How to Become a Physician Assistant By State

Physician Assistant License and Certification

The occupation of a Physician Assistant is a highly demanding one that requires its practitioners to possess a myriad of skills in patient care, medical technology, and therapeutic implementation. In order to ensure that Physician Assistants possess the essential skills and knowledge necessary to serve in the challenging environment of a hospital or doctor’s office, the National Commission on Certification of Physician Assistants has developed a set of requirements that all applicants must meet prior to national certification.


Long before an applicant can take the certifying exam offered by the NCCPA, they must have completed an intensive education at the undergraduate and post-graduate levels. There are currently 200 Physician Assistant programs in the United States with accreditation from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Prior to enrolling in a PA degree program, it is imperative that students ensure their school has an ARC-PA accreditation; otherwise, they are ineligible to take the national certification exam or obtain state licensure.

The typical PA program is 27 months in length which includes a combination of classroom instruction and clinical experience. While most PA students have completed an undergraduate education that was rich in biological, scientific and pre-medical courses, the curriculum at most PA schools is likely to challenge even the most abundantly prepared students. These graduate level courses are likely to include instruction in

  • Human anatomy
  • Medicine and surgery
  • Micro/infectious disease
  • Pathology
  • Genetics
  • Pharmacology

In addition to a rigorous set of academic courses, PA students must complete more than 2,000 hours in a clinical setting. This clinical experience includes firsthand application of medical concepts and techniques to patients in a hospital, physician’s office or emergency medical settings. This experience may also include a diverse set of rotations across the medical spectrum including pediatrics, OB/GYN, internal medicine, or psychiatry.

NCCPA Certification

Once students have graduated from their PA programs with the requisite knowledge and practical experience, they may apply to the National Commission on Certification of Physician Assistants to take the Physician Assistant National Certifying Exam (PANCE). This is a computer based, multiple choice test which will evaluate applicants’ knowledge of the following areas:

  • Laboratory procedures and diagnostic studies
  • Producing most likely diagnoses
  • Taking histories and performing physical examinations
  • Maintaining health
  • Pharmacology
  • Basic science concepts
  • Clinical intervention

There are 300 questions on each exam with five sections of 60 questions each. Each section is allotted 60 minutes with a total of 45 minutes in breaks permitted during the test. This exam is scored from 200 to 800, with 500 being the average score. Each test has a slightly different passing score scaled to the difficulty of that particular version; once all of the scores are tabulated, students are notified what score was required to pass that version and what their score was.

Prospective Physician Assistants must pass PANCE in order to obtain national certification. It is critical that recent graduates schedule a PANCE as soon as possible following degree acquisition, because students are only allowed to take this exam within six years of graduation. Prospective PAs are also limited to only six attempts within those six years, although they are allowed to take the exam up to three times in a single year.

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