My Picmonic PANRE/PANCE Study Plan

Brought to you by Picmonic. Affiliate links are provided. 

Fun fact - to become a physician assistant (PA), you not only have to successfully complete both the didactic and clinical portions of the program, but you also have to pass an exam at the end called the PANCE - Physician Assistant National Certifying Exam. And yes, we pronounce it “pants.”

To continue to be a PA, every 10 years you must take a recertification exam called the PANRE, and although many PAs specialize, this is a general test. For PAs like myself who have only ever worked in a specialty, this is a bit daunting. Since I am in my 8th year as a PA, it’s time to start studying and brushing up on the other 96% of medicine I’ll be tested on outside of dermatology! That’s where Picmonic comes in to save the day.

When I was in PA school, I adopted a mindset early on during the didactic portion that I was studying for not only the end of subject test, but also boards, the entire time. Once I figured out the resources that worked best for me, I stuck to those throughout the program. I’m a note-taker by nature and need a way to put together the information I’m seeing and hearing to apply it to real-life situations. This happens on rotations, but how can you learn that same way before being thrown into the real world?

Visual tools that combine memory devices with application, like Picmonic, are great resources that weren’t available when I was in school. Now that I have to start over, I’m so grateful I can use Picmonic in my studying for the PANRE and I’ve seen how it would have been such a great supplement to the death by PowerPoints we sat through for 8 hours a day. Here’s my approach for studying using Picmonic.

The PANCE/PANRE is made up of 14 subject areas in the PANCE Blueprint that are each assigned a percentage. Dermatology is a whopping 5% compared to the cardiovascular system at 13%. 

Luckily, Picmonic is organized into the same categories with the main subjects broken down into digestible bite-size videos. From a broad perspective, Picmonic is an audiovisual learning system with unforgettable stories and characters to help you remember everything you need to know for school. The quick little anecdotes stick with you throughout clinical rotations and tests as a long-term memory retention tool. If you’re anything like me, finding little connections and different word similarities to remember quick facts helps so much with recall on test day.

Click here to sign up and be sure to use code THEPAPLATFORM!  

Your Next Steps After Graduation

Once you graduate, all you have to do is pass the PANCE right? Everything else is self-explanatory, isn’t it? Unfortunately, it is not. The focus of your program has likely been on the PANCE and understandably so. Schools are ranked on their pass rates, so they are very invested in your success on this test. However, that is merely the start of your career. There are many more steps to come, much of which are not straight forward. By being aware of the next steps you can minimize the time it takes before you start your new career and get your first paycheck (here is an article on what to actually do with that paycheck). So, what are these next steps?

First off, make sure you have plenty of money saved.  The process from graduation to practice will add up, costing up to $2,000. I don’t have to tell you that nothing about becoming a PA is cheap. Be sure you save all your receipts so you can submit them for a potential refund from your new employer (this should be brought up in the negotiation process of your contract). Any money you saved that is not needed can be thrown at your student loans! Let the payback begin!

After you pass the PANCE (congratulations by the way!) you need to apply for your PA license in the state in which you will be practicing.  Each state has their own website and process for this, so be sure to look into your own state ahead of time. Do not wait until you have your PANCE results to prepare. Have a game plan so you can get you application in as quickly as possible. The timeline and cost for this will also vary state by state. My experience (the state of Colorado) was a cost of under $300 and a 3-week wait. Other states can be more expensive and have longer waits. Because of this, you want to ideally have your application submitted the same day you received your passing PANCE results. Save the celebrations for the evening (but then go HARD in the paint. You deserve it!)

Once you have your PA license you can apply for your DEA license (so you can prescribe controlled substances) and your NPI (National Provider Identifier). You can apply for these at the same time. The NPI application is free and has a very quick turnaround of a week or less. This is not the case with a DEA license.  This will cost you a whopping $731. This is one that is definitely worth getting your employer to refund you for. The process typically takes 1-2 weeks to get your approval and DEA number. Some employers may not initially require this, but I recommend everyone obtain a DEA as prescribing controlled substances is well within the scope of PA practice. Plus, not having this may be a negative for a potential new employer in the future. 

If you are in an office-based private practice, this may be the end of your licensing journey and you can finally start practicing as a full-fledged PA! If you have any involvement with a hospital, whether in the ER, specialist consultant, or as a surgical PA, you will need to get credentialed with any hospital you are going to work at. If you thought the previous steps were slow, you’re in for a surprise. The credentialing process with a hospital will often take around 3 months! This will entail copious amounts of paperwork and a lot of back and forth with the credentialing department. To help speed up the process there are a number of documents that you should have ready ahead of time.  These include:

• Your new PA license

• Resume or Curriculum Vitae

• Vaccinations included updated PPD

• Passport or Birth Certificate

• Undergrad and PA degrees

• Reference list- they may need to fill out a reference the hospital will send to them

Have these on hand to quickly provide if a hospital requests them. 

These various processes can be overwhelming, especially when all you want to do is start your new job. Stay organized and think ahead. The first few steps are all up to you, but once you get to credentialing, you will have additional guidance. You may be able to shadow in an office setting, but you will not be able to step foot in the hospital or OR until your credentialling is completed! 

We all just want a minute to relax after school is over, but don’t worry, you will have plenty of time for that. Stay on top of your game for another couple months and save yourself the hardship of delayed employment or running out of money as you wait to start your new job. Congratulations on all your achievements and welcome to the world of PA-C!

Thank you so much to Savanna and The PA Platform for this opportunity. If this article was helpful to you and you would like more guidance on things like job hunting, contracts, retirement accounts, or choosing a specialty, head over to www.panextsteps.com to get my guide on what to do after physician assistant school.  

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PANCE Blueprint Breakdown: Normal Physiology of the Heart

Jamie's back with a very basic overview of normal heart anatomy and physiology to serve as the basis for pathology like cardiac murmurs, hypertension and heart failure. Check out her video, and you can get the notes and powerpoint below. If you're viewing this as an email, here's a link to the video. 

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Guest Post from Jamie: How to Prepare for End of Rotation (EOR) Exams for PA School

Jamie has been a huge contributor to the Pre-PA section of The PA Platform, but now she's giving us some tips on PA school with this post and through the PANCE Blueprint Breakdown video series. This is a very thorough post, which should help immensely with your study plans for EORs. Some of the Amazon links are affiliate links, which means Jamie gets a small percentage if you take her recommendations. 

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Hello all, it’s so nice to have you all reading my words again!

First and foremost: if you haven’t already visited Dose of PA’s blog about clinical rotations and end of rotation (EOR) exams, I suggest you start there. Now you’re probably wondering, “Okay Jamie, you’re just going to send us to Paul’s blog? Why do I even need you? I can Google that.” That’s fair, but my man Paul’s blog was last updated August 2016. As you know, we are in 2018. That means there are roughly two years worth of updates to share with you here. So read the above and then we’ll catch up together!

Now most importantly, there have been updates to PAEA’s exam content. The core end of rotation (EOR) exams are still the same: emergency medicine, family medicine, general surgery, internal medicine, pediatrics, psychiatry & behavioral health, and women’s health. The blueprints and topic lists can be found here. A blueprint is the exam breakdown – it tells you the subtopics (e.g. cardiology, gastrointestinal) and what percentage of the exam that topic takes up. The topic list is self-explanatory; it’s the topics covered on the exam – an outline of every disorder/disease covered. With these tools, there is some strategy when it comes to studying for these exams.

Your primary focus should be to study the most high-yield information. For most of these exams, that means cardiology, pulmonology, and orthopedics (which mimics the physician assistant national certification exam (PANCE) as well). One notable exception is surgery which focuses 50% on gastrointestinal. Using this information to your advantage, you know that by studying GI for surg, you’re ready for half the exam.

In my opinion, the best way to do this is to cover the details of each item on the topic list in whatever method works for you. I always suggest podcasts for passive studying (car rides, cleaning, taking a walk) and outlines or flashcards for active studying. I cover the presentation, diagnostic testing/imaging needed, treatment, and “misc notes” which is typically epidemiology and occasionally pathophysiology. I’ve found that knowing the epidemiology is helpful to recognize a case study based on the patient’s profile – it can help you narrow the diagnosis by considering the question is about a middle-aged man, for example, or a post-menopausal woman. Otherwise, the best bang for your buck is signs and symptoms (buzzwords), labs, imaging, and treatment. You don’t need to stress about second-line, third-line treatments. Don’t spend three days trying to understand idiopathic thrombocytopenic purpura when it’s only 1 topic out of 10 in the hematology category and hematology is only 3% of the exam! This again goes back to strategy.

There are many different podcasts available which I like to listen to on my commutes; I made playlists ahead of time to lump high-yield topics together so they’d auto-play on my rides. For most rotations, that was Brian Wallace’s Physician Assistant Exam Review Podcast. I like to edit his MP3s in iTunes to have the tracks auto-start after the 3-5 minutes of “updates” regarding his other activities (book and website stuff) – because frankly, I don’t care about that stuff. For emergency medicine, I listened to EM Basic Podcast by Steve Carroll, DO, which is actually geared toward clerkship and residency for medical students/physicians. He frequently has guest lecturers and sometimes that person is a PA-C which is awesome. His episodes feature commonly seen ER complaints (and can be sped up and understood at 1.5 speed). 

There are several books I bounce between to study from; I shared most of these in my guest blog “Clinical Medicine Study Tips." 

To understand the pathology:

• Current Medical Diagnosis and Treatment 
• Clinical Pathophysiology Made Ridiculously Simple

For buzzwords/pearls/mnemonics: 

• PANCE Prep Pearls 
• Step Up to Medicine 

Lastly, SmartyPANCE (by The PA Life) is becoming more and more worth the membership cost. Not only are there tons of topics, flashcards, videos, and practice questions, there is an all new section for EOREs. He is slowly, but surely, adding practice exams for the end of rotation exams. So far this includes surgery, women’s health, emergency medicine, pediatrics, and family medicine. Trust me when I say these are VERY reflective of the PAEA EOR Exams. Sometimes it seems like the questions might even come from the same bank, if you catch my drift. These are an awesome way to spend your last week of the rotation. Study throughout, take the practice test, and go to your exam feeling confident and ready. If you’re more into printed pages and physical books, there is a decent PANCE question book by Lange (Lange Q&A Physician Assistant Examination) as well as a question book by Dwayne Williams, the author of PANCE Prep Pearls (PANCE PANRE Question Book). Lange is split up by topic (cardiology, GI, pulm, etc.) while the PPP companion is more general PANCE practice questions. 

I think that about covers it; end of rotation exams are a good way to prepare you for the PANCE so learning some strategy to study for them is an important piece of PA school. Best of luck studying and enjoy your clinical rotations!

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Introducing the PANCE Blueprint Breakdown Video Series

We're so excited at The PA Platform to introduce a new study tool for PA students. Jamie Murawski is a current PA student at Detroit Mercy, and she will be facilitating a series of YouTube videos as she prepares to take the PANCE this fall. 

For the first video, here is an introduction and general overview of the PANCE and what will be included in these videos. 

General PANCE information, how to navigate the NCCPA's website, and where to find a sample study schedule. - Thanks so much for watching!

Momentum Chrome Plug-In
NCCPA PANCE Blueprint PDF
NCCPA PANCE by Organ Systems
NCCPA PANCE Task Areas:
NCCPA FAQ

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PANCE/PANRE Review Course - The Resource You Need to Pass Boards!

From the first day of PA school, you are fully aware that boards will be necessary at the end to practice as a Physician Assistant.  Although some people wait until after school to buckle down and study exclusively for the PANCE, I think it's best to start studying from day 1.  All of the tests during didactic year and clinical year are important, but that last test is the MOST important.  

I'm really excited to be able to share an awesome resource when it comes to studying for the PANCE - the PANCE/PANRE Study Guide and Review Course. There are so many aspects to this that will be helpful to every kind of learner.

The Study Guide - When studying for this all important test, you want to make the most of your time and focus on high yield material. The Study Guide is a 109 page PDF that focuses on everything you need to know. It's short and sweet, and to the point. It's essential that you are able to recognize buzzwords and match them with diagnosis, imaging, or treatment. For example sausage mass on palpation in a pediatric patient should automatically make you think of intussusception. This is the resource you need to focus your brain on what you NEED to know. If you just want the guide, you can download the study guide for 9.99.

Online Content - For the review program , you log in, and are able to access a ton of content. The course is organized based on the NCCPA Blueprint, so again, the focus is everything you actually need to know. In each section, you'll find an introductory video, the NCCPA Blueprint information for that section, the percentage it is on the PANCE, an audio review section, the PANCE Study Guide for that section, quizzes, flash cards, and more review material. Basically, there's a little bit of everything and the material is reviewed in multiple ways.

Quizzes - There are different options available when it comes to the quizzes.  There are basic ones that just ask pretty straightforward questions and some situational ones, and then there are buzzword matching ones.  Practicing actual questions is the best thing you can do because you are testing your understanding and knowledge.  Knowing buzzwords for the PANCE is also necessary.  Like other standardized tests, there is strategy involved, not just knowledge.   I was reminded just how much I don't remember from school after taking just 2 quizzes.  

So why should you invest in this review course?  Well, if you don't pass your boards, you get a full refund.  That's a pretty bold promise.  There's a free trial available that still has a ton of valuable knowledge, so you can try it and see if it would work for you.  For lifetime access, it's $199 (and there's a discount below!), and you get access to so much knowledge.  And that means you can start it the day you start school and use it throughout your program.  This is a resource that I will use to stay up to date on the material I need to know and I plan on using it when I have to recert.  The creators have worked really hard to make this an all-inclusive study guide, and I think they have succeeded.  

I think if I was using this today to study, I would do a practice quiz, then read through the study material, listen to the audio review, and then take more quizzes.  It's basically everything I did to prepare for PANCE 2 years ago, just in one source instead of multiple books.  

If you are interested in checking out the study guide or review course here is a coupon code that will get you 15% off of your purchase!! - thepaplatform15

I was provided access to the course and a copy of the study guide for free, but my thoughts are completely my own!  

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My Favorite Books to get through PA School

If your program is anything like mine, they will give you recommended books or resources for each section.  While a few of these were helpful, there were other books that I used during the entire didactic and clinical years, and I don't think I would have made it without knowing where to find the information I needed.  The internet is a great resource, but I love being able to flip through a book and highlight and make notes too.  Here are some of my favorite books, and make sure to comment below with anything you think I left off! This post contains some Amazon affiliate links. 

A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants - This was my main PANCE study book, but I used it all year long.  It is based off of the NCCPA Blueprints for the PANCE exam and goes through every single section with the main ideas that are important for PA school.  I would always read through the related section the morning before a test just for a refresher.  My only complaint about this book is that the medications are not always specific in the treatment section, and I could use a little more info there.  

Step Up to Medicine - While this book is technically for medical school, it's great for studying all of the basics of PA school, especially all of the Internal Medicine topics.  It's split up really well and easy to read.  This book fills in what the PANCE review book leaves out, and I wish I had known about it for more of didactic year, but it's great for clinical year too.  

Pocket Medicine - This is a pocket reference for your white coat that I actually didn't have, but I wish I knew about it.  My husband currently uses this book on his medical school rotations, and it's really cool.  It has all of the current recommendations for Internal Medicine subjects, and also all of the articles that the recommendations are based on, so it's truly evidence-based.  If you're in an academic center, the attendings love it when you can reference an important study.  There's a Pediatric version as well.  

Maxwell Pocket Reference - This is another book you should have in your white coat.  It's really small, and for $5 it comes in handy.  This little book has outlines for different types of notes in the hospital, ACLS codes, physical exam and history, and all kinds of other important topics.  Unless they've stopped, if you join the AAPA as a student, they will send you a copy of this.  

Lange Smart Charts for Pharmacology - This was my go-to for pharmacology, aka the worst class of PA school.  It's just so hard until you're actually seeing these drugs on rotations or practicing .  This book is a flip chart of all the drugs separated by class with everything you want to know, including brand name, mechanism of action, side effects, and contraindications.  I love a good chart, and these made studying so much easier.  

Bate's Physical Examination - This is basically the go-to book for learning how to do a proper physical exam.  It was required by my program, and my husband used it as a reference in medical school too even though it was never recommended.  There's pictures and great explanations for any part of the physical exam that you can imagine.  And there's even a pocket version as well.  

Lange Q&A Book - This was my main book for practice questions.  Doing questions and attempting to apply the knowledge I'm trying to learn has always been the best way for me to evaluate where I'm at.  I used this book during the clinical year and studying for the PANCE, but I wish I had it for didactic year as well.  The questions cover all subjects, and have awesome in-depth explanations.  

Tarascon Pocket Pharmacopoeia 2015 - Shirt version and White coat version - This is another reference book you can use on rotations.  I know you have Epocrates on your smart phone, but I liked having this book as well.  It's really easy to find what you're looking for and they update it every year.  

Basic Concepts in Pharmacology - This is a small book, and it has really short and straightforward chapters about different drug classes.  I liked to read the relevant sections before Pharm tests as just a quick overview.  I probably just need to read this book every month to retain some of the knowledge from PA school.  Sometimes it feels like all I prescribe are topical steroids and acne medicine! 

First Aid for the USMLE Step 2 CS - If you have physical exam or practical examinations with standardized patients, then you need this book.  This is another one that I unfortunately did not have while in school, but it would have made my life so much easier.  I spent hours trying to come up with practice cases, and come to find out, here's a book with everything I was looking for.  There are checklists for each case, and you'll need a partner to get the most out of this book.

Pance Prep Pearls - This book had just come out when I was in study mode for PANCE, but a few of my classmates did use it, and they passed!  I've heard a lot of buzz about this book recently, and I definitely plan on using it when it comes time for me to recertify...in 8 years! 

Here is a blog post from a fellow blogger with her recommended resources, some of which are the same as the ones you will see here.  

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