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PANCE® NCCPA Content Blueprint

Last updated: December 17, 2024

Summarytoggle arrow icon

The Physician Assistant National Certifying Examination (PANCE) serves as the primary pathway for physician assistants (PAs) for licensure to entry-level practice. Administered by the National Commission on Certification of Physician Assistants (NCCPA), the PANCE evaluates the competencies of aspiring PAs. The PANCE NCCPA Content Blueprint outlines the exam content. Exam candidates are encouraged to review the exam specifications on the NCCPA® website (www.nccpa.net) [1] and access the original outline at https://www.nccpa.net/wp-content/uploads/2024/02/PANCE-Blueprint-effective-2025.pdf. [2]

AMBOSS is an independent entity with no affiliation to the PANCE® or NCCPA. The content within this article is derived from the NCCPA Content Blueprint, which is solely created and owned by the NCCPA®. AMBOSS does not claim ownership of any portions originating from the Content Blueprint. This article is provided at no cost to the public, serving as an informational resource for educators, medical students, clinicians, and other healthcare professionals. The use of the NCCPA Content Blueprint is aligned with the terms of use and guidelines established by the NCCPA. [3]

Overviewtoggle arrow icon

Content Categories

Content Categories
Percentage
Cardiovascular System 11%
Dermatologic System 4%
Endocrine System 6%
Eyes, Ears, Nose, and Throat 6%
Gastrointestinal System/Nutrition 8%
Genitourinary System 4%
Hematologic System 5%
Infectious Diseases 7%
Musculoskeletal System 8%
Neurologic System 7%
Psychiatry/Behavioral Science 7%
Pulmonary System 9%
Renal System 5%
Reproductive System 7%
Professional Practice* 6%

Task Categories

Task Categories
Percentage
History Taking and Performing Physical Examination 16%
Using Diagnostic and Laboratory Studies 10%
Formulating the Most Likely Diagnosis 18%
Managing Patients
Health Maintenance, Patient Education, and Preventive Measures 11%
Clinical Intervention 16%
Pharmaceutical Therapeutics 15%
Applying Foundational Scientific Concepts 8%
Professional Practice* 6%

*Medical content comprises 94% of the exam. All medical content questions are also coded to one of the task areas, with the exception of the Professional Practice category. Questions related to professional practice issues comprise 6% of the exam. Some questions on the exam will cover surgical topics (8% to 10%), and some will focus on conditions in pediatric patients (12% to 15%). The specific percentage allocations may vary slightly on exams.

Medical Content Categoriestoggle arrow icon

Content Categories

Content Categories
Percentage
Cardiovascular System 11%
Dermatologic System 4%
Endocrine System 6%
Eyes, Ears, Nose, and Throat 6%
Gastrointestinal System/Nutrition 8%
Genitourinary System 4%
Hematologic System 5%
Infectious Diseases 7%
Musculoskeletal System 8%
Neurologic System 7%
Psychiatry/Behavioral Science 7%
Pulmonary System 9%
Renal System 5%
Reproductive System 7%
Professional Practice* 6%

*Medical content comprises 94% of the exam. All medical content questions are also coded to one of the task areas, with the exception of the Professional Practice category. Questions related to professional practice issues comprise 6% of the exam. Some questions on the exam will cover surgical topics (8% to 10%), and some will focus on conditions in pediatric patients (12% to 15%). The specific percentage allocations may vary slightly on exams.

Cardiovascular System (11%)toggle arrow icon

Cardiomyopathy

Conduction disorders/dysrhythmias

Congenital heart disease

Coronary artery disease

Heart failure

Hypertension

Hypotension

Lipid disorders

Shock

Traumatic, infectious, and inflammatory heart conditions

Valvular disorders

  • Aortic
  • Mitral
  • Pulmonary
  • Tricuspid

Vascular disease

Dermatologic System (4%)toggle arrow icon

Acneiform eruptions

Desquamation

Diseases/disorders of the hair and nails

Envenomations and arthropod bite reactions

Infectious diseases

Keratotic disorders

Neoplasm

  • Benign
  • Malignant
  • Premalignant

Papulosquamous disorders

Pigment disorders

Skin integrity

Vascular abnormalities

Vesiculobullous disease

Other dermatologic disorders

Endocrine System (6%)toggle arrow icon

Eyes, Ears, Nose, and Throat (6%)toggle arrow icon

Eye disorders

Ear disorders

Foreign bodies of the eyes, ears, nose, and throat

Trauma to the eyes, ears, nose, and throat

Neoplasms

  • Benign
  • Malignant

Nose/sinus disorders

Oropharyngeal disorders

Other oropharyngeal disorders

Gastrointestinal System/Nutrition (8%)toggle arrow icon

Biliary disorders

Colorectal disorders

Diarrhea

Esophageal disorders

Gastric disorders

Gastrointestinal bleeding

Hepatic disorders

Hernias

Hyperemesis

Ingestion of toxic substances or foreign bodies

Metabolic disorders

Neoplasm

  • Benign
  • Malignant

Nutrition

Obesity

Pancreatic disorders

Small intestine disorders

Genitourinary System (4%)toggle arrow icon

Hematologic System (5%)toggle arrow icon

Infectious Diseases (7%)toggle arrow icon

Bacterial diseases

Fungal diseases

Mycobacterial diseases

Parasitic diseases

Perinatal transmission of disorders

Prion diseases

Sepsis/systemic inflammatory response syndrome

Spirochetal diseases

Viral diseases

Musculoskeletal System (8%)toggle arrow icon

Chest/rib disorders

Compartment syndrome

Degenerative diseases

Infectious diseases

Lower extremity disorders

Neoplasms

Rheumatologic disorders

Spinal disorders

Thoracic outlet syndrome

Upper extremity disorders

Neurologic System (7%)toggle arrow icon

Cerebrovascular disorders

Closed head injuries

Cranial nerve palsies

Encephalopathic disorders

Headaches

Infectious disorders

Movement disorders

Neoplasms

  • Benign
  • Malignant

Nerve disorders

Neurocognitive disorders

Neuromuscular disorders

Seizure disorders

Spinal cord syndromes

Psychiatry/Behavioral Science (7%)toggle arrow icon

Abuse and neglect

Anxiety disorders

Bipolar and related disorders

Depressive disorders

Disruptive, impulse-control, and conduct disorders

Dissociative disorders

Feeding and eating disorders

Human sexuality and gender dysphoria

Neurodevelopmental disorders

Obsessive-compulsive and related disorders

Personality disorders

Psychogenic nonepileptic seizure

Schizophrenia spectrum and other psychotic disorders

Sleep-wake disorders

Somatic symptom and related disorders

Substance-related and addictive disorders

Trauma- and stressor-related disorders

Pulmonary System (9%)toggle arrow icon

Renal System (5%)toggle arrow icon

Reproductive System (7%)toggle arrow icon

Breast disorders

Cervical disorders

Contraceptive methods

Human sexuality and gender identity

Infertility

Menopause

Menstrual disorders

Neoplasms of the breast and reproductive tract

  • Benign
  • Malignant

Ovarian disorders

Pelvic inflammatory disease

Pregnancy

Trauma in pregnancy

  • Physical
  • Psychological
  • Sexual

Uterine disorders

Vaginal/vulvar disorders

Task categoriestoggle arrow icon

Task Categories

Task Categories
Percentage
History Taking and Performing Physical Examination 16%
Using Diagnostic and Laboratory Studies 10%
Formulating the Most Likely Diagnosis 18%
Managing Patients
Health Maintenance, Patient Education, and Preventive Measures 11%
Clinical Intervention 16%
Pharmaceutical Therapeutics 15%
Applying Foundational Scientific Concepts 8%
Professional Practice* 6%

*Medical content comprises 94% of the exam. All medical content questions are also coded to one of the task areas, with the exception of the Professional Practice category. Questions related to professional practice issues comprise 6% of the exam. Some questions on the exam will cover surgical topics (8% to 10%), and some will focus on conditions in pediatric patients (12% to 15%). The specific percentage allocations may vary slightly on exams.

History Taking and Performing Physical Examination (16%)toggle arrow icon

  • Knowledge of:
  • Skill in:
    • Reviewing pertinent resources to conduct comprehensive and/or problem-based interviews and physical examinations with compassion and empathy
    • Identifying pertinent patient and family historical information from patients and caregivers
    • Identifying pertinent physical examination information
    • Triaging patients based on recognition of abnormal vital signs, examination findings, and/or general observations

Using Diagnostic and Laboratory Studies (10%)toggle arrow icon

  • Knowledge of:
  • Skill in:
    • Collecting diagnostic and laboratory specimens
    • Communicating risks, benefits, and results effectively to other members of the health care team
    • Communicating risks, benefits, and results effectively to patients, families, and caregivers
    • Integrating diagnostic and laboratory results with history and physical examination findings
    • Reviewing and interpreting results of diagnostic and laboratory studies
    • Selecting appropriate diagnostic and/or laboratory studies
    • Using diagnostic equipment safely and appropriately

Formulating Most Likely Diagnosis (18%)toggle arrow icon

  • Knowledge of:
    • Significance of diagnostic and laboratory studies as they relate to diagnosis
    • Significance of history as it relates to the differential diagnosis
    • Significance of physical examination findings as they relate to diagnosis
  • Skill in:
    • Formulating most likely differential diagnoses
    • Incorporating history, physical examination findings, and diagnostic data into medical decision-making
    • Recognizing the need for referral to a specialist
    • Selecting the most likely diagnosis in light of presented data

Managing Patients — Health Maintenance, Patient Education, and Preventive Measures (11%)toggle arrow icon

  • Knowledge of:
    • Appropriate patient education regarding preventable conditions and lifestyle modifications
    • Early detection and prevention of medical conditions
    • Effects of aging and changing family roles
    • Human growth and development
    • Human sexuality and gender identity, gender transition, and associated medical issues
    • Immunization schedules and recommendations for infants, children, adults, and foreign travelers/adoptions
    • Impact of patient demographics on risks for medical conditions
    • Prevention of communicable diseases
    • Preventive screening recommendations
    • Psychosocial effects of illness, stress, and injury as well as related healthy coping strategies
    • Signs of abuse and neglect, and psychological distress
  • Skill in:
    • Adapting health maintenance to an individual patient’s context
    • Communicating effectively with and educating patients, family members, and caregivers regarding medical conditions
    • Conducting education on modifiable risk factors with an emphasis on primary and secondary prevention
    • Reporting suspected abuse and/or trafficking
    • Using appropriate screening tools
    • Using counseling techniques

Managing Patients — Clinical Intervention (16%)toggle arrow icon

  • Knowledge of:
    • Clinical procedures and their indications, contraindications, complications, risks, benefits, and techniques
    • Conditions that constitute medical emergencies
    • Criteria for admission to or discharge from the hospital or other facilities
    • Management, treatment, and follow-up of medical conditions
    • Palliative care and end-of-life issues
    • Roles of other health professionals
    • Sterile technique
    • Support structure systems, based on patient needs
    • Therapeutic regimens
    • Universal precautions and special isolation conditions
  • Skill in:
    • Demonstrating technical expertise related to performing specific procedures
    • Determining the existence of support structures and using community resources to meet the needs of patients and caregivers
    • Evaluating patient competence to make decisions
    • Evaluating patient response to treatment/intervention
    • Facilitating patient/caregiver adherence to and active participation in treatment
    • Formulating and implementing treatment plans in accordance with applicable practice guidelines
    • Interfacing in multidisciplinary teams, including education of other health care professionals
    • Making appropriate dispositions
    • Monitoring and managing nutritional status
    • Prioritizing tasks
    • Recognizing and initiating treatment for life-threatening conditions
    • Using community resources to meet the needs of patients/caregivers

Managing Patients — Pharmaceutical Therapeutics (15%)toggle arrow icon

  • Knowledge of:
    • Alternative/complementary therapies and their side effects, interactions, and toxicities
    • Contraindications
    • Drug interactions, including presentation and treatment
    • Indications for use
    • Mechanism of action
    • Methods to reduce medication errors
    • Monitoring and follow-up of pharmacologic regimens
    • Pharmacokinetics, pharmacogenomics, and pharmacodynamics
    • Prescribing, monitoring, and regulating controlled substances
    • Presentation and management of adverse effects, allergic reactions, and toxicities
    • Special populations requiring drug/dose modification
    • Substances of abuse
  • Skill in:
    • Assessing patient adherence to drug regimens
    • Drafting a prescription
    • Evaluating, treating, and reporting adverse drug reactions and/or adverse effects
    • Identifying and managing medication issues
    • Maintaining knowledge of relevant pharmacologic agents
    • Monitoring pharmacologic regimens and adjusting as appropriate
    • Prescribing controlled substances appropriately
    • Selecting appropriate pharmacologic therapy and dosing

Applying Foundational Scientific Concepts (8%)toggle arrow icon

  • Knowledge of:
    • Genetics
    • Human anatomy and physiology
    • Microbiology
    • Pathophysiology
    • Immunology
    • Pharmacology
    • Human behavior (e.g., sociology, psychology)
  • Skill in:
    • Evaluating emerging medical trends critically as they relate to patient care
    • Maintaining awareness of trends in infectious disease
    • Relating pathophysiologic principles to specific disease processes
    • Incorporating evidence-based medicine practices

Professional Practice (6%)toggle arrow icon

Legal/medical ethics

Medical informatics

  • Knowledge of:
    • Billing/coding to maintain accuracy and completeness for reimbursement and administrative purposes
  • Skill in:
    • Using appropriate medical informatics sources

Patient care and communication (individual patients)

  • Knowledge of:
    • Affordable and effective health care that is patient specific
    • Communication and care preferences of diverse patient populations
    • Impact of social determinants of health
  • Skill in:
    • Acknowledging and applying patient/provider rights and responsibilities
    • Establishing clinical rapport
    • Patient-based interactions, including the ability to demonstrate cultural humility and competency
    • Providing patient advice and education regarding the informed consent and refusal process
    • Providing patient counseling related to end-of-life decisions

PA role in professional practice

  • Knowledge of:
  • Skill in:
    • Communicating and consulting with members of the health care team

Professional development

  • Knowledge of:
    • Continuing medical education resources
  • Skill in:
    • Critically analyzing evidence-based medicine
    • Identifying and interpreting data from medical informatics sources and identifying appropriate reference sources

Public health (population/society)

Risk management

Disclaimertoggle arrow icon

AMBOSS is an independent entity with no affiliation to the NCCPA® or PANCE. The content within this article is derived from the NCCPA Content Blueprint, which is solely created and owned by the NCCPA®. AMBOSS does not claim ownership of any portions originating from the Master Blueprint. This article is provided at no cost to the public, serving as an informational resource for educators, medical students, physicians, and other healthcare professionals. The use of the NCCPA Content Blueprint is aligned with the terms of use and guidelines established by the NCCPA. [3]

Referencestoggle arrow icon

  1. National Commission on Certification of Physician Assistants. https://www.nccpa.net/. . Accessed: December 11, 2024.
  2. NCCPA PANCE Blueprint 2025. https://www.nccpa.net/wp-content/uploads/2024/02/PANCE-Blueprint-effective-2025.pdf. . Accessed: December 11, 2024.
  3. National Commission on Certification of Physician Assistants - Terms of use. https://www.nccpa.net/terms-of-use. . Accessed: December 11, 2024.
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