Licensing and Certification Tests for the Physician Assistant

Professional licensing and certification are important because they ensure public health safety. When a physician assistant adds the “C” after the PA credential (PA-C), it lets patients know that not only has the PA graduated from a physician assistant program, but he or she has also passed a national board exam that tested the knowledge the PA acquired in school. This extra “C” stands for “certified” and indicates the PA has passed the physician assistant national certification exam, or PANCE. This is “a computer based, multiple choice test comprising questions that assess basic medical and surgical knowledge” (, n.d.). In essence it means the PA has proven him or herself competent and trustworthy to provide high quality health care to the public. PAs have to pass this initial certification exam, but they’re also required to take continuing education courses to help keep them up-to-date on current events in medicine and the latest technological advancements and treatments.

PAs have to re-certify every six years to prove they’re still competent and capable of providing the highest quality health care to their patients. Continuing education and recertification are important because they force physician assistants to remain committed to providing the best health care to the public.

Preparing for the Tests

Solid preparation for the PANCE is a must. You will spend an extraordinary amount of time and exert an extraordinary amount of effort in a PA program; it would be disheartening to fail the national certification exam and thus, be unable to practice as a PA. There are several approaches one can take when preparing for this test.

First, PANCE preparation courses are available either in the classroom setting or online. Study guides are available from several different test prep companies. These test prep kits offer sample questions from the PANCE exam, which will help you become comfortable with the format of the test and the subject matter covered. Finding or starting a study group with fellow students is a great way to prepare for national boards. Different people bring different study and test-taking strategies to the table. Conferring with other candidates helps you think differently and see things from a fresh perspective—both effective means of addressing test questions in a stressful environment.

Taking one section at a time and reviewing is a good way to prepare for the PANCE. Begin with one body system (the endocrine system for example) and move through each system reviewing the normal states of that system, the disease states, assessment, tests, diagnoses, and treatments. Visit with your professors and advisors and talk with other PAs who have already passed the PANCE and see what advice they have to offer. The most invaluable resource appears to be the website. Here they offer content blueprints of PANCE exams and practice exams that utilize retired test questions. You can purchase a test prep kit from NCCPA for $35. The NCCPA also offers a video of what you can expect on test day to help alleviate any fears or test anxiety you might experience.

Licensing and Certification Tests for the Physician Assistant

State and National Boards

The PANCE is the national certification test for all physician assistants. PAs must pass this exam in all 50 states in order to be licensed to practice. There are no individual state exams for PAs to pass. The PANCE is accepted everywhere, but it’s best to research your state of residency to see if any special requirements need to be met before you can practice as a PA. The place to find this information is your state board of consumer affairs and/or public health and/or medical examiners’ websites. The administrative staff of your PA program should set you on the right path regarding these issues prior to graduation. The test is administered at Pearson VUE testing centers and costs $475.

The best resource for information regarding the PANCE test is the National Commission on Certification of Physician Assistants ( The following information and suggestions are taken from an informative video offered on the NCCPA website.

  • Before taking the PANCE you must graduate from an accredited PA program.
  • Register for the exam shortly before you graduate.
  • After you register, you will receive an email with scheduling instructions at a test center of your choice (there are 200 test sites nationwide).
  • Review exam policies.
  • Tests are scored using the Rasch model, which looks at the number of questions you get correct as opposed to the number you get wrong. Thus, it is important you answer every question on the test!
  • Tests are scored using two independent computer systems to ensure accuracy.
  • Scores are given online through a secure personal record and are submitted within two weeks of your test date.

The website encourages those who fail the exam on their first attempt to keep trying. There is a “six attempts/six year rule” that states you must pass the PANCE in six attempts or within six years of graduation, whichever comes first. There is a 90-day waiting period between tests in order to give you time to study and prepare again. The website suggests using your test score report, which details how you performed on each section of the test. This way, you can see where your strengths and weaknesses lie and what material you need to review most before attempting the test again. The website comforts those worried about failing on the first try by saying the majority of candidates pass the PANCE on their first attempt (, 2009).

The best advice regarding taking these exams is to be prepared. This requires intensive studying. Take advantage of the old test questions so that you are accustomed to the question and test format. Know the directions to the testing site; take a “test drive” before the test date so that you don’t get lost on the way to the center. Knowing exactly what lies ahead helps alleviate any test anxiety.


PAs must take and pass the Physician Assistant National Recertification Exam (PANRE) every five to six years. This is to ensure continuing competency in medical practice and helps guarantee public safety. Again, the best resource for information regarding the PANRE is the National Commission on Certification of Physician Assistants ( This website says PAs can take the PANRE anytime between their fifth and sixth year of practice. PAs are allowed four attempts to pass the PANRE—two in their fifth year and two in the sixth (, 2009). The PANRE is a generalist exam made up of 300 multiple choice questions. This test is special, however, in that the PA can direct 40% of the questions to be concentrated in one of three areas: adult medicine, surgery, or primary care. The PA can choose his or her strongest area or specialty in practice. To take the PANRE, the PA must register online through the website and pay a fee of $350. As with the PANCE exam, the NCCPA offers practice exams and questions for a fee of $35. Applicants must take the exam within 180 days of the time frame established for them when they submitted their test application. The PANRE is scored by the same method as the PANCE, and test scores are made available to the PA in the same manner—via email and through a secure, personal record established by the PAs themselves. If the PA fails the PANRE, there is another 90-day waiting period before he or she is allowed to retake the exam.

Last Updated: 05/12/2014


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