The Psychiatric & Behavioral Health End of Rotation (EOR) exam has undergone one of the most dramatic restructurings in the 2026 blueprint update: Health Maintenance has been removed entirely as a task area, Clinical Intervention has doubled, and Sleep-wake disorders is a brand-new content area. This page explains what the exam tests, what changed, and what is inside the PAtopia Psychiatry EOR review. There is a free 25-question sample quiz and unlocked study library chapters below.
5 practice exams · 600 questions · complete study library · 27 months of access · $39.99
What is on the Psychiatry EOR exam?
The Psychiatric & Behavioral Health EOR exam is 120 multiple-choice questions with a two-hour limit and a ten-minute break between sections. Only 100 of the 120 are scored — the remaining 20 are unscored pretest items, and you cannot tell which is which.
Unlike the other EOR exams, the content areas here are organized by diagnostic category rather than organ system, and they map closely to the DSM-5-TR chapter structure.
The 2026 Psychiatry EOR blueprint update
PAEA publishes updated End of Rotation exams on July 27, 2026. Legacy versions remain available through July 2027, so ask your clinical coordinator which blueprint your program is using.
Content areas — current vs. updated
| Content area | Current | Updated |
|---|---|---|
| Depressive disorders; Bipolar and related disorders | 18% | 17% |
| Substance-related disorders; Addictive disorders | 14% | 15% |
| Trauma- and stress-related disorders; Abuse and neglect | 18%* | 13% |
| Anxiety; Somatic symptom-related disorders | —* | 11% |
| Schizophrenia spectrum and other psychotic disorders | 12% | 11% |
| Feeding or eating disorders | 8% | 8% |
| Neurodevelopmental disorders; Dissociative disorders | 10% | 8% |
| Sleep-wake disorders (NEW) | — | 7% |
| Human sexuality | 4% | 5% |
| Personality disorders; Obsessive-compulsive and related disorders | 8% | 5% |
| Somatic symptom disorders; Nonadherence to medical treatment | 8% | REDISTRIBUTED |
*The legacy blueprint combined Anxiety with Trauma- and stress-related disorders in a single 18% category. The updated blueprint splits them into two separate areas.
Task areas — current vs. updated
| Task area | Current | Updated |
|---|---|---|
| Clinical Intervention | 10% | 20% |
| Clinical Therapeutics | 20% | 20% |
| Diagnosis | 25% | 20% |
| History & Physical | 15% | 16% |
| Diagnostic Studies | 10% | 11% |
| Scientific Concepts | 10% | 7% |
| Professional Practice (NEW) | — | 6% |
| Health Maintenance | 10% | REMOVED |
What this means for how you study
Clinical Intervention doubling from 10% to 20% is the most dramatic task-area shift on any of the six updated exams. The exam is now heavily weighted toward what you actually do: therapy modality selection, crisis intervention, level-of-care decisions, involuntary hold criteria, safety planning. Knowing the diagnosis is no longer enough — you have to know the next step.
Health Maintenance is gone entirely. Ten percent of the exam has been reallocated, mostly into Clinical Intervention.
Sleep-wake disorders at 7% is a genuine new study burden — roughly eight scored questions. Insomnia, narcolepsy, obstructive sleep apnea, circadian rhythm disorders, parasomnias. If you study from an older Psychiatry resource, this is a gap.
Substance-related and addictive disorders rose to 15%, making it the second-largest content area. Intoxication and withdrawal syndromes, MAT (buprenorphine, methadone, naltrexone), and the CIWA and COWS scales.
Anxiety was split out from trauma. They were one 18% category; now Trauma/abuse is 13% and Anxiety/somatic is 11% — 24% between them. Both grew.
Personality and OCD disorders dropped from 8% to 5%.
What is in the PAtopia Psychiatry EOR review
- 5 full-length practice exams — each 120 questions, for 600 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.
- Blueprint-weighted — question distribution matches the PAEA Psychiatric & Behavioral Health blueprint.
- Complete study library — written review with high-yield tables, DSM-5-TR criteria, and exam pearls.
- 27 months of access — covers your rotation, the EOC, and 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 so you can judge the depth. 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 Psychiatry EOR
Learn the next step, not just the label. With Clinical Intervention at 20% and Clinical Therapeutics at 20%, forty percent of the updated exam asks what you would do. Which therapy, which medication, which level of care, when to hold involuntarily. Diagnosis is only 20%.
Know the DSM-5-TR criteria precisely — duration matters. Two weeks for major depression, six months for GAD, one month for PTSD (less than that is acute stress disorder), six months for schizophrenia (one to six months is schizophreniform, under one month is brief psychotic disorder). These duration cutoffs are the single most reliable source of exam questions in psychiatry.
Master intoxication and withdrawal. Substance-related disorders is 15% — the second-biggest area. Know which withdrawals can kill you (alcohol, benzodiazepines) and which are merely miserable (opioids).
Do not skip sleep-wake disorders. It is new, it is 7%, and everyone studying from last year’s material will miss those questions.
Frequently asked questions
How many questions are on the Psychiatry EOR exam?
120 questions, of which 100 are scored and 20 are unscored pretest items. Two hours.
What is the biggest change in the 2026 update?
Clinical Intervention doubled from 10% to 20%, and Health Maintenance was removed entirely as a task area. Sleep-wake disorders was added as a new 7% content area.
Do I need to know DSM-5-TR criteria verbatim?
You need the duration thresholds and the core symptom counts. The exam tests discrimination between similar diagnoses, and duration is usually how it does that.
Which blueprint will my exam use?
Exams published from July 27, 2026 use the updated blueprint. Legacy versions remain available through July 2027. Ask your clinical coordinator.
Will this help with the PANCE?
Yes — and more than you might expect. Psychiatric/behavioral health content is now tested on five of the seven EOR exams, not just this one.
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 is the author of Ace the Psychiatry & Behavioral Health EOR: The Ultimate Study Guide & Question Bank. He founded CME Review Courses and created the PAtopia app.
Blueprint figures are taken from PAEA’s official 2025 Psychiatric 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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- Internal Medicine EOR — free sample quiz & library preview
- Pediatrics 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
- End of Curriculum (EOC) — 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 →