Everything You Need to Know to Start Preparing for the PANRE

The Physician Assistant National Recertifying Exam has changed as we know it. If you decided you’re going to take the pilot exam, starting in the first quarter of 2019 you will be emailed 25 questions per quarter. These questions are an open resource test. You’ll have five minutes to answer each question.

I had the privilege of speaking to the CEO of the NCCPA, and one of the big concerns about the PANRE in the past was its very academic-like test writers. These are college faculty PAs who haven’t seen patients in a long time. The questions are textbook-y and very tricky. It does no good if you work in orthopedics and you’re asked a question about someone having a myocardial infarction while they have Kawasaki’s Disease.

First off, it’s clinically not something that you see. Secondly, if you are taking care of a patient with that disease process, you are going to immediately get your supervising doc and a specialist involved.

With the new curriculum, the questions have changed and the exam as a whole is going to be way more clinical.

The NCCPA said they’re going to shrink the content. When you graduate PA school, you are required to know general medical knowledge. That’s a much bigger pool of water. Now, as practicing PAs, we have to know the core knowledge, which is more focused on clinical application. The NCCPA went one step further, identifying diseases and disorders as one of three different levels: Level 1, Level 2 and Level 3.

Level 1

Level 1 diseases are the things that as PAs identify and immediately get help for. These are things like a thoracic dissection. You identify someone with ripping chest pain going to their back with neurological symptoms. You go, “Holy crap, this patient looks like they have a thoracic dissection.” It’s our job as PAs to immediately get our supervising doc. On the PANRE, this would be classified as Red or Level 1, meaning that’s all we need to know for our boards. That is fantastic, because it’s what we actually do clinically!

Level 2

If it’s a Level 2, or Yellow, bit of information, that’s something that we need to identify using signs and symptoms, physical exam findings, lab testing or diagnostic testing, and have first-line treatment for. That’s something like an unstable tachycardia or a tension in the thorax. We have to identify it, diagnose it and then at least do the initial intervention, such as synchronized cardioversion or a needle decompression.

Level 3

If it’s a Level 3 bit of information, we really need to know everything about it. Looking at exactly how the NCCPA has written up the levels, with a Level 3 disease, you need to make the appropriate diagnosis by recognizing signs, symptoms and risks and/or interpreting results of diagnostic studies. You also need to have full knowledge of first-line treatments. In addition, it’s necessary to have the knowledge required to manage well-known contraindications and complications.

When studying for your alternative PANRE, you have to be very aware of the different levels that you need to study in the disease processes. With each disease process, you have to know is it a Level 1, Level 2 or Level 3 and study accordingly. It’s a new era in physician assistant education. What the NCCPA did was fantastic for our profession. It will make us stronger clinicians, and therefore better be able to serve the patients that we take care of.

Here at CME4Life, we will have a number of resources available for you, including live conferences and downloadable study materials.