How to Create a PANCE Study Guide -

How to Create a PANCE Study Guide and Pass on the First Try

June 2, 2023
The PANCE is a rite of passage we all have to endure on the road to becoming a PA-C. The question is, with everything you have to know for the test, how do you go about creating a PANCE study guide? At times, exam prep can seem as big a mountain to climb as the exam itself! 
As with most things in life, there is no perfect way to go about it, but here are four things that will help you succeed on exam day.

1. Make a Formal PANCE Study Plan 

You’ll absolutely want to make a formal study plan for the PANCE. This will help you stay on target and organize the enormous amount of information you need to go over before the exam. If you don’t have a plan, you could miss topics, overstudy in certain areas, and make poor use of your time.

So, you’ll want to come up with a study plan—I’ll have some tips later on for how to go about doing it, but if you’re looking for a sample schedule to get you started, here’s a PANCE study schedule from Dr. Adam Rosh:

2. Start Studying for the PANCE Early 

Overall, the earlier you start preparing for the PANCE, the less stress you will (hopefully) have by the time the test comes around. Getting an early start means you won’t have to worry about cramming, and you can spend less time per day preparing. One way to get a jump on your studying is to treat your end-of-rotation exam prep as a way of getting ready for the PANCE, though you’ll want to have time set aside for specific PANCE prep outside of this.

I started seriously studying for the PANCE about 6 months out as I was entering my final semester of PA school. This period of time included a month-long break for the holidays, and the ~2 weeks after my last clinical. I think this timeline worked well, and I see it often recommended by others. 

Of course, there is no perfect timeline. If you feel like you need more time, then you should start studying earlier. Realistically, when you reach the end of the didactic portion of your studies, you have everything you need to start getting ready. 

If you find yourself just now thinking about starting to study and you are less than 6 months out from the exam, don’t freak out! You’ll just want to devote more time per day to studying. Remember, if you are feeling overwhelmed and unprepared as you approach your test date, you can always reschedule it up to one day prior to the exam without penalty.

3. Create a PANCE Study Guide

Any study guide you create will have a lot to do with your timeline. The key is to make sure you are allowing yourself time to review all of the topics, so nothing is missed, and to make sure every time you sit down to study you have a plan of what you want to review.

Use the PANCE Content Blueprint

The best way to get started on a study guide is to look at the PANCE content blueprint. This is an excellent resource provided by the NCCPA that goes over the different topics that are tested on the PANCE. It also breaks down the exam content by percentages. For example, cardiovascular is the largest topic on the PANCE, and it makes up 13% of the exam. The PANCE content blueprint also breaks down each system into specific topics that could be covered.

Schedule Your Topics

After you check out the PANCE content blueprint, you’ll need to look at your timeline to see how the two should align. For example, if you find yourself studying ~6 months before the exam, I would recommend dividing topics into what you want to cover per month. Personally, I would recommend starting out with your more challenging topics rather than saving them for the end. 

Here is a brief example of what a study guide might look like: 

Month 1: Cardiology (13%) + Dermatology (5%) = 18%
Month 2: Pulmonology (10%) + Neurology (7%) = 17%
Month 3: Hematology (5%) + Infectious Disease (6%) + Musculoskeletal (8%) = 19%
Month 4: Renal (5%) + Reproductive System (7%) + GU (5%) = 17% 
Month 5: Endocrine (7%) + GI (9%) = 16%
Month 6: (before the exam): EENT (7%) + Psych (6%) = 13%

Now, this is just an example—yours will be different! However, I recommend trying to pair certain topics with various clinical rotations you have. For example, a general surgery clinical rotation is often a great time to study GI, whereas cardiology is a good topic to pair with any internal medicine rotation. The main thing I want you to get from this is that you need to space out the topics so they each get the attention they require. 

I also highly recommend using your last month to review “lighter” topics, as you’ll want to pair this last month of studying with high numbers of practice questions and practice exams. Stimulating a testing environment is extremely important to help you be prepared on exam day. I utilized Rosh Review as my question bank. The NCCPA also has two practice exams you can purchase.

Once you have generalized systems assigned to each month, you can further break down (by weeks and days) specific portions of the blueprint. Make this work within the context of your overall schedule. You know your availability, which will undoubtedly vary with your clinical rotation schedule, program requirements, end-of-rotation exams, and other life events.

Struggling to remember key topics during your PANCE prep? Download our FREE study sheet with mnemonics that our PA instructors use during our live PANCE/PANRE review course!

Allow Flexibility to Fall Behind

The key here is to include weekly “make-up” time in your schedule, so you can catch up on things when you inevitably do fall behind in your study schedule. If you don’t do this, you will keep falling behind and cause yourself a lot of stress. I typically used Sundays as my “catch-up” days to finish up any loose ends for the week. I wouldn’t have any other scheduled topics on these days, that way if I was done early I would just utilize the free time!

Pro tip: If you’re looking for a PANCE study planner that automatically rebalances your schedule using your prep resources so that you can stay on track even when you fall behind, check out this “smart” PANCE study planner resource (and try it for free)!

4. Use PANCE Practice Questions 

While I stressed the importance of practice questions in that last month of studying, I actually highly recommend incorporating time for PANCE practice questions throughout the studying process. In my opinion, these questions should not be tailored to a specific system while you are studying for the PANCE. You should keep the questions generalized throughout. That way, you are reviewing all topics as you go. The PANCE is not divided into topics, so you should not have study questions presented that way. 

With resources such as Rosh Review, you can identify any areas of “weakness” you have by seeing what questions you are having trouble with. This can help you determine where you should be spending your time. I often find that students seem to try and over-study areas they are comfortable with. Make sure you are spending the most time on topics that make you uncomfortable, as that is where you have the most room to grow!


While there is no one way to prepare for the PANCE, these tips will no doubt help you be ready for the big day. If you make a formal study plan, start early, create a study guide, and utilize practice questions through your exam prep, you’ll be on your way to success. We’re here to help you prepare for the PANCE, so you can ace it and start life as a PA!

Interested in joining a live course for accelerated review? Look no further—the 4-day Rosh Review PANCE Review Course is now open for enrollment to help you pass the exam on the first take!

Rosh Review is the leading Qbank provider for PA programs across the United States. Whether you’re a pre-PA student or PA-C, Rosh Review has something for you along your PA journey. Start a free trial today!

By Olivia Graham, PA-C

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