PANRE Alternative Pilot Program

The NCCPA will be administering an alternative to the PANRE that will be much more flexible and accommodate to PA’s from all specialties. This announcement can be found on the NCCPA’s website and comes in response to years of backlash from the PA community who have long been complaining of the inherent problems in taking a generic PANRE assessment exam.

This excerpt was taken from a letter written by a member of going by the name “Irish Bulldog” and was written to the NCCPA president in 2015:

December 2015

To the NCCPA President,

I regret to inform you that YOU have failed to achieve a passing score by MY standards.

I have completed and failed my PANRE second attempt. And I have NO intention of spending any more money, time or stress over your continued scam. (Changing the diagnostic symptomatology to “full faced” instead of “moon faced”? That’s just outright trickery.) To this point I have spent $1600 dollars on prep courses. I have multiple books, one of which is titled “Teach to the Test”. Do you think that is ironic?  

I understand a re-certification exam is intended to uphold the standards of good medical care, by weeding out those poor practitioners who don’t keep up and practice good medicine. So here am I, 26 years out and at the peak of my profession, providing stellar care thanks to years of experience and skill in my specialty area (Orthopedic and Spine surgery). Twenty-six years practical experience with no malpractice, no disciplinary actions, maintained all CME requirements, and now in the last cycle of my career, and you would have me lose my job because I missed some one-minute questions while racing to “diagnose”  240 different “patients” in 4 hours in topics such as OB/GYN, Endocrinology, or accurate generic names for new drugs indicated for conditions that have been “discovered” in the 26 years since I graduated in specialty areas that I have not set foot in during that time! This makes sense how?

See the full post here

From member johnN in a post on the Physician Assistant Forum:

Just took the panre yesterday.  It was much harder than I’ve anticipated.  Spend about ~ one month study off and on 1-2 hrs/night for it but vigorously the past  5 days [cram].  I think you need to ‘know the stuff’.  I’ve taken the general adult med exams but I find many questions were on pediatrics, think it was unfair.  Many valvular issues /cardiology [never seen so much valves issues my whole life].  My background is in IM/Urgent care, very little peds but I did suffer a great deal on the exams – the colleagues prior did not recommend to spend time on peds and I did not do this.

From surgblumm in a post on the Physician Assistant Forum:

The PANRE is both unfair, an educational experiment and does not assist a specialty PA to move forward by attending their specialty meeting or that of their discipline. There are far more specialists out in our profession and we are not being heard. 

The examples are never ending. Here at NPAE, we still get weekly calls from frantic PA’s who have failed their first or second attempt at their most recent PANRE and are looking for study advice.

PANRE Alternative Pilot Program Overview

The pilot program is scheduled to begin in January 2019 and is open to any Physician Assistant who is scheduled to take their PANRE in either 2018 or 2019. The NCCPA claims this new program does not require any prior preparation, can be taken from any device at your leisure, and does not require scheduling at a test center. It will consist of a 200 question set taken over the course of 2 years due quarterly at a rate of 25 questions per quarter. You may take all the questions at once or at any rate you want as long as you don’t drop below 25 per quarter and complete the entire set by the end of the second year.

This is different from the Pathway II (previous take home NCCPA exam) because it is designed so that PA’s should know the answers to the questions without needing to research further information. The questions on the alternative PANRE cover core medical information that should be part of the everyday knowledge base of any practicing PA.

Of note, it is mentioned in the program policies attachment that any PA who fails the pilot program will be given 12 months to pass the PANRE in order to maintain certification. If you withdraw from the pilot, you can take the PANRE up to three times during that 12 month period. This essentially gives your four strikes to fail.

Sample Question

(Taken directly from the NCCPA’s example, here)

Question A 22-year-old woman is brought to the emergency department for evaluation three hours after falling backward out of a chair and striking her head on a carpeted floor. She has tenderness over the back of her head but does not report loss of consciousness. Physical examination, including neurologic and musculoskeletal evaluation, shows no abnormalities except a 2-cm area of swelling and minimal abrasion overlying the left occiput. Which of the following is the most appropriate next step?

(A) Anteroposterior and lateral x-ray studies of the skull

(B) CT scan

(C) Discharge and observation by family or friends

(D) Hospital admission for observation


[Option C is correct]


To learn more, visit the NCCPA’s article on this topic.  

2 thoughts on “PANRE Alternative Pilot Program

  1. shaian says:


    I am wondering if there are any recommendations of studying for the pilot. I am in a subspecialty and I think its unrealistic to think we will just know some things or 1st line treatments, etc if we are not practicing in those fields. If you have any recommendations of how I can review material that would help answer questions correctly on the pilot I would appreciate it.

  2. Darlene Nastansky says:

    I also have this same question, as I have been in Ortho for 18+ years.
    Would be nice if we knew the first quarter was cardiac, second quarter was endocrine, at least we could study for something. Any other ideas?

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