How to Study for (and Pass) Your PANRE
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 prepping for your PANRE, and provide you with an 8-week PANRE study schedule/plan that walks you from implementation to successful recertification!
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 your certification expiration year.
- Years 1 & 2: 100 CME + fee
- Years 3 & 4: 100 CME + fee
- Years 5 & 6: 100 CME + fee
- Years 7 & 8 : 100 CME + fee
- Years 9 & 10: CME + fee + PANRE
You are eligible to take the PANRE for recertification if you are in the ninth or tenth year of the PA-C certification maintenance cycle.
You can find your recertifying exam status, along with the years in which you are eligible to take your PANRE on your NCCPA account dashboard.
About the PANRE
The 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 PANRE performance report from 2016 (when I last took my 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 PANRE + an 8 Week PANRE Blueprint Study Schedule and Plan
When to take your 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 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 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 exam is based upon an NCCPA generated exam content blueprint. This NCCPA PANRE content blueprint provides information on how exam questions are allocated to the 14 different content categories on the PANRE.
Updated in 2019, the NCCPA revised the PANRE blueprint by surveying certified PAs to identify specific diseases and disorders considered part of core medical knowledge across all disciplines. Based on this survey, they assigned each disorder to one of three levels determining to what extent each disease and disorder should be assessed.
The levels are defined as follows:
- Level 1: Recognize most likely diagnosis using signs, symptoms, and risks; refer appropriately.
- Level 2: Make appropriate diagnosis by recognizing signs, symptoms, risks, and/or interpreting results of diagnostic studies, and have knowledge of first-line treatment.
- Level 3: Make appropriate diagnosis by recognizing signs, symptoms, risks, and/or interpreting results of diagnostic studies and have knowledge of first-line treatment. In addition, have the knowledge required to manage well-known comorbid conditions, contraindications, and complications.
The PANRE blueprint has 275 diseases/disorders: 31 level-three disorders, 150 level-two disorders, and 94 level-one disorders.
To build an effective study plan, you will need to familiarize yourself with all 275 diseases/disorders. Then pay particular attention to the level 2 and 3 disorders as these will be assessed at the highest level.
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 content blueprint, and you know exactly which topics you are going to study.
The Smarty PANCE 8-Week PANRE 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 10+ 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 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. We have created additional checklists based on assessment level 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
- Post-test (virtual PANRE) and NCCPA PANRE exam
Our Trello Board includes all 275 PANRE blueprint diseases and disorders broken into digestible bite-sized morsels!
You can access this 8-week PANRE Trello study template here. Trello is free to use, and you can create an account and 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.
PANRE Pro Tip: Use our Trello 8-week PANRE study planner to create your study plan, organize, and track your progress through the PANRE blueprint
Final step: Take your PANRE
You have made it! You are now ready to take your 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 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 completed the Virtual PANRE to simulate your test day experience best.
This process will take two to three months to complete at a relaxed and manageable pace from start to finish.
Although you may still resent the recertification process by the end of this, you will certainly have refined your clinical skills, making you a stronger, more confident, and capable clinician. And above all, this will translate into better patient care. Which in the end, is really all that matters!
Stephen Pasquini PA-C
PANCE, PANRE and EOR Study Schedules (Trello)
These eight-week NCCPA PANCE and PANRE Blueprint study schedules have been pre-built using Trello, a FREE project management tool that utilizes an intuitive drag and drop interface with outbound links to Smarty PANCE lessons corresponding to each blueprint topic, completion tracking, calendar power-ups so you can set deadlines, create reminders, and modify the study schedule as you see fit.