PANCE Question Types
Every question format explained with tips and strategies to maximize your score.
Overview
PANCE is a 5-hour, 300-question multiple-choice exam taken after graduating from an accredited PA program. Administered by the NCCPA, it's required to become a PA-C (Physician Assistant - Certified). The exam covers 14 organ systems and 7 task areas including history/physical, diagnostics, pharmacology, and clinical intervention.
Question Types
Clinical vignette
Patient scenario with symptoms, history, labs — identify diagnosis, next step, or treatment.
Strategies
- ✓Focus on the final question, not the full stem
- ✓Look for classic 'buzzwords'
- ✓Think: 'what would a supervising physician want me to do?'
Diagnostic studies
Given findings, interpret ECG, X-ray, labs.
Strategies
- ✓Learn classic ECG patterns
- ✓Memorize common lab reference ranges
- ✓Practice with images
Pharmacology
Drug choice, mechanism, side effects, contraindications.
Strategies
- ✓Master first-line therapies for common conditions
- ✓Know drug classes by prototype
- ✓Watch for interactions
General Strategies
- 1.Start Qbank questions early in the 2nd year of PA school.
- 2.Focus on cardiology and pulmonology — together they're ~23% of the exam.
- 3.Review ECG interpretation systematically.
- 4.Use spaced repetition (Anki) for pharm and microbio.
- 5.Take full-length NCCPA practice exams 2–4 weeks before testing.