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Board Review Tools for PA and NP Students
As a student, the biggest barrier between your student status and starting your career is a high-stakes licensing exam. Whether you are studying to pass the PANCE., FNP board certification (ANCC or AANP), or NAPLEX, you probably spend a lot of time thinking about how you plan to do it. You can probably relate to searching for every strategy, question bank, review article, and 'study hack' out there.

You Need to Pass the PANCE, FNP, or NAPLEX
As a student, the biggest barrier between your student status and starting your career is a high-stakes licensing exam. Whether you are studying to pass the PANCE, FNP board certification (ANCC or AANP), or NAPLEX, you probably spend a lot of time thinking about how you plan to do it. You can probably relate to searching for every strategy, question bank, review article, and ‘study hack‘ out there.
And you are not alone. If there's one thing that all healthcare students – PA, NP, medical, pharmacy, PT, OT, and others – all have in common, it's a fear of not passing The Boards.
The Boards represents the culmination of years of hard work, high-interest student loans, and missed holidays with your family. It’s also the reason you can’t think of anything to talk about at parties except for gross medical stuff now.
For those who do not pass on the first attempt, it can be crushing. Furthermore, even if you do pass eventually, your career prospects can still be limited. You might have to explain any second attempts to your future employers or disclose a non-passing attempt to state licensing boards.
Don't be fooled by the gunners in class. When it comes to The Boards, there are two types of test-takers: those who admit they are worried about passing…and liars.
However, by taking advantage of the most effective medical education resources available, you can reduce your chances of having to go through this nightmare.
But first, let's look at your chances of passing a high-stakes board exam like the PANCE from a purely statistical perspective. We'll then compare this to other medical professionals to get a better idea of how the numbers relate.
Cold, Hard Statistics About the Board Exam Pass Rates
Let's look at board exam statistics for three well-regarded healthcare professions. We'll consider physician assistants (PA's), nurse practitioners, and pharmacists for this example.
The PANCE
We'll begin with a typical, recent year (at the time of this writing). In 2016, ninety-six percent of first time test-takers passed the Physician Assistant National Certifying Examination (PANCE). Overall, ninety-three percent passed.
Here is the data:
- Total NCCPA examinations: 8,631
- Passing: 8,025
- Overall pass rate: 93%
- Not Passing: 606
- Overall ‘not passing’ rate: 7%
- First-time candidates: 8,082
- First-time pass rate: 96%
Here is what can be extrapolated from that:
- Total second attempt examinations: 549 (8,631 – 8,082)
- Second-attempt passing: 266
- Second-attempt not passing: 283
- Overall Second-attempt pass rate: 49%
Nothing drives a point home like a visual. Here's an infographic that breaks down these PANCE pass-rate statistics.
The ANCC or AANP FNP Board Exam
Aspiring Family Nurse Practitioners don’t have it much better. In 2016, almost eighty-two percent of first-timers passed. The overall pass rate was around 78 percent.
Unfortunately, we can't clearly identify how many new graduates did not pass based on the data. However, the number of successful re-certification exams or second attempts appears to be in line with the PANCE pass rate data above.
The NAPLEX
Looking at pharmacy graduates from ACPE accredited programs, we can draw the same conclusions. National pass rates for the North American Pharmacy Licensure Examination (NAPLEX) were right around eighty-five percent in 2016, down from around ninety-two percent the penultimate year.
The first-time pass rates in this group were just a touch higher, close to eighty-six percent. However, some pharmacists say these low NAPLEX pass rates may be driven by changes in the examination format. A few unfortunate outliers with dismal NAPLEX pass rates may also complicate the results, according to some pharmacists.
Over the years, pharmacy has stayed fairly even when considering first-attempt and overall NAPLEX pass rates. Based on these data, it would seem that pharmacists have around a seventy-five percent chance of passing a second attempt exam.
Although that is still not great, it is not as gloomy as the other professions discussed above.
What the PANCE, FNP, and NAPLEX Have in Common
Let’s think about it. For any given year, the overall pass rate is lower than the first-time pass rate. This suggests that not passing on the first attempt is even worse than we thought. Those who do not pass the first time are at risk of never passing.
There are limitations to this interpretation, however.
The data we used was reported for examinations taken in the same year, not individual test-takers. Information this granular was not available.
Additionally, the gap mandated by the testing authorities between attempts may further skew our perspective. Those who did not pass near the end of the year would be unable to retest until the following year.
This forces them into the next year’s data set and makes them ‘invisible' for the current year's analysis.
The Best Resources to Ensure You Pass Your PANCE, FNP, or NAPLEX Board Exam
With this in mind, the most effective tactic is to ‘just’ pass the first time.
That’s kind of like saying the best cure for a hangover is to totally avoid alcohol. It’s technically correct, but if you say that to someone with a hangover, you can rest assured you are never getting invited to one of their parties.
How can you give yourself the best shot at passing the first time? There's no way around it; we’ll need to study. But which method is best? I don't know about you, but I find standard-issue textbooks unbearable. The method of loci seems to work pretty well, and even has scientific evidence to back it up.
Fortunately, there are now a million excellent resources, platforms, and tools that can deliver the medical education you need without any fluff.
Tools and Resources to Strengthen Your Clinical Knowledge Base
By the time of matriculation, most folks have an idea of their preferred learning style. Thankfully, modern medical education has caught on, and these innovative educational resources and platforms are here to stay.
Here are the best ones around, organized to be ultra-personalized for your situation.
For Those With a Commute
Podcasts and audio books are your secret sauce to success. Because of this, we view Hippo Education as no less than a god-send. They are a phenomenal group of educators with a broad portfolio of audio programs.
What’s the catch? Because this audio gold takes an entire team of clinicians, producers, engineers and others to create, it’s going to cost you. Fortunately, it's reasonably priced.
They also have PANCE/PANRE question banks as well as PANCE review audio and video material.
Once you are out in practice, Hippo Education’s monthly reviews and perspectives (RAPs) CME programs are fantastic for anyone in primary care, urgent care, or pediatrics.
These shows are gold for any specialty. I work in neurosurgery and still find myself regularly listening to the podcast. And not only because I was a contributor. Bookmark this page so you can return to subscribe after graduation. We've also compiled a list of the best audio CME out there for you.
Pricing
A one-year subscription is $395 for physicians and $195 for PA's, NP's, RN's, and other members of the healthcare team. Residents pay just $95 for an entire year of audio gold. There is an option of a free account, but it's limited to one chapter (about fifteen minutes of content) per month.
You can lower your cost even more with $25 off your subscription by signing up through our affiliate links here. Get Primary Care RAP, Urgent Care RAP, or Pediatrics RAP at this special price.

Get a High Yield Board Review Question Bank
It should go without saying that you need to do practice questions every day to get ready for the boards. And not just any questions. Free items found online are generally written haphazardly and won't truly prepare you for what's coming. Furthermore, the information could be outdated or even worse, flat out wrong.
Instead, get your practice questions from reputable sources like Board Vitals. They have targeted, high-quality question banks for whatever exam you have coming up. They have PANCE question banks, NP review questions, NAPLEX preparation, and tons of CME.
Get a Targeted Board Review Book
Many PANCE review books are full of retired PANCE items that you can use to prepare. This comprehensive review is one of the most-recommended by professors and top students around the country.
FNP students may want to check out the latest review book that also comes with a free app full of practice questions.
Pharmacy students have several options to study for the NAPLEX including books and study strategies from education giant Kaplan, as well as Rx Prep, the Cadillac of NAPLEX review books.
Use Spaced Repetition with Free Medical Education Videos
Another favorite of students everywhere is Online MedEd (no relation). There is a video lecture on every topic you could possibly need to know as a PA, NP, or medical student.
I listened to their entire library several times before taking the PANCE. I can say without a doubt that it made a definitive positive impact on my test scores AND my ability to retain everything.
The videos are free; the downloadable audio, notes, clinical cases, and more are available in the premium version, and worth their weight in gold.
Three Medical Education Apps You Need to Download
Classic medical education lives and dies by the mantra “see one, do one, teach one.” Which of these is missing from ninety-nine percent of your medical education experience?
The most important of them all; doing one! It may not be procedural practice, but doing practice cases and questions can be your secret weapon against The Boards.
If you are more of a hands-on learner and can find your way around a smartphone, there are a ton of apps for you. They can satisfy your need to feel something other than an impending sense of doom and help you learn medicine. Here are our favorites.
Medical Joyworks
Medical Joyworks is an innovative company taking FOAMed (Free Open Access Medical education) to another level. Prognosis: Your Diagnosis is a totally free, interactive case scenario app covering every major organ system. Plus, it is created by an international team of the most intelligent, good-looking clinicians.
And I'm not just saying that because I wrote a bunch of their cases.
The beauty is that each case makes you decide upon a workup and a treatment plan based on the information you've obtained. Then the app gives you feedback of your performance before delving into a thorough – but surprisingly fun and easy to read – discussion and explanation.
This company also makes Clinical Sense and Explain Medicine. One of the coolest features is that you can download each case to your phone if you somehow find yourself without WiFi. Highly recommended.
Epocrates
Epocrates is the go to reference for drug information for many clinicians. With a vast drug database, robust interaction checker, guidelines, and more, you can’t go wrong. Most features are free, although you can unlock more with a premium subscription.
Higher Learning Technologies
Higher Learning Technologies makes app-based board-review question banks for a plethora of examinations. The PANCE/PANRE Mastery app has hundreds of practice questions, study tips, and other helpful resources for students.
Of all their medical apps, PANCE Mastery is probably their highest quality product.
The company does strive to make a good product, which is exemplified by the ability to ask a question to a real life subject matter expert within the app. When I was a student, I would always challenge board-prep companies on their content if I didn’t agree.
When I was right, it was a huge confidence boost, and when I was wrong, a powerful learning experience.
One Last Insider Tip to Pass the FNP-BC, NAPLEX, or PANCE
Make it a point to learn one thing per day. Not something huge, but knowledge you can turn into your own short test question.
For example, at the end of the day, know that Guillain Barre is an ascending motor neuron disease. Tomorrow, know to avoid nitro for an inferior myocardial infarction. The next day, something else. You’ll be golden come test day, and a better clinician for your efforts.
Take the Next Step to Passing Your Initial Certification Exam
There is nothing more certain than student clinicians’ anxieties of The Boards. Use these tips and resources to reduce your stress and increase your chance of success.
It’s helpful to remember that most of us will pass the exam on the first try. However, a few won’t, and we are all concerned about being one of these few.
If you are truly concerned, pick up some extra resources to help. A lot of students feel good about buying one with a 100% pass rate guarantee. At least you get your money back in an otherwise worst-case scenario.
And if you don’t pass on the first try, remember that you are no less of a clinician for it. You'll be taking care of patients, not multiple choice questions when the time comes.
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