Everything to Know About the 2023 NCCPA PANRE/PANRE-LA Content Blueprint Updates

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January 13, 2023
On January 3, the first quarter of the PANRE-LA began for many recertifying PAs (myself included). Whether you’re like me, deciding on the best way to prepare for your PANRE-LA quarterly question sets, or you’re in the process of preparing for an upcoming traditional PANRE, you should direct your attention to the 2023 updates made to the NCCPA PANRE/PANRE-LA content blueprint.

Firstly, what is the NCCPA content blueprint?

The NCCPA content blueprint provides a framework for the allocation of exam questions based on specific topic categories (cardiology, dermatology, etc.). The blueprint is developed by NCCPA based on the results of practice analysis surveys sent to certified PAs. This allows PAs the opportunity to give feedback on whether a specific medical topic should be considered “core medical knowledge”—ultimately, the basis for the recertification examination. 

In addition to the percentage allocation of questions to specific topic areas, there is an expanded version of the blueprint that provides a more in-depth breakdown of specific diseases and disorders under each topic area along with the degree to which the condition may be assessed.


So, what’s different in the 2023 blueprint update compared to the 2019-2022 version?
Distribution of topics

First, the percentage allocation of questions is different between the previous blueprint and the 2023 updates. Based on feedback from PAs, topic areas either increased, decreased, or stayed the same.

This distribution is shown below:

Topic2019-2022 Blueprint2023 Blueprint
Cardiology13%12%
Dermatology6%5%
Endocrinology6%8%
Ophthalmology & Otolaryngology8%8%
Gastroenterology & Nutrition11%10%
Genitourinary5%5%
Hematology4%4%
Infectious Disease6%7%
Musculoskeletal9%8%
Neurology7%5%
Psychiatry & Behavioral Sciences5%7%
Pulmonology10%10%
Nephrology3%4%
Obstetrics & Gynecology7%5%
Emerging Topics (Legal, Ethics, DEI)N/A2%

**It should be noted that hematology was left off of the posted blueprint update for 2023, though it can still be found on the expanded version. Additionally, a new “emerging topics” area was officially added.

The expanded version of the content blueprint for 2023 includes the addition of new topics (e.g., myocarditis, dental pain/abscess, acute liver failure) and the regrouping of previous topics. For example, the 2019-2022 version listed the individual valvular disorders (e.g., mitral regurgitation, mitral valve prolapse), while in the 2023 update, all valvular disorders are now in one category. 

Performance expectation levels

The biggest change in the expanded version of the blueprint appears to be the grouping of performance expectation levels. In the 2019-2022 version of the blueprint, topics were rated as “Level 1”, “Level 2”, or “Level 3”, with each level increasing in the depth of expected knowledge.

For example, bundle branch block was categorized as a Level 1 topic, which would only require the test taker to be able to diagnose the condition and refer appropriately. Alternatively, essential hypertension was categorized as a Level 3 topic, which would require the test taker to not only make the diagnosis, but also interpret diagnostic studies, recommend first-line treatment, and demonstrate knowledge of contraindications and complications.

In the 2023 update, the levels have changed to become the following performance expectation groupings:

  • History & Physical – Recognize signs, symptoms, risk factors, and complications for a specific disease
  • Diagnosis – Make the diagnosis based on history, symptoms, risk factors, physical examination findings, and/or interpretation of diagnostic study results
  • Intervention (Basic) – Provide basic management of a disease, including when/who to refer and complications of treatment
  • Intervention (Complex) – Manage a complex disease, more severe presentations, or complications of the management

Knowledge at the “History & Physical” and “Diagnosis” level is the minimum requirement for all conditions on the blueprint, with the exception of macular degeneration and hydrocephalus, which both only require an understanding at the “History & Physical” level. 


Is there a difference between the PANRE/PANRE-LA blueprint and the PANCE blueprint?

Yes, there is! PAs that are recertifying should not use the PANCE blueprint, as there are some key differences:

  1. While similar, there are slight differences in the percentage allocation of questions on the PANCE and PANRE, most notably in the topic areas of neurology and obstetrics & gynecology.
  2. The PANCE provides a percentage allocation of questions related to task areas (e.g., most likely diagnosis, applying basic scientific concepts, using diagnostic and laboratory studies), while the PANRE blueprint does not.
  3. The PANCE has a disclaimer that up to 5% of the topics may be related to professional practice areas and up to 20% of the exam may be related to general surgery topics. This same disclaimer is not found on the PANRE/PANRE-LA blueprint.
  4. There are some differences in the included topics. For example, several pituitary disorders are listed on the PANCE topic list, but only SIADH and diabetes insipidus are found on the PANRE/PANRE-LA topic list.
  5. The PANCE blueprint does not provide a detailed level of performance expectations for each topic, while the PANRE-LA blueprint does.

So, how can I best use the content blueprint in my studying?

Certified PAs taking the PANRE-LA have the benefit of seeing the general topic area (e.g., psychiatry) of each question before deciding to move forward with the question or to skip it until later on. This feature, in conjunction with the blueprint, can aid in preparation for the exam.

PAs can see the topic area and then consult the blueprint to see what specific topics may be tested along with the performance expectation. If a PA feels uncomfortable with those topics, they may choose to skip the question, focus on reviewing specific topics from that area before proceeding with the question, or preemptively pull up resources based on the topic list to utilize while completing the question.

Additionally, certified PAs taking the traditional PANRE should use the blueprint to guide their studying. Reviewing the topic list to identify areas of strengths and weaknesses can allow the PA to prioritize areas of study and recognize the depth at which they must be comfortable with a specific medical condition.

Regardless of whether you’re on the PANRE-LA or traditional PANRE pathway, the Rosh Review PANRE/PANRE-LA Qbank is a great resource to assist you in selecting the medical categories that you need to focus on and track your performance. 

Good luck to my fellow recertifying PAs!


Rosh Review is the leading Qbank provider for PA programs across the United States. Whether you’re looking for a free trial or a PANRE/PANRE-LA Qbank, Rosh Review has something for you along your PA journey.

By Jennifer Comini, PA-C


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