PANCE Sample Quiz & Study Library Preview

The PANCE (Physician Assistant National Certifying Examination) is the exam that decides whether you practice. Everything else — the PACKRAT, the seven End of Rotation exams, the End of Curriculum exam — is preparation for this one. This page explains what the exam is, what the current NCCPA blueprint tests, and what is inside the PAtopia PANCE Review Course. There is a free 25-question sample quiz and unlocked study library chapters below.

15 practice exams · 4,500 questions · 18-chapter study library · 27 months of access · $99.99

What is on the PANCE?

The PANCE is 300 multiple-choice questions, delivered in five blocks of 60 questions with 60 minutes per block — five hours of testing time, plus break time.

Every question is coded to a medical content category (an organ system) and a task category (the clinical job the question asks of you) — with one exception, described below.

The 2025 NCCPA blueprint — what you are actually sitting

The current PANCE blueprint took effect in January 2025 and remains the active blueprint for candidates certifying in 2026 and 2027. If your study materials predate 2025, they are aligned to the wrong blueprint.

The structural facts that matter

  • Medical content is 94% of the exam (down from 95% on the 2019 blueprint). Every one of those questions is coded to both an organ system and a task category.
  • Professional Practice is 6% (up from 5%), and it is the only category not cross-coded to a task area. It stands alone. Roughly eighteen questions.
  • Surgical topics: 8–10% of the exam. Note this is a sharp reduction — the 2019 blueprint allocated 20% to surgical content. If you are working from older prep material, you are likely over-studying surgery.
  • Pediatric conditions: 12–15% of the exam. This is new — the 2019 blueprint had no explicit pediatric allocation.

NCCPA notes that specific percentage allocations may vary slightly between exam forms.

What this means for how you study

The surgery reduction is the most actionable change and the most missed. Surgical topics dropped from 20% of the exam to 8–10%. That is roughly thirty fewer questions. Students still working from a study plan built on the old blueprint are spending double the necessary time on surgery.

Pediatrics is now explicitly 12–15% — around forty questions. Surgery and pediatrics have effectively swapped places in importance.

Professional Practice at 6% is free score. It is not cross-coded, it is not clinical medicine, and it is entirely learnable in an evening or two. Most candidates never open it.

Go to the source. Download the current blueprint directly from NCCPA rather than relying on any third party’s summary — including this one. Using outdated percentages distorts your study priorities in ways you will not notice until test day.

What is in the PAtopia PANCE Review Course

  • 15 full-length practice exams — each one 300 questions, matching the real exam’s length exactly, for 4,500 unique board-style questions with no repeats between exams. That is fifteen complete PANCE simulations.
  • Every question fully explained — the correct answer, why it is right, why each distractor is wrong, and primary-source references.
  • Blueprint-weighted — questions follow the NCCPA content blueprint, so the proportion you practice matches the proportion you will face.
  • 18-chapter study library — a complete written review organized by organ system, with high-yield tables and exam pearls.
  • 27 months of access.

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 so you can judge the depth. No account, no email, no card.

Free 25-question sample quiz

Look inside the study library

The full Cardiovascular chapter is unlocked. The other 17 chapters are locked — click any to see what is included.

How to study for the PANCE

Build the plan around the blueprint, not around your comfort. Weight your hours to the organ system percentages. Most students over-study what they enjoy and under-study what they find dull, and the exam does not care.

Do full-length, timed blocks. The PANCE is five hours in five blocks of sixty. Stamina and pacing are real skills and they are trainable. Sixty questions in sixty minutes means one minute per question — practice at that speed until it feels normal.

Do questions from day one, not at the end. Questions are how you discover what you do not know; reading is how you fix it. Students who read for six weeks and then start questions discover their gaps too late to close them.

Read every explanation, including for the ones you got right. A correct answer for the wrong reason is a question you will miss next time in a slightly different form. This is the single most common reason students plateau.

Use your PACKRAT and EOR data. You already have years of diagnostic information about your weak areas — content-area breakdowns, task-area breakdowns, keyword feedback. Most students never look at it again. It is the most personalized study guide you will ever have, and you already paid for it.

Frequently asked questions

How many questions are on the PANCE?
300 multiple-choice questions, in five blocks of 60, with 60 minutes per block.

Which blueprint is current?
The NCCPA blueprint that took effect in January 2025. It remains active for candidates certifying in 2026 and 2027.

How much surgery is on the PANCE?
8–10% under the current blueprint — down sharply from 20% on the 2019 version. This is the change most often missed by people using older study materials.

How much pediatrics?
12–15%. The 2019 blueprint had no explicit pediatric allocation.

What is Professional Practice?
A 6% category covering professional and practice-based issues. It is the only category not cross-coded to a task area, and it is the most commonly skipped section of the blueprint.

How long should I study?
Most graduates work over six to twelve weeks. What matters more than total hours is whether you started doing questions early and whether you weighted your time to the blueprint.

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 details are taken from NCCPA’s published PANCE Content Blueprint effective January 2025. Candidates should download the current blueprint directly from nccpa.net. PANCE® is a registered trademark of the National Commission on Certification of Physician Assistants. PAtopia and CME Review Courses are not sponsored by, endorsed by, or affiliated with NCCPA or PAEA.

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