I Failed a PANRE-LA Quarter. Now What?

If you’re anything like us, you most likely signed up for the PANRE-LA hoping for a less stressful process that would result in a passing score. The attractiveness of an exam that’s open book with testing times five-times longer than a typical recertification exam sounded like a win! 
While it certainly can be, at the end of the day, it’s still a standardized recertification examination and that comes with its own set of stressors, struggles, and questions to navigate. As you go through the PANRE-LA quarter by quarter, you may find yourself asking “How do I know which outside materials are the right ones? Am I doing as well as my peers? Have I answered enough questions right?” Or even, “What happens if I fail a quarter? And what happens if I fail the entire PANRE-LA?”

6 Tips When it Comes to Taking the PANRE-LA

Like anything that’s new, sometimes we forget to read the manual! Don’t forget these critical components (and perks!) about the PANRE-LA to make the testing process easier for you. 

When taking the exam, remember that:

1. You don’t need to complete all 25 questions in one sitting. 

While some PAs prefer to complete all 25 questions at once, that may not be the best fit for everyone. Determine what your testing threshold is. Is it three questions? Or maybe five? 10? 

Maybe you discover that once you get two questions wrong in a row, it’s best that you take a break and start again on another day. One of the best things about the PANRE-LA is that it gives you the freedom to take it in a way that works for you!

2. You can skip a quarter. 

Sometimes our lives get busy or we have a lot of life changes happening all at once, which makes the thought of recertifying seem insignificant. Remember that you have up to 12 quarters to complete your PANRE-LA, but you could pass in as few as eight quarters.

So what does this mean? If maybe April-June is just not your time of year, no sweat! Don’t force yourself to rush through questions you may not do well on. Pick it up next quarter and try again to increase your chances of earning the PANRE-LA passing score.

3. You can store questions. 

Maybe the next question is on pulmonology and that isn’t a strength of yours. No worries! You can store it for later.

While it may feel like you’re postponing the inevitable, you’re also giving yourself more time to review pulmonology topics or practice pulmonology questions until you feel more comfortable.

4. You receive feedback immediately after submitting your answer. 

Don’t skip over the explanations. Review the correct and incorrect answers. Make a note of topics you need to review again. 

5. You receive a score update after each quarter’s questions are completed. 

This allows you to see how you’re progressing after each quarter, how you’re performing compared to your peers, and how you’re performing relative to the PANRE-LA passing score.

Of note, the exam score scale ranges from 1000-1500, and the PANRE-LA passing score is 1150.

6. You can use outside resources.

Don’t miss out on the opportunity to reference your favorite medical textbook or go-to peer reviewed website. This is one of the striking differences between the traditional PANRE and PANRE-LA, so take full advantage of it. 

You can check out UpToDate, textbooks from Access Medicine, journal articles from JAAPA, etc. Phoning a friend or working on the exam with a peer isn’t allowed. 


I Failed a PANRE-LA Quarter. Now What?

While it’s certainly discouraging to not meet or surpass the PANRE-LA passing score, you still have a lot of options (unlike the traditional PANRE, where it’s one and done). 

A failing PANRE-LA score after one quarter is the equivalent of performing poorly on a small section of the traditional PANRE. The NCCPA even states that you don’t need to meet the passing standard each quarter. You still have 11 quarters to improve your score if you fail the first PANRE-LA quarter. 

If you do fail a quarter, you’ll want to review your overall performance and do some self-reflection. Consider asking yourself these questions:

  1. Which topic areas were missed? Were there any surprises?
  2. What resources (if any) were used? Were they helpful?
  3. Was there enough time to look up the information and answer the questions? (Did you know you can use testing accommodations for the PANRE-LA? See the NCCPA’s website for more information.)

Once you’ve answered these questions, make a game plan for the next quarter, so you can achieve a PANRE-LA passing score the next time. 

First, review any topic areas that you missed. Why? The PANRE-LA will repeat topics that were answered incorrectly the previous quarter and count the better responses.

Next, create a practice exam using the Blueprint PANRE-LA Qbank based on the topics that were missed. Aim to spend no more than five minutes on each question and practice using the same references you’ll use on test day. This will improve your confidence, allow you to review topics in greater detail, and assist you in figuring out how to use your resources properly within the allotted time.

For more information about how to use the PANRE-LA Qbank during the exam itself, check out this video demo:

And be sure to check out our PA team’s blog for tips on how we’re approaching the PANRE-LA!


My Interim PANRE-LA Score is Below Passing. Now What? 

Remember, you don’t need to meet the passing standard each quarter to pass the overall exam. As noted, the PANRE-LA passing score is 1150, and recertifying PAs who don’t reach this score after eight quarters will continue into the third year of the exam to complete the final four quarters.

If you’re early in the testing process, missing more questions will have a disproportionate impact on your interim score. So you’ll want to adjust your testing strategies, review important concepts, and complete practice questions as quickly as possible. 

If you’ve been practicing within a specialty for a long time and feel out of your element when it comes to general medical knowledge, consider the Blueprint PANRE/PANRE-LA Live Review Course to brush up on material you haven’t accessed in a while!


I Failed the Entire PANRE-LA. Now What?

If you don’t reach the PANRE-LA passing score after 12 quarters, you’ll have to complete the traditional PANRE. There are no PANRE-LA retake options. 

You’re given three opportunities to pass the PANRE after taking the PANRE-LA. Recertifying PAs must wait at least 90 days before taking the traditional PANRE. Again, if you’d like a more structured, accelerated review of the exam material, we highly recommend the PANRE/PANRE-LA Live Review Course to get you back on track!

Important note: If you’ve gotten through two years (or eight quarters) of the PANRE-LA and your peers are being informed that they’ve passed, but you haven’t received the same good news, don’t fret! This just means that your score after eight quarters isn’t at the passing standard, but you still have four more quarters to pass!


If you failed a PANRE-LA quarter, please remember that you can fail a quarter of the exam and still wind up with a PANRE-LA passing score in the end!

If you happen to fail the entire PANRE-LA, once again it’s not the end of the world—you’ll still have three chances to pass the traditional PANRE, and we’re here to help along every step of the way. Reach out to us and we’ll help get you back on track for your PA recertification! 

About the Author: Nadya Tsytsyna, PA-C

I was born and raised in Belarus, and moved to New York in 2006. I completed my undergraduate degree at The City College of New York in Biology and graduated from the Physician Assistant Program at Pace University – Lenox Hill Hospital PA Program in 2017. I joined the surgery team at the NYU Langone Hospital - Brooklyn General Surgery Department in 2017 and have been greatly honored to serve the Brooklyn community since then. My path with Rosh Review started in 2016 while I was in PA school as a part time PA Champion. In 2023 I took on a full time role at RR as an Associate Director of PA Content. I am passionate about education and enjoy working with an amazing team of PA Content Editors and PA Authors on developing and creating content for PA learners.

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.

About the Author: Ashley Love, PA-C

I am a 2015 graduate of University of Florida School of Physician Assistant Studies. I worked in women’s health for 3 years and transitioned to a medical dermatology clinic specializing in Mohs Surgery 6 years ago. Clinic and surgery are my joy and my purpose, but I missed academia, which is what led me to begin writing for Rosh Review 5 years ago. As a part time derm PA, now part time Rosh editor, and full time mother and wife, my plate and my heart are full of what I am passionate about.

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