PANCE Performance Guide

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PANCE Passing Score

To pass the Physician Assistant National Certifying Examination (PANCE), an examinee must reach or exceed the passing score of 350, which is determined via a process called standard setting. Standard setting requires a panel of Physician Assistant content experts with experience about the knowledge, skills, and abilities an entry-level PA should possess for safe and effective practice. The panelists are chosen to be representative of the entire PA profession on a set of criteria including practice setting, practice focus, experience in the field, and other demographic variables.

These content experts engage in a standard setting process known as the Angoff method, which requires panelists to review individual test questions and decide whether someone who is “just qualified” would be able to answer the question correctly. The question-level ratings provided by the content experts are aggregated to define a recommended cut score. The final recommendation is taken from the decisions by the panelists. This final recommendation goes to the NCCPA Board of Directors for consideration and approval.

PANCE Reference Group

Reference groups are provided to give examinees a sense of how they compare to their peers. The reference group for PANCE comprises first-time takers: all examinees over the past two years who have taken PANCE for the first time ever. Using the past two years ensures that sample sizes will be large enough to provide a wide breadth of test takers at all ability levels.

PANCE Score Scale

Performance on PANCE is reported on a scale-score metric. Scale scores are used to place all scores on a unified scale regardless of the difficulty of any specific test form, so examinees with the same level of ability will achieve the exact same score on PANCE regardless of the test form taken. The PANCE scale has a minimum score of 200, a maximum score of 800, and the passing score is 350.


The standard error of measurement (SEM) is used to create a range in which an examinee would score if that examinee took the test repeatedly with no additional preparation/remediation The SEM does not affect pass/fail decisions.

PANCE Test Standardization

NCCPA builds every PANCE test form to be equivalent in terms of the content blueprint, tasks, response time, and difficulty. The testing experience should be the same for all examinee, regardless of the test forms that they take. Test standardization is achieved through a process called Automated Test Assembly (ATA).  During the ATA process, test forms are built to match the content specifications in the content blueprint. In addition, the test questions are selected to ensure that all test forms are approximately equal in terms of difficulty and that each form will take approximately the same amount of time to complete. Prior to the finalization of the test forms, two independent committees of PAs review each test form to make sure the content covered by the questions is relevant and reflects current standards of care.  Questions that are out-of-date are removed and replaced with questions that cover similar content and are of similar difficulty. The test forms are checked one last time to ensure that statistical features have not drifted before the forms are approved for use.

PANCE Blueprint

The content blueprint is a set of specifications that describes the relative proportion of questions from each content category and task area that should be included on a test form. This blueprint is the output of a practice analysis, which is an analysis of the various diseases and disorders PAs encounter and the skills they use in practice. The last practice analysis was conducted in 2015. A committee of PAs used survey data gathered as part of the 2015 practice analysis as well as their own personal experience set the blueprint that became live in 2019. This blueprint can be found here.

PANCE Subscores

Content area subscores provide examinees with information about their relative strengths and weaknesses based on their performance on the test. The subscores displayed in this score report provide the test-taker with information about performance in each content area and an indication of the standard error of measurement (SEM) for each content area. Large content areas (e.g., Cardiovascular) have greater numbers of questions, resulting in smaller SEM values. For the larger areas, the width of the SEM bar will be smaller. Smaller content areas (e.g., Hematology) have fewer questions, which leads to larger SEM values. Thus, the smaller content areas have a wider SEM bar.

To provide the most reliable estimates, subscores and the associated SEMs are estimated using a statistical method called augmented scoring. This method considers the relationships between the various content areas to supplement the scoring method.

Even with augmentation, subscores should be interpreted with caution due to the number of questions in each area: a different set of questions, particularly in the smaller content blueprint areas, could result in a different subscore interpretation.