Spend even a short amount of time surfing blogs and online forums for Physician Assistants (PAs) and you will quickly encounter anxiety around the Physician Assistant National Recertifying Examination (PANRE). There appears to be a growing sense among PAs that, within the past few years — and with the NCCPA’s elimination of the take-at-home version of the recertification exam and move to more-clinical vignette-based question types — the difficulty of the PANRE has increased dramatically. Even seasoned PAs, claiming to have studied assiduously for their exams, report leaving the PANRE fearing failure or having — at best — no sense for how they might have fared on the exam.
Here are just a few examples of comments appearing in PA online forums:
“I just finished taking the PANRE about an hour ago and all I have to say is ‘wow’. I found it to be much more confusing and trickier than anticipated…Not sure what more/how much harder I can study if I have to retake it….”
“I just took my PANRE for the first time and felt like I guessed a lot on the exam. Anyone out there who took the primary care exam this month who felt like it was hard too?”
“I found the exam difficult. Of the four sections, one was particularly more difficult than the other three. I walked out of there feeling happy it was over, but scared I might have to take it again in 3 months.”
“…I just recently took my PANRE (5th year) and I share the horrendous feeling that others have experienced…Furthermore, I’m slightly upset since I poured a lot of time into studying.”
Responses to those experiencing severe post-PANRE anxiety are generally soothing, pointing out, for example, that:
- Pass rates for the PANRE typically run in the 95 to 96% range.
- The NCCPA often tests new questions on the PANRE, but does not count them toward one’s pass/fail score. (To the test-taker, those questions are indistinguishable from scored questions during the exam.)
- The PANRE is designed statistically and scientifically to test knowledge across a broad array of medical areas with a primary focus on isolating PAs either hovering very near to or falling clearly below the pass/fail cut score for general medical knowledge.
In other words, if you have been practicing successfully as a PA, keeping pace with required CME activities, pursuing lifelong medical learning outside of CME, and actively studying for the PANRE, the likelihood of passing is quite high even if you leave the exam feeling otherwise. Of note is that anxious forum posters often return to report that they did indeed pass their exams.
Preparing for the PANRE
The perception of increasing difficulty on the high-stakes PANRE has generated plenty of debate around the exam itself and the NCCPA’s overall approaches to knowledge assessment and PA recertification. While the debates are certainly healthy for the profession, their influence on changing the PANRE in material ways is slow at best. So what can PAs do in the meantime to alleviate severe pre- and post-PANRE anxiety?
To maximize confidence both leading up to and during the PANRE, PAs are first advised to time their self-scheduled exams carefully, leaving plenty of room in recertification cycles for retakes if needed. The PANRE can be taken up to four times within the final 2 years leading up to certification expiration, but only two times in each year and only once every 90 days.
“We recognize that facing the recertification exam is a stressful event. That’s why we strongly encourage PAs to take full advantage of the opportunity to test a year early, before the pressure of the certification expiration deadline begins to add to the understandable test anxiety that drives many to overspend as they prepare,” says Dawn Morton-Rias, Ed.D, PA-C, who is also president and CEO of the NCCPA.
Christie J. Lucente — Physician Assistant Reviewer for NEJM Knowledge+ Family Medicine Board Review, a practicing PA-C since 2004 who has passed one PANRE, one specialty Certificate of Added Qualifications (CAQ) in Emergency Medicine, and is now preparing for her second PANRE — suggests a large portion of PANRE-related anxiety can be attributed to specialization.
“There are PAs in practice who have become extremely specialized. For example, there may be a PA who has focused exclusively on skin biopsies for the past five or ten years. The PANRE is designed to test a much broader base of medical knowledge. And, while that makes the test more challenging for those who are specialized, it’s also what distinguishes our profession from MDs and nurse practitioners (NPs). In fact, most choose the PA profession because we want the flexibility to practice in different areas of medicine throughout our careers. However, the price of that flexibility is to maintain a broad base of general medical knowledge, which is tested periodically through the PANRE.”
If you have never yet taken a PANRE, it is important also to understand that exam questions differ in style from the initial Physician Assistant National Certification Exam (the PANCE). Lucente describes the key difference:
“The PANCE and PANRE cover the same subject matter, so being mindful of topics included in the NCCPA’s Content Blueprint is important for both exams. As for the types of questions you might see on each exam, the NCCPA states that, in general, questions on the PANCE are more specific in nature. The PANRE, by contrast, focuses on how we apply broader medical principles.”
Especially for first-time PANRE takers, Lucente advises gaining plenty of practice answering more clinically focused questions, which require individuals to perform higher-level cognitive tasks — application, analysis, and strategy vs. just definition and understanding, for example. There are many options for doing so, beginning with the NCCPA’s own practice exams, which are also assured to reflect the exam’s content blueprint as well as the style and pacing of the actual PANRE exam. The NCCPA offers two PANRE practice exams, which can be taken an unlimited number of times. While not intended to predict performance on the PANRE, the low-cost practice exams do provide clear indicators of how much studying and advance preparation might be needed in various topic areas for each individual PA.
The NCCPA provides practice-exam reporting broken down according to the exam blueprint. If a test taker performs poorly across many or most subcategories, a broad PANRE review course might be indicated as a strong point of departure for refreshing core medical knowledge, building test-taking confidence and directing subsequent independent study. If, on the other hand, you are weak in only a few specific areas of the NCCPA practice test, your study time and CME budget might be better spent in more focused ways. As Lucente describes:
“Most PAs have a certain annual budget allocated for continuing medical education (CME). A PANRE review course — especially a multiday course involving travel — can consume a large portion or even all of that budget, leaving little for CME that might be more relevant to one’s specialty and/or specific PA career path. While I have taken PANRE review courses in the past and believe they can be quite effective, each PA needs to make an assessment of how to spend his or her limited CME dollars each year.”
When to Consider Taking a PANRE Review Course
A review of materials set forth by course providers — including location-based, CD/DVD, and online-only types — suggests that broad PANRE review courses may be best suited for PAs who:
- Have left exam prep until very late in their recertification cycles
- Are not especially disciplined about studying independently
- Are not typically strong test takers
- Have yet to experience computer-based versions of the PANRE
- Do not make a regular habit of keeping current with general medical knowledge via journals, conferences, peer networking, question banks, self-assessment tools, and so forth
- Have daily distractions, such as child or elder care that can make it difficult to carve out focused time for self-directed study
- Have been narrowly specialized over a long duration (some 60% of PANRE questions test general/primary care medical knowledge while 40% can, by test taker’s choice, be more specialized, focusing either on adult medicine or surgical practice)
- Show downwardly trending PANRE scores over time (a function of distance from academic settings and regular study)
- Have taken NCCPA practice tests and performed poorly across the board (versus in just a few specific areas)
Choose Wisely
In 2012, the American Academy of Physician Assistants (AAPA) surveyed more than 2,800 certified PAs to gain insights on perceived usefulness of specific PANCE/PANRE preparation options. While the AAPA poll looked at specific resource titles, each mode of study showed similar ranges in terms of perceived usefulness among PAs:
- Review books: 53% to 73%
- Practice exams: 48% to 77%
- Online or self-study review courses: 45% to 80%
The key takeaway here is that each PANRE prep category has both weak and strong contenders, so careful research is needed in deciding how to invest one’s time and CME money on specific board-review offerings.
Many PANRE review courses and other resources can be purchased conveniently online, but checking original publication dates for content as well as content-revision frequencies is a must to ensure it is both up to date with advances in medical knowledge and with changes in how the NCCPA structures the PANRE to assesses that knowledge.
While it is a reasonable assumption that PANRE review courses have been developed using the NCCPA exam blueprint — meaning they portion course content appropriately across the breadth of subject areas covered in the exam — this is not a given and should always be verified when weighing PANRE review course options.
A big positive for many PANRE review courses, according to Lucente, is that — in addition to medical knowledge — they teach specific test-taking strategies, including how to rapidly deconstruct and decode exam questions. PANRE review courses also provide key insights into how questions are developed for the exam, how the exam is structured and scored, why it is important to answer every question (even by guessing), and specific strategies for making best-possible guesses.
PANRE review courses, Lucente notes, may also highlight how to work more effectively in both timed and computer-based testing environments. When taking the actual PANRE, you have approximately 60 seconds to read, digest and answer each question; due to exam scoring methods, it is always best to answer every question. Practicing questions repeatedly within realistic time constraints can go a long way to relieving test-takers’ anxiety, Lucente says.
While many PANRE review courses offer money-back guarantees, they are not failsafe as online forums reveal plenty of examples of PAs who have failed the PANRE even after taking reputable and popular PANRE review courses. At the end of the day, says Lucente, each PA must make a clear and honest assessment of his or her own learning styles, capacities for retaining information and testing, and career-path priorities.
“It is always going to come down to what is right for each individual PA, their lifelong learning and study habits, where they are in their careers and specialties, how much experience they have with taking these sorts of exams, and how they want to spend their CME money. If there is an effective way to prepare for the PANRE that delivers the same benefits of a PANRE review course — and there is no other reason to travel to a specific destination — I believe many would choose to spend their CME money in ways that add to their core clinical and specialty knowledge.”
More from NEJM Knowledge+ on PANCE and PANRE:
Physician Assistant Certification
PANCE/PANRE Blueprint
Taking the PANCE/PANRE Exam
Please join our ongoing conversation about best practices for PANRE review by sharing your own experiences with PANRE review courses in the comments below.
I just failed panre by 9 points .i was deppressed didnt know how to check lab values . Or go back to questions. I didnt even focus well on questions. I need to perk up.
Review course at Rutgers seemed to be good and chock full of useful material. However, just took the PANRE and am disgusted. The blueprint they covered missed a lot of things and the questions on the exam were vague. This is no way to test. I’m really sad and depressed that after 3 months studying for hours, this is what I got. Hope that passed.
I took mine in April, walked in as I have done before x3 passed easily. This time I Failed… I was disgusted with myself needless to say. I went to Chicago 3day course in July and still did not feel comfortable and postponed my exam, I went to CME for Life course in November. I took exam again and felt I was prepared.
Friging Failed…I’ve been practicing fo almost 20 years, never been sued, haven’t had a love note on my charts from a supervising physician in decades, I have been a preceptor for some of the best PA programs in the U.S. For 7years. I thought about this for entire month of December even went to a psychiatrist to discuss this problem. It turned out I have ADD. Probably explains my inability this time around to actually read and retain. He said people like me have adjusted through the years by what he calls “brain hacking” similar to computer hacker who finds the back door into a computer. But I have realized as well that I did not do very many practice questions. I made a promise to myself and as a New Years resolution when I get through this PANRE exam. I am going to do everything I can for other PA’s who are struggling as I am. I can’t believe I am the only PA out here with this problem. I also want to mention that the questions on the PANRE exam can be very vague and zebra-ish. I’ve read recently that policy changes with the NCCPA are coming concerning a alternative path way for PA’s who have failed the exam twice. This will potentially give these PA’s a fighting chance to continue to practice medicine w/o loosing their certification. There will be a certain exam score that would need to have been achieved they have not said what that will be. The problem is it’s not coming anytime soon.
Francis
Hi I need major help ! I am unable to pass my PANRE I have take it a few times! I have done cme resource, NCCPA book, lange book, pa easy, panre questions etc etc… paid lots of money and still struggle thru this exam!
I have to eat the books next!!! lol
Any advice anyone
This is to Francis….. I have also failed the PANRE twice. I will say the first exam I took without fully preparing myself however, the second time I purchased a test booklet with questions in addition to the Rutgers review online. I felt fully prepared going into the test a second time. Coming out after completion I felt fully deflated. I too felt the questions were sometime vague, zebra-ish, and very long at times. I have been in Endocrinology practice for over 10yrs and before that Family practice for 3. Being specialized truly hurts those of us taking the PANRE where a speciality exam is not offered. My certification ended December 31st, now according to NCCPA I have to do an additional 20hrs of CME before scheduling to retake exam. I am torn about how to proceed! Maybe a 3day review class or do more and more questions or both! I feel like a failure! Like you, I am very knowledgeable in my speciality and have established a great patient base within the practice. Luckily, my employer is supportive. I wish so very much that the rules regarding recertification would be modified sooner rather than later! Thank you for posting your information at least now I don’t feel alone.
Tina
Hi Tina
Thank you for replying
What was the name of the booklet you were talking about along with the Rutgers program? ( and would you use it again), The 2nd exam that you failed. was this your last try, or do u still have 2 more attempts, I have 2 more attempts this year and if I don’t pass again ….I feel like I’m going to be done… I’m not aware of having to take additional 20 hours of CME in order to retake the PANRE. Could you elaborate on this .. who did speak to” Did they give you any advice” did they seem concerned about “our” issue.
The one good thing when I was recently Dx with ADD. I did sit down and took the NCCPA practice exam (on adderall) I had taken that one in late October and retook that test the following week after I posted my first blog. The jump in performance was dramatic. I was pleased. I’m certainly not confident yet. But I am feeling better about this process. I have been studying CME for life DVD’s and have been reading the Chicago course notes. And I actually havebeen retakeing there exams that they gave when I went to the course in July. Only to see that with in the first 10 questions there was one question That was difficult for me I don’t do much gyn stuff I.E: 23 y/o female normal pap at first on on visit she was at a 35 wk gestation had sudden onset lower-abdominal pain passed a small amount blood after sex the night before, on PE transabdominally the the uterus was firm and tender to palp. It came down to 2 answers abrupto placente or cervical dysplasia both will have pain both can have blood. The difference I did not see was the word ” sudden” “35wks”, dysplasia ( which means changes like HPV) and when I looked the answer up. I realized that there questions were vague and there answers they offered were so close. I know the difference now. I thought our exams are based on general knowledge. Keep me posted on you endeavors and if I can help with anything I will. Maybe we can bounce questions, case studies or what ever off each other till we both get through this. I have also looked for specific blue print questions for where I am weak and I can’t seem to find any if you know of a site or source please let me know
Francis
Hi Francis,
Yes my last attempt to pass was in 2015 (for that year). In order to retake this year I had to complete 20hr SA CME before I could retake exam. The (Self Assessment) new requirement was recently implemented as standard CME requirement. Of course, its a cost. I purchased on the website (my CME Marketplace) . I selected the Internal Medicine questions since I thought it would help me more since I am in a specialty practice. The program consisted of 400 questions with given answers and why the other answers were incorrect. Upon completion, the certificate was sent directly to NCCPA. So, now I am able to retest for the PANRE. The questions were great! Like you, I’m nervous about it. My entire future consists of a “test” that does not measure my knowledge especially in my field of practice. I really think the NCCPA needs to establish another way instead of retesting like additional CME’s etc. I would get so much more out of CME than I do taking a test that is not truly what you would in your practice. As far as the Rutgers program again I purchased that from (my CME Marketplace) It was a review course online with post lecture questions. I’ll start reviewing again soon. The booklet I purchased from Amazon was PANCE/PANRE 600 question review. I do think it is helpful.
Having the retest “hanging” over my head is so extremely stressful!!!!!
I wish you all the best and thanks for the reply!
Have a terrific day
Tina
I took the panre three times in my 5 th and 6th years. Failed each time. Just failed for the 4th time. My employer is giving me one more attempt after which I have to leave voluntarily. I’m at a total loss. I don’t know how much more studying I can do. So ridiculous that my whole career depends on this exam. Anyone have any studying techniques that helped them? I’m not that young anymore and it’s so hard to concentrate .
Heidi
Good evening. Please know that you are not alone in your anxiety over the PANRE. I just recently took my exam for the 3rd time and finally passed. Yes it’s extremely stressful to base your career on one test and it really takes a toll on you however, please hang in there! Please feel free to email me and we can talk further. Take care.
The questions are so ambiguous, failed twice by 3 points. 2 prior PANRE test mid to high 400’s. I dont understand how this can be. Practicing I’m spot on but differential diagnosis of diseases we never will see in our lifetime is ridiculous.
Ditto to all the above. I’ve been practicing in IM for the past 35 years and passed the exam handily 6 yrs ago but have failed this one twice. I’m due to take again in July and find the whole process demeaning when my whole career is and has been stellar in every way. Yes, they talk about changing recertification to reflect only your specialty but why has it taken so long and why is a NP one of the ones in charge of recertification when NP’s NEVER have to retest!!!
Carol thanks for your reply. I promised myself when I finally passed the PANRE I would help others in similar situations. I don’t want anyone to feel like he/she is the “only” one like I felt. Thank goodness for this site! I wish you the best for July!
I have been taking the recertification exam for the past 30 years. I just took the exam this past weekend and have never felt so discussed with my profession after taking the exam. I could not have studied any harder. I have spent the last 3 months preparing myself. I paid to take over 2000 questions purchased the last books, flash cards etc. I know I will have to retake it again. This process is such a waste of our time and money.
I don’t even know how to prepare to start studying again to be insult at this level.
This is one time I wished I was an NP and knowing that when I take the first exam it will be MY LAST. PA’s should not have to put themselves through this stress anymore and something needs to be done about the process of recertification.!!!!!!!!!!!!!!!!
I walked out of this exam feeling as though I failed. I am a cardiology PA and have been for the past 5-6 years. I can easily diagnose a heart murmur with my stethoscope. Luckily I passed; however, theses questions were ridiculous. The cardiology portion of my PANRE was my lowest score… with that being said, I did take a review course prior to my exam–you can never be to sure…
I took the exam as well and left the exam hopeless to say the least. These questions are not reflective of how we practice. I want to email NCCPA, but don’t feel like is gone do any good. I been preparing for a year. Reviewed exam master questions and NCCPA reviews yet the exam was totally the opposite of.
You are not alone! I took the Exam a few times before I was able to pass (barely). I totally agree that the exam is not reflective of my ability to practice as an Endo PA. It’s very disheartening and makes you feel like a failure. I also reviewed questions, bought a exam review and took a review class. Please just know that there are many of us that feel this way! I truly hope that you passed the exam so that you do not have to endure another review. Take care.
The study that you pointed out by the AAPA is very interesting. I’ve come across the page that you linked to with the results of the study many times now and I can’t help but wonder how scientific they were when surveying PAs. Did they actually product a publication outlining the methods they used to construct this list? I would be very interested in reading it. It honestly wouldn’t surprise me either way. The AAPA does tend to be scientific in its approaches however it is a business and does put its own agenda first. Interestingly, I’ve noticed that they have been updating that page over the years by adding and removing listings, but don’t seem to mention any new surveys. Even though the AAPA/Hippo review course wasn’t even formed in 2012 when the study was conducted, they included it at the top for better visibility and just neglected to mention how many PA’s reported using it as a resource in their study. I’m happy there are good companies like nejm that can write straightforward and unbiased review articles such as this one.
In reply to vic.
Here is a bit of information I recently found out.
I found out through a PA who spoke with someone directly from the AAPA that they are purposely making the ‘older’ PA’s exams more difficult to “weed” out the older PA’s so the newer ones will have jobs. Please check your local state requirements, most of them don’t require you to recertify once you have passed your original certication as long as you keep up with your state license.
Hopefully, this will get back to the AAPA and they will begin to make all the exams fair and equal across the board!
Thank you so much such a great Review courses 🙂 I Appreciate Thanks for sharing this post 🙂
Hi,
Okay, where to begin? Well, I studied a lot last summer and thought I did pretty well…Nope, failed. I then prepared again for the next exam to be taken in December. In the meantime, my dad fell ill. Needless to say, I couldn’t focus on studying the several weeks he was in the CCU. Dad passed away in November and, YUP, I failed for the 2nd time. I was granted an extension for this year because I waited too late and I’m now in my 6th year. Well people, I just took it for the 3rd time LAST WEEK, and it was horrendous. I actually put my all into studying the entire review book yet again, some questions in a few of my weaker subjects, and flash cards. Now what? Granted, I’m dealing with my grief over my dad, which definitely was a hindrance in studying. However, I’m absolutely at a loss. I’ll be taking a CME course in May and then the 4th exam in June. This is it for me. What the HELL am I going to do. I’ve been a PA for 20 years. And I’m 48. Is that it for me? I’d hate to think it is. Thanks for listening.
Hi Lynn
I feel your pain ! My mom was just dx with Lung Ca and now bone Mets ! I the worry for this exam is besides itself ! I feel like i am going to have a heart attack any day now!
I too dont know what else to try to study with or read !
which exam are you going to take !
I have taken both primary and adult medicine and i think the adult medicine is harder not sure ? Any advise !!
Thanks and stay strong and so sorry for your loss !
Mich
Lynn her again. Btw, will somebody PLEASE tell me which PANRE exam they feel is the more routine to take, primary care OR medicine? It’s the primary care that I keep taking and bombing. Thanks.
I’m fast becoming one of the “older” PAs out there, having been specialized in Urology for 18 years. I passed the PANRE fairly easily on first two recerts 6 and 12 yrs ago but took it 2 weeks ago and failed . I always take it on the first go round so I do have 3 more shots at it but I am verrrrry nervous. Very difficult to study more than I did, giving that I’m a single mom, chasing around a 4 year old. Getting a review course will be next to impossible so I am going to try an online review. What I found disheartening was the specificity of the exam. Ask me broad based knowledge questions and not confusing detail oriented / 2 possible answer questions. ( I work in urology and only got 73% correct). I left so confused. I felt that I only knew about 20 questions with certainty – out of 240?! wow.
It makes me feel somewhat better though, knowing that everyone seems to have the same complaints that I do regarding this silliness. Just not sure how to make it better before we all lose our jobs and careers.
I too am one of the older PA’s who took her PANRE exam for the first time and failed. Unfortunately I was having a migraine that day and had had the date pushed out for the medical reason of having daily headaches. I was also on a medication that I found out since, causes me to have “memory issues”. Also, since that time, my mom was also diagnosed with cancer and passed away 6 months ago. I lost my job when I didn’t pass the exam as my company did not allow me to retake the test in a timely fashion. Needless to say, I have also not been able to find employment other than a temp job because no one wants to hire a physician assistant to flip burgers, answer phones etc. I am going to attempt to take the exam once more but I am extremely stressed as my lifestyle including paying for my home depends upon this. I too wish that I had considered a different route of healthcare when it means that our livelihood is based upon ongoing testing. I wish I could say I feel better knowing that we are all in the same situation, but I don’t. It bothers me that this is an issue for us at all.
Oh man, I take the PANRE for the first time in a couple days. I find it hard to believe the pass rate is 95-97%. I studied tremendously hard, gave up time/money/ADLs for it to come down to 240 multiple choice questions. There needs to be a better format to measure core proficiencies. T- minus 48 hours. Two of my PA buddies failed last month, its seemingly the norm.
What happens to the PA’s who fail? Can they lose their job?
Been in prax over 15 years. Took computer-based PANRE 2 weeks ago. Studied online questions (thousands!), 2 review books, & Clinical Medical Diagnosis & Treatment text. First time with this “high security” test place. Passed 2 previous PANRE “take home, open book” which I thought were hard. But this PANRE – felt had questions about minutiae and info which I do not even think I was ever taught. Definitely felt overwhelmed. And, oh yes, failed it by just 9 points: that’s what – 2 questions?
Been a PA for 19 years. Been certified the entire time. Waited until my last year in my re-certification cycle like I always do. Only had 2 chances to pass. No sweat right? Studied ” a little” being that I am married with 2 kids and working a full time job. Read and broke down my re-cert book highly recommended on line. Took my test…failed by 25 points! Gotta be a fluke right? Took one week off of work, unpaid. Studied my book again front and back, study questions on line, etc. Took it again 90 days later. Guess what? Failed again by 15 points!. Who does that? Not me….If someone could recommend a good prep course I would appreciate it, because the third time has got to be a charm! This bites….
I am hoping Tina will check this chat. I am in the same boat as Carmel. I took my PANRE the last year (2015) and failed. I could not believe it. As a result, I am no longer certified. I have been a PA for 17 years. I never saw this one coming.
I want to take course. I think this may help me this time. If Tina is here, I am hoping she can share what other methods besides the book and online review she took to prepare for her third and successful PANRE result. I know we are all different, but I need additional support. My Certification and job opportunities depend on it.
I am hoping this would assist me. I reached a little over the 100 CAT 1 CME requirement so I am now able to take the PANRE. I want to give myself time to review the material and learn how to take this exam! I passed the my previous reverts…why was this one so difficult???
If anyone can help, I would appreciate it. If you get a response Carmel, please share!
To work in California PANRE is not required right? Anyone here from California?
According to the State of California’s website, PANRE is not required for practice as a PA in California: “No. California does not currently require that you maintain national certification for renewal of your physician assistant license. However, the new continuing medical education requirements of 50 continuing medical education for each renewal cycle allows licensees who maintain certification from NCCPA during the renewal cycle to use that certification to satisfy this requirement.”
(http://www.pac.ca.gov/licensees/faq_cme.pdf)
I really don’t get why people are failing. I don’t think it’s a lack of knowledge. It has to be anxiety or ADD or overthinking. I was the dumbest in my class, passed the PANRE twice. This last time was while breastfeeding a colicky infant with no sleep, and I had to pump between sessions. I think compared to the baby stress the test stress was easier! No crying for six hours!
Now I’m scared. I’ve been a PA since 1994 and never had a problem with passing the PANRE. But my last test was 5 years ago. I’ve been doing HIV without any primary care for the last 15 years. Tomorrow is the last day to register for the new pilot program and I don’t know what to do. Last time I went to a CME review course but did not take the test for another 4 months. Did some review in reviews books and passed with a good score. I’m due to retire in a few months but want to keep my options open for locum tenums work.