Price: $399.99 for 30 months of access
Deliverables: 1,600+ questions, answers, and detailed clinical explanations; 1,200+ lecture slides
CME Credit: 100 Hours of AAPA Category 1 CME (PANRE Review Course only)
Add-ons: Amazon or Apple Gift Cards available from $100 to $1500
As of 2026, the Physician Assistant National Recertification Exam (PANRE) landscape offers two distinct pathways for maintaining your certification. Choosing between the traditional PANRE and the longitudinal PANRE-LA depends on your test-taking style, schedule, and clinical environment. Both pathways require a solid foundation in the core medical blueprints.
The Traditional PANRE: High-Stakes Efficiency
The traditional PANRE remains a single-day, high-stakes assessment. It is administered at a Pearson VUE test center and consists of 240 multiple-choice questions delivered over four hours.
- Format: 240 questions in four 60-minute blocks.
- Location: Proctored testing center.
- Scoring: Immediate unofficial results are often available, with official scores following shortly.
- Best for: PAs who prefer to "get it over with" in one sitting and those who perform well under timed, proctored conditions.
The PANRE-LA: Longitudinal Flexibility
The PANRE-LA (Longitudinal Assessment) is designed to reduce testing anxiety and integrate learning into daily practice.
- Format: 25 questions per quarter over 12 quarters (3 years).
- Location: Anywhere with an internet connection; open-book format.
- Scoring: Cumulative performance over the 12-quarter period.
- Best for: PAs who want to avoid testing centers, utilize reference materials, and spread the assessment over several years.
Preparation Strategy for 2026
Regardless of the path you choose, the medical content remains consistent with the NCCPA blueprints. Our PANRE Review Course provides 100 hours of AAPA Category 1 CME credit, which is essential for those on the traditional 10-year cycle. This content was written by physician assistants for physician assistants, ensuring the clinical relevance is prioritized over theoretical fluff.
For those choosing the PANRE-LA, our PANRE/PANRE-LA Review Exams offer a targeted way to stay sharp each quarter. The ability to add an Amazon or Apple Gift Card to your purchase allows you to maximize your employer's CME budget efficiently while receiving high-yield educational materials.
Clinical Assessment and Practice Questions
The following clinical scenarios are designed to reflect the level of difficulty found in both the PANRE and PANRE-LA.
Cardiology Vignette
Your patient is a 68-year-old male with a history of hypertension and tobacco use who presents to the emergency department with a 2-hour history of substernal chest pressure radiating to his left jaw. Vitals show a BP of 152/94, HR of 98, and SaO2 of 96% on room air. An EKG reveals ST-segment elevation in leads II, III, and aVF.
Which of the following is the most appropriate next step in management?
A. Administer 324 mg of aspirin and arrange for emergent percutaneous coronary intervention (PCI).
B. Start a heparin drip and admit for observation.
C. Administer oral beta-blockers and schedule an exercise stress test.
D. Perform a d-dimer to rule out pulmonary embolism.
Explanation:
The correct answer is A. Administer 324 mg of aspirin and arrange for emergent percutaneous coronary intervention (PCI). This patient is presenting with an inferior wall ST-elevation myocardial infarction (STEMI). Standard of care requires immediate antiplatelet therapy and reperfusion therapy. PCI is the preferred method of reperfusion if it can be performed within 90 minutes of first medical contact. Heparin (Choice B) is used as an adjunctive therapy but does not replace the need for emergent reperfusion. Beta-blockers (Choice C) should be avoided in the acute phase if there are signs of heart failure or bradycardia and do not address the acute occlusion. A d-dimer (Choice D) is inappropriate given the clear EKG findings of a STEMI.
Gastrointestinal Vignette
Your patient is a 45-year-old female who presents with a 24-hour history of severe right upper quadrant pain that radiates to her right scapula. She reports associated nausea and one episode of non-bilious emesis. On physical exam, she has a positive Murphy’s sign. Her temperature is 101.2°F, and labs show a WBC of 14,000/µL.
What is the initial imaging study of choice for this patient?
A. CT scan of the abdomen and pelvis with IV contrast.
B. Ultrasound of the right upper quadrant.
C. HIDA scan.
D. Abdominal X-ray (flat and erect).
Explanation:
The correct answer is B. Ultrasound of the right upper quadrant. This patient's presentation is highly suggestive of acute cholecystitis (RUQ pain, fever, leukocytosis, and positive Murphy’s sign). Ultrasound is the initial imaging study of choice due to its high sensitivity for gallstones and gallbladder wall thickening/pericholecystic fluid. A HIDA scan (Choice C) is the gold standard for diagnosis if the ultrasound is inconclusive but is not the first-line study. A CT scan (Choice A) is less sensitive for gallstones and involves radiation exposure. Abdominal X-rays (Choice D) are rarely useful for diagnosing biliary disease.
Pulmonology Vignette
Your patient is a 22-year-old female with a history of mild persistent asthma who presents for a follow-up. She reports using her albuterol inhaler four times per week and waking up twice a month due to cough. She is currently using a low-dose inhaled corticosteroid (ICS) daily.
Based on the current GINA guidelines, what is the most appropriate adjustment to her regimen?
A. Discontinue the ICS and use albuterol only as needed.
B. Increase to a medium-dose ICS.
C. Add a long-acting beta-agonist (LABA).
D. Maintain the current regimen and monitor.
Explanation:
The correct answer is C. Add a long-acting beta-agonist (LABA). The patient’s asthma is not well-controlled on low-dose ICS alone, as evidenced by using her rescue inhaler more than twice a week. Moving to Step 3 of asthma management involves adding a LABA to the low-dose ICS. Discontinuing the ICS (Choice A) would increase the risk of exacerbations. Increasing to a medium-dose ICS (Choice B) is an alternative but the combination of ICS-LABA is generally preferred for better symptom control. Maintaining the regimen (Choice D) is inappropriate as the patient remains symptomatic.
Endocrinology Vignette
Your patient is a 54-year-old male with Type 2 Diabetes Mellitus who presents for a routine visit. His current A1c is 8.2% despite compliance with Metformin 1000 mg twice daily. He has a history of atherosclerotic cardiovascular disease (ASCVD).
Which of the following medications should be added next?
A. Glipizide.
B. Pioglitazone.
C. Empagliflozin (SGLT2 inhibitor).
D. Sitagliptin (DPP-4 inhibitor).
Explanation:
The correct answer is C. Empagliflozin (SGLT2 inhibitor). For patients with Type 2 Diabetes and established ASCVD, SGLT2 inhibitors or GLP-1 receptor agonists with proven cardiovascular benefit are recommended regardless of the baseline A1c or metformin use. Empagliflozin has demonstrated a reduction in major adverse cardiovascular events. Sulfonylureas like glipizide (Choice A) and DPP-4 inhibitors like sitagliptin (Choice D) do not provide the same cardiovascular protection. Pioglitazone (Choice B) should be used with caution in patients with or at risk for heart failure.
Maximizing Your 2026 CME Funds
Whether you are preparing for a quarterly PANRE-LA assessment or the full PANRE Review Course, our packages are designed to provide the most efficient use of your time and money. Our Family Medicine and Internal Medicine packages offer Category 2 CME for physicians and nurse practitioners, while our PANRE-specific content provides the required Category 1 credits for PAs.
By utilizing the CME with Gift Card option, you can receive up to a $1500 Amazon or Apple Gift Card with your purchase, facilitating further educational enrichment through the purchase of medical equipment, textbooks, or technology needed for your practice. All content is written by PAs who understand the specific demands of these exams and the realities of clinical practice.