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Encouragement for anyone who has failed PANCE or struggling as a student

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I just wanted to share my story as a means of encouragement for any student who has not done as well in their PA program as they had hoped and for anyone who has had a failed attempt on the PANCE. Long post, but I think worth your time...

I took the PANCE for the first time after graduating in May of this year and failed by 50 points. I obviously was very disappointed and felt down and deflated for weeks. Throughout the program I attended, I managed to do OK and came out with a decent GPA, but in reality I was probably in the bottom 1/3 of my class in knowledge base (I thrived in clinicals...likely due to work ethic, bedside manner, and the ability to focus in and be a fast learner in the medicine of whichever rotation I was on...)

I took my PANCE again exactly 3 months from my original exam and passed with a score of 421 and got between 70-75% of the questions correct, based on raw scores/ percentage breakdown in each content area. Long story short I am a PA-C!! 

These were the tools I used to prepare:

- LANGE question and answer App

- 7 old PACKRAT forms

- The book: A Comprehensive Review For the Certification and Recertification Examinations for Physician Assistants by Claire O'Connell

- HippoEd online questions 

- Rutgers Review Material (I had someone give my copies of video/audio lectures and PowerPoints). If you are going to attend an inperson review, this is the one I would attend... The lecturers shared about previous content they had seen on the PANCE which were spot on with some of my questions on PANCE. I watched the lectures over and over and took notes on printed versions of the lecture slides. I would consider my using the lectures to be CRITICAL in my passing.

-I also used various other questions I could get my hands on. 

I went to a small university for my undergraduate work where I did not take a lot of courses with muliple choice exams  as primary means of testing and was not strong at taking MC tests (which reflected in some of my struggles throughout the PA program I attended). When I began restudying, I first watched all of the lectures tailored to the blueprint to make sure and offset any knowledge base deficit I may have had first time around. Then... I took questions CONSTANTLY. Most days at least 100, and a lot of days closer to 200. I conditioned myself like it was a sport, because I knew this is my career and I am passionate about serving in medicine and without conquering this test I could not do that. I did not only want to pass, but wanted to pass by a good margin and accomplished my goal. I took harder questions (LANGE and HippoEd) and easier questions, which kept me from getting too burnt out. All in all, in the 3 months of studying I did well over 8,000 questions.

Inaddition, I got a job as a server working close to full time to put structure into my day and money in my pocket (This kept me from going stir crazy). This may not be something you need to do, but I had to make money somehow to keep living and being forced to manage my time worked in my favor. The week before my exam, I made sure to eat right and even took Melatonin for a few weeks to assure I got good rest. (First attempt I did not sleep at all the night before and barely slept all week I was so nervous). 

On test day I brought snacks for breaks to make sure I did not get hungry. I took every break offered to make sure and stay sharp and not get fatigued and at least tried to use the bathroom on each break. I felt more confident when I left than the first time taking the exam but of course the week of waiting was still Hell... 6 days later I received the news I passed. Chances are, if you suceeded in a PA program you CAN AND WILL do this. Just come up with an intense disciplined study plan and stick to it. DO NOT memorize answers to sample questions, you will not see ANY straight repeat questions and if so it will be very few and you're lucky. Make sure you understand the diseases/conditions and could answer a question from any angle (Patho/DDX/Diagnostics/Pharm and DO NOT neglect studying those physical exam findings we learned in Phys Dx class)

I want to say too, that there is nothing about my study material combo that is foolproof. But... I became confident in my knowledge base by watching review lectures over and over and I became so much better at MC questions by practicing them non-stop. Confidence is crucial on this test. On test day, it was very reassuring being confident with my answers to all the straight forward questions when the tougher questions came.

Best of luck to anyone who is discouraged or nervous,

A new graduate who was humbled and by the grace of God rose to occasion, PA-C

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Congratulations on your success!


But I'm wondering how your program let you get to the PANCE without at least knowing what all you'd have to put into it.  Can you tell us a bit more about how your program prepared you--or failed to?  You've done an admirable job at pointing out your own flaws and areas where YOU now know you needed to improve, but I would counter that by saying that any program that is evaluated based on its first time PANCE pass rate has a vested interest in identifying students likely to have problems and investing in such students, and it seems like your PA school failed to do that.  Am I right?

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Rev Ronin 


I would prefer not to mention the specific program I went to because I do not think it was their fault and the program over the past two years with close to 100 graduating only about 7 have failed. So, the program has averaged 93% the past two years. They did sit down and meet with me about my strategy for approaching PANCE but my test scores had improved since starting the program as exams became harder. I will say that on my EOR exams I was sucessful and was not having to remediate. I also was not constantly failing exams throughout my program, I just feel I could have do better than mostly B's. 


I want to say too that I believe lack of sleep, nerves, and rushing through aspects of the exam and not reading querstions correctly was a HUGE factor in my failing the first time around. There were only a handful of exams in the program that I did not pass and most were early in. I would say I may have underestimated how much test anxiety would rattle me on test day and being confident in my test taking made a world of difference.

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  • 2 months later...

Newbie ,


My story is almost like yours. But I have failed PANCE twice and this week I took my third. Please give me some advice and strategies before is to late. I felt somewhat good after I left the exam site. But it was challenging specially against the 60 seconds when there were lengthy questions. As I was returning home I felt dissapointed. In PA school I was in the bottom of the class. Sometimes I failed an exam but finally I passed the retake. My EOR were satisfactory except for psych I had to repeat. Just like you had to work, I had to do it 6 to 7 days a week 35 hours. I have to pay the rent and my bread. It was difficult. So studying was not done fully. Not to mention the marriage problems, legal issues, and love's death. Now I am struggling in passing the PANCE. I am frustated. I am feel lonely specially during this season. I feel like not sleeping because is lonely. I have nobody to talk too. All my classmates, even those that were not good students, have passed. At th beginning I had problem with the lengthy questions for 60 seconds. Now I got used them but as I read the question I get confused with the distrators and what the question is asking. For this exam I practice more questions then the previous failed exam. My questions were from old PACKRATS. My monetary resources are limited. I cannot afford the exam master. But If I am not succesful, I will work extra hours to purchase it. I dream being in a clinic helping my community, giving my relatives a better life and being able to give my son what he deserves. It is upsetting. So many dreams, but without passing that exam nothing will come a reality. Please give me an idea. My opportunities are running out. Thanks.

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