Updates to PANCE Blueprint in 2025 

NCCPA periodically conducts practice analysis studies to ensure that our examinations include the content most appropriate for the certification of physician assistants. Board Certified PAs are involved in every step of that process: providing input into the development of the survey instrument, completing the survey that is disseminated to the entire profession, and reviewing the response data to help develop recommendations for the exam blueprint. 

Based on the information gleaned from our most recent practice analysis, minor revisions have been made to the PANCE blueprint that will become effective in 2025.  

See our Exam Development & Scoring webpage for more information. 

PANCE Content Blueprint

(effective January 2019 - 2024)

The content blueprint released in 2019 for the Physician Assistant National Certifying Examination (PANCE) provides guidance on the information assessed on the Physician Assistant National Certifying Examination (PANCE). The examination is categorized in two dimensions:

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

The detailed listings provided under each of these two categories represent examples of the material that may be covered on PANCE. It is not possible to include all topics on a single exam, and it may be possible that some questions on the exam cover content that is not listed in the examples.

The content blueprint for PANCE is based on information provided from certified physician assistants who participate in profession-wide practice analysis studies.  Certified PAs are involved throughout the exam development process, including:  reviewing results of the practice analysis, writing questions that appear on PANCE, reviewing exams before they are administered, reviewing performance data for exam questions, and developing recommendations for the passing standard.  Certified PAs work with NCCPA to continuously review the content included on PANCE to ensure it is relevant and current, as the practice of medicine changes and treatment guidelines are revised or new ones introduced.
Medical Content Categories Percent Allocation*
Cardiovascular System 13%
Dermatologic System 5%
Endocrine System 7%
Eyes, Ears, Nose, and Throat 7%
Gastrointestinal System/Nutrition 9%
Genitourinary System (Male and Female) 5%
Hematologic System 5%
Infectious Diseases 6%
Musculoskeletal System 8%
Neurologic System 7%
Psychiatry/Behavioral Science 6%
Pulmonary System 10%
Renal System 5%
Reproductive System (Male and Female) 7%
Task Categories Percent Allocation*
History Taking and Performing Physical Examination 17%
Using Diagnostic and Laboratory Studies 12%
Formulating Most Likely Diagnosis 18%
Managing Patients
Health Maintenance, Patient Education,
and Preventive Measures
Clinical Intervention 14%
Pharmaceutical Therapeutics 14%
Applying Basic Scientific Concepts 10%
Professional Practice 5%

*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.

PANCE Content Blueprint (effective for all PANCE administrations between January 2019 and December 2024)

Sample NCCPA Questions

PAs preparing for PANCE have often asked the NCCPA about how the exam items are developed and should be answered. To help address that request, NCCPA has taken items removed from the item pool and created a tool for PAs. In the PDF document below, PAs can review sample NCCPA items and critiques written by NCCPA test committee members.

To review sample NCCPA questions and explanations regarding why the correct answer is correct and why the other answer choices are incorrect, please click here.