Thoughts on the PANRE

[crosby1]

1. There is no effective way to study for this exam. You can and should review the material based on the "blueprint" outlined by the nccpa. Do not try to memorize facts; this will not help you at all. You can not possibly learn every detail, every medication, and every diagnosis for every subspecialty on the exam. The best you can do is review the areas you are weak in.

 

2. IMO, the "blueprint" is not representative of the actual exam. There are questions on the exam that fall outside the "blueprint".

 

3. No matter how much you know going in to the exam, there will be questions that you simply will not be able to answer and will not be able to make an educated guess on.

 

4. Do not answer questions based on your experience, current practice protocols, or current research. They are looking for the "one best answer". Realize that the large majority of the questions are not new; they are 1 to 2 years old, and current knowledge is not what is being tested. It is of no use on this exam.

 

5. Do not rush. Read each question carefully. Read each question 2 or 3 times. Come up with an answer before you look at the choices. If your answer is not one of the choices, narrow it down to 2 or 3 if you can. Then pick what you think is the "best answer".

 

6. Remember, what you think is "best answer" may or may not be what the nccpa thinks is the "best answer"

 

7. Answer all questions. Don't leave any unanswered.

 

8. Only guess if you have absolutely no idea what the answer could be. I can guarantee you that there will be questions that you must guess at.

 

9. If you have an issue or complaint with the conditions at the testing center, and plan to file an exam grievance with the nccpa, make it known to the testing center staff BEFORE you leave. Make your complaint and make it loud and clear. Get documentation if at all possible. The nccpa apparently doesn't like exam grievances and will deny your complaint even it's a valid one.

 

10. PA's should be lobbying for an end to the PANRE. Once we have successfully passed the PANCE and file 100 hours of CME every 2 years, there should be absolutely no reason for a re-test. Other than making millions of dollars for the nccpa, it simply makes no sense.

 

No other mid-level practitioner is required to sit for a re-cert exam, why do we as PA's put up with this constraint and stress?

 

Why does the nccpa have this kind of power and hold on our profession? Who exactly are they? What gives them the right to decide that we have to take a recert exam every 6 years? They are extremely tight-lipped about exam content, exam results, exam grievances, and they certainly are not here to help our profession in any way.

 

11. The farther out you are from your graduation, the more stressful the exam becomes and the less likely you are to pass. How many PA's in orthopedic surgery remember how to read an EKG? How many dermatology PA's know how to diagnose renal insuffiency? How many cardiac surgery PA's know how to distinguish among the types of anemias? How many neurosurgery PA's know the pediatric vaccination schedule?

 

12. The nccpa practice tests are not helpful and are not worth the $35 they charge. Again, a money-maker for the organization. They will not tell you which questions you answered correctly or incorrectly. They will not give you explanations for the answers or allow you to review them. They will only give you your final score and tell you how you scored in each subsection. This is not a useful resource in my opinion.

 

It's quite simple, the PANRE simply does not test you on what you know. It tests you on what the nccpa has decided you SHOULD know which has nothing to do with reality or with how you function in your current role as a PA.

 

So basically, it comes down to this: either pass the exam or face losing your job, your house, your car, your marriage, your kids' college education, and everything else you've worked so hard for.

 

Until we stand as a group and until we have a say in how our profession is run, nothing will ever change.

[mikejfox]

I stand amazed. More complaints, more complaints.

All viable, I suppose.

 

BUT, nobody is willing to take action.

 

Why don't we fire the folks at AAPA and cut our ties with NCCPA. It's not the president or congress we are facing.

 

I'm not a good leader, but I'd sure take a stand with somebody having guts and not just words.

[crosby1]

i'm not sure i understand your response. what do you mean, "you stand amazed"? what are you amazed at?

 

and you should know that these are not "more complaints, more complaints". these are the FACTS.

[LIPPER]

This is taken from the NCCPA website. It appears that you can make an arguement for a more specific, specialty focused exam based on NCCPA's own drescription of core competencies

 

 

PHYSICIAN ASSISTANT COMPETENCIES

Vers. 3.5 (3/22/05)

The PA profession defines the specific knowledge, skills, and attitudes required and provides educational experiences as needed in order for physician assistants to acquire and demonstrate these competencies.

MEDICAL KNOWLEDGEMedical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. Physician assistants must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Physician assistants are expected to: ..."

[MikeyBoy]

#1-8 are basic test taking skills.

 

#11 should be no surprise to any PA. After reading and following along through all the numerous threads on the PANRE difficulties, I sure hope the examples given above are not the source of all this ire...

[mikejfox]

Complaints can be facts; I did NOT say they were false. I said they are viable, ie, alive, real, true.

 

I actually agreed with your statement.

 

Now, enough words. We need action.

[mikejfox]

Yea, but when NCCPA gives you a list and description of what the exam focuses on, it should actually focus on those areas. Go to the NCCPA web site and look under test content, it gives you a break down of what is supposed to be on the exam.

[LIPPER]

"One of NCCPA's ongoing projects was initiated in 2003 and is now part of a collaborative effort jointly undertaken by four national PA organizations (NCCPA, AAPA, PAEA, and the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)) to establish a profession-wide definition of PA competencies that can be used as a map for further developing and evaluating those competencies throughout a PA's career"

 

I think a key point here is that the PANRE questions are no different then the PANCE. They are drawn from the same question test bank. The goal (maybe not the process) is to insure that experienced PA's share the same competencies as those who are newly graduated. Field PA's IMHO should at the very least show that are as booksmart as a new grad.

 

Furthermore, it is not unprecedented that clinicians retest. Board Certified MD's retest every 10 years. And their exams are unquestioningly harder than ours. That NP's aren't expected to recertify may explain at least in part why MD's in gerneral have a higher opinion of PA's, and why PA's salaries are essentially higher across the board than NP's.

[EMEDPA]

what concerns me about this is folks who passed pance no problem and panre several times and recently failed...what's up with that....

[LIPPER]

what concerns me about this is folks who passed pance no problem and panre several times and recently failed...what's up with that....

 

I would agree with you, that until NCCPA opens itself to a more transparent review process, that these types of questions will continue to appear, and resentments will fester.

[KCMA79]

what concerns me about this is folks who passed pance no problem and panre several times and recently failed...what's up with that....

 

 

Not only failed but scoring in the low 200s. Going from a passing score to the lowest possible, or close to it, score from one PANRE to the next in mult. instances just isn't logical. The NCCPA does not answer to anyone and the AAPA has always been a paper tiger and now only exists to sponsor an annual conf.

[crosby1]

"#1-8 are basic test taking skills.

 

#11 should be no surprise to any PA. After reading and following along through all the numerous threads on the PANRE difficulties, I sure hope the examples given above are not the source of all this ire...

"

 

my goal in putting this on the forum was to generate conversation and perhaps action. i realize that some of the points are basic test-taking principles. i also realize #11 should be no surprise to any PA.

 

i also realize that the nccpa and the PANRE as it stands is a farce and we as a profession are at their mercy.

 

never a question asked?? never a challenge to their authority?? never a complaint about the monopoly they have over us???

 

 

and in response to mr. lippman's comment above that

"Furthermore, it is not unprecedented that clinicians retest. Board Certified MD's retest every 10 years. And their exams are unquestioningly harder than ours.":

 

"Through ABMS’ Maintenance of Certification (MOC) process, board certified physicians in 24 medical specialties build six core competencies for quality patient care in their medical specialty". (from the ABMS website).

 

note that physicians recertify in THEIR MEDICAL SPECIALTY. an ob/gyn will not be tested on neurology, a dermatologist will not be tested on salter fractures, and a cardiac surgeon will not be tested on rheumatology!!!

 

this is a huge difference! as i said above: if you need to test me, test me on what i know, not on what i don't know and don't need to know in order to perform my job!!!

 

and i would hope that their exams are "unquestioningly harder" than ours...they are DOCTORS, right?? they earn about 5 times what i do, have the ultimate responsibility, and spent much more time in training than i did. their exams should reflect that, no?

[dm123]

The PANRE has not been proven to increase compentency. Therein lies the rub. To claim so would imply PAs working 20+ years ago, when the “C” was mostly voluntary, were incompetent. There are even now PAs that work without the “C” in many states. Some of those don't have a degree higher than an associates degree. Ask the President of AAPA how he feels about the necessity of even a four year degree for PAs. Ask the medics who came from the military, the ones that blazed the trail for all of us as PAs.

 

As far as MDs preferring PAs over NPs, I don’t see that being the case. $$$ re-imbursement doesn’t indicate that point either.

 

Not all MDs have to take a recertification exam. Those that do, except for FP, are tested in their specialty.

 

There are many highly trained professionals that require an initial certifying exam. None that I’m aware of require recurrent exams with the same questions as their initial certifying exam. Think engineers, architects, accounting, and let’s not forget lawyers. Try getting them to take a bar exam every six years. Consider an airline pilot. The FAA requires they take a written and practical exam to get their ATP (airline transport pilot) license. Recurrent training (call it CMEs) are required but not anything comparable to a PANRE exam.

 

My wife is a CRNA with 20+ years experience. She was trained as a CRNA before it was even a Bachelor’s degree program. She is as competent, more so if you ask the surgeons she works with, than those recent grads with a Masters or PhD (the piled higher and deeper degree). The bureaucrats covering CRNAs tried to institute a recertification program a few years back. There was such an outcry from those actually doing the work that had long forgotten the idioms, gas computations, etc., that no one uses except to pass their initial exam, it was felt at least half the CRNAs currently practicing would fail a re-certification exam.

 

The big point everyone at NCCPA seems to overlook is experience counts for something. After a few years, your belly starts to talk to you. If you are teetering on the edge of a decision you think is right but are not sure, consult you belly. Mine is very stubborn and stops me sometimes when I know I’m right, at least at first when I though I was right. Mine rarely lets me down.

 

Those currently required to recertifying have already proven themselves in the trenches. Their knowledge of academics might not be as great as a recent grad, especially out of their specialty field but experience far out weighs a book.

 

I could go on and on but the NCCPA needs to test the PANRE. Since NCCPA now takes in millions of dollars, one barometer might be to offer the PANRE to a cross section of docs, including specialties such as orthopedics, who have been in practice for say 10 years. PAs shouldn’t be held to a higher level of knowledge than their supervising physician. Give them $1,000.00,or even $2,000.00 each to go to a test center and take the PANRE, obviously not for credit but to help establish a baseline to measure PAs. Offer 4-5 hours CMEs to boot. NCCPA could agree to keep their scores confidential and not affect their legal status or practice in any way. It’s a test to measure the exam, not the test takers. Take 10-20 docs a year. The PANRE exam, as it sits now, it is doing far more harm than good.

[MMiller]

Has anyone found out what the current pass rate is?

[KCMA79]

I called NCCPA and asked for the pass rate on the PANRE prior to Jun and after Jun. They refused to tell me and told me to write a letter. I wrote the letter and received a form letter telling me how they scored the test but no ans. to my original question.

 

I feel there is a glitch somewhere in the system whether it is with Prevue and the way they transmit the info to NCCPA, the test questions themselves on one particular form of the test or whatever, but NCCPA appears to be stonewalling and not forhcoming with any information.

[GeneValgene]

what concerns me about this is folks who passed pance no problem and panre several times and recently failed...what's up with that....

 

smells fishy

[crosby1]

good luck trying to get information of any kind from the nccpa. they are extremely tight-lipped about anything related to the PANCE and PANRE. they won't release pass/fail numbers, or stats of any kind.

 

this organization is NOT out to help our profession in any way, shape, or form.

 

they are out to continue to make millions of dollars a year from PA's.

 

they answer to NO ONE, and there-in lies the problem.

 

and if anybody is interested, there are states where you can practice without having to sit for and pass the PANRE every 6 years. this is from the aapa. it's about the only useful thing i've seen from this organization:

 

http://www.saaapa.aapa.org/images/stories/Advocacy-state-summaries/Requirements_for_Licensure.pdf

[LIPPER]

I wonder if there are any trolls on this board, claiming to be PA's who have failed and are railing against the system.

 

If this board is representative of the quantity of those who have not passed (given overall membership on the board with the relatively few here who have claimed to have failed).... and If one takes a good look at the scoring breakdown of PANRE/PANCE...I would argue that things may actually be in line.

 

The exam is described as a generalist exam. That objective is clearly stated. The NCCPA practice exams correlate well with the actual test. I can recall but ONE obscure and irrelevant question on my PANRE (related to genetics). Missing a minor # of zebra-type questions should not induce failure.

 

Lastly. Why exactly did those (like me) wait until the 6th year to recert?... $350 is a drop in the bucket compared to the potential lost income of losing certification/job status.

[KCMA79]

No troll here. I graduated from KCMA in '79. Passed the PANCE the first time around and and all subsequent PANREs.

 

I don't need the C to work where I do but have always maintained it for my personal satisfaction. As far as knowing the pass rate I guess we will never know if NCCPA doesn't change their policy and will just have to rely on anecdotal evidence and opinion and you know what they say about opinion.

 

I took both NCCPA practice exams and was in the green in all areas so I'm not sure how well they correlate. There are apparently various forms of the PANRE. You might not have taken the same form I did. On mine there was a single question on genetics while others on here have said they had mult questions on genetics. I had an infectious disease question that dealt with a disease that CDC says <50 cases/yr are reported in the US, hardly a generalist question, so maybe a better correlation might be how well people scored on various forms of the current PANRE.

 

In going back through the various threads most of the complaints re: the PANRE have come since the change in June. What changed, if anything, other than the number of questions? NCCPA isn't talking. People who have failed since have reported not just failing by a few points but have failed with scores of 200 or slightly above. This from people that have passed mult. PANREs with no probs. In my case, my score dropped 52% from my last PANRE in spite of a good study program and good results on both of the NCCPA practice exams and practice exams in the AAPA approved review book.

 

I think many of us took it in the 6th yr because having passed mult. PANREs we didn't expect any problems since we felt prepared based on past experience. Sorry you think we are trolls.

[crosby1]

yup. agreed...no troll here either. i''m not sure why anybody would be trolling in here anyway.

 

i graduated in 1986 and have passed every exam since then with minimal study. all of a sudden, the exam changes somehow and i don't pass. and just FYI, i'm in my 5th year. took it once; will take it again in dec, and then again twice next year if i have to. $1400 for the privilege of taking an exam we should never have to take in the first place. yes, it's a drop in the bucket compared to the potential lost income; but that's $1400 i really don't want going to line the nccpa's pockets.

 

kcma, you're lucky you don't need the "C" where you work...what state is that if you don't mind me asking? i might need to move there at some point in the next year :;-D:

 

right now i'm doing some USMLE step 2 studying along with video lectures on my weak subjects. i'll also probably order the UNJMD review course DVD's. qbanks on exam master and paeasy.com and hopefully i'll be able to pass next time.

 

BEWARE THE TROLLS!!!!!!!!

[KCMA79]

crosby1,

 

California

[dm123]

No troll here either. Univ of Florida, class of '81 and have NCCPA cert #. Happy to provide proof for anyone in doubt. Besides, what difference does it make. A bad test is a bad test. LIPPER, are you a troll from NCCPA? You seem to be trying to twist everything in their favor.

[LIPPER]

Dont think anyone in particular is a troll. I believe there needs to be much more transparency from NCCPA. I also believe that the exam should be more focused to one's own specialty, not a generalist exam, though I do feel we (field/experienced PA's) should be scored/tested on a higher level than a new grad.

 

I understand the NCCPA's reasoning for not revealing scoring/results regarding specific questions; with only a fixed # of questions and so many test takers, it would compromise future exam results. It's sort of a Fort Knox situation...You just have to trust the gold is really in there.

[dm123]

Don’t think anyone in particular is a troll. I believe there needs to be much more transparency from NCCPA. I also believe that the exam should be more focused to one's own specialty, not a generalist exam, --Good points. I think most would agree-- though I do feel we (field/experienced PA's) should be scored/tested on a higher level than a new grad. --Why??

 

I understand the NCCPA's reasoning for not revealing scoring/results regarding specific questions; with only a fixed # of questions and so many test takers, it would compromise future exam results. --This is a given.-- It's sort of a Fort Knox situation...You just have to trust the gold is really in there. --Don’t agree. Trust but verify. Verification can be done without compromising the exam. What I don’t understand is the refusal by NCCPA to means test the exam, preferably by an outside source, and refusal of an outside monitor to verify applicability to competence. The “C” was originally intended to be a minimum standard, not an elitist standard like the military equivalent of a Navy Seal. The “C” was originally designed to give prospective employers confidence that a PA, especially those without experience, has basic knowledge strong enough, with supervision, to learn more and practice medicine as delegated by your supervising physician. Back in the late ‘70s and early ‘80s, PAs were a rare unknown and needed a bit of boost in credibility and the “C” helped in this regard. Now, the requirements have gotten completely out of hand, serving not the PA community, but NCCPA. I keep referring to other healthcare providers. RNs don’t revert back to GNs if they don’t recertify. NPs don’t, most non-specialty MDs don’t. What makes PAs so unique in medicine that they have to be held to a higher standard? When multiple PAs who have been working for 10-20 or more years fail what is called a proficiency exam, something is terribly wrong.

[crosby1]

crosby1,

 

California

 

california, here i come!!!