National EOR Exam Scores Reveal the Toughest and Most Useless Rotations

The Study

The End-of-Rotation (EOR) exams were launched by PAEA in 2013 and cover the core clinical rotation content. These exams are similar in many ways to the National Board of Medical Examiner’s subject exam. A recent study by Theresa Hegmann, Michel Statler, and Mike Roscoe evaluated the reliability and validity of the EOR exams against the Physician Assistant National Certification Exam (PANCE). Thus, the study aimed to discover if there was a correlation between a scores on the EOR exams and scores on the PANCE.

The Results

The study was conducted retrospectively using re-existing data from three PA programs. Here are the results:

In the above chart, red dots represent PANCE failures (note that there are very, very few failures… you don’t want to fail your PANCE exam…). We can see that the resulting R-squared = 0.65 in the above regression. This means that the 7-item EOR exam average explains ~65% of PANCE score variance. If you are averaging a score of 70 on each of your EOR exams, you are very unlikely to fail your comprehensive certification exam; none of the students in the study who averaged 70 or above on their EOR exams failed the PANCE!

Which EOR exam is the hardest? Which is the best predictor of PANCE scores?

Data first, interpretation later:


EOR Exam

N Mean Std. Dev Correlation with PANCE scores
Internal Medicine 134 76.1 8.45 0.68
Surgery 134 75.64 6 0.66
Family Medicine 134 77.64 6.75 0.64
Pediatrics 134 76.46 6.22 0.61
Psychiatry 134 75.63 5.59 0.47
Emergency Medicine 134 72.6 7.24 0.66
Women’s Health 134 74.28 5.67 0.57


Which EOR is the hardest?

Drumroll please… The hardest EOR exam according to our data is Emergency Medicine. The average score on this exam is 72.6. The scores on the EM EOR, however, are pretty much all over the board as noted by the high standard deviation of 7.24. This likely means that this rotation is the hardest to grasp but the easiest to remember. Kind of like riding a really complicated bicycle, maybe.

Which EOR is the best predictor of PANCE scores?

Internal Medicine. Your score on the Internal Medicine EOR accounts for 68% of the score you will achieve on the PANCE.

Which EOR is the worst predictor of PANCE Scores?

Psychiatry. If you failed your Psychiatry EOR exam, don’t worry. It doesn’t mean much and we already knew that. The Psychiatry/Behavioral section of the PANCE only accounts for 6% of the exam content.

Hegmann, Theresa, Mike Roscoe, and Michel Statler. “Reliability and Validity of PAEA End of Rotation™ Examination Scores for Predicting Performance on the Physician Assistant National Certification Examination.”The Journal of Physician Assistant Education 26.4 (2015): 187-192.

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