Everything to Know About the New NCCPA PANCE Blueprint for 2025

When I’m asked what’s on the PANCE blueprint, I’m reminded of a catchphrase my program faculty used when I was in PA school. Any student in our program could recite “reading is fundamental” and know exactly which of our faculty members you were talking about.
The thing is, they were right. Reading is fundamental. And since we know you’re all busy PA students who may not have time to sit down and read all 21 pages of the new NCCPA PANCE blueprint, we did it for you!
If you didn’t already know changes have been made to the PANCE blueprint, there’s no need to panic! You still have plenty of time. Beginning in January 2025, a new NCCPA content blueprint for the PANCE exam will go into effect.  Here’s an overview of the changes, why these changes were made, and how to incorporate the new PANCE blueprint into your study plan.

What is the NCCPA PANCE blueprint?

The NCCPA PANCE blueprint tells you the percentage of questions on the exam devoted to specific medical topics (e.g., cardiology, neurology) and different task areas (e.g., making a diagnosis or selecting an appropriate clinical intervention).

The PANCE blueprint is developed by the NCCPA and based on the results of practice analysis studies completed by certified PAs. They use this information to determine what medical content is considered core medical knowledge for a recent graduate.

In addition to determining the percentage of questions devoted to specific topics and task areas, the PANCE blueprint also provides a list of specific diseases that pertain to each medical category that may be on the exam (pages 2-16). The NCCPA makes it clear that not every topic will be on every exam, and that you may also see questions covering material that’s not explicitly listed on the blueprint.

The last five pages of the NCCPA PANCE blueprint break down each task area, giving examples of the types of skills you’ll need to demonstrate on the exam and areas of knowledge that would be good to review.


Why is the PANCE blueprint being changed? 

The NCCPA updates the PANCE blueprint periodically based on the results of their practice analysis surveys. The last time the blueprint was updated was in preparation for the 2019 calendar year. The updates reflect the changing landscape of PA practice and the conditions they frequently (or infrequently) encounter.

As mentioned previously, the PANCE blueprint changes go into effect in January 2025. If your exam date is anytime between now and the end of December 2024, this change will not impact you. It’s important to note that exam takers who don’t successfully pass the exam in 2024 and have to retest in 2025 would be subject to the new blueprint.


What changes have been made to the PANCE blueprint?

We can group the changes into two categories: 1) allotment adjustments and 2) content adjustments. 

Let’s check out allotment adjustments first.

Allotment Adjustments 

Many topic categories were reduced with the exceptions of infectious diseases and psychiatry, which both increased by 1%. Additionally, hematology, neurology, renal, and musculoskeletal did not change.

Professional practice, which was previously given a 5% allotment on the exam but not explicitly included in the content categories, is now officially included and has increased to 6%. Many task categories also changed, with only “Formulating the Most Likely Diagnosis” remaining the same.

At the end of the percentage distribution, the NCCPA provides a disclaimer noting that questions pertaining to surgery and pediatric patients can make up a percentage of the exam. These aren’t unique categories, but rather are represented in the larger medical content areas. For example, a gastrointestinal question that pertains to a surgical topic, or an EENT question that tests otitis media on a pediatric patient.

Content Adjustments 

The content adjustments in the new PANCE blueprint are more granular. You may notice minor changes (e.g., stress cardiomyopathy being added to the cardiovascular topic list), changes in topic names (e.g., essential hypertension to primary hypertension), correction of errors (e.g., removal of eczema since atopic dermatitis was already listed), or some topic lists expanding quite significantly (the EENT topic list is now 2 pages). In some of these instances, topics that may have already been a staple in your didactic lectures (or hey, here on Rosh/Blueprint!) are now formally added (e.g., uveitis).

You may also find that topics are reorganized (finally asthma is in obstructive disorders where it belongs) or topics that you may have been taught previously but didn’t have a home are now given one. For example, refeeding syndrome and tardive dyskinesia are sometimes quickly tacked onto a psychiatry lecture. Now both of these topics have a home in GI and neuro, respectively.

We’ve gone through and compiled a list of all the new topics for you below.


How can I use the PANCE blueprint while studying for the exam?

Ultimately, your study technique will depend on what works best for you!

Here are some of my favorite tips:

1. Color code your PANCE blueprint based on areas of priority. 

I would go through the topic list and identify critical areas I needed to review (e.g., areas of weakness, topics I’ve been avoiding), areas that would benefit from a cursory review, and areas that I felt good about!

This would help streamline my studying so that I wasn’t spending too much time on topics I was already strong in and determine what I needed to prioritize.

2. Turn your PANCE blueprint into a study guide.

I started creating a study guide using the PANCE blueprint from the moment I began didactic year! I would fill it in as I went through the program with information from lectures, clinical rotations, medical textbooks, etc. By the time I graduated, I had a very comprehensive document to study from.

3. Use the PANCE blueprint to create exams in Rosh Review/Blueprint PA.

Our question bank follows the PANCE blueprint! You can use the NCCPA blueprint in conjunction with our question bank to assess your strengths, weaknesses, and readiness for the exam.

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!


When will the Rosh/Blueprint PANCE Qbank update with questions that follow the new blueprint?

For the past year, our team has been updating our current questions in the PANCE Qbank, with the goal of enhancing their difficulty, adding a 5th answer option, and reviewing them for compatibility with the new PANCE blueprint. We make changes in real time!

Additionally, our PA authors and PA content team have been hard at work creating new questions for our Qbank, which will be available in January 2025.


Will the live course change as well?

Our PANCE Live Review Course is updated on an ongoing basis. You may see new topics added into our slide decks or reflected in learning activities. With the help of our PA author team, all content for the Live Review Course is unique to the course and was developed based on the 2025 blueprint.


We’re here to help you work through the PANCE blueprint! 

Regardless of whether your test is based on the old NCCPA PANCE blueprint or the new one, we’ll be here with you every step of the way!

Want a quick look at all of your PANCE prep options? 👀 Here’s the TL;DR!
👩‍💻 Join our live PANCE/PANRE Review Course
📈 Try out the PANCE Qbank (with 3,800 NCCPA-formatted questions!)
🤝 Get a free consultation for PANCE tutoring

Or, looking for more (free!) content to help you prepare for the PANCE? Check out these other posts:

Best of luck on your PANCE prep!


About the Author: 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.

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