The 3-Step PANRE Prep and 8-Week PANRE & PANRE-LA Study Schedule

How to Study for (and Pass) Your PANRE and PANRE-LA

PANRE - an acronym for the Physician Assistant National Recertifying Examination (PANRE) Exam - is a word dreaded by even the most well-intentioned and hard-working physician assistant.

Just saying the word "PANRE" in casual conversation is enough to invoke an Incredible Hulk-like level of catecholamine release - as I am in my third recertification cycle, my index finger just turned green while writing this sentence.

Unfortunately, no amount of fear, dread, or PAs turning green and ripping our t-shirts will ever seem to make the PANRE go away. For those of you who wish to maintain (or regain) certification, it's just a fact of life.

In this post, we break down the 10-year recertification process, identify the three steps to successfully prepping for your PANRE, and provide you with an 8-week PANRE study schedule/plan that walks you from implementation to successful recertification!

In addition, we have a new kid on the block, "The PANRE-LA." It incorporates elements of a longitudinal assessment and significantly reduces the stress quotient by being open book and open door - meaning you take the exam anywhere and anytime you want to.

Unlike the traditional PANRE, your score on the PANRE-LA will be based on your best eight quarters. You may work straight through or skip up to four quarters during the process, as long as you complete at least 1 quarter in year 7 and 1 in year 8. Completing more quarters gives you more opportunities to pass.

Both exam options are based on the same PANRE/PANRE-LA content blueprint and share the same question format. They both use a scale score to account for question difficulty. The scale score required to pass is not tied to a set percent correct.

The 10-year certification maintenance process

As PAs, we have a 10-year certification maintenance process. The 10-year process includes five two-year cycles during which all certified PAs must log 100 CME credits online and submit a certification maintenance fee by December 31 of their certification expiration year.

1. Years 1 & 2: 100 CME + fee
2. Years 3 & 4: 100 CME + fee
3. Years 5 & 6: 100 CME + fee + option to apply for PANRE-LA during the 6th year of the recertification cycle and start the exam in January of 7th year
4. Years 7 & 8: 100 CME + fee + start the PANRE-LA exam in January of 7th year. Successfully complete eight quarters and finish the PANRE-LA in year 8. 
5. Years 9 & 10: CME + fee + traditional PANRE (if not signed up for PANRE-LA). Finish PANRE-LA in year 9 (if not completed in year 8)

You are eligible to take the PANRE for recertification if you are in the ninth or tenth year of the ten-year PA-C certification maintenance cycle.

You are eligible to sign up for the PANRE-LA if you are in the sixth year of your ten-year certification maintenance cycle. You begin taking the exam in year 7 and can finish as early as year 8 if you pass all 8 required quarters. Otherwise, you will complete your PANRE-LA in year 9. If you do not pass, you have the option to take the traditional PANRE in year 9 or year 10 of your certification maintenance.

You can find your recertifying exam status, along with the years in which you are eligible to take your PANRE or PANRE-LA, on your NCCPA account dashboard.

The application window for the PANRE-LA for those PAs due to recertify in 2027 is July 5 – November 30, 2023. 

Key Dates for PANRE-LA 

Below are the quarterly date ranges when PAs who are registered for PANRE-LA can log in to answer questions in 2023. NCCPA will send email notifications when questions are available and when deadlines are approaching.

2023
Quarter Starts	Quarter Ends
Tuesday, January 3	Friday, March 10
Monday, April 3	Monday, June 12
Monday, July 3	Monday, September 11
Monday, October 2	Monday, December 11

About the traditional PANRE

The traditional PANRE is a 4-hour exam consisting of 240 multiple choice questions given in 4 blocks of 60 questions with 60 minutes for each block. 45 minutes are allotted for breaks between each block. There are several different versions of the PANRE called "forms." The NCCPA builds every PANRE form to be equivalent in terms of the content blueprint, tasks, response time, and difficulty.

Performance on PANRE is reported on a scale-score metric. The PANRE scale has a minimum score of 200, a maximum score of 800, and a passing score of 379. 

Your exam results, along with your score report, will be available on your NCCPA dashboard under the exams tab. Here you can review your score report and the standard interpretation guidelines.

Here is my traditional PANRE performance report from 2016 (when I last took the traditional PANRE). You will receive your score (highlighted below in yellow) along with a performance breakdown.

The breakdown will be important if you have failed and need to retake your exam. I found my results surprising, given I got a 100% in infectious disease (a relative weakness of mine) and a 60% in dermatology (an area I consider myself to be strong in).

Your score here does not matter. As long as you have scored above the required 379, you can celebrate. Nobody will ever ask to see your PANRE score unless you find yourself writing a blog post about it someday!

How to prepare for and pass your traditional PANRE + an 8 Week PANRE Blueprint Study Schedule and Plan

When to take your traditional (proctored) PANRE exam

It goes without saying that when it comes to taking your PANRE, like most things in life, the earlier, the better.

PAs may take the PANRE up to two times in the ninth year and up to three times in the tenth year, with a maximum of four total attempts. Read that last sentence again, and you will realize that if you take the PANRE in your ninth year and fail, you gain one extra attempt by taking your exam early.

Given ~ 97% of PAs pass the PANRE on their first try, you will most likely not need this extra attempt. Those organized and motivated enough to take their PANRE in their ninth year will have less anxiety and will likely perform better as a result.

You can register for the PANRE online; the exam registration fee is $350. You may schedule your exam anytime (depending on testing center availability) within a 180-day timeframe established for you to take the exam based on the successful submission of all required materials to NCCPA.

Some people like to set an exam date before they start studying. Having a hard deadline on your calendar means no more messing around! Your exam date can be changed - you will need to contact the accommodations services at Pearson VUE directly to schedule or reschedule your exam appointment, and you will need to provide your candidate ID, the name of the exam you are registered for (PANRE), and your preferred test date and center.

PANRE Pro Tip: Take your PANRE in your 9'th year and schedule your exam date

PANRE 3-Step Prep:

Step 1: Take a PANRE Pre-test

The best way to see what the PANRE is like and focus your exam preparation is to take a PANRE pre-test.

Smarty PANCE members have access to seven summative exams. We have five 225-question exams and a virtual PANCE and PANRE exam built on top of the NCCPA blueprint. Any (and all) of these exams can be used as a pre-assessment tool for your PANRE.

But in this case, I would recommend spending a little extra moola ($50 as of this writing) and prepare with a test from the exam writers themselves by taking the NCCPA PANRE practice exam.

The NCCPA offers practice exams for PANCE, PANRE, and Specialty CAQs. Many people make the mistake of waiting until they are close to their exam day to take an NCCPA practice exam, but I advise against this approach. By taking the NCCPA practice exam late in your preparation, you lose much of the benefit of the reported exam performance profile (see below), and depending on your score, it may only cause unnecessary anxiety.

If you follow the 8-week study plan that I outline here, I recommend taking the NCCPA PANRE practice exam before you start studying. 

There are 120 questions included in the NCCPA PANRE practice exam. You have 60 minutes to complete each block of 60 questions, but you can pause the clock while in a block and return and finish it later, as long as it is still within the 180-day time frame.

This means that you DO NOT have to finish the entire practice exam in one sitting. You can space it out as you see fit - you could even take one question a day for 120 days if you want to (although I don't recommend it 😀). I recommend giving yourself no more than 7 days to complete the 120-question NCCPA PANRE practice exam.

You will receive a performance profile after the completion of the practice exam. This will give you insight into your relative strengths and weaknesses in the content areas based on the PANRE/PANRE-LA Blueprint.

You can access your performance profile from the NCCPA practice exam overview page in your online record for as long as you are a PA!

Alongside, before, or immediately after completing the 120-question NCCPA summative exam, consider taking one of our five 225-question practice exams mentioned above. Unlike the NCCPA practice exam, these exams provide real-time feedback with links to PANRE Blueprint lessons.

Although you don't need to take two pre-assessment exams before digesting the PANRE blueprint and diving into blueprint topics, you mustn't skip this critical pre-assessment step.

Now that you have completed your pre-test, you can take this self-assessment along with your NCCPA practice test performance profile and proceed to step two.

PANRE Pro Tip: Take a PANRE pre-test to identify your strengths and weaknesses

Step 2: Know what to study.

Just like the PANCE, the PANRE & PANRE-LA exams are based upon an NCCPA-generated exam content blueprint. This NCCPA PANRE & PANRE-LA content blueprint provides information on how exam questions are allocated to the 14 different content categories on the PANRE.

Updated in 2023, the NCCPA revised the PANRE/PANRE-LA blueprint by surveying certified PAs to identify specific diseases and disorders considered part of core medical knowledge across all disciplines.

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.

To build an effective study plan, you will need to familiarize yourself with all 378 diseases/disorders. Then pay particular attention to the intervention complex and intervention basic performance expectation levels as these will be assessed at the highest degree.

You can view and download the official NCCPA PANRE content blueprint from the NCCPA website here.

On Smarty PANCE, we have created an interactive NCCPA PANRE blueprint, a replica of the latest blueprint with links to lessons covering all requisite topics and a breakdown of each topic by assessment level.

Now that you have taken your pre-test, reviewed your PANRE performance profile, and downloaded, printed, and bookmarked your copies of the NCCPA PANRE blueprint, it's time to proceed to step 3 - start studying!

PANRE Pro Tip: Download, print, and bookmark a copy of the NCCPA content blueprint and use this as your guide for studying

Step 3: Create a schedule and start studying

By this point, you have taken a PANRE practice exam, identified your weak areas, and familiarized yourself with the anatomy of a well-written multiple-choice question. You have downloaded and printed a copy of the NCCPA PANRE/PANRE-lA content blueprint, and you know exactly which topics you are going to study.

Now you will create a systemized plan to review these topics and practice questions along the way.

The Smarty PANCE 8-Week PANRE & PANRE-LA Blueprint Study Plan

As a busy PA finding the time to study is challenging. Unlike when you took your PANCE, you now have a full-time job and 7-8+ years of life and "liberties" to juggle alongside. You must break this all down and approach the blueprint systematically. Using this clear and systemized approach will make the process a whole lot easier to manage.

This 8-week PANRE & PANRE-LA blueprint study plan is based on my 8-week PANCE study plan but has been refined to only cover only those topics required for the PANRE & PANRE-LA. We have created additional checklists based on performance expectation levels, giving you various options to organize and optimize your prep.

For some, it may be as simple as crossing off topics and taking notes in the margins of your printed PANRE blueprint. This analog + digital approach can be very effective.

For those who prefer a more fluid and dare, I say, "nuanced" approach, I recommend using our pre-built Trello PANRE template. This template uses the following 8-week schedule with the addition of the pre and post-test along with your scheduled PANRE exam.

• Pre-Study: NCCPA PANRE Practice Exam
  • Week 1: 45 Intervention Complex diseases and disorders covering all organ systems
  • Week 2: 106 Intervention Basic diseases and disorders covering Cardiovascular, Dermatology, EENT, GI/Nutrition, and Genitourinary
  • Week 3: 78 Intervention Basic disease and disorders covering Hematology, Endocrine, Infectious Disease, Musculoskeletal, Neurology, Psychiatry, and Pulmonary
  • Week 4: 21 Intervention Basic disease and disorders covering Renal and Reproductive
  • Week 5: 59 H&P + diagnosis diseases and disorders covering Cardiovascular, Dermatology, EENT, GI/Nutrition, and Endocrine
  • Week 6: 39 H&P + diagnosis diseases and disorders covering Hematology, Infectious Disease, Musculoskeletal, Neurology, Psychiatry,
  • Week 7: 20 H&P + diagnosis diseases and disorders covering Pulmonary, Genitourinary, Renal, and Reproductive
  • Week 8: Play catch-up and review with Practice Exams

• Post-test (virtual PANRE) and NCCPA PANRE exam

Our Trello Board includes all 378 PANRE/PANRE-LA blueprint diseases and disorders broken into digestible bite-sized morsels!

Follow this link to access this 8-week PANRE & PANRE-LA Trello study template. Trello is free to use. You must log in or create an account and then import this template into your Trello account. You can drag, drop, and modify it to fit your desired approach.

If you are a Smarty PANCE member, you can take advantage of the included lesson links with ReelDx, Osmosis, and Picmonic add-ons to enhance your PANRE preparation. We have used icons to identify lessons with these enhancements.

You can mark off each topic upon completion. At the end of each week, we have included links to topic-specific practice exams to test your knowledge. Optional Trello "power ups" allow you to create a custom study calendar, set optional due dates, set reminders, and link this to your personal calendar.

You can use our pre-built flashcard sets (located in the blueprint courses) or create your own flashcards (using a tool like Quizlet, Anki, or good old-fashioned paper) to practice spaced repetitions of hard-to-remember topics. I also recommend you practice writing your own test questions as you go.

Content Blueprint PEARLS tables summarize the highest yield information on the presentation, exam findings, diagnosis, and treatment.

At the end of these 8 weeks, you will have confidently reviewed the requisite topics, flipped through enough flashcards, practiced enough questions, and dusted off enough cobwebs that you will be ready and confident for your exam.

For those of you taking the PANRE-LA, you may choose not to complete the 8-week study schedule prior to beginning your first quarter of questions (or at all). But you will have a blueprint for success nonetheless.

PANRE Pro Tip: Use our Trello 8-week PANRE/PANRE-LA study planner to create your study plan, organize, and track your progress through the PANRE blueprint

Final step: Take your PANRE or PANRE-LA

Take the traditional PANRE

• You began this process by logging into your NCCPA dashboard and knowing when you were eligible to take your PANRE exam.
• Once eligible, you submitted all the required materials to the NCCPA, paid the registration fee, and scheduled your PANRE exam to be taken at the PEARSON Vue testing center near you.
• You completed your PANRE pre-assessment, identified your weak (and strong areas), and printed out your performance assessment.
• You obtained your copy of the NCCPA PANRE & PANRE-LA content blueprint and knew exactly which topics you needed to study.
• You used our 8-week study plan (or created your own) to progress through the PANRE content blueprint topics and completed practice questions and flashcards along the way
• You completed the Virtual PANRE to simulate your test day experience best.
• You took your traditional PANRE exam and ace it!

This process will take two to three months to complete at a relaxed and manageable pace from start to finish. 

Take your PANRE-LA

• You began this process by logging into your NCCPA dashboard and knowing when you were eligible to sign up for and take your PANRE exam.
• Once eligible, you pay the registration fee and are signed up for the first quarter set to begin in your 7th year of the 10-year recertification cycle.
• You completed your PANRE pre-assessment, identified your weak (and strong areas), and printed out your performance assessment.
• You obtained your copy of the NCCPA PANRE & PANRE-LA content blueprint, and you knew exactly which topics you needed to study.
• You used our 8-week study plan (or created your own) to progress through the PANRE content blueprint topics and completed practice questions and flashcards along the way
• You take your first quarter of "open book" questions (see below)

How best to answer PANRE-LA questions in real-time:

Unlike the traditional PANRE, the PANRE-LA is open book (with 5 minutes to answer each question) and longitudinal over 8-12 quarters with the ability to pause and come back at any point during the quarter. You may be wondering, "what resources do I use during my PANRE-LA exam?"

I did some testing while taking the PANRE-LA on my end and used a combination of our Smarty PANCE general search, which is located at the top of every page on this website (I think I liked it better than the PANRE-LA rapid search tool we have, but feel free to try both), Google search, Merck Manual online, and the Family Practice Notebook to check my answers while taking the exam. I found this to be a winning combo, scoring 25/25 correctly during my first quarter.

When using the general search tool, I like to let it populate a list and watch as it quickly formulates a differential. I included an example of what I see as I type the word "Philidelphia" into the general search tool. As you can see, it provides AML and CML first in the list of options. Clicking on this will give you very quick access to all the high-yield pearls.

You can do the same thing with the Smarty PANCE PANRE-LA Rapid Blueprint Search Tool. Here is what you will see when you type in the search query "Philidelphia." Immediately, the system searches the PANRE-LA Blueprint and comes up with CML as the answer, and highlights the results. You can then click on the lesson to read more.

I have a multi-screen setup, which has helped a lot. I recommend (if you haven't already) trying to work with two monitors. This could be a two-monitor desktop configuration or a laptop connected to an inexpensive second monitor so you can have the question on one screen and perform your searches on the other.

Of course, I know it helps that I wake up every day and write new content and questions for the website, so I am very familiar with the topics the NCCPA is testing on and the blueprint. I know the blueprint well enough at this point that I can look at the content area they are testing me on and formulate a differential rather quickly. One trick that might help is to open up a copy of the PANRE blueprint when you see that first screen with the organ system listed:

Quickly familiarize yourself with the topics they could test you on within the content area (Cardiovascular System in the example above). This will allow you to focus your differential.

Between quarters, you may wish to brush up on (or review) topics using our 8-week PANRE/PANRE-LA Trello Study Planner.

A note on PANRE-LA scoring: 

I emailed the NCCPA about scoring. You may (or may not) find their response helpful:

Per NCCPA:

Like our proctored exams (PANCE and PANRE), PANRE-LA is scored on a scale that accounts for the relative difficulty of the set of questions each person receives. This is the fairest way to score exams in which all test-takers are not receiving the same exam form. As such, the passing standard cannot be tied to a set percent correct, or raw score, and the number of questions you will need to answer correctly may vary slightly from that of your peers. While we cannot give you a percent correct to aim for, here are a few things we would ask you to keep in mind:

Your final PANRE-LA score will be based on your cumulative performance across 8 quarters out of 12 (i.e., we score your best 8 quarters). This means that even if you have one or more quarters where you don’t answer as many questions correctly as you’d like, you will have opportunities to improve your overall performance over time.  PANRE-LA was designed to facilitate learning. One such component is that after your first quarter, you will receive five questions each subsequent quarter that are targeted to reinforce your knowledge on topics you have already answered questions on. An example scenario would be answering a question incorrectly with high confidence – in a future quarter you will likely receive a similar question on that topic. If you answer the question correctly the second time you see it, we will discard your first incorrect response and count the correct response. You may consider setting aside a bit of time before starting a new quarter’s questions to review your PANRE-LA Item History, paying closer attention to questions you answered incorrectly or questions answered correctly with lower confidence.  At the start of each new quarter, you will receive a performance graph that gives you an idea of how you’re performing in relation to both the passing standard and to your peers. So, you will know as you move through the program if you should spend a little extra time preparing for an upcoming quarter.

Final thoughts:

Although you may still resent the recertification process by this end, you will undoubtedly have refined your clinical skills, making you a more capable and confident clinician. Above all, this will translate into better patient care. Which, in the end, is all that matters!

Warmly,

Stephen Pasquini PA-C
CEO/Founder of Smarty PANCE and The PA Life
PANRE-LA test taker 😀