PANRE vs PANRE-LA: Which Exam Should You Take?

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If you are a PA due to recertify in 2027, you now have multiple options for completing your NCCPA recertification. Before this year, we only had one option for PA recertification: the high-stakes PANRE recertification exam, taken every 9–10 years. Now, we have an additional, flexible option that began earlier in 2023: the new PANRE-LA.

So, which exam should you take? Here’s everything you need to know about the PANRE vs PANRE-LA, including similarities, differences, and how to prepare.

Originally published July 2022

Updated October 2023

What is the PANRE-LA?

The Physician Assistant National Recertifying Examination-Longitudinal Assessment (PANRE-LA) was developed after the successful two-year Pilot Alternative to the PANRE. The PANRE-LA provides the flexibility to recertify on your own time and aims to promote retention, identify and assess knowledge gaps in core medical content, and alleviate test anxiety associated with high-stakes exams.

The PANRE-LA is an asynchronous exam that can span up to 12 quarters, with the next cycle starting January 2024 and ending December 2026. During each quarter, PAs gain access to 25 questions with 5 minutes allotted to each question. You can complete the questions at any point during the quarter and use any device connected to the Internet, but questions do not need to be completed all in one sitting. Additionally, you can decide to skip a quarter altogether (up to four quarters total), allowing for greater convenience than the traditional testing method.

How do PANRE-LA questions differ from the PANRE?

One major difference between the PANRE vs PANRE-LA is that the PANRE-LA is open book, so you can use any outside reference materials to identify the correct answer. This is in stark contrast to the traditional PANRE, which has a 60-second per question time limit and is strictly closed book.

Before you begin a set of questions, you can also preview the question topics and whether any images or other media are included. This allows you to defer questions to optimize device usage (e.g., to view an electrocardiogram on a larger screen) and review material in advance.

Additionally, you’ll receive feedback immediately after answering a question correctly or incorrectly. This includes a rationale that explains why the correct answer is the best response and why the other options are incorrect. You can also refer to references in case you’d like to read more about the question content.

In future quarters, the PANRE-LA will include questions from topics you previously answered incorrectly. This method customizes the recertification process by identifying and addressing your unique knowledge gaps throughout the course of the exam.

How long is the PANRE-LA, and how is it scored?

The PANRE-LA is a longitudinal exam administered on a quarterly basis over a three-year period. Its flexible testing allows you to complete questions at your own convenience during at least eight quarters over the span of three years.

Scoring is based on eight quarters, which means you could finish the exam in two years (as early as December 2025 for this upcoming cycle) if you don’t skip a quarter. This gives PAs flexibility from quarter to quarter, allowing the option to skip an entire quarter of questions without impacting your overall score. However, you must participate in a minimum of at least one quarter in each of the two years (for example, at least one quarter in 2024 and at least one quarter in 2025). PAs that do not meet this minimum requirement will be removed from the program.

If you don’t achieve a passing score after the first eight quarters, you can continue to complete questions through the remaining quarters. The best-performing eight quarters will then be used to calculate the score. If you don’t obtain a passing score by the end of the cycle (December 2025 for the upcoming cycle), then you still have the option to take the traditional PANRE.

If you’re looking for a “one-and-done” option where you test once and then forget about it for another 10 years, the PANRE-LA may not be for you. The traditional PANRE requires only one day of test-taking, so you’ll take all 240 questions over the span of four hours. Although, it’s important to note that this does not take into account the time it takes to prepare for the exam.

When do I need to sign up?

PAs in the sixth year of their certification cycle will be able to apply for the PANRE-LA and start the longitudinal exam the following year. So, PAs recertifying in 2027 who wish to take the PANRE-LA must sign up on the NCCPA website by November 30, 2023. Those who miss this deadline will need to take the traditional PANRE.

For a more comprehensive timeline for the upcoming cycle, check out this infographic from the NCCPA:

PAs can apply for the traditional PANRE in the ninth or tenth year of the certification cycle. After submitting the application, PAs have a 180-day window to take their exam.

How do I study for the PANRE vs PANRE-LA?

Both the standard PANRE and the PANRE-LA follow the same NCCPA content blueprint, which ranks topics by the level of expected performance for a specific topic, with history and physical being the simplest level assessed and complex interventions being the most thorough.

One study option for the PANRE-LA is the Rosh Review PANRE-LA Qbank, which you can use to prepare for the quarterly PANRE-LA question sets or specific content areas after previewing upcoming topics. Additionally, you can use your Qbank as a reference during the actual exam (see demo below):

If you’re looking at the traditional recertification route, you can use the Rosh Review PANRE Qbank and study with thousands of practice questions (including a Pass Guarantee) that gives you the tools to tackle all 240 questions on the exam. You can find other study options below in this blog post about PANRE Qbanks.

What happens if I fail?

If you don’t achieve a passing score on the PANRE-LA, you will have to complete the traditional PANRE. There are no PANRE-LA retake options at this time.

You have three attempts to pass the PANRE after taking the PANRE-LA. Recertifying PAs must wait at least 90 days between traditional PANRE attempts.

Can I earn CME by taking either exam?

The PANRE-LA option awards (2) Category 1 Self-Assessment CME credits for each quarter as long as you complete all 25 questions. You can also earn Category 2 CME credits for hours you spend studying for the traditional PANRE.

For either exam, you can earn Category 1 CME credits when you purchase a Qbank that includes CME credits.

So, which exam should I take?

Ultimately, the exam you choose depends upon the timing of your recertification cycle and your test preferences. You may choose to take the new PANRE-LA if you want to avoid the stress of an all-or-nothing exam or don’t have much time to devote to board review classes and hours of studying. In contrast, you may choose the traditional PANRE if you prefer to take the exam in a physical location or perform better on high-stakes exams that you can complete in one sitting.

Here’s a breakdown of the important factors to consider between the PANRE vs PANRE-LA when making your final decision:

	PANRE	PANRE-LA
Cost	$350	$350
Location	Pearson VUE Test Center	Anywhere with a reliable Internet connection
Time in Recertification Cycle	9th or 10th year	Start in 7th year and finish in 8th or 9th year
Exam Structure	Synchronous	Asynchronous
Number of Questions	240	25 per quarter 200 per 8 quarters 300 per 12 quarters
Exam Length	4 hours of testing 5 hours with breaks and tutorials *Extended time per question accommodations available	8-12 quarters total (spans 2-3 years) Up to 5 minutes per question Up to 125 minutes per quarter *Extended time per question accommodations available
Ability to Preview Topics	No	Yes
Outside Materials and References	Not allowed	Allowed
Content Blueprint Available	Yes	Yes
Option for Regaining Certification	Yes	No
Option to Retake Exam	Yes	No
CME Available	Category 2 credits for time studying	(2) Category 1 credits for each quarter in which you complete 25 questions

PANRE vs PANRE-LA

Interested in joining a live course for accelerated review? Look no further—the 4-day Rosh Review PANRE 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 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

Jenn Comini, PA-C, is a physician assistant educator in Los Angeles. After receiving a bachelor’s in behavioral neuroscience from Northeastern University, Jenn completed her MS in Physician Assistant Studies at the Pace University-Lenox Hill Hospital PA Program. She has worked clinically in urgent care and neurology, with a special interest in headache disorders, neuroimmunology, and mental health. She now works as an Assistant Professor at a PA program. Jenn has been a question author for Rosh Review since 2017. When not lecturing or writing questions, Jenn is often spending time with her rescue dogs and doing yoga.