for your PANCE. This can seem daunting, but I did a lot of review questions during clinicals in preparation for my rotation exams. The PANCE/PANRE question book has 600 questions within 6 practice tests alone, so trust me, this number is easy to reach by the time you take your PANCE or PANRE. Finding a quality question bank should include things like: (a) online to stimulate the real PANCE exam, (b) performance feedback for each category that mimics the blueprint, (c) a mixture of lengthy vignettes and first order questions, (d) ability to time yourself during exams and select up to 300 question exams at a time, (e) ability to study in “blocks” by organ system in addition to mixing up questions to mimic a real PANCE.
  4. Time Yourself and Stimulate a Real Exam. Some of the best advice I can give students is timing yourself and simulating a real test-taking environment. For example, schedule a 5 hour block on a  Saturday or Sunday in your PANCE prep to take a 300-question exam without interruptions. You are allowed breaks during the PANCE, but make sure you’re not taking several hours off in between. If you have taken the PACKRAT, you know exactly what exam fatigue feels like. I can tell you from experience that burnout is real after doing 3,000+ questions and reading/re-reading information. Make sure to time yourself on questions and try to only give yourself 60 seconds for each question. By the time I reached section 4 of 5 in my PANCE, I was definitely tired. I woke up almost 2 hours before my PANCE and had studied hardcore for the week before. Reading vignettes was the last thing I wanted to do after 4 hours of testing.
  5. Review the Big 5 Topics Most/First. These are Cardiovascular (16%), Pulmonary (12%), Gastrointestinal/Nutritional (10%), Musculoskeletal (10%), and EENT (9%). Be prepared for these topics - together they make up 57% of the PANCE alone. You will see EKGs and X-rays. You shouldn’t forget to review those, even if they aren’t covered in detail in your review book.


  1. which question books would you recommend to study for EOR exams?

    1. Great question! See the section on EORs:


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