As a practicing or aspiring physician assistant, you directly impact patient lives every day. Maintaining your medical expertise over time will ensure your patients' continued well-being. That's why the Physician Assistant National Certifying Examination (PANCE) and Physician Assistant National Recertifying Examination (PANRE) play different but vital roles in your healthcare journey.
This guide highlights the similarities and differences between the exams to help you excel on both and provide the high-quality care your patients deserve.
PANCE vs. PANRE
The PANCE and PANRE are distinct exams with overlapping elements. The key difference is that the PANCE is required for initial licensure, while the PANRE is required for recertification. There are also other significant differences between the two exams.1
| Aspect | PANCE | PANRE |
|---|---|---|
| Purpose | Initial certification for PA graduates | Recertification for practicing PAs |
| Timing | Taken after graduating from an accredited PA program | Required every 10 years to maintain certification |
| Exam Structure | 300 multiple-choice questions over 6 hours (5 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) | 240 multiple-choice questions over 5 hours (4 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) |
| Content Areas | Covers various medical systems with specific weightings | Similar content with slight variations in emphasis |
| Complexity | Focuses on entry-level medical knowledge | May include more complex scenarios to assess ongoing competency |
| Eligibility | Up to 6 attempts within 6 years post-graduation | Can be taken during the ninth or 10th year of the certification cycle |
| Scoring | Scaled score from 200 to 800; passing typically at 350 | Same scoring system as PANCE |
| Certification Validity | Grants initial certification as a PA-C | Ensures continued certification and competency |
When to Take the PANCE vs. PANRE
You will take the PANCE and PANRE at different stages in your career. The PANCE is essential for earning your initial certification and beginning your practice. If you're a recent graduate of an accredited PA program, this exam is your first step toward obtaining the PA-C credential. You have a 6-year window to pass the PANCE after completing your PA program, with up to 6 attempts allowed to earn your certification.1
The PANRE, on the other hand, is an exam required to maintain your certification as a practicing PA. Every 10 years, you'll need to pass this recertification exam to ensure your medical knowledge remains current and your competency is validated. You can take the PANRE any time during the last 2 years of your certification cycle, giving you flexibility in your preparation timeline.2
If you're looking for a more flexible recertification option, the PANRE Longitudinal Assessment® (PANRE-LA®) might be the right choice for you. With this option, you can complete the recertification process over 12 quarters by answering questions online and receiving immediate feedback. The PANRE-LA supports continuous learning and provides the convenience of completing the assessment at a pace that works for your current lifestyle.3
About the PANCE: The Initial Certification Exam
Embarking on a career as a physician assistant starts with a significant milestone: the PANCE. It is a computer-based, multiple-choice exam administered by the National Commission on Certification of Physician Assistants® (NCCPA®). The exam ensures you're prepared for entry-level practice as a physician assistant at any location, whether that be a hospital, clinic, or nursing home. Passing the PANCE is required to earn your PA-C designation, which is necessary to practice in the United States.
To qualify for the exam, you must graduate from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant® (ARC-PA®). After applying and paying the exam fee, you can schedule your test at a Pearson VUE testing center, where the PANCE is offered year-round.
The exam features 300 questions covering various organ systems and medical tasks, divided into 5 timed blocks. Successfully passing the PANCE validates your readiness for clinical practice, secures your place as a certified PA, and opens the door to getting hired in your desired specialty and location.4
About the PANRE: The Recertification Exam
After a decade in your field, you'll need to take the PANRE. It is a critical assessment required to maintain your certification and the PA-C designation. Administered by the NCCPA, the PANRE evaluates your ongoing medical knowledge and skills to ensure you remain competent after years of practice. This recertification exam is a requirement for maintaining licensure in all U.S. states.
The PANRE consists of 240 multiple-choice questions designed to test your knowledge across specialties. It is known for its rigorous format, requiring thorough preparation on topics such as medical knowledge categories, clinical reasoning, patient management, and professional practice.
The PANRE is considered more difficult than the PANCE. This reflects the assumption that you have gained essential knowledge and skills by working in the field for 10 years. Due to this expectation, the exam includes more complex questions and a greater emphasis on clinical reasoning than base medical knowledge.
Conducted in a secure environment at Pearson VUE testing centers, the PANRE demands focus and stamina. Proper preparation ensures you stay certified and ready to continue delivering quality patient care.2
About the PANRE-LA: The Recertification Alternative
If you're looking for a more flexible and manageable recertification option, the PANRE-LA provides an alternative to the traditional PANRE, focusing on continuous learning that fits seamlessly into your busy schedule.
The PANRE-LA is administered for 12 quarters (3 years). Each quarter, you'll complete 25 multiple-choice questions at your own pace using a personal device, with 5 minutes per question and access to references. Immediate feedback and detailed rationales enhance your understanding and retention. Your performance across the best 8 quarters determines your passing score. Completing questions also earns Continuing Medical Education (CME) credits, adding another benefit to choosing this recertification path.
The PANRE-LA is ideal for reducing test-day anxiety and integrating continued learning into your busy schedule. If unsuccessful, you'll still have the option to take the traditional PANRE before your certification expires. This alternative recertification option combines convenience, ongoing education, and flexibility.5
Contrasting the PANRE and PANRE-LA
Both recertification options have pros and cons. The route you choose truly depends on your lifestyle and priorities.3
PANRE vs. PANRE-LA
| Aspect | PANRE | PANRE-LA |
|---|---|---|
| Purpose | A recertification exam for practicing PAs | An alternative recertification option focused on ongoing learning |
| Timing | Taken during the ninth or 10th year of your certification cycle | Begins in the seventh year and can be completed by the eighth or ninth year |
| Exam Structure | 240 multiple-choice questions over 5 hours (4 blocks of 60 questions plus 45 minutes for breaks between blocks and 15 minutes to view the tutorial) | 25 questions per quarter over 8-12 quarters (spanning 2-3 years) |
| Content Areas | Covers multiple medical specialties based on the NCCPA blueprint | Follows the exact NCCPA content blueprint as the traditional PANRE |
| Complexity | Focuses on clinical reasoning and includes more complex scenarios | Adapts question difficulty based on your performance over time |
| Eligibility | Available to certified PAs in their ninth or 10th year | Open to certified PAs starting in the sixth year of their cycle |
| Scoring | Scored on a scale of 200-800, with 379 required to pass | Scored on a scale of 1000-1500, with 1150 required to pass. |
| Certification Validity | Certification is valid for 10 years upon passing | Certification is valid for 10 years upon passing |
| Format | Proctored, closed-book exam at a testing center | Open-book exam that can be completed at home |
| Flexibility | A 1-day, single-attempt exam | Spreads out over multiple quarters |
| CME Credits | No CME credits are allotted for PANRE prep. | Earns 2 Category 1 CME credits for completing each quarter |
| Retake Options | Allows up to 3 attempts in the 10th year if needed | Can continue through all 12 quarters, with the option to switch to the traditional PANRE if necessary |
| Reference Materials | No external materials are allowed during the exam | Permits the use of reference materials during the assessment |
| Question Time Limit | Each question must be answered in 60 seconds | Provides up to 5 minutes per question |
How to Choose Between PANRE and PANRE-LA
Choosing the right recertification exam is a personal decision that depends on your learning style, professional goals, and lifestyle needs.6 When trying to decide between the PANRE and PANRE-LA, ask yourself:
- Can I handle the pressure of high-stakes exams?
- Do I prefer the opportunity to improve my performance over time, or am I confident in my ability to perform well in a single sitting?
- Am I prepared to commit to a long-term assessment process, or would I prefer a 1-time exam experience?
- Do I value getting immediate feedback and learning from my answers?
- Would I benefit from using reference materials during the exam?
- How much time can I dedicate to studying with my current schedule?
- Can I regularly stick to a study schedule over an extended period?
- Is my internet connection stable and reliable enough for the PANRE-LA's online format?
- How important is the option to finish recertification earlier in my cycle?
Preparing for PANCE, PANRE, and PANRE-LA
You can confidently approach your preparation for the PANCE, PANRE, or PANRE-LA with the right study strategies. Here are some tips to help you stay focused and pass your exam.7
PANCE Study Tips:
- Begin studying 2-3 months before the exam.
- Use high-quality resources such as QBanks and visual aids.
- Take practice exams to identify strengths and weaknesses.
- Focus on high-weighted topics and areas you find challenging.
- Practice answering at least 2,000 timed questions.
- Use spaced-repetition flashcards to reinforce retention.
PANRE Study Tips:
- Create a study plan that fits your work schedule.
- Focus on reviewing the test blueprint topics.
- Use current medical guidelines as study material.
- Use PANRE-specific resources.
- Practice full-length, timed exams to simulate test day.
PANRE-LA Study Tips:
- Set a regular schedule to answer questions each quarter.
- Review feedback to strengthen weak areas.
- Avoid overconfidence — the open book format doesn't make this exam easier.
- Answer the first set without prep and use results to establish a study baseline.
- Practice answering questions within the 5-minute time limit.
References
- The PA Life. (n.d.). PANCE/PANRE pilot blueprint breakdown. Retrieved from https://www.thepalife.com/pance-panre-pilot-blueprint-breakdown/
- Physician Assistant Exam Review. (n.d.). Everything you need to know about the PANRE. Retrieved from https://physicianassistantexamreview.com/everything-you-need-to-know-about-the-panre/
- CME4Life. (n.d.). PANRE-LA vs. PANRE. Retrieved from https://cme4life.com/panre-la-vs-panre/
- TrueLearn. (n.d.). What is the PANCE? Everything you need to know about this exam. Retrieved from https://truelearn.com/resource-library/what-is-the-pance-everything-you-need-to-know-about-this-exam/
- Smarty PANCE. (2023). 2023 PANRE and PANRE-LA. Retrieved from https://smartypance.com/2023-panre-and-panre-la/
- Blueprint Prep. (n.d.). PANRE vs. PANRE-LA: Which exam should you take?. Retrieved from https://blog.blueprintprep.com/pa/panre-vs-panre-la-which-exam-should-you-take/
- BoardVitals. (n.d.). Tips for passing PANCE and PANRE exams. Retrieved from https://www.boardvitals.com/blog/tips-passing-pance-panre-exams/
