The New PANCE Content Blueprint

pa checking girl patient

The Physician Assistant National Certifying Exam, known simply as the PANCE, is an exam PA students must pass to become certified clinicians. As thousands of PA students will be preparing for this exam in 2020, let’s review how the PANCE changed in 2019 and what this means for the foreseeable future of PA certification. So, what’s new about the exam? Well, let’s examine the latest PANCE content blueprint to find out.

The Content Blueprint

According to the National Commission on Certification of Physician Assistants (NCCPA), effective January 2019, there is a new content blueprint for the PANCE. This content blueprint serves as the official guide for topics and concepts tested in the PANCE and is organized into two categories:

  1. Knowledge of the diseases and disorders PAs encounter; and
  2. Knowledge and skills related to tasks PAs perform when treating patients.

Per the NCCPA, the list of topics under these categories (see the table from the content blueprint below) is only meant to give examples of the content that students may see on the PANCE as not all topics can be covered in a single exam. Likewise, students may encounter questions on the PANCE that are not on the content blueprint.

The PANCE content blueprint is influenced by studies and analyses conducted by certified PAs who remain involved throughout the exam development process. Since the practice of medicine is ever-evolving, with treatment guidelines revised or new ones introduced, certified PAs continue to work closely with the NCCPA to review and update the content included on the PANCE.

2019 NCCPA PANCE Content Blueprint

Medical Content CategoriesPercent Allocation*
Cardiovascular System13%
Dermatologic System5%
Endocrine System7%
Eyes, Ears, Nose, and Throat7%
Gastrointestinal System/Nutrition9%
Genitourinary System (Male and Female)5%
Hematologic System5%
Infectious Diseases6%
Musculoskeletal System8%
Neurologic System7%
Psychiatry/Behavioral Science6%
Pulmonary System10%
Renal System5%
Reproductive System (Male and Female)7%
Task CategoriesPercent Allocation*
History Taking and Performing Physical Examination17%
Using Diagnostic and Laboratory Studies12%
Formulating Most Likely Diagnosis18%
Managing Patients 
Health Maintenance, Patient Education, and Preventive Measures10%
Clinical Intervention14%
Pharmaceutical Therapeutics14%
Applying Basic Scientific Concepts10%
Professional Practice5%

*Medical content comprises 95%+ of the exam. All medical content questions are also coded to one of the task areas, with the exception of the professional practice task category. Questions related to professional practice issues comprise 5% of the exam. In addition, up to 20% of the exam may be related to general surgical topics. The specific percentage allocations may vary slightly on exams.

Decreased PANCE Pass Rates

While it remains uncertain whether the PANCE got “harder” with the 2019 content blueprint update, what we do know is that the passing standard changed. Specifically, it increased, meaning that we can expect a slightly lower passing rate as compared to the past few years since passing the exam has become more challenging. This trend is typical since, throughout the NCCPA’s history, an increased passing standard typically results in a slightly reduced passing rate. However, over time, scores tend to gradually increase once test-takers become more acclimated with the new PANCE content blueprint and adjust their preparation accordingly.

Degree of Difficulty

After examining the NCCPA’s announcements about the changes to the content blueprint, there is no evidence to suggest that the questions themselves got more difficult. Nonetheless, with an increased passing standard, it is fair to say that passing the PANCE has indeed become more difficult. For example, if you managed to pass the PANCE under the old content blueprint with a score of 350, you would fail the PANCE under the new content blueprint with that same score. With an increase in the passing score corresponding to a decrease in the passing rate, we can expect that a slightly greater percentage of PA students are likely to fail the PANCE at first try under the new standard.

What It Means for You

The silver lining is that, in spite of a slight decrease in the passing rate, the vast majority of students who prepare for the PANCE will pass. However, it may be more important than ever for entry-level PAs pursuing initial certification to prepare not just to barely pass the PANCE. It will be equally important to demonstrate a slightly increased level of content knowledge, which was precisely the NCCPA’s goal in making this latest PANCE content blueprint update.

Ultimately, by adjusting your preparation from a pass/fail mindset to an active learning approach where you focus on understanding the concepts more than you would have otherwise under the old content blueprint, you should have no problem passing the PANCE. And with UWorld now preparing PA students to not only pass the PANCE but to become better clinicians with our brand new PANCE | PANRE Exam Prep, PA students have more reason to remain confident in their ability to succeed on the exam.

If you are a PA student prepping for an upcoming PANCE exam and want to optimize your chances of success, click here for your FREE trial of our PANCE QBank. We’ll have you ready to ace the PANCE on exam day.