To meet the PANCE exam requirements, you need to graduate from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), apply through the NCCPA, pay the $550 fee, and score at least 350 out of 800 on a 300-question multiple-choice exam. First-time pass rates sit between 91 and 93 percent, but the logistics around eligibility, scheduling windows, and attempt limits catch people off guard more often than the content does.
Who Can Sit for the Exam
Graduation from an ARC-PA-accredited PA program is the only pathway. The program must hold its accreditation at the time you matriculate, not just when you graduate. A program placed on accreditation-probation while you’re enrolled still counts as actively accredited, so your eligibility stays intact unless the program loses accreditation entirely.1ARC-PA. Student Questions If a program does lose accreditation, students generally lose their path to certification unless a formal teach-out arrangement is in place.
The NCCPA does not accept graduates of non-U.S. medical schools, foreign PA programs, or any program that lacks ARC-PA accreditation. There is no alternative route and no equivalency path.2National Commission on Certification of Physician Assistants. Become Certified
Applying and Scheduling
Applications open through the NCCPA’s online portal up to 180 days before your expected program completion date. The application fee is $550. You’ll submit your legal name (which must match your government-issued ID exactly), your Social Security number, your graduation date, and the name of your ARC-PA-accredited program.2National Commission on Certification of Physician Assistants. Become Certified
Once the NCCPA confirms your eligibility, you receive an acknowledgement email with your testing window. The earliest you can test is seven days after your program completion date, and you then have 180 days from your graduation date to actually take the exam.2National Commission on Certification of Physician Assistants. Become Certified Scheduling the appointment happens through Pearson VUE: create an account using the NCCPA ID from your acknowledgement email, then pick a date and testing center.3Pearson VUE. National Commission on Certification of Physician Assistants Certification Exams
Let the 180-day window expire without testing and you forfeit the $550 fee and have to reapply.
Exam Structure and Scoring
The PANCE is 300 multiple-choice questions split into five blocks of 60. You get 60 minutes per block, five hours of total testing time, and a 15-minute tutorial at the start. Between blocks you have 45 combined minutes of break time to use however you want; go over, and the overage comes out of your remaining exam time.4National Commission on Certification of Physician Assistants. What to Expect on Test Day
Scores are scaled from 200 to 800. You need a 350 to pass. Results arrive by email about two weeks after your test date and also appear in your NCCPA portal, along with a performance profile showing how you did across each content category.5National Commission on Certification of Physician Assistants. PANCE Policies, Procedures and Authorization
Medical content accounts for 94 percent of the exam, with professional practice issues making up the remaining 6 percent. Under the blueprint effective January 2025, the organ-system and content-area weights are:6National Commission on Certification of Physician Assistants. PANCE Content Blueprint
- Cardiovascular system: 11%
- Pulmonary system: 9%
- Gastrointestinal system/nutrition: 8%
- Musculoskeletal system: 8%
- Infectious diseases: 7%
- Neurologic system: 7%
- Psychiatry/behavioral science: 7%
- Reproductive system: 7%
- Endocrine system: 6%
- Eyes, ears, nose, and throat: 6%
- Professional practice: 6%
- Hematologic system: 5%
- Renal system: 5%
- Dermatologic system: 4%
- Genitourinary system: 4%
Surgical topics make up roughly 8 to 10 percent of the exam and pediatric conditions 12 to 15 percent, but they appear inside the organ-system categories rather than as separate sections.6National Commission on Certification of Physician Assistants. PANCE Content Blueprint
What to Bring on Test Day
Pearson VUE requires two forms of valid, unexpired ID. Your primary ID has to be government-issued with both a photo and a signature; a driver’s license, passport, or military ID all qualify. Your secondary ID needs your name plus either a signature or a photo and doesn’t have to be government-issued.7Pearson VUE. Global ID Policy 1S
The first and last name on both IDs must match your NCCPA registration exactly. If they don’t match, you won’t be admitted, and you forfeit the fee. Recently changed your name through marriage, divorce, or a court order? Update your NCCPA record before test day by sending a copy of your current government-issued ID and the supporting court document to the NCCPA. Updates typically process within two to three business days.8NCCPA. Name Changes
Rescheduling, Canceling, and Withdrawing
To reschedule or cancel an appointment, contact Pearson VUE at least one business day before your exam date. Miss that deadline and the full $550 is gone.5National Commission on Certification of Physician Assistants. PANCE Policies, Procedures and Authorization
Here’s where people slip up: canceling a Pearson VUE appointment is not the same as withdrawing from your NCCPA testing window. If you decide not to take the PANCE during your window at all, you need to submit a separate written withdrawal request directly to the NCCPA by mail, email, or fax. If you’ve already scheduled, that written request must reach the NCCPA at least one business day before the appointment. If you haven’t scheduled, it must arrive before the last day of your testing window. Skip either step and you forfeit the fee. Once the exam has started, no cancellation or refund is possible.5National Commission on Certification of Physician Assistants. PANCE Policies, Procedures and Authorization
How Many Times You Can Take the PANCE
The NCCPA enforces a six-year, six-attempt rule. Starting from your graduation date, you have six years to pass the PANCE and a maximum of six attempts within that period. Whichever limit you hit first ends your eligibility.2National Commission on Certification of Physician Assistants. Become Certified
Inside that window, you can take the exam only once in any 90-day period and no more than three times in a single calendar year. If you burn through all six attempts or let six years elapse without passing, the only way back to eligibility is to complete another unabridged ARC-PA-accredited PA program from scratch. That means two-plus years of school and tuition over again, so a realistic study and retake schedule matters more than racing to retest.5National Commission on Certification of Physician Assistants. PANCE Policies, Procedures and Authorization
Testing Accommodations
If a disability or medical condition affects how you can take the exam under standard conditions, request accommodations through the NCCPA as part of the application process. You submit an online request form plus supporting documentation from a qualified medical professional who has diagnosed or treated you. The documentation must be on the provider’s letterhead, describe the disability and its functional impact, identify the specific accommodations requested, and explain how those accommodations address the limitations.9National Commission on Certification of Physician Assistants. Policies and Procedures for Examination Accommodations
Assessments older than 12 months generally need an updated statement confirming your condition and limitations haven’t materially changed. Approved accommodations apply only to the specific exam administration you applied for, so each new attempt requires a new request.9National Commission on Certification of Physician Assistants. Policies and Procedures for Examination Accommodations
Conduct Issues That Can Block Eligibility
The application includes background questions, and the NCCPA can deny or revoke eligibility based on your answers. Certain conduct triggers automatic denial, including a felony conviction related to PA practice, loss of a license to practice for six months or more, and adjudication of mental incompetence.10National Commission on Certification of Physician Assistants. Policies and Procedures for PA Disciplinary Matters
The NCCPA also has discretion to deny eligibility for other criminal history, including any felony conviction, misdemeanors related to health care or violence, and documented gross incompetence or unethical conduct. Failing to disclose relevant issues honestly on the application can itself be grounds for denial. On test day, anything that compromises exam integrity, such as bringing unauthorized materials, attempting to record questions, or having someone else take the exam for you, results in automatic disqualification and potential permanent loss of eligibility.10National Commission on Certification of Physician Assistants. Policies and Procedures for PA Disciplinary Matters
What Passing the PANCE Gets You
Passing earns you NCCPA board certification and the right to use the PA-C credential. It does not, on its own, let you treat patients. Every U.S. state, the District of Columbia, and U.S. territories require a separate state license, and NCCPA certification is one of the criteria for that license.2National Commission on Certification of Physician Assistants. Become Certified Fees and requirements vary by state, so check with your state medical board once your result is in.
Once certified, you’ll move into a 10-year maintenance cycle built around continuing medical education and a recertification exam. You’ll earn at least 100 CME credits every two years (with 50 of those as Category 1), pay a $180 certification maintenance fee by December 31 of your certification expiration year, and pass either the PANRE or the PANRE-LA before year 10.11National Commission on Certification of Physician Assistants. Continuing Medical Education (CME)12National Commission on Certification of Physician Assistants. Maintain Certification That’s the next chapter; the PANCE is the entry point.