Failed PANCE (Physician Assistant National Certifying Exam)? Here's Your Recovery Plan

Pro tip: Contact the exam provider directly for their specific retake policy.

• Studying organ systems in the order a textbook presents them rather than in the order the blueprint weights them.
  Cardiovascular is 11 percent and Pulmonary is 9 percent, while Dermatologic and Genitourinary are 4 percent each. Multiply your practice subscore gap in each system by that system's weight and spend hours in that order. A perfect dermatology score buys you at most 12 questions out of 300.
• Answering with the most definitive test rather than the most appropriate initial test.
  NCCPA's own sample critique makes this explicit: coronary arteriography is the most definitive test for coronary artery disease but is wrong as an initial step in an asymptomatic patient with a normal electrocardiogram, where the exercise stress test wins on being noninvasive, inexpensive and sensitive. Read whether the stem asks for initial, most appropriate, or most definitive.
• Ignoring the task dimension of the blueprint entirely and preparing only by organ system.
  Formulating Most Likely Diagnosis is 18 percent, History Taking and Physical Examination is 16 percent, and Clinical Intervention is another 16 percent. Filter your question bank by task category and find out whether you are losing points on diagnosis, on management, or on test selection, because the remedy differs for each.
• Treating Professional Practice as unstudiable common sense and skipping it.
  It is 6 percent, roughly 18 questions, and it is the only category coded outside the task dimension. NCCPA's released items cover disclosing an embryo implantation error immediately, refusing to chart a McMurray test that was not performed, and identifying the p value as the marker of statistical significance. All three are learnable rules, not intuitions.
• Mismanaging the 45 minutes of break time, either burning it early or never using it.
  NCCPA states candidates are responsible for managing their own break time, and that any scheduled break time used beyond the 45 minutes is deducted from exam time and may close the exam earlier than expected. Decide in advance how to split 45 minutes across four inter-block gaps, and rehearse that split during your full-length simulations rather than improvising on the day.
• Assuming a raw percentage correct translates into a scaled score, and chasing a target like 70 percent.
  NCCPA states that because forms are equated for difficulty, the number of correct answers required to meet the passing standard varies from one examinee to another. Track your scaled or predicted score from practice exams instead, and read the 350 cut against the 200 to 800 range rather than against a percentage.
• Overreading a weak subscore on a small content area after a practice exam or a real score report.
  NCCPA warns that subscores should be interpreted with caution because smaller content areas such as Hematology carry fewer questions and therefore wider standard error bars. A poor hematology subscore may reflect five unlucky items. Look at the width of the error bar before rebuilding a study plan around one number.
• Scheduling the exam without accounting for the 180-day window or the 90-day retake interval.
  Your acknowledgement email defines a 180-day testing window based on your graduation date and your application. You may take PANCE only once in any 90-day period and no more than three times in a calendar year. Booking too late in the window leaves no room to retake within the same calendar year if the first attempt fails.
• Neglecting paediatric and surgical content because neither is a named organ system on the blueprint.
  NCCPA states that 12 to 15 percent of questions focus on conditions in paediatric patients and up to 8 to 10 percent cover general surgical topics, spread across the organ systems rather than gathered in one place. Deliberately filter your question bank for paediatric and surgical presentations within each system block.

• 300 questions in 5 hours
• Rosh Review highly recommended
• Study organ systems approach
• Focus on primary care scenarios
• PANCE Prep Pearls is popular
• Must complete PA program first