NCCPA
PANCE
Physician Assistant National Certifying Examination
The national certifying exam every physician assistant must pass to earn the PA-C credential, which all US states require for PA licensure. The single gateway between PA school and clinical practice.
Full program: 15 decks, 1,319 cards.
What's on the exam
PANCE Content Blueprint (effective January 2025)
Cardiovascular System
11%Coronary artery disease · Heart failure · Arrhythmias · Valvular disease · Hypertension · Vascular disease
Dermatologic System
4%Eczematous and papulosquamous disorders · Skin infections and infestations · Skin cancers · Acneiform disorders · Drug eruptions
Endocrine System
6%Diabetes mellitus · Thyroid disorders · Adrenal disorders · Pituitary disorders · Lipid disorders
Eyes, Ears, Nose, and Throat
6%Eye disorders (glaucoma, conjunctivitis, retinal disease) · Otitis and hearing loss · Sinusitis and rhinitis · Pharyngitis · Vertigo
Gastrointestinal System / Nutrition
8%GERD and peptic ulcer disease · Hepatobiliary disease · Inflammatory bowel disease · GI bleeding · Pancreatitis · Nutritional deficiencies
Genitourinary System
4%Urinary tract infections · Nephrolithiasis · Benign prostatic hyperplasia · GU cancers · Erectile dysfunction
Hematologic System
5%Anemias · Coagulation disorders · Leukemias and lymphomas · Thrombocytopenia · Hemoglobinopathies
Infectious Diseases
7%Bacterial infections and sepsis · Viral infections (HIV, hepatitis) · Fungal and parasitic infections · Sexually transmitted infections · Vaccination
Musculoskeletal System
8%Fractures and dislocations · Osteoarthritis and rheumatologic disease · Back and spine disorders · Sprains, strains, and overuse injuries · Compartment syndrome
Neurologic System
7%Stroke and TIA · Seizure disorders · Headache · Movement disorders · Peripheral neuropathies
Psychiatry / Behavioral Science
7%Depressive and bipolar disorders · Anxiety disorders · Psychotic disorders · Substance use disorders · Eating disorders
Pulmonary System
9%Asthma and COPD · Pneumonia · Pulmonary embolism · Lung cancer · Pleural disease · Obstructive sleep apnea
Renal System
5%Acute kidney injury · Chronic kidney disease · Fluid and electrolyte disorders · Acid-base disorders · Glomerular disease
Reproductive System
7%Pregnancy and prenatal care · Complications of pregnancy · Menstrual disorders · Contraception · Breast and gynecologic cancers
Professional Practice
6%Medical ethics · Patient safety and quality improvement · Legal and regulatory issues · Communication and cultural humility · Public health
Frequently asked questions
How much does the PANCE cost?
The PANCE costs $550. Plus state licensure fees.
How long is the PANCE and how many questions does it have?
300 items — 5 hours of testing (plus scheduled break time).
What do you need to pass the PANCE?
Scaled score above the NCCPA passing standard (pass/fail).
Can you retake the PANCE?
After 90 days; limited attempts per year and 6 attempts total within 6 years of graduation.
What is the best way to study for the PANCE?
Start from the official outline and your primary study materials: the exam is weighted by domain (Cardiovascular System 11%, Dermatologic System 4%, Endocrine System 6%, Eyes, Ears, Nose, and Throat 6%, Gastrointestinal System / Nutrition 8%, Genitourinary System 4%, Hematologic System 5%, Infectious Diseases 7%, Musculoskeletal System 8%, Neurologic System 7%, Psychiatry / Behavioral Science 7%, Pulmonary System 9%, Renal System 5%, Reproductive System 7%, Professional Practice 6%). Once you've learned the material, spaced-repetition flashcards organized by those domains are an efficient way to retain it and refresh it before test day.
Ready to prepare?
Our PANCE program is organized by this outline's domains and scheduled by spaced repetition, with a path from first card to test day.
Flashcards are a memory tool. Learn the material first, then use NoReread to retain it and refresh what you already know. It doesn't replace studying the subject.