PANCE

Thephysicianassistantnationalcertifyingexam(Pance)

The PANCE is a computer-based, multiple-choice exam that assesses the basic medical and surgical knowledge a physician assistant needs to enter practice. It is developed by the National Commission on Certification of Physician Assistants (NCCPA) and delivered year-round at Pearson VUE testing centers. Questions are written and reviewed by practicing PAs and physicians and are organized by a published content blueprint.

Exam Pattern

The exam has 300 questions in five blocks of 60, with 60 minutes for each block. A total of 45 minutes of break time can be taken between blocks, and a 15-minute tutorial precedes the exam, so the full appointment lasts about 6 hours. Most questions are single-best-answer items with five options; many present a patient scenario and ask for the most likely diagnosis, the next step in management, or the best therapy. Some questions include images such as ECGs, radiographs, or skin findings. Each block mixes content from all organ systems and task areas.

Component	Details
Questions	300 multiple-choice questions most with five options (A–E) ,
Blocks	5blocksof60questions;60minutesperblock(1minuteperquestion)
Breaks	45minutestotal takenbetweenblocks;timeinablockcannotbecarriedover ,
Tutorial	15minutesbeforethefirstblock
Questionstyle	Clinicalvignettesanddirectknowledgequestions;someincludeclinicalimages
Specialemphases	About8–10%ofquestionsaddresssurgicaltopicsand12–15%addresspediatricpatients

The Content Blueprint

Every question carries one medical content category and one task category. The medical content categories are the 14 organ systems (94% combined) plus Professional Practice (6%). The weights below show where the 300 questions fall; Cardiovascular alone accounts for about 33 questions, while Dermatologic and Genitourinary each account for about 12.

Medicalcontentcategories(Percentofexam)

TaskCategory	Weight	Approx. Questions
FormulatingMostLikelyDiagnosis	18%	about54
HistoryTakingandPerformingPhysicalExamination	16%	about48
ClinicalIntervention	16%	about48
PharmaceuticalTherapeutics	15%	about45
HealthMaintenance PatientEducation andPreventiveMeasures , ,	11%	about33
UsingDiagnosticandLaboratoryStudies	10%	about30
ApplyingFoundationalScientificConcepts	8%	about24
ProfessionalPractice	6%	about18

Formulating the most likely diagnosis is the single largest task category, and the history, physical examination, intervention, and pharmacology tasks together make up almost half of the exam. Study each disease as a decision sequence: recognize it, confirm it, treat it, and prevent its complications.

Scoring

PANCE performance is reported as a scaled score from 200 to 800, and the passing score is 350. Scaling adjusts for small differences in difficulty between exam forms, so the same level of knowledge earns the same score on any form. Candidates also receive performance feedback by content area, which shows relative strengths and weaknesses. There is no penalty for incorrect answers, so every question should be answered.

Exam at a Glance

ExamAspect	Details
Developerandadministrator	NationalCommissiononCertificationofPhysicianAssistants(NCCPA)
Eligibility	Graduation from or completion of an entry-level PA program accredited by ARC-PA , ,
Registrationfee	$550 paidwhenapplying ,
Delivery	Computer-based at Pearson VUE testing centers offered year-round ,
Examwindow	180daysaftertheapplicationisapproved;theearliesttestdateis7daysafterprogramcompletion
Format	300questions;5blocksof60questions;60minutesperblock;45minutesofbreaktime
Scoring	Scaled score 200–800; passing score 350; content-area performance feedback
Retakes	Once in any 90 -day period and no more than 3 times in a calendar year
Attemptlimit	6attemptswithin6yearsaftercompletingthePAprogram
Credential	PA-C maintained through continuing medical education and periodic recertification ,