NCCPA’s PANRE Proposal

For a PA to maintain their national certification, they are required:
  • To earn at least 100 hours of CME every two years
  • Pay a certification maintenance fee every two years
  • Take and pass a recertification assessment exam (PANRE) by the end of their maintenance cycle*

*In 2014, the maintenance cycle was lengthened, from every 6 years to every 10 years.



The Physician Assistant National Recertifying Exam (PANRE) is a 4 hour long exam designed to assess general medical and surgical knowledge. This test is available for PA-C’s to take during the last two years of their maintenance cycle, and must be taken at an accredited testing center.  

The PANRE is different than the PANCE in that it is shorter and has a varied structure. PAs have the option of choosing from one of three focus areas when applying for the exam: adult medicine, surgery and primary care. 60% of the exam will cover general primary care, while the remaining 40% will cover the elected focus area. This allows for the content blueprint to be universal for all recertifying PAs while still giving the opportunity for some to focus more on their practice area. The election of a focus area is not equitable to earning a specialty certificate.


Changes to the PANRE

Over the past several years there has been much debate regarding PA recertification. Arguments have been made that the recertification process is outdated,  “too general” for the majority of PAs who practice outside of primary care, and that the content tested on has an insignificant relationship to the “walking knowledge” of people’s day-to-day practice.

In late 2015, the National Commission on Certification of Physician Assistants (NCCPA) proposed a new model for recertification with the publication of the white paper “Re-examining Recertification for the PA Profession”.  The paper noted the organizations principles of serving the public’s best interest and in maintaining the generalist nature of PA-Cs.

Data collected by the NCCPA during the process of formulating their new model proposition consisted of a 2015 PA practice analysis study, a multi-day PA focus group with 2 subsequent surveys sent out to PAs and state medical boards, and an analysis of performance data from previous recertification examinations. The data uniformly pointed towards the need for a new recertification structure.

The proposed new model entails testing core medical knowledge with un-timed, non-proctored exams, with opportunities for remediation with CME instead of retest. Specialty-related knowledge would then be accessed via timed, proctored exams during the final year of the certification cycle. There would be 10-12 specialty exam options, including primary care options.

In July 2017, the American Academy of Physician Assistants (AAPA) responded to this by commencing a research project in conjunction with the RAND Corporation, to investigate the recertification process for health professionals in the US and abroad. The goal of this research is that it will provide valuable insight into how the PA profession should approach their recertification process, and if alternative methods of recertification should be enacted. Key project findings are expected to be published in September 2018.

In the meantime, the NCCPA has set to launch a pilot program for an alternative PANRE. Details of the pilot program:

  • Is set to launch January 2019
  • Is available only to PA-Cs who are due to take the PANRE in 2018 or 2019
    • Is not available for PA’s wishing to regain certification after a lapse
    • If you are a PA-C that must pass the PANRE in 2018 and are registered for the pilot program, your certification is automatically renewed at the end of 2018 given that you have completed the necessary CME and have paid the certification maintenance fee. If you fail to successfully complete the pilot program, your certification will be extended one additional year for you to have the chance to take and pass the PANRE.
  • Requires no advance preparation- it is meant to test your working knowledge
  • Requires no scheduling, as it is not taken at a testing center
  • Involves answering only 25 questions, every 3 months, for two years.
    • Immediate feedback provided on answers, with information on what the correct answer is and why it is the best answer.
    • 2 years, 200 questions
  • The registration period is from January 2, 2018- June 30, 2018