The End of Curriculum (EOC) exam is the last standardized exam you take before the PANCE, and PAEA describes it as an evaluation of your readiness to graduate. It is the closest thing to a PANCE dress rehearsal that exists. Important: the EOC blueprint changed on April 27, 2026 — the new exam forms are already live, and much of the material written about the EOC online is now out of date. This page explains what the exam tests now, and what is inside the PAtopia EOC review. There is a free 25-question sample quiz and unlocked study library chapters below.
5 practice exams · 1,500 questions · 13-chapter study library · 27 months of access · $69.99
What is on the End of Curriculum exam?
The EOC exam is 300 multiple-choice questions — 250 scored and 50 unscored pretest items. It is designed to be given in the final four months of PA training. It is by far the longest PAEA exam, and the closest in scope to the PANCE.
Unlike the End of Rotation exams, the EOC blueprint has four dimensions, not two. Every question is coded by content area, task area, clinical setting, and stage of life — plus a target for cognitive level.
The 2026 EOC blueprint update — already live
New EOC exam forms built to the updated blueprint launched on April 27, 2026. If you are sitting the EOC now, you are almost certainly sitting the updated version.
The headline change: Infectious diseases has been removed as a content area entirely — its topics redistributed across the organ systems.
Content areas — current vs. updated
| Content area | Current | Updated |
|---|---|---|
| Cardiovascular | 16% | 13% |
| Pulmonary | 12% | 11% |
| Gastrointestinal | 10% | 11% |
| Neurologic | 6% | 9% |
| Psychiatric/behavioral health | 6% | 9% |
| Endocrine | 6% | 8% |
| EENOT | 8% | 8% |
| Gynecologic/reproductive health | 8% | 8% |
| Rheumatologic/musculoskeletal | 10% | 8% |
| Dermatologic | 4% | 5% |
| Hematologic | 4% | 5% |
| Renal/genitourinary | 6% | 5% |
| Infectious diseases | 4% | REMOVED / REDISTRIBUTED |
Task areas — current vs. updated
| Task area | Current | Updated |
|---|---|---|
| Diagnosis | 22% | 19% |
| History & Physical | 18% | 18% |
| Diagnostic Studies | 10% | 16% |
| Clinical Therapeutics | 18% | 14% |
| Clinical Intervention | 12% | 13% |
| Health Maintenance | 10% | 10% |
| Scientific Concepts | 10% | 5% |
| Professional Practice (NEW) | — | 5% |
Setting — the dimension nobody studies
The EOC codes every question to a clinical setting, and the targets changed:
| Setting | Current | Updated |
|---|---|---|
| Outpatient | 60% | 50% |
| Inpatient | 20% | 20% |
| Emergency department | 10% | 16% |
| Perioperative | 10% | 10% |
| Rehabilitative (NEW) | — | 4% |
Life course and cognitive level
Unchanged in the update, but worth knowing: Pediatric 20%, Adult 60%, Geriatric 20%. And by cognitive level: Analyze & evaluate 40%, Understand & apply 50%, Remember only 10%. Ninety percent of the EOC asks you to reason, not recall. Flashcards alone will not carry you.
What this means for how you study
Emergency department content rose from 10% to 16%. That is a 60% increase — roughly forty questions on the full exam. Undifferentiated, acute presentations.
Diagnostic Studies rose from 10% to 16% while Clinical Therapeutics fell from 18% to 14%. Interpretation over prescription.
Neurology and psychiatry both jumped from 6% to 9%. Together they are now 18% of the exam.
Infectious diseases did not disappear — it was redistributed. You will still see pneumonia, meningitis, and cellulitis. They are now coded to the organ system instead.
Only 10% of the exam is pure recall. The EOC is built to test clinical reasoning, and it is explicitly weighted that way.
What is in the PAtopia EOC review
- 5 full-length practice exams — each 300 questions, matching the real exam’s length, for 1,500 unique board-style questions with no repeats.
- Every question fully explained — why the answer is right, why each distractor is wrong, and a primary-source reference.
- 13-chapter study library — a complete written review organized by content area.
- 27 months of access — carries you from the EOC straight through the PANCE.
Try it free — 25 questions and unlocked library chapters
Below is a free 25-question sample quiz pulled straight from Practice Exam 1 — same questions, same explanations, same references. Underneath, the study library is open with the first chapters unlocked. No account, no email, no card.
Free 25-question sample quiz
Look inside the study library
The first chapters are unlocked so you can judge the depth. The remaining chapters are locked — click any to see what is included.
How to study for the EOC
Treat it as a PANCE rehearsal, because that is what it is. Three hundred questions, all organ systems, all settings, all ages. If you build a study plan for the EOC, you have built most of your PANCE plan.
Practice full-length. The EOC is 300 questions. Stamina is a real variable and most students have never sat an exam that long. Do at least two complete timed run-throughs before test day.
Do not neglect geriatrics. Twenty percent of the exam is geriatric — the same weight as pediatrics. Polypharmacy, falls, delirium versus dementia, Beers criteria.
Reason, do not memorize. Ninety percent of items are coded above pure recall. Practice explaining why the answer is right out loud.
Frequently asked questions
How many questions are on the EOC exam?
300 questions — 250 scored and 50 unscored pretest items.
Did the EOC blueprint change?
Yes. New exam forms built to the updated blueprint launched April 27, 2026. Infectious diseases was removed as a content area, Professional Practice was added as a task area, and a new Rehabilitative setting was added.
Is the EOC the same as the PACKRAT?
No. PACKRAT is 225 questions and is a self-assessment tool with no passing score. The EOC is 300 questions and is a summative evaluation of graduation readiness.
Is there a passing score?
PAEA discourages programs from using the EOC as a single determinant of graduation. Your program sets its own interpretation.
Will this help with the PANCE?
More than any other exam prep you will do. The EOC is the closest existing analogue to the PANCE in scope, length, and cognitive demand.
About the author
Jeremy Boroff, MPAS, PA-C is a practicing Emergency Medicine Physician Assistant with 24 years of clinical experience and more than 20 years as an APC Director of an emergency department. He founded CME Review Courses and created the PAtopia app to help PA students prepare for the PACKRAT, all seven End of Rotation exams, the End of Curriculum exam, and the PANCE.
Blueprint figures are taken from PAEA’s official 2025 End of Curriculum Blueprint Crosswalk. PAtopia and CME Review Courses are not sponsored by, endorsed by, or affiliated with PAEA or NCCPA.
Other PAtopia exam reviews
PAtopia covers every standardized exam of the PA clinical year. Each review includes free sample questions and unlocked study library chapters — no account required.
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- Family Medicine EOR — free sample quiz & library preview
- Internal Medicine EOR — free sample quiz & library preview
- Pediatrics EOR — free sample quiz & library preview
- Psychiatry EOR — free sample quiz & library preview
- General Surgery EOR — free sample quiz & library preview
- GSR / Women’s Health EOR — free sample quiz & library preview
- PACKRAT — free sample quiz & library preview
- PANCE — free sample quiz & library preview
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Read: 2026 PAEA EOR Blueprint Changes — A Complete Guide for PA Students →